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Biomedical subjects

H Kawagoe

Publications and source records attributed to H Kawagoe.

At least 19 recordsLinked to original sources

Marked eosinophilia induced by nafamostat mesilate, an anticoagulant in a hemodialysis patient.

A 61-year-old Japanese female on hemodialysis developed marked eosinophilia induced by nafamostat mesilate as an anticoagulant for hemodialysis. This is the first case of hypereosinophilic syndrome induced by nafamostat mesilate in a hemodialysis patient. The elevated eosinophil counts (51,900/mm3) are the highest for hemodialysis-associated eosinophilia. This eosinophilia was eliminated after cessation of nafamostat mesilate. We confirmed that the cause of this eosinophilia was nafamostat mesilate by using the challenge test.

Anticoagulants

[Therapeutic effects of cefuzonam against severe infections in patients with hematopoietic disorders. Hanshin Infection Study Group].

Cefuzonam (CZON) was used to treat severe infections in 151 patients with hematopoietic disorders, and its efficacy and safety were assessed. The drug was given in doses of 2.0 to 6.0 g a day, divided into 2 or 3, intravenously by injection or infusion. The clinical effects were excellent in 34 cases, good in 40 cases, fair in 5 cases, and poor in 57 cases. Therefore, the results were excellent or good in 54.4% of the patients treated. The efficacy rates were 43.8 and 35.9% for groups of patients whose neutrophil counts were 500/microliters or less and 100/microliters or less, respectively. It was excellent or good in 70.6% of patients in whom causative agents were identified, and in 66.7 and 80.0% of patients infected with Gram-negative and -positive bacilli, respectively. The efficacy rate for patients infected with unidentified agents was 52.1%. The rate for patients who had received other antibiotics previously was 41.5%. The rate for patients having received only one antibiotic for the preceding treatment was 50.0%. Six (3.9%) of the treated patients experienced adverse effects including changes in laboratory test results observed in 4.

Adolescent

[Therapeutic effects of meropenem against severe infections in patients with hematopoietic disorders. Hanshin Study Group of Hematopoietic Disorders and Infection].

The efficacy and the safety of meropenem (MEPM), a newly developed carbapenem antibiotic, were investigated in 150 patients with severe infections complicated with hematopoietic disorders. 1. Clinical responses in 132 patients who were evaluable for effectiveness were excellent in 33 patients, good in 45, fair in 10 and poor in 44, with an efficacy rate of 59.1%. 2. The efficacy rate in patients who had previously been treated with the other antibiotics was 51.2%, while that in patients who had not been thus treated was 62.9%. 3. The efficacy rate in patients whose neutrophil counts increased during the therapy with MEPM was higher than that in patients whose neutrophil counts did not increase. The efficacy rate in patients whose neutrophil counts during the therapy were below 100/mm3 was 48.1%. 4. Out of 150 cases, side effects were observed in 4 patients, 3 with eruption and 1 with jaundice. Abnormalities in laboratory test results on liver functions were noted in 8 patients. These results indicate that MEPM is an effective and safe antibiotic for the treatment of severe infections in patients with hematopoietic disorders.

Adolescent

[A study of combination chemotherapy (BHAC-ACVP) for adult acute lymphocytic leukemia. Hanshin Co-operative Study Group of Hematological Malignancies].

Twenty-nine adult patients with acute lymphocytic leukemia (ALL) were treated with combination chemotherapy consisting of behenoyl-ara-C, adriamycin, cyclophosphamide, vindesine and prednisolone (BHAC-ACVP regimen). Complete remission (CR) was obtained in 7 of 13 (54%) of the previously untreated, and 4 of 16 (25%) of the previously treated patients. Six of 10 (60%) L1 and 5 of 17 (29%) L2 patients achieved CR. Side effects such as nausea, GPT elevation and fever were observed, but these were not severe in most cases. The result indicates that BH-AC is useful for the treatment of adult patients with ALL.

Antineoplastic Combined Chemotherapy Protocols

[Effects of maintenance treatment after high-dose intravenous gamma-globulin for idiopathic thrombocytopenic purpura].

