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Background The aim of this study was to evaluate the efficacy and feasibility of preoperative chemotherapy with S-1 plus cisplatin in patients with initially unresectable locally advanced gastric cancer. Methods We enrolled patients with initially unresectable locally advanced gastric cancer because of severe lymph node metastases or invasion of adjacent structures. Preoperative chemotherapy consisted of S-1 at 80 mg/m2 divided in two daily doses for 21 days and cisplatin at 60 mg/m2 intravenously on day 8, repeated every 35 days. If a tumor decreased in size, patients received 1 or 2 more courses. Surgery involved radical resection with D2 lymphadenectomy. Results Between December 2000 and December 2007, 27 patients were enrolled on the study. No CR was obtained, but PR was seen in 17 cases, and the response rate was 63.0%. Thirteen patients (48.1%) had R0 resections. There were no treatment related deaths. The median overall survival time (MST) and the 3-year overall survival (OS) of all patients were 31.4 months and 31.0%, respectively. Among the 13 patients who underwent curative resection, the median disease-free survival (DFS) and the 3-year DFS were 17.4 months and 23.1%, respectively. The MST and the 3-year OS were 50.1 months and 53.8%, respectively. The most common site of initial recurrence after the R0 resection was the para-aortic lymph nodes. Conclusions Preoperative S-1 plus cisplatin can be safely delivered to patients undergoing radical gastrectomy. This regimen is promising as neoadjuvant chemotherapy for resectable gastric cancer. For initially unresectable locally advanced gastric cancer, new trials using more effective regimens along with extended lymph node dissection are necessary.

Energy distributions of secondary charged particles were calculated in tissue substitutes irradiated by neutrons from 0.14 to 65 MeV, using the Particle and Heavy Ion Transport code System. The calculations were compared with experimental data measured by tissue equivalent proportional counters (TEPC). It is found that the calculated distributions of the lineal energy, y, generally agree well with the measured ones for neutrons from several 100 keV to 15 MeV. In the case of 40 and 65 MeV neutron irradiations, wall effects of TEPC should be considered and the fluence of alphas is underestimated by the calculations. Integrated dose contributions of the secondary charged particles are generally in good agreement with those of the measured ones.

An adaptive antenna that forms an adaptive beam by adjusting current induced in the parasitic elements has been experimentally produced. The antenna consists of a radiating element placed at the center and six parasitic elements placed on the circumference of a circle with a radius of 0.5 /spl lambda/. These elements are monopoles on the reflector. A three-state switched load is connected with each parasitic element. The combination for which the correlation between the received signal and the reference signal maximizes is selected from all load setting combinations. The advantages of using three alternative loads instead of a variable reactance, that is, fast convergence and avoidance of falling into local cost function minimum are demonstrated by numerical experiments. The adaptive beam pattern and bit error rate (BER) of the binary phase shift keying (BPSK) signal were measured in an anechoic chamber, and the capability of the adaptive antenna to form adaptive beams was confirmed.

BackgroundPoorly defined cohorts and weak study designs have hampered cross-cultural comparisons of course and outcome in schizophrenia.AimsTo describe long-term outcome in 18 diverse treated incidence and prevalence cohorts. To compare mortality, 15- and 25-year illness trajectory and the predictive strength of selected baseline and short-term course variables.MethodHistoric prospective study. Standardised assessments of course and outcome.ResultsAbout 75% traced. About 50% of surviving cases had favourable outcomes, but there was marked heterogeneity across geographic centres. In regression models, early (2-year) course patterns were the strongest predictor of 15-year outcome, but recovery varied by location; 16% of early unremitting cases achieved late-phase recovery.ConclusionsA significant proportion of treated incident cases of schizophrenia achieve favourable long-term outcome. Sociocultural conditions appear to modify long-term course. Early intervention programmes focused on social as well as pharmacological treatments may realise longer-term gains.

