K Kawazoe

Gifu University, Gihu, Gifu, Japan

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Publications (52)94.5 Total impact

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    ABSTRACT: The injectable cephalosporin cefpirome (CPR) was launched in Japan in 1993. It has widely been used in the various infectious diseases. We therefore studied the clinical and bacteriological efficacy of CPR against infections caused by Bacteroides species, Prevotella species and Porphyromonas species frequently isolated from the obstetric and gynecologic infections. Thirteen institutions were involved in this study which ran from March 1994 to January 1999. The administration dosage of CPR was 2 to 4 gram per day administered by drip infusion or intravenous infusion. The duration of treatment was from 3 to 15 days. The evaluations were performed before and after the treatment. CPR was administered to 194 patients with obstetric and gynecologic infections, and 146 of 194 cases were acceptable for the evaluation of drug efficacy. Bacteroides species were identified in 102 patients. Clinical efficacy in 146 cases was excellent in 12 patients, good in 110, fair in 9 and poor in 15 patients. The eradication rate for Bacteroides species could be in 37 cases out of 54 evaluable cases; Prevotella species in 38 out of 49; and Porphyromonas species in 5 out of 5. The overall assessment of bacteriological efficacy was "eradicated" in 91 cases out of 133 (68.4%). Adverse reactions including abnormal findings in laboratory tests were seen in 8 patients (4.76%). Based on these results, CPR promises efficacy and safety in the treatment of obstetric and gynecologic infections due to Bacteroides species.
    The Japanese journal of antibiotics 02/2000; 53(1):26-45.
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    ABSTRACT: AM-1155 is a new 8-methoxyquinolonecarboxylic acid with a broad spectrum of antibacterial activity. It inhibited more than 90% of clinical isolates of Streptococcus agalactiae, Escherichia coli, Peptostreptococcus magnus, Bacteroides fragilis and Prevotella bivia at the concentration of 3.13 mg/l. The antibacterial activity of AM-1155 was almost equal to that of sparfloxacin. The in vivo efficacy of AM-1155 was evaluated using a polymicrobial pyometra (E. coli and B. fragilis) model of rats. The accumulation of neutrophils to the uterus in the AM-1155-treated group was less marked than that of the nontreated group, as well as the bacteriological response. These results suggest that the new antimicrobial agent AM-1155 might be useful for the treatment of polymicrobial infections in the fields of obstetrics and gynecology.
    Chemotherapy 01/2000; 44(4):238-42. · 2.07 Impact Factor
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    ABSTRACT: The effects of crude herbal ingredients that constitute Juzen-taihoto and Ryutan-shakan-to on serum levels of inflammatory cytokines in a rat uterine endometritis model were investigated. Extracts of Glycyrrhizae Radix, Cnidii Rhizoma, Rehmanniae Radix, Alismatis Rhizoma, Cinnamomi Cortex, Hoelen, and Angelicae Radix significantly inhibited serum levels of the inflammatory cytokines tumor necrosis factor-α, interleukin-1β, and interleukin-6. The decreased serum levels of inflammatory cytokines appeared to support a previous report on decreased uterine bacterial counts in the rat uterine endometritis model. Based on these results, it is thus speculated that herbal medicines might enhance the host-defense mechanism by decreasing the production of inflammatory cytokines.
