Mass Spectrometry Analysis of Oxygen Gas Exchange in High- and LOW-CO2 Cells of Chlorella vulgaris

Oxygen gas exchange was monitored in the unicellular green alga Chlorella vulgaris 211 - 11 h by means of a mass spectrometer equipped with a special membrane gas-inlet-system and a photosynthetic reaction vessel. CO2-dependent 18O2-uptake as well as 16O2-evolution were analyzed in both High- and Low-CO2 cells. In High-CO2 cells, the 18O2-ruptake in the light (UL) decreased by 65% upon addition of 3 mᴍ NaHCO3 , while 16O2-evolution (E) was increased approx. 1.8 times by the same treatment. 18O2-uptake in the dark (UD) was not affected by the addition of external inorganic carbon (Ci). The addition of 3.3 mᴍ NaHCO3 also affected UL and E in Low CO2-cells, however, to a minor extent. UL under CO2-saturating conditions was light intensity-independent up to 2 klux and 1.2 klux in High- and Low-CO2 cells, respectively.

Above these light intensities UL increased approx. 4-fold in High- and approx. 6-fold in Low-CO2 cells. Under CO2-limiting conditions, however, UL increased in High-CO2 cells even under very low light intensities, showing that photorespiratory oxygen uptake occurred even in the near vicinity of the light compensation point. Under C02-saturating and strong light conditions UL represented almost half of E in Low-CO2 cells and about 30 % of E in High-CO2 cells. In Low-CO2 cells addition of ethoxyzolamide (EZA), an inhibitor of carbonic anhydrase, enhanced UL and suppressed E and NET under CO2-limiting conditions, whereas the compound had only a minor effect on High-CO2 cells.

DCMU (3 μᴍ) strongly inhibited E and UL under CO2-saturating conditions, with the remaining UL being smaller than UD . KCN (1 mᴍ) and SHAM (1.5 mᴍ) added to DCMU-treated Low-CO2 cells suppressed UL by approx. 50 % . The resulting value corresponded to half of UD . KCN also inhibited E under CO2-saturating conditions, with UL being strongly enhanced showing a maximal uptake at 0.4 mᴍ KCN . Under these conditions NET was nearly zero. The effect seems to be due to an inhibition of RubisCO and an enhancement of Mehler reactions. At 0.7 mᴍ KCN , DCMU entirely inhibited UL , but oxygen uptake appeared increased after turning the light off. This uptake corresponded to approx. 60 % of UD . Whereas KCN and SHAM inhibited approx. 70 % of UD , only 16% of UL was suppressed. These results suggest that the contribution of mitochondrial respiration to UL was negligeable, since UL seemed to be suppressed in the light under CO2-saturated conditions. Iodoacetamide, which is an inhibitor of the Calvin cycle and thereby diverts carbon into the respiratory pathway, inhibited E and NET under CO2-saturating conditions, but did not affect UL . This result also shows that UL is not due to mitochondrial respiration. A hydroxylamine derivative [20, 21] which changes the ratio of the RuBP carboxylation to oxygenation activity in tobacco leaves did not affect this ratio in Chlorella.

Purification and Characterization of Mannitol-l-Phosphatase in the Red Alga Caloglossa continua (Ceramiales, Rhodophyta)

Purification of mannitol-l-phosphatase, an enzyme catalyzing the final step of mannitol biosynthesis, was first achieved in the mannitol-accumulating red alga Caloglossa continua (Okamura) King et Puttock. The enzyme was shown to be a monomer, since gel filtration and sodium dodecyl sulfate-polyacrylamide gel electrophoresis gave close values of apparent molecular weights of 28,500 and 30,200, respectively. The protein exhibited an isoelectric point of 4.8. The substrate specificity for mannitol-l-phosphate (MIP) was very high, and that for K(m)(MIP) was 0.41 mM. The catalytic activity was optimal at pH 7.4. The enzyme was activated by Mg(2+), but was strongly inhibited by Ca(2+), NaF, N-ethylmaleimide, and p-hydroxymercuribenzoic acid. Seawater levels of NaCl and physiological levels of mannitol also inhibited the activity by 50% or more. Changes in the concentrations of those ions and metabolites may regulate the biosynthesis of mannitol as an osmoregulant in vivo.

Accommodative load from handheld game consoles in kindergarten children

We analyzed and compared the visual accommodation of kindergarten children who were gazing fixedly at images from three different sources: Nintendo Game Boy DMG-01(TM) (non-backlit type game console: NBGC), NEC PC EnginePI-TG6(TM) (color backlit-type game console: CBGC) and a cartoon drawing (drawing). Subjects for the experiment were 13 4- to 5-year-old kindergarten children. The contrast ratios were, in the order, 1.1 (NBGC), 3.1 (drawing), and 3.4 (CBGC). These values show that the contrast of the NBGC screen was considerably lower than the others. The mean accommodative power increased when looking at all three types of image: a drawing (1.75±0.52 D; mean±S.D.), CBGC (1.82±0.61 D), and NBGC (2.26±0.50 D). Compared with the other 2 targets, NBGC required stronger accommodation, indicating that the legibility of the NBGC was poor. Repeated measures ANOVA was used for the values of accommodation for each type of target. There were significant differences among the 3 targets (p<0.01). Significant differences were seen between NBGC and drawings (p<0.01) and NBGC and CBGC (p<0.05) using paired Scheffe test, but not between CBGC and drawings. This supports the finding that the legibility of NBGC is low due to dark and low contrast screens with poor resolution.

[Significance of interferon alpha therapy for advanced renal cell carcinoma. Fukushima Renal Cancer Study Group]

We ranked prognostic factors to retrospectively evaluate the clinical significance of interferon alpha (IFN-alpha) therapy in patients with Robson stage IVB renal cell carcinoma. A total of 44 Robson stage IVB renal cancer patients were divided into 2 groups, one with more than 6 months administration of IFN-alpha (3-7 times a week: group A) and another without any IFN-alpha administration. The distribution of these 2 groups was not randomized. In addition to IFN-alpha therapy, survival was analyzed with respect to performance status (PS), mass reductive nephrectomy, concomitant use of other cytotoxic therapies, the number of metastatic organs, growth type, site of metastasis and the period of diagnosis, using a multivariate method with Cox proportional hazards regression. The multivariate analysis showed administration of IFN-alpha to be the most significant factor influencing a good prognosis. Improved survival was also significantly correlated with slow growing type and good PS. Among group A, a significant favorable prognosis was obtained in patients with the responses of no change (NC), partial response (PR) and complete remission (CR) 6 months after initiating administration of IFN-alpha, as well as with good PS and a slow growing type carcinoma. We conclude that IFN-alpha therapy might improve the prognosis of patients with Robson stage IVB renal cell carcinoma, especially, in cases when a greater than NC response is obtained after 6 months administration of IFN-alpha.

Liquid-Saturated Hydrocarbons Resulting from Pyrolysis of the Marine Coccolithophores Emiliania huxleyi and Gephyrocapsa oceanica

: Two nanoplanktonic marine coccolithophores, Emiliania huxleyi and Gephyrocapsa oceanica, were grown at 23 degrees C with a 16-hour light and 8-hour darkness regimen. The cells were dried at room temperature and then subjected to pyrolysis at 100 degrees to 500 degrees C under anoxygenic conditions to produce hydrocarbons. Temperature-dependent profiles of the liquid-saturated hydrocarbons (saturates) produced during pyrolysis were very similar for the two strains, although the total amount was higher in E. huxleyi than in G. oceanica. The amount of saturates produced was only 0.05% to 0.15% below 200 degrees C, but about 2.1% to 2.8% at 300 degrees C. Their major components were normal alkanes in a series ranging from nC(11) to nC(35) with the predominant peak at nC(15). At 400 degrees and 500 degrees C most of saturates transformed into gaseous compounds. The major saturates identified in all pyrolysates were normal C(31) monounsaturated and diunsaturated alkenes, a series of normal alkanes, phytenes, C(28) sterenes, and steranes. Profiles of saturates in gas chromatography-mass spectroscopy varied with increasing pyrolysis temperature and also differed between E. huxleyi and G. oceanica. The two coccolithophores are useful candidates for the production of renewable liquid fuel through pyrolysis-especially E. huxleyi, which has higher production. The results also provide information for further studies on the characterization, source, and paleogeographic distribution of marine sediment.

