We report a case of aortic arch rupture due to blunt chest trauma. The patient was a 66-year-old man who was driving a motorcycle and collided with a parked car. The chest roentogenogram showed mediastinal widening and computed tomography showed hematoma of the mediastinum and intimal tear of the aortic arch. As his hemodynamic state was stable, he underwent aortography which demonstrated pseudoaneurysm of the aortic arch. An emergency operation was performed under cardiopulmonary bypass with selective cerebral perfusion. The intimal and medial tear of the aortic arch and left common carotid artery were replaced with grafts and his postoperative course was uneventful. Traumatic aortic rupture is frequent in the descending aorta but aortic arch injury is rare. Immediate diagnosis and surgical repair are necessary in such cases.

Since 1976, allergic contact dermatitis caused by Chrysanthemum morifolium Ramalk (commercial name: Kinriki) occured on the grower in Tokushima Prefecture. Consequently, a systematic study aimed at the isolation of the allergen of the chrysanthemum was udertaken.
The allergens were contained in the fresh juice of the leaves of chrysanthemum and they were of two types: one was water-soluble and the other was fat-soluble, judging from the results of application test of the skin reaction for sensitized guinea pigs.
The fresh juice of the chrysanthemums was fractionated with ammonioum sulfate saturation method and the active precipitates were chromatographed on Sephacryl S-300 and DEAE-cellulose column, successively. The most active fractions contained sugar and protein, suggesting that the water-soluble principles are high molecular glyco-protein. The other hand fat-soluble fraction was obtained from ethyl acetate extract of the supernatant of 65% ammonium sulfate saturation. The extract was chromatographed on silica gel column and on the thin layer to yield 5, 7-dihydroxychromone (I) and sesquiterpens (II-VI). Unfortunately, at that time the sensitization of ginea pigs was unsuccessfuly. Therefore their compounds could not be tested for the allergenic reaction.
When the precipitates of ammonium sulfate were extrcted with ethyl acetate, the allergenic activeity of the precipitates decreased. However, re-addition of the ethyl acetate extracts to the extracted precipitates recovered the activity. Cross reaction between the juice of leaves and sesquiterpene lactone, alantolactone, failed on skin reaction of sensitized ginea pigs.

Objectives: To investigate renal function during denosumab therapy using the estimated glomerular filtration rate based on cystatin C (eGFRcys) which is more accurate than creatinine (eGFRcr) for renal function. Methods: Bone mineral densities (BMDs) of lumbar spine and hip regions, eGFRcys, eGFRcr, creatinine clearance (Ccr), and serum total homocysteine (S-Hcy) were measured during 2-year denosumab therapy in 53 women with osteoporosis naïve to anti-osteoporosis drugs (new group) and 64 women who were switched from long-term bisphosphonate treatment to denosumab therapy (switch group). Results: There were no significant differences in age, eGFRcr, Ccr, eGFRcys, and S-Hcy levels at baseline between the groups. BMDs in the lumbar spine, femoral neck, and total hip increased significantly after 2-year denosumab therapy in both groups. eGFRcr decreased in the switch group, and Ccr decreased in both groups; however, eGFRcys and S-Hcy levels did not change significantly in either group. To investigate the causal factors associated with the decrease in eGFRcr and Ccr, multiple regression analysis was performed in all patients. Denosumab initiation within 3 months after fracture and eGFRcr or Ccr at baseline were independent factors for the decrease in eGFRcr or Ccr during the 2-year denosumab therapy. Decline in creatinine-based renal function could be reflected by increased muscle mass during the ongoing recovery from fracture. Conclusions Renal function was preserved in all patients, including those in the switch group during denosumab therapy. Creatinine-based renal function should be cautiously interpreted during denosumab therapy in patients with recent fractures.

We have reported that many chrysanthemum- and lettuce-growers have dermatitis caused by juice of the leaves of these plants and that this dermatitis is caused by an allergic mechanism. In arecent questionnaire on the cause of this dermatitis, half the farmers answerd that it was due to agricultural chemicals. Therefore, we tested the farmers by skin patch tests with several widely used chemicals. In the tests, daconil gave the strongest reaction, results being positive in 60% of the farmers. Daconil was very irritative and phototoxic, the percentage of positive reactions in the patch test with 800 times diluted daconil solution of the concentration commonly used being about 30% after 48 hours and about 60% at 48 hours after peeling off the patch.
The parcentage of positive reactions in the skin patch test with several fractions of chrysanthemums on chrysanthemum-growers were significantly higher than non-farm-workers. Similary, tests with allergen extracted from lettuce showed a significantly higher percentage incidence in lettuce -growers than in other subjects. The patch test with 4000 times diluted daconil solution showed ahigher incidence in farmers than in other subjects. Therefore, 4000 times diluted daconil solution seems to cause allergic contact dermatitis in farmers, and as farmers reported, dermatitis seems to be caused by allergy to farm products, and the irritability, phototoxicity and allergenicity of TPN (Daconil).