隆一郎 森口’s scientific contributions

Using Hitachi CT-3, the changes in CT numbers of the kidney were calculated in 10 normal and 12 transplanted kidneys. Two mililiters per kg of meglumine diatrizoate (Angiografin(R)) was given intravenously in bolus fashion. Kidneys were scanned before injection, at termination of injection and correctly 10 minutes after injection. In control group, the CT numbers of the cortex, the medulla and the aorta showed rapid increase after contrast administration. Ten minutes after administration of medium, the CT numbers of the medulla remained a little higher than the cortex, though that of the aorta showed rapid decrease. In contrast to control group, in transplanted kidneys the CT numbers of the cortex and medulla showed less increase than the control group just after contrast administration. Moreover, in the recipients who have had good graft function the CT numbers of the cortex and medulla showed gradual increase, in the recipients who have had poor graft function the CT numbers showed gradual decrease 10 minutes after injection. Enhancing indices calculated from the formula: [CT numbers 10 minutes after contrast enhancement / CT numbers before contrast enhancement] were inversely proportional to the serum creatinine. These results lead to the conclusion that the CT scans employing contrast enhancement method after kidney transplantation has the diagnostic value of graft function in addition to diagnostic usefulness for post-transplantation complications such as hematoma, urinoma or Iyrnphocele.

ofloxacinを22例の細菌性前立腺炎の治療に用いた.GNB感染8例に対し,全例に有効であった.GPC感染(感染症の疑い5例も含む)14例に対する効果は,有効10例,無効4例で有効率71%であった.副作用として消化器症状(下痢)2例をみたが中止例は1例のみであった Ofloxacin (OFLX), a new pyridonecarboxylic acid derivative for oral use, was administered in the treatment of 22 cases of bacterial prostatitis (acute 4, chronic 18). In advance of the clinical trial, the concentration of OFLX in prostatic fluid (PF) was determined following administration of the drug to 3 patients with chronic bacterial prostatitis at a stationary phase. Assays revealed antibiotic concentrations of a mean level of 1.34 micrograms/ml in 3 PF samples. The ratios to the plasma antibiotic level (R value) averaged approximately 1.10. In clinical use, the drug was given at a daily dosage of 300-600 mg for 5-21 days. The bacteriological response of the infections caused by gram negative bacteria, in all eight patients (100%) was complete eradication, whereas that in 14 cases (including 5 mild infections) caused by gram positive cocci, was excellent or moderate in 10 (71%) and poor in 4 cases. Adverse reactions were observed in 2 cases; complaint of diarrhea (drug administration was discontinued in 1 case). No abnormal values such as of kidney or liver functions or of peripheral hematology were encountered. From the data obtained ofloxacin was concluded to be highly effective, safe and useful in treatment of bacterial prostatitis.

34例の複雑性因子が多く,かつ重症な感染症の治療や感染防止にCAZ 1回1 gを1日2回9～30日にわたり静注または点滴静注し,感染症25例に対して著効6例,有効14例,やや有効例4,無効1例であり,また,術後感染防止上も75%の有効率を得た.副作用は無かったが,検査上肝機能異常4例,及び白血球減少症1例が認められた CAZ was administered to 34 patients in the field of urology for treatment or prevention of serious infections with many complicated factors. The duration of treatment ranged from 9 to 30 days, the most frequent being 14 days, which was the duration originally set as the standard. As the results CAZ was considered to be one of the drugs of choice in the cases requiring long-term treatment, from the viewpoint of both efficacy and usefulness.

