The purpose of the present study was to determine the involvement of central neurotransmitters in hot water bathing. In the first experiment, the alterations of the neurotransmitters, and in the second the effects of intracereb-roventricular (ICV) administration of the neurotransmitters, or their related substances on changes of gastric mucosal blood flow (GMBF) or foot BF were examined in the rats subjected to hot water bathing. The results were as follows.
1) Increases of dopamine (DA) metabolism and decreases of neurotensin (NT) -like immunoreactivity were observed in the nucleus accumbens and the amygdala of the rats subjected to 40°C hot water bathing.
2) 40°C hot water bathing normalized the GMBF decreased by the restraint stress with its duration of 60min almost to the level prior to the stress. The ICV administration of antiserum against NT inhibited the normalization of the GMBF.
3) The pretreatment with reserpine and with naloxone (β-endorphin (β EP) antagonist) inhibited the effects of NT and EP, respectively, on normalization of GMBF.
4) An inhibitory effect of ICV administration of saralasin (angiotensin II (A II) antagonist) was recognized on the FBF elevated by 34°C hot water bathing.
These results suggest central mechanisms of cerebral DA, NT and β EP during 40°C hot water bathing in which DA neuron systems activated by the bathing, together with NT and β EP, protect the gastric mucosa via the actions of increased GMBF through the sympathetic nervous system. Cerebral A II was assumed to be involved in the hydrostatic actions of hot water bathing on peripheral circulation.

We investigated muscle activities of the scapular muscles during low row procedure (LR) usually used 12 weeks after a rotator cuff repair, and evaluated its effective application period comparing with scapular retraction procedure (SR) used for early postoperative period. Twelve healthy adults (mean age, 26.8 years) were enrolled in the current study. %MVICs (maximal voluntary isometric muscle contractions) of middle trapezius, lower trapezius, serratus anterior, posterior deltoid, and infraspinatus were calculated from the surface electromyography during both LR and SR. The %MVIC of either the middle trapezius or lower trapezius was not significantly different between during the LR and the SR. The %MVIC of the serratus anterior, posterior deltoid and infraspinatus during the LR was significantly higher than those during the SR (p=0.018, p<0.001, p<0.001, respectively). Additionally, the %MVIC of the posterior deltoid and infraspinatus in the SR was less than 20%. In training phase after rotator cuff repair, LR was considered to be effective procedure for most of the scapular muscles 12 weeks after a surgical repair of the rotator cuff. However, LR earlier than 12 weeks after the surgery is considered to yield a risk of re-tear of the rotator cuff, and SR may be a preferred training procedure in this early phase.

We studied maxillofacial fractures treated by departments of oral and maxillofacial surgery in Tokyo. A retrospective review of records and radiographs for patients admitted during the 5-year period from 2000 to 2004 was conducted at five departments in Tokyo. Date, age, gender, cause of injury, fracture site, concomitant injury, domestic violence against women, and treatment were reviewed. 674 patients with maxillofacial fractures were admitted. Male-to-female ratio was 3.6:1. The most frequent age group was 21-25 years. Fractures of the mandible were most frequent (87%), followed by the maxilla (14%) and the zygomatic bone (12%). Thirty-one percent of fractures were due to traffic accidents, 29% to accidental falls, 23% to violence and 14% to sports. The incidence of maxillofacial fractures caused by traffic accidents was lower, and that caused by falls and violence were higher than in other countries. Seventeen percent of the maxillofacial fracture patients had concomitant injuries. The incidence of domestic violence-related maxillofacial fracture was 1.6% of all cases. These cases were mainly caused by a husband (55%) or a sexual partner (36%). Most patients (67%) were treated by open reduction surgery. However, condylar fracture alone was usually treated by closed reduction surgery.

PURPOSE: Because the true prevalence of food allergy (FA), as based on the results of an oral food challenge test (OFC), is unknown, it is likely that children with suspected FA unnecessarily eliminate potentially causative foods. This study aimed to identify the prevalence of FA and to determine the proportion of children who unnecessarily eliminate food. METHODS: To identify children with FA, a primary survey was conducted via a questionnaire with all children aged 0-18 years in Niijima village (remote islands of Japan). In the secondary survey, a detailed medical interview was conducted by doctors with children who currently did not eat some foods. The third survey involved serum food-specific immunoglobulin E (IgE) tests and an OFC for children with suspected FA. RESULTS: Of 376 enrolled children, 374 (99.5%) completed the questionnaire. Some foods were eliminated by 18.6% and 13.0% of all children and those ≥6 years old, respectively. The target population for the secondary survey included 69 children who all completed the medical interview. The target population for the third survey consisted of 35 children, of whom 26 (74.3%) underwent the blood test. An OFC was performed 35 times with 20 children. As a result, the prevalence of FA was 4.9% in children of all ages and 4.7% in those ≥6 years old. Moreover, 55.0% children were able to cease eliminating food intake. CONCLUSIONS: It is possible that a considerable number of children unnecessarily eliminate food because of suspected FA.
Child ; Eating ; Epidemiology ; Food Hypersensitivity* ; Health Services Needs and Demand ; Hematologic Tests ; Humans ; Immunoglobulin E ; Immunoglobulins ; Islands ; Prevalence*

