Biomedical subjects

Y Kumamoto

Publications and source records attributed to Y Kumamoto.

At least 37 records · Page 2Linked to original sources

PubMed1999

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (1997). II. Background of patients].

Clinical background was investigated on patients with urinary tract infections (UTIs) from whom 603 bacterial strains were isolated in 9 hospitals during the period from June, 1997 through May, 1998. 1. Distribution of age and sex of patients and type of infections Among males, those with ages less than 50 years were only 12.5%, and those in the 70's were most frequent (33.3%). Among females, those with ages less than 20 years were only 3.4%, and those in the 60's were the most frequent (22.9%). With regard to type of infections, more than a half of infections among males with ages 50 years or older were of complicated types, but most of infections among females were of uncomplicated types, especially those of ages less than 50 years. 2. Ages of patients and types of pathogens Escherichia coli was the most frequently isolated in uncomplicated and complicated UTIs without indwelling catheters. In complicated UTIs with indwelling catheters, Pseudomonas aeruginosa and Enterococcus faecalis had mainly detected, they had no relationship with ages. 3. Effect of antibiotic use on isolation frequencies of pathogens Use of antibiotics decreased pathogens isolated from patients with uncomplicated UTIs drastically (183 isolates before antibiotics compared to 13 after). Even isolated pathogens from patients with complicated UTIs decreased drastically with the use of antibiotics when indwelling catheters were not in use (175 isolates before antibiotics compared to 53 after), but when indwelling catheters were in use, antibiotics slightly decreased (109 isolates before antibiotics compared to 70 after). 4. Surgical procedures and types of causative organisms for UTIs E. faecalis were more isolated when a surgical procedures were used, and E. coli were more isolated when, they were not used in uncomplicated and complicated UTIs without indwelling catheters. In complicated UTIs with indwelling catheters, E. coli and E. faecalis were more isolated when a surgical procedures were used, and P. aeruginosa and Staphylococcus aureus were more isolated when they were not used.

Adult↗

PubMed1998

Discontinuous total parenteral nutrition prevents postischemic mitochondrial dysfunction in rat liver.

Although discontinuous total parenteral nutrition (d-TPN) has recently been favored for clinical use over continuous total parenteral nutrition (c-TPN) to ameliorate liver dysfunction, mechanisms for the protection against postoperative liver dysfunction remain unknown. This study aimed to examine differences in mitochondrial function in d-TPN- and c-TPN-pretreated livers during ischemia-reperfusion. Rat livers pretreated with d-TPN or c-TPN were perfused with Krebs-Ringer buffer and were exposed to 25% low-flow hypoxia followed by reperfusion. Intrahepatic mitochondrial membrane potential (triangle up) and cell viability were assessed by dual-color digital microfluorography using rhodamine 123 (Rh123) and propidium iodide (PI), respectively. In response to hypoxia, livers pretreated with c-TPN, d-TPN, and an ordinary chow diet exhibited a significant triangle up reduction among the entire lobules. Upon reperfusion, the regional triangle up values further decreased in the c-TPN liver, whereas those in the d-TPN-treated or chow-treated livers displayed a rapid recovery toward the control levels. The severity of cell injury did not differ among the groups, showing that the reperfusion-induced triangle up drop in the c-TPN-pretreated liver is not a consequence of cell injury. Differences in the triangle up drop among the groups appear to occur irrespective of those in the glycogen storage, because the livers undergoing d-TPN display a marked triangle up recovery even when reperfused at the end of a fasted state. These results indicate that c-TPN, but not d-TPN, jeopardizes mitochondrial re-energization and suggest that a circadian pattern of the TPN serves as a potentially beneficial strategy to reduce the risk of postischemic mitochondrial dysfunction in the liver.

Animals↗

PubMed1998

Testicular findings, endocrine features and therapeutic responses of men with acquired hypogonadotropic hypogonadism.

