Clinical studies on vancomycin in the treatment of MRSA infection

We evaluated the effectiveness and safety of vancomycin (VCM) alone and in combination with beta-lactam antibiotics in the treatment of MRSA infections, and obtained the following results: 1. Effectiveness. (1) In cases of MRSA infections alone, the improvement rate was 71.4% (5/7 patients) with VCM alone and 77.8% (35/45) with VCM in combination with beta-lactam antibiotics. (2) In cases of polymicrobial infections, few cases were treated with VCM alone, but the improvement rate in combination use with beta-lactam antibiotics was 71.8% (28/39). 2. Bacteriological effect. (1) In cases of single infection with MRSA, the rate of bacterial eradication was 71.4% (5/7) with VCM alone and 68.2% (30/44) with VCM in combination with beta-lactam antibiotics. (2) In cases of polymicrobial infections, few cases were treated with VCM alone, but the rate of bacterial eradication in combination use with be ta-lactam antibiotics was 63.2% (24/38) against MRSA and 31.6% (12/38) against polymicrobial agents including MRSA. 3. Safety. Occurrences of adverse reactions and abnormal laboratory test values when VCM was used alone or when it is used in combination with another drug were about the same in these uses. As a whole, advance reactions were observed in 16 patients (9.5%). Main adverse reactions were whole body redness, drug eruption, and rash etc. Abnormal laboratory test values were observed mainly in hepatic functions, and renal functions. 4. VCM concentrations in blood was determined in 38 patients. Doses of 0.5 g and 1.0 g of VCM was administered by intravenous drip infusion over a period of 1 to 2 hours, and mean blood concentrations 1 to 2 hours after the completion of drip infusion were 25.4 micrograms/ml and 14.4 micrograms/ml, respectively. 5. Synergic effects between VCM and other antibiotics tested were observed in FIC index against all of the six MRSA strains isolated from six patients, and the clinical effects of improvement or better were obtained against five of them.     

A case of convulsion induced by propofol

A 71-year-old man was scheduled for laryngomicrosurgery under total intravenous anesthesia. Anesthesia was induced and maintained with propofol. Seven to eight minutes after induction of anesthesia, convulsion was observed first on his lower limbs and then on his all limbs and the head. This clonicotonic convulsion of a few minute duration lasted for 25 minutes. Later neurological examination revealed normal functions. Although the etiology of convulsion by propofol is controversial, the convulsion observed in our patient seems to be related to glycinergic as well as glutamate receptors. When we administer propofol to patients, we should be careful about the occurrence of convulsion.     

Survival and disability in stroke by stroke subtype based on computed tomographic findings in three rural Japanese communities

PURPOSE: We conducted an epidemiological study of survival and disability in stroke in three Japanese communities to seek community strategies for improvement in survival and disability. METHODS: A total of 297 first-ever strokes were identified between 1988 and 1992 in three rural communities (total population = 47,000) located in Akita and Ibaraki. We analyzed survival rates and activity of daily living by sex, age-group and stroke subtypes. Successful review of computed tomography (CT) for 84 percent of the strokes (249 out of 297) was possible and the data were used for subtype analyses. RESULTS: For all strokes (n = 297) survival rates were 85% for 30 day, 70% for one year, 62% for three year. The rates tended to be lower in women than in men. The rates were lowest in ages less than 60 at thirty day, and in ages 80 and older at the end of the first and third year. Intracerebral hemorrhage with ventricular rupture, subarachnoid hemorrhage and cortical cerebral infarction had lower survival rates than intracerebral hemorrhage without ventricular rupture and lacunar infarction. Based on Cox's proportional hazard model, risk ratio for death was 2.07 in ages 70-79, and 3.80 in ages 80 and older compared with ages 60-69. The risk ratio was 3.46 for intracerebral hemorrhage with ventricular rupture, 3.38 for subarachnoid hemorrhage and 2.46 for cortical cerebral infarction compared with lacunar infarction. The proportion of stroke survivors who need assistance from others in the first and third years tended to be higher in women than in men. The proportion was higher in older patients than in the younger, and higher for intracerebral hemorrhage with ventricular rupture and cortical cerebral infarction than in other subtypes of stroke. From logistic regression analysis, the odds ratio for disability in the first year was 6.55 for ages 80 and older compared with ages 60-69. The odds ratio was 5.61 for intracerebral hemorrhage with ventricular rupture, 4.53 for cortical cerebral infarction compared with lacunar infarction. In the third year the odds ratio was significant for ages 70-79, and decreased for intracerebral hemorrhage with ventricular rupture (odds ratio = 2.98), and increased for cortical cerebral infarction (odds ratio = 6.06). CONCLUSIONS: Survival and disability in stroke depended on age and stroke subtypes. Even after age adjustment, stroke subtypes with large cerebral involvement had worse prognosis than stroke subtypes. Community-based hypertension control programs are important to prevent any subtypes of stroke. Stroke subtypes as well as age should be taken into account to develop effective care and medical treatments for strokes.     

Simultaneous operation of intra-descending aorta bypass grafting and brachiocephalic artery reconstruction in a patient of aortitis syndrome

OBJECTIVE: To determine the intracavernous partial oxygen pressure in different etiological groups of erectile dysfunction: psychogenic (control group), arterial and veno-occlusive and the value of intracavernous gasometry as an indicator of the degree of severity of impotence. METHODS: A total of 16 patients were evaluated according to the diagnostic protocol utilized to determine the etiology of erectile dysfunction. Intracavernous blood samples were obtained during the initial phase of gasometry and PO2 was determined by standard gasometric methods. RESULTS: After injection of the vasoactive drug, the mean intracavernous PO2 was 92.4 +/- 1.27 for the control group, 62.2 +/- 0.85 for the group with arterial impotence, and 76.8 +/- 1.45 for the group with venous impotence, demonstrating a statistically significant difference (p < 0.01). CONCLUSIONS: Intracavernous gasometry, in combination with other diagnostic tests, is useful for evaluating the degree of severity of erectile dysfunction. The reduction in cavernous oxygen tension, which induces cavernous tissue fibrosis, can be considered to be a common mechanism in arterial and venous impotence.     

