Reduced vancomycin clearance despite unchanged creatinine clearance in patients treated with vancomycin for longer than 4 weeks.

Creatinine clearance-based nomograms are used routinely during the early phase of vancomycin therapy for individualizing doses. The authors studied whether such nomograms are also valid for patients receiving the drug for an extended period of longer than 4 weeks. A retrospective analysis was conducted on the therapeutic drug monitoring data obtained from 85 patients who received an intermittent intravenous infusion of vancomycin.

Reliability and validity of the Japanese version of the 24-item Dysfunctional Attitude Scale.

Background: The 24-item Dysfunctional Attitude Scale (DAS-24) is a short version of the Dysfunctional Attitude Scale, which is a self-report inventory for depressogenic schemata.

Objective: The object of this study was to examine the reliability and validity of the Japanese version of the DAS-24 (DAS-24-J).

Methods: Subjects consisted of non-clinical sample 1 (248 university students), non-clinical sample 2 (872 Japanese company employees) and a clinical sample (59 depressed out-patients).

Morning rise of blood pressure assessed by home blood pressure monitoring is associated with left ventricular hypertrophy in hypertensive patients receiving long-term antihypertensive medication.

To assess the influence of morning rise of systolic blood pressure (SBP) as assessed by home blood pressure monitoring on the left ventricular mass index (LVMI) in relation to the blood pressure control status, we evaluated M-mode cardiac echocardiography in 626 hypertensive subjects (412 men and 214 women; mean age, 61.3+/-10.1 years) who were receiving antihypertensive medication.

[Case of acute primary HIV infection with menigoencephalitis demonstrating high signal intensity of the bilateral globus pallidus in T2-weighted MRI].

A slightly obtunded 59-year-old man admitted for headache and consciousness disturbance after two weeks of fever, sore throat, and general malaise. His cerebrospinal fluid showed a slight increase in the white cell count and protein content. T2-weighted MRI demonstrated high signal intensity of the bilateral globus pallidus.

[Transient chromosomal abnormalities following autologous peripheral blood stem cell transplantation for acute myelogenous leukemia].

Twenty-three patients with acute myelogenous leukemia (AML) have received autologous hematopoietic stem cell transplantation (autoHSCT) in our institute from 1997 to 2005. Among them, 3 patients relapsed, and the other 4 patients (17%) showed cytogenetic abnormalities after the autoHSCT. In these 4 patients with AML1/MTG8 or CBFbeta/MYH11 AML, RT-PCR findings using bone marrow cells were all negative when a cytogenetic abnormality was detected.

Lower leukocytes at initial diagnosis may predict poor outcome of very late relapse of acute lymphoblastic leukemia.

We have reported a rare case of acute lymphoblastic leukemia (ALL) recurring 19 years after the first presentation. Since 1984, 36 relapse cases 10 years or more after the first diagnosis have been reported. All cases were childhood ALL with a low to standard risk.

[Evaluation for anaerobic culture system: Anoxomat Mart II].

Anoxomat Mart II (Mart Microbiology BV, Lichtenvooorde, Netherlands, Central Scientific Commerce Inc., Tokyo, Japan) is an anaerobic jar apparatus which uses a vacuum pump in combination with catalyst as gas replacement procedure to remove all traces of oxygen. As we had a chance to use Anoxomat Mart II, we compared it with other two anaerobic culture methods; namely AnaeroPack anaero (Mitsubishi Gas Chemical Co.

Profile of psychiatry in Japan.

During the Edo period in Japan (1603-1867), people with mental illness were not excluded from society. Upon the introduction of European psychiatry around the 1870s, Japanese society became more discriminatory, however. In 1900 a primary law was introduced to regulate the custody of patients.

A multicenter randomized, double-blind, placebo-controlled late-phase II/III study of recombinant human interleukin 11 in acute myelogenous leukemia.

To investigate the efficacy of using recombinant human interleukin 11 (rhIL-11) to reduce the need for platelet transfusions, we performed a randomized, double-blind phase II/III study with 110 acute myelogenous leukemia (AML) patients in the first complete remission. Following chemotherapy patients were subcutaneously administered either placebo (n=37) or rhIL-11 at a dose of 25 microg/kg (n=37) or 50 microg/kg (n=36). rhIL-11 administration was well tolerated.