Purification, characterization and cDNA cloning of soluble carbonic anhydrase from Chlorella sorokiniana grown under ordinary air

Soluble carbonic anhydrase (CA, EC 4.2.1.1) inducible by low levels of CO2 was purified from the unicellular green alga Chlorella sorokiniana grown at alkaline pH. The purified CA had a specific activity of 2,300 units (mg protein)-1. The molecular mass of the CA was found to be 100 kDa by non-dissociating (native)-polyacrylamide gel electrophoresis and 50 kDa by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The 50-kDa subunit was recognized by concanavalin A. These results suggest that the protein has a dimeric form with two 50-kDa subunits that are glycosylated in an asparagine-linked manner. The native CA was revealed by isoelectric focusing to be a very acidic protein with an isoelectric point of 4.2. About 60% of the CA activity was inhibited by 0.5 M NaCl. The enzyme was inactivated over 95% by preincubation with 50 mM dithiothreitol but not with 1 mM dithiothreitol. After partial amino acid sequence analysis, a cDNA clone of the CA was isolated and characterized. The cloned cDNA fragment encoded a 348-amino-acid polypeptide (36,709 Da) including an NH2-terminal hydrophobic signal peptide composed of 35 amino acids (3,725 Da). Conserved regions of sequences found in animal CAs, in the periplasmic (pCA) and the intracellular CAs of Chlamydomonas, and in the plasma-membrane-bound CA of Dunaliella (Dca) were also found in this Chlorella CA. The signal sequence was significantly homologous to the pCA and the Dca. The internal signal sequence between the large and the small subunits reported for pCA was not found in this Chlorella CA. The soluble CA of this alga was an alpha-type CA with salt-sensitive, periplasm-locating and acidic properties and very different from pCA and Dca with their salt-sensitive/neutral and salt-resistant/acidic properties, respectively.

Effect of naloxone on the bladder activity of rabbits with acute spinal injury

BACKGROUND

Naloxone enhances bladder activity in patients with chronic spinal cord injury. However, there are few reports on naloxone for bladder morbidity in acute spinal cord injury.

METHODS

We performed a prospective, controlled study of the effects of naloxone on bladder function in rabbits with and without surgical transection of the spinal cord at the 10th thoracic vertebra. Acute and chronic stages of injury were defined according to bladder function. Naloxone was given intravenously at both stages, and intrathecally at the acute stage. Bladder activity was monitored by cystometry. Blood concentrations of methionine-enkephalin were measured by radioimmunoassay.

RESULTS

Spinal cord injuries were acute 1 or 2 days after surgery, and chronic after 1 or 2 weeks. Bladder capacity significantly decreased after 0.01 mg of intravenous naloxone in uninjured control rabbits, and after 0.03 mg of intravenous naloxone in rabbits with chronic-phase injuries. During the acute-injury phase, 0.3 mg of intravenous naloxone, or 0.02 mg of intrathecal naloxone, was necessary to evoke the micturition reflex. No significant changes in blood enkephalin levels were seen before or after spinal cord injury.

CONCLUSION

In rabbits with acute spinal cord injury, intrathecal naloxone evoked the micturition reflex at a much lower dose than did intravenous naloxone. Intrathecal naloxone promises to become a new therapy for the acute stage of spinal cord injury for active recovery of bladder function, and could replace current therapy.

[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.

[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.

[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

[Neoadjuvant intra-arterial chemotherapy based on chemosensitivity tests for locally invasive bladder cancer]

We investigated the clinical usefulness of individualization of chemotherapeutic regimen in neoadjuvant intra-arterial chemotherapy for locally invasive bladder cancer. Anticancer drugs were selected according to the results of an in vitro chemosensitivity test (collagen matrix assay or succinic dehydrogenase inhibition test). Nine patients with locally invasive bladder cancer received 1 to 4 courses of neoadjuvant intra-arterial chemotherapy, followed by radical cystectomy. Histopathological responses in the cystectomized specimens were grade 3 in 3 cases, grade 2 in 2, grade 1b in 2 and no response in 2. Pathologically, a complete response and downstaging were observed in 3 and 4 cases, respectively. Seven of the 9 patients were alive no evidence of disease with a mean follow-up period of 38.9 months, whereas 2 patients died of metastasis within 2 years. Six of the 7 patients who showed a complete response or down staging have been free of recurrence. These findings suggest that our chemotherapeutic strategy may improve the prognosis for locally invasive bladder cancer.

[Transurethral balloon laser thermotherapy for benign prostatic hyperplasia]

Between April 1994 and March 1995, transurethral balloon laser thermotherapy (TUBAL-T) using Prostalase was performed on 53 patients with benign prostatic hyperplasia. Clinical efficacy was evaluated at 3 months after TUBAL-T. The mean international prostate symptom score (I-PSS) decreased from 21.5 at baseline to 11.3 after 3 months (p < 0.0001). Irritative (the sum of items 1, 2, 4 and 7 of I-PSS) decreased by 55%, while obstructive symptoms (the sum of items 3, 5 and 6 of I-PSS) by 45%. However, other objective parameters such as maximum flow rate, voided volume, percent postvoid residual volume and prostate volume showed no significant change (7.8 to 7.2 ml/s, 130 to 147 ml, 33 to 28% and 39.7 to 41.0 ml, respectively). In conclusion, significant improvement after TUBAL-T was observed for subjective symptoms, especially irritative symptoms, but not for objective parameters.

[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.

[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.

[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

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (1994). III. Secular changes in susceptibility]

Susceptibilities of Enterococcus faecalis, Staphylococcus aureus, Citrobacter spp., Enterobacter spp., Escherichia coli, Klebsiella spp., Proteus mirabilis, Pseudomonas aeruginosa and Serratia spp. isolated from patients with urinary tract infections (UTIs) in 10 hospitals during June 1994 to May 1995 to various antimicrobial agents were compared with those in the same period of previous years according to a classification, uncomplicated UTIs, complicated UTIs without indwelling catheter, and complicated UTIs with indwelling catheter. No remarkable changes were found in susceptibilities of Citrobacter spp., Enterobacter spp. and Serratia spp. The susceptibilities of E. faecalis to amikacin and quinolones were better than those in 1993. As for S. aureus, susceptible strains to all drugs increased in uncomplicated UTIs. Against E. coli in 1993, the antimicrobial activities of piperacillin, cefotiam and aminoglycosides have decreased, however, in 1994, these activities have turned to the better state. As for Klebsiella spp. susceptible strains to ABPC decreased. The susceptibilities of P. mirabilis to all drugs except minocycline were good. Against P. aeruginosa in 1993, the activities of aminoglycosides have decreased, but, in 1994, these activities have turned to the better state. These data should be considered in clinical treatment of various urinary tract infections.

Combination therapy of Pseudomonas aeruginosa pyelonephritis in neutropenic mice with human antilipopolysaccharide monoclonal antibody and cefsulodin

PURPOSE

These studies were designed to determine the combined inhibitory effect of a human monoclonal antibody (MAb) and cefsulodin on Pseudomonas aeruginosa renal infection in a neutropenic condition.

MATERIALS AND METHODS

Protection against the infection of mice was estimated by survival rate and bacterial numbers in the kidney and blood. Opsonophagocytic assay by human polymorphonuclear neutrophils (PMNs) and fluorescence activated cell sorter (FACS) analysis were also examined.

RESULTS

Treatment of infected mice with MAb combined with a suboptimal dose of cefsulodin prevented the mice from developing pyelonephritis and bacteremia and resulted in a significantly higher survival rate than treatment with either MAb or cefsulodin alone (p < 0.01). When bacteria were preexposed to cefsulodin, a significant enhancement in opsonophagocytic killing with MAb was observed. Fluorescence activated cell sorter analysis suggested that the bacteria incubated with 1/4 minimal inhibitory concentration (MIC) of cefsulodin showed greater binding of MAb to bacteria than the control.

CONCLUSION

The combination therapy with human antilipopolysaccharide MAb and cefsulodin is useful for P. aeruginosa pyelonephritis in neutropenic hosts.

