We have managed information on adverse drug reaction using the clinical records to obtain data from within our hospital and using Medicine-Pocketbooks to obtain data outside our hospital.  Our system for management of side effect information does not require the development of a separate specialized system.  Our method of collecting side effect information was changed in April 2007.  Therefore, we evaluated our present method of collecting information on side effects by comparing the method used before the change with the new method.  The amount of side effect information collected has clearly increased since April 2007.  Although the amount of data collected directly from doctors has increased eight-fold, the amount collected from other data sources has hardly changed.  Side effect symptoms have hardly changed, with skin symptoms being the most frequent side effect.  Suspected drugs have also hardly changed, with antibiotics being the most frequently suspected drugs.  In addition, we conducted questionnaire surveys on the use of Medicine-Pocketbooks by patients who registered side effect information at our hospital to determine whether Medicine-Pocketbooks were being used effectively as a tool for the management of side effect information.  Among patients who registered their side effect information at our hospital, 76% also presented their Medicine-Pocketbooks to other medical institutions.  In addition, all patients received a change in prescription or were questioned about their side effect information when they presented their Medicine-Pocketbooks.  Our present method of collecting side effect information is considered appropriate since there was an increase in the amount of side effect information collected from doctors.  Medicine-Pocketbooks have also been effectively used as a tool for managing side effect information.

Although the combined administration of glycyrrhizin (SNMC) and ursodeoxycholic acid (UDCA) is usually used for intractable patients with active HCV-associated chronic hepatitis (HCV-CH) or cirrhosis (LC), there are many cases that do not respond to this combination therapy. In this study, we examined the effects of adding Juzen-taiho-to (TJ-48) to lower the serum alanine aminotransferase (s-ALT=s-GPT) levels in such cases. Methods: The average s-ALT levels for 6 months were compared before and after 7.5g of Juzen-taiho-to was added to the combined therapy of SNMC and UDCA for 9 HCV-CH and 12 HCV-LC patients. In some cases, the effectiveness of the therapy over 12 months was also evaluated. Results: In the HCV-CH cases s-ALT levels were significantly decreased in 3 of 9 (33%) cases in 6 months (about 30 INU in average). In the HCV-LC cases, s-ALT levels were significantly decreased in 5 of 12 (42%) cases in 6 months (more than 40 INU in average). There were some patients whose s-ALT levels decreased significantly after 6 months. As to the improvement of clinical symptoms, general fatigability improved in 12 out of 20 cases (60%) and anorexia improved in 10 out of 19 cases (53%). Conclusions: Juzen-taiho-to (TJ-48, 7.5g daily) added to the combined therapy of SNMC and UDCA may be an effective therapy for intractable cases of active HCV-CH or LC.

Methods: Thirty patients with ASD aged ≥50 years who were admitted to our hospital between July 2016 and September 2019 were included in this study. X-ray parameters (i.e., sagittal vertical axis, pelvic tilt, and pelvic incidence minus lumbar lordosis) were evaluated from the full-length standing radiographs of the subjects. Trunk and hip extensor strength was evaluated using a hand-held dynamometer. Dynamic postural changes (i.e., sagittal trunk shift during standing, sagittal trunk shift during gait, and delta sagittal trunk shift) were assessed using a three-dimensional motion analysis system. The relationships between dynamic postural change and various X-ray parameters, as well as trunk and hip extensor strength, were examined using multivariable analysis. Results: Multivariable analysis showed that hip extensor strength is the factor most strongly associated with dynamic postural change among the X-ray parameters and physical functions assessed in this study (β=−0.41, R2=0.12). Conclusions We demonstrated the association between dynamic postural change and hip extensor strength in patients with ASD. Our results may be useful to healthcare providers treating patients with ASD. Interventions for dynamic postural change in patients with ASD should focus on hip extensor strength.

Methods: Thirty patients with LSS scheduled for spine surgery participated in this study. Lower limb pain was assessed using the Visual Analog Scale (VAS), and the patients were divided into two groups based on the mean scores (patients with scores above and below the mean were classified as the high-VAS and low-VAS groups, respectively). The kinematics of the spine, pelvis, and hip joints during gait were then measured using a 3D motion analysis system. Student paired t -tests were used to compare the angles of the spine, pelvis, and hip during gait between the two groups. Results: Compared to those in the low-VAS group, the spine was significantly extended and bent toward the more painful lower limb side, and the pelvis was significantly anteriorly tilted among individuals in the high-VAS group. Conclusions Patients with LSS experiencing severe pain in their lower limb tend to keep the spine in a more extended position, bend laterally toward the painful side, and have an anteriorly tilted pelvic posture. The dynamic spinal and pelvic alignment was closely related to the intensity of the lower limb pain.

