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Biomedical subjects

Y Shirai

Publications and source records attributed to Y Shirai.

At least 235 records · Page 13Linked to original sources
PubMed1988

[Pharmacokinetics and clinical efficacy of imipenem/cilastatin sodium in neonates].

Clinical pharmacology and clinical efficacy and safety of imipenem/cilastatin sodium (IPM/CS), a beta-lactam antibiotic with a carbapenem nucleus and a dehydropeptidase-I inhibitor, were investigated in newborns. 1. Peak serum concentrations of IPM/CS at a dose of 20 mg/20 mg/kg were achieved at the end of 60-minute infusion. Maximum serum levels of IPM and CS were 44.2 micrograms/ml and 70.0 micrograms/ml, respectively, in neonates with ages 0-3 days. IPM and CS peak levels in premature infants with ages 0-3 days were 47.2 micrograms/ml and 56.1 micrograms/ml, respectively. IPM and CS peak levels in neonates 4 day-old or older were 35.0 micrograms/ml and 41.5 micrograms/ml, respectively, and in premature infants of similar ages were 45.7 micrograms/ml and 65.3 micrograms/ml, respectively. 2. Mean serum half-lives of IPM and CS in 0-3 day-old neonates were 1.6 hours and 3.1 hours, respectively, and the mean serum half-lives in premature infants were 2.1 hours and 4.6 hours, respectively. In neonates 4 day-old or older, the mean serum half-lives of IPM and CS were 1.6 hours and 2.6 hours, respectively, and in premature infants they were 1.5 hours and 1.9 hours, respectively. 3. A dose response was evident between doses of 10 mg/10 mg/kg and 20 mg/20 mg/kg of IPM and CS. 4. Urinary recovery rates of IPM for the 0- to 6-hour post IPM/CS infusion period ranged between 27.2 and 46.6%. For CS, urinary recovery rates for the 0- to 6-hour post IPM/CS infusion period ranged between 25.3 and 100.8%. 5. Clinical efficacy was evaluated in 9 patients and 7 patients showed excellent or good responses. 6. Of 14 patients who received IPM/CS treatment, 1 patient showed hematuria, leukopenia and thrombocytopenia, and 3 patients showed eosinophilia. However, these adverse reactions improved after the completion of therapy. 7. IPM has excellent antimicrobial activity against aerobic and anaerobic Gram-positive and Gram-negative bacteria. In this study, coadministration of IPM and CS produced good clinical responses and no serious adverse reactions. It is hence concluded that IPM/CS sodium is very useful for the treatment of severe bacterial infections in neonates, especially in the presence of beta-lactamase resistant strains and in polymicrobial infections.

Absorption↗
PubMed1987

[Histological differentiation of Rokitansky-Aschoff sinus involvement from stromal invasion of carcinoma of the gallbladder].

It is often difficult to judge the depth of invasion in carcinomas of the gallbladder, because some extend along Rokitansky-Aschoff sinus (RAS) without stromal invasion. The purpose of this study is to clarify the histological differentiation of RAS involvement from stromal invasion. One hundred and fifty three RAS, which were in 31 gallbladders without carcinoma, were examined histologically. They were surrounded by "peri-RAS stroma", which was similar to lamina propria mucosae. Cancerous glands, which were surrounded by "peri-RAS stroma" or showed "border (front)" of cancerous and non-cancerous epithelia, were judged to suggest RAS involvement of carcinoma. Desmoplastic stroma surrounding invasive carcinoma could be histologically distinguished from "peri-RAS stroma". Therefore it was possible to differentiate RAS involvement from stromal invasion. In 13 carcinomas which reached subserosal layer by way of RAS involvement, there was none of vascular permeation, perineural invasion and lymph node metastasis. No recurrence was encountered among these patients. Therefore these carcinomas, together with carcinomas confined to mucosa or proper muscle layer, can be entitled "early carcinoma of the gallbladder".

Adult↗
PubMed1987

[Trigeminal somatosensory evoked potentials: II. Some clinical experiences].