To examine the involvement of transforming growth factor-β1 (TGF-β1) in intestinal anastomotic repair, we administered a TGF-β1-neutralizing antibody to rats after operation, and then examined its influence on the healing process and interaction with other peptide growth factors. Thirty male Sprague-Dawley rats were subjected to primary anastomosis after transection of the small intestine (n = 30) and treated by intraperitoneal administration of IgG (n = 15) or the TGF-β1 neutralizing antibody (n = 15). Treatment with the antibody against TGF-β1 resulted in more definite mucosal growth and increased vascularity on day 5 after surgery. Augmented mRNA expression of epidermal growth factor and vascular endothelial growth factor, and an increased number of cells that expressed these peptides in granulation tissue were demonstrated by RT-PCR and immunohistochemical staining. Taken together it was indicated that TGF-β1 has negative effects on regeneration of the bowel wall mucosa and angiogenesis in the course of intestinal anastomotic wound healing.

Short beak (SBK) is a new semilethal mutation of Japanese quail (Coturnix japonica). The SBK individuals are characterized externally by short beaks, shanks, and digits. The shank is also thicker than the wild type. The shape of the mutant beak does not show a parrotlike appearance, contrasting with that of other poultry chondrodystrophic mutants reported in the literature. Bones in the fore and hind limbs of the SBK mutant are also shorter than the wild types. The humerus and ulna in the wing are significantly thicker than the wild types. Other bones in the wing and leg show approximately the same thickness as the wild types. The majority of the SBK mutans die at the late embryonic stage. Some chicks can hatch with no assistance, but almost all die around 3 days of age. However, a part of the SBK individuals (5.3%, 8/151) reach sexual maturity and can reproduce. Genetic analyses revealed that the SBK mutation is controlled by an autosomal recessive gene. The proposed gene symbol is sbk. The sbk gene is not allelic to the previously reported stumpy-limb (sl) gene that expresses a somewhat similar phenotype to the SBK.

The neutron build-up factor is newly defined for describing the dose equivalent profiles of medium energy neutrons (E n ≤ 400 MeV) in shields of concrete, iron and a double-layered shield of iron + concrete. The definition of the build-up factor is made in a straightforward way which is analogous to that of gamma rays. The obtained neutron build-up factors are parameterised by empirical expressions. Systematics of the parameters in the expressions and removal cross sections which are used instead of the linear attenuation coefficients in gamma ray cases, are examined regarding the neutron energy.

1 Department of Environmental Engineering for Symbiosis, Faculty of Engineering, Soka University, 1-236, Tangi-cho, Hachioji, Tokyo, 192-8577, Japan 2 Department of Bioinformatics, Faculty of Engineering, Soka University, 1-236, Tangi-cho, Hachioji, Tokyo, 192-8577, Japan 3 Department of Environmental Sciences, Faculty of Life and Environmental Sciences, Prefectural University of Hiroshima, 562, Nanatsuka-cho, Shobara, Hiroshima, 727-0023, Japan

Indium-tin oxide (ITO) films are prepared on silica glass substrates by the dynamic mixing method, that is, indium and tin are simultaneously evaporated on the substrates and the oxygen ions with energies of 10, 2 and 0.6 keV are also simultaneously bombarded normal to the substrate surface. The film thickness is about 500 A and the substrate temperature is lower than 50° C. Films formed with 10 keV ions have a preferred orientation of the [111] axes of In2O3 crystals which are normal to the film surface and the film with the deposition rates O/In = 3.2, and Sn/In = 0.19 has a transmittance of 96% and an electric resistivity of 7 × 10−3 Ω cm. Films prepared with 0.6 keV ions and O/In = 2.1, Sn/In = 0.2 have a transmittance of 92% and a resistivity of 2.5 × 10−4 Ω cm. The film has a preferred orientation of the [110] axes which are normal to the film surface. Films produced with 2 keV have no definite preferred orientation and have worse quality than those prepared with 10 and 0.6 keV.

Various portable electronic devices now have wireless interfaces as standard equipment. Such interfaces will be common in ad hoc networks, relaying packets mutually among users' nodes in a network without base stations. However, a fear is emerging of selfish nodes in ad hoc networks. These nodes take advantage of other ones and do not cooperate with others, making network resources unavailable for legitimate nodes. This problem is categorized as a security issue. Our research demonstrates the impact of these selfish nodes. The authors have studied the problem of selfish nodes and tested primitive detection and countermeasure methods by network simulation.