BACKGROUND: Men with acquired hypogonadotropic hypogonadism (AHH) who desire restoration of fertility are treated with exogenous gonadotropin. However, gonadotropin (Gn) therapy does not always restore testicular function. It is unknown whether the therapeutic responses to Gn therapy correlate with their testicular histological findings. Thus, we analyzed factors influencing testicular dysfunction and therapeutic responses in AHH. METHODS: Of 21 men with AHH, 11 had no postmeiotic germ cells and were classified as the severe spermatogenic failure group. These were compared with the other 10 patients who had postmeiotic germ cells and comprised the mild spermatogenic failure group. RESULTS: Testicular volume and tubular diameter were significantly smaller, and the basement membrane and tunica propria were significantly thicker in the severe failure group. The gonadotropin basal level and response to exogenous gonadotropin-releasing hormone, and the testosterone response to exogenous human chorionic gonadotropin were significantly lower in the severe failure group of patients. Also, the recovery of spermatogenesis and testosterone secretory potentials was poor in the cases with a duration between diagnosis and treatment of 2 years or more. CONCLUSION: Longer periods without treatment may be responsible for irreversible testicular dysfunction in AHH. Gn therapy should be initiated very soon after the diagnosis of AHH if fertility is desired.

Adult↗

PubMed1998

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (1996). I. Susceptibility distribution].

The frequencies of isolation and susceptibilities to antimicrobial agents were investigated on 680 bacterial strains isolated from patients with urinary tract infections (UTIs) in 10 hospitals during the period of June 1996 to May 1997. Of the above bacterial isolates, Gram-positive bacteria accounted for 30.4% and a majority of them were Enterococcus faecalis. Gram-negative bacteria accounted for 69.6% and most of them were Escherichia coli. Susceptabilities of several isolated bacteria to antimicrobial agents were as followed; 1. Enterococcus faecalis Ampicillin (ABPC) showed the highest activity against E. faecalis isolated from patients with UTIs. Its MIC90 was 1 microgram/ml. Imipenem (IPM) and vancomycin (VCM) were also active with the MIC90S of 2 micrograms/ml. The others had low activities with the MIC90S of 16 micrograms/ml or above. 2. Staphylococcus aureus including MRSA Arbekacin (ABK) and VCM showed the highest activities against both S. aureus and MRSA isolated from patients with UTIs. The MIC90S of them were 1 or 2 micrograms/ml. The others except minocycline (MINO) had low activities with the MIC90S of 32 micrograms/ml or above. 3. Staphylococcus epidermidis ABK and VCM showed the strongest activities against S. epidermis isolated from patients with UTIs. The MICs for all strains were equal to or lower than 2 micrograms/ml. Cefazolin (CEZ), cefotiam (CTM) and cefozopran (CZOP) were also active with the MIC90S of 4 micrograms/ml. Compared with antimicrobial activities of cephems is 1995, the MIC90S of them had changed into a better state. They ranged from 4 micrograms/ml 16 micrograms/ml in 1996. 4. Streptococcus agalactiae All drugs except MINO were active against S. agalactiae. ABPC, CZOP, IPM, and clarithromycin (CAM) showed the highest activities. The MICs for all strains were equal to or lower than 0.125 micromilligrams. Tosufloxacin (TFLX) and VCM were also active with the MIC90S of 0.5 micromilligrams. 5. Citrobacter freundii Gentamicin (GM) showed the highest activity against C. freundii isolated from patients with UTIs. Its MIC90 was 0.5 micrograms/ml. IPM and amikacin (AMK) were also active with the MIC90S of 1 microgram/ml and 2 micrograms/ml, respectively. Cefpirome (CPR) and CZOP were also active with the MIC90S of 8 micrograms/ml. The MIC90S of the others were 16 micrograms/ml or above. 6. Enterobacter cloacae IPM showed the highest activity against E. cloacae. The MICs for all strains were equal to or lower than 0.5 microgram/ml. The MIC90S of ciprofloxacin (CPFX) and TFLX were 1 microgram/ml, the MIC90 of AMK was 2 micrograms/ml, the MIC90S of CZOP, GM and ofloxacin (OFLX) were 4 micrograms/ml. The MIC50S of cephems except CEZ, cefmetazole (CMZ) and cefaclor (CCL) had changed into a better state in 1996, compared with those in 1995. 7. Escherichia coli All drugs except penicillins and MINO were active against E. coli. Particularly CPR, CZOP and IPM showed the highest activities against E. coli. The MIC90S of them were 0.125 microgram/ml or below. Among E. coli strains, those with low susceptibilities to cephems except CEZ, cefoperazone (CPZ), latamoxef (LMOX) and CCL have increased in 1996, compared with those in 1995. 8. Klebsiella pneumoniae K. pneumoniae was susceptible to all drugs except penicillins, with the MIC90S of 2 micrograms/ml or below. CPR had the strongest activity, the MICs for all strains were equal to or lower than 0.25 microgram/ml. Flomoxef (FMOX), cefixime (CFIX), CZOP and carumonam (CRMN) were also active with the MIC90S of 0.125 microgram/ml or below. 9. Pseudomonas aeruginosa All drugs except quinolones were not so active against P. aeruginosa with the MIC90S were 32 micrograms/ml or above. Quinolones were more active in 1996 than 1995. The MIC90S of them were between 4 micrograms/ml and 8 micrograms/ml, and the MIC50S of them were between 1 microgram/ml and 2 micrograms/ml. 10. Serratia marcescens GM showed the highest activity against S. marcescens. Its MIC90 was 1 micro

