Cestode zoonosis cases confirmed by PCR-based mitochondrial DNA analysis were investigated. The cestodiosis included taeniasis, cysticercosis, alveolar echinococcosis, cystic echinococcosis, sparganosis mansoni, diphyllobothriasis and diplogonoporiasis. DNA samples were extracted from the ethanol-fixed, formalin-fixed, paraffin-embedded sections, HE-stained, and the PAS- or acetocarmine-stained samples submitted for histopathology. For PCR-based analysis, cytochrome c oxidase subunit 1 and⁄or cytochrome b genes were amplified by multiplex PCR or conventional PCR coupled with DNA sequencing. Although DNA molecules were degraded in most formalin-fixed samples, smaller gene fragments were successfully amplified and the species causing cestodiosis could be identified by DNA sequence analysis of the amplicons. This review describes cestode zoonosis cases in which mitochondrial DNA analysis was useful not only for routine and retrospective diagnosis, but also for genetic polymorphism analysis and molecular identification of the species associated with pathogenicity. The significance of molecular diagnosis using histopathological specimens for cestode zoonoses is also discussed.

It is known that drug disposition is altered by concurrent administration of different drugs. Drug-drug interaction may also enhance a side effect that is linked to either drug. The purpose of this report is to demonstrate the usefulness of therapeutic drug monitoring (TDM) in the early detection of side effects induced by drug-drug interaction and its treatment.
The combined use of rifampicin and mexiletine may require an increase in the dose of mexdletin by about 50% due to increased clearance resulting from enzyme induction. In addition, three days after discontinuation of the rifampicin therapy, the serum mexiletine level increased from 0.83 mcg/ml to 2.44 mcg/ml. The patient has developed a tremor. After discontinuation of mexiletine medica-tion, the symptom disappeared in two days.
On the other hand, the patient who took theophylline and mexiletine together developed nausea, vomiting and tachycardia. Four days after initiation of the combination therapy, the serum theophyl-line level was in the toxic range of 27.3 mcg/ml. The patient's theophylline dose was decreased 25%, and side effects completely resolved. The serum theophylline concentration became normal (18.8 mcg/ml) seven days later.
Whatever the mechanism, these drug interactions may be sufficient to necessitate the adjustment of drug dosage, preferabily in accordance with serum drug concentration levels. These results suggest that TDM is useful for the suppression of incidence of side effects by drug interactions.

Introduction: We studied the characteristics and treatment outcomes of the following risk groups for tuberculosis (TB): those with HIV and diabetes mellitus (DM), contact cases, the homeless, foreigners, health care workers (HCW) and the elderly. Method: A descriptive cross-sectional study was conducted by analysing the Japanese TB surveillance data of all cases registered between 2007 and 2010 (N = 96 689). Results: The annual proportion of TB cases by risk group was stable over the study period, although there was a slight but significant increase observed for foreigner and elderly cases. Homeless and elderly TB cases had the highest DM co-morbidity (16.6% and 15.3%), respectively. HIV co-infection was low in all TB cases (0.2%) yet highest in foreigners (1.3%). HIV status of 45% of TB cases was unknown. The proportion of multidrug-resistant TB (MDR-TB) was similar among all risk groups (0.0%–0.9%) except foreigner, at 3.4%. Males in most risk groups had higher mortality than females; the mortality of all TB cases in all age groups for both males and females was 3.6–24 times higher than the general population. Discussion: Reasons for the high proportion of “HIV status unknown” should be investigated and improved. Contact tracing among foreign cases with MDR-TB should be a priority. Homeless persons should be screened for DM together with TB. Programmes to enhance health and nutrition status may benefit TB prevention among the elderly. Tuberculosis screening and TB education are important for HCW.

Phagocytic cells, polymorphonuclear leucocytes and macrophages, play an important role in non-specific cellular immunity, which is the first line of defense against infectious diseases. The purposes of this study were to clarify the combined effects of forced exercise and sleep disturbance on non-specific cellular immunity in mature rats, and to compare the effects between forced and voluntary exercise. Non-specific cellular immunity represented by the yield of cells from bronchoalveolar lavage and the superoxide-generating capacity of alveolar macrophages was investigated using mature rats.
Male Wistar rats (11 weeks old) were divided into 5 groups:
1) Training group ; exercised on a treadmill at a belt speed of 35 m/min for 15 min/day,
2) Jet Lag group ; disturbance of the sleep cycle by day/night time shifts at 2-week intervals,
3) Training+ Jet Lag (T + J) group ; exercised on a treadmill with sleep disturbance, a model identified by our research group to simulate chronic fatigue, 4) Voluntary group ; housed with running wheels, and 5) Control group ; housed under sedentary conditions.
Body weight and food consumption measured during the experimental period showed coincidental changes. After 6 weeks of the experiment, the rats were sacrificed at the age of 17 weeks. Negative effects on non-specific cellular immunity were observed in the training group, and the rats were also slightly affected by sleep disturbance (Jet Lag group) . These negative effects seemed to be cumulative in the T+J group. In contrast, significant positive effects were observed in the voluntary group.
These results suggest that stress, forced exercise and sleep disturbance negatively affect non-specific cellular immunity, and that voluntary exercise is able to enhance immunity even if it is started after maturation.

