In this study, we investigated total sweat rate per unit area of body surface per hour (TSR), the percentage of total sweat loss to initial body weight (%TSL) and the percentage of fluid intake volume to total sweat loss (%FIV) in children (during baseball or basketball practice), young adults (during softball or baseball practice), and the elderly (during gateball practice) in summer. During the practice all participants were given access to drink sports drink or Japanese tea ad libitum. In the basketball group of children no sex difference was observed in TSR, %TSL and %FIV. Although TSR and %TSL in the baseball group of children were significantly higher than in the basketball group due to a higher WBGT, there was no group difference for %FIV. Children drank sports drinks (with carbohydrate-electrolyte) of the similar volume with total sweat loss. The baseball group of children showed a significantly greater %FIV compared to the young adult group regardless of simi lar %TSL, when they drank sports drinks. Children showed a significantly higher %FIV in sports drinks than in Japanese tea, whereas the %FIV of young adults was not affected by the type of beverage. The TSR, %TSL and %FIV of the elderly group were significantly lower than in young adults and children. These results suggest that children can prevent voluntary dehydration by con-suming sports drinks with carbohydrate-electrolyte ad libitum regardless of sex and WBGT, and that periodic drinking should be actively encouraged for the elderly because of their blunted rehydration ability, to prevent heat disorders during sports activity in summer.

The apparent degradation rate constant of fluticasone propionate (FLT) in 0.1 M NaOH:methanol=1:1 at 37 ℃ was previously reported to be 0.169 ± 0.003 h?1, and four degradation products (products 1–4) were observed in the solution. The aims of the present study were to assess the degradation rates of FLT in other alkaline solutions and clarify the chemical structures of the four degradation products in order to obtain basic data for designing an enema for inflammatory bowel disease. The apparent degradation rate constants in 0.05 M NaOH and 0.1 M NaOH:CH3CN=1:1 were 0.472 ± 0.013 h?1 and 0.154 ± 0.000 h?1 (n=3), respectively. The chemical structures of products 1–4 in 0.1 M NaOH:methanol=1:1 were revealed by nuclear magnetic resonance (NMR) and mass spectrometry data. The chemical structure of products 2 was that the 17-position of the thioester moiety of FLT was substituted by a carboxylic acid. The degradation product in 0.1 M NaOH:CH3CN=1:1 was found to be product 2 based on 1H NMR data. The degradation product in 0.05 M NaOH was considered to be product 2 based on the retention time of HPLC. These results are useful for detecting the degradation products of FLT by enzymes of the intestinal bacterial flora in the large intestine after dosing FLT as an enema.

The apparent degradation rate constant of fluticasone propionate (FLT) in 0.1 M NaOH:methanol=1:1 at 37 ℃ was previously reported to be 0.169 ± 0.003 h?1, and four degradation products (products 1–4) were observed in the solution. The aims of the present study were to assess the degradation rates of FLT in other alkaline solutions and clarify the chemical structures of the four degradation products in order to obtain basic data for designing an enema for inflammatory bowel disease. The apparent degradation rate constants in 0.05 M NaOH and 0.1 M NaOH:CH3CN=1:1 were 0.472 ± 0.013 h?1 and 0.154 ± 0.000 h?1 (n=3), respectively. The chemical structures of products 1–4 in 0.1 M NaOH:methanol=1:1 were revealed by nuclear magnetic resonance (NMR) and mass spectrometry data. The chemical structure of products 2 was that the 17-position of the thioester moiety of FLT was substituted by a carboxylic acid. The degradation product in 0.1 M NaOH:CH3CN=1:1 was found to be product 2 based on 1H NMR data. The degradation product in 0.05 M NaOH was considered to be product 2 based on the retention time of HPLC. These results are useful for detecting the degradation products of FLT by enzymes of the intestinal bacterial flora in the large intestine after dosing FLT as an enema.

Objective: This study aimed to determine if the discrepancy between depression severity rated by clinicians and that reported by patients depends on key behavioral/psychological features in patients with mood disorders. Methods: Participants included 100 patients with mood disorders. First, we examined correlations and regressions between scores on the Hamilton Depression Rating Scale (HAMD) and Beck Depression Inventory (BDI). Second, we divided the participants into those who provided 1) greater ratings for the BDI compared with the HAMD (BDI relative-overrating, BO) group, 2) comparable ratings for the BDI and HAMD (BDI relatively concordant, BC) group, or 3) less ratings for the BDI (BDI relative-underrating, BU) group. Adverse childhood experiences, autistic-like traits, and coping styles were evaluated with a six-item short version of the Childhood Trauma Questionnaire (CTQ-6), the Social Responsiveness Scale for Adults (SRS-A), and the Ways of Coping Checklist (WCCL), respectively. Results: A significant correlation was found between HAMD and BDI scores. Total and emotional abuse subscale scores from the CTQ-6, and the self-blame subscale scores from the WCCL were significantly higher for the BO group compared with the BU group. The BO group also elicited significantly higher SRS-A total scores than did the other groups. Conclusion These findings suggest that patients with adverse emotional experiences, autistic-like traits, and self-blame coping styles perceive greater distress than that evaluated objectively by clinicians. The results indicate the need for inclusion of subjective assessments to effectively evaluate depressive symptoms in patients deemed to have these psycho-behavioral concerns.