Anti-Bacterial Agents↗

PubMed1998

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (1996). II. Background of patients].

Clinical background was investigated on patients with urinary tract infections (UTIs) from whom 752 bacterial strains were isolated in 10 hospitals during the period from June, 1996 through May, 1997. 1. Distribution of age and sex of patients and type of infections. Among males, those with ages 40 years or older were more frequent, the higher the ages of them. Among females, those with ages in the 60's were the most frequent (24.6%), and those with ages in the 20's, 40's and 50's were about 13%. With regard to type of infections, more than a half of infections among males with ages 30 years or older were of complicated types, but most of infections among females were of uncomplicated types, especially among females of ages less than 60 years. 2. Ages of patients and types of pathogens. The higher the ages of patients, the lesser became the isolation frequencies of Escherichia coli, but the higher were those of Pseudomonas aeruginosa and Klebsiella spp. 3. Effect of antibiotic use on isolation frequencies of pathogens. Use of antibiotics decreased pathogens isolated from patients with uncomplicated UTIs drastically (231 isolates before antibiotics compared to 60 after). Even isolated pathogens from patients with complicated UTIs decreased drastically with the use of antibiotics when indwelling catheters were not in use (193 isolates before antibiotics compared to 75 after), but when indwelling catheters were in use, antibiotics apparently failed to decrease the isolation frequency. 4. Surgical procedures and types of causative organisms for UTIs. From cases of uncomplicated UTIs, E. coli was the most frequently isolated, followed by Enterococcus Faecalis and Klebsiella spp. E. coli was the most frequently isolated organism from complicated UTIs without indwelling catheters. When a surgical procedures were not done, E. coli was isolated most frequently. From cases of complicated UTIs with indwelling catheters, P. aeruginosa, E. coli and E. faecalis were the organisms that were mainly isolated, with isolation frequencies of 23.2%, 15.2, 12.2, respectively. When no surgical procedures were used, isolation frequencies of P. aeruginosa, E. faecalis and Enterobacter spp. were 17.2%, 13.8%, 13.8%, respectively.

Adolescent↗

PubMed1998

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (1996), III. Secular changes in susceptibility].

Susceptibilities to various antimicrobial agents were examined for Enterococcus faecalis, Staphylococcus aureus, Escherichia coli, Klebsiella spp., and Pseudomonas aeruginosa that were isolated from patients with urinary tract infections (UTIs) in 10 hospitals during June 1996 to May 1997, and the results were compared with those obtained during the same period in earlier years. 1. E. faecalis Among E. faecalis strains, those with high susceptibilities to ampicillin and minocycline appeared to have decreased in the latest study period. 2. S. aureus To almost antimicrobial agents, S. aureus isolated from uncomplicated UTIs showed low susceptibilities. But the MIC50s of those agents for S. aureus from complicated UTIs have changed better state. Particularly, the MIC50s of imipenem and clindamycin were 0.125 microgram/ml or below in the latest period for the first time in our history. 3. E. coli The susceptibilities to piperacillin and quinolones of E. coli isolated from uncomplicated UTIs were better than those isolated from complicated UTIs. 4. Klebsiella spp. The susceptibilities to almost antimicrobial agents of Klebsiella spp. have been better during the latest period, compared to those during period of 1995-1996, but to ofloxacin and ciprofloxacin have appeared to have been lower. 5. P. aeruginosa The susceptibilities to quinolones of P. aeruginosa have been better during the latest period compared those during periods of 1995-1996. But, the susceptibilities to cefozopran, carbapenems and monobactams of P. aeruginosa isolated from complicated UTIs appeared to have been lower. These susceptibility changes should be utilized in determining clinical treatments.

