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Biomedical subjects

H Yoshida

Publications and source records attributed to H Yoshida.

At least 1,045 records · Page 58Linked to original sources

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (1994). I. Susceptibility distribution].

The frequencies of isolation and susceptibilities to antimicrobial agents were investigated on 567 bacterial strains isolated from patients with urinary tract infections in 10 hospitals during the period of June 1994 to May 1995. Of the above total bacterial isolates, Gram-positive bacteria accounted for 26.8% and a majority of them were Enterococcus faecalis. Gram-negative bacteria accounted for 73.2% and most of them were Escherichia coli. 1. Enterococcus faecalis. Ampicillin (ABPC) and imipenem (IPM) showed the highest activities against E. faecalis isolated from patients with urinary tract infections. The MIC90s of them were 1 microgram/ml. Vancomycin (VCM) was also active with the MIC90 of 2 micrograms/ml. Piperacillin (PIPC) and biapenem (BIPM) were also active with the MIC90s of 4 micrograms/ml and 8 micrograms/ml, respectively. The others were not so active with the MIC90s of 16 micrograms/ml or above. 2. Staphylococcus aureus including MRSA. VCM showed the highest activities against S. aureus isolated from patients with urinary tract infections. Its MIC90 was 1 microgram/ml against both S. aureus and MRSA. Arbekacin (ABK) was also active with the MIC90 of 2 micrograms/ml. The others except minocycline (MINO) were not so active with the MIC90s of 64 micrograms/ml or above. 3. Staphylococcus epidermidis. MINO showed the strongest activity against S. epidermidis isolated from patients with urinary tract infections. Its MIC90 was 0.25 microgram/ml. ABK was also active with the MIC90 of 1 microgram/ml. Cephems were active with the MIC90s of 2 approximately 16 micrograms/ml, but penicillins and quinolones were not so active with the MIC90s and 64 approximately 128 micrograms/ml. 4. Citrobacter freundii. Gentamicin (GM) showed the highest activities against C. freundii isolated from patients with urinary tract infections. Its MIC90 was 1 microgram/ml. IPM was also active with the MIC90 of 2 micrograms/ml. Cefpirome (CPR) and cefozopran (CZOP) were also active with the MIC90s of 4 micrograms/ml and 8 micrograms/ml. The others were not so active with the MIC90s of 32 micrograms/ml or above. 5. Enterobacter cloacae. IPM showed the highest activities against E. cloacae. Its MIC90 was 0.5 microgram/ml. GM and amikacin (AMK), ciprofloxacin (CPFX) and tosulfloxacin (TFLX) were also active with the MIC90s of 4 micrograms/ml. Penicillins and cephems except latamoxef (LMOX), cefmenoxime (CMX), CPR and CZOP showed lower activities with the MIC90s of 256 micrograms/ml or above. 6. Escherichia coli. Most of antimicrobial agents were active against E. coli. CPR, CZOP, IPM, carumonam (CRMN), CPFX and TFLX showed the highest activities against E. coli. The MIC90s of them were 0.125 microgram/ml or below. Cefotiam (CTM), flomoxef (FMOX) CMX, ceftazidime (CAZ), and LMOX were also active with the MIC90s of 0.25 microgram/ml. Penicillins were not so active with the MIC90s of 128 micrograms/ml or above. 7. Klebsiella pneumoniae. CRMN showed the highest activities against K. pneumoniae. Its MIC90 was < or = 0.125 microgram/ml. CZOP was also active with the MIC90 of 0.25 microgram/ml. Penicillins were not so active with the MIC90s of 128 micrograms/ml or above. 8. Proteus mirabilis. P. mirabilis was susceptible to a majority of drugs. CMX, CAZ, LMOX, CRP, cefpodoxime (CPDX), CRMN, CPFX and TFLX showed the highest activities against P. mirabilis isolated from patients with urinary tract infections. The MIC90s of them were 0.125 microgram/ml or below. MINO was not so active with the MIC90 of 128 micrograms/ml. 9. Pseudomonas aeruginosa. Most of the agents were not so active against P. aeruginosa. IPM showed MIC90 of 8 micrograms/ml. The others were not so active with the MIC90s of 16 micrograms/ml or above. CPFX showed MIC50 of 0.5 microgram/ml.

Anti-Bacterial Agents↗

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (1994). II. Background of patients].

