Objective: To quickly collect and provide information on package insert revisions, packaging changes, discontinuation of drug manufacturing and distribution, and other information without fail.
Methods: Information was collected with the use of a drug information service site (SAFE DI) managed by an organization formed by 15 pharmaceutical wholesalers (SAFE Co., Ltd.).  The information obtained was processed into a house journal and provided to the department of pharmacy and other hospital personnel via an employees-only website (hospital LAN).
Results: Before the introduction of the SAFE DI, incomplete or delayed information collection sometimes forced personnel to urgently cope with packaging changes or discontinuation of drug manufacturing and distribution and assume a heavy workload.  Introduction of the system allowed quick collection and dissemination of such information without fail.
Conclusion: The recently introduced SAFE DI contributes to qualitative improvement in collection and dissemination of information.  Introduction of such a system may also be useful in other hospitals.

Anterior cruciate ligament (ACL) is the first restraint against anterior tibial translation (ATT) in the knee joint. Previous studies suggested that knee joint laxity might be increased by the repeated stress imposed on the knee joint. The purpose of this study was to demonstrate the effect of the repeated soccer ball kicking actions on the ATT in healthy knees. Forty female collegiate students volunteered for this study. KT-2000 knee arthrometer was used to measure ATT before and after the task. The findings demonstrated that the repeated kicking actions had no significant effect on the ATT in healthy knees. The maximum knee extension angle on the striking side was greater than the supporting side (p<0.05). Significant correlations between mean anterior translation and maximum knee extension angle were observed on both sides (p<0.05). The kicking force on a soccer ball resulted in no increase in the knee laxity.

A comparative study was made on bathing-induced changes in body temperature, blood pressure, pulse rate and tissue blood flow of 12 healthy adults using tap water and artificial CO₂ water at 37°C to clarify the physiological effects of CO₂ at various concentrations of 0, 100, 300, 600, 800 and 1000ppm. There was no change in body temperature during bathing in either water, whereas blood pressure and pulse rate were similarly decreased during bathing, but either of these decreases was not significantly different between tap water and CO₂-water. Therefore, it seemed that the decrease in blood pressure due to vasodilation during bathing would be controlled through some regulatory system like autonomic nerve system not so as to result in too much decrease. But, tissue blood flow was more increased during bathing in CO₂-water than tap water, suggesting that blood circulation in the tissue near skin surface would have been more enhanced by bathing in hot CO₂-water, resulting in a decrease of blood pressure.
Since the increase in tissue blood flow during bathing was dependent on the concentration of CO₂, it seemed that an improvement of tissue circulation and metabolism would have resulted from venous return increase associated to venous dilatation, one of dose-dependent CO₂ effects.

A 44-year-old woman with Marfan's syndrome presented complaining of severe back pain. Angiography revealed annulo aortic ectasia, aortic regurgitation, acute aoric dissection (DeBakey IIIb) and distal aortic arch aneurysm. One month after admission, she underwent cardiopulmonary bypass was established through the femoral artery, the superior and inferior vena cava. The heart was arrested by aortic cross clamping and retrograde cold (20°C) cardioplegia. At first, a modified Bentall's procedure was done in addition to a Carrel patch procedure. After this procedure, the heart was perfused continuously (300ml/min) with warm (37°C) blood until the end of the cardiopulmonary bypass. The heart recovered a sinus rhythm spontaneously. Subsequently, aortic arch replacement and the elephant trunk method was done with the aid of deep hypothermia and circulatory arrest. The patients is well 1 year after the operation. This technique is useful for patients who require prolonged aortic cross clamping time.

For the purpose of establishing a method for evaluation of crude drugs, we demon strated the effect of aqueous extracts from the roots of seven different (types of) Angelicae (“Toki”) and rhizomes of seven different (types of) Atractylodes (lancea) (“Jutsu”) on the binding of immune complexes to macrophages. Among the extracts from “Toki”, extract of Angelica acutiloba Kitagawa (harvested in Nara Prefecture and the Hokuriku district in Japan) had the most potent enhancing activity on the binding. Among the extracts from “Juste”, extract of Atractylodes lancea DC, (An Hui Sheng in China) had the most potent enhancing activity. However, when the extracts were made from the codecoction of Angelica and Atractylodes lancea, the enhancing activities were varied. These results suggest that the combination of crude drugs tays an important role in the appearance of the pharmacological activities.