Anti-Bacterial Agents↗

PubMed1997

Up-regulation of oxygen-derived free radicals by interleukin-1 in hepatic ischemia/reperfusion injury.

BACKGROUND: Oxygen-derived free radicals (FRs) are critical mediators of ischemia/reperfusion injury. Inflammatory cytokines have been shown to play important roles in tissue injury. To examine the relationship between FRs and interleukin-1 (IL-1) in hepatic ischemia/reperfusion injury, we used interleukin-1 receptor antagonist (IL-1ra) to block endogenous IL-1 production in a rat model of hepatic ischemia/reperfusion. METHODS: Female SD rats were subjected to 30 min of hepatic ischemia followed by reperfusion. The animals were divided into two groups, control group and IL-1ra-treated group, according to the rinse solution. In both groups, FR production, histological changes, and interactions between leukocytes and endothelial cells were analyzed in the course of reperfusion. RESULTS: In the control group, production of FRs increased significantly after 60 min of reperfusion. After 60 and 180 min of reperfusion, histological examination showed atrophy and degeneration of hepatocytes. Hepatic microcirculation demonstrated a marked increase in the number of leukocytes adherent to endothelial cells and of injured cells after reperfusion. In the IL-1ra-treated group, IL-1ra pretreatment markedly reduced FR production after 60 min of reperfusion, the number of leukocytes adherent to endothelial cells, and tissue injury. CONCLUSION: These data clearly show an important role for IL-1 in the induction of FR production, leukocyte adhesion, and tissue injury after hepatic ischemia/reperfusion injury.

Animals↗

PubMed1997

Efficacy of intraportal infusion of prostaglandin E1 to improve the hepatic blood flow and graft viability in porcine liver transplantation.

BACKGROUND: Prostaglandin E1 (PGE1) has been reported to have a protective effect in experimental and clinical models of liver damage. The aim of this study was to elucidate the effects of the intraportal infusion of PGE1 on hepatic blood flow and graft viability after orthotopic liver transplantation in pigs. METHODS: First, the hepatic arterial flow (HAF), portal venous flow (PVF), and liver tissue blood flow (LTBF) were measured during the continuous intravenous or intraportal infusion of PGE1. Second, two groups of pigs underwent orthotopic liver transplantation: group A, untreated controls; and group B, animals that received intraportal PGE1 for 2 hr after vascular reconstruction of the allograft. Changes in HAF, PVF, LTBF, and hepatic function were measured. RESULTS: The intraportal infusion of PGE1 significantly increased HAF and had no effect on blood pressure, PVF, or LTBF. In group B, HAF and LTBF increased significantly with time. In group A, HAF remained unchanged and a decrease in LTBF was observed. Group B exhibited a higher arterial ketone body ratio and a greater bile flow compared with group A. A significant elevation in serum glutamic oxaloacetic transaminase concentration was observed in group A, but not in group B. CONCLUSIONS: This study demonstrates that the intraportal infusion of PGE1 improves hepatic allograft blood flow, predominantly through an effect on HAF, and may improve graft viability after orthotopic liver transplantation.

Alprostadil↗

PubMed1997

Association between cigarette smoking and prostatism in a Japanese community.

BACKGROUND: The purpose of this study was to examine the association between cigarette smoking and prostatism among Japanese men. METHODS: Male residents of Shimamaki-mura, Japan, aged 40-79 years old (n = 286), completed a self-administered questionnaire that included the international prostate symptom score (IPSS). A detailed cigarette smoking history was also obtained. All men had a transrectal ultrasonographic estimate of prostatic volume and a peak urinary flow rate measurement. RESULTS: Current cigarette smoking was inversely associated with an impaired peak urinary flow rate (< 15 mL/sec) (odd ratio [OR] = 0.39, 95% confidence interval [CI] = 0.18, 0.84), and with moderate to severe symptoms (IPSS > 7) (OR = 0.84, 95% CI = 0.48, 1.49), but was not significantly associated with prostatic volume. Smokers of 1 to 1.4 packs a day were less likely and smokers of less than a pack a day or 1.5 or more packs a day were more likely to have moderate to severe symptoms and a greater prostatic volume. CONCLUSION: These findings suggest that cigarette smoking may have a protective effect on prostatism at certain smoking intensities, but no effect or a deleterious effect at other intensities.

Adult↗

PubMed1997

Effect of oral administration of prostaglandin E1 on erectile dysfunction.

