[Discussion on the coagulation-fibrinolytic system in plasma during pregnancy--changes in the system in DIC].
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Adolescent↗
Biomedical subjects
E Takashima
Publications and source records attributed to E Takashima.
[Source of increased plasminogen activators in pregnancy plasma].
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Adult↗
[Contact hysteroscopic exploration of the uterine cavity].
The contact hysteroscope gives a clear view only upon contact with the observed surface. There are 6mm and 8mm diameter models. A total of 172 contact hysteroscopic examinations were performed to view the uterine cavity. The following results were obtained: After the previous observation with the panoramic hysteroscope, the rate of correct diagnosis with the 6mm model was 83.3% and that with the 8mm one was 98.5%. The rate of correct diagnosis with the 8mm model was 85.3% and that with the 6mm one was 92.7%, when used initially. The main disadvantages of the contact hysteroscope were a lack of perspective view and occasional existence of a dead angle just above the internal os. Among the contact hysteroscopic diagnosis, that of endometrial polyp was the most difficult, followed by those of slightly bulging submucous myoma and endometrial hyperplasia, while diagnosis of IUD, hydatidiform mole and endometrial carcinoma were easier. After acquiring the necessary experience, the 6mm model also gave very accurate results, requiring no cervical dilatation in multiparous cases. The 6mm model should therefore be a useful instrument to use in outpatient diagnosis.
Endoscopes↗
[Basic and clinical studies on cefminox in the field of obstetrics and gynecology].
Human pharmacokinetics and clinical studies of cefminox (CMNX, MT-141) were carried out and the following results were obtained. The concentrations of CMNX transferred to the uterus and its appendages after CMNX 1 g intravenous injection were maintained above 12.5 micrograms/g during first 3 hours or more. The concentrations of CMNX transferred to the pelvic dead space exudate were above 12.5 micrograms/ml during 6 hours or more. Those concentrations were sufficiently effective against the major pathogens (Gram-negative and anaerobic bacteria) demonstrated in the field of obstetrics and gynecology. We administered CMNX to 4 cases with postoperative infections at a dose of 2 g per day (twice a day) for a period of 4-6 days. The clinical effect was excellent in 3, good in 1 case. No side effect was observed.
Abscess↗
Usefulness of hysteroscopy for detection of cancer in the endocervical canal.
Preoperative hysteroscopic and histologic findings of endocervical cancerous lesions were compared with postoperative histologic findings of cervices. A total of 132 patients consisting of 72 carcinoma in situ, 16 microinvasive carcinoma and 44 invasive squamous cell carcinoma were examined during the 5 years beginning in 1977. The rates of cancerous lesions observed in the endocervix were 33.3% carcinoma in situ, 56.2% microinvasive carcinoma and 72.8% invasive squamous cell carcinoma. The preoperative diagnoses of endocervical lesions were histologically identical with the postoperative ones in 24 (88.9%) of 27 cases of carcinoma in situ, 7 (87.5%) of 8 cases of microinvasive carcinoma and all of 30 cases of invasive squamous cell carcinoma. Mosaics and punctations were noticed in the endocervix near the external os in the early stage of cancer, whereas white epithelia were observed more frequently and, over a wide range in the endocervix. Abnormal gland openings were noticed predominantly in carcinoma in situ. Atypical vessels were recognized mainly in microinvasive carcinoma. Gross irregular and dilated atypical vessels were recognized mainly in microinvasive carcinoma. Gross irregular and dilated atypical vessels, opacity, irregular surface and necrosis were observed predominantly in invasive carcinoma. In conclusion, hysteroscopy is useful in detecting cancerous lesions located in the endocervical canal.
Carcinoma in Situ↗
[The antibacterial activity of new cephem antibiotics against clinical isolates. A comparison of the antibacterial activity of cefotaxime with 6 other antibiotics].
During the period from May through July 1981, a comparative study was carried out on the antibacterial activities of cefotaxime (CTX) and ceftizoxime (CZX), cefoperazone (CPZ), latamoxef (LMOX), cefotiam (CTM), cefmetazole (CMZ) and cefazolin (CEZ). CTX and these other cephem antibiotics were tested against fresh clinical isolates which had been obtained from clinical materials by the laboratories of 14 participating medical institutions. 1. The clinical isolates were obtained from various clinical materials in the following decreasing order: urine, sputum and pus/discharge; 85.7% of the isolates came from these materials. 2. Concerning the sources of each species of clinical isolates, it was found that P. aeruginosa was isolated from the greatest number -9- of different clinical materials. This was followed by E. coli and E. cloacae, each isolated from 8 different clinical materials, and C. freundii and E. aerogenes, each found in 7 different clinical materials. 3. In relation to S. pyogenes, S. agalactiae and S. pneumoniae, CTX showed the best antibacterial activity; the second most potent antibiotic was CZX. CMZ and LMOX were found to show relatively high MIC values for those species. Against S. aureus, CEZ showed the best antibacterial activity, but 3 resistant strains had MICs of greater than 100 micrograms/ml. 4. With regard to Gram-negative bacteria, CTX and CZX showed the best antibacterial activities for all of the species, except for P. aeruginosa. These were followed, in order, by LMOX and CPZ. Compared with these 4 antibiotics, CTM, CMZ and CEZ were found to have inferior antibacterial activities against these bacteria. In relation to P. aeruginosa, the peak of the MIC distribution for CPZ was 6.25 micrograms/ml, and this was the best antibacterial activity detected with the various antibiotics tested. This was followed by CTX (25 micrograms/ml) LMOX (25 micrograms/ml) and CZX (50 micrograms/ml). CTM had an MIC of 100 micrograms/ml for 1 strain, and MICs of greater than 100 micrograms/ml for all of the other strains of P. aeruginosa, indicating them to be resistant to this antibiotic. All of the strains were resistant to CMZ and CEZ, showing MICs of greater than 100 micrograms/ml. 5. For each of the tested antibiotics, no correlation was found between the MIC and the serogroup for either P. aeruginosa or S. marcescens.