MK-0787/MK-0791をUTIを主とした感染症や,感染防止目的で35例36回,原則として1日0.5 g×2を10日間以上にわたり投与した.1)評価可能26例で有効以上は,治療初期で88.5%,終了時で92.3%であった.有用性についても全く同様の成績を得た.P. aeruginasa等を含む分離菌35株の全てが治療後除菌された.投与後出現菌は,真菌類が多かった.2)長期投与の方が短期投与に比べて,有用性が高い傾向を認めた.3)副作用として,嘔吐による中止例が1例あった.臨床検査値異常では,血小板減少1件,好酸球増多1件,GOT上昇2件,GPT上昇3件,γ-GTP上昇1件をみたが,変動幅は小さく,中止により可逆的であった MK-0787 (Imipenem)/MK-0791 (Cilastatin sodium), a new compound of Thienamycin, was administered in treatment of 35 patients (36 cases) with chronic complicated UTI or for prevention of serious infections with much complicated factors. The patients were principally treated at a daily dose of 1 g for over 10 days. The efficacy rate of 26 patients who were evaluable in the early phase (4-7 days) was 88.5%, while it became up to 92.3% in the final phase judgment. As for clinical usefulness, the result was obtained to be as high as that of the clinical efficacy. In bacteriological study, 35 strains were clinically isolated including 7 strains of P. aeruginosa from UTI. All the strains disappeared with an eradication rate of 100% after treatment. Strains appearing after Imipenem/Cilastatin sodium treatment mainly consisted of fungi. Usefulness judgements tended to be greater in the final phase than in the early phase. As for side effects, vomiting was recorded in one case, in which the administration was discontinued. In laboratory findings there were 3 cases with elevated GPT, 2 cases with elevated GOT, one case with elevated gamma-GTP, one with thrombocytopenia, and one with eosinophilia each, but these abnormal values were slight and transient. In summary our clinical study showed that Imipenem/Cilastatin sodium was a very effective antibiotic in treatment on moderate or serious UTI or preventive use for infections in compromised hosts. Considering the features of this agent, it might be more effective and useful for clinical use in treatment on polymicrobial infections including stubborn organisms than any other antimicrobial compounds. Furthermore, it was safe and well tolerable in a long term treatment.

Cisplatin was administered to eleven patients bearing urogenital malignancies to evaluate clinical efficacy. (1) In testicular tumor cases combination therapy with cisplatin, bleomycin and vinblastine was very effective resulting in 100% efficacy rate. Effect of this combination regimen was noticed in every tumor of germ cell origin and malignant interstitial cell tumor suggesting wide anti-tumor spectrum of this regimen. (2) Efficacy of cisplatin against prostatic cancer was noticed only in 25% of cases by single administration of this drug. Therefore, combination with anti-androgen therapy or other anti-cancer chemotherapeutics should be considered. (3) Efficacy of single administration of cisplatin was noticed in no case ofuroepithelial tumors. Therefore, radiation therapy and other anti-cancer drugs should be combined to obtain anti-tumor effect against malignancies of uroepithelial origin. (4) Renal toxicity and ototoxicity could be avoided by confluent fluid administration combined with diuretics. Therefore, this drug seemed relatively safe to be administered to any case in this respect. However, administration of this drug to aged patients was hindered by rather severe gastrointestinal symptoms.

Aztreonamを複雑性尿路感染症に使用した.投与対象は1984年7月より1985年1月までの間に練馬総合病院泌尿器科,立川共済病院泌尿器科に入院した複雑性尿路感染症15例である.Aztreonamは1回2 g 1日2回を静注または点滴静注で5日間連続投与した.U.T.I.薬効評価基準(第2版)に適合する11例の総合臨床効果は著効6例,有効2例,無効3例で有効例は全例単独感染,無効例は全例混合感染症例であった.細菌学的効果ではグラム陰性菌はすべて除菌され,グラム陽性菌では8株中4株が除菌された.副作用は全例に認められず,臨床的検査値にも著変は認められなかった Efficacy and safety of Aztreonam, a monobactam antibiotic developed by E.R. Squibb & Sons, Inc. U.S.A., in complicated urinary tract infections (UTI) were studied. Aztreonam was administered to 15 patients with complicated UTI admitted to our Hospitals between July, 1984 and January, 1985. A two-gram dose of Aztreonam was administered twice a day intravenously or intraductally for 5 days consecutively. There were 11 evaluable cases in accordance with the UTI Drug Efficacy Evaluation Standard (the second issue). Overall clinical effect of these cases were "excellent" in 6 cases, "good" in 2 cases and "poor" in 3 cases. All the effective cases ("excellent" and "good") were of single infections and all the non-effective cases ("poor") were of complicated infections. All of the gram-negative pathogens and 4 of the 8 gram-positive pathogens were eliminated. In no cases were side effects or significantly abnormal laboratory findings reported. Therefore, Aztreonam is very effective and safe for complicated UTI, especially gram-negative infections.