Clinical background was investigated on 628 bacterial strains isolated from patients with urinary tract infections (UTIs) in 10 hospitals during period from June, 1994 to May, 1995. 1. Distributions of sex, age and urinary tract infections Among over sixties males, the majority was taken by complicated urinary tract infections. Among females, the uncomplicated urinary tract infections was most frequent without a relation of age. As for over 40 females, the increase of complicated UTI was admitted. 2. Distribution of sex, age and pathogens isolated from UTIs In uncomplicated UTIs, Escherichia coli was most frequently isolated without a relation of age, and next Enterococcus faecalis and CNS. In complicated UTIs without indwelling catheter, E. coli, Pseudomonas aeruginosa and E. faecalis were isolated the most frequent. In complicated UTIs with indwelling catheter, P. aeruginosa was most frequently isolated, and next E. faecalis and Staphylococcus aureus. 3. Administration of antimicrobial agents and pathogens isolated from UTIs In uncomplicated UTIs, pathogens, after administration of antibiotics, isolated from patients have obviously decreased from 216 to 32 isolates. And also, pathogens of complicated UTIs without indwelling catheter, have decreased from 127 to 50 isolates. However, in complicated UTIs with indwelling catheter, pathogens after or before administration of antibiotics, were not revealed an obvious change. 4. Pathogens and UTIs with or without factor and operation In uncomplicated UTIs with or without factor and operation, E. coli was mainly detected. In complicated UTIs without indwelling catheter and with factor and operation E. faecalis was mainly detected, and next E. coli, S. aureus and P. aeruginosa. Without factor and operation, E. coli was mainly detected. In complicated UTIs with indwelling catheter and with factor and operation, P. aeruginosa, E. faecalis and S. aureus were mainly detected at 23.5%, 15.0%, 15.0%, respectively. Without factor and operation, Proteus spp. 22%, and next E. faecalis and P. aeruginosa 10% and 12%, were detected, respectively. The distribution of pathogens, in the case of Proteus spp. and P. aeruginosa has been obviously varied by the influence of factor and operation.

Adolescent↗

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (1994). III. Secular changes in susceptibility].

Susceptibilities of Enterococcus faecalis, Staphylococcus aureus, Citrobacter spp., Enterobacter spp., Escherichia coli, Klebsiella spp., Proteus mirabilis, Pseudomonas aeruginosa and Serratia spp. isolated from patients with urinary tract infections (UTIs) in 10 hospitals during June 1994 to May 1995 to various antimicrobial agents were compared with those in the same period of previous years according to a classification, uncomplicated UTIs, complicated UTIs without indwelling catheter, and complicated UTIs with indwelling catheter. No remarkable changes were found in susceptibilities of Citrobacter spp., Enterobacter spp. and Serratia spp. The susceptibilities of E. faecalis to amikacin and quinolones were better than those in 1993. As for S. aureus, susceptible strains to all drugs increased in uncomplicated UTIs. Against E. coli in 1993, the antimicrobial activities of piperacillin, cefotiam and aminoglycosides have decreased, however, in 1994, these activities have turned to the better state. As for Klebsiella spp. susceptible strains to ABPC decreased. The susceptibilities of P. mirabilis to all drugs except minocycline were good. Against P. aeruginosa in 1993, the activities of aminoglycosides have decreased, but, in 1994, these activities have turned to the better state. These data should be considered in clinical treatment of various urinary tract infections.

4-Quinolones↗

Ex vivo ultrathin endoscopy of the seminal vesicles.

PURPOSE: We used a newly developed ultrathin endoscope to examine the interior of the seminal vesicles ex vivo. MATERIALS AND METHODS: Resected specimens of bladder (8 patients) and prostate (2) cancer were examined. RESULTS: Examination was successful in 3 specimens with an antegrade approach. The tortuous lumen of the seminal vesicles made passage of the guide catheter difficult. The mucosa of the seminal vesicles and vas deferens was clearly visible. CONCLUSIONS: Our results suggest that ultrathin endoscopy in useful for diagnosis and evaluation of disorders of the seminal vesicles.

Endoscopes↗

[Advancement of management of arrhythmias associated with exercise testing].

Exercise-induced isolated premature contractions occur in healthy subjects, as well as in patients with cardiac disease. On the other hand, the prevalence of exercise-induced supraventricular or ventricular tachycardia is uncommon among most healthy subjects in usual clinical laboratory settings. Significant coronary heart disease may be found in patients who reveals ventricular arrhythmias during the phase of graded exercise testing. The absence of increase of heart rate during submaximal exercise usually suggests sinus node dysfunction. Exercise testing is of value when it comes to assessing the site of AV block in patients with atrioventricular (AV) block. Exercise testing is also useful to clarify arrhythmic implications for various exercise-related complaints and may help to assess risk strafication and effects of interventions. The clinical significance of induction or suppression of arrhythmia during exercise still remains to be investigated.