BACKGROUND/AIMS: The aim of this study is to investigate the degree of delayed gastric emptying (DGE) and evaluate how the severity of DGE affects gastroesophageal reflux disease (GERD) in neurologically impaired (NI) patients utilizing 24-hour multichannel intraluminal impedance pH measurements (pH/MII) and ¹³C-acetate breath test (¹³C-ABT) analyses. METHODS: ¹³C-ABT and pH/MII were conducted in 26 NI patients who were referred to our institution due to suspected GERD. At first, correlation analyses were performed to investigate the correlation between the ¹³C-ABT parameters and the clinical or pH/MII parameters. Thereafter, all patients were divided into 2 groups (DGE and severe DGE [SDGE] group) according to each cut off half emptying time (t(1/2), 90–170 minutes). Each pH/MII parameter was compared between the 2 groups in each set-up cutoff t(1/2). RESULTS: The mean t(1/2) of all patients was 215.5 ± 237.2 minutes and the t(1/2) of 24 (92.3%) patients were > 100 minutes. Significant moderate positive correlations were observed between both t(1/2) and lag phase time and the non-acid reflux related parameters. Furthermore, the patients in the SDGE group demonstrated higher non-acid reflux related parameters than those of the DGE groups when the cutoff was t(1/2) ≥ 140 minutes. CONCLUSION: The present study demonstrated that GE with t(1/2) ≥ 140 minutes was related to an increase of non-acid exposure reaching up to the proximal esophagus in NI patients, and indicating that NI patients with SDGE might have a high risk of non-acid GERD.
Breath Tests ; Electric Impedance ; Esophagus* ; Gastric Emptying* ; Gastroesophageal Reflux ; Humans ; Hydrogen-Ion Concentration

Background and Objectives  Falsified or substandard antimicrobials present a health hazard to patients, and may promote antimicrobials resistance. We conducted a four-year study to evaluate the quality of selected antimicrobials and to examine the prevalence of falsified or substandard antimicrobials in Cambodia, aiming to promote efforts to improve the quality of medicines in Cambodia.Methods   We collected samples of clarithromycin, sulfamethoxazole/trimethoprim, ceftriaxone, cefuroxime, levofloxacin, gentamicin, ciprofloxacin, fluconazole, nalidixic acid, ofloxacin, phenoxymethyl penicillin and roxithromycin products from several different types of drug outlets in five provinces (rural areas) and Phnom Penh (an urban area), during 2011 to 2014. The authenticity of the collected medicines was investigated, and the medicines were analyzed to determine whether they met the appropriate pharmacopoeial standards.Results   We collected 647 samples, produced by 179 manufacturers, from 353 outlets. Only 51 (15%) of the outlets were air-conditioned. We found different-coloured packaging of the same brand (different lots) of products from some manufacturers. The insert information of one sample was different from the package information. Twelve (1.9%) samples were not officially registered with Department of Drug and Food (DDF). In authenticity investigation, 43 of 179 manufacturers replied and confirmed the authenticity of 154 samples (out of 647); also, 18 out of 40 Medicine Regulatory Authority (MRA) replied to enquiries about whether products were licensed or not (one was not). Among the samples, 424 (80.4%), 406 (86%) and 533 (90.6%) passed in dissolution, content uniformity and quantity tests, respectively. Samples of cefuroxime and roxithromycin that failed were significantly cheaper than those that passed.Conclusion  Poor-quality antimicrobials were found in Cambodian markets, though no falsified medicines were detected. Result of samples were not confirmed in authenticity, so it was possible to include falsified medicines. Manufacturers should be encouraged to improve GMP implementation. Storage conditions in the distribution chain may also need to be improved. Continuous efforts by stakeholders are needed to ensure that medicines are properly licensed.

The patient was a 73-year-old woman. She had been treated for squamous cell carcinoma of the lung (cT3N3M0, Stage IIIC) at our department. The patient had low back pain due to retroperitoneal lymph node metastasis; in June 2022, this was exacerbated as lung cancer progressed. She had difficulty in body movements due to edema in both lower limbs, in addition to the pain. Consequently, she was urgently admitted on July 8 and received radiotherapy (30 Gy/10 fractions) for retroperitoneal lymph node metastasis. She was being given tapentadol at a dose of 200