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (1994). II. Background of patients]

Clinical background was investigated on 628 bacterial strains isolated from patients with urinary tract infections (UTIs) in 10 hospitals during period from June, 1994 to May, 1995. 1. Distributions of sex, age and urinary tract infections Among over sixties males, the majority was taken by complicated urinary tract infections. Among females, the uncomplicated urinary tract infections was most frequent without a relation of age. As for over 40 females, the increase of complicated UTI was admitted. 2. Distribution of sex, age and pathogens isolated from UTIs In uncomplicated UTIs, Escherichia coli was most frequently isolated without a relation of age, and next Enterococcus faecalis and CNS. In complicated UTIs without indwelling catheter, E. coli, Pseudomonas aeruginosa and E. faecalis were isolated the most frequent. In complicated UTIs with indwelling catheter, P. aeruginosa was most frequently isolated, and next E. faecalis and Staphylococcus aureus. 3. Administration of antimicrobial agents and pathogens isolated from UTIs In uncomplicated UTIs, pathogens, after administration of antibiotics, isolated from patients have obviously decreased from 216 to 32 isolates. And also, pathogens of complicated UTIs without indwelling catheter, have decreased from 127 to 50 isolates. However, in complicated UTIs with indwelling catheter, pathogens after or before administration of antibiotics, were not revealed an obvious change. 4. Pathogens and UTIs with or without factor and operation In uncomplicated UTIs with or without factor and operation, E. coli was mainly detected. In complicated UTIs without indwelling catheter and with factor and operation E. faecalis was mainly detected, and next E. coli, S. aureus and P. aeruginosa. Without factor and operation, E. coli was mainly detected. In complicated UTIs with indwelling catheter and with factor and operation, P. aeruginosa, E. faecalis and S. aureus were mainly detected at 23.5%, 15.0%, 15.0%, respectively. Without factor and operation, Proteus spp. 22%, and next E. faecalis and P. aeruginosa 10% and 12%, were detected, respectively. The distribution of pathogens, in the case of Proteus spp. and P. aeruginosa has been obviously varied by the influence of factor and operation.

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (1994). I. Susceptibility distribution]

The frequencies of isolation and susceptibilities to antimicrobial agents were investigated on 567 bacterial strains isolated from patients with urinary tract infections in 10 hospitals during the period of June 1994 to May 1995. Of the above total bacterial isolates, Gram-positive bacteria accounted for 26.8% and a majority of them were Enterococcus faecalis. Gram-negative bacteria accounted for 73.2% and most of them were Escherichia coli. 1. Enterococcus faecalis. Ampicillin (ABPC) and imipenem (IPM) showed the highest activities against E. faecalis isolated from patients with urinary tract infections. The MIC90s of them were 1 microgram/ml. Vancomycin (VCM) was also active with the MIC90 of 2 micrograms/ml. Piperacillin (PIPC) and biapenem (BIPM) were also active with the MIC90s of 4 micrograms/ml and 8 micrograms/ml, respectively. The others were not so active 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 urinary tract infections. 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 others except minocycline (MINO) were not so active with the MIC90s of 64 micrograms/ml or above. 3. Staphylococcus epidermidis. MINO showed the strongest activity against S. epidermidis isolated from patients with urinary tract infections. Its MIC90 was 0.25 microgram/ml. ABK was also active with the MIC90 of 1 microgram/ml. Cephems were active with the MIC90s of 2 approximately 16 micrograms/ml, but penicillins and quinolones were not so active with the MIC90s and 64 approximately 128 micrograms/ml. 4. Citrobacter freundii. Gentamicin (GM) showed the highest activities against C. freundii isolated from patients with urinary tract infections. Its MIC90 was 1 microgram/ml. IPM was also active with the MIC90 of 2 micrograms/ml. Cefpirome (CPR) and cefozopran (CZOP) were also active with the MIC90s of 4 micrograms/ml and 8 micrograms/ml. The others were not so active with the MIC90s of 32 micrograms/ml or above. 5. Enterobacter cloacae. IPM showed the highest activities against E. cloacae. Its MIC90 was 0.5 microgram/ml. GM and amikacin (AMK), ciprofloxacin (CPFX) and tosulfloxacin (TFLX) were also active with the MIC90s of 4 micrograms/ml. Penicillins and cephems except latamoxef (LMOX), cefmenoxime (CMX), CPR and CZOP showed lower activities with the MIC90s of 256 micrograms/ml or above. 6. Escherichia coli. Most of antimicrobial agents were active against E. coli. CPR, CZOP, IPM, carumonam (CRMN), CPFX and TFLX showed the highest activities against E. coli. The MIC90s of them were 0.125 microgram/ml or below. Cefotiam (CTM), flomoxef (FMOX) CMX, ceftazidime (CAZ), and LMOX were also active with the MIC90s of 0.25 microgram/ml. Penicillins were not so active with the MIC90s of 128 micrograms/ml or above. 7. Klebsiella pneumoniae. CRMN showed the highest activities against K. pneumoniae. Its MIC90 was < or = 0.125 microgram/ml. CZOP was also active with the MIC90 of 0.25 microgram/ml. Penicillins were not so active with the MIC90s of 128 micrograms/ml or above. 8. Proteus mirabilis. P. mirabilis was susceptible to a majority of drugs. CMX, CAZ, LMOX, CRP, cefpodoxime (CPDX), CRMN, CPFX and TFLX showed the highest activities against P. mirabilis isolated from patients with urinary tract infections. The MIC90s of them were 0.125 microgram/ml or below. MINO was not so active with the MIC90 of 128 micrograms/ml. 9. Pseudomonas aeruginosa. Most of the agents were not so active against P. aeruginosa. IPM showed MIC90 of 8 micrograms/ml. The others were not so active with the MIC90s of 16 micrograms/ml or above. CPFX showed MIC50 of 0.5 microgram/ml.

[Efficacy of the chemosensitivity test using collagen gel matrix-supported culture system for urogenital tumors]

BACKGROUND

We evaluated the usefulness of in vitro tumor culture system using a specialized collagen gel matrix (CGM assay) as a chemosensitivity test.

PATIENTS AND METHODS

Chemosensitivity results of CGM assay were compared with other in vivo and in vitro assays on an implantable murine bladder tumor cell line (MBT-2). In addition we investigated the possibility of the clinical use of CGM assay using clinical specimens obtained from urogenital malignant tumor patients by comparing the result with that of the other chemosensitivity test, SDI testing using single cells (conventional SDI test). Methods of CGM assay were as follows. Tumor tissues on the collagen gel matrices were incubated under the existence of anticancer drugs following 4 days preculture. Drug sensitivities were evaluated by counting the number of viable cells adjusted to the tumor weight.

RESULTS

Inhibition rates in MBT-2 were high in the order of mitomycin C, cisdiamminedichloroplatinum (II), (2"R)-4'-0-tetrahydropyranyl adriamycin. Four of 6 anticancer drugs were decided as chemosensitive drugs. These results corresponded to the results of the antitumor effects on subcutaneously transplanted MBT-2 in vivo, moreover was correlated well with those of the conventional SDI test. Twenty of 22 cases, including 11 of 13 bladder cancer cases, 1 of 3 renal cancer cases, 2 of 3 testicular cancer cases and 1 of 1 adrenal cortical cancer cases, were evaluable in the clinical study of the CGM assay. Corresponding rates between the results of the CGM assay and those of the conventional SDI test performed simultaneously in 12 cases were excellent for each anticancer drug.

CONCLUSION

This CGM assay can serve as an effective tool for chemosensitivity testing because of its convenience and high evaluable rate.

[Clinical early phase II study of bicalutamide (Casodex) in patients with prostatic cancer]

To investigate the efficacy and safety of bicalutamide (Casodex) with its clinically recommended dose, the randomized early phase II study was performed in 124 patients with prostatic cancer (stage C, D). The patients were given 50, 80 or 100 mg of bicalutamide orally once a day in fixed doses for 12 weeks; 122 patients were eligible for evaluation. The overall response rate was 50.0% (20/40), 61.0% (25/41) and 53.7% (22/41) in the 50 mg, 80 mg and 100 mg groups, respectively. The response rate in prostate lesion, bone and lymph node metastases was slightly higher in the 80 mg group than in the 50 mg and 100 mg groups. The proportion of patients showing a response with regard to serum PSA (CR and PR) was 84.2, 92.7 and 97.6% in the 50, 80 and 100 mg groups, respectively. The incidence of adverse reactions was 65.0, 61.0 and 61.0% in the 50, 80 and 100 mg groups, respectively, and there was no significant difference in overall safety rating in the three groups. Frequent adverse reactions were gynecomastia and breast pain. Only one patient in the 80 mg group was withdrawn due to shortness of breath. Serum concentrations of LH, testosterone and estradiol increased significantly after treatment. Bicalutamide was concluded to be effective and well tolerated in patients with prostatic cancer, and its recommended dose was 80 mg once daily.

