Objective : To determine how much label information on over-the-counter (OTC) medicines is contained on packaging, we investigated the items, description methods, and area of label information on packages.
Methods : We selected 75 common cold remedy products for investigation and classified the items into 3 categories (“items for use”, “items with a regulation requirement”, “items related to product image”) and measured the space given to each item in the total package area.
Results : All 75 products had “items with a regulation requirement (total 13 items),” but 8 products (only 2 manufacturers) had “consult a physician or pharmacist before use,” which was not a regulation requirement.  There were differences in description methods, especially in “caution” and “product name.”  Sixty percent of the OTC products used non-red characters with no box-frame, and 11% used red characters and box-frames.  The description order was not standardized, but “caution” was located in the lowest space on 80% of products.  Many item descriptions appeared in one place, but “product name” generally appeared in more than 4 places. While 4.5 to 8.0 points were commonly given for “items for use,” 16 to 100 points were given for “product name,” and the difference in number of points was greater than 6-fold among products.  The percentage of average area for “items related to product image” (6.1%) was 2-fold greater than for “items for use” (3.1%) and “items with a regulation requirement” (2.9%).  Almost half of the total package area was blank space.
Conclusion : Current descriptions in label information vary among items, products, and pharmaceutical companies.  Rules on describing information on OTC medicine packaging are thus necessary.

This report deals with the response of heart rate, blood pressure and respiratory rate when the subjects of different ages and sexes worked on a bicycle ergometer. The subjects were 126 healthy persons of both sexes. They consisted of 8 groups : prepuberty male (N=15) and female (N=16), puberty male (N=20) and female (N=18), young adult male (N=15) and female (N=16), middle aged male (N=17) and female (N=9) . All subjects tried pedalling exercise with 3 kinds of loads, i.e., 5kgm/kg/min, 10kgm/kg/min and 12.5 kgm/kg/min for 6 minutes.
Heart rate was calculated from chest lead ECG and respiratory rate was measured by the thermistor method continuously recorded before, during and after exercise. Blood pressure was measured by Riva Rocci sphygmomanometer before exercise, at the early stage of recovery and in 10 minutes after exercise.
The results of this study are summarized as follows
1) In both sexes the heart rate decreased with age in resting status and exponentially increased during moderate and heavier exercise. A linear relationship was found between the work load and the exercise heart rate.
In males the heart rate during light exercise was high in the prepuberty and the puberty, low in the young adult and the middle aged. But the heart rate during heavy exercise in the middle aged was extremely high. The heart rate in females was higher than that in males when the same work load was given in both sexes. The rising phase of heart rate in prepuberty was the earliest of 4 age groups.
2) The systolic blood pressure and the pulse pressure in resting status increased with age. As for the blood pressure during exercise, it was low in the youth and high in the middle aged. The blood pressure after exercise in the middle aged males was the highest of 4 groups. Generally in all females the systolic blood pressure and the pulse pressure increased with work load, but the former levelled off during heavy exercise.
3) The respiratory rate during exercise increased rapidly, but when the exercise was stopped, the increased respiratory rate returned rapidly to the resting level. As for the respiratory rate, in both sexes it decreased with age from the prepuberty to the middle aged in resting status and during exercise. The sex difference of the respiratory rate during heavy exercise was large.
4) In the youth the correlation coefficient between the heart rate and the blood pressure was high. Therefore, it was suggested that the heart rate was important in adaptation to exercise.

Recently several papers have been published on the use of vancomycin (VCM) to prevent perioperative infection during open-heart surgery, but there have been few papers from Japan. In this study, we evaluated the pharmacokinetics of VCM in the serum and right atrial tissues of eight patients (4 men and 4 women) who underwent open-heart surgery, to prevent perioperative infection. Preoperatively all patients had neither hearing disorder nor renal dysfunction. A total of 1, 000mg of VCM was given intravenously over 40-50 minutes before a skin incision. The serum levels of VCM were measured every 20 minutes during open-heart surgery with enzyme-immunoassay. VCM levels in the right atrial tissues were also assayed before the start of extracorporeal circulation (ECC). The peak serum levels of VCM were 55.3±10.1μg/ml and decreased gradually to 10μg/ml prior to the ECC. During the ECC, the serum levels of VCM remained between 7.6 and 9.9μg/ml, while VCM levels in the right atrial tissues were 18.9±6.9μg/ml (serum/tissue ratio: 0.34). Staphylococcal infection is generally inhibited by VCM levels of 2.0-6.5μg/ml. This study suggests that 1, 000mg of VCM given intravenously before a skin incision may be effective to prevent perioperative infection during open-heart surgery.

