As members of the hospital acquired infection study committee, we expsained the necessty of Vancomycin (VCM) Therapeutic Drug Monitoring (TDM) and proposed to establish a VCMTDM system in our hospital.
At first, the physicians decided to treat the patients with antiseptic-resistant strains of methicillin-resistant Staphlococcus aureus (MRSA) in combination with VCM.
We determined the loading dose, dosing interval and points of drawing blood, and inform the doctors of these data. Pharmacokinetic parameters were determined using a one-compartment model. We consulted the doctors on the individualization of dosage regimen.
So, to avoid renal failure, it is important to measure serum VCM concentration and to adjust the dose and dosing interval, after prescribing the estimated dose. In three case reports, patients could avoid adverse effects such as renal failure. Dose adjustment based on VCM serum concentration was necessary.

We report a case of rheumatoid arthritis (RA) that was successfully treated with Kei-kyo-so-so-o-shinbu-to. A 56-year-old woman had been receiving treatment in our department for RA since 1992, and polyarthralgia and multi-joint swelling had become exacerbated from the beginning of April 2003. C-reactive protein and erythrocyte sedimentation rate were elevated. She was hospitalized on_??_, but even with some Kampo formulas, these levels did not improve. The epigastric region was extended and appeared to be in a state of “Hotori-senpai” from _??_, and the administration of Kei-kyo-so-so-o-shinbu-to was begun on _??_. From the next day, pain, swelling of joints, and the “Hotori-senpai” status began to improve, as did the inflammatory reactions. Thus, it was considered, when Kei-kyo-so-so-o-shinbu-to was prescribed, focusing on the “Hotori-senpai”, “Ki-bun” and “Sui-in” status of this patient, that this prescription exerted immediate favorable effects.

Objectives: The relationship between weight-related load and bone mineral density (BMD)/bone microstructure under normal load conditions using high-resolution peripheral quantitative computed tomography (HR-pQCT) remains unconfirmed. The study aims to investigate the differences in effect of body mass index (BMI) on BMD/bone microstructure of loaded and unloaded bones, respectively, in Japanese postmenopausal women. Methods: Fifty-seven postmenopausal women underwent HR-pQCT on the tibia and radius. Correlation analysis, principal component (PC) analysis, and hierarchical multiple regression were performed to examine the relationship between BMI and HR-pQCT parameters. Results: Several microstructural parameters of the tibia and radius correlated with BMI through a simple correlation analysis, and these relationships remained unchanged even with an age-adjusted partial correlation analysis. PC analysis was conducted using seven bone microstructure parameters. The first PC (PC1) reflected all parameters of trabecular and cortical bone microstructures, except for cortical porosity, whereas the second PC (PC2) reflected only cortical bone microstructure. Hierarchical multiple regression analysis indicated that BMI was more strongly related to BMD/bone microstructure in the tibia than in the radius. Furthermore, BMI was associated with trabecular/cortical BMD, and PC1 (not PC2) of the tibia and radius. Thus, BMI was strongly related to the trabecular bone microstructure rather than the cortical bone microstructure. Conclusions Our data confirmed that BMI is associated with volumetric BMD and trabecular bone microstructure parameters in the tibia and radius. However, although BMI may be more related to HRpQCT parameters in the tibia than in the radius, the magnitude of association is modest.

Objectives: The relationship between weight-related load and bone mineral density (BMD)/bone microstructure under normal load conditions using high-resolution peripheral quantitative computed tomography (HR-pQCT) remains unconfirmed. The study aims to investigate the differences in effect of body mass index (BMI) on BMD/bone microstructure of loaded and unloaded bones, respectively, in Japanese postmenopausal women. Methods: Fifty-seven postmenopausal women underwent HR-pQCT on the tibia and radius. Correlation analysis, principal component (PC) analysis, and hierarchical multiple regression were performed to examine the relationship between BMI and HR-pQCT parameters. Results: Several microstructural parameters of the tibia and radius correlated with BMI through a simple correlation analysis, and these relationships remained unchanged even with an age-adjusted partial correlation analysis. PC analysis was conducted using seven bone microstructure parameters. The first PC (PC1) reflected all parameters of trabecular and cortical bone microstructures, except for cortical porosity, whereas the second PC (PC2) reflected only cortical bone microstructure. Hierarchical multiple regression analysis indicated that BMI was more strongly related to BMD/bone microstructure in the tibia than in the radius. Furthermore, BMI was associated with trabecular/cortical BMD, and PC1 (not PC2) of the tibia and radius. Thus, BMI was strongly related to the trabecular bone microstructure rather than the cortical bone microstructure. Conclusions Our data confirmed that BMI is associated with volumetric BMD and trabecular bone microstructure parameters in the tibia and radius. However, although BMI may be more related to HRpQCT parameters in the tibia than in the radius, the magnitude of association is modest.