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from urinary tract infections (1993). III. Secular changes in susceptibility]

Susceptibilities of Enterococcus faecalis, Staphylococcus aureus, Citrobacter spp., Enterobacter spp., Escherichia coli, Klebsiella spp., Proteus mirabilis, Pseudomonas aeruginosa and Serratia spp. isolated from patients with urinary tract infections (UTIs) in 10 hospitals during June 1993 to May 1994 to various antimicrobial agents were compared with those in the same period of previous years according to a classification, uncomplicated UTIs, complicated UTIs without indwelling catheter, and complicated UTIs with indwelling catheter. The susceptibilities of E. faecalis to chloramphenicol decreased. As for S. aureus, susceptible strains to minocycline (MINO) decreased in complicated UTIs. As for Citrobacter spp., and Enterobacter spp., their susceptibilities were not observed an obvious change. Against E. coli, the activities of cefotiam decreased in complicated UTIs, and aminoglycosides decreased. As for Klebsiella spp., susceptible strains to aminoglycosides decreased. The susceptibilities of P. mirabilis to all drugs except aminoglycosides and MINO were good. The susceptibilities of P. aeruginosa to quinolones isolated from complicated UTIs with indwelling catheter increased, but susceptible strains to aminoglycosides decreased. The susceptibilities of Serratia spp. to MINO has decreased. These data should be considered in clinical treatment of various urinary tract infections.

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from urinary tract infections (1992). III. Secular changes in susceptibility]

Susceptibilities of Enterococcus faecalis, Staphylococcus aureus, Citrobacter spp., Enterobacter spp., Escherichia coli, Klebsiella spp., Proteus mirabilis, Pseudomonas aeruginosa and Serratia spp. isolated from patients with urinary tract infections (UTIs) in 11 hospitals during June 1992 to May 1993 to various antimicrobial agents were compared with those in the same period of previous years according to a classification, uncomplicated UTIs, complicated UTIs without indwelling catheter, and complicated UTIs with indwelling catheter. The susceptibilities of E. faecalis isolated from uncomplicated UTIs to quinolones has decreased. As for S. aureus, Citrobacter spp., Enterobacter spp., P. mirabilis and Serratia spp., which were detected very few in 1989, 1990, 1991 and 1992, their susceptibilities were not observed an obvious change. E. coli, all strains were highly susceptibilities to latamoxef and cefozopran. And the susceptibilities of E. coli isolated from uncomplicated UTIs and complicated UTIs without indwelling catheter to minocycline has decreased in 1991, but they has been indicated a trend of recovery in 1992. The difference in according UTI's classification of the susceptibilities of Klebsiella spp. to minocycline in 1991 has not recognized in 1992. And the susceptibilities of Klebsiella spp. isolated from complicated UTIs without indwelling catheter to quinolones has decreased. The susceptibilities of P. aeruginosa isolated from complicated UTIs to quinolones has been indicated a trend of recovery. These data should be considered in clinical treatment of various urinary tract infections.

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from urinary tract infections (1993). II. Background of patients]

Clinical background was investigated on 734 bacterial strains isolated from patients with urinary tract infections (UTIs) in 10 hospitals during the period from June, 1993 to May, 1994. 1. Distribution of sex, age and infections Among over fifties males, the majority was taken by complicated urinary tract infections. Among females, the uncomplicated urinary tract infections was most frequent without a relation of age. 2. Distribution of sex, age and pathogens isolated from UTIs In uncomplicated UTIs, Escherichia coli was most frequently isolated without a relation of age, and next Klebsiella spp. and CNS. In complicated UTIs without indwelling catheter, E. coli and Enterococcus faecalis were the most frequent. In complicated UTIs with indwelling catheter, Pseudomonas aeruginosa were most frequently isolated, and next E. faecalis. 3. The frequency of complexed infections in UTIs The frequency of complexed infections has increased from in uncomplicated UTIs to complicated UTIs. 4. Administration of antibiotics and pathogens isolated from UTIs In uncomplicated UTIs, pathogens, after administration of antibiotics, isolated from patients have obviously decreased from 222 to 33 isolates. And also, pathogens of complicated UTIs without indwelling catheter, have decreased from 205 to 50 isolates. However, in complicated UTIs with indwelling catheter, pathogens after or before administration of antibiotics, were not revealed an obvious change. 5. Pathogens and UTIs with or without factor and operation In uncomplicated UTIs with or without factor and operation, E. coli was mainly detected. In complicated UTIs without indwelling catheter and with or without factor and operation, E. coli and E. faecalis were mainly detected. In complicated UTIs with indwelling catheter and with factor and operation, P. aeruginosa and E. faecalis were mainly detected, 22.0% and 14.1%, respectively. Without factor and operation, was detected, E. faecalis 21.1%, and next Proteus spp. 15.8%. The distribution of pathogens, in the case of Serratia spp., has been obviously varied by the influence of factor and operation.

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from urinary tract infections (1992). I. Susceptibility distribution]

The frequencies of isolation and susceptibilities to antimicrobial agents were investigated on 732 bacterial strains isolated from patients with urinary tract infections in 11 hospitals during the period of June 1992 to May 1993. Of the above total bacterial isolates, Gram-positive bacteria accounted for 35.4% and a majority of them were Enterococcus faecalis. Gram-negative bacteria accounted for 64.6% and most of them were Escherichia coli. 1. Enterococcus faecalis Ampicillin (ABPC), imipenem (IPM) and vancomycin (VCM) showed the highest activities against E. faecalis isolated from patients with urinary tract infections. The MIC90S of them were 2 micrograms/ml. Piperacillin (PIPC) was also active with the MIC90 of 8 micrograms/ml. The others except chloramphenicol (CP) were not so active with the MIC90S of 32 micrograms/ml or above. 2. Staphylococcus aureus including MRSA VCM showed the highest activities against S. aureus isolated from patients with urinary tract infections. Its MIC90 was 1 microgram/ml. Arbekacin (ABK) was also active with the MIC90 of 2 micrograms/ml. The others were not so active with the MIC90S of 32 micrograms/ml or above. 3. Staphylococcus epidermidis ABK showed the highest activities against S. epidermidis isolated from patients with urinary tract infections. Its MIC90 was 0.5 microgram/ml. Cefotiam (CTM) and VCM were also active with the MIC90S of 2 micrograms/ml. Penicillins except ABPC, gentamicin (GM), clindamycin (CLDM) and quinolones were not so active with the MIC90S of 64 micrograms/ml or above. 4. Streptococcus agalactiae Most of the agents were active against S. agalactiae isolated from patients with urinary tract infections. Penicillins, cephems, erythromycin (EM), and CLDM showed the highest activities. The MIC90S of them were 0.25 microgram/ml or below. Amikacin (AMK) and minocycline (MINO) were not so active with the MIC90S of 32 micrograms/ml or above. 5. Citrobacter freundii IPM showed the highest activities against C. freundii isolated from patients with urinary tract infections. Its MIC90 was 1 microgram/ml. Cefozopran (CZOP) and amikacin (AMK) were also active with the MIC90S of 4 micrograms/ml. Penicillins and cephems generally were not so active. 6. Enterobacter cloacae IPM and GM showed the highest activities against E. cloacae. The MIC90S of them were 0.5 microgram/ml. Ciprofloxacin (CPFX) and tosufloxacin (TFLX) were also active with the MIC90S of 4 micrograms/ml. Penicillins and cephems generally showed lower activities. 7. Escherichia coli Most of the agents were active against E. coli. Flomoxef (FMOX), cefmenoxime (CMX), CZOP, IPM, carumonam (CRMN), norfloxacin (NFLX), ofloxacin (OFLX), CPFX and TFLX showed the highest activities against E. coli. The MIC90S of them were 0.125 microgram/ml or below. Cefotiam (CTM), ceftazidime (CAZ), cefuzonam (CZON) and latamoxef (LMOX) were also active with the MIC90S of 0.25 microgram/ml. Penicillins were not so active with the MIC90S of 32 micrograms/ml or above. 8. Klebsiella pneumoniae Most of the agents were active against K. pneumoniae. FMOX, CMX, CZOP and CRMN showed the highest activities. The MIC90S of them were 0.125 microgram/ml or below. But ampicillin (ABPC) was not so active with the MIC90 of 128 micrograms/ml. 9. Proteus mirabilis Most of the agents were active against P. mirabilis. FMOX, CMX, CAZ, CZON, LMOX, CFIX, CPDX, CRMN, NFLX, CPFX and TFLX showed the highest activities against P. mirabilis isolated from patients with urinary tract infections. The MIC90S of them were 0.125 microgram/ml or below. ABPC and MINO were not so active with the MIC90S of 256 micrograms/ml or above. 10. Pseudomonas aeruginosa Most of the agents were not so active against P. aeruginosa. IPM showed MIC90 of 8 micrograms/ml. Cefclidin (CFCL) and AMK showed MIC90S o

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from urinary tract infections (1993). I. Susceptibility distribution]