    Current Therapeutic Research 01/2000; 60(2):81-86. · 0.45 Impact Factor
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    ABSTRACT: An investigation was carried out to determine the therapeutic effect of levofloxacin (LVFX) once-a-day oral therapy at the dose of 200 mg/day for 7 days on uterine cervicitis, in comparison with LVFX twice-a-day oral therapy at the dose of 200 mg/day for 7 days. Of the 102 patients enrolled in the study, 90 were subjected to the analysis. The efficacy rate on uterine cervicitis of the once-a-day therapy and twice-a-day therapy groups according to the evaluation of the Drug Efficacy Evaluation Committee were 72.0% (36/50) and 82.5% (33/40), respectively. The efficacy rate on uterine chlamydial cervicitis of the once-a-day therapy and twice-a-day therapy groups according to the evaluation of the Drug Efficacy Evaluation Committee were 88.0% (22/25) and 85.7% (18/21), respectively. Safety was evaluated as "safe" in 88 of the 90 assessable patients (97.8%). Side effects were seen in two cases, which belong to the once-a-day therapy group; mild candidiasis and mild breast distension sense. As the antimicrobial treatment started, the levels of the inflammatory cytokines, interleukin-6 (IL-6) and interleukin-8 (IL-8) in the cervical mucus, decreased. It is suggested that IL-6 and IL-8 can be useful indicators of the antimicrobial treatment in the uterine cervicitis. These results suggested that the LVFX once-a-day therapy can be useful on uterine cervicitis.
    The Japanese journal of antibiotics 08/1999; 52(7):511-6.
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    ABSTRACT: Gynecological diseases may affect the growth of vaginal bacterial flora. We investigated the relationship between uterine cervical cancer and the vaginal bacterial flora. In 20 patients with uterine cervical cancer, we investigated the intravaginal bacterial flora, including Gardnerella vaginalis and Mobiluncus spp. In the patients with uterine cervical cancer, there was a mixed flora of aerobes and anaerobes and, of special note, G. vaginalis was detected in 50% of the patients with uterine cervical cancer (10/20). Bacterial vaginosis was present in 8 of these 10 patients (80%). The count of G. vaginalis detected was higher than that of the other coexisting species and was higher in both pre- and postmenopausal patients with uterine cervical cancer than in a control group of pre- and postmenopausal women with benign gynecological diseases. In contrast, none of Mobiluncus spp. was detected. G. vaginalis was detected at a high incidence in patients with uterine cervical cancer, suggesting that the lesions of uterine cervical cancer provide favorable conditions for the growth of G. vaginalis and anaerobes, which leads to bacterial vaginosis.
    Journal of Infection and Chemotherapy 07/1999; 5(2):82-85. · 1.55 Impact Factor
  • H Mikamo, K Kawazoe, Y Sato, T Tamaya
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    ABSTRACT: A total of 131 anaerobes isolated from amniotic fluid with preterm premature rupture of membranes and stored were examined for elastolytic activity by the method described by Williams et al (Lett Appl Microbiol 1988;7:173-6). Each strain was spot inoculated on a Columbia blood agar plate containing 1% solubilized elastin and incubated for 5 days under anaerobic conditions. Undigested elastin was precipitated by flooding trichloroacetic acid solution onto the plate, and a clear zone was visible as the elastolytic reaction around the spot of bacterial growth. Ninety-three (71.0%) of 131 organisms showed a positive elastolytic reaction. Eleven of 20 strains (55.0%) of Peptostreptococcus magnus, 9 of 18 strains (50.0%) of Peptostreptococcus micros, 12 of 12 strains (100.0%) of Fusobacterium nucleatum, 15 of 28 strains (53.6%) of Bacteroides fragilis, 8 of 15 strains (53.3%) of Bacteroides thetaiotaomicron, and 38 of 38 strains (100.0%) of Prevotella bivia were elastolytic. Anaerobic bacterial species prevalent in the normal vaginal flora that were isolated from amniotic fluid of women with preterm rupture of membranes produced elastolytic activity, plausibly inducing the destruction of host constitutive components.
