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  • 1
    ISSN: 1440-1797
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary: Accumulation of the extracellular matrix (ECM) in IgA nephropathy (IgAN) is thought to cause deterioration of glomerular function. Stromelysin and tissue inhibitor of matrix proteinase 1 (TIMP1) may play an important role in the turnover of the glomerular ECM. However, the expression of these enzymes in human renal tissues remains undefined. In the present study, non-radioactive in situ mRNA hybridization, which permitted the analysis at a cellular level, was performed to localize stromelysin and TIMP1 in renal tissue of IgAN. We also determined the percentage of cells positive for stromelysin or TIMP1 mRNA among intraglomerular cells. A total of 16 patients with IgAN were examined, including eight patients with severe histopathological changes and eight with mild changes. Three patients without glomerular disease were also studied. Stromelysin and TIMP1 mRNA were weakly expressed in the mesangium of normal kidneys and IgAN renal tissues with mild damage. However, the expression of both mRNA was significantly increased in the area of mesangial proliferation, in glomerular epithelial cells and in Bowman's capsule of advanced lesions. Several cells in the area of mesangial proliferation were double positive for stromelysin and TIMP1 mRNA, while certain cells positive for stromelysin mRNA did not express TIMP1 mRNA. In the interstitium, epithelial cells of certain tubules and some mononuclear cells were positively stained for these mRNA, especially in advanced lesions. Our results indicated that stromelysin and TIMP1 genes were expressed in glomerular resident cells, tubular epithelial cells and infiltrated mononuclear cells in IgAN, and their expression was enhanced in advanced tissue damage. the demonstration of a co-expression and discordant expression of the genes indicates that each gene expression may be regulated in a cell type-specific manner and that it could also be altered by cellular environmental factors.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1437-7780
    Keywords: aspergillosis ; candidiasis ; combination therapy ; cryptococcosis ; miconazole ; flucytosine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This study evaluated combination therapy with miconazole and flucytosine for treating deep seated mycosis. Both mycological and clinical efficacy against candidemia and pulmonary cryptococcosis were satisfactory: All four isolatedCandida spp. were eradicated and all four patients with candidemia were cured, while six of nine patients with pulmonary cryptococcosis exhibited clinical improvement. The efficacy of combination therapy appeared to be low against aspergillosis, since only one of two patients with invasive pulmonary aspergillosis and two of five patients with pulmonary aspergilloma exhibited clinical improvement. Nevertheless, the clinical efficacy against aspergillosis was higher than that obtained with monotherapy in our previous study. Adverse reactions were observed in 36% (13 of 36) and abnormal laboratory findings in 22% (8 of 36) of patients treated with combination therapy; these rates were higher than those reported for monotherapy. These increases were not due to changes in serum concentrations of the two drugs due to simultaneous administration. The findings of this study suggest that combination therapy with miconazole and flucytosine may be an alternative therapy for refractory mycoses for carefully chosen patients.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1437-7780
    Keywords: Mycoplasma pneumoniae ; mycoplasmal pneumonia ; minocycline ; bacterial elimination
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Seventeen patients with mycoplasmal pneumonia were administered intravenous minocycline, a tetracycline antibiotic with long-acting effects. Excellent therapeutic effects were observed both clinically and bacteriologically. The organism was eliminated in a shorter period of time compared to other antibiotics used for the treatment ofMycoplasma pneumoniae infections. Aside from 1 patient who experienced nausea and vomiting and was taken off minocycline, no other adverse effects were noted in these patients. Minocycline should be strongly considered as therapy for mycoplasmal pneumonia because it may completely eradicate the organism within 7 days.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1437-7780
    Keywords: clarithromycin ; antimycobacterial agents ; chronic pulmonary infection ; Mycobacterium avium complex (MAC)
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Clarithromycin, a new macrolide antibacterial agent, is effective against disseminatedMycobacterium avium complex (MAC) infection in AIDS patients. In this study, we evaluated the therapeutic effect of clarithromycin, used in combination with other antimycobacterial drugs, against chronic pulmonary MAC infections in non-AIDS patients. Patients were divided into two groups based on the antimycobacterial drugs used for treatment. Patients of group A (n=5) were recent cases diagnosed to have atypical mycobacteriosis. They were treated on diagnosis, with rifampicin (450 mg q.d.), isoniazid (400 mg q.d.), and clarithromycin (200 mg b.i.d.). Patients of group B (n=23) were treated by adding clarithromycin (200 mg b.i.d.) to an existing therapeutic regimen consisting of several antimycobacterial agents. Clinical improvement was observed in seven (25%) patients, including two (40%) from group A and five (22%) from group B. Treatment was associated with a total mycobacterial eradication rate of 100% (5/5) in group A and 22% (5/23) in group B. Clarithromycin was more effective in patients receiving the drug as the first-line therapy than when used in later therapy. Clarithromycin had a lower efficacy rate in this study compared with the reported effect of clarithromycin in AIDS patients with in disseminated MAC infection. Our results of the first-line use of clarithromycin in combination with other mycobacterial agents for the treatment of chronic pulmonary MAC infections indicate that this agent has a limited but encouraging effect on atypical pulmonary mycobacteriosis.