The frequencies of isolation and susceptibilities to antimicrobial agents were investigated on 657 bacterial strains isolated from patients with urinary tract infections in 10 hospitals during the period of June 1993 to May 1994. Of the above total bacterial isolates, Gram-positive bacteria accounted for 28.3% and a majority of them were Enterococcus faecalis. Gram-negative bacteria accounted for 71.7% and most of them were Escherichia coli. 1. Enterococcus faecalis Ampicillin (ABPC), imipenem (IPM) and vancomycin (VCM) showed the highest activities against E. faecalis isolated from patients with urinary tract infections. The MIC90s of them were 2 micrograms/ml. Piperacillin (PIPC) was also active with the MIC90 of 8 micrograms/ml. The others were not so active with the MIC90s of 32 micrograms/ml or above. 2. Staphylococcus aureus including MRSA VCM showed the highest activities against S. aureus isolated from patients with urinary tract infections. Its MIC90 was 1 microgram/ml. Arbekacin (ABK) was also active with the MIC90 of 2 micrograms/ml. The others were not so active with the MIC90s of 32 micrograms/ml or above. 3. Staphylococcus epidermidis VCM showed the strongest activity against S. epidermidis isolated from patients with urinary tract infections. Its MIC90 was 1 microgram/ml. ABK was also active with the MIC90 of 4 micrograms/ml. The others except ABPC were not so active with the MIC90s of 32 micrograms/ml or above. 4. Streptococcus agalactiae Most of the agents were active against S. agalactiae isolated from patients with urinary tract infections. Penicillins, cephems, erythromycin (EM), and clindamycin (CLDM) showed the highest activities. The MIC90s of them were 0.25 microgram/ml or below. Amikacin (AMK) and minocycline (MINO) showed somewhat low activities with the MIC90s of 16 micrograms/ml. 5. Citrobacter freundii IPM showed the highest activities against C. freundii isolated from patients with urinary tract infections. Its MIC90 was 2 micrograms/ml. Cefozopran (CZOP) and gentamicin (GM) were also active with the MIC90s of 8 micrograms/ml. Penicillins and cephems generally were not so active. 6. Enterobacter cloacae IPM and GM showed the highest activities against E. cloacae. The MIC90s of them were 1 microgram/ml. CZOP and tosufloxacin (TFLX) were also active with the MIC90s of 8 micrograms/ml. Penicillins and cephems except CZOP showed lower activities with the MIC90s of 64 micrograms/ml or above. 7. Escherichia coli Most of antimicrobial agents were active against E. coli. Flomoxef (FMOX), CZOP, IPM, CPFX and TFLX showed the highest activities against E. coli. The MIC90s of them were 0.125 microgram/ml or below. Cefmenoxime (CMX), ceftazidime (CAZ), cefuzonam (CZON), latamoxef (LMOX), carumonam (CRMN), norfloxacin (NFLX) and ofloxacin (OFLX) were also active with the MIC90s of 0.25 microgram/ml. Penicillins and MINO were not so active with the MIC90s of 32 micrograms/ml or above. 8. Klebsiella pneumoniae CZOP, IPM and CRMN showed the highest activities against K. pneumoniae. The MIC90s of them were 0.125 microgram/ml or below. CAZ, CZON, CFIX, CPFX and TFLX were also active the MIC90s of 0.25 microgram/ml. Penicillins were not so active with the MIC90s of 128 micrograms/ml or above. 9. Proteus mirabilis P. mirabilis was susceptible to a majority of drugs. CMX, CAZ, CZON, LMOX, CFIX, CRMN and CPFX showed the highest activities against P. mirabilis isolated from patients with urinary tract infections. The MIC90s of them were 0.125 microgram/ml or below. MINO was not so active with the MIC90 of 256 micrograms/ml or above. 10. Pseudomonas aeruginosa Most of the agents were not so active against P. aeruginosa. IPM showed MIC90 of 8 micrograms/ml.

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from urinary tract infections (1992). II. Background of patients]

Clinical background was investigated on 913 bacterial strains isolated from patients with urinary tract infections (UTIs) in 11 hospitals during the period from June, 1992 to May, 1993. 1. Distribution of sex, age and infections Among over forties males, the majority was taken by complicated urinary tract infections. Among females, the uncomplicated urinary tract infections was most frequent without a relation of age. 2. Distribution of sex, age and pathogens isolated from UTIs IN uncomplicated UTIs, Escherichia coli was most frequently isolated without a relation of age, and next CNS in under fifties. In complicated UTIs without indwelling catheter, E. coli and Enterococcus faecalis were isolated with a frequency of 12-28%, respectively. In complicated UTIs with indwelling catheter, Pseudomonas aeruginosa were most frequently isolated, and next E. faecalis. 3. Administration of antibiotics and pathogens isolated from UTIs In uncomplicated UTIs, pathogens, after administration of antibiotics, isolated from patients have obviously decreased from 306 to 44 isolates. And also, pathogens of complicated UTIs without indwelling catheter, have decreased from 217 to 76 isolates. However, in complicated UTIs with indwelling catheter, pathogens after or before administration of antibiotics, were not revealed an obvious change. 4. Pathogens and UTIs with or without factor and operation In uncomplicated UTIs with or without factor and operation, E. coli was mainly detected. In complicated UTIs without indwelling catheter and with or without factor and operation, E. coli was mainly detected. In complicated UTIs with indwelling catheter and with factor and operation, P. aeruginosa and E. faecalis were detected, 19.6% and 16.0%, respectively. Without factor and operation, P. aeruginosa was detected, 28.9%, and next E. faecalis 13.3%. The distribution of pathogens after administration of antibiotics was similar.

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from urinary tract infections (1991). I. Susceptibility distribution]

The frequencies of isolation and susceptibilities to antimicrobial agents were investigated on 751 bacterial strains isolated from patients with urinary tract infections in 11 hospitals during the period of June 1991 to May 1992. Of the above total bacterial isolates, Gram-positive bacteria accounted for 28.6% and a majority of them were Enterococcus faecalis. Gram-negative bacteria accounted for 71.4% and most of them were Escherichia coli. 1. Enterococcus faecalis Ampicillin (ABPC), imipenem (IPM) and vancomycin (VCM) showed the highest activities against E. faecalis isolated from patients with urinary tract infections. The MIC90s of them were 2 micrograms/ml. Piperacillin (PIPC) and chloramphenicol (CP) were also active with the MIC90s of 8 micrograms/ml. The others were not so active with the MIC90s of 32 micrograms/ml or above. 2. Staphylococcus aureus including MRSA Arbekacin (ABK) showed the highest activities against S. aureus isolated from patients with urinary tract infections. Its MIC90 was 0.5 microgram/ml. VCM was also active with its MIC90 of 1 microgram/ml. The others were not so active with the MIC90s of 32 micrograms/ml or above. 3. Citrobacter freundii Ciprofloxacin (CPFX) showed the highest activities against C. freundii isolated from patients with urinary tract infections. Its MIC90 was 0.5 microgram/ml. IPM, gentamicin (GM), ABK and norfloxacin (NFLX) were also active with the MIC90s of 1 microgram/ml. Penicillins and cephems were not so active. 4. Enterobacter cloacae IPM showed the highest activities against E. cloacae isolated from patients with urinary tract infections. Its MIC90 was 0.5 microgram/ml. CPFX was also active with the MIC90 of 2 micrograms/ml. Aminoglycosides were active comparatively. The MIC90s of them were 4 micrograms/ml. Penicillins and cephems generally showed lower activities. 5. Escherichia coli IPM and ciprofloxacin (CPFX) showed the highest activities against E. coli isolated from patients with urinary tract infections. The MIC90s of them were 0.125 micrograms/ml or below. Flomoxef (FMOX), cefmenoxime (CMX), cefuzonam (CZON), latamoxef (LMOX), norfloxacin (NFLX) and ofloxacin (OFLX) were also active with the MIC90s of 0.25 microgram/ml. Penicillins except mecillinam (MPC) were not so active showing the MIC90s of 32 micrograms/ml or above. 6. Klebsiella pneumoniae IPM showed the highest activities against K. pneumoniae isolated from patients with urinary tract infections. Its MIC90 was 0.25 microgram/ml. Gentamicin (GM) and arbekacin (ABK) were also active with the MIC90s of 0.5 microgram/ml, respectively. But minocycline (MINO) and penicillins were not so active showing the MIC90s of 32 micrograms/ml or above. 7. Proteus mirabilis Most of the agents were active against P. mirabilis.(ABSTRACT TRUNCATED AT 400 WORDS)

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from urinary tract infections (1991). II. Background of patients]