Compared to other somatosensory evoked potentials (SEP), little information has been published so far on trigeminal somatosensory evoked potentials (TSEP) in the various kind of disorders. This may be due to few recording technique suitable for clinical practice. We previously reported a new recording method and showed the normal pattern of TSEP. The purpose of this report is to examine its reliability for clinical use. Sixty patients, with either a complaint of facial numbness or an organic lesion supposed to involve facial sensory pathway, were investigated. Their age ranged from 13 to 74 years old (mean 47.0). They consisted of 34 organic lesions (30 brain tumors and 4 cerebrovascular diseases) and 26 non-organic lesions (16 hemifacial spasms, 6 trigeminal neuralgias and other miscellaneous disorders). TSEP was recorded by the stimulation of the half of the contralateral upper or lower lip with the clip-shaped electrode. C'5 or C'6 (midpoint between Cz and the external auditory porus) was used as an active electrode and Fz as a reference. Two hundred or four hundred responses were averaged by a Nicolet Pathfinder II. All recordings were repeated at least twice to confirm the reproducibility. (1) Among 21 patients with a complaint of facial numbness except for neuralgia, the abnormality rate of TSEP was significantly different (p less than 0.02) between organic and non-organic lesions. The former was 87.5% (14 out of 16 cases) and the latter was 20% (1 out of 5 cases).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

[Trigeminal somatosensory evoked potentials: I. Recording technic and normal responses].

The general wave form and time course of somatosensory evoked potentials (SEP) to the stimulation of upper and lower extremities has been well known in recent years. However, only a little information has been published so far on SEP to the trigeminal nerve stimulation (TSEP), and at present there is not always common methodology available in clinical practice. These may be due to the technical problems from the close proximity of stimulating and recording electrodes. The purpose of this report is to attempt to solve some of the difficulties of the procedure, as well as to show the morphology and time course of TSEP in a group of normal healthy subjects. Twenty healthy volunteers were investigated. Their age ranged from 22 to 61 years old (mean 29.3). Clip shaped silver-balled stimulating electrodes with 2 mm contact surface and interelectrode distance of 10 mm were applied to the inner surface of the lips. They were held in place without any support, thus minimizing muscle activity of the subject. Each half of the upper and lower lip was then stimulated in turn by an electrical rectangular pulse of 3 or 4 times sensory threshold (usually 1.5-2.0 mA) and 0.2 msec duration, at a rate of 2.3 per second. TSEP was recorded contralaterally from C'5 or C'6 (midpoint between Cz and external auditory porus). Fz was used as a reference. Four hundred responses were averaged by a Nicolet Pathfinder II, which also generated stimulation pulses. Stimulus polarity was reversed after each 100 stimuli to eliminate stimulus artifact. Analysis time was set to 50 msec.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

[Bone and soft-tissue tumors].

There have been great advances in recent years in the treatment of malignant bone and soft-tissue tumors thanks to advanced diagnostic techniques, improved chemotherapy and improved surgery involving extensive resection of the area involved, with bone and joint replacement. Here, we present details of the pathological findings, treatment and prognosis of cases of malignant bone and soft-tissue tumors, such as osteosarcoma, bone MFH, soft-tissue MFH, rhabdomyosarcoma and synovial sarcoma.

Adolescent↗
PubMed1986

A case of carcinoma arising in the intrapancreatic terminal choledochus 12 years after primary excision of a giant choledochal cyst.

A 27-yr-old woman with carcinoma developing in the intrapancreatic terminal choledochus 12 yr after the initial excision of giant choledochal cyst with Roux-en-Y hepaticojejunostomy is reported. Despite the generally accepted concept that the presence of bile is associated with malignancy in the remnant biliary ducts after excision of a choledochal cyst, this is the first report of a malignant growth developing in the terminal choledochus which had been free from the bile exposure long after the excision of the choledochal cyst. Long-term follow-up of the patient is advisable even after operation for primary resection of the choledochal cyst.

Adult↗
PubMed1985

Comparison of steady-state pharmacokinetics of valproic acid in children between monotherapy and multiple antiepileptic drug treatment.

Steady-state pharmacokinetics of valproic acid (VPA) with or without other antiepileptic drug (AED) treatment were studied in 37 children. Children (N = 16) receiving multiple AED therapy had a higher clearance (23.5 vs 13.0 ml/hr/kg, P less than 0.001), larger volume of distribution (0.30 vs 0.22 L/kg, P less than 0.01), and shorter half-life (9.4 vs 12.3 hours, P less than 0.01) than did those (n = 21) receiving VPA only. Inverse correlations of age with clearance (R = -0.559, P less than 0.01) and apparent volume of distribution of VPA (r = -0.490, P less than 0.05) were observed in children receiving monotherapy. In determining the dose and dosing interval of VPA, consider a possible alteration in the pharmacokinetics relating to age and other concurrent AED therapy.

Adolescent↗