This paper describes space-time resource tradeoff experiments carried out on the dynamically reconfigurable “Plastic Cell Architecture (PCA)” with cryptographic and evolutionary computation kernels. Data-path-oriented processing functionality is encapsulated in asynchronous hardware objects with variable graining and implemented using look-up tables. Communication (i.e. connectivity and control) between the distributed processing objects is achieved by means of inter-object message passing. The key point of the truly scalable, asynchronous PCA architecture is that it offers flexible low power pipeline processing combined with the ability to evolve new circuit functionality through on-line adaptation due to a uniform data and circuit representation and rich communication facilities.

We are trying to build a general purpose computing environment where all computations are performed using wired logic. We have claimed that autonomous reconfigurability is indispensable for this purpose. Autonomous reconfigurability means that functions configured on a reconfigurable computer can configure other functions and all can communicate with each other by themselves at run-time. This paper suggests the concept of resource management and virtualization operated by programmed wired logic on the general purpose computing environment: virtualizing the locations used by applications implemented by wired logic. This paper also describes the result of implementing the basic resource management and virtualization system based on the concept to evaluate its spatial and time overheads. It also estimates the improvement achieved in time overheads.

An adaptive antenna, which consists of a feed element and some circular arrays of parasitic elements on the counterpoise and forms adaptive pattern by connecting the each parasitic element to switched load us proposed. In this paper, the antenna aperture, that is, number of parasitic elements, number of circular arrays and the radius, and the switched load are examined by the Monte-Carlo simulation.

A multi-band adaptive array antenna has been proposed. The aperture is consisted by a central radiating element and several parasitic elements on the counterpoise. Multi-band monopole is applied to the central radiating element. The parasitic elements are located on various concentric circles of which radius is proportional to the wavelength. Output of the parasitic element is connected to either the open circuit or a switched load. When the parasitic elements on a circular array corresponding to the desired frequency are used, each switched load is set such that the correlation between symbols received by the central element and the reference is maximized by means of the Full Search Method. Monte-Carlo simulation shows probability that the correlation coefficient exceeds 0.99 in case of 2 incident signal is 0.92 and that the unused array has little influence. VEGA can be used in order to optimize the correlation coefficients and VSWR at the same time.

A radiation streaming experiment has been carried out at the Takasaki Ion Accelerator Facility for Advanced Radiation Application at the Japan Atomic Energy Research Institute in a room housing a Cu target irradiated with 68 MeV protons and in a labyrinth of three-legs having a total length of 29 m. In the experiment, neutron and gamma ray energy spectra, neutron reaction rates, and neutron and gamma ray dose equivalent rates were measured using various counters and dosimeters. The experimental data show the applicability of some empirical formulas for estimating the thermal neutron flux in a room and neutrons streaming in a labyrinth designed for a proton accelerator operating in the intermediate energy region. The data suggest that it is mandatory to estimate the gamma ray dose equivalent rate in a labyrinth, which is dominated by the secondary gamma rays due to the neutron capture reaction.

The classification of 'Manic-depressive illness(MDI)' has been changing in this several years greatly. MDI is recently named as a 'mood(affective) disorder' according to the ICD and DSM diagnostic system. Since 1990, with ICD-10(WHO), and 1994, with DSM-IV(APA), practitioners have had at their disposal two(practically compatible) classifications of mental disorders containing operational criteria for diagnosis, and helpful in guiding clinical and therapeutic approach. In ICD-10, mood disorder belongs to the F3 category, and there are seven subcategories which were divided in to subclasses. The two other subclasses of 'F06.3 organic mood disorder' 'F41.2 mixed anxiety and depressive disorders' were set up additionally.

To determine the optimum pouch reconstruction after total gastrectomy, we conducted a randomized trial to compare the usefulness between PR and PI in terms of quality of life.Thirty patients younger than 70 years of age were selected and randomly classified into the following 2 groups: pouch and Roux-en-Y (PR; n = 15) and pouch and interposition (PI; n = 15). In each subject, the postoperative symptoms, food intake in a single meal, body weight, serum nutritional parameters, endoscopy, emptying time of the gastric substitute, and gallstone formation were evaluated.There were no significant differences in terms of the postprandial symptoms, food intake, body weight, and serum nutritional parameters until 2 years postoperative. Endoscopy showed a tendency of food stasis in the PR group, although this was not significant. The gastric emptying test in the PR group indicated that the retention capacity was slightly superior to that in the PI group.The impact of the duodenal passage on symptoms and nutrition could not be ascertained.