High-dose intravenous immunoglobulin (IVIG) for idiopathic thrombocytopenic purpura (ITP) produces a dramatic and substantial increase in platelet count, but the increased count tends to return rapidly to its pretreatment level. We studied the effects of immunosuppressive treatment aimed at the maintenance of platelet counts following the IVIG administration in ITP. Thirty-five patients with ITP were treated with IVIG, and then thirty-two of them with an immunosuppressant (azathioprine) and a glucocorticoid (prednisolone). After IVIG, the platelet count increased significantly. With immunosuppressive therapy after IVIG, most patients had a tendency to maintain the counts. In particular, this maintaining effect was remarkable in those patients who had been responsive to the standard prednisolone therapy while non-responders to the prior prednisolone failed to maintain the counts. When prednisolone was given after IVIG, the effect of maintaining platelet counts was dose-dependent. The treatment with azathioprine and prednisolone after IVIG appears to be effective in maintenance of platelet counts.

Adolescent

[Actual conditions of bacterial infection associated with hematopoietic disorders--changes in 10 years. The Hanshin Study Group of Hematopoietic Disorders and Infections].

This study showed several accumulated data through ten years from our experience in hematopoietic disorders and associated infections, which has been analyzed by the Hanshin Study Group of Hematopoietic Disorders and Infections. Since 1979 to 1988, our group had evaluated the sorts of causative organisms and the efficacy of various antibiotics therapy in 2119 cases of infectious diseases associated with hematopoietic disorders. On behalf of evaluating the changes of disease profile for ten years, we divided the accumulated data into three phases; former phase the first three years, middle phase the second three years and late phase the last four years. There was no significant difference in the frequency of various hematopoietic disorders among the three phases. Each leukemia patients occupied 77% of all cases. Sepsis suspected is the most frequent infectious disease accounting for 68.8%. The other infectious diseases were 8.4% of the sepsis, 14.8% of the respiratory infections and 3.1% of the urinary tract infections. Comparing the frequency of infections among the three phases, the respiratory and urinary tract infections inclined to decrease. Of the 532 strains isolated from 2119 cases and identified as causative organisms, gram-negative bacilli occupied 62.8% and gram-positive bacteria 36.5%. In comparing the percentage of gram-negative bacilli among the three phases, it showed a decreasing tendency in order former phase 63.6%, middle phase 76.4% and late phase 43.8%. Pseudomonas, however, had been isolated at almost constant ratio through ten years. On the other hand, the ratio of gram-positive bacteria isolated were 34.5% in former phase, 23.6% in middle phase and 56.3% in late phase, showing increasing a tendency through the period. Twenty-three kinds of antibiotics were administered by intravenous drip infusion. The efficacy rate was 43.9% to 67.2%. In particular, effectiveness of antibiotic therapy often depends on the change of peripheral neutrophil counts from the onset and during the therapy. The efficacy rate, however, was 36% even neutrophil counts have not shown the tendency of increase from less than 100/microliters.

Adolescent

[On the pain experience of the tooth caused by placement of initial archwire].

Twenty nine patients completed a pain index card for the first 14 days following placement of an archwire. The index card divided the day into morning, afternoon and evening sessions and the patients were asked to score on a 0-3 basis of the severity of discomfort caused to the teeth (score 0: no discomfort, score 1: discomfort, score 2: mild pain, score 3: severe pain). Results were as follows: 1) All patients suffered discomfort and/or pain following placement of an archwire (discomfort: 10.3%, mild pain: 72.4%, severe pain: 17.2%). 2) There was no significant difference in the pain experience among the three age groups (under 12, 13 to 19 and over 20 years of age). 3) There was statistically significant difference in the pain experience between the sexes. 4) There was no significant difference in the pain experience among the four kinds of archwires (0.0175" braided wire, 0.012" stainless steel wire, 0.016" and 0.016" x 0.022" nickel titanium alloy wire). 5) The discomfort experience was observed in 37.9% and the mild pain experience was in 3.4% of the cases immediately after placement of the archwire. 6) The pain experience was observed in 62.1% of the cases by the end of the day. In 20.7% the pain experience was observed the next day and the pain experience was observed after 2 days in 3.4%. 7) In the severe pain group, the mean value of the pain experience was 4.4 days and that of the discomfort experience was 8.2 days.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent

[Statistical investigation on orthodontic patients who received treatment at Fukuoka Dental College during 15 years].