Clinical background was investigated on 632 bacterial strains isolated from patients with urinary tract infections (UTIs) in 11 hospitals during the period from June, 1991 to May, 1992. 1. Distribution of sex, age and infections Among over forties males, the majority was taken by complicated urinary tract infections. Among females, the uncomplicated urinary tract infections was most frequent without a relation of age. 2. Distribution of sex, age and pathogens isolated from UTIs In uncomplicated UTIs, Escherichia coli was most frequently isolated without a relation of age, and next Enterococcus faecalis in over fifties. In complicated UTIs without indwelling catheter, E. coli and E. faecalis were isolated with a frequency of 17.4-26.6%, respectively. In complicated UTIs with indwelling catheter, E. faecalis were most frequently isolated, and next Pseudomonas aeruginosa. 3. Administration of antibiotics and pathogens isolated from UTIs In uncomplicated UTIs, pathogens, after administration of antibiotics, isolated from patients have obviously decreased from 319 to 34 isolates. And also, pathogens of complicated UTIs without indwelling catheter, have decreased from 122 to 49 isolates. However, in complicated UTIs with indwelling catheter, pathogens after or before administration of antibiotics, were not revealed an obvious change. 4. Pathogens and UTIs with or without factor and operation In uncomplicated UTIs with or without factor and operation, E. coli was mainly detected. In complicated UTIs without indwelling catheter and with or without factor and operation, E. faecalis and E. coli were mainly detected. In complicated UTIs with indwelling catheter and with factor and operation, E. faecalis and P. aeruginosa were detected, 24.3% and 22.9%, respectively. Without factor and operation, E. faecalis was detected 18.4%, and next Klebsiella spp. 15.8%. And the distribution of pathogens after administration of antibiotics was similar.

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from urinary tract infections (1990). II. Background of patients]

Clinical background was investigated on 861 bacterial strains isolated from patients with urinary tract infections (UTIs) in 10 hospitals during the period from June, 1990 to May, 1991. 1. Distribution of sex, age and infections: Among over fifties males, the complicated urinary tract infections was most frequent. Among females, the uncomplicated urinary tract infections was most frequent without a relation of age. 2. Distribution of sex, age and pathogens isolated from UTIs: In uncomplicated UTIs, Escherichia coli was most frequently isolated without a relation of age. In complicated UTIs without indwelling catheter, E. coli and Enterococcus faecalis were isolated with a frequency of 20-30%, respectively. In complicated UTIs with indwelling catheter, Pseudomonas aeruginosa were most frequently isolated, and next E. faecalis. 3. Administration of antibiotics and pathogens isolated from UTIs: In uncomplicated UTIs and complicated UTIs without indwelling catheter, pathogens, after administration of antibiotics, isolated from patients have obviously decreased. In complicated UTIs with indwelling catheter, pathogens, before and after administration of antibiotics, isolated from patients were not decreased. And the distribution of pathogens after administration of antibiotics was similar.

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from urinary tract infections (1990). III. Secular changes in susceptibility]

Susceptibilities of Enterococcus faecalis, Citrobacter spp., Enterobacter spp., Escherichia coli, Klebsiella spp., Proteus mirabilis, Pseudomonas aeruginosa, Serratia spp. isolated from patients with urinary tract infections (UTIs) in 10 hospitals during June 1990 to May 1991 to various antimicrobial agents were compared with those in the same period of previous years according to a classification, uncomplicated UTIs, complicated UTIs without indwelling catheter, and complicated UTIs with indwelling catheter. The susceptibilities of E. faecalis to minocycline (MINO) and ofloxacin (OFLX) has decreased. As for Citrobacter spp., Enterobacter spp. and P. mirabilis, which were detected very few in 1989 and 1990, their susceptibilities were not observed an obvious change. The susceptibilities of E. coli to MINO was observed a very clear alteration, that is, in uncomplicated UTIs and complicated UTIs, the susceptibilities has decreased. However, the susceptibilities of Klebsiella spp., P. aeruginosa and Serratia spp. were not observed an obvious variation.

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from urinary tract infections (1990). I. Susceptibility distribution]

The frequencies of isolation and susceptibilities to antimicrobial agents were investigated on 848 bacterial strains isolated from patients with urinary tract infections in 10 hospitals during the period of June 1990 to May 1991. Of the above total bacterial isolates, Gram-positive bacteria accounted for 23.9% and a majority of them were Enterococcus faecalis. Gram-negative bacteria accounted for 76.1% and most of them were Escherichia coli. 1. Enterococcus faecalis: Ampicillin (ABPC), imipenem (IPM) and vancomycin (VCM) showed the highest activities against E. faecalis isolated from patients with urinary tract infections. The MIC90s of them were 2 micrograms/ml. Piperacillin (PIPC) was also active with the MIC90 of 4 micrograms/ml. The others were not so active with the MIC90s of 32 micrograms/ml or above. 2. Staphylococcus aureus: VCM and arbekacin (ABK) showed the highest activities against S. aureus isolated from patients with urinary tract infections. The MIC90s of them were 1 micrograms/ml. The others were not so active with the MIC90s of 32 micrograms/ml or above. 3. Escherichia coli: Cefozopran (CZOP), carumonam (CRMN) and ofloxacin (OFLX) showed the highest activities against E. coli isolated from patients with urinary tract infections. The MIC90s of them were of 0.125 microgram/ml or below. IPM, cefotiam (CTM) and cefmenoxime (CMX) were also active with the MIC90s of 0.25 micrograms/ml. Penicillins were not so active with the MIC90s of 32 micrograms/ml or above. 4. Klebsiella pneumoniae: Flomoxef (FMOX), cefixime (CFIX), CZOP and CRMN showed the highest activities against K. pneumoniae isolated from patients with urinary tract infections. The MIC90s of them were of 0.125 microgram/ml or below. IPM and gentamicin (GM) were also active with the MIC90s of 0.25 microgram/ml and 0.5 microgram/ml, respectively. All other cephems were also active with the MIC90s of 4 micrograms/ml or below. 5. Citrobacter freundii: GM and IPM showed the highest activities against C. freundii isolated from patients with urinary tract infections. The MIC90s of them were 1 microgram/ml. Amikacin (AMK) was also active with the MIC90 of 4 micrograms/ml. The others were not so active. 6. Enterobacter cloacae: IPM and GM showed the highest activities against E. cloacae isolated from patients with urinary tract infections. The MIC90s of them MIC90s of 0.5 microgram/ml. AMK and OFLX were also active with the MIC90s of 4 micrograms/ml. Penicillins and cephems generally showed lower activities. 7. Proteus mirabilis: Most of the agents were active against P. mirabilis. Cephems were generally active with the MIC90s in a range of < or = 0.125 microgram/ml-4 micrograms/ml.(ABSTRACT TRUNCATED AT 400 WORDS)

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from urinary tract infections (1991). III. Secular changes in susceptibility]

Susceptibilities of Enterococcus faecalis, Citrobacter spp., Enterobacter spp., Escherichia coli, Klebsiella spp., Proteus mirabilis, Pseudomonas aeruginosa and Serratia spp. isolated from patients with urinary tract infections (UTIs) in 11 hospitals during June 1991 to May 1992 to various antimicrobial agents were compared with those in the same period of previous years according to a classification, uncomplicated UTIs, complicated UTIs without indwelling catheter, and complicated UTIs with indwelling catheter. The susceptibilities of E. faecalis to cefmenoxime and amikacin has decreased. As for Citrobacter spp., Enterobacter spp., P. mirabilis and Serratia spp., which were detected very few in 1989, 1990 and 1991, their susceptibilities were not observed an obvious change. The susceptibilities of E. coli to minocycline was observed a very clear alteration, that is, in uncomplicated UTIs and complicated UTIs without indwelling catheter, the susceptibilities has decreased. However, the susceptibilities of Klebsiella spp. was not observed an obvious variation. The susceptibilities of P. aeruginosa to quinolones isolated from uncomplicated UTIs has clearly decreased. These data should be considered in clinical treatment of various urinary tract infections.