There have been many reports proposing some advantages of pylorus-preserving gastrectomy for gastric ulcer compared to the conventional distal gastrectomy. However, it is not clear whether similar results will be obtained from the patients with early gastric cancer.Of 50 patients with early gastric cancer, 25 underwent pylorus-preserving gastrectomy under strict criteria and the other 25 underwent distal gastrectomy with Billroth I anastomosis by the same surgeon. The subjects were then interviewed and examined periodically to assess symptoms, food intake, body weight and serum nutritional parameters. Endoscopy and a radioisotope gastric emptying test was performed 1 year after the operation.Many of the patients with pylorus-preserving gastrectomy complained of gastric fullness after meals, resulting in poor food intake; a significant between-group difference was found up to 1 year after the operation. A low incidence of reflux gastritis and slow gastric emptying were confirmed in the patients after pylorus-preserving gastrectomy.Pylorus-preserving gastrectomy has advantages over distal gastrectomy in terms of the avoidance of dumping syndrome and protection against duodeno-gastric reflux. However, more time was necessary for improved gastric fullness or food intake. Pylorus-preserving gastrectomy should be applied in younger patients with early gastric cancer expecting long survival.

Most acute psychotic episodes are regarded as indicators of schizophrenia. We developed an algorithm for the treatment of such episodes. In Japan, psychiatrists tend to prescribe two or more neuroleptics at once, but it is thought that using a single neuroleptic is better, and the algorithm we report is based on this view. Since there are few reports on how to choose and use a single neuroleptic in Japan, our method is simply an example, with insufficient scientific support. It will need to be revised in future.

The clench (CL) is a new morphological mutation in Japanese quail (Coturnix japonica). The CL mutants rigidly clench their toes in both legs, which gives rise to a human fistlike appearance in the distal ends of the legs. Other parts of the CL body are quite normal. In spite of the severe toe abnormality, the CL mutants are normal in fertility, hatchability, and postnatal viability. Genetic analysis revealed that the CL mutation is an autosomal recessive with 100% penetrance. The proposed gene symbol is cl.

Short break (SBK) is a new semilethal mutation of Japanese quail (Coturnix japonica). The SBK individuals are characterized externally by short breaks, shanks, and digits. The shank is also thicker than the wild type. The shape of the mutant beak does not show a parrotlike appearance, contrasting with that of other poultry chondrodystrophic mutants reported in the literature. Bones in the fore and hind limbs of the SBK mutant are also shorter than the wild types. The humerus and ulna in the wing are significantly thicker than the wild types. Other bones in the wing and leg show approximately the same thickness as the wild types. The majority of the SBK mutants die at the late embryonic stage. Some chicks can hatch with no assistance, but almost all die around 3 days of age. However, a part of the SBK individuals (5.3%, 8/151) reach sexual maturity and can reproduce. Genetic analyses revealed that the SBK mutation is controlled by an autosomal recessive gene. The proposed gene symbol is sbk. The sbk gene is allelic to the previously reported stumpy-limb (sl) gene that expresses a somewhat similar phenotype to the SBK.

Hereditary multiple malformation (HMM), a new mutation of Japanese quail (Coturnix japonica), is controlled by an autosomal recessive gene. The proposed gene symbol for the mutant gene is hmm. The majority of the homozygotes die at the sixth day of incubation, and the remainder die at various stages by 15 days of incubation. The homozygotes surviving to the late embryonic stage have greatly shortened lower and upper beaks that are set apart and show an early embryo-like body shape, with feather buds but no plumules. Furthermore, they show syndactylous polydactyly in both fore and hind limbs. In the abdomen of the homozygote, a part of the ventriculus, liver, and small intestine protrudes out of the umbilicus region. In the skeleton of the late HMM embryos, ossification is generally delayed and morphogenetic abnormalities are observed all over the body. This mutant seems to become a powerful animal model in the research fields for morphogenesis.