A 70-year-old man was found to have aortic regurgitation and underwent aortic valve replacement. About 10 minutes after disconnection from the cardiopulmonary bypass, cardiac arrest occurred suddenly and the bypass was immediately resumed. At this point, a Stanford type A aortic dissection was detected by transesophageal echocardiography, and the orifice of the left coronary artery was considered to be occluded by invasion of a hematoma. Although ascending aortic replacement with a prosthesis was performed under hypothermic circulatory arrest with selective cerebral perfusion, the heart did not resume vigorous beating. Therefore, saphenous vain graftings to the left anterior descending artery and the right coronary artery were performed. Finally, the patient could be weaned from the cardiopulmonary bypass. On postoperative digital subtraction angiography, neither occlusion nor stenosis in both coronary arteries was observed. We conclude that it would be considered to perform coronary artery bypass graftings in this particular condition.

An in vitro infection system of Trypanosoma cruzi and HeLa cells was used to measure the anti-T. cruzi activities of various calcium antagonists classified into dihydropyridines, diphenylalkylamines, and benzothiazepines and of allopurinol and benznidazole as medium and highly effective reference compounds, respectively. Six dihydropyridines (10 μM each), i. e. nifedipine, nicardipine, nimodipine, nisoldipine, nitrendipine, and amlodipine, decreased the rates of infection of HeLa cells from 11.7% (control) to 5.8, 0.9, 1.2, 3.6, 5.9, and 1.7%, respectively. Nicardipine and amlodipine were highly toxic to HeLa cells, causing detachment of cells from coverslips. Nimodipine was thus the most effective inhibitor tested against T. cruzi infection in HeLa cells. Verapamil and gallopamil (diphenylalkylamines), diltiazem and midazolam (benzothiazepines), and allopurinol (positive control) were less effective than nimodipine. IC₅₀ values, the concentrations of compounds that elicited a 50% reduction in the infection rates of HeLa cells, were 2.5, 2.6, 1.3, 2.1, and 1.7 μM for nicardipine, nimodipine, amlodipine, verapamil, and benznidazole, respectively, while the values for nifedipine, diltiazem, and allopurinol were much higher. Nicardipine, amlodipine, and verapamil again showed significant cytotoxicities to HeLa cells. When Swiss 3T3 fibroblasts replaced HeLa cells, nimodipine markedly lowered the host-cell-infection rate, with an IC₅₀ value of 8.3 nM. Thus, nimodipine is expected to be a highly effective anti-T. cruzi lead compound, with low cytotoxicity to mammalian cells. Structural formulas of nimodipine and nicardipine in relation to their low and high cytotoxicities, respectively, against HeLa cells are discussed.

The aim of this study is to investigate the characteristics of pre-existing physical factors associated with the onset of Osgood-Schlatter disease (OSD) in junior soccer players. Fifty-nine junior soccer players of the elementary school were included in this study. The boys who had been diagnosed as OSD were excluded. At the time of the first investigation, the subjects were examined through physical evaluation and an ultrasonography. The subjects were followed up one and a half years, and the tibial tuberosity was classified according to the growth stages using the ultrasonography. After the end of follow-up period, the subjects were divided into two groups, those with signs and symptoms of OSD that appeared during the follow up period and those without that. The Mann-Whitney U test was used for the comparison between OSD group’s and control group’s initial assessments. The players who were followed up for one and half years were 38 people. 5 knees of the 4 players were clinically diagnosed as OSD (OSD group), and the remaining 34 players with no symptoms of the OSD constituted the control group. The range of the bilateral hip external rotation, straight leg raise of the non-dominant side, and knee flexion in the OSD group were significantly lower than those in the control group (p < 0.05). We concluded that a decrease in specific joint flexibility might be related with the onset of OSD.

