晴好 浅野’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.

Adverse reactions due to Futraful administration were subjectively observed in 9 of 75 cases (12%): 4 cases with skin eruption, 2 cases with anorexia, and 3 cases with gastrointestinal disorders. Laboratory examination of 35 cases, after one-year administration of Futraful, showed the abnormal findings in 9 cases (23.7%): 3 cases with decreased blood cell count, 3 cases with elevated GOT and GPT, and 3 cases with elevated alkaline phosphatase level. A problem in bladder cancer after a conservative is the frequent local recurrence of the tumor. Intravesical administration of MMC or Thio-TEPA and/or oral administration of SLA have been recognized as a successful prophylactic measure. In this paper, the prophylactic effect of Futraful administration was tested between 75 patients and 110 controls with transitional cell carcinoma. Futraful was orally administered 600-800mg a day for one to two years to the patients operated by either TUR (TUC), simple resection, or partial cystectomy. The rate of recurrence was significantly lower for the postoperative period of 0-10 months and lower, though insignificantly, for that of 11-24 months in the patients operated for the first time, as compared to that in the controls; the rate of postoperative recurrence after 12 months being 15.5% in the patients treated by Futraful and 25.5% in the controls. In the recurrent cases, however, administration of Futraful effectively reduced the recurrence only for the postoperative period of 0-6 months; the rate of recurrence being higher thereafter in the patients treated by Futraful than in the controls.

塩酸タムスロシンあるいはナフトピジルを1ヵ月以上投与しても夜間排尿回数が2回以上の前立腺肥大症患者52例(平均年齢72.1歳)を対象として, 塩酸フラボキサート400～600mg/日を8～12週投与し, その有用性と安全性を検討した。塩酸フラボキサート投与前後で夜間排尿回数は3.8回→2.7回へ有意に減少し, 国際前立腺症状スコア, QOLスコア, 前立腺肥大症影響度スコアもそれぞれ15.2点→12.5点, 4.3点→3.9点, 5.3点→4.2点へ有意に低下した。投与期間中14例(26.9%)に消化器症状を主とする副作用を認め, そのうち8例は投与を中止したが, いずれも重篤ではなかった。α1遮断薬投与中の前立腺肥大症患者に対して塩酸フラボキサートを就寝前に追加投与する治療法は, 前立腺肥大症に伴う夜間頻尿に対する治療の選択肢の1つとなりうると考えられた。 We examined the effectiveness of supplemental administration of flavoxate hydrochloride in patients with benign prostatic hyperplasia (BPH) whose nocturia was not adequately relieved by an alpha1-adrenoceptor blocker. Fifty-two patients who had two or more nocturnal micturition after administration of tamsulosin hydrochloride or naftopidil for 4 weeks or more received 400-600 mg of flavoxate hydrochloride in addition to an alpha1-adrenoceptor blocker for another 8-12 weeks. With supplemental administration of flavoxate hydrochloride, significant improvement was observed in the number of nocturnal micturition, total International Prostate Sympton Score, quality of life score and BPH impact index. No significant change was observed in the voided volume, Qmax, voiding time and residual urine volume. Supplemental administration of flavoxate hydrochloride is therefore effective for the improvement of nocturia and QOL in BPH patients resistant to an alpha1-adrenoceptor blocker.

Clinical effect of Estracyt was investigated in prostatic cancer patients. Twenty seven patients had been previously treated and 20 had not received prior treatment. Improvement rate of subjective symptoms was 85% in the previously untreated patients and that of objective findings was 85%, while those rates were 44% and 50% in the previously treated patients, respectively. Most of the adverse reactions were changes in mamma and mammary papilla which were considered to be due to the estrogenic activity.

1984年7月から同11月までの間に当大学および関連19施設で経験した難治性の複雑性尿路感染症64例を対象として,新しく開発されたquinolone carboxylic acid系薬剤のNFLXを投与し,臨床効果を検討した.なお起炎菌が証明されなかったり,真菌の検出された20例は除外し,計44例を検討対象とした.投与方法は1日600 mg(分3),14日間とした.効果判定はUTI薬効評価基準に準じて行ない,MICも測定した.疾患別の有効率は単独感染62.1%,混合感染60.0%で,単独感染のカテーテル留置例の有効率は50%であった.従来の本剤による報告では有効率が52%～85%であり,今回の成績が平均61%とやゝ低いが,G-1, G-5のカテーテル留置例が多かった結果と考えられる.従ってカテーテル留置群を除くと有効率は67%となり,経口剤単独治療としては満足できるものといえた.細菌学的効果は分離株61株中65.6%に効果を認め,既存の抗菌剤より優れていた.最も多く分離されたP. aeruginosaのMIC分布をみると,MIC 3.13以下に効果を認め,評価できる結果であった.副作用は軽度の胃腸障害を4例に認め,GOTの上昇を1例に認めたに過ぎない.以上の成績より,NFLXは経口抗菌剤として複雑性尿路感染症に有効かつ安全性の高い有用な薬剤といえる The new chemotherapeutic agent NFLX was orally administered 600 mg a day for 5 consecutive days in 44 cases having complicated urinary tract infection, and its clinical efficacy was evaluated. They consisted of 8 marked effective cases, 19 moderately effective cases and 17 ineffective cases, and its overall clinical efficacy was 61%. The bacteria disappeared in 10 cases, and decreased in 9 cases. Thirteen cases showed bacterial alternation, and 12 cases remained unchanged. By type of disease group, the efficacy was slightly inferior in the indwelling catheter group compared with that of the nonindwellt group.