In order to evaluate antimicrobial activities of clarithromycin (CAM), minimum inhibitory concentrations (MICs) of CAM and control drugs were determined against clinical isolates that were obtained from outpatients in 1994 and 1996. The results are summarized as follows; 1. It was not showed that CAM-resistant strains were increasing among Staphylococcus spp., beta-streptococci, Moraxella subgenus Branhamella catarrhalis, Haemophilus influenzae, Bordetella pertussis, Campylobacter jejuni subsp. jejuni, Chlamydia trachomatis and Mycoplasma pneumoniae. It appeared that resistances to CAM and macrolides (MLs) were increasing among Streptococcus pneumoniae and Peptostreptococcus spp. 2. The drug susceptibility patterns to MLs were similar and detection frequencies of induced resistant strains that were resistant to only 14-membered ring MLs including CAM and constitutive resistant strains that were resistant to 14 and 16-membered ring MLs were high among Streptococcus pneumoniae and Peptostreptococcus spp. It appears that MLs-resistance systems are linked to each other, and that this was a cause of increasing MLs-resistance among these bacterial species. 3. Notwithstanding of antibiotic resistance problems, CAM is still useful since it maintains strong antimicrobial activities against M. (B.) catarrhalis, B. pertussis, C. jejuni subsp. jejuni, C. trachomatis and M. pneumoniae, and it controls arginate producing abilities of mucoide strains of Pseudomonas aeruginosa.

Long-term mortality and morbidity was evaluated in 267 patients with a minimum follow-up of 10 yr and the physical status, graft function and quality of life in 15 patients with a functioning graft surviving for over 20 yr were reviewed. Actual patient and graft survival rates were 80.2% and 51.1% at 10 yr (n = 267) and 56.4% and 32.7% at 20 yr (n = 55), respectively. Although the rate of graft failure due to rejection was 4 times higher than that of patient death within 10 yr, it decreased to the level of patient death in the second decade. Dominant causes of death in patients with graft surviving for over 10 yr were hepatic failure due to viral hepatitis and malignancies. In 15 patients with graft currently surviving beyond 20 yr, while all patients have excellent graft function, malignancy occurred in 5, viral hepatitis in 3, aseptic necrosis in 3, and diabetes mellitus in one patient. No patient has suffered cardiovascular complications. Despite a high rate of morbidity, they show a satisfying status of rehabilitation (full time working 11/ 15, 73.3%). In order to attain more improved QOL in patients with long-term surviving renal transplant, close follow-up aiming at diminution of complications is required throughout the period after transplantation.

The authors modified the operative procedures used in pouch and interposition (PI) reconstruction in an attempt to improve the surgical results after a total gastrectomy, because a randomized controlled trial had revealed that the clinical assessment of PI was quite poor, even though it is a physiological route. In most of the treated patients, the gastric emptying test revealed delayed emptying, and an X-ray video film showed folding and twisting of the jejunal conduit between the pouch and duodenum, which disturbed the transmission of the nutrition. Modified PI (m-PI) was performed by decreasing the length of the jejunal conduit and widening the jejunal pedicle to preserve the blood and nerve supply. The m-PI group showed a lower incidence of symptoms, a greater food intake, and a greater weight recovery than the PI group. The gastric emptying test also revealed an acceptable degree of emptying. We conclude that the m-PI reconstruction is more useful for improving the postoperative quality of life than the previously used method of PI reconstruction.

The mechanism of pleural fibrosis in malignant and inflammatory pleural effusion remains unclear. We measured the levels of type III procollagen N-terminal amino peptide (PIIIP) and type IV collagen 7S in patients who had pleural effusion and lung carcinoma, and in others who had inflammatory diseases (parapneumonic and tuberculous pleuritis). The PIIIP level and the PIIIP/type IV collagen 7S ratio in patients with malignant pleural effusion were significantly lower than those in patients with inflammatory pleural effusion (p0.01), but the levels of type IV collagen 7S did not differ. The ratio of PIIIP to type IV collagen 7S was higher in patients with tuberculous pleuritis than in those with parapneumonic pleuritis (p0.05). These data indicate that pleural fibrotic adhesion may be accelerated in inflammatory pleural effusion because of elevated production of type III collagen; basement membrane injury in malignant and inflammatory pleural effusion may be caused by similar damage. We conclude that a high level of PIIIP and a high PIIIP/type IV collagen 7S ratio may indicate the presence of inflammatory pleuritis, and that the latter may indicate the presence of tuberculous pleuritis.