PURPOSE: The purpose of this study was to quantify the target coverage, homogeneity, and robustness of the dose distributions against geometrical uncertainties associated with four whole breast radiotherapy techniques. METHODS: The study was based on the planning-computed tomography-datasets of 20 patients who underwent whole breast radiotherapy. A total of four treatment plans (wedge, field-in-field [FIF], hybrid intensity-modulated radiotherapy [IMRT], and full IMRT) were created for each patient. The hybrid IMRT plans comprised two opposed tangential open beams plus two IMRT beams. Setup errors were simulated by moving the beam isocenters by 5 mm in the anterior or posterior direction. RESULTS: With the original plan, the wedge technique yielded a high volume receiving > or =107% of the prescription dose (V107; 7.5%+/-4.2%), whereas the other three techniques yielded excellent target coverage and homogeneity. A 5 mm anterior displacement caused a large and significant increase in the V107 (+5.2%+/-4.1%, p<0.01) with the FIF plan, but not with the hybrid IMRT (+0.4%+/-1.2%, p=0.11) or full IMRT (+0.7%+/-1.8%, p=0.10) plan. A 5-mm posterior displacement caused a large decrease in the V95 with the hybrid IMRT (-2.5%+/-3.7%, p<0.01) and full IMRT (-4.3%+/-5.1%, p<0.01) plans, but not with the FIF plan (+0.1%+/-0.7%, p=0.74). The decrease in V95 was significantly smaller with the hybrid IMRT plan than with the full IMRT plan (p<0.01). CONCLUSION: The FIF, hybrid IMRT, and full IMRT plans offered excellent target coverage and homogeneity. Hybrid IMRT provided better robustness against geometrical uncertainties than full IMRT, whereas FIF provided comparable robustness to that of hybrid IMRT.
Breast Neoplasms ; Breast* ; Humans ; Prescriptions ; Radiotherapy* ; Radiotherapy, Intensity-Modulated

STUDY DESIGN: Retrospective study. PURPOSE: To investigate the relationship between preoperative total spinal sagittal alignment and the early onset of adjacent segment degeneration (ASD) after single-level posterior lumbar interbody fusion (PLIF) in patients with normal sagittal spinal alignment. OVERVIEW OF LITERATURE: Postoperative early-onset ASD is one of the complications after L4–L5 PLIF, a common surgical procedure for lumbar degenerative disease in patents without severe sagittal imbalance. A better understanding of the preoperative characteristics of total spinal sagittal alignment associated with early-onset ASD could help prevent the condition. METHODS: The study included 70 consecutive patients diagnosed with lumbar degenerative disease who underwent single-level L4–L5 PLIF between 2011 and 2015. They were divided into two groups based on the radiographic progression of L3–L4 degeneration after 1-year follow-up: the ASD and the non-ASD (NASD) group. The following radiographic parameters were preoperatively and postoperatively measured: sagittal vertebral axis (SVA), thoracic kyphosis (TK), lumbar lordosis, pelvic tilt, and pelvic incidence (PI). RESULTS: Eight of the 70 patients (11%) experienced ASD after PLIF (three males and five females; age, 64.4±7.7 years). The NASD group comprised 20 males and 42 females (age, 67.7±9.3 years). Six patients of the ASD group showed decreased L3–L4 disc height, one had L3–L4 local kyphosis, and one showed both changes. Preoperative SVA, PI, and TK were significantly smaller in the ASD group than in the NASD group (p <0.05). CONCLUSIONS: A preoperative small SVA and TK with small PI were the characteristic alignments for the risk of early-onset ASD in patients without preoperative severe sagittal spinal imbalance undergoing L4–L5 single-level PLIF.
Animals ; Female ; Follow-Up Studies ; Humans ; Incidence ; Kyphosis ; Lordosis ; Male ; Retrospective Studies

Background: A 30-60 min rest after exercising is generally recommended before taking a bath. Although this was considered an appropriate bathing method, effects of pre-bath rest on recovery from exercise fatigue remain unclear. Here, we aimed to examine the effects on fatigue recovery of pre-bath rest after a workload, with the focus on changes in lactic acid levels. Methods and Results: Ten healthy adult men increased their blood lactic acid levels through a treadmill workload performed in accordance with the Bruce method, then took either a 60-min post-workload rest followed by a 10-min full-immersion 38°C bath (Experiment A) or a 10-min full-immersion 38°C bath followed by a 60-min rest (Experiment B). Body temperature, blood pressure, pulse rate, and blood lactic acid level were measured at three time points: before workload (Test 1), after workload (Test 2), and after bathing/resting (Test 3). Decreases and percent decreases in blood lactic acid levels were calculated by comparing Test 3 results with Test 2 results. These calculated values and the measured values in three tests were compared between Experiment A and Experiment B using paired-t test. There were no significant differences in maximum systolic blood pressure, maximum diastolic blood pressure, maximum workload attained, and maximum pulse rate measurements between Experiment A and Experiment B. Differences in systolic blood pressure and diastolic blood pressure measurements in Tests 1, 2, and 3 were not significant. The pulse rates measured at the final measurement (Test 3) were significantly higher in Experiment A than in Experiment B (90.4 ± 18.2 bpm vs 79.6 ± 11.6 bpm, p = 0.04). No significant differences were observed in other measurement timings. The body temperature measurements at the final measurement were slightly higher in Experiment A than in Experiment B (36.4 ± 0.4 vs 36.1 ± 0.3°C, p = 0.05). No significant differences were observed in other measurements. Blood lactic acid levels before workload (Test 1) were significantly higher in Experiment A (6.6 ± 4.7mmol/L) than in Experiment B (2.0 ± 1.4 mmol/L, p = 0.02), but those at other measurement points (Test 2 and Test 3) were similar. Neither decreases nor percentage decreases in blood lactic acid levels differed between Experiment A and Experiment B. Conclusions: Resting before a post-exercise bath did not change the decreases or percent decreases in blood lactic acid levels after bathing at 38°C, suggesting negligible effects of pre-bath resting on recovery from exercise fatigue.