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Journal of infection and chemotherapy 1 (1996), S. 166-176 
    ISSN: 1437-7780
    Keywords: respiratory infection ; invasive technique ; bronchoscopic catheter method ; quantitative culture
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Conclusion Reviewing the history of diagnostic procedures of causative organisms of respiratory infections, invasive techniques such as the protected specimen catheter (PSB) and bronchoalveolar lavage (BAL) have become the preferred choices because they have many advantages. These methods cause the patient relatively little discomfort, and permit an early diagnosis since they can easily be performed at the bedside and the causative organism from the disease site is obtained in cultures. These procedures can be used not only in patients with community-acquired lung infections, but also in immunocompromised hosts, including those with blood diseases or following renal transplantation, in patients in intensive care units and in mechanically-ventilated patients so that the cause can be accurately determined and chemotherapy started quickly, resulting in better therapeutic efficacy. Although these invasive procedures are advantageous for the diagnosis of respiratory infections, they also present various problems which remain to be addressed including minimizing contamination and setting diagnostic threshold values. However, the importance of accurately determining the causative organism in respiratory infections should be recognized as the most important factor, and these methods have shown to date to provide the most accurate information to aid in the timely treatment of respiratory infections in a wide variety of patients.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Journal of infection and chemotherapy 1 (1996), S. 201-206 
    ISSN: 1437-7780
    Keywords: DU-6859a ; new quinolone ; clinical trial ; respiratory tract infection ; efficacy ; safety ; clinical utility
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The efficacy, safety, and clinical utility of DU-6859a, a novel “new quinolone” antibacterial agent, were evaluated in patients with mild-to-moderate pneumonia or chronic respiratory tract infection (RTI) in a multicenter study. DU-6859a was administered orally after meals at a dose of 50 to 100 mg, mainly twice daily, for 6 to 14 days. The clinical efficacy rate was 100% (26/26) for pneumonia and 89% (66/74) for chronic RTI, for an overall clinical efficacy rate of 92% (92/100). The overall eradication rate of causative organisms was 76% (42/55). Among the main causative organisms,Streptococcus pneumoniae, Haemophilus influenzae, andPseudomonas aeruginosa had eradication rates of 100% (14/14), 100% (13/13), and 27% (4/15), respectively. Side effects such as abdominal discomfort, soft stools, headache, or swelling of the face and lips were observed in 5.6% (6/107) of patients; most of these symptoms were mild. Abnormal laboratory test findings, such as elevation of glutamic-oxaloacetic transaminase and/or glutamic pyruvic transaminase, and eosinophilia, were noted in 16.5% (17/103) of patients; most of these abnormalities were mild. In conclusion, DU-6859a (50 to 100 mg b.i.d.) showed excellent efficacy for pneumonia and chronic RTI without causing any severe, clinically significant adverse reactions. These findings show that DU-6859a is worthy of further clinical study for the treatment of RTI.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1437-7780
    Keywords: burn ; septicemia ; infection ; pulmonary injury ; drug resistance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Serial microbiological tests were performed on 4 patients burned by the pyroclastic flow of Mt. Fugen in Unzen, Japan on June 3, 1991. The patients were young (average age, 30 years) and had extensive burns (average total burn surface area, 83%) and inhalation injury. All 4 patients died of multiple organ failure and septicemia. Methicillin-resistantStaphylococcus aureus (MRSA) andPseudomonas aeruginosa were persistently isolated from bronchial aspirates, burn wounds and the blood until death. There were no differences in isolates among the 3 specimen sites.S. aureus isolated from all patients became resistant to all antibiotics used, and the use of imipenem/cilastatin sodium, and ceftazidime transformedP. aeruginosa to a resistant strain within a short period of time. On the other hand, the sensitivity to gentamicin varied from one patient to another. From a study of the phenotypic character ofS. aureus strains, there was a suggestion of nosocomial infection in 2 patients. Our results demonstrate that extensive burns are usually associated with bacteremia and septicemia. In spite of prudent management with antibiotics, the control of resistant bacteria is difficult. We stress the need for the development of specific therapy for severe infections in burn patients, encompassing immunotherapy, antibiotic treatment, and wound treatment.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1437-7780
