Satoru Kioi

Physiologic Approach to Dialysis-Induced Hypoxemia

This study was undertaken to evaluate the effects of membrane-related complement activation and dialysate composition on dialysis-associated hypoxemia. Seven chronic hemodialysis patients were hemodialyzed 3 times sequentially with the following three combinations; Cuprophan membrane with acetate dialysate, polymethylmethacrylate (PMMA) membrane with acetate dialysate, and PMMA membrane with bicarbonate dialysate. During dialysis with acetate dialysate, the pulmonary diffusing capacity (DLco) at 30 min after the start of dialysis was decreased to 88% (p 2 tension gradient. Although the changes in transcutaneous PO2 (tcPO2) were not constant in all three combinations, a distinct fall in tcPO2 was observed in the first half of dialysis with acetate dialysate. During dialysis with acetate dialysate but not with bicarbonate, the extracorporeal dialyzer removed an average of 60 ml/min of CO2, and the respiratory quotient dropped from a mean predialysis value of 0.86 to 0.59 (p 2 tension was not significantly changed throughout dialysis, but the alveolar ventilation decreased significantly in proportion to the fall in carbon dioxide output. The arterial oxygen tension fell from a control level of 91 ± 6 to 77 ± 8 mm Hg (p 2 loss via the dialyzer, resulting in reflex hypoventilation.

Serum angiotensin converting enzyme activity in ex-smokers

A low activity of angiotensin converting enzyme (ACE) has been reported in people who smoke. To determine whether this low ACE activity would be reversible on cessation of smoking, we measured serum ACE activity in 107 healthy male volunteers. They included 27 active cigarette smokers, 28 non-smokers, 24 ex-smokers who had stopped smoking for less than 10 yr, and 28 ex-smokers who had stopped smoking for more than 10 yr. The mean value (+/-SD) of serum ACE in those who had stopped smoking for more than 10 yr was comparable to that of non-smokers: 23.2 +/- 5.1 and 23.5 +/- 4.5, respectively. ACE activity in smokers and the ex-smokers who had stopped smoking for less than 10 yr was significantly lower (17.8 +/- 4.5 and 17.8 +/- 3.9, respectively) than values obtained in non-smokers and the group who had not smoked for more than 10 yr (p less than 0.001). These findings suggest that the effect of chronic smoking on the serum ACE activity may be reversible.

Mycobacterium chelonae subsp. abscessusによる肺感染症の2症例

Two cases of lung infection due to Mycobacterium chelonae subsp. abscessus are reported. Case 1, a 50-year-old female, was a secondary infection-type, and case 2, a 53-year-old female, was a primary infection-type. The 16 cases reported, between the ages of 29 and 76 years, there were 6 males and 10 females. The roentgenographic examinations, revealed that the ratio of the primary and secondary infection-type was 3:1. Effective agents for this organism has not been yet confirmed. In the present study, we treated two patients with AMK and IPM/CS, and obtained negative conversion of the sputum culture as well as improvement of roentgenographic features.

A multicentric randomized trial of combination chemotherapy based on cisplatin plus vindesine in inoperable non-small cell lung cancer.

1986年12月から1988年12月まで, 新潟肺癌化学療法検討会に参加した22施設で, 進行期非小細胞肺癌102例について, CDDP+VDSを基本にした4種類のregimenによる無作為比較試験を行った. 奏効率と50%生存期聞は, それぞれ, CDDP+VDS (CV) 群17.4%, 31週, CDDP+VDS+MMC群31.8%, 50週, CDDP+VDS+IFX (CVI) 群50.0%, 58週, CDDP+VDS+ADM群17.6%, 50週であった. CVI群は, CV群に比し, 奏効率と生存曲線の上で有意な差を認めた.