Objective: The aim of this study was to review cautionary statements regarding hypersensitivity to drugs with a moiety similar to sulfonamide on Japanese package inserts.
Methods: From approved drugs listed as of March 2015, we selected those with a moiety similar to sulfonamide and examined their therapeutic categories, together with the presence or absence, location, and wording of cautionary statements regarding usage, and matters pertaining to a history of drug hypersensitivity that was not limited to sulfonamide, on the package inserts.
Results: We extracted 73 drugs (65 components) that included a moiety similar to sulfonamide.  Their therapeutic categories were diverse, and 39 (53.4%) had cautionary statements about hypersensitivity caused by a moiety similar to sulfonamide.  Among these 39 drugs, the cautionary statements were located in different sections (Contraindication 31, Careful Administration 4, and Important Precautions 4).  The cautionary statements showed differences in wording according to the individual drugs or positions.  For 10 of the drugs, information pertaining to a history of drug hypersensitivity not limited to sulfonamide was provided.
Conclusion: Medical staff should recognize that package inserts are not standardized with regard to cautionary statements about hypersensitivity caused by moieties similar to sulfonamide, and that it is necessary to predict or judge the likelihood of cross-hypersensitivity reaction to such moieties on the basis of their chemical structure.  In addition, it is necessary to carefully observe the clinical condition of individual patients who are receiving drugs that have a moiety similar to sulfonamide.

Since January, 1981 to December, 1990, eight patients (one male, 7 female) of Stanford A type aortic dissection underwent surgical treatments with deep hypothermic circulatory arrest. The average was age 59.6 years (range 50 to 72 years). All of them were diagnosed with UCG and/or CT before operation. Two cases had already been in shock state due to cardiac tamponade. Three cases had aortic insufficiency and one had neurological deficit. After median sternotomy, right atrial-femoral artery bypass was established. Right atrium was incised and coronary sinus was cannulated. Then retrograde coronary infusion of cardioplegic solution was employed at a continuous flow rate of 20ml/kg/hr. The mean rectal temperature was 19.6°C and the mean circulatory arrest time was 35.5min (22-58min). Two of eight cases died, because of DIC followed by necrotizing enteritis at 28th postoperative day, and prolonged shock state before operation. The rest were all survived without any neurological deficits. There were no severe complications related to deep hypothermia. We concluded that deep hypothermic arrest is safe and simple method, allows good inspection of operative field and makes it easier to repair the dissected aorta.

In Japan there are many people who are intolerant to alcohol. Known as flushers, they do not genetically have low Km acetaldehyde dehydrogenase (AlDH₂). Flushers are judged easily and accurately by the alcohol patch test. An ethanol patch test carried out on agricultural and fishing populations in Japan showed that approx. 40% were deficient in AlDH₂. A questionnaire survey of the drinking behavior of many people showed significant differences between the normal AlDH₂ and AlDH₂-deficient groups. The normal group drinks positively and actively, while the deficient group drinks negatively and passively. As a result, there were significant differences in subjective and objective symptoms that result from drinking between the two groups: More frequent hangovers, abnormal physical conditions and higher KAST scores were seen in the normal group, and health examination showed higher values in liver function tests, including γ-GTP, and higher levels of blood pressure, HDL-cholesterol (HDL-C), etc., in the normal AlDH₂group.
It may be very useful for prevention of alcohol-related health disorders to help Mongoloid peoples, such as the Japanese, recognize whether their AlDH₂ is normal or deficient, which is as determined by the ethanol patch test.