    American Journal of Obstetrics and Gynecology 03/1999; 180(2 Pt 1):378-80. · 3.88 Impact Factor
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    ABSTRACT: An investigation was carried out to determine the therapeutic effect of panipenem/betamipron (PAPM/BP), a injectable carbapenem antimicrobial agent, on infections in pregnant women during perinatal period. Of the 41 patients enrolled in the study, 34 were subjected to the analysis, with 1 exemption because of protocol violations (regimen), 3 because of uncertain evidence symptoms of infection, and 3 because of failure to undergo laboratory tests. PAPM/BP was administered by intravenous drip infusion at doses of 0.5 g twice or three times a day daily for periods of 3 to 14 days. The efficacy rate according to the evaluation of the Drug Efficacy Evaluation Committee and the attending physicians was 79.4% (27/34), with 49 of the 61 clinical isolates (80.3%) being eradicated. Safety was evaluated as "safe" in 39 of the 41 assessable patients (94.1%). Mild headache and nausea were experienced by 1 patient (2.4%) as adverse drug reactions, but the symptoms disappeared after the completion of treatment. Slight elevations of GOT, GPT and LDH in laboratory tests were observed in 1 patient (2.4%), but these values returned to normal after the completion of treatment. These results suggested that PAPM/BP may be a useful drug in the treatment of bacterial infections during the perinatal period. To firmly establish its safety, however, further clinical and pharmacokinetic studies are needed in larger populations.
    The Japanese journal of antibiotics 02/1999; 52(1):24-33.
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    ABSTRACT: The aim of this study is to describe the bacterial flora of women in preterm labor with or without premature rupture of membranes. Retrospective studies of 239 patients with preterm labor were performed. One hundred and twenty-three of 239 patients with preterm labor (51.5%) had bacterial vaginosis. Seventy of the 239 patients with preterm labor (29.3%) developed premature rupture of the membranes (preterm PROM). Of the 70 patients with preterm PROM, 51 (72.9%) had bacterial vaginosis. Therefore, 51 of the 123 patients with bacterial vaginosis (41.5%) developed preterm PROM. An increased number of organisms detected from the vaginal discharge in patients with preterm labor was associated with preterm PROM by Cochran-Armitage test. An increased number of organisms detected from the vaginal discharge in patients with preterm labor complicated with bacterial vaginosis was significantly associated with preterm PROM by Cochran-Armitage test. In preterm labor, the number of different species detected in the vagina provide sensitive and specific prediction of preterm PROM in patients with preterm labor.
    Infectious Diseases in Obstetrics and Gynecology 02/1999; 7(4):190-4.
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    ABSTRACT: Penetration of fluconazole into female genital tissues was examined. Fluconazole was administered orally at a dose of 150 mg to patients undergoing total abdominal hysterectomy 1 to 151 h prior to surgery. During surgery, blood, uterus, ovary, and oviduct were sampled. Fluconazole concentrations in each tissue were determined by high-performance liquid chromatography. The peak concentrations in serum reached approximately 6.1 microg/ml 1.0 h after a drip infusion was begun. At each time after the infusion, the concentrations in portio vaginalis, cervix uteri, myometrium, endometrium, ovary, and oviduct were higher than those in the serum: the peaks in the tissues ranged from 6.4 to 9.5 microg/g around 1.0 h after the drip infusion was begun. Thus, the levels of penentration of fluconazole into gynecological tissues appeared to be similar to or slightly above those in serum samples. Fluconazole can rapidly penetrate from plasma into the female genital organs, supporting high efficacy of fluconazole against fungal infections in the field of gynecology.
    Antimicrobial Agents and Chemotherapy 02/1999; 43(1):148-51. · 4.57 Impact Factor
  • Drugs 01/1999; 58:408-409. · 4.63 Impact Factor
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    ABSTRACT: Prevotella bivia is common in pelvic inflammatory diseases. Parenteral antimicrobial agents have been widely used against those infections. We investigated the bactericidal activities of three cephalosporins, i.e. cefluprenam (CFLP), ceftazidime (CAZ) and cefotaxime (CTX) and of two other antimicrobial agents, i.e. clindamycin (CLDM) and imipenem (IPM) against P. bivia. We also investigated the in vitro morphological changes induced by these agents in P. bivia. Cephalosporins exhibited bactericidal activities against P. bivia and induced time- and concentration-dependent morphological changes in P. bivia (filamentation). CLDM and IPM also had bactericidal activities, but induced different morphologic alterations: formation of spheroblasts and lysis. These results confirm the fact that each antimicrobial agent has characteristic aspects.