    Keywords: cellular immunity ; chronic renal failure ; hemodialysis ; infection ; neutrophil function ; nutritional index
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Infection is a major complication associated with increased morbidity and mortality in patients on hemodialysis. We analyzed the incidence and type of infection occurring in 4841 patients on hemodialysis between 1986 and 1993 in our hospital and 11 other hemodialysis centers. Infection was noted in 193 patients (4.98 infections/1000 patients/year). Pneumonia (n=71) and bacteremia (n=24) were the 2 most common infections, followed by tuberculosis (n=14), herpes zoster infections (n=12) and infections at the vascular access site (n=12). The most commonly isolated organism in pneumonia, bacteremia and vascular access site infections wasStaphylococcus aureus. Analysis of the prognosis of patients with pneumonia showed a mortality rate of 50% in patients greater than 60 years old, which was significantly higher than that of younger patients (6.7%,P〈0.01), whereas the mortality rate in patients with bacteremia was not different between the 2 age groups (60.0% vs. 57.9%, respectively). We also analyzed changes in immunological function and nutritional status in 16 patients on hemodialysis and 21 healthy control subjects. Although the phagocytic and bactericidal activities of neutrophils and monocytes were not different between the groups, superoxide production, the percentage of natural killer cells and the degree of blastoid transformation with phytohemagglutinin stimulation were significantly lower in hemodialysis patients. Low levels of Niderman's index and serum albumin and transferrin indicated poor nutritional status in these patients. Furthermore, the degree of Niderman's index and serum albumin significantly correlated with impairment of immunological function, such as reduced blastoid transformation and the number of lymphocytes. Our results suggest that analysis of the patterns of infection in patients on hemodialysis should provide better management and that improvement of malnutrition may ameliorate impaired immunity in hemodialysis patients.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1432-0843
    Keywords: Key words Hematopoietic growth factor ; Lung cancer ; Chemotherapy ; Neutropenia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  A prospective randomized study was conducted to determine the optimal schedule of rhG-CSF (recombinant human granulocyte colony-stimulating factor). A group of 33 lung cancer patients treated with MVP therapy (mitomycin, vindesine, and cisplatin) were randomly assigned to three groups: an early prophylaxis group in which rhG-CSF was initiated on day 2 of the MVP cycle; a late prophylaxis group in which rhG-CSF was initiated on day 8; and a therapeutic group in which rhG-CFS was initiated after the onset of neutropenia. Ten patients who had received MVP therapy without rhG-CSF were also analyzed as a no-support group. The incidence of neutropenia was 80% (16/20 courses) in the early prophylaxis group, 44% (8/18) in the late prophylaxis group, 94% (17/18) in the therapeutic group, and 94% (16/17) in the no-support group. The incidence of neutropenia in the late prophylaxis group was less than in the early prophylaxis group (P〈0.05), the therapeutic group (P〈0.01), and the no-support group (P〈0.01). The late prophylactic rhG-CSF schedule was therefore more effective in countering neutropenia than either the early prophylactic or therapeutic schedule.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1432-0843
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A sensitive enzyme immunoassay method (EIA) for an anticancer drug, aclacinomycin A (ACM), has been developed.With a double-antibody technique, ACM at a concentration as low as 100 pg/tube can be detected. An antibody to ACM was obtained by immunizing rabbits with an antigen prepared by coupling ACM with mercaptosuccinylated bovine serum albumin via N-maleoyl aminobutyric acid (MABA) as a coupling agent. Enzyme labeling of ACM was performed withβ-D-galactosidae (β-Gal; EC 3.2.1.23) via m-maleoyl benzoic acid (MBA). The standard curve of the assay was linear on a logit-log plot over a concentrationrange of 30 pg to 10 ng. The antibody detected ACM and its metabolites, MA144 M1 (M1), MA144 N1 (N1), MA144 S1 (S1), and aklavin (T1) equally well, but was only minimally reactive with aklavinone (D1) and 7-deoxyaklavinone (C1), thus suggesting that this EIA can detect the total amounts of ACM and its biologically active glycosides among metabolites of ACM. This EIA is practically free from interference by any other anticancer drugs. Using this assay, serum levels of ACM equivalents can be determined accurately after administration of the drug to rats at a single dose of 10 mg/kg. Since ACM is now undergoing clinical trial, the EIA of the drug will be a valuable tool in clinical pharmacological studies.
    Type of Medium: Electronic Resource
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