著者

Miwako Omori Yoshinobu Saito Yukiko Miura Toru Tanaka Takeru Kashiwada Kenichiro Atsumi Hiroki Hayashi Yuji Minegishi Kazue Fujita Arata Azuma Masahiro Seike Akihiko Gemma

出版者

The Medical Association of Nippon Medical School

雑誌

Journal of Nippon Medical School (ISSN:13454676)

巻号頁・発行日

vol.86, no.5, pp.296-300, 2019-10-15 (Released:2019-12-03)

参考文献数

23

被引用文献数

1

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We report a case of pneumonitis with alveolar hemorrhage induced by herbal medicines in a 73-year-old woman who was admitted to our hospital because of dyspnea and an abnormal shadow on a chest radiograph. She had received treatment with numerous drugs, including the herbal medicines Seisin-renshi-in, Chotosan, Rikkunshi-to, and Shakuyakukannzo-to. Chest radiography revealed diffuse ground-glass shadows in both lungs, and bronchoalveolar lavage fluid was progressively hemorrhagic. A culture of the fluid showed no evidence of microorganisms. Moreover, there were no findings suggestive of rheumatic disease or vasculitides. On the basis of this evidence, we suspected drug-induced diffuse alveolar hemorrhage. She discontinued all medicines and started treatment with corticosteroids. Her respiratory condition and chest radiographic findings improved. The timing of administration and rechallenge with other drugs suggested that the herbal medicines were the causative drugs. The primary concern was Seisin-renshi-in, because it contains Ougon (skullcap; a known cause of pneumonitis) and because a drug lymphocyte stimulation test was positive for Seisin-renshi-in. This is the first report indicating that Seisin-renshi-in may cause diffuse alveolar hemorrhage. Diffuse alveolar hemorrhage due to herbal medicines is a rare but emergent disorder. Therefore, treating physicians should be aware that it may be caused by herbal medicines, including Seisin-renshi-in.

著者

Toru Tanaka Akimasa Sekine Yoshiya Tsunoda Hiroyuki Takoi Shin-Yuan Lin Yohei Yatagai Kenji Hayasihara Takefumi Saito

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.54, no.7, pp.847-851, 2015 (Released:2015-04-01)

参考文献数

16

被引用文献数

8 21

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A 64-year-old neurologically asymptomatic woman with rheumatoid arthritis who was treated with the tumor necrosis factor (TNF)-α antagonist adalimumab developed disseminated tuberculosis (TB). After receiving anti-TB therapy and discontinuing adalimumab, she exhibited paradoxical worsening due to immune reconstitution inflammatory syndrome (IRIS) with the appearance of meningitis and brain tuberculomas. This case indicates that continuing anti-TNF therapy may be necessary to prevent IRIS in patients who develop TB, particularly disseminated TB, during the course of anti-TNF therapy. In addition, careful screening for central nervous system (CNS) TB should be performed prior to the initiation of therapy, as even neurologically asymptomatic patients can develop CNS manifestations of IRIS.

著者

Takayuki Sakamoto Motoyasu Ochi Yutaka Kikuchi Kyo Kobayashi Toru Tanaka Yukio Ozaki

出版者

一般社団法人 園芸学会

雑誌

The Horticulture Journal (ISSN:21890102)

巻号頁・発行日

pp.MI-081, (Released:2016-05-12)

被引用文献数

2

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Harvesting of asparagus spears is hard work because farmers have to harvest spears in a crouching posture. We previously developed electric long-shafted shears and a large-wheeled cart to improve the harvest posture, and we reported that the visibility of spears can be improved by modified branch training using string, without any yield or quality reduction. In the present study, we investigated the harvest efficiency, harvest posture, and subjective burden with electric long-shafted shears and a large-wheeled cart under modified branch training methods (the new standing harvest method) for labor-saving asparagus spear harvesting. Two male subjects in their 30s and 60s harvested spears for 60 min using (standing harvest) and without using (control) the new standing harvest method. The harvest efficiency of the new standing harvest method was 18% lower than that of the control. In the standing harvest, subjects had to pull the shears up to take the harvested spear from the shears with their left hand after each spear was cut (“take”). The subjects needed time for the “take” action, and the time necessary to harvest a spear with the electric long-shafted shears was longer than that required for the control. We also evaluated the harvest posture using the Ovako Working Posture Analyzing System (OWAS). For the subject in his 30s, action category(AC)2 and AC3 accounted for 72% and 14% of the postures recorded in the control, respectively, whereas in the standing harvest, AC1 and AC2 accounted for 57% and 41%, respectively. For the subject in his 60s, AC2 and AC3 accounted for 41% and 58% of the postures recorded in the control, respectively, whereas in the standing harvest, AC1 and AC2 accounted for 27% and 70%, respectively. Unfavorable postures during harvest were reduced by the new standing harvest method. The subjective physical burden on the subjects was evaluated using a modified Borg scale after 60 min of harvesting using and without using the new standing harvest method. The subjective physical burden in both subjects was highest (> 8) at the waist in the control, whereas the scores were lower than 3 in the standing harvest. Thus, the new standing harvest method reduced harvest efficiency, but resulted in substantial improvements in posture and reduced the physical burden on the subjects.