Objectives: The purpose of this study was to investigate current fact of cancer outpatients’ opioid pain management and its possible abusive applications and to establish corrective treatments by the palliative care team. Methods: Our palliative care team investigated cancer outpatients’ prescribed opioid clinical records for 4 months in 2014, and the result revealed inappropriate opioid use which could lead to further abuse or dependency. Through this the team recommended attending physicians viable options including decrease of opioid eventually leading to final withdrawal. Results: Among 67 cancer outpatients, the finding of inappropriate opioid use which could lead to further abuse or dependency was in 5 patients (7.4%). The details are as follows: (1) Three patients were treated with opioid analgesia for initial pain relief but the application continued in spite of recovering from a cancer which had been responsible to the pain. (2) Two patients were medicated with opioid for pain but further diagnosis revealed the disease which caused pain was benign. Four out of 5 patients were successfully withdrawn from opioids. Conclusion: In cancer outpatient settings, it can be overlooked or undetected inappropriate use of opioids which may lead to abuse or dependency without a team approach. To prevent opioid abuses, it is imperative to find the cause of pain as accurately as possible.

OBJECTIVE: Family and twin studies have suggested genetic liability for panic disorder (PD) and therefore we sought to determine the role of noradrenergic and serotonergic candidate genes for susceptibility for PD in a Japanese population. METHODS: In this age- and gender-matched case-control study involving 119 PD patients and 119 healthy controls, we examined the genotype distributions and allele frequencies of the serotonin transporter gene linked polymorphic region (5-HTTLPR), −1019C/G (rs6295) promoter polymorphism of the serotonin receptor 1A (5-HT1A), and catechol-O-methyltransferase (COMT) gene polymorphism (rs4680) and their association with PD. RESULTS: No significant differences were evident in the allele frequencies or genotype distributions of the COMT (rs4680), 5-HTTLPR polymorphisms or the −1019C/G (rs6295) promoter polymorphism of 5-HT1A between PD patients and controls. Although there were no significant associations of these polymorphisms with in subgroups of PD patients differentiated by gender or in subgroup comorbid with agoraphobia (AP), significant difference was observed in genotype distributions of the −1019C/G (rs6295) promoter polymorphism of 5-HT1A between PD patients without AP and controls (p=0.047). CONCLUSION: In this association study, the 1019C/G (rs6295) promoter polymorphism of the 5-HT1A receptor G/G genotype was associated with PD without AP in a Japanese population.
Agoraphobia ; Asian Continental Ancestry Group ; Case-Control Studies ; Catechol O-Methyltransferase* ; Gene Frequency ; Genotype ; Humans ; Panic Disorder* ; Panic* ; Polymorphism, Genetic* ; Receptor, Serotonin, 5-HT1A* ; Serotonin Plasma Membrane Transport Proteins ; Serotonin*

OBJECTIVE: In cervical intraepithelial neoplasia (CIN), p16INK4a immunohistochemistry has been reported to be a useful diagnostic biomarker. However, limited information is available about the association between the p16INK4a immunohistochemistry and the outcomes of CIN. Here, we report p16INK4a immunohistochemistry as an effective biomarker to predict the outcomes of CIN. METHODS: p16INK4a immunohistochemistry was performed in patients with CIN from January 2000 to August 2009. Among these patients, we have performed a retrospective analysis of the medical records to evaluate the outcome of CIN 1-2 and performed statistical analysis to determine the correlation between p16INK4a expression and the outcomes. We also performed HPV genotyping and analyzed the relation between the infecting human papillomavirus (HPV) genotype and the outcomes. RESULTS: A total of 244 patients, including 82 with CIN 1, 60 with CIN 2, and 102 with CIN 3, were examined. The rate of p16INK4a overexpression increased with increasing CIN grade, 20.7% for CIN 1, 80.0% for CIN 2, and 89.2% for CIN 3, with significant differences between CIN 1 and CIN 2-3 group. In the 131 CIN 1-2 patients, the progression rate was significantly higher for the patients showing p16INK4a overexpression than for those not showing p16INK4a overexpression (p=0.005); the regression rate was also found to be significantly lower for the patients showing p16INK4a overexpression (p=0.003). High-risk HPV genotypes were detected in 73 patients (73.7%). Both progression and regression rates were not significantly different between the high-risk HPV-positive and HPV-negative groups (p=0.401 and p=0.381, respectively). CONCLUSION: p16INK4a overexpression was correlated with the outcome of CIN 1-2, and p16INK4a is considered to be a superior biomarker for predicting the outcome of CIN 1-2 compared with HPV genotyping.
Cervical Intraepithelial Neoplasia ; Genotype ; Humans ; Immunohistochemistry ; Medical Records ; Retrospective Studies