[Superior sagittal sinus thrombosis during remission induction therapy for acute lymphoblastic leukemia].

Superior sagittal sinus thrombosis (SSST) has been reported to be caused by coagulopathy following oral contraceptive therapy, DIC, infection around the sinus, compression from a tumor, infiltration of tumor, and an inherited deficiency of proteins C and S, but SSST associated with hematological malignancies and L-asparaginase (L-Asp) therapy is rare. We report a case of an adult patient with acute lymphoblastic leukemia (ALL) who developed SSST during the remission induction therapy. A 25-year-old man was admitted with left facial nerve palsy and, following bone marrow aspiration and lumbar puncture, he was diagnosed as having T-ALL with CNS involvement.

[Status of measures against angiography room infection as determined by questionnaire].

Although the cleanliness of the angiography room and that of the operating room have long been equally attended to, the concept of Standard Precautions (including the basic measures and procedures to prevent infection) of the Centers for Disease Control and Prevention (CDC), 1996, as well as the introduction of transmission-based precautions, have been changing to preventive measures that are based on concrete measures. Therefore, a questionnaire was introduced in order to determine the actual status of countermeasures against infection used in the angiography room. The questionnaire was sent to 530 institutions, and 286 responded, a response rate of 54.

Infective endocarditis associated with Sjogren's syndrome.

Sjögren's syndrome is one of the major autoimmune diseases, however infective endocarditis associated with Sjögren's syndrome has not previously been reported. A patient with Sjögren's syndrome associated with aortic valve regurgitation due to infective endocarditis, underwent successful aortic valve replacement. Patients with Sjögren's syndrome tend to be at a higher risk of intraoral infections due to diminished secretion of saliva.

[Cancer care with informational technology].

New innovations in clinical information technology have brought about changes in cancer care. The high-speed Internet provides an enormous real-time information exchange among physicians anywhere on earth. Computer-aided clinical decision support systems free up cancer experts in all stages of the cancer care continuum, including prevention, early detection, treatment and end-of-life care.

[Surgical site infection (SSI) surveillance].

Surgical site infections (SSI) are major complications after surgery. SSI leads to the longer hospital stay, higher costs and patients' dissatisfaction to the surgical treatment. SSI surveillance is not only an activity to investigate the incidence and causes of SSI but also an infection control activity to reduce SSI rates.

[Two cases of heterozygous Fabry disease].

We report two cases of heterozygous Fabry disease with severe organ damage. Case 1 was a 47-year-old woman. In April 1977, at the age of 27 years, she had proteinuria and edema around the 26th week of her second pregnancy and was diagnosed as toxicosis of pregnancy.

Reduction in the motor unit number estimate (MUNE) after cerebral infarction.

Background: The mechanism of the decrease in motor unit number estimates (MUNEs) after cerebral infarction has not been studied systematically. We examined the relationship between the degree to which MUNEs decreased and the other clinical features of patients with the infarction.

Methods: Using a multiple point stimulation technique, we obtained the MUNE of the hypothenar muscle group in 13 age-matched control subjects and 30 patients with cerebral infarction.

[Chronic myelogenous leukemia].

In the therapy of chronic myelogenous leukemia (CML), interferon (IFN) brought about a big progress resulting in the good hematologic as well as cytogenetic response and prolongation of survival. Recently, imatinib, the BCR/ABL antagonist, took over the first choice drug of the treatment CML. However, IFN still has the possibility to contribute the improvement of the therapy efficacy of CML.

Stable response after administration of stem cell factor combined with granulocyte colony-stimulating factor in aplastic anemia.

We report successful treatment with 25 microg/kg of recombinant methionyl human stem cell factor (SCF) combined with 400 microg/m2 of recombinant human granulocyte colony-stimulating factor (G-CSF) in 2 patients with aplastic anemia refractory to immunosuppressive therapy. In one patient, hemoglobin levels increased from 6.4 g/dL to 11.