We investigated the recovery time of walking ability after total knee arthroplasty (TKA) and patient's background : age at the operation time, gender, BMI, the affected joints (single or bilateral), assessment criteria for the evaluation of osteoarthritis of the knee (JOA score), and surgical approach. We examined predictors of walking ability recovery time after TKA. There were 88 knees operated on in 67 patients (7 men and 60 women) using TKA in our institution. The causes of disease were osteoarthritis (OA) in 80 knees and spontenous osteonecrosis (ON) in 8 knees. We investigated the period required to be able to walk using parallel bars, to walk with a T cane and to go up and down stairs with a handrail. The period required to be able to walk with parallel bars averaged 5.7 days post operation ; to walk with a T cane averaged 16.1 days, and to go up and down stairs required an average of 22.9 days. In conclusion, the factors that significantly influenced the postoperative walking ability recovery period were the affected joints (single or bilateral), age at operation, surgical approach and preoperative JOA score.

Tohoku Medical and Pharmaceutical University Hospital uses an information form created by doctors and pharmacists to provide postoperative information to patients who undergo nephrectomy at the Department of Urology. The form recommends that patients' physicians change prescriptions and adjust medication doses considering post-nephrectomy deterioration of renal function in patients with a single remaining kidney. Of the 7 patients who used this information form, prescription changes were made in 4 patients. An information form jointly created by a physician and pharmacist may affect prescription changes.

Objective: The sports community has placed its great hope on pharmacist since the establishment of the Accredited Sports Pharmacist System.  Thus, we constructed an anti-doping database for pharmacist so that pharmacist can support appropriate drug use and contribute to the sports community.
Methods: The database was constructed by using Microsoft®Access 2007, based on our previously prepared anti-doping list.
Results: 686 prescription drugs and 268 ingredients for non-prescription drug were registered in the data base.  It was able to retrieve the advisability of use for athlete, blood half-life and the other notes of the drugs easily and promptly.
Conclusion: We confirm that pharmacist can provide drug information easily, promptly and from the viewpoint of pharmaceutics by utilizing the database including necessary information for anti-doping.

A 27-year-old woman developed circulatory failure 4 days after birth and was diagnosed with mid-aortic syndrome (MAS) 10 days after birth. Despite repeated endovascular treatments, restenosis recurred, and descending aorta-abdominal aorta bypass surgery was performed at the age of 6. Since the age of 14, bilateral external iliac artery occlusion has been observed, but no ischemic symptoms were observed in the lower extremities, and the patient was followed up. From around the age of 26, significant claudication appeared in both lower extremities, and it was determined that surgical intervention was required. Bilateral common iliac artery-common femoral artery bypass surgery was performed. The bilateral common iliac arteries were used as the central anastomosis, and the common femoral artery just above the bifurcation of the bilateral superficial and deep femoral arteries was used as the peripheral anastomosis. No ischemic symptoms in the lower extremities have been observed up to now (2 years after the operation). Bilateral common iliac artery-common femoral artery bypass surgery was performed for abdominal aortic stenosis with hypoplasia of the bilateral external iliac arteries and lower extremity artery disease (LEAD). Since we experienced the case with favorable results, we will add a review of the literature and report it.

A 68-year-old female had been diagnosed with granuloma annulare a year earlier. She was prescribed tranilast and was recovering, but had to discontinue the tranilast because she suffered liver damage as a side effect.
She was also suffering from a worsening rash and so decided to try Kampo medicine. We prescribed orengedokuto because of thermal symptoms suggestive of hot flushes, the appearance of her tongue, and the character of her rash. Initially, the rash improved, but from the 3rd day following admission did not change greatly. We suspected the existence of interior cold and started combining maobushisaishinto. Five days later, the granulomas had rapidly shrunk. We believe she had overlapping diseases of a yin and yang pattern from the fact that she improved clinically.