OBJECTIVES: To investigate the effect of limaprost, an oral prostaglandin E1 (PGE1) derivative, on erectile dysfunction and to compare the effects of limaprost with a Chinese herbal drug, gosyajinki-gan. PATIENTS AND METHODS: The study comprised 50 consecutive patients with mild erectile dysfunction who showed a good erectile response to intracavernosal injection with 20 micrograms of PGE1. Limaprost was administered to the first 25 patients (30 micrograms three times daily) and gosyajinki-gan (7.5 g three times daily) to the next 25 patients, for 8 consecutive weeks. Patients were evaluated by their ability to achieve vaginal penetration and by a subjective assessment of erectile function (penile rigidity and maintenance of erection) before and after the treatment, using a self-administered questionnaire. Objective measurements (nocturnal penile tumescence, NPT, values) were also evaluated. RESULTS: Eleven of the 24 patients who received limaprost without interruption and four of the 24 taking gosyajinki-gan succeeded in vaginal penetration; the difference in the positive response rate was significant. The mean increment of NPT was significantly higher with limaprost treatment. However, all positive responders in both groups did not experience a full erection. There were no side-effects in any patient except one in the limaprost group who developed a facial flush. Thus the treatment was mild enough to be tolerated. CONCLUSION: Limaprost was more effective for mild erectile dysfunction than was gosyajinki-gan.

Administration, Oral↗

PubMed1997

Functional outcome and late complications in patients with continent urinary reservoirs.

BACKGROUND: We reviewed the functional outcome and late complication of continent urinary reservoirs (CUR) constructed with a cecocolonic segment, including the Indiana pouch, in 37 patients treated in our clinic. METHODS: The CUR procedure was performed on 37 patients, creating partially detubularized (PD) reservoirs in 9 patients, totally detubularized (TD) reservoirs in 16 patients and reservoirs with an ileal patch (IP) in 12 patients. Continence was achieved by the nipple valve in 10 patients and by ileal plication in 27 patients. The mean follow-up period was 46 months (range, 15 to 87 months). The function of the reservoir was evaluated by measurement of the intrareservoir pressure. RESULTS: Patients with the TD reservoir had less frequent appearance of involuntary, phasic elevation of the intrareservoir pressure (30.8%) than those with the PD reservoir (62.5%). In contrast, this phasic elevation was found in only 1 patient with an IP reservoir. The IP reservoir had the largest capacity accompanied by the lowest maximum intrareservoir pressure. Total incontinence was observed in 2 patients with ileal plication due to disruption of the plicated sutures on the terminal ileum. Frequent difficulty in catheterizing the reservoir was found in 2 patients, and reservoir-ureter reflux was found in 3 renal units. The serum chloride level was significantly elevated after surgery, however, in most patients the levels remained within normal limits. CONCLUSION: Our experience of the outcome and late complications of reservoirs indicates that the cecocolonic reservoir with an ileal patch and stapled ileal plication, i.e., the Indiana pouch, is a better choice for continent urinary diversion for patients who need a cystectomy.

Adult↗

PubMed1997

[The background factors influencing loss of sexual intercourse after transurethral resection of the prostate (TUR-P)--A study using the Sapporo Medical University-Questionnaire].

BACKGROUND: Sexual dysfunction after transurethral resection of the prostate (TUR-P) depends on multiple factors including preoperative erectile function itself. Using the Sapporo Medical University-questionnaire, we analyzed background factors contributing to loss of sexual intercourse after the operation. PATIENTS AND METHODS: We sent the self-administered questionnaires to 1,000 patients who had received TUR-P. Answers to questions were ranked as scores. Multiple regression analysis was used to identify factors significant for loss intercourse after TUR-P. RESULTS: The response rate was 63.5%. Patient with incomplete answers and those having diseases affecting voiding or sexual function and antiandrogen medication were excluded from the study. Leaving 536 patients for the final analysis. Scores for sexual desire and erectile function in the patients who received TUR-P were lower than those of age-matched healthy males. When we divided the patients according to frequency of sexual intercourse before and after TUR-P, there was distinct differences in age, scores for sensory disturbance, depression, the cooperative value of the sexual partner, sexual desire, erectile function, nocturia, residual sensation and urgency between those maintaining sexual intercourse and those having lost it. Multiple regression analysis using these factors indicated that the scores of erectile function was the most significant determinant for maintaining sexual intercourse after TUR-P in patients aged from 50 to 69 years, followed by the cooperative value of the sexual partner, residual sensation and sensory disturbance. In those 70 old and older, the score for erectile function was the most significant determinant, followed by the cooperative value of sexual partner. CONCLUSION: Our results suggest that, irrespective of age, the cooperation of the patient's sexual partner as well as erectile function significantly influence the maintenance of sexual intercourse after TUR-P. In addition, voiding condition and psychological status after TUR-P may affect the maintenance of sexual intercourse in patients in their fifties and sixties.