Arrhythmias, Cardiac↗

[Endothelial cell dysfunction in patients with impaired renal function].

In order to investigate endothelial cell dysfunction in patients with impaired renal function, we measured circulating endothelin (ET-1) and thrombomodulin (Tm) concentrations used as markers for endothelial cell injury in patients with renal failure. 1) ET-1 and Tm were significantly higher in patients with renal failure and pre-dialysis patients than in normal subjects. Tm in CRF patients was significantly greater than that in ARF patients. In contrast, ET-1 was significantly greater in ARF than in CRF. 2) A positive correlation was found between serum creatinine concentration (Cr) and Tm in pre-dialysis patients. However, no correlation was found between Cr and ET-1. 3) A positive correlation was found between Tm and the duration of dialysis in HD patients, but not in CAPD patients. 4) With the improvement of renal function after regular HD treatment, a substantial reduction was found in ARF patients in both Tm and ET-1, but not in CRF patients. The present study suggests the presence of endothelial cell dysfunction in patients with impaired renal function. The progression of endothelial cell damage may differ between patients on HD and those on CAPD. In addition, it is suggested that endothelial cell dysfunction reverses in ARF patients with improved renal function.

Acute Kidney Injury↗

[Clinical reliability of a new IgE detection system using chemiluminescent enzyme immunoassay named LUMIWARD immunoassay system].

The measurement of allergen-specific IgE antibodies and total IgE was performed with LUMIWARD immunoassay system (chemiluminescent enzyme immunoassay) using 406 serum samples obtained from patients with various allergic diseases and 81 serum samples from normal donors. These were collected by departments of internal medicine, pediatrics, dermatology and otorynolaryngology at eleven institutes in Japan. In addition to a comparative study with CAP RAST, skin tests were also performed to establish a clinical diagnosis. Simultaneous measurements were performed and an excellent correlation with CAP RAST was observed with a concordance rate of 92.6% and correlation coefficient of 0.922. The specificity determined by the normal serum samples was 96.4% for CAP RAST and 96.2% for LUMIWARD. The sensitivity determined by the samples, of which etiological allergens were identified clinically, was 84.8% for CAP RAST and 85.5% for LUMIWARD. Among them, the sensitivity of skin test was 91.8%. The concordance rate with clinical diagnosis was as high as 90.6% and 90.8% for CAP RAST and LUMIWARD. The normal upper limit of total IgE by cumulative 95% value was calculated to be 170 IU/ml for adult subjects. These results indicate the clinical usefulness of the LUMIWARD immunoassay system in evaluating IgE antibodies and total IgE.

Adult↗

[Evaluation of postoperative pain in spinal surgery--usefulness of the administration of local anesthetics into the peridural cavity].

Analgesic effects of perioperative administration of local anesthetics into the peridural cavity were examined in 21 patients with cervical or lumbar vertebral diseases. Sufficient analgesic effects were obtained particularly in patients with lumbar vertebral disease. Administration of local anesthetics was also effective for postoperative sleep on the day of operation. No postoperative neurological side effects were observed. These findings suggest that peridural administration of local anesthetics during spinal surgery is very useful.

Adult↗

[A case of idiopathic thrombocytopenic purpura combined with lung cancer].

A 71-year-old male was admitted to our hospital because of a chest abnormal shadow. His chest X-ray film showed a mass in the right lower lobe (S6), which was diagnosed as adenocarcinoma by transbronchial lung biopsy. A lab data on the admission showed thrombocytopenia (44,000 per cu. mm), and the results of the bone marrow aspiration was compatible with idiopathic thrombocytopenic purpura. Immediately after the right lower lobectomy with lymphnode dissection, intrathoracic bleeding from the wound due to hemorrhagic tendency appeared necessitating a re-thoracotomy. High-dose intravenous gamma-globulin infusion for 4 days and the frequent concentrated platelet transfusion were employed to prevent the hemorrhagic tendency after the 2nd operation, and the postoperative hemorrhage was successfully controlled. Perioperative high-dose intravenous gamma-globulin infusion was concluded to be useful in the patient of idiopathic thrombocytopenic purpura for preventing hemorrhagic tendency after the operation.

Adenocarcinoma↗

[Comparison of bone mineral levels in healthy Japanese perimenopausal women measured by dual energy X-ray absorptiometry and ultrasound methods].