It has been fifteen years since the Department of Orthodontics started in 1973, and this report concerns mainly the results of clinical observations during these period. The results were as follows: 1) Three thousand four hundred and three patients visited during a fifteen years period and 2,065 (61%) of them received orthodontic treatment. This statistical investigation was performed on 2,065 patients. 2) The numbers of treated patients increased from 1973 to 1983 without 1980 but have almost unchanged with about 180 patients from 1984 to 1987. 3) The male patients were less than the female by the ratio of 1:1.67. As to age, the patients from 6 to 12 years old accounted for 72% of all the treated. 4) Analyzed by dental age categories, patients at the stage of III A and III B comprised 54% of all the treated. 5) Analyzed by month, the patients visited on March, July and August in spring and summer vacations. 6) Most of the patients (92%) lived in Fukuoka Prefecture and 38% of them lived in Sawara-ku, where lay in the south-western part of Fukuoka city. 7) Fifty six per cent of all patients were introduced by doctors and dentists. 8) As to malocclutions, the number of mandibular protrusion was the largest, crowding case was next, and maxillary protrusion was third. The total sum of these three cases accounted for 78% of all the treated. 9) In the initial orthodontic appliances, the use of the multi-brackets appliances was first, the chin cap appliances was second and plate appliances was third. The total sum of these three appliances accounted for about 73%. 10) Analyzing to age and initial orthodontic appliances, plate, chin cap, F. K. O. and I. M. A. appliances were used at the age from 7 to 8. Lingual arch appliances were also used at the age of 8. The multi-brackets appliances increased remarkably during the recent five year period and were used at the age of 10 to 11 and over 20 years.

Adolescent

[Malignant lymphoma which contained EBV DNA and lacked EBNA2 antibody].

A case of non-Hodgkin malignant lymphoma which contained EBV DNA and EBNA was reported. The serum of this patient showed high titer of VCA, EA, and EBNA1 antibody but lacked EBNA2 antibody. The relation with EBV originated malignancy and defect of EBV specific antibody suggests a process of oncogenicity of this virus.

Antibodies, Viral

A new nitrosourea derivative for the treatment of chronic myelogenous leukemia.

A new water-soluble nitrosourea derivative, methyl 6-[3-(2-chloroethyl)-3-nitrosoureido]-6-deoxy-alpha-D-glucopyranoside (MCNU), was found to be useful for the treatment of chronic myelogenous leukemia (CML) in the chronic phase. To compare the efficacy of MCNU with that of busulfan, patients were randomized. In the 40 patients administered MCNU, the median time to the achievement of a complete remission (CR) was 50 days. This value was shorter than that observed in 37 patients administered busulfan (126 days, p less than 0.05). There were no differences in the rate of CR achieved, mortality, median time to the onset of blast crisis (BC), BC rate, or survival rate during the observation period. The overall incidence of side effects was higher for MCNU (31%) than for busulfan (15%), but the symptoms were mild, transient and tolerable for most patients. These results suggest that MCNU is a safe and valuable addition to the therapeutic repertoire for the control of CML.

Adult

[Efficacy and safety of cefbuperazone in severe infections complicating hematologic diseases Hanshin Infection Study Group].