Bacteria↗
[Experimental and clinical studies of cefmenoxime in the field of obstetrics and gynecology].
The study group was organized to evaluate the usefulness of cefmenoxime (CMX) injection, a new synthetic cephalosporin, for the treatment of infections in the field of obstetrics and gynecology. Fundamental and clinical studies were made by the society and the following results were obtained. 1. The peak distribution of CMX's MIC for E. coli, Klebsiella sp., Enterobacter sp., Bacteroides sp. and Peptococcus sp. isolated from obstetrical and gynecological infections with relatively high frequencies area 0.1, less than or equal to 0.05, 0.2, 3.13, 1.56 micrograms/ml, respectively, with an inoculation of 10(6) cells/ml. 2. When 1 g of CMX is administered by intravenous drip infusion for 1 hour, the maximum concentrations in various tissues of female genital organs were as follows: 14.2 and 13.2 micrograms/g in ovary and oviduct, respectively, at 1.20 hours after the start of administration, and 16.9 and 26.3 micrograms/g in corpus uteri and cervix uteri, respectively, after 1 hour. As for the transfer to the exudate in the pelvic dead cavity, the peak concentration was 15.6 micrograms/ml after 2.13 hours. 3. In the clinical studies, CMX was given to 258 cases with female genital organ infections and others. As for the clinical effects, with exclusion of 3 cases in which other antibiotics are concomitantly used, responses were excellent in 76 cases, good in 162 cases and poor in 17 cases, among 255 cases in total. The efficacy rate was 93.3%. The efficacy rates by diseases were 97.1% (68/70) for intrauterine infections, 88.8% (79/89) for intrapelvic infections, 98.4% (62/63) for adnexitis, and 100% (23/23) for infections of external genital organs. As for the clinical effects on causative bacteria, the efficacy rates were 100% (19/19) for single infections due to Gram-positive bacteria, 94.8% (55/58) for single infections due to Gram-negative bacteria, and 88.2% (15/17) for single infections due to anaerobic bacteria. And its efficacy rates were 89.6% (69/77) for mixed infection cases. Side effects were observed in 2 cases (0.8%); 1 case with eruption, and 1 case with diarrhea and vomiting. As for abnormal laboratory findings, lower white blood cell count was observed in 2 cases and elevation of the values regarding hepatic functions in 9 cases. All cases were returned to the normal after the completion of the administration. Cefmenoxime showed a satisfactory clinical efficacy and a potent bacteriological effect in treatment of the infections in the field of obstetrics and gynecology, and it has been concluded that cefmenoxime will be useful addition to the antibiotics for the therapy of these infections.
Adolescent↗
[Transfer of cefotaxime to the pelvic organs (author's transl)].
The new antibiotic cefotaxime (HR 756, CTX) has been proved to be clinically effective against infections observed in the field of obstetrics and gynecology. The present study was intended to investigate the transfer of CTX to the internal genital organs and the dead pelvic space. The results were obtained as follows: 1. The concentrations of CTX transferred to the uteri and its appendages after CTX 1 g intravenous injection were sufficiently effective against the major pathogens (Gram-negative and anaerobic bacteria) demonstrated in the field of obstetrics and gynecology. 2. The concentrations of CTX transferred to the dead space of the pelvis were effective against almost all of the Gram-negative bacteria for 6 to 12 hours after CTX 1 g or 2 g intravenous injection. CTX was thus proved to be very effective for the prevention and treatment of infections of the dead pelvic space.
Cefotaxime↗
Computed tomography of ovarian masses.
A retrospective analysis of CT images in 138 histologically proven ovarian masses in 100 patients was undertaken to evaluate the usefulness and limitation of CT in the diagnosis of ovarian tumors. Benign masses were purely cystic in 98 (94.2%) and had solid component (including thickened walls, thickened septa, papillary projections) in five of 104 lesions (4.8%) on CT. These five masses, which are classified as benign solid tumors, could not be differentiated from malignant tumors by either the size of the solid portion or the intensity of contrast enhancement. In the malignant tumors a solid portion was detected in 32 of 34 tumors (94%). When a solid component is detected in an ovarian mass, the mass should be considered malignant although a few cases will be benign solid tumors. In Krukenberg tumors, which were all of gastric origin, the solid component was so large that it occupied more than one-half the mass. Therefore, if the solid portion of the ovarian mass is large on CT, upper gastrointestinal study should be performed to rule out Krukenberg tumor.
Diagnosis, Differential↗