1) The molluscicidal effect of 10 agricultural chemicals which are commonly usedby farmers in Saitama Prefecture was tested experimentally against A. ollula in the laboratory. The snails were made to contact with chemical solution for 48 hrs. at 23-25°C, then transferred to new containers with fresh water. The death rate was observed after 1 more hr.
LC₅₀ value of Saturn emulsion (Benthiocarb 50%), Saturn-S granule (Benthiocarb 7%, Simetryne 1.5%), MO emulsion (CNP 20%), NIP emulsion (NIP 25%), Sumithion emulsion (MEP 50%), Baysid emulsion (MPP 50%), Disiston granule (Ethylthiometon 5%), Bassa emulsion (BPMC 50%), Kitasin-Pemulsion (IBP 4%), and Lime nitrogen granule (CaNCN 21%) were 13.0, 92.5, 24.8, more than 50, 16.5, 13.5, more than 500, more than 50, more than 50 and 360 ppm. respectively, all figures were far larger than the doses in practical use for each chemicals. So it can not be expected that these chemicals would be effective against the snail in the ordinally practice.
2) Themolluscicidal effect of Lime nitrogen granule was also investigated with the snail in the paddy field where this fertilizer had been applied at an ordinally dose that is 2 Kg per are., 5 days prier to the test. The snails were introduced into the paddy and the mortality rate was observed 1, 2 and 3days after the introduction. The mortality rates of the snails at each day were 7.5%, 11.0% and 12.9% respectively. In the untreated field these figures were 7.0%, 14.9% and 4.4%.
It was concluded that Lime nitrogen granule was not effective against the snail at the ordinally dose for the use for fertilizer.

Clinical decisions on infectious diseases in terminally-ill cancer patients are often made based on physicians’ and nurses’ personal medical experiences, which may lead to an intra-team conflict. We conducted a qualitative analysis with prospectively gathered, semi-structured interviews in order to identify physicians’ and nurses’ beliefs and perceptions contributing to the variabilities in their attitudes toward patient care and the conflicts during decision-making process. We obtained the following categories with respect to beliefs and perceptions: estimated prognosis; patient’s discomfort due to tests and treatment; agreement to physician’s treatment plan; patient’s and family’s wish for tests and treatment; and patient’s benefits by tests and treatment. The intra-team conflicts resulted from disagreement on patient’s condition, and difficulty understanding mutual intent or opinion among physicians and nurses. Our findings may help improve team-based communication and the quality of care in terminally-ill cancer patients with infectious diseases.

A dermatitis of unknowns etiology has occurred among the farmers working in paddy fields in some districts of Kagoshima Prefecture, such as Ibusuki, Hiyoshi, Oura, Makizono and Minami-tane.
In order to acertain the cause of the disease, the epidemiological investigations have been made since1975.
The dermatitis occurrs from March to July when rice-planting and weeding are on and is characterized by erythemato- papulo-vesicular eruptions accompanied with severe itching. The chief symptoms are observed on the parts exposed to water, especially on forearms and lower legs.
The research for snail intermediate hosts was carried out in the paddy fields where the dermatitis originated.
As a result, two species of apharyngeal furcocercous cercariae were obtained from the fresh water snails, Polypylis hemisphaerula and Austropeplea ollula. The cercaria from P. hemisphaerula resembled to that of Gigantobilharzia sturniae in shape and size, and the other one from A. ollula was identified as species belonging to the genus Trichobilharzia and was regarded the same species as described in Saitama Prefecture by the authors.
An experimental infection with the cercaria belonging to the genus Trichobilharzia was performed. A few drops of water containing10cercariae were placed on the forearm. The cercariae invaded into the skin and produced a dermatitis quite similar to that prevailing in the endemic areas.
Therefore, it was concluded that the etiological agent were the cercariae of two different avian schistosomes, namely, G. sturniae and Trichobilharzia sp.

Objective: There are only a few studies evaluating the effects of drug information services on pharmacotherapy.  We, therefore, studied the effects of providing drug information such as the effectiveness and safety of aliskiren on its pharmacotherapeutic efficacy by comparing before versus after drug information provision.
Methods: Pharmacists provided drug information such as the effectiveness and safety of aliskiren coadministered with either ACE-I (angiotensin converting enzyme inhibitor) or ARB (angiotensin receptor blocker) to physicians and other healthcare professionals.  We compared the number of patients for whom aliskiren was prescribed, the proportion of diabetic patients taking both aliskiren and ACE-I (or ARB), the proportion of patients with low eGFR (estimated glomerular filtration rate), and the proportion of patients with hyperkalemia and related conditions, before versus after providing the drug information to the healthcare professionals.
Results: The number of patients for whom aliskiren was prescribed decreased.  The proportion of patients taking both aliskiren and ACE-I (or ARB) decreased significantly after providing the drug information (p=0.007).  The proportion of diabetic patients taking both aliskiren and ACE-I (or ARB), the proportion of patients with low eGFR, and the proportion of patients with hyperkalemia also decreased, after providing the drug information.
Conclusion: This study showed the drug information service to be clinically beneficial, achieving better pharmacotherapy.  Pharmacists should evaluate and provide information on the effectiveness and safety of drugs announced by authorities in a timely manner to achieve optimal patient care.