    Chemotherapy 01/1999; 45(5):342-8. · 2.07 Impact Factor
  • Drugs 01/1999; 58:166-168. · 4.63 Impact Factor
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    ABSTRACT: T-3762 is an injectable new quinolone with a broad spectrum of antibacterial activity. Pazufloxacin (T-3761) is an active form of T-3762. The minimal inhibitory concentrations (MICs) of pazufloxacin for 50% of the clinical isolates tested were 3.13 µg/ml for Streptococcus agalactiae, 6.25 µg/ml for Gardnerella vaginalis, 0.025 µg/ml for Escherichia coli, 0.78 µg/ml for Pseudomonas aeruginosa, 6.25 µg/ml for Peptostreptococcus magnus, 6.25 µg/ml for Bacteroides fragilis and 12.5 µg/ml for Prevotella bivia. The MICs of T-3762 for 90% of the clinical isolates tested were 3.13 µg/ml for S. agalactiae, 6.25 µg/ml for G. vaginalis, 0.10 µg/ml for E. coli, 12.5 µg/ml for P. aeruginosa, 25 µg/ml for P. magnus, 12.5 µg/ml for B. fragilis and 25 µg/ml for P. bivia. The results of this study suggest that, subject to confirmation by clinical trials, T-3762, in combination with an agent with reliable activity against anaerobic bacteria, is suitable as an empirical therapy of patients with obstetric and gynecological infections.
    Chemotherapy 01/1999; 45(3):154-157. · 2.07 Impact Factor
  • H Mikamo, K Kawazoe, Y Sato, A Imai, T Tamaya
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    ABSTRACT: The studies presented in this report were undertaken to evaluate whether Fusobacterium nucleatum, a common anaerobic isolate in intrauterine infection, stimulates arachidonic acid metabolism, a rate-limiting step for prostaglandin synthesis, in the human uterine endometrium. Effects of F nucleatum on arachidonic acid liberation from human uterine endometrial cells and of F nucleatum extract on lysophosphatidylcholine production in human uterine endometrial cells were investigated. When human uterine endometrial cells labeled with tritiated arachidonic acid to an isotopically steady state were exposed to an extract of F nucleatum, arachidonic acid liberation was stimulated, accompanied by lysophospholipid formation. Similar stimulatory effects on phospholipid degradation were also observed in the experiment with bacterially conditioned media. These results suggest that F nucleatum stimulates endometrial phospholipid metabolism, related to activity of phospholipase A2, which might induce the onset of labor associated with intraamniotic infection.
    American Journal of Obstetrics and Gynecology 01/1999; 179(6 Pt 1):1579-82. · 3.88 Impact Factor
  • Journal of Antimicrobial Chemotherapy 07/1998; 41(6):664-5. · 5.34 Impact Factor
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    ABSTRACT: This study was designed to investigate bacterial flora of the endometrial cavity in healthy puerperae. Thirty puerperae who underwent an uneventful course in pregnancy, delivery or postpartum were subjects for this study. Intrauterine contents were collected on the first and fifth days of the puerperium and submitted for microbiologic examination. On the puerperal first day, a total of 76 strains (53 strains of aerobic bacteria, 21 strains of anaerobic bacteria, and 2 strains of fungi) were detected in the uteri of the 30 subjects. More than 2 strains were detected in 97% (29/30 subjects). The incidence of aerobic gram-positive cocci, aerobic gram-negative bacilli, and anaerobic bacteria was 51%, 16%, and 28% of 76 strains, respectively. On the puerperal fifth day, a total of 102 strains (68 strains of aerobic bacteria, 30 strains of anaerobic bacteria, and 4 strains of fungi) were detected in the uteri of the 30 subjects. More than 2 strains were detected in 97% (29/30 subjects). The incidence of aerobic gram-positive cocci, aerobic gram-negative bacilli, and anaerobic bacteria was 46.1%, 18.6%, and 29.4% of the 102 strains, respectively. The population of the former seemed to decrease, and that of the latter 2 seemed to increase during the postpartum course. However, the number of strains detected for these 3 classifications of bacteria increased from the first to fifth postpartum day. There is no significance between bacterial strains and frequency detected, using the 2×39 chi-square test (P=0.571). There is no significance between classification of bacteria and frequency detected, using the 2×7 chi-square test.