A 14-ns 14-Mb CMOS DRAM with 300-mW active power

A 4-Mb high-speed DRAM (HSDRAM) has been developed and fabricated by using 0.7-μm L_eff CMOS technology with PMOS arrays inside n-type wells and p-type substrate plate trench cells. The 13.18-mm×6.38-mm chip, organized as either 512 K word×8 b or 1 M word×4 b, achieves a nominal random-access time of 14 ns and a nominal column-access time of 7 ns, with a 3.6-V V_cc and provision of address multiplexing. The high level of performance is achieved by using a short-signal-path architecture with center bonding pads and a pulsed sensing scheme with a limited bit-line swing. A fast word-line boosting scheme and a two-stage word-line delay monitor provide fast word-line transition and detection. A new data output circuit, which interfaces a 3.6-V V_cc to a 5-V bus with an NMOS-only driver, also contributes to the fast access speed by means of a preconditioning scheme and boosting scheme. Limiting the bit-line voltage swing for bit-line sensing results in a low power dissipation of 300 mW for a 60-ns cycle time     

Evaluation of vibration in many positions by SOM

We propose a method of evaluating the vibration of motor-operated electric tools (MOETs) by using a self-organizing feature map (SOM). The vibration spectrum is used to evaluate the MOET vibration. These vibration spectra are derived from 18 vibration data obtained by measurements on three different positions of a MOET. The spectra are then sent to the SOM network for the calculations. The vibration spectra are classified by the SOM, and calculations give the Euclidean distance from the weight vector in order to develop a quantitative evaluation. A statistic analysis of the Euclidean distance allows a quantitative evaluation of a MOET with respect to vibration stress and other relevant parameters.This work was presented, in part, at the 9th International Symposium on Artificial Life and Robotics, Oita, Japan, January 28–30, 2004     

Angular resolution of the Ohya air shower detector

Accurate measurements of the total number of muons in an air shower are important for the discrimination of showers produced by astronomical gamma rays from those produced by protons. In order to perform this discrimination, muon detectors with a total area of about 400 m² have been constructed in the Ohya stone mine. At ground level, scintillation detectors have been distributed for determining the total number of electrons in the air shower. The arrival direction of the air shower determined by usual timing information was examined using independent data on the arrival direction determined by muons in the shower. The angular resolution thus obtained at the shower maximum is 1.7° in the south-north plane and 2° in the east-west plane. The difference of the resolution is due to the asymmetric arrangement of scintillation detectors.     

Effects of a long-term hypertension control program on stroke incidence and prevalence in a rural community in northeastern Japan

BACKGROUND AND PURPOSE: Although randomized clinical trials have demonstrated the benefit of antihypertensive treatment in preventing stroke, the effectiveness of community-based programs is largely unknown. We investigated long-term community-based prevention activities. METHODS: In rural northeastern Japan, people aged > or = 30 years numbered 3219 in the full intervention community and 1468 in the minimal intervention community in 1965. Systematic blood pressure screening and health education began in 1963. Stroke was registered through 1987. RESULTS: More than 80% of people aged 40 to 69 years were screened in both communities in the 1960s. One community charged for screening services after 1968, whereas the other community intensified intervention; subsequently, screening rates and the follow-up of hypertensive individuals declined in the minimal intervention community, especially in men. In men, stroke incidence declined more (P < 0.001) in the full intervention (42% in the period 1970 to 1975, 53% in the period 1976 to 1981, and 75% in the period 1982 to 1987) than in the minimal intervention community (5% increase, 20% decrease, and 29% decrease, respectively); in women, the stroke incidence declined about 45% to 65% in both communities. Changes in stroke prevalence paralleled those in stroke incidence. Trends in systolic blood pressure levels tend to explain the differential stroke rates in men. CONCLUSIONS: Delivery of hypertension control services through intensive, free, community-wide screening and health education was effective in prevention of stroke for men in a community.     

The effect of interleukin-6 on enhancing the invasiveness of head and neck cancer cells in vitro

Three male patients, aged 43, 41 and 44 years, were referred to the cardiologist because of complaints of angina pectoris; one of them also had an aortic valve stenosis. Nine to 22 years before, they had received radiotherapy on the mediastinum because of Hodgkin's disease. Coronary angiography showed severe stenoses of the ostium of the right coronary artery or of the main left coronary artery, following which the patients were treated with coronary artery bypass surgery, aortic valve replacement and (or) drugs. These locations are very unusual in patients with angina who did not receive any radiation therapy, but they are seen frequently in patients who have received radiotherapy on the mediastinum. The pathogenesis of these lesions is not exactly known. The normal risk factors for atherosclerosis plus free oxygen radicals are probably involved. The free oxygen radicals, generated by radiation, locally activate coagulation via various hypothetical mechanisms. The damaging effect of radiotherapy could therefore be prevented by antioxidants. However, the therapeutic effect of radiation would most likely decrease as well. A more rational approach to prevent these vascular lesions would be to reduce the radiation load, to treat the risk factors for atherosclerosis and to give platelet aggregation inhibitors such as acetylsalicylic acid.