Cefbuperazone (CBPZ) was administered to patients with severe infections complicating hematologic diseases to assess its efficacy and safety under such clinical conditions. Primary diseases in this series of 78 cases included; acute leukemia in 41 cases, chronic leukemia in 6 cases, other leukemia in 9 cases, malignant lymphoma in 13 cases, multiple myeloma in 3 cases, aplastic anemia in 5 cases and 1 other case. Types of infection included sepsis; proven or suspected, in 59 cases, pulmonary infection in 8 cases, upper respiratory infection in 5 cases, and other cases. CBPZ was infused by an intravenous drip method at a dosage of 4-8 g daily. Patients' ages ranged from 14 to 85 years. Clinical response to the CBPZ regimen was excellent in 24 cases, good in 22 cases, fair in 2 cases, and poor in 30 cases. Thus the overall efficacy rate (percentage of cases showing an excellent or good response) was 59.0%. Efficacy rates for individual types of infection were: documented sepsis 16.7%, suspected sepsis 58.5%, lower respiratory infection 62.5%, and upper respiratory infection 100%. CBPZ also proved to be effective in 61.0% of cases with a neutrophil count of less than 500/mm3 prior to therapy. Side effects encountered were diarrhea in 1 case, gastric discomfort in 1 case and hepatic dysfunction in 5 cases. These side effects, however, were not dose-related, and none were serious. These results indicate that CBPZ has a high therapeutic efficacy even in patient with compromised immunodefenses.

Adolescent

[Assessment of abnormal left ventricular systolic blood flow in atrial fibrillation].

In atrial fibrillation, it is known that hemodynamics vary according to the preceding R-R intervals. However, the informations of blood flow dynamics have not been available because of the methodological limitations. In this study, blood flow dynamics of atrial fibrillation were assessed using pulsed Doppler echocardiography. The subjects were 160 consecutive patients with atrial fibrillation and without left ventricular asynergy. Using a commercially-available pulsed Doppler instrument (Aloka SSD-910), blood flow patterns in the left ventricle were investigated from the apical long-axis view. The results were as follows: 1. In 22 of the 160 cases (14%), systolic blood flow in the central or apical region of the left ventricle directed towards the apex (termed "back flow"). 2. In the cardiac cycle with "back flow", the preceding R-R interval was shorter; whereas it was longer when "back flow" was absent (591 +/- 103 vs 817 +/- 179 msec, p less than 0.01). Moreover, when a long R-R interval (PPI) followed by a short R-R interval (PI) was observed (greater PPI/PI ratios), the next beat showed distinct "back flow". 3. Left ventricular ejection fraction decreased significantly in patients with "back flow" compared to those without it (42 +/- 15 vs 66 +/- 12%, p less than 0.01). 4. On left ventriculography, the motion of the base of the heart was preserved; however, with "back flow", the motion of the apical area was abnormal, extending towards the apex along the longitudinal axis. 5. Left ventricular ejection flow at the outflow tract disappeared in 13 of the 22 cases with "back flow" in cardiac cycles with short preceding R-R intervals.(ABSTRACT TRUNCATED AT 250 WORDS)

Atrial Fibrillation

[Phase II study of etoposide (VP-16) in the form of intravenous injection for malignant lymphomas and acute leukemias: Hanshin Cooperative Study Group for Hematological Disorders].

Twenty patients with malignant lymphomas and 12 with acute leukemias were treated with intravenous administration of etoposide, 60-100 mg/m2/day for five days, repeated for three to four weeks. Eighteen cases of malignant lymphoma and nine of acute leukemia were evaluable. CR was achieved in three cases (16.7%) and PR in four cases (22.2%) of malignant lymphoma. Although CR was not achieved in any patients with acute leukemia, and PR was in three (33.3%), it was found that etoposide was most effective for the patients with the M4 or M5 subtype in the FAB classification. The most serious adverse effect of the drug was leukopenia in patients with lymphoma. In three patients (30.0%), the leukocyte count was lower than 1,000/mm3. Gastrointestinal complications, such as anorexia, nausea, vomiting and diarrhea occurred in 60.7% of all patients, but were not serious. Alopecia was observed in 73.1%. Intravenous administration of etoposide was apparently effective for the patients with malignant lymphoma of the diffuse mixed type, and this efficacy found in our study was the same as that for oral administration of etoposide reported by us previously.

Adult