We report a rare case of trigeminovagal reflex (TVR) resulting from stimulation of the mandibular division of the trigeminal nerve under general anesthesia. Although general anesthesia reportedly prevents TVR, it should be part of the differential diagnosis in all cases of unexplained sinus arrest during oral and maxillofacial surgery.

We evaluated the association between respiratory symptoms and hydration volume during last 1 week of life in terminal cancer patients using retrospective study. The subjects were 138 terminally patients with malignancies. Patients were classified into two groups: the low hydration group (group L, n=85) who received 1,000 ml or less of artificial hydration per day in 1 week before death and high hydration group (group H, n=53) who received over 1,000 ml per day. We compared appearance of dyspnea and bronchial secretion on group L with group H. 64.1% of group H had dyspnea, and 52.8% had bronchial secretion. These fractions are significantly higher than group L (32.9%, 15.3%). In the results of multiple regression analysis, lung involvement (odds ratio: 3.55), hydration over 1,000 ml per day (3.54), and administration of opioid (0.40) were significantly related dyspnea. Lung involvement (7.29), hydration over 1,000 ml per day (4.43), and oral intake (0.31) were significantly related bronchial secretion. Our results provide preliminary evidence that excessive artificial hydration therapies influence the respiratory symptoms in terminal cancer patients. 1,000 ml of hydration may be used as a rough indication in terminal stage.

Our hospital has a nutrition support team (NST) serving inpatients of all department. Two years ago, the team started activities with the motto “Apt nutritional management for inpatients”. It is an interdepartmental unit consisting of physicians, nurses, dietitians, pharmacists and speech therapists. Initially we found it difficult to make time to join forces, but now it has become possible to screen patients for undernourishment on a weekly basis while making nutritional assessment and planning, and holding consultations. The main purpose of the consultations is to improve the nutritional status of patients according to plans formulated after nutritional assessment made at the request of physicians and nurses in charge of the patients. To achieve the objective, we are expected to concentrate all our efforts and brains. This paper presents some consultation cases we have handled. In addition, the nutritional assessment and nutritional intervention activities of our hospital are described.
Nutrition Assessment ; Nutritional status ; Nutritional Support ; Hospitals ; Consultation

It has been made known that there isn't any significant regional difference in the frequencies of cases of viral hepatitis C by subtypes in our country. In the present study we investigated the subtypes in hepatitis C virus carring patients without blood transfusion history in the southern region of Ibaraki Prefecture to clarify the occurrence ratio of each subtype of the virus. The results of interferon therapy were also examined in those patients with chronic hepatitis C. The frequencies of subtypes 2, 3 and 4 were found to be 71%, 16% and 10%, respectively. Although these ratios were the same as the national average, a significantly high frequency (P>0.01) of subtype 3 was observed in the patients from Tsuchiura in the region, suggesting that there may have existed some particular source of infection other than blood transfusion. The effectiveness of interferon therapy was significantly higher (P>0.01) in the patients with subtype 3 (75%) than in those patients with subtypes 2 and 4 (23% and 43%, raspectively), suggesting that interferon is a remedy specific to subtype 3.

IT Strategic Headquarters of the Japanese government compiled the Priority Policy Program 2007, in which "Establishment of the structure for every citizen to be able to manage and utilize his health information by himself" and "Foundation of the e- Post-Office box for the realization of the social security service in aspects of people" are declared. For this purpose, a health information system is considered that delivers healthcare data to the server, where the data is to be individually self.administered by the owner. A patient can register his data, and download or reference it from any medical institution or home when necessary. We made a prototype system to realize such a personal health data referring system based on the e. post.office box concept. The system is to be used in field trial experiment with the staffs and students of Tokyo Institute of Technology using their ID Card. This prototype system is expected to be available for the policy suggestion in the realization of the e-P.O.Box stated in the Priority Policy Program of the government.
Asian Continental Ancestry Group ; Delivery of Health Care ; Fertilization ; Health Information Systems ; Humans ; Social Security ; Tokyo

AIMTo identify proteins induced by androgen in Sertoli cells during spermatogenesis.

METHODSWe analyzed protein profiles in TM4 Sertoli cells treated with dihydrotestosterone (DHT) using surface enhanced laser desorption ionization time-of-flight mass spectrometry (SELDI-TOF-MS).

RESULTSWe found increases in the expression of a 5.0-kDa protein at 15 min, an 11.3-kDa protein at 24 h and 4.3 kDa, 5.7 kDa, 5.8 kDa, 9.95 kDa and 9.98 kDa proteins at 48 h after the treatment. In contrast, the expression of 6.3 kDa and 8.6 kDa proteins decreased at 30 min, and 4.9 kDa, 5.0 kDa, 12.4 kDa and 19.8 kDa proteins at 48 h after the treatment. The 11.3-kDa protein was identified as macrophage migration inhibitory factor (MIF) known to having various functions. The 9.98-kDa protein was identified as calgizzarin related to calcium channels. The timing of their expression suggests that MIF and calgizzarin are involved in late regulation of spermatogenesis in Sertoli cells by androgen.