Aged↗

PubMed1997

[A clinical study on combination therapy of antimicrobial agents for complicated urinary tract infection--with special reference to combination with clarithromycin].

PURPOSE: To confirm the clinical efficacy of the combined therapy to complicated urinary tract infection (UTI), we conducted a comparative clinical study of the combined therapy with ciprofloxacin (CPFX) and clarithromycin (CAM) acting an biofilm elimination or CPFX alone in patients with complicated UTI. PATIENTS AND METHODS: The study was carried out in patients with complicated UTI having WBCs with 5/hpf or more in urinary sediment and bacteriuria at least 10(4) CFU/ml. The combined therapy was CPFX and CAM, each 600 mg/day, for 14 days, and the single therapy group CPFX, 600 mg/day, for 14 days. On Day 7 and 14, the eradication rate and efficacy rate (according to the criteria of the Japanese UTI committee) were determined. In the patients with indwelling catheter, the surface of the catheter tip was observed under a scanning electron microscope (SEM) on Day 14. RESULTS: In both cases with and without catheters, clinical efficacy was higher in the combined therapy group than in the single therapy group. In particular, the efficacy rates at 14 Day were significantly higher in the former group. Furthermore, we investigated the therapeutic effect in the below MIC breakpoint of CPFX in complicated UTI. The combined therapy group showed a higher clinical efficacy in both cases with and without indwelling catheter than the single therapy group, although there was not statistically significant. Biofilm on the surface of the catheter tip was eliminated in 75% of the combined therapy group. However, none of the biofilm was eliminated in the single therapy group. CONCLUSION: From the above results, we surmise that the combined use of CPFX and CAM will show some degree of efficacy in eliminating both the causative organism and its biofilm in the complicated UTI.

Adult↗

PubMed1997

[Maximum increase of penile circumference as a parameter for evaluation of penile erectile capacity].

PURPOSE: Male erectile capacity has been often evaluated with the maximum changes of penile circumference during nocturnal penile tumescence (NPT) by erectometer. However, it has not been fully established that the changes actually reflect penile rigidity. In this paper, we evaluated how the maximum change (the increase in circumference or its rate) of the circumference is related to penile rigidity. PATIENTS AND METHODS: The study included 116 men with or without complaints of sexual dysfunction. The maximum increase (penile circumference on erection-that when flaccid) and increase rate ¿(penile circumference on erection-that when flaccid)/penile circumference when flaccid¿ of penile circumference and penile rigidity were studied during artificial erection induced by intracavernous injection of vasoactivedrugs. RESULTS: When the maximum increase of penile circumference on erection was 21 mm or more, more than 80% of men achieved adequate rigidity of the penile for vaginal penetration. However, if the increase was 10 mm or less, all men had poor rigidity. In men having an increase of 11 mm or more and less than 21 mm, more than 80% did not achieve adequate rigidity if their penile circumference in the flaccid state was less than 95 mm. In contrast, 80% or more of the men showed penile rigidity sufficient for vaginal penetration when the flaccid circumference was 95 mm or more. Studies on the maximum increase rate revealed results similar to those in the study on the maximum increase. These two parameters had a similar diagnostic accuracy for evaluating penile rigidity. CONCLUSIONS: A higher prediction rate for penile rigidity was achieved by adding the parameter of penile circumference in the flaccid state to the maximum increase or increase rate of penile circumference. Thus, evaluation of erectile capacity by maximum changes (the increase in circumference or its rate) of penile circumference with an erectometer can be used for screening of men with sexual dysfunction.

Adult↗

PubMed1997

Age-related differences in internal prostatic architecture on transrectal ultrasonography: results of a community based survey in Japan.

