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T Yoshiyama

Publications and source records attributed to T Yoshiyama.

9 recordsLinked to original sources
PubMed1998

[Multidrug-resistant tuberculosis. 3. Epidemiology of drug-resistant tuberculosis in Japan].

In Japan, the frequency of drug-resistant tuberculosis has been investigated every 5 years since 1950s and increase of initial and acquired drug resistance has not been observed. However, the mathematical model analyse of time trend of prevalence of drug-resistant tuberculosis and frequency of initial drug resistance in Korea shows that there is little difference of infectivity and/or proportion of clinical breakdown between susceptible bacilli and resistant ones. The prognosis of isoniazid (INH) and rifampicin (RFP) resistant tuberculosis cases in Fukujuji Hospital was investigated. 367 cases including 50 initial drug resistant cases were analyzed with life table analysis. 50% of all cases and 70% of initial drug resistant cases became negative, 13% of all cases and 4% of initial drug resistant cases remained as positive, 37% of all cases and 27% of new cases died. Among cases who did not convert negative within one year, 41% of all cases and 34% of initial drug resistant cases died. The prognosis of INH and RFP resistant tuberculosis cases were still not satisfactory.

Adolescent↗
PubMed1995

Endothelium-dependent and -independent vasodilation of isolated rat aorta induced by caffeine.

Caffeine (10(-4)-10(-3) M) induced concentration-dependent relaxations of phenylephrine-precontracted rat aortic rings with endothelium. Endothelial denudation significantly, but only partially, attenuated caffeine-induced relaxation. Pretreatment with NG-nitro-L-arginine, oxyhemoglobin, and methylene blue attenuated the relaxations to an extent similar to endothelial denudation. Guanosine 3',5'-cyclic monophosphate (cGMP) and adenosine 3',5'-cyclic monophosphate (cAMP) contents of aortic strips with endothelium increased significantly after exposure to caffeine (10(-3) M). Endothelial denudation attenuated caffeine-induced cGMP increase. Pretreatment with ryanodine (2 x 10(-5) M), which has been shown to combine with receptors on endoplasmic reticulum (ER) of endothelium, attenuated caffeine-induced relaxation and cGMP content increase of rings with endothelium. Pretreatment with caffeine potentiated sodium nitroprusside-induced relaxations and cGMP increase of rings without endothelium. These results demonstrated that caffeine-induced relaxation comprises two components. In the endothelium-dependent mechanism, caffeine promotes nitric oxide synthesis in endothelium by release of Ca2+ from ER through a ryanodine-sensitive Ca2+ channel, and the suppression of cGMP degradation also contributes to the relaxation. In the endothelium-independent mechanism, caffeine acts as a 3',5'-cyclic-nucleotide phosphodiesterase inhibitor.

Animals↗
PubMed1994

[Efficacy of the standard regimen for initial treatment of pulmonary tuberculosis: results of long-term followed-up].

In 1986, the regimen with isoniazid, rifampicin and streptomycin or ethambutol for 9 or 6 months was introduced as the standard therapy for the initial treatment of pulmonary tuberculosis in Japan. Since then, several reports have been published on the relapse rate after such standard regimen, but follow-up observation was limited to relatively short period in these studies, except one study. Further, none of these studies reported overall efficacy rate of the treatment which was the most important index to evaluate the regimen. So we investigated the deaths, defaults, treatment failures, and relapses during and after the initial treatment of pulmonary tuberculosis patients to calculate the efficacy rate. Three hundred and six patients with newly diagnosed pulmonary tuberculosis, who had admitted to Fukujuji Hospital and started initial treatment with standard regimen, were followed-up, retrospectively. At the start of the initial treatment, mean age of the male patients were 47.0 and those of the female patients were 42.2 years old (male: 232 cases, female: 74 cases). Of the total 306 patients, 84.5% were basically positive and 50.7% were cavitary tuberculosis. Resistance to isoniazid, rifampicin, streptomycin and ethambutol was noticed in 3.5%, 0.4%, 4.3% and 0.4% of the patients tested. Their medical records in Fukujuji Hospital were reviewed, and for the patients who had not visited the hospital more than one year letters were sent to request to visit the hospital and to answer to questionnaire. The questionnaire were also sent to the referred hospitals and the concerned health-centers. Of 306 patients enrolled in the present investigation, 7 have dropped out.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

Severe respiratory depression after epidural morphine in a patient with myotonic dystrophy.

We describe a patient with myotonic dystrophy who underwent cholecystectomy, and developed severe respiratory depression following epidural administration of morphine to provide postoperative analgesia. At preoperative assessment, he demonstrated near normal vital capacity and maximal voluntary ventilation, but the presence of chronic ventilatory failure with a resting value of PaCO2 51 mmHg. Anaesthesia was produced by a combination of epidural and light general anaesthesia without intravenous anaesthetics, narcotics or neuromuscular relaxants. Five hours after epidural administration of 2 mg morphine, the patient developed severe respiratory depression with a PaCO2 of 93 mmHg. Intravenous naloxone resulted in transient improvement in minute volume, suggesting that epidural morphine was responsible for the depression. Epidural morphine can cause unexpected respiratory depression, even at a small dose, because of the sensitivity of the respiratory centre to morphine in patients with myotonic dystrophy.

Analgesia, Epidural↗
PubMed1992

[Influence of bronchoscopic examinations on the statistics of tuberculosis incidence].

The frequency of the modes of bacteriological examinations other than direct sputum smear were observed for a total of 955 "smear-positive" pulmonary tuberculosis cases which were notified at 7 health centres in the Metropolitan and suburban areas during 1986-1990. Of them 21 cases (2.2%) were examined for the specimens obtained by bronchofiberscopic procedures, and in 4 cases (0.4%) gastric juice was taken. The proportion of the non-sputum positivity as seen above was higher in females than in males, but it was uniform across all age group. Non-cavitary cases showed higher proportion of the non-sputum positivity than cavitary cases. There was wide variation in the frequency of these aggressive modes of examination among health centres, probably indicating the difference in the extent to which hospitals are interested in these modes of examination in each health center area. In addition to the above observed cases, there were 60 cases with direct smear positive finding of mycobacteria other than tuberculosis (MOTT). They account for 5.9% of all of 1,015 new notifications of AFB-smear positive cases. It is possible that these non-sputum "smear positive" cases, as well as the MOTT-smear positive cases may be underestimated in our study, because of the notification form not necessarily requesting to enter the type of bacteriological examinations. They may contribute to the recent upward trend of incidence rate of smear positive tuberculosis in Japan to a considerable extent.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

[Drug-induced psychiatric disturbance by lidocaine].

Lidocaine is widely used as an antiarrhythmic agent. One of the side effects of lidocaine is disorientation. Measurement was made of the plasma level of lidocaine in twelve consecutive cases. Lidocaine infusion had been given to these cases for more than twenty-four hours. Measurements were then made of the frequency of psychiatric disturbance. Psychiatric disturbances were recognised in six cases and the plasma levels in four cases among them were more than 5 micrograms.ml-1. The psychiatric disturbances disappeared within three hours after the cessation of lidocaine infusion. When disorientation occurs in a patient who receives lidocaine treatment, drug-induced psychiatric disturbance should be suspected.

Female↗