CONCLUSIONMIF and calgizzarin are two important androgen-responsive proteins produced by Sertoli cells and they might play a role in regulating spermatogenesis.

Androgens ; pharmacology ; Animals ; Cell Line ; Dihydrotestosterone ; pharmacology ; Gene Expression Regulation ; drug effects ; Kinetics ; Macrophage Migration-Inhibitory Factors ; genetics ; Male ; Mice ; Protein Array Analysis ; S100 Proteins ; genetics ; Sertoli Cells ; drug effects ; physiology ; Spermatogenesis

The objectives of the present study were to evaluate the anatomic localization of porcine reproductive and respiratory syndrome virus (PRRSV) in naturally infected pigs and to determine whether oral fluid could be used to detect the virus in infected animals. Two sows, seven 2-month-old grower pigs, and 70 6-month-old gilts were included in this study. PRRSV in sera and oral fluid were identified by nested reverse transcription PCR (nRT-PCR) while lung, tonsil, and tissue associated with oral cavity were subjected to nRT-PCR, immunohistochemistry, and in situ hybridization. In sows, PRRSV was identified in oral fluid and tonsils. PRRSV was also detected in oral fluid, tonsils, salivary glands, oral mucosa, and lungs of all seven grower pigs. However, viremia was observed in only two grower pigs. Double staining revealed that PRRSV was distributed in macrophages within and adjacent to the tonsillar crypt epithelium. In gilts, the North American type PRRSV field strain was detected 3 to 8 weeks after introducing these animals onto the farm. These results confirm previous findings that PRRSV primarily replicates in tonsils and is then shed into oral fluid. Therefore, oral fluid sampling may be effective for the surveillance of PRRSV in breeding herds.
Animals ; Female ; In Situ Hybridization/veterinary ; Lung/virology ; Male ; Palatine Tonsil/virology ; Polymerase Chain Reaction/veterinary ; Porcine Reproductive and Respiratory Syndrome/*virology ; Porcine respiratory and reproductive syndrome virus/*physiology ; Saliva/*virology ; Salivary Glands/virology ; Swine/virology ; Virus Replication/physiology

Objective : Recently, a directive that all pharmacies should have a family pharmacist by 2025 was announced. However, this directive has not been clearly communicated to patients. The purpose of this study was to examine the effect of patient information handouts on the number of patients who use the new family pharmacist system, using the evaluation index of family pharmacies (Key Performance Indicator [KPI]). Methods : We created and distributed patient handouts about family pharmacists. The number of new family pharmacists, the number of consultations, and the consultation content from June-August 2021 (pre-distribution period) and September-November 2021 (distribution period) were examined to compare the KPI group and non-KPI group. A cutoff score of the KPI index was used to determine compliant vs. non-compliant. Results : The median (interquartile range) number of new patients in the KPI group (7 pharmacies) increased from 0 (0.0, 1.5) in the pre-distribution period to 4 (2.5, 10.5) in the distribution period (P＝0.019). In the non-KPI group (4 pharmacies) it was 0 (0.0, 0.0) both before and after distribution. The number of consultations about unused prescribed medications and health increased (P＝0.031 and 0.047, respectively) in the KPI group during the distribution period, with no change in the non-KPI group. Conclusion : The use of handouts led to an increase in users of the family pharmacist system in the KPI group. The use of handouts at KPI pharmacies will help patients understand the pharmacist profession and the benefits of the family pharmacist system.

Following the revision of the structure and content of the Model Core Curriculum for Medical Education to be more outcome-based and the legal status of the medical practice performed by medical students in the clinical clerkship, we have revised the Guideline for Participatory Clinical Clerkship. The following items were revised or newly described : significance of enhancing the participatory clinical clerkship, scope of medical practice, confidentiality, patient consent, patient consultation and support service, objectives of the clinical clerkship, simulation education, departments where the clinical clerkship is conducted, assessment in the clinical practice setting, CC-EPOC, and entrustable professional activities. A foundation has been established to promote seamless undergraduate and postgraduate medical education. However, future work is needed to examine the specific level of performance expected at the end of the clinical clerkship and department-specific clinical practice goals and educational strategies.

OBJECTIVEThe changes in serum adipokines and cytokines related to oxidative stress were examined during 3 months 'Off to On' and 'On to Off' periods using negatively charged particle-dominant indoor air conditions (NCPDIAC).

METHODSSeven volunteers participated in the study, which included 'OFF to 3 months ON' periods (ON trials) for a total of 16 times, and 'ON to 3 months OFF' (OFF trials) periods for a total of 13 times.

RESULTSWith the exception of one case, serum amyloid A (SAA) levels decreased significantly during the ON trials.

CONCLUSIONConsidering that SAA is an acute phase reactive protein such as C reactive protein (CRP), this observed decrease might indicate the prevention of cardiovascular and atherosclerotic changes, since an increase in high-sensitive CRP is associated with the subsequent detection of these events.

Adult ; Air ; analysis ; Air Pollution, Indoor ; Environmental Monitoring ; Female ; Housing ; Humans ; Male ; Serum Amyloid A Protein ; metabolism