In order to facilitate the simultaneous search of structural and pharmacological information for drugs, we studied the design of the coding system for pharmacological information.  In this study, pharmacological information was defined as information that describes the nature of principal action, specifically “where and how the drug acts”.  Furthermore, we developed a standardized code generation system for describing such information.  First, in order to describe the drug delivery location, organs and subcellular organelles were assigned hierarchical codes by referring to the hierarchical classification of human anatomy.  Next, drug interacting receptors and their action results were encoded and coupled to the location codes, and procedures for generating pharmacological information codes were developed.  Regarding drug structure information, Cartesian coordinates that describe the planer structure were transformed into sequences of numbers in order to obtain molecular fingerprints, which were then used to generate drug structural information codes.  Drug information was compiled into a database that comprises the two categories of codes (pharmacological/structural codes), and a simultaneous search system was developed that links structural similarity and pharmacological information.  A web-based interface for searching the structural information codes was created, and searches could be performed as expected.

Background : The safety of newly approved drugs must be assessed using postmarketing surveillance data. One of the difficulties in assessing the hazard rates of adverse events induced by the anti-cancer drug TS-1 was that the time to event was not exactly identified due to the interval censoring. Most patients were outpatients who underwent clinical laboratory tests almost periodically at 1- or 2-week intervals and therefore, the occurrence of an adverse event was confirmed at the time of testing days after the event occurrence.
Objective : The purpose of this study was to propose a new model of hazard functions for each of 4 items of adverse event induced by TS-1 using post-marketing surveillance data considering the interval censoring.
Methods : The data obtained from 3, 294 patients with gastric cancer who received an initial 4-week course of therapy with TS-1 administered orally twice a day, followed by a 4-week second course with a 2-week no-treatment period after the initial course, were used to estimate hazard functions. Four items of adverse event--hemoglobin level (HB), white blood cell (WBC), neutrophil (NEUT) and platelet counts (PLT) --were graded, respectively, using the criteria established by the Japan Society of Clinical Oncology. Slip-mixed log-logistic and slip-mixed Weibull models were proposed as candidate models for estimating hazard functions. The goodness of fit of the two candidate models was evaluated by applying them to the above-mentioned data. The hazard functions for each of 4 items were assessed using the model with the better fit.
Results : The initial occurrence of adverse event was shown to follow the slip-mixed log-logistic model for each of 4 items. Although most events occurred early on in the initial course of therapy, a small peak in HB was also observed in the second course, while no such peak appeared for the other items.

Limb lymphedema is a serious complication following surgery or radiation therapy for malignant soft tissue tumors. We have recently experienced two cases where we provided symptomatic relief for lymphedema as part of palliative care for patients with sarcoma in the advanced stage. For the treatment of lymphedema, complex physical therapy (manual lymphatic drainage, compression, and exercise therapy), elevation of the affected limb, and skin care were carried out after ruling out the presence of deep venous thrombosis. Inelastic bandaging provides containment and effectively arrests the progression of swelling that stretches the skin. Since obstructive masses interrupt the entire lymphatic quadrants, lymphatic drainage is focused on creating a collateral flow in the truncal territories and in the limb. No complications associated with treatment were observed. In spite of refractory edema due to disease progression in both cases, the swelling of the affected limb or patients' subjective symptoms were temporarily improved by the treatment. While aiming to reduce swelling, the provision of comfort, relief from pain or other swelling-related symptoms, and maintenance or restoration of function are desirable and beneficial outcomes. Palliative therapy for lymphedema may lead to an improvement of the quality of life (QOL) of patients with sarcoma in the advanced stage.