The reservoir and transit capacity of the post-gastrectomy jejunal pouch was evaluated, using a radioisotopic method, to examine the relationship of the gastric emptying to postprandial symptoms and to the food intake status.Thirty-seven patients who had undergone total gastrectomy for cancer (Roux-Y reconstruction, 8; Hunt- Lawrence pouch and Roux-Y, 15; pouch interposition, 5; modified pouch interposition, 9) were retrospectively studied. Based on the percent retention in the gastric substitute, the emptying curves were classed as showing delayed, intermediate, and rapid emptying types.All of the patients with pouch reconstruction showed either delayed or intermediate emptying. High frequency of the sensation of epigastric fullness, nausea, or vomiting was demonstrated in the patients with delayed emptying (p0.01). The patients with delayed emptying showed poor food intake compared to those with intermediate emptying (p0.05). Given the X-ray video film and endoscopic findings, the delayed emptying was thought to be due to poor drainage of the efferent loop resulting from the post-operative adhesions.The present study revealed that delayed emptying is associated with postprandial symptoms and with poor food intake. The examination of gastric emptying is useful in evaluating or predicting the postoperative status.

In order to evaluate antimicrobial activity of arbekacin (ABK), coagulase-type and minimum inhibitory concentrations (MICs) of ABK and other drugs were determined against 700 strains of methicillin-resistant Staphylococcus aureus (MRSA) that were obtained in our laboratory from 1990 to 1996, 7 years. The results are summarized as follows; 1. The MIC-distributions of ABK against 100 strains of MRSA obtained yearly did not show stochastically significant differences. 2. The coagulase-type distributions showed differences over the years. Coagulase-type II strains increased and type IV strains decreased, and MIC-distributions of ABK and other drugs were different according to coagulase-types. 3. The detection frequencies of ABK-resistant strains (MIC of ABK:or = 12.5 micrograms/ml) were 2.0 approximately 8.0% through the years. The frequency reported in 1980 was equal to the frequency obtained in 1992 approximately 1993 in a nationwide survey. Coagulase-types II, IV and VII that were ABK-resistant strains were frequently obtained, and most of ABK-resistant strains were also highly resistant to gentamicin.

In order to evaluate antimicrobial activity of cefodizime (CDZM), minimum inhibitory concentrations (MICs) of CDZM and control drugs were determined against clinical isolates collected from nation-wide medical institutions and in our laboratory from September to December of 1992 and from September to December of 1995. The results are summarized as follows: 1. Bacterial species with no or few strains resistant to CDZM included Streptococcus pyogenes, Haemophilus influenzae, Citrobacter koseri, Proteus mirabilis and Neisseria gonorrhoeae. The range of MIC values of CDZM against Klebsiella pneumoniae was spread. Other strains, Streptococcus pneumoniae, Moraxella subgenus Branhamella catarrhalis, Escherichia coli, Citrobacter freundii, Enterobacter spp., Serratia marcescens, Proteus vulgaris, Morganella morganii, Providencia spp., Peptostreptococcus spp. and Bacteroides fragilis group were resistant to cephems including CDZM. 2. The MIC90's of CDZM were 0.05 approximately 3.13 micrograms/ml against Streptococcus spp., H. influenzae, M. (B.) catarrhalis, E. coli, Klebsiella spp., P. mirabilis, N. gonorrhoeae and Peptostreptococcus spp. obtained in 1995 that were frequently found in daily treatment of infections. It appears that the effectiveness of CDZM was still relatively high against community-acquired infections. 3. Among H. influenzae isolates included imipenem (IPM)-resistant and norfloxacin (NFLX)-resistant strains. The MIC-range of CDZM against strains collected in 1995 including IPM-resistant and NFLX-resistant strains wasor = 0.025 approximately 0.1 microgram/ml, and MIC90 against these strains was 0.05 microgram/ml. CDZM showed strong antimicrobial activities against H. influenzae strains resistant to carbapenems and new-quinolones.