PURPOSE: We determined age-related differences in prostate internal architecture and prostate volume by transrectal ultrasonography in Japanese men 40 to 79 years old. MATERIALS AND METHODS: The 287 study participants were categorized by transition zone disease: group 1-not visible (normal prostate), group 2-visible, borders unclear (diffusely enlarged hyperplasia) and group 3-visible, border clear (nodularly enlarged hyperplasia). RESULTS: Group 1 comprised 40% of men 50 to 79 years old and showed slightly decreased median prostate volume with age. Prostate volume and its variance increased with age in group 3 but differed little across age in group 2. CONCLUSIONS: In a community sample the prostatic internal architecture relationship with age and prostate volume suggested differing growth patterns.

Adult↗

PubMed1997

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (1995). III. Differences in susceptibilities from previous years].

Susceptibilities to various antimicrobial agents were examined for Enterococcus faecalis, Staphylococcus aureus, Escherichia coli, Klebsiella spp. and Pseudomonas aeruginosa that were isolated from patients with urinary tract infections (UTIs) in 11 hospitals during June, 1995 through May, 1996, and the results were compared with those obtained during the same period in earlier years. 1. Macrolide resistant E. faecalis isolated from uncomplicated UTIs during the latest study period appeared to have increased compared to those in previous study periods. More than 50% of the isolated E. faecalis during the latest study period were resistant to macrolide antibiotics, for the first time in our history. 2. No obvious changes were observed through the years for susceptibilities of S. aureus to various antimicrobial agents. Vancomycin (VCM) showed the highest activity against S. aureus, with MICs below 2 micrograms/ml or below. 3. Among E. coli strains, those with low susceptibilities to quinolones appeared to have increased over the years with MIC90 changed from between 0.125 microgram/ml or below and 0.5 microgram/ml in the 1989-1990 period to between 8 micrograms/ml and 128 micrograms/ml in the latest study period. 4. Klebsiella spp. showed higher resistance to most antimicrobial agents during periods of 1993-1994 and 1994-1995, but somewhat lower resistance during period of 1995-1996. No resistant Klebsiella spp. were detected from uncomplicated UTIs during the latest study period. 5. Among P. aeruginosa isolates from complicated UTIs, resistance isolates to gentamicin appeared to be increasing over the years. Resistant strains to quinolones were isolated at lower frequencies during periods of 1991-1994, but higher frequency was observed in the latest period, and MIC50s were between 0.5 and 4 micrograms/ml during 1991-1994, but were 16-32 micrograms/ml during 1995-1996. These susceptibility changes should be utilized in determining clinical treatments.

Anti-Bacterial Agents↗

PubMed1997

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (1995). I. Susceptibility distribution].

