The purpose of this study was to determine the effects of supine floating on rectal temperature and cardiac autonomic nervous system activity after exercise. Seven healthy males volunteered for this study. Subjects performed supine position for 30 minutes in both control condition (C-condition) and water condition (W-condition) after exercise with a cycle ergometer for 15 minutes. Exercise intensity was high (80%VO₂max) and moderate (60%VO₂max). Water temperature was 30 degrees Celsius. Rectal temperature of post exercise showed no significant differences under the W-condition, as compared to the C-condition. Delta rectal temperature (point 0-0 was end of exercise) was significantly reduced (p<0.05) under the W-condition, as compared to the C-condition. Log HF was significantly increased (p<0.05) under the W-condition, as compared to the C-condition. These data suggested that supine floating after high and moderate intensity exercise could promote recovery of rectal temperature and increased in cardiac parasympathetic nervous system activity.

Objective: When responding to questions regarding drug-drug interaction by the medical staff of our hospital, pharmacists previously collected information using some drug databases from Japan and the United States.  The aim of this study was to construct a search system for interaction information using drug databases from both Japan and the United States for streamlining questions and answers regarding drug-drug interaction.
Methods: Using the drug databases from Japan and the United States, we collected information on the interaction pertaining to drugs prescribed at Kobe University Hospital.  This information was further assessed for consistency.  Furthermore, we constructed an original search system for interaction information for streamlining questions and answers regarding drug-drug interaction.
Results: The difference between information obtained from the databases from Japan and the United States was apparent.  Thus, we concluded that it was necessary to obtain interaction information via a database search that included information from both the countries.  Therefore, our original interaction search system was reconstructed with interaction information collected using databases from both the countries.  We compared the response to questions regarding the previous and present methods using our original search system for interaction information; the time required to obtain the responses was 5.89 and 3.09 min, respectively, and it took lesser time for providing responses than the previous method.
Conclusion: We evaluated the usefulness of the original search system for interaction information.  We found that the original system provides a more rapid response to questions compared with the previous method.  We are considering a further upgrade and update for the original system by adding information on drugs not prescribed by our hospital.

BACKGROUND/AIMS: Recently, recombinant human soluble thrombomodulin (rTM) has been developed as a new drug for disseminated intravascular coagulation (DIC). This study aims to evaluate the clinical benefit of rTM in patients with sepsis-induced DIC caused by acute cholangitis who underwent biliary drainage. METHODS: Patients were divided into two groups: the rTM therapy group and the non-rTM therapy group. The primary outcome was the DIC resolution rate at 7 days, and the secondary outcome was 28-day mortality rate. RESULTS: Thirty-five patients were treated by rTM, and 36 patients were treated without rTM for DIC. The rate of resolution of DIC at day 7 was significantly higher in the rTM group than in the non-rTM group (82.9% vs 55.6%, p=0.0012). Compared with the non-rTM group, the 28-day survival rate of the r-TM group was significantly higher (rTM vs non-rTM, 91.4% vs 69.4%, p=0.014). According to multivariate analysis, non-rTM (hazard ratio [HR], 2.681) and CRP (HR, 2.370) were factors related to decreased survival. CONCLUSIONS: rTM treatment may have a positive impact on improving DIC and survival rates in patients with severe acute cholangitis.
Cholangitis* ; Dacarbazine ; Disseminated Intravascular Coagulation* ; Drainage ; Humans ; Mortality ; Multivariate Analysis ; Survival Rate ; Thrombomodulin* ; Thrombosis