OBJECTIVE: To test the effects of heart rate, body mass index (BMI) and noise level on interscan and interobserver variability of coronary artery calcium (CAC) scoring on a prospective electrocardiogram (ECG)-triggered 64-slice CT. MATERIALS AND METHODS:One hundred and ten patients (76 patients with CAC) were scanned twice on prospective ECG-triggered scans. The scan parameters included 120 kV, 82 mAs, a 2.5 mm thickness, and an acquisition center at 45% of the RR interval. The interscan and interobserver variability on the CAC scores (Agatston, volume, and mass) was calculated. The factors affecting the variability were determined by plotting it against heart rate, BMI, and noise level (defined as the standard deviation: SD). RESULTS: The estimated effective dose was 1.5 +/- 0.2 mSv. The mean heart rate was 63 +/- 12 bpm (range, 44-101 bpm). The patient BMIs were 24.5 +/- 4.5 kg/m2 (range, 15.5-42.3 kg/m2). The mean and median interscan variabilities were 11% and 6%, respectively by volume, and 11% and 6%, respectively, by mass. Moreover, the mean and median of the algorithms were lower than the Agatston algorithm (16% and 9%, respectively). The mean and median interobserver variability was 10% and 4%, respectively (average of algorithms). The mean noise levels were 15 +/- 4 Hounsfield unit (HU) (range, 8-25 HU). The interscan and interobserver variability was not correlated with heart rate, BMI, or noise level. CONCLUSION: The interscan and interobserver variability of CAC on a prospective ECG-triggered 64-slice CT with high image quality and 45% of RR acquisition is not significantly affected by heart rate, BMI, or noise level. The volume or mass algorithms show reduced interscan variability compared to the Agatston scoring (p < 0.05).
Adult ; Aged ; Aged, 80 and over ; *Body Mass Index ; Calcium/*analysis ; Coronary Angiography/*methods ; Coronary Vessels/*chemistry ; *Electrocardiography ; Female ; *Heart Rate ; Humans ; Male ; Middle Aged ; Observer Variation ; Prospective Studies ; Tomography, X-Ray Computed/*methods

OBJECTIVETo investigate the effect and mechanism of FTY720 on acute graft versus host disease (GVHD) in rat small bowel transplantation (SBTx).

METHODSHeterotopic SBTx was performed using a parent (WF)-into-F1 (WFxACI) rat combination. Recipient rats were divided into experimental group (n=6) and control group (n=6). Rats in the experimental group were administered with FTY720 at 0.5 mg/kg for 14 days. Lymphocyte apoptosis in the liver and the mucosa of intestine and graft was detected by TUNEL and flow cytometry 15 days after transplantation. Recipient survival and lymphocyte apoptosis were compared between the two groups.

RESULTSRecipients in the control group died of GVHD after a mean survival time of (16+/-2.1) days. FTY720-treated recipients had a significantly longer survival (>100 days). After administration of FTY720, the percentage of apoptotic lymphocytes was significantly increased in the graft as compared to that in the control group by flow cytometry. The ratio of apoptotic lymphocyte in the liver and graft was also significantly higher in the experimental group by TUNEL.

CONCLUSIONFTY720 effectively induces the lymphocyte apoptosis, inhibits the lesion of target tissues by GVHD, and prolongs the recipient survival.

Animals ; Apoptosis ; drug effects ; Fingolimod Hydrochloride ; Graft vs Host Disease ; immunology ; prevention & control ; Immunosuppressive Agents ; pharmacology ; Intestine, Small ; transplantation ; Lymphocytes ; cytology ; drug effects ; Male ; Propylene Glycols ; pharmacology ; Rats ; Rats, Inbred WF ; Sphingosine ; analogs & derivatives ; pharmacology ; Transplantation, Heterotopic

Farmer's lung is a form of hypersensitivity pneumonitis, which is manifested mainly as an occupational disease among dairy farmers exposed to organic dusts from moldy hay and compost in silos and lofts. In Europe and America, it has been known for many years. In Japan, it frequently occurs in Hokkaido, Iwate and Hokuriku districts during winter months from November to March. The culprit antigens are spores of actinomycetes thermophilus such as Micropolyspora faeni and Thermoactinomyces vulgaris. In recent years, various preventive measures have been taken. For instance, in order to prevent hay from heating by fermentation and the thermophile from thriving, farmers desiccate hay as much as possible and keep it in air-tight plastic containers. The result is a notable decrease in the prevalence rate of this ailment. Nonetheless, with graying the rural population, pulmonary fibrosis caused by chronic exposure to low levels of organic dust is posing a grave health problem in the dairy farming communities. As a prophylactic measure against chronic fibrotic lung disease, there is a need to implement a comprehensive heath control program consisting of continual sanitary checkups at workplace and counseling at an early stage in addition to periodic health examinations. Another health threat which has more recently loomed up in the dairy farming communities is environmental pollution.

Otsujito is a well-known herbal preparation used for treating hemorrhoidal disease. However, we considered the anatomical similarities between the lips and the anus, and here report a case of inflammation of the lips with blood stasis successfully treated with otsujito as well.
The case was a 59-year-old woman suffering from eczema on her face and neck. The eczema showed a tendency to improve with herbal treatment, but inflammation and pruritus of the lips continued. Taking into account the presence of blood stasis, we included otsujito in the treatment and her symptoms improved.
Otsujito contains bupleurum, cimicifuga, scutellaria, and rhubarb, which dissipates heat, and angelica,which resolves blood stasis. Therefore, we consider that inflammation of the lips with blood stasis can be treated with otsujito.