Objective: At Kitasato Institute Hospital, Kitasato University (henceforth, the hospital), the first edition of an antimicrobial use guidebook (henceforth, the guidebook) was produced in 2000.  This time, the Pharmaceutical Department’s members on the hospital’s Infection Control Committee (ICC) took the lead and revised the guidebook so that it better conforms to clinical conditions and assessed the guidebook they created.
Methods: A Working Group (WG) consisting of two ICC Pharmaceutical Department members and two members of the Medical Products Information Office staff examined the items to be listed in the guidebook.  These items were approved by the ICC and then assigned to physicians and pharmacists to be written up.  A questionnaire survey was conducted on the physicians and pharmacists in the hospital as to their assessment of the content and the conditions of use of the guidebook created.
Results: In the revised edition, “Antimicrobials PK/PD,” “TDM,” “Empiric Therapy for Infections in Each Department,” etc. have been added, the physicians wrote “Empiric Therapy for Infections in Each Department” and everything else was written by the WG.  The return rate of the questionnaire was 65.7% (N=99), and the guidebook utilization rate was 75.4%.  Frequently viewed items were “List of Antimicrobials Used In-Hospital,” “How to Administer Medication during Decreased Renal Function,” “Empiric Therapy for Infections in Each Department,” etc. by the internal medicine physicians, “List of Antimicrobials Used In-Hospital” and “How to Administer Medication during Decreased Renal Function,” etc. by the surgeons, and “Classification of Antimicrobials,” “List of Antimicrobials Used In-Hospital,” “When Renal Function is Decreased,” “TDM,” and “Empiric Therapy for Infections in Each Department,” etc. by the residents.  Furthermore, there were no items deemed “not necessary for inclusion” for a clear reason.  As to be expected in this guidebook, 72.3% of all respondents mentioned it was “a source of information on basic antimicrobial use” and next, “a source of information for treating infections outside one’s area of specialty.”
Conclusion: The items listed in the guidebook are thought to be appropriate, and its usage conditions are also good.  As they are specialists on antimicrobials, the pharmacists playing a central role while cooperating with the physicians on the ICC led to the creation of a highly useful guidebook.

The durability of the Starr-Edwards (SE) mitral caged-disk valve, model 6520, is not clearly known. We reported that SE mitral caged-disk valves implanted ＞20 years previously should be carefully followed up, and that SE caged-disk valves implanted ＞30 years previously should be electively replaced with modern prosthetic valves in our experience. We found the removed valve 39 years after implantation, which seemed minimal structural deterioration. The patient was discharged on the 10th postoperative day without any complications.

Recently, patient safety has become a social concern in Japan. Even though cases of “incidents” and “accidents” by interns have been collected and analyzed in each hospital, few published reports have concerned teaching hospitals. The purpose of this study was to identify the incidence of “incidents” and “accidents” by first-year and second-year interns in Japan.
1) In August 2005, a questionnaire was mailed to 231 interns at 14 teaching hospitals. A total of 192 interns participated in this study, with a response rate of 83.1%.
2) The number of cases of “incidents” and “accidents” involving interns since the start of their training was collected.An “incident” was defined as an error that was prevented before occurrence, whereas an “accident” was defined as an unplanned, unexpected, and undesired event with adverse consequences.
3) Among first-year interns, “incidents” occurred at a rate of 0.79 per resident-month (95% confidence interval [CI]: 0.30-1.28), while “accidents” were observed at a rate of 0.13 per resident-month (95% CI: 0.06-0.20).
4) Among second-year interns, “incidents” occurred at a rate of 0.24 per resident-month (95% CI: 0.14-1.34), and “accidents” were observed at a rate of 0.06 per resident-month (95% CI: 0.01-0.11).
5) There was no significant difference in the number of cases of “incidents” and “accidents” in regards to sex, age, or the number of beds of teaching hospitals.