BACKGROUND/AIMS: Electrohydraulic lithotripsy (EHL) under endoscopic retrograde cholangiopancreatography (ERCP) guidance can be an option to treat difficult stones. Recently, a digital, single-operator cholangioscope (SPY-DS) has become available. Peroral transluminal cholangioscopy (PTLC) using SPY-DS has also been reported. In this retrospective study, the technical feasibility and clinical effectiveness of EHL for difficult bile duct stones under ERCP guidance and under PTLC guidance was examined. METHODS: In this pilot study, patients with difficult bile duct stones between July 2016 and July 2017 were retrospectively enrolled. RESULTS: Forty-two consecutive patients underwent EHL using a SPY-DS; 34 patients underwent EHL under ERCP guidance, and the other 8 patients underwent EHL under PTLC guidance. Median procedure time was 31 minutes (range, 19 to 66 minutes). The median number of EHL sessions was 1 (range, 1 to 2), and that of ERCP sessions was also 1 (range, 1 to 3). The rate of complete stone clearance was 98% (41/42). Adverse events such as cholangitis and acute pancreatitis were seen in 14% (6/42), which could be treated conservatively. CONCLUSIONS: EHL using SPY-DS was technically feasible, not only under ERCP guidance, but also PTLC guidance. A prospective clinical study of EHL using SPY-DS is needed.
Bile Ducts* ; Bile* ; Cholangiopancreatography, Endoscopic Retrograde* ; Cholangitis ; Clinical Study ; Common Bile Duct ; Humans ; Lithotripsy* ; Pancreatitis ; Pilot Projects ; Prospective Studies ; Retrospective Studies ; Treatment Outcome

PURPOSE: Deciding on treatment carcinoma of the tongue when the tumor has a thickness of 1.5 cm or more is difficult. Surgery often requires wide resection and re-construction, leading to considerable functional impairment. A cesium implant is an attractive option, but according to the Manchester System, a two plane implant is needed. MATERIALS AND METHODS: According to the textbook, a tumor is sandwiched between the needles, which are implanted at the edge of the tumor. This may cause an unnecessarily high dose to the outer surface of the tongue, which sometimes leads to a persistent ulcer. To avoid this complication, we invented a modified implantation method, and applied the method to five consecutive patients. RESULTS: With a minimum follow-up of 2 years, all primary tumors in 5 consecutive patients have been controlled. No complications occurred in soft tissue of the tongue or in the mandible. CONCLUSION: Our modified Manchester System was feasible and effective for tumors that has a thickness of 1.5 cm or more.

We reported nine cases of metastatic skin carcinoma experienced at the Department of Dermatology, Obihiro Kosei Hospital during the period from April 1991 to March 1993. Lung was the most common primary lesion (four out of nine cases), followed by uterus (two) and stomach, breast, and kidney (one each). The clinical features of the metastases were classified into nodular (five cases), inflammatory (one case) and sclerotic (three cases) types. Peculiar zoster-like inflammation was seen in metastatic gastric cancer. Pathologically, adenocarcinoma was more common than squamous cell carcinoma. The average interval between the diagnosis of the primary cancers and the development of the skin metastases was about 30±25 months. The average life span after the detection of the skin metastases was 6.8±5.6 months. Poor prognosis of skin metastasis was thus reconfirmed.

Objectives: Few studies examined the association between deterioration of masticatory ability assessed by objective marker and physical function. Therefore, we examined the association between salivary flow rate which is one of the objective and surrogate marker of masticatory ability and lower Timed Up & Go (TUG) performance which is one of major measurement of physical function among aging Japanese. Methods: This cross-sectional study enrolled 464 Japanese aged 60e84 years old. Participants chewed tasteless and odorless gum for 5 min, calculated stimulated salivary flow rate (g/min) during all chews.The 3 m TUG was conducted, and 75th percentile value (6.8 s for men and 7.0 s for women) or higher was defined as lower TUG performance. Logistic regression analysis was used to examine the association between stimulated salivary flow rate and lower TUG performance. Results: We found that the stimulated salivary flow rate tended to be negatively associated with the TUG time. We also observed significant negative association between stimulated salivary flow rate and lower TUG performance; the multivariable-adjusted OR (95% confidence interval, CIs) of lower TUG performance for the highest quartile of stimulated salivary flow rate compared with the lowest quartile was0.34 (0.16e0.69, P for trend ¼ 0.02). Further adjusting for BMI, the association was attenuated but remaind significant; the OR (95% CIs) in highest quartile was 0.37 (0.18e0.76, P for trend ¼ 0.04). Conclusions Higher stimulated salivary flow, which means well masticatory ability, was inversely associated with lower TUG performance in the aging Japanese population.