One hundred and seventy Japanese perimenopausal women, 44 to 65 years old (average 55.3), living in the Tokyo metropolitan area were evaluated for bone minerals by two methods of measurement--DXA (dual energy x-ray absorptiometry) measured at the 2nd-4th lumbar spine and three areas of proximal femur, and US (ultrasound bone densitometry) measured at the calcaneal area of the foot. Menopausal status was determined by interview, and anthropometric measurements, grip strength and various foot measurements including length, breadth, girth, area, and angles were taken. The relationship between these physical factors and bone minerals measured by DXA and US was considered in comparisons of evaluations of bone mineral condition by these two different methods. The results were as follows: 1) The means of bone mineral density (BMD) at four sites by DXA and of broadband ultrasound attenuation (BUA) by US decreased with age significantly in a graded fashion. The mean of speed of sound (SOS) by US, however, did not show a significant decrease by age. 2) All measurements but one (SOS by US) showed significant differences among three groups of menopausal status (premenopause, < 6 years after menopause, and > or = 6 years after menopause) by ANOVA. 3) Concerning the relationship between physical variables and bone measurements, all measurements for bone mineral showed significant correlations with body weight (positive) and age (negative) except SOS by US. Grip strength had significantly positive correlations to all bone measurements. BUA by US showed strong correlations with several of the foot measurements. 4) Correlations between bone measurements by DXA and US, were all strong and positive particularly in the combinations within the measurement by DXA. 5) Multiple regression analysis of the physical variables to each bone measurement as the dependent variable, showed significant relationship of age (negative) and body weight or BMI (positive) to each bone measurements except for SOS. The foot area remained significant for BUA. The significant relationship of combinations of physical factors that persisted for US were somewhat different from those in DXA. These results indicate that the level of accuracy of measurements of bone mineral by ultrasound may not necessarily be equivalent to that of dual energy x-ray absorptiometry measurements and must be utilized with caution especially in risk factor analysis of osteoporosis.

Absorptiometry, Photon↗

[Reration between symptom and counts of scattering Japanese cedar pollen--examination of clinical observation and repeated provocation].

We examined relation with the scattering number of Japanese cedar pollens in Mibu, Tochigi, Japan and a nasal allergy symptom expects from pollen observation at an appearance and symptom progress in detail. We investigated appearance day of nasal allergy symptom and relation with pollen number. High relation was admitted as accumulate rate of nasal allergy as accumulation pollen during a numerical square root. When it was long period of the first observation day of pollen to the first day of pollen scatterring, the rate of nasal allergy symptom became high. An equilateral correlation was admitted as symptom a score in symptom progress and relation with pollen number accumulation pollen during a numerical square root. ECP and tryptase value in nose juice washing liquid rose with progressive of symptom. Early phase reaction progresses in a continuation nose mucous membrane induction examination and ECP in nose juice washing and tryptase rose with it. Late phase reaction was halved with positive group by negative group, progress of reaction by repetition of induction was not accepted. In our conclusion, a symptom is caused by little pollen being exposed repeatedly and that a symptom will become worsen was observed by numerical accumulation pollen.

Blood Proteins↗

[Sarcoidosis representing multiple splenic nodules in a patient with IgA nephropathy].

We have encountered a 49-year-old female with persistent proteinuria and hematuria. Blood pressure, renal function, physical findings and chest X-p showed no abnormality, but blood tests disclosed mild thrombocytopenia, elevated serum ACE activity, serum lysozyme activity and serum IgA concentration. Abdominal echography and CT revealed multiple nodules in her spleen. In order to make a definite diagnosis and exclude the possibilities of malignant lymphoma or metastatic malignant tumor, splenectomy, and open renal biopsy were performed at the same time. On histological examinations, light microscopic appearance of the spleen was characterized by non-caseating granulomas compatible with sarcoidosis. Renal biopsy specimen showed diffuse proliferative glomerulonephritis with positive staining of IgA predominantly located in the mesangial area, compatible with IgA nephropathy. The present case may provide suggestive evidence for a link between sarcoidosis and IgA nephropathy in the pathogenesis. IgA nephropathy complicated by sarcoidosis is rare, and thus is of particular interest because common immunological abnormalities might be considered in the disease process of both diseases. We feel that despite a low index of suspicion, physicians must be alert to the possibility of IgA nephritis associated with sarcoidosis. The literature is reviewed regarding the relationship between IgA nephropathy and sarcoidosis.

Female↗

[The volume and pH of gastric fluid in elective surgical patients after preoperative oral fluid intake].