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from urinary tract infections (1989). I. Susceptibility distribution]

The frequencies of isolation and susceptibilities to antimicrobial agents were investigated on 1,032 bacterial strains isolated from patients with urinary tract infections in 10 hospitals during the period of June 1989 to May 1990. Of the above total bacterial isolates, Gram-positive bacteria accounted for 30.8% and a majority of them were Enterococcus faecalis. Gram-negative bacteria accounted for 69.2% and most of them were Escherichia coli. 1. Enterococcus faecalis Imipenem (IPM) showed the highest activity against E. faecalis isolated from patients with urinary tract infections. The followings, ampicillin (ABPC) and vancomycin (VCM) showed potent activities, with the MIC90S of 2 micrograms/ml. Piperacillin (PIPC), minocycline (MINO) and chloramphenicol (CP) were also active with the MIC90S of 8 micrograms/ml. The others were not so active with the MIC90S of 32 micrograms/ml or above. 2. Staphylococcus aureus VCM showed the highest activity against S. aureus with MIC90 of 1 microgram/ml. Dicloxacillin (MDIPC) and arbekacin (ABK) were active with the MIC90S of 2 micrograms/ml. MINO showed the MIC90 of 4 micrograms/ml. All other agents except ciprofloxacin (CPFX) showed lower activity. 3. Staphylococcus epidermidis MINO showed the highest activity against S. epidermidis. Its MIC90 was 0.25 microgram/ml. The followings, ABK and VCM were also active with the MIC90S of 0.5 microgram/ml, 2 micrograms/ml, respectively. The others except CPFX were not so active. 4. Coagulase-negative staphylococci (CNS) Most of the agents were active against CNS. IPM, ABK and MINO showed the highest activities with the MIC90S of 0.125 microgram/ml or below. MDIPC, cefazolin (CEZ), cefotiam (CTM) and VCM were also active with the MIC90S of 1 microgram/ml. Clindamycin (CLDM) showed lower activity, with the MIC90 of 128 micrograms/ml. 5. Streptococcus agalactiae CEZ, cefuzonam (CZON), IPM and CLDM showed the potent activity, all strains were inhibited at the MIC of 0.125 microgram/ml or below. The followings, cefmenoxime (CMX) and erythromycin (EM) were active with the MIC90S of 0.125 microgram/ml or below. PIPC and VCM were also active with the MIC90S 0.25 microgram/ml and 0.5 microgram/ml, respectively Amikacin (AMK) showed lower activity. Escherichia coli IPM, CTM, flomoxef (FMOX), CMX, carumonam (CRMN), norfloxacin (NFLX), ofloxacin (OFLX) and CPFX showed the highest activities against E. coli. The MIC90S of them were .125 microgram/ml or below. ceftazidime (CAZ) and CZON were also active with the MIC90S of 0.25 microgram/ml. Penicillins except mecillinam (MPC) were not so active showing the MIC90S of 32 micrograms/ml or above. 7. Klebsiella pneuminiae FMOX, CMX, cefixime (CFIX), IPM, CRMN and NFLX showed the highest activities against K. pneumoniae.(ABSTRACT TRUNCATED AT 400 WORDS)

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from urinary tract infections (1989). II. Background of patients]

Clinical background was investigated on 1,197 bacterial strains isolated from patients with urinary tract infections (UTIs) in 10 hospitals during the period from June, 1989 to May, 1990. 1. Distribution of sex and age A majority of female patients with UTIs accounted for a twenties and thirties. The proportion of male patients with UTI has increased with age, accounting for majority in patients 70 years or older. 2. Distribution of infection types and age Most cases among twenties or thirties were uncomplicated UTIs. Fifties and older cases were most frequent in complicated UTIs. 3. Distribution of isolated bacteria and age Escherichia coli was most frequent on the whole, followed by Enterococcus faecalis, Pseudomonas aeruginosa, Staphylococcus spp. and Klebsiella spp.. E. coli had declined with age, and on the other hand, E. faecalis and P. aeruginosa had increased with age. 4. Administration of antibiotics and pathogens isolated from UTIs. In uncomplicated UTIs, pathogens, after administration of antibiotics, isolated from patients have obviously decreased from 439 to 4. Before an administration of antibiotics, E. coli was mainly detected, but after an administration of antibiotics, E. coli has decreased into two strains. After administration of antibiotics, pathogens of complicated UTIs, without indwelling catheter, have decreased from 324 to 19: E. coli has decreased from 86 to 2, but E. faecalis, Staphylococcus spp., Enterobacter spp. and P. aeruginosa have increased. Pathogens of complicated UTIs with indwelling catheter, have decreased from 156 to 14 after administration of antibiotics, and mainly isolated pathogens were E. faecalis and P. aeruginosa.

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from urinary tract infections (1989). III. Secular changes in susceptibility]

Susceptibilities of Citrobacter spp., Enterobacter spp., Escherichia coli, Klebsiella spp., Proteus mirabilis, Pseudomonas aeruginosa, Serratia spp. isolated from patients with urinary tract infections (UTIs) in 10 hospitals during June 1989 to May 1990 to various antimicrobial agents were compared with those in the same period of previous years according to a classification, uncomplicated UTIs, complicated UTIs without indwelling catheter, and complicated UTIs with indwelling catheter. As for Citrobacter spp., P. mirabilis and Serratia spp., which were detected very few in 1989, their susceptibilities were not observed an obvious change. As for Enterobacter spp., the susceptible strains to flomoxef, cefixime, cefuzonam and ceftazidime increased in complicated UTIs with indwelling catheter. The susceptibilities of E. coli to penicillins increased slightly in complicated UTIs with indwelling catheter. Against Klebsiella spp., a good activity of minocycline or cephems was found. The susceptibilities of P. aeruginosa to ciprofloxacin and new quinolones increased in uncomplicated UTIs. These data should be considered in clinical treatment of various urinary tract infections.

[A case of adult Wilms' tumor with vena caval involvement]

The patient was a 35-year-old female with the chief complaint of macrohematuria. Computerized tomographic (CT) scan, ultrasonography and magnetic resonance imaging (MRI) revealed the presence of a large and inhomogeneous mass in the left kidney, and a tumor thrombus growing in the inferior vena cava. Angiography also showed a hypervascular tumor in the left kidney. The chest X-ray and CT scan demonstrated multiple metastatic lesions in the bilateral lungs. Radical nephrectomy and thrombectomy was performed under the diagnosis of left renal tumor with its invasion of inferior vena cava. Pathological findings revealed that this tumor was nephroblastoma, and its type was clear cell sarcoma of the kidney (CCSK). The patient received chemotherapy according to National Wilms' Tumor Study (NWTS) IV chemotherapeutic drug regimen. In general, CCSK is known to have poor prognosis. However, doxorubicin has been reported to have a relatively good antitumor effect for CCSK. However, in this case, the evaluation after the first course of chemotherapy was progressive disease, because some new lesions appeared, although most old pulmonary metastatic lesions were reduced.

[A case of adult mature nephroblastic tumor]

A 22-year-old woman had a well differentiated nephroblastic tumor. The tumor was composed of mesenchymal elements with mature tubules and occasionally smooth muscle elements. None of the cellular elements showed any feature indicative of malignancy. Histologically this was similar to congenital mesoblastic nephroma, but the tumor showed an evidence of a uniform expansile growth. It was considered to be a form of mature nephroblastoma.

Potentiation of antitumor effect of bleomycin by local electric pulses in mouse bladder tumor

C3H mice bearing subcutaneously transplanted mouse bladder carcinoma (MBT-2) were treated with intramuscular injection of bleomycin followed by local delivery of electric pulses at the tumor site. The tumors markedly reduced and even disappeared for several days after this treatment. Neither electric pulses nor bleomycin administration alone showed a significant inhibitory effect on the tumor growth. Thus, it is demonstrated that in mouse bladder tumor the antitumor effect of bleomycin can be considerably potentiated by local electric pulses.

[Two cases of primary sclerosing lipogranuloma in scrotum--review of 63 cases reported in Japan]

We reported two cases of primary sclerosing lipogranuloma in the scrotum. We performed tumor resection in both cases, but in one of the two cases tumor recurrence was observed 7 days after the removal. Sixty-three cases have been reported in our country, and we discuss the diagnosis and treatment with reference to previous reports.

Calcium control of actin-myosin-based contraction in Triton-treated murine bladder tumor cells

Using mouse bladder tumor cells (MBT-2 cells) and epithelial cells, the present study evaluated the functional characteristics of the actomyosin system in bladder cancer cells. An immunofluorescence study demonstrated the presence of contractile proteins (actin and myosin) in MBT-2 cells as well as bladder epithelial cells. Triton-treated MBT-2 cells and epithelial cells showed a Ca(2+)-dependent contraction. This was inhibited by N-ethylmaleimide-modified myosin subfragment 1 (NEM-S1), demonstrating that the interaction between actin and myosin is responsible for the contraction of Triton-treated cells. The extent of Ca(2+)-dependent contraction was much greater in MBT-2 cells than in epithelial cells. These results suggest that MBT-2 cells possess a locomotive apparatus consisting of actin and myosin, and that Ca2+ can activate this actomyosin system, leading to the contraction or active locomotory movement of tumor cells.