The purpose of the study was to evaluate the potential of dynamic Gd-DTPA-enhanced MR imaging in assessing of the function of transplanted kidneys. Dynamic MR imaging was performed using the GRASS pulse sequence in 21 subjects (56 examinations), and in each examination 30 images were obtained after a bolus injection of Gd-DTPA. Imaging findings including signal increase and/or signal drop in cortex, signal drop in medulla, and signal drop in calyces were utilized for the evaluation of renal function. Renal function was also evaluated using the following parameters: Ta, time between the initial observation of signal increase in cortex and signal drop in medulla. Tb, time between the initial observation of signal drop in medulla and in calyces; Tc, Ta + Tb, and Max. C/M, maximum ratio of signal intensity between cortex and medulla among 30 images. In the group of patients with normal graft function (Ccror = 60ml/min), all imaging findings were observed. In the group of patients with mild graft dysfunction (30ml/minor = Ccr60ml/min), all imaging findings but signal drop in cortex were observed. The time parameters of Ta, Tb, and Tc were significantly larger, and Max. C/M was significantly smaller than those observed in the group with normal graft function. In the group of patients with severe graft dysfunction (Ccr30ml/min), almost none of the findings were observed. The investigation in patients in the postoperative state revealed a close correlation of the imaging findings and the values of parameters with changes in graft function over time. The results indicated the usefulness of the method in semiquantitative evaluation of graft function, including that of patients in postoperative state. This study suggests that dynamic Gd-DTPA-enhanced MR imaging could be a valuable method for the management of transplanted kidneys.

To evaluate antimicrobial activities of tosufloxacin (TFLX), minimum inhibitory concentrations (MICs) of TFLX and other drugs were determined against clinical isolates that were obtained in our laboratory from February of 1993 to January of 1994 (Period I), and from February of 1995 to January of 1996 (Period II). The results are summarized as follows: 1. Compared to MIC90's reported by others for TFLX in the 1980's, those obtained by us against beta-streptococci, Streptococcus pneumoniae, Peptostreptococcus spp., Haemophilus influenzae and Salmonella spp. were similar to, but those obtained against other bacteria were higher than those reported values. 2. Detection frequencies of resistant strains to TFLX were compared between Period I and Period II. MIC90's of TFLX against Staphylococcus spp., Morganella morganii, Providencia spp., Pseudomonas aeruginosa, beta-streptococci, S. pneumoniae and Peptostreptococcus spp. were lower in Period II than in Period I. TFLX-insensitive or -resistant H. influenzae were found among strains isolated in either of the Periods. 3. Most of the TFLX-resistant Gram-negative organisms tested were also resistant to other NQ's. 4. TFLX showed strong antimicrobial activities against penicillin-resistant S. pneumoniae.

In order to evaluate the antimicrobial activity of meropenem (MEPM), minimum inhibitory concentrations (MICs) of MEPM and control drugs were determined against clinical isolates from blood and cerebrospinal fluid that were obtained from January, 1993 to December, 1994. The results are summarized as follows; 1. The MIC-range, 50% MIC (MIC50) and 90% MIC (MIC90) of MEPM were equal to those of imipenem (IPM) and panipenem (PAPM) against Streptococcus pneumoniae including benzylpenicillin (PCG)-insensitive or -resistant S. pneumoniae, Streptococcus agalactiae and Listeria monocytogenes which are Gram-positive strains, and were stronger than those of ampicillin (ABPC) and cefotaxime (CTX). 2. The MIC-range, MIC50 and MIC90 of these 3 drugs of carbapenems (MEPM, IPM and PAPM) were different against Escherichia coli and Haemophilus influenzae which are Gram-negative strains. The MIC90 of MEPM wasor = 0.025 microgram/ml and those of IPM and PAPM were 0.2 microgram/ml against E. coli. The MIC90 of MEPM was 0.1 microgram/ml, that of IPM was 25 micrograms/ml and that of PAPM was 6.25 micrograms/ml against H. influenzae. Thus, the antimicrobial activity of MEPM was stronger than those of IPM and PAPM. The MIC90's of IPM and PAPM against H. influenzae were high with the MIC of IPM at 12.5 approximately 25 micrograms/ml and the MIC of PAPM at 3.13 approximately 12.5 micrograms/ml against 3 IPM-resistant strains among 17 isolates. 3. The MIC90 of ABPC was 0.39 microgram/ml and that of CTX was 0.1 microgram/ml against 20 strains of S. pneumoniae including 6 strains of PCG-insensitive or resistant S. pneumoniae. The MIC90 of ABPC and CTX were higher than those of 3 carbapenem drugs. There were E. coli of 8 strains with ABPC-high resistance (the MIC of ABPC was100 micrograms/ml) and 2 strains for which MIC of CTX were 0.39 microgram/ml and 3.13 micrograms/ml. It was found that 29.4% of H. influenzae were beta-lactamase producing strains. 4. It appeared that antimicrobial activities of carbapenems, particularly MEPM were strong against clinical isolates from blood and cerebrospinal fluid. MEPM will be first choice drug by empiric therapy in infections including sepsis and purulent meningitis.

