Takayuki Miyara

Kinki University, Ōsaka, Ōsaka, Japan

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Publications (6)4.4 Total impact

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    ABSTRACT: We isolated three strains of vancomycin intermediate Staphylococcus aureus (VISA) from a blood sample of a patient with infective endocarditis (VISA-1), postoperative pneumonia sputum (VISA-2), and pyogenic spondylitis blood sample (VISA-3). These VISA strains did not carry vanA, vanB, vanC1, or vanC2/C3 genes. Cell wall thickening was observed. VISA-1 and VISA-3 PFGE patterns showed the completely same pattern compared to the PFGE pattern of methicillin-resistant Staphylococcus aureus first isolated from patients 1 and 3. After 10 days on brain heart infusion agar, wall thickening in all three type of VISA was unchanged, but VISA-2 and VISA-3 reversed vancomycin susceptibility. The most suitable use of vancomycin in patients with MRSA infection thus appears to be in reducing the opportunity for cell wall thickening.
    Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 11/2012; 86(6):734-40. DOI:10.11150/kansenshogakuzasshi.86.734
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    Akira Watanabe · Yuji Watanuki · Takayuki Miyara · Sayaka Ohara · Makoto Miki ·

    Nihon Naika Gakkai Zasshi 12/2011; 100(12):3586-606. DOI:10.2169/naika.100.3586
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    ABSTRACT: Exertional dyspnea is the primary symptom that limits exercise in patients with chronic obstructive pulmonary disease (COPD). It is unknown which activated brain area is associated with this symptom in COPD patients. To investigate the activation of cortical areas associated with dyspnea during exercise in COPD patients. COPD patients (n = 10) and age-matched controls (n = 10) performed mild-intensity constant work rate cycle exercise (40% of their symptom-limited peak work rates) for 10 min, while cerebral hemodynamics and oxygenation were measured by near-infrared spectroscopy (NIRS). Ventilatory responses (breathing pattern and pulmonary gas exchange) and Borg scale ratings of dyspnea and leg fatigue were measured during exercise. Three NIRS probes were placed over the prefrontal and temporoparietal cortical regions of the subjects' heads. Changes in cortical oxyhemoglobin (oxy-Hb), deoxyhemoglobin (deoxy-Hb), and total hemoglobin (total Hb) concentrations from baseline recordings were measured. Increased oxy-Hb (oxygenation) was assumed to reflect cortical activation. Oxy-Hb concentration was significantly increased in the prefrontal region during exercise in both groups but not in the temporoparietal regions. The change in prefrontal oxy-Hb concentration of COPD patients was not different from that of controls. Dyspnea scores were positively correlated with changes in oxy-Hb concentrations of the prefrontal regions in both groups. Multivariate analysis showed that oxy-Hb concentration in the prefrontal region was the best predictor of dyspnea in both groups. Exertional dyspnea was related to activation (oxygenation) of the prefrontal cortex in COPD patients and control subjects.
    Respiration 04/2011; 82(6):492-500. DOI:10.1159/000324571 · 2.59 Impact Factor
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    ABSTRACT: Various factors have been reported to be useful for predicting future exacerbations. This study was intended to determine a usefulness of a combination of a patient-based questionnaire, such as the Asthma Control Test (ACT) score with objective assessments, such as forced expiratory volume in 1 second (FEV(1)) and/or exhaled nitric oxide (FE(NO)), for predicting future exacerbations in adult asthmatics. We therefore enrolled 78 subjects with mild to moderate asthma, who were clinically stable for 3 months who all had been regularly receiving inhaled steroid treatment. All subjects underwent a routine assessment of asthma control including the ACT score, spirometry, and FE(NO), and then were followed up until a severe exacerbation occurred. The predictors of an increased risk of severe exacerbation were identified and validated using decision trees based on a classification and regression tree (CART) analysis. The properties of the developed models were the evaluated with the area under the ROC curve (AUC) (95% confidence interval [CI]). The CART analysis automatically selected the variables and cut-off points, the ACT score <or=23 and FEV(1) <or= 91.8%, with the greatest capacity for discriminating future exacerbations within one year or not. When the probability was calculated by the likelihood ratio of a positive test (LP), the ACT score <or=23 was identified with a 60.3% probability, calculated by 1.82 of LP, whereas the combined ACT score <or=23 and the percentage of predicted FEV(1) <or= 91.8% were identified with an 85.0% probability, calculated by an LP score of 5.43, for predicting future exacerbation. These results demonstrated that combining the ACT score and percentage of predicted FEV(1), but not FE(NO,) can sufficiently stratify the risk for future exacerbations within one year.
    Journal of Asthma 09/2009; 46(7):677-82. DOI:10.1080/02770900902972160 · 1.80 Impact Factor
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    ABSTRACT: A 39-year-old woman, who had a history of recurrent oral and genital ulcerations and folliculitis and had had a low-grade fever since December 2003, consulted our hospital on February 5, 2004. Chest radiography and computed tomography (CT) showed multiple pulmonary abscess-like opacities. She was admitted to the Department of Respiratory Medicine and Allergology, Kinki University School of Medicine on February 19, 2004. A transbronchial lung biopsy showed nonspecific inflammation with lymphocytic infiltration. The patient was discharged after she showed improvement with antibiotic therapy. She was readmitted to our hospital on October 3, 2006, because of recurrence of pulmonary abscess-like opacities. Bronchoalveolar lavage showed lymphocytosis (53%) but yielded no significant bacteria on culture. Behçet's disease was diagnosed on the basis of the three major symptoms (recurrent oral and genital ulcerations and folliculitis). The frequent recurrence of pulmonary lesions was suspected to be due to immunological impairment associated with Behçet's disease, and the pulmonary lesions and inflammatory reaction tests showed improvement after colchicine was administered. The patient was discharged on October 28, 2006. To our knowledge this is the third reported case of frequently recurrent multiple pulmonary abscess-like opacities in Behçet's disease.
    Arerugī = [Allergy] 11/2007; 56(10):1301-5.
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    ABSTRACT: A 38-year-old man with atopic dermatitis presented with right chest pain and dyspnea. Previously, he had received 2mg of betamethasone daily, to prevent rejection of the right transplanted cornea, for 24 days. His body temperature was 37.4 degrees C, peripheral leucocyte count measured 12,000/mm3, and C-reactive protein was 6.3 mg/dl. A computed tomogram of the chest revealed infiltration in the right lower lung field, and he was then treated for pneumonia. The second day he fell down one flight of stairs due to a syncopal attack and received a head injury. At this point his vital blood pressure was 102/55 mmHg, heart rate was 130/min and SpO2 under breathing room air was 76%. These findings indicated possible acute pulmonary thromboembolism. Enhanced computed tomography revealed pulmonary arteries occluded by massive thrombosis and anomalous inferior vena cava with azygous continuation. To decrease the risk of further cerebral bleeding, anti-coagulation therapy was administered with only 24,000 IU/day of heparin. Following treatment, the patient completely recovered. We reported this rare case of acute pulmonary thromboembolism accompanied by anomalous inferior vena cava with azygous continuation.
    01/2007; 44(12):957-61.

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