Seasonal changes of parathyroid hormone in chronic hemodialysis patients

We investigated various factors related to secondary hyperparathyroidism among hemodialysis patients. Subjects were 26 patients (20 men and 6 women) ranging in age from 24 to 75, treated at an ordinary hemodialysis center throughout the year 1991. The serum inorganic phosphate level and serum intact PTH level varied greatly from 2.5 to 12.5 mg/dl and from 10 to 1,102 pg/ml (normal range, 10-60 pg/ml), respectively. All patients were classified according to the serum intact PTH level into two groups: those with less than 120 pg/ml (Group I) and those with 120 pg/ml or more (Group II). The patients in Group I responded well to hemodialysis and drug therapy, but those in Group II were likely to have secondary hyperparathyroidism. In all patients in Group II, the PTH level increased markedly in the summer. This may be attributed to insufficient ingestion of calcium, vitamins, and other nutrients due to loss of appetite.

Recording the bladder electromyogram for bladder activity evaluation during post-operative urinary urgency

When the intravesical pressure cannot be measured because of continuous drainage, bladder electromyography is an alternative means of evaluating the functional condition of the urinary bladder. However, many problems that accompany this procedure have not been solved. In the present study we tried bladder electromyography with a newly-developed carbon fiber electrode in a patient who underwent an open prostatectomy. It was helpful in recognizing the relationship between urinary urgency and the spasmic activity of the vesicular detrusor muscle.

[Clinical results of prophylactic intravesical chemotherapy on superficial bladder cancer using the dye exclusion assay]

A chemosensitivity test was carried out on superficial bladder cancer using the dye exclusion assay for the purpose of screening chemosensitive drugs for prophylactic intravesical chemotherapy. Bladder cancer cells of each patients were incubated, in vitro, in the presence of adriamycin, (2"R)-4'-0-tetrahydropyranyladriamycin, mitomycin C, pepleomycin and 4'-epi-adriamycin (500 micrograms/ml) at 5%, CO2, 37 degrees C for 2 hours. The cytotoxic effect of the drugs was evaluated by the ratio of stained cells by trypan-blue. The most effective drug was instilled postoperatively into the bladder 3 times for the first week, and every 2 weeks during the following 14 weeks. In 18 patients followed more than 4 months the prophylactic effect was evaluated. Fifteen of the 18 patients completed the protocol, but the remaining 3 patients failed to complete to the instillation because of severe irritability of the bladder. Tumor recurrence was demonstrated in two patients. Non-recurrence rates of tumors at 12 and 24 months were 93.8% and 82.0%, respectively. These results suggested that this rapid and handy assay was useful for the purpose of screening chemosensitive drugs for the intravesical chemotherapy.

Prototype of a reflux-preventing ureteral stent and its clinical use

We have experimentally produced a ureteral stent which prevents vesicorenal reflux. This stent has a thin silicon sleeve at its distal end (intravesical portion). In a model experiment the sleeve demonstrated an excellent capability to prevent reflux. The sleeve allowed flow of fluid with minimal pressure rise. A patient with bilateral ureteral obstruction was managed with endoscopic insertion of a sleeved stent in the right ureter and a usual pigtail stent in left ureter. During cystography vesicorenal reflux was not observed on the right side while reflux occurred on the left side. Excretory urography forty days after stent placement demonstrated recovery of renal function and maintenance of drainage in both renal units. Thus, the drainage characteristic of this stent appears to be approximately the same as that of usual stent.

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from urinary tract infections (1988). III. Secular changes in susceptibility]

Sensitivities to various antibacterial and antibiotic agents of strains of Escherichia coli, Klebsiella spp., Proteus spp., Citrobacter spp., Enterobacter spp., Serratia marcescens and Pseudomonas aeruginosa isolated from patients with urinary tract infections (UTIs) in 9 hospitals during June to November 1988 were compared with those in the same period of previous year according to a classification, uncomplicated UTIs, complicated UTIs without indwelling catheter, and complicated UTIs with indwelling catheter. No remarkable changes were found in sensitivities of E. coli, Proteus spp., Citrobacter spp. and S. marcescens. The sensitivity of Klebsiella spp. to cephems decreased in complicated UTI without indwelling catheter and increased in complicated UTI with indwelling catheter. The sensitivity of Enterobacter spp. to third generation cephems decreased in complicated UTI with indwelling catheter. Sensitivities of P. aeruginosa to aspoxicillin and cefsulodin increased. The number of resistant strains to new quinolones increased slightly.

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from urinary tract infections (1988). II. Background of patients]

Clinical background was investigated on 916 bacterial strains isolated from patients with urinary tract infections (UTIs) in 9 hospitals during the period from June to November, 1988. 1. Distribution of sexes, ages and infections: Among males, fifties and older were most frequent and most of them had complicated UTIs. Among females, most cases among twenties or thirties were uncomplicated UTIs. Forties and older cases were most frequent and complicated UTIs were more frequent among them than among patients in twenties and thirties. 2. Distribution of sexes, ages and pathogens isolated from UTIs: In males, Pseudomonas spp. and Enterococcus spp. were frequently isolated. In contrast, in females, Escherichia coli was the most frequent. In thirties, E. coli was not the most frequently isolated bacterium. Frequency of Pseudomonas spp., other non-fermented Gram-negative rods and Enterococcus spp. were greater among patients with higher ages. 3. Administration of antibiotics and pathogens isolated from UTIs: (1) Before administration: In uncomplicated UTIs, E. coli accounted for the majority of causative organisms. In complicated UTIs, particularly in those cases with indwelling catheter, Enterococcus spp. and Pseudomonas spp. were rather frequently isolated. (2) After administration: In complicated UTIs, higher number of pathogens were isolated. Pseudomonas spp. and Enterococcus spp. were the most frequent. Distribution of pathogens isolated from complicated UTIs without indwelling catheter was similar to that before antibiotic administration.

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from urinary tract infections (1988). I. Susceptibility distribution]

Isolation frequencies and sensitivities to antibacterial and antibiotic agents were investigated on 801 bacterial strains isolated from patients with urinary tract infections in 9 hospitals during the period of June to November 1988. Of the above total bacterial population, Gram-positive bacteria accounted for 29.3% and a majority of them were Enterococcus spp. Gram-negative bacteria accounted for 70.7% and most of them were Escherichia coli. 1. Enterococcus faecalis: Vancomycin was most active with its MIC90 < or = 0.78 microgram/ml. Ampicillin, piperacillin, ofloxacin (OFLX), ciprofloxacin (CPFX) and imipenem (IPM) were also active. 2. Staphylococcus aureus: Arbekacin and minocycline were most active with their MIC90s 0.39 microgram/ml and 1.56 micrograms/ml, respectively. Among penicillins, dicloxacillin was the most active. Activities of cephems were considerably lower. 3. E. coli: Most of the agents were tested active. Particularly the second and third generation cephems were active in a range of < or = 0.10-0.20 microgram/ml. Carumonam (CRMN), IPM, OFLX and CPFX were also active with MIC90s < or = 0.10 microgram/ml. 4. Klebsiella pneumoniae CRMN and IPM were highly active. Penicillins generally showed lower activities. Cephems and new quinolones had high activities with their MIC90s in a range of 0.39-0.78 microgram/ml. 5. Proteus mirabilis: The third generation cephems were active with their MIC90s in a range of < or = 0.10-0.20 microgram/ml. CRMN, OFLX and CPFX were also active with their MIC90s < or = 0.10 microgram/ml, 0.39 microgram/ml and 0.20 microgram/ml, respectively. 6. Pseudomonas aeruginosa: IPM and tobramycin were active with their MIC90s 1.56 micrograms/ml and 3.13 micrograms/ml, respectively. CRMN and new quinolones showed MIC80s of 25-100 micrograms/ml. Most of penicillins and cephems were not active. 7. Other Gram-negative rods: Against Citrobacter freundii, Enterobacter cloacae and Serratia marcescens, IPM, CPFX and OFLX were active. Penicillins and cephems were not so active. CRMN was active against S. marcescens with its MIC80 at 6.25 micrograms/ml.

[Visualization of the intravesical urine stream]

Although many urodynamic techniques have been used to evaluate the function of the lower urinary tract, the principles of these measurements are only based on a relationship between flow rate and pressure. In addition to these measurements, the intravesical urine stream would provide useful information on urodynamics. We have experimentally attempted to visualize the urine stream in a bladder using transrectal ultrasound examination. Since an air-particle is a good target for ultrasound visualization, we instillated a 10% glycerine solution into the bladder for the maintenance of air-particles. Before instillation, this glycerine solution was strongly shaken so that air-particles were kept in the solution. The urine stream was successfully observed throughout the whole process of voiding. In video-recording analysis, the velocity of urine stream was measured by tracing some air-particles. The velocity of urine stream was approximately 28.4 cm/sec in the body and increased to 116.6 cm/sec at the bladder neck. Thus, the urine stream was accelerated toward the urethra during voiding. Therefore, it seems that visualization of the urine stream offers a new parameter for evaluation of urodynamic studies.