    Journal of Infection and Chemotherapy 02/1998; 4(1):12-15. · 1.55 Impact Factor
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    H Mikamo, K Kawazoe, Y Sato, M Itoh, T Tamaya
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    ABSTRACT: Transvaginal ultrasound-guided aspiration of ovarian endometrioma has been applied and emphasized as a safe and simple procedure. Two 27-year-old infertile women, both gravida 0, para 0, underwent medical follow-up examinations for cases of ovarian endometrioma. Both had undergone transvaginal ultrasound-guided aspiration of ovarian endometrioma. Because both were continuously febrile and had abdominal pain and cysts with tenderness in spite of antibiotic therapies, both underwent laparotomies for treatment. In both cases, enucleation of the ovarian abscess revealed purulent and malodorous fluid that demonstrated Peptostreptococcus magnus in culture. We theorize that following transvaginal ultrasound-guided aspiration of ovarian endometrioma and fixation with pure ethanol, anaerobic infection by P. magnus occurred, and a cyst formed in the abscess.
    Infectious Diseases in Obstetrics and Gynecology 02/1998; 6(2):66-8.
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    ABSTRACT: Prevotella bivia is one of the anaerobic bacteria that resides in the flora of the female genital tract. We studied the pathogenicity of P. bivia in a rat pyometra model. The experimental animal (rat) model of pyometra was developed to investigate the pathogenicity of P. bivia in a rat pyometra model. In the groups inoculated with aerobes alone, the infection rate was 10% (1/10) in the Staphylococcus aureus- or Staphylococcus agalactiae-inoculated group and 20% (2/10) in the Escherichia coli-inoculated group. Infection was not established in the groups inoculated with anaerobes alone. High infection rates were observed in all the mixed-infection groups. In the S. agalactiae- and Bacteroides fragilis-, S. agalactiae- and P. bivia-, F. coli- and B. fragilis-, and E. coli- and P. bivia-inoculated groups, an infection rate of 100% (10/10) was demonstrated. The efficacy of antibiotics such as flomoxef (FMOX) could be determined using a rat pyometra model. In relation to the alteration of vaginal microbial flora during the menstrual cycle, estrogen increased the growth of P. bivia. Mixture of aerobic bacteria and P. bivia increased the pathogenicity of P. bivia. Estrogen would be useful for raising up the inflammatory change of the uterus in experimental models of genital tract infection due to P. bivia.
    Infectious Diseases in Obstetrics and Gynecology 02/1998; 6(2):61-5.
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    ABSTRACT: S-1090 is a new synthetic, nonesterified, oral cephalosporin with a broad spectrum of antibacterial activity. The activities of S-1090 against the causative organisms in the fields of obstetrics and gynecology are superior to those of the currently prescribed oral cephems, cefdinir, cefpodoxime, and cefaclor. The in vivo efficacy of S-1090 was evaluated using uterine endometritis of model rats. The accumulation of neutrophils in the uterus in the S-1090-treated group was milder than that in the nontreated group, and the same was true for the bacteriological response. S-1090 is a promising oral cephalosporin antibiotic for the treatment of infections in the fields of obstetrics and gynecology.
    Chemotherapy 01/1998; 44(3):153-6. · 2.07 Impact Factor
  • Infectious Diseases in Obstetrics and Gynecology 01/1998; 6(2):61-65.