Background : With the recent progression of the aging society in Japan, what is now seen as important is not simply treatment of disease alone, but also increased quality of life. We have investigated the correlation between the feeling of subjective health and mortality after mean 3.8 year among local residents.
Methods : In fiscal 2008, a self-recording questionnaire survey was conducted by mailing the questionnaire to 2,657 local residents. Correlation with deaths after mean 3.8 years was investigated based on the Resident Register. With regard to the evaluation items, as background factors related to death, social life conditions (gender·age), health conditions (history of cardiovascular disease, state of depression, subjective happiness, subjective health)and basic activities of daily living (BADL : walking, diet, excretion, bathing, dressing, and ambulation)were evaluated using a 4-point scale ranging from total assistance to completely independent. The Tokyo Metropolitan Institute of Gerontology (TMIG : instrumental independence, intellectual activity, and social role)was used to evaluate the lifestyle factors.
Results : Of 1825 subjects, 767 males (mean age : 67±13 years)and 1058 females (mean age : 68±11 years), could be analyzed. There were 91 deaths from 2008 to 2012. Investigation of factors that increased subjective health revealed that age, cardiovascular disease, state of depression, intellectual activities, and subjective happiness were items that showed significant correlation. Multivariate logistic regression analysis revealed that subjective health was a significant explanatory variable of death.
Conclusion : How one personally feels about one's state of health and how one recognizes that, are important. Though not seen physically, they can be considered as important parameters that predict prognosis.

A 72-year-old woman had undergone resection and graft replacement of the proximal ascending aorta for a DeBakey type II aortic dissection. She presented again 7 years later with progressive dyspnea and a cough. Computed tomography confirmed an aortic arch aneurysm and Doppler echocardiography demonstrated aortopulmonary shunting. Cardiac catheterization revealed a fistula between the aorta and pulmonary artery with a 54.3% left-to-right shunt and a Qp/Qs of 2.19. Operative repair was performed under profound hypothermic circulatory arrest with selective cerebral perfusion. The aortopulmonary artery fistula was closed from within the aneurysm using an equine pericardial patch and the transverse aortic arch was resected and replaced with a graft. The patient recovered uneventfully and was discharged on postoperative day 43.

We report a patient with unilateral midbrain hemorrhage which caused ipsilateral complete oculomotor nerve palsy with pupillary involvement, contralateral upgaze paresis, contralateral limb ataxia and Parinaud’s syndrome. CT scan and MRI brain demonstrated a hemorrhage in the left paramedian midbrain probably involving the oculomotor fascicles; extension of the hemorrhage to the most rostral midbrain may have involved the pupillary fi bers. It was previously thought that a lesion in the superior colliculus, surrounding nuclei (Darkschewitsch and Cajal nuclei), and the posterior commissure (i.e. dorsal midbrain) were responsible for clinical fi ndings similar to those found in our patient, but our patient showed a hemorrhagic lesion in the left ventral midbrain which did not extend to dorsal midbrain. We propose that the responsible lesion in our patient might involve the rostral interstitial nucleus of the medial longitudinal fasciculus (riMLF).

A dermatitis of unknown etiology has occurred among the farmers working in paddyfields in some districts of Tokushima Prefecture, such as Anan, Kainan and Komatsujima.
The dermatitis occurs from March to May when rice-planting and weeding are on and is characterized by erythemato-papulo-vesicular eruptions accompanied with severe itching. The chief symptoms are observed on the parts exposed to water, especially on forearms and lower legs. The results of the epidemiologicaland clinical observations indicated that the dermatitis was due to the invasion of cercariae of an avian schistosome.
The investigation for snail intermediate hosts was carried out in the paddy fields where the dermatitis occurred.
Cercariae of apharyngeal furcocercous type were detected from the fresh water snails (Austropeplea ollula) which were collected most abundantly from the paddy fields during the season of occurence of the dermatitis.
The cercaria wasidentified as species belonging to the genus Trichobilharzia and was regarded as the same species as so far described in Saitama Prefecture by Suzuki et al (1973).
An experimental infection with the cercaria was performed. A few drops of watercontaining cercariae was placed on the fore-arm of. a voluntor. The cercariae invaded into the skin and produced a dermatitis quite similar to that prevailing in the endemic areas.
Therefore, it was concluded that theetiological agent was the cercaria of a species of an avian schistosome.

There were 16 patients who developed acute renal failure (ARF) follwing cardiovascular operation using extracorporeal circulation. They were treated by either CPD or CAVH because their ARF were resistant to medical treatment. These patients were divided into three groups according to their treatment; 7 patients treated by CPD (Group A), 5 patients treated both CPD and CAVH (Group B), 4 patients treated by CAVH (Group C). The survival rate was 33% in Group A, 20% in Group B, and 0% in Group C. The prognosis of the each group was poor. CPD and CAVH were effective to control the concentration of serum potasium and water removing. But CPD and CAVH were not very effective to control the concentrations of serum creatinine and blood urea nitrogen. There were three patients who developed low proteinemia which was one of the side effects of CPD. Seven of nine patients treated by CAVH, developed bleeding. The side effects of CAVH were seemed to be more severe than those of CPD.