Anjo Kosei Hospital Research Articles

Electroencephalographic aspects of periventricular hemorrhagic infarction in preterm infants.

The aim of this study was to investigate electroencephalographic aspects of periventricular hemorrhagic infarction (PVHI) in preterm infants. The subjects were 11 preterm infants with PVHI, who were admitted to the Neonatal Intensive Care Unit of Anjo Kosei Hospital from April 1985 through December 1997. The patients underwent serial cranial ultrasonography and were diagnosed as having PVHI. An EEG was recorded at least once within 1 week after PVHI and then recorded at 1- to 4-week intervals until 40 weeks of postconceptional age. The EEG findings were classified into acute and chronic stage abnormalities. Acute stage EEG abnormalities were seen in 5 infants after PVHI, which were symmetrical in all infants. Among them, 3 infants died during the early neonatal period. The infants who had a higher grade of acute stage EEG abnormalities showed significantly higher mortality. Among the surviving 8 infants, chronic stage EEG abnormalities were seen in 3 predominantly in the ipsilateral side of PVHI, and all of them developed hemiplegia. The sensitivity and specificity of chronic stage EEG abnormalities to predict outcome were 0.75 and 1.0, respectively. Acute and chronic stage EEG abnormalities give valuable information for short-term and long-term outcome in preterm infants with PVHI.

メチシリン耐性黄色ブドウ球菌感染患者における硫酸アルベカシンの血清中濃度モニタリングの有用性についての研究

Although vancomycin has been exclusively used for methicillin-resistant Staphylococcus aureus (MRSA) therapy, there are many patients recently observed to suffer from gram negative bacteria, Pseudomonas aeruginosa as well as MRSA.Arbekacin (ABK), an aminoglycoside antibiotic (AG) is an alternative medication for such patients with those infection disease. However, it seems that the dosage of ABK used according to the manufacture's recommendations is insufficient for MRSA therapy to obtain a sufficient patient outcomes. Moreover, the relationship between the effectiveness of ABK on MRSA infection and the serum ABK concentration remains unclear. For the long-term treatment of AG, we can not rule out the possibility that AG may induce nephrotoxicity and ototoxicity.Therefore, the present study was carried out to clarify the significance of therapeutic drug monitoring (TDM) of ABK for patients with an MRSA infection, and elucidate the relationship between the serum ABK level and its clinical outcomes, including its antibacterial action and side effects. We investigated 30 patients with an MRSA infection, who received ABK at the Anjo Kosei Hospital from September 1996 to June 1998. The treatment of the patients by ABK but without TDM showed a 46.6% (7/15) therapeutic efficacy, while the patients with drug monitoring had a remarkably successful therapeutic efficacy (100% : 21/21) with a peak serum ABK concentration over 10μg/mL. Dysphagia badly affected the efficacy of ABK therapy in patients with an MRSA infection even when the serum ABK level was well-controlled. The incidence of ABK induced nephrotoxicity was observed in all patients when ABK was administered at a total dose of over 5, 000mg, while it was 4% at a total dose of less than 5, 000mg. When the duration of ABK therapy was longer than 2 weeks, the incidence of nephrotoxicity also significantly increased.These results thus suggest that TDM of ABK is useful for increasing the efficacy of ABK therapy in patients with an MRSA infection. In light of nephrotoxicity, these results indicate that ABK therapy may be completed within 2 weeks with an ABK dose of less than 5, 000mg, as the total dose.

EaeA genes in Escherichia coli derived from Japanese patients with sporadic diarrhea.

To investigate the prevalence of attaching and effacing Escherichia coli, we examined 364 strains isolated from the feces of 9,684 patients with diarrhea at the Anjo Kosei Hospital in Japan for the presence of eaeA. Twenty-nine (8%) of the strains were eaeA positive. Of enteropathogenic E. coli (EPEC), 11 of the 87 (13%) strains were for the positive eaeA gene. The serotypes and the numbers of eaeA-positive strains among the strains tested were as follows: O26:H-(2/3), O55:H7 (4/4), O55:H-(2/ 2) and O128:H2(3/3). Two enterohemorrhagic E. coli (EHEC) strains (Verotoxin positive O157:H7) were also eaeA positive. Among 260 non-EPEC strains that were not categorized as diarrheagenic E. coli, 16 (6%) were eaeA positive. Those serotypes were as follows: O15:H2, O20:H6, O28:H28, O63:H6. O153:H7, O28:H6, O153:H19 and O157:H45. EPEC strains including O18:H7 and six other serotypes, enteroinvasive E. coli (EIEC), and enterotoxigenic E. coli (ETEC) were all eaeA negative.

Benign Partial Epilepsy in Infancy

The frequency of occurrence of benign partial epilepsy in infancy (BPEI) in a first line general hospital was determined among 75 patients presenting with epilepsy in the first 2 years of age and evaluated between 1987 and 1993 at the Departments of Paediatrics, Anjo Kosei Hospital, Anjo Aichi, and Nagoya University School of Medicine, Nagoya, Japan.

小児科領域におけるCefpodoxime proxetilの基礎的・臨床的検討

小児科領域におけるCefpodoxime proxetilの基礎的・臨床的検討