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Stage-up症例の経過中,p53蛋白は浸潤癌(T1以上)になった時点で初めて陽性となった.この結果からp53遺伝子の変異と表在性膀胱腫瘍のstage-upの関係が示唆された.一方,進達度TaやTISの表在性膀胱腫瘍でp53 overexpressionは検出されず,今回の検討では表在性膀胱腫瘍のstage-upをp53overexpressionを用いて予見することはできなかった To evaluate the significance of p53 overexpression on the progression of bladder cancer, seven patients with Ta bladder cancer who eventually progressed to the invasive stage ( > or = stage T1) were immunohistochemically analyzed. The immunohistochemical study was performed using the p53 protein antibody on formalin-fixed, paraffin-embedded tissue sections from all primary and recurrent tumors. In three patients, immunoreactivity was detected only at the time of disease progression, suggesting that p53 mutation may be related to the disease. However, since no staining could not be found in stage Ta bladder cancer, the patient with a risk of progression could not be detected by this immunohistochemical study.
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.