The effect of preoperative oral fluid intake on the volume and pH of gastric fluid was examined in 45 elective surgical patients ranged in ages from 18 to 70 years. Two hours preoperatively they all received oral roxatidine 75 mg with 10 ml water, immediately followed by 150 ml oral water or 150 ml refreshing drink or no fluid as control. Just after the induction of anesthesia, a Salem-sump tube was put down to the stomach to collect gastric fluid in each patient. The volume and pH of gastric fluid taken were 10.9 +/- 7.9 ml, 16.3 +/- 2.3 in control group, 8.0 +/- 6.0 ml, 6.2 +/- 2.4 in the water group and 6.3 +/- 6.0 ml, 7.1 +/- 1.7 in the refreshing drink group. As there were no significant differences in gastric pH values in the three groups, the highest value was found in the refreshing drink group. No significant difference in VAS of hungry and thirsty feeling was found among the three groups. We conclude that preoperative oral water or refreshing drink with roxatidine 75 mg 2 hours before the start of anesthesia may not increase the risk of aspiration during the induction of anesthesia.

Adolescent↗

Surface coverage of vascular grafts with cultured human endothelial cells from subcutaneous fat tissue obtained with a biopsy needle.

Surface coverage with autogeneous endothelial cells is effective in reducing thrombogenicity of an artificial vascular graft, but procedure for obtaining the cells is invasive for patients. The purpose of this study was to establish cultures of human endothelial cells separated from a small piece of subcutaneous fat tissue. A piece of tissue weighing about 10 mg was obtained from subcutaneous fat using a biopsy needle, and treated with collagenase and dispase. Microvascular endothelial cells were selected and other types of cells contaminating the cultures were eliminated by scraping with a needle under a microscope. The yield of the cells was 8362 +/- 4264/10 mg of subcutaneous fat (n = 7). The cultures reached confluence in about 2 weeks. The cells were positive for von Willebrand factor, P-selectin, and uptake of acetylated low density lipoprotein. The cells produced 15.9 +/- 3.3 ng/mg cell protein/h of 6-ketoprostaglandin F1 alpha (n = 5) when stimulated with thrombin. Thrombin also stimulated the production of platelet-activating factor: 7653 +/- 4297 dpm/10(6) cells (n = 5). Endothelin-1 accumulation in the medium of unstimulated endothelial cells was 0.54 +/- 0.16 ng/mg cell protein/10 h (n = 8). As a preliminary experiment for graft seeding, the cells were also cultured on pieces of a gelatin-coated Dacron graft, and scanning electron microscopy revealed the surface coverage of the graft. We herein described about successful culture of human microvascular endothelial cells from subcutaneous fat tissue obtained using a biopsy needle. The cultured cells may be applicable to a seeded vascular graft.

6-Ketoprostaglandin F1 alpha↗

[A study on anticoagulation for cardiovascular diseases using international normalized ratio (INR)].

The usefulness of INR as an index for assessing anticoagulation was studied using 85 outpatients, all suffering cardiovascular diseases and receiving warfain as subjects. The thrombotest, prothrombin time and INR were measured at follow-up, monthly intervals. The correlation between the thrombotest value and the INR value were assessed retrospectively. We found a stronged correlation between them. The 10 approximately 25% range of the thrombotest value, the therapeutic range, corresponded to 2.29 approximately 3.60 of the INR value. The INR value was more accurate than the thrombotest valve in the situation of prolonged coagulation time. It is recommended to use INR as an objective index for the anticoagulation due to increase accuracy and objectivity when comparing the data among the various institutions.

Anticoagulants↗

[Self-assessed quality of mastication in relation to remaining teeth and self-assessed health status in elderly persons].

To explore factors related to quality of mastication, information about teeth status and self-assessed health status were obtained by a self-administered questionnaire from participants in a dental screening program. Invitation letters for participation in the program were distributed by members of the neighborhood association to 1.275 residents of a town in Gifu prefecture aged 65 years or older. Participation rate in the dental screening program was 40.5%. A total of 513 participants (245 males and 268 females) completed the program and the questionnaire. The results were as follows. 1. Overall, 32% had 20 teeth or more and 88.4% had bridge(s) and/or denture(s). 2. The mean number of remaining teeth were 12.9 for males and 12.5 for females. There was no statistical difference in the number of remaining teeth between males and females. The mean numbers of remaining teeth among those aged 65-69 years was 15.7 and two thirds of them had lost the Lower First Molar. 3. Those who reported to be satisfied with their present mastication were 83.3% of men and 86.3% of women. The proportions were not influenced by age or sex. 4. Quality of mastication was related to self-reported "good physical condition' and "not easily tired'. 5. The proportion of those satisfied with their mastication was large in the groups with remaining teeth index 0-8 and > or = 17, and small in the group with remaining teeth index 9-16, showing a U-shaped curve for satisfaction rate against remaining teeth index. These results suggest a relationship of quality of mastication on health status. The importance of primary dental care for the elderly persons is underlined.

Aged↗