The frequencies of isolation and susceptibilities to antimicrobial agents were investigated on 704 bacterial strains isolated from patients with urinary tract infections (UTIs) in 11 hospitals during the period of June 1995 to May 1996. Of the above bacterial isolates, Gram-positive bacteria accounted for 29.8% and a majority of them were Enterococcus faecalis. Gram-negative bacteria accounted for 70.2% and most of them were Escherichia coli. Susceptibilities of several isolated bacteria to antimicrobial agents were as followed; 1. Enterococcus faecalis Ampicillin (ABPC) and imipenem (IPM) showed the highest activities against E. faecalis isolated from patients with UTIs. The MIC90S of them were 1 microgram/ml. Vancomycin (VCM) and piperacillin (PIPC) were also active with the MIC90S of 2 micrograms/ml and 4 micrograms/ml, respectively. The others had low activities with the MIC90S of 16 micrograms/ml or above. 2. Staphylococcus aureus including MRSA VCM showed the highest activities against S. aureus isolated from patients with UTIs. Its MIC90 was 1 microgram/ml against both S. aureus and MRSA. Arbekacin (ABK) was also active with the MIC90 of 2 micrograms/ml. The other except minocycline (MINO) had very low activities with the MIC90S of 64 micrograms/ml or above. 3. Staphylococcus epidermidis ABK and MINO showed the strongest activities against S. epidermidis isolated from patients with UTIs. The MIC90S of them were 0.25 microgram/ml. VCM was also active with the MIC90 of 1 microgram/ml. The MIC90S of cephems ranged from 2 micrograms/ml to 16 micrograms/ml in 1994, but they ranged from 8 micrograms/ml to 128 micrograms/ml in 1995. These results indicated that some resistances existed among S. epidermidis to cephems. 4. Streptococcus agalactiae All drugs except gentamicin (GM) were active against S. agalactiae. ABPC, cefmenoxime (CMX), IPM, erythromycin (EM), clindamycin (CLDM) and clarithromycin (CAM) showed the highest activities. The MICs for all strains were lower than 0.125 microgram/ml. The MIC90S of the others were 2 micrograms/ml or below. 5. Citrobacter freundii IPM showed the highest activity against C. freundii isolated from patients UTIs. Its MIC90 was 1 microgram/ml. GM was also active with the MIC90 of 2 micrograms/ml. Cefpirome (CPR), cefozopran (CZOP) and amikacin (AMK) were also active with the MIC90S of 4 micrograms/ml. Penicillins and cephems except CMX, CPR and CZOP showed low activities with MIC90S of 256 micrograms/ml or above. 6. Enterobacter cloacae IPM showed the highest activity against E. cloacae. The MICs for all strains were equal to or lower than 1 microgram/ml. MINO and tosufloxacin (TFLX) were also active with the MIC90S of 8 micrograms/ml. Penicillins and cephems except CPR and CZOP showed lower activities with the MIC90S of 256 micrograms/ml or above. 7. Escherichia coli. Most of the antimicrobial agents were active against E. coli. Particularly CPR, CZOP and IPM showed the highest activities against E. coli. The MICs for all strains were equal to or lower than 0.5 microgram/ml. CMX and TFLX were also active with the MIC90S of 0.125 microgram/ml or below. Penicillins were slightly active with MIC90S of 128 micrograms/ml or above. 8. Klebsiella pneumoniae K. pneumoniae was susceptible to all drugs except penicillins, with MIC90S of 2 micrograms/ml or below. Carumonam (CRMN) had the strongest activity against K. pneumoniae, the MICs for all strains were equal to or lower than 0.125 microgram/ml. Comparing with the result of 1994, the sensitivities of K. pneumoniae against all drugs had obviously changed into a better state. For example, the MIC90S of cephems ranged from 0.25 microgram/ml to 16 micrograms/ml in 1994, but they were all lower than 2 micrograms/ml in 1995. 9. Proteus mirabilis P. mirabilis was susceptible to a majority of drugs. CMX, ceftazidime (CAZ), cefixime (CFIX), and CRMN showed the highest activities against P. mirabilis isolated from patients with UTIs. MICs of CRMN for all

Anti-Bacterial Agents↗

PubMed1997

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (1995). II. Background of patients].

Clinical background was investigated on patients with urinary tract infections (UTIs) from whom 785 bacterial strains were isolated in 11 hospitals during the period from June, 1995 through May, 1996. 1. Distributions of age and sex of patients and type of infections. Among the patients examined, those with ages 50 years or older were the most frequent (males: 80.5%, females: 69.7%), and, among females, those with ages in the 20's were 12.6%. With regard to types of infections, more than a half of infections among males were of complicated types, but most of infections among females were of uncomplicated types, especially among females of ages less than 60 years. 2. Ages of patients and types of pathogens. The higher the ages of patients, the lesser became the isolation frequencies of Proteus spp. and Serratia spp., but the higher were those of Klebsiella spp. and Pseudomonas spp. 3. Effect of antibiotic use on isolation frequencies of pathogens. Use of antibiotics decreased pathogens isolated from patients with uncomplicated UTIs drastically (237 isolates before antibiotics compared to 33 after). Even isolated pathogens from patients with complicated UTIs decreased drastically with the use of antibiotics when indwelling catheters were not in use (200 isolates before antibiotics compared to 83 after), but when indwelling catheters were in use, antibiotics apparently failed to decrease the isolation frequency. 4. Surgical procedures and types of causative organisms for UTIs. Escherichia coli was the most frequently isolated organism from uncomplicated cases of UTIs. From cases of complicated UTIs without indwelling catheters, Enterococcus faecalis was the most frequently isolated, followed by E. coli, P. aeruginosa and Klebsiella spp. When a surgical procedures were not done, E. coli was isolated most frequently. From cases of complicated UTIs with indwelling catheters, P. aeruginosa, E. faecalis and S. aureus were the organisms that were mainly isolated, with isolation frequencies of 23.9%, 17.3% and 12.7%, respectively. When no surgical procedures were used, isolation frequencies of P. aeruginosa, Klebsiella spp. and E. faecalis were 25.7%, 14.3% and 14.3%, respectively.

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