Six (1.2%) of 501 patients sustained phrenic nerve injury during operation for congenital heart disease at our institutions between 1992 and 1998. The diagnosis was confirmed by percutaneous stimulation of the phrenic nerve. All but 1 patient were less than 9 months old, and the average weight was 3.6kg. All 6 patients underwent diaphragmatic plication and were extubated by 7 days after operation. Percutaneous stimulation of the phrenic nerve allowed direct assessment of phrenic nerve function which was difficult to detect by clinical and radiological evidence. This method can be non-invasively used at the bedside to facilitate early and accurate diagnosis of phrenic nerve palsy.

The effectiveness of the Kampo medicine shakuyakukanzoto extract for patients with muscle cramp is well known, but recently side effects related to pseudoaldosteronism have also been reported. To avoid this issue, Kampo medicines without Glycyrrhizae Radix are needed for treatment of muscle cramp. We investigated the therapeutic effect of shimotsuto extract, which has traditionally been used to treat anemia, in 26 patients (mean age : 70.7 ± 12.1 years) with muscle cramp. Improvement of the symptom was noted in 18 patients (69%), with no change in 8 patients (31%). The abdominal muscle tension of the former patients was significantly lower than the latter. Here, the cases of four representative patients in whom muscle cramp was improved by shimotsuto are described. The response rate to shimotsuto was similar to that of shakuyakukanzoto. Our results suggest that shimotsuto extract is a suitable alternative to shakuyakukanzoto for treatment of muscle cramp in older non-robust type patients not in need of emergency care.

Case 1 was a 42-year-old woman who was admitted because of infective endocarditis. Pulmonary embolism occurred during medical treatment for infective endocarditis. Despite the acute infectious phase, surgical treatment was successfully performed. Case 2 was a 50-year-old man who was admitted because of infective endocarditis. Cardiac catheterization showed ventricular septal defect and atrial septal defect. Surgical treatment was performed successfuly. In both cases, and the postoperative courses were unventful.

As regards to low back pain of agricultural worker, there are many problems still as to a syndrom of “Nofusho” in rural medicine, a disease in ocupational medicine and clinic of orthopedic.
Agricultural worker who complained of low back pain varies with their country and farm products, and it tend to increase with adding to their age. Further, the female rate of low back pain showed slightly high tendency than the made rate, 8.5-12.5 % of male, 6.5-13.4 % of female always complained of low back pain.
According to the findings of roentogenographic examination of back bone, the deformed vertebrae was found clearly, especially, low back pain caused by a trauma of soft tissue and iscogenic pain showed in farmers. Therefor, it is necessary to be improved working posture and condition.
In comparrison with non-farmer, it is located in order of truck drivers. bus drivers and repairmen.

Continuous duodenal levodopa/carbidopa intestinal gel delivery by a gastrostomy infusion system improves control of Parkinson’s disease. The overall complication rates of percutaneous endoscopic gastrojejunostomy were reported to be 41% and 59% for immediate and delayed adverse events, respectively. A 72-year-old woman underwent percutaneous endoscopic gastrojejunostomy using the delivery system noted above. Abdominal pain and vomiting occurred 3 months later. Esophagogastroduodenoscopy showed a longitudinal ulcer extending from the lower gastric body to the ileum end, with small intestinal telescoping. Colonoscopy showed a large bezoar of food residue that was attached around the tip of the tube, reaching the ascending colon, which may have acted as an anchor. Thus, the gastric antrum and small intestine were shortened with telescoping. This complication was resolved by crushing the bezoar with forceps during colonoscopy and can be prevented by consuming a fiber-free diet and periodic exchanges of the tube using esophagogastroduodenoscopy.
Abdominal Pain ; Aged ; Bezoars ; Colon ; Colon, Ascending ; Colonoscopy ; Diet ; Endoscopy, Digestive System ; Female ; Gastric Bypass ; Gastrostomy ; Humans ; Ileum ; Intestine, Small ; Pyloric Antrum ; Surgical Instruments ; Ulcer ; Vomiting