The aim of this study was to investigate the end of life care provided by long-term care facilities and nursing homes. A cross-sectional survey of all long-term care facilities and nursing homes in Kobe was performed in July 2013. Questionnaires were sent to 350 facilities with an 89.7％ response rate. In total, 121（39％）of respondents stated that end of life care was available, and 151（48％）responded that facilities were willing to provide end of life care for terminally ill residents. One hundred fifty-two（48％）and 183（58％）of respondents answered that facilities were available for managing residents with percutaneous endoscopic gastrostomy, and transfusion, respectively. Seventy-two（23％）of respondents reported that facilities for managing the use of narcotics were available. In conclusion, a minority of long-term care facilities and nursing homes ware available for providing end of life care for residents, though approximately 50％ were willing to do so.

Studies using real-world data are recently increasing worldwide. Various types of real-world data are available in Japan. Administrative claims databases include the National Database (NDB) and other types of databases including several commercially available databases. This article describes the DeSC database, newly constructed by DeSC Healthcare Co., Ltd. in 2020. One of the features of the DeSC database is that it includes data from the National Health Insurance, Health Insurance, and Advanced Elderly Medical Service System. In the present article, we referred to our previous study on population representativeness of the DeSC database and explained its overview. Estimated prevalence of some diseases were described for each type of insurance. Furthermore, we discussed the use of the DeSC database for clinical epidemiology and pharmacoepidemiology research.

The package inserts revision regarding prescription drugs is an ongoing process. In this study, we examined the status of this revision and how the content of the information provided has been updated with the new instructions, including the rationale for contraindications for pregnant and breast-feeding women. A total of 407 prescription drugs for pregnant and breast-feeding women were contraindicated, accounting for approximately 15% of the 2,627 nonproprietary names. The number of contraindicated drugs for pregnant, breast-feeding, and both pregnant and breast-feeding women were 406, 44, and 43, respectively. The majority of the contraindications were based on nonclinical data, such as teratogenicity and fetotoxicity data in reproductive toxicity studies involving pregnant animals and pharmacokinetic information in breast-feeding animals. The overall revision rate for the new instructions was 16.2% after three years of revision work for each drug. The alert wording has been revised to provide more clarity and consistency, with three categories of statements: “should not be administered/avoid breastfeeding,” “advisable not to administer/breastfeed,” and “should be administered/breastfeed in consideration of the therapeutic benefit (benefit-risk consideration).” The statement indicating that the drug should not be administered to pregnant women remained in the revised instructions. Conversely, the revision of the description for breast-feeding women from “should be discontinued/avoided” to “benefit-risk consideration” may have improved the usefulness of the product, allowing healthcare professionals to make more informed decisions after considering the transfer of the drug into milk, its pharmacological effects, and other factors.

Purpose: Thyroid transcription factor 1 (TTF-1) expression is a useful predictor of treatment efficacy in advanced non-squamous non–small cell lung cancer (NSCLC). This study aimed to evaluate whether TTF-1 could predict the effectiveness of chemotherapy versus chemoimmunotherapy in patients with non-squamous NSCLC with programmed death ligand-1 (PD-L1) expression between 1% and 49%. Materials and Methods: We conducted a retrospective study of patients with NSCLC who were treated with chemotherapy or chemoimmunotherapy between March 2016 and May 2023. The patients had histologically confirmed NSCLC, stage III-IV or postoperative recurrence, TTF-1 measurements, and PD-L1 expression levels between 1% and 49%. Clinical data were analyzed to evaluate the effect of TTF-1 expression on treatment efficacy. Results: This study included 283 of 624 patients. TTF-1–positive patients showed longer progression-free survival (PFS) and overall survival (OS) (PFS: 6.4 months [95% confidence interval (CI), 5.0 to 9.4] vs. 4.1 months [95% CI, 2.7 to 6.1], p=0.03; OS: 17.9 months [95% CI, 15.2 to 28.1] vs. 9.4 months [95% CI, 6.3 to 17.0], p < 0.01) in the chemotherapy cohorts (n=93). In the chemoimmunotherapy cohort (n=190), there was no significant difference in PFS and OS between TTF-1–positive and –negative groups (PFS: 7.6 months [95% CI, 6.4 to 11.0] vs. 6.0 months [95% CI, 3.6 to 12.6], p=0.59; OS: 25.0 months [95% CI, 18.0 to 49.2] vs. 21.3 months [95% CI, 9.8 to 28.8], p=0.09). Conclusion In patients with NSCLC with PD-L1 expression between 1% and 49%, TTF-1 expression was a predictor of chemotherapeutic, but not chemoimmunotherapeutic, efficacy.