To examine the antimicrobial activity of clarithromycin (CAM) against strains clinically isolated from outpatients in 1994, minimum inhibitory concentrations (MICs) were determined for CAM and the control drugs. The results were as follows; 1. MIC50 and MIC90 of CAM were similar to those investigated in 1980's against many bacterial species. 2. CAM showed strong antimicrobial activities against beta-lactamase producing Moraxella subgenus Branhamella catarrhalis, Bordetella pertussis, Campylobacter jejuni subsp. jejuni and Peptostreptococcus spp. 3. It appears that resistance to MLs including CAM is increasing among Streptococcus pneumoniae.

We report a pulmonary blastoma lacking sarcomatous features in 33-year-old woman. Abnormal shadow was detected in the right upper field in a routine chest X-ray film. The preoperative imaging films showed a 4 x 4 cm, well-circumscribed solid tumor in S3 of the right lung. The preoperative clinical diagnosis of primary lung cancer was considered. The operative findings showed that an elastic hard tumor, 5 cm in diameter, was localized in S3 of the right lung and partially contacted the middle lobe. Right upper and middle lobe resection was performed with lymph node dissection. The postoperative diagnosis was pulmonary blastoma, well differentiated fetal lung (= WDFA). It is considered that the degree of the malignancy of WDFA is lower and the prognosis of WDFA is better than conventional pulmonary blastoma (= biphasic blastoma). There are not available treatments except for surgical resection. It is suggested that it necessary to collect as many cases as possible, to make definite classifications and to examine the clinical course and prognosis of pulmonary blastoma.

In order to investigate antimicrobial activities of clavulanic acid/ticarcillin (CVA/TIPC) against Escherichia coli, Enterobacter spp. and Pseudomonas aeruginosa in 1992 and 1994, beta-lactamase activities were analyzed and minimum inhibitory concentrations (MICs) were determined including those of the control drugs. The results are as follows; 1. Compared to a report in 1980, the MIC distributions of CVA/TIPC against E. coli and P. aeruginosa did not show large differences. We found, however, that CVA/TIPC-resistant strains increased among Enterobacter spp. 2. Almost all of CVA/TIPC-resistant strains of Enterobacter spp. were also resistant to cephems and new quinolones, thus they were multiple drug resistant. 3. CVA/TIPC showed strong antimicrobial activities against penicillinase producing E. coli.

In order to evaluate antimicrobial activity of cefepime (CFPM), minimum inhibitory concentrations (MICs) of CFPM and other drugs were determined against clinical isolates that were obtained in 1994. 1. CFPM showed a wide antibacterial spectrum against Staphylococcus spp. and glucose non-fermentative Gram-negative rods ((G)NF-GNR). Antimicrobial activities of CFPM against Staphylococcus spp. were stronger than those of ceftazidime (CAZ) and somewhat stronger than those of cefotaxime (CTX), and antimicrobial activity of CFPM against Pseudomonas aeruginosa was same as that of CAZ. 2. Antimicrobial activities of CFPM against almost all of Enterobacteriaceae were stronger than those of CAZ and CTX. And CFPM showed strong antimicrobial activities against CAZ-resistant Escherichia coli, Citrobacter freundii and Enterobacter spp. 3. Antimicrobial activities of CFPM were weaker than those of CAZ against some of strains of Klebsiella oxytoca, beta-lactamase high producing strains of Moraxella subgenus Branhamella catarrhalis and than those of CTX against beta-lactamase high producing strains of Prevotella spp. 4. The feature of new cephems was demonstrated in that CFPM had wider antibacterial spectrum than cephems of previous genenations against Staphylococcus spp. and (G)NF-GNR and CFPM showed strong antimicrobial activities against almost all of oxacephem-resistant Enterobacteriaceae.