A case of emphysematous pyelonephritis is presented. A 66-year-old woman with diabetes mellitus was hospitalized for sudden pyrexia and left abdominal pain on January 13, 1987. She had shown preshock, pre-disseminated intravascular coagulation, hyperglycemia and renal dysfunction. Plain X-ray films of the abdomen and abdominal computer tomographic scanning showed a gas shadow in the left kidney. Retrograde pyelography demonstrated the left complete ureteral obstruction. A diagnosis was made of emphysematous pyelonephritis associated with diabetes mellitus and ureteral obstruction. Left nephrectomy was performed on January 17, 1987, and the pus obtained from the kidney yielded E. coli. After the operation, she has been doing well with diabetes mellitus under good control without insulin therapy. Thirty two cases of emphysematous pyelonephritis in the Japanese literature including our case are reviewed.

56例の男子淋菌性尿道炎に対しNFLX, 600 mg/dayを7日間投与し,3日目,7日目にその効果を検討した.3日目で77.8%著効,7日目に94.4%が著効であり7日目までに100%有効と認められた.淋菌のMICを14株についてAMPCおよびNFLXについて測定した.AMPC, NFLXともに耐菌性は見られなかったが,NFLXはAMPCに比べMICの中央値は全体に低い値(0.05 μg/ml)を示した Fifty six males with gonococcal urethritis were administered 600 mg of norfloxacin (NFLX) daily for 7 days, before the effects were examined. The pharmaceutical effects were studied on the third and the seventh day after administration. Pronounced effectiveness of 77.8%, effectiveness of 19.4% and ineffectiveness of 2.8% were found on the third day after administration, and pronounced effectiveness of 94.4%, effectiveness of 5.6% and ineffectiveness of 0% were found on the seventh day after administration. Effectiveness of 100% was obtained up to the seventh day. Minimum inhibitory concentration (MIC) of NFLX and ampicillin (AMPC) were determined for 14 strains. The peak of MIC of NFLX was found at 0.05 micrograms/ml and all strains were 0.78 micrograms/ml or lower. The peak of MIC of AMPC was 0.1 microgram/ml. MICs of both drugs were 0.78 micrograms/ml or lower, and resistant bacteria were not found. In view of the analyses of age distribution of patients and source of infection, the peak was found in the twenties and the source of infection in 64.7% were, so-called, professional women.

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.

55～83歳の前立腺肥大症患者35例において,本剤1.5 mg/日投与群と3.0 mg/日投与群とを比較したが,主治医による自覚症状改善度,他覚所見改善度,全般改善度,概括安全度,有用度の判定,並びに判定委員会による薬剤効果の判定において,両群間に統計学的有意差が認められず,初回投与量は1.5 mg/日が至適と考えられた.12週間投与した症例で特徴的な副作用はなかった.主治医判定における12週後の改善度は,4週後の改善度に比べ低かった.しかし判定委員会判定で自覚症状の重症度及び他覚所見は,12週後では4週に比べ,より改善が認められた Thirty-five patients with prostatic hyperplasia were entered into a randomized controlled study using bunazosin hydrochloride(alpha 1-adrenergic blocker). Eighteen patients were allocated to be treated with an initial dose of 1.5 mg/day (group 1) and 17 patients received an initial dose of 3.0 mg/day (group 2). Subjective symptoms and parameters of urodynamic studies were evaluated after 4 weeks and 12 weeks. There were 5 withdrawals or exclusions within 4 weeks and 6 within 12 weeks. Therefore, 15 patients in group 1 and 15 patients in group 2 were eligible for evaluation at 4 weeks, 12 patients in group 1 and 11 patients in group 2 were eligible for evaluation at 12 weeks. The rates of the improvement in subjective symptoms such as retarded urination, protracted urination, weakened urinary stream, abdominal straining on voiding, and sense of residual urine were 40%, 25% in group 1 and 46.7%, 36.4% in group 2, at 4 weeks and at 12 weeks, respectively. The rate of improvement in objective parameters of the urodynamic study such as voiding volume, residual volume, maximum flow rate and average flow rate were 26.7%, 16.7% in group 1 and 26.7%, 20.0% in group 2, at 4 weeks and at 12 weeks, respectively. Thus, these improvements were not correlated with the dosage of drug. Adverse effects such as diarrhea, mild headache, palpitation and gastric disturbance were observed in 2 patients in group 1, and 3 patients in group 2. In the 24 patients treated with the drug over 12 weeks, there were no specific adverse effects due to prolonged administration. These findings showed that bunazosin hydrochloride is beneficial for the treatment of prostatic hyperplasia, and could be safety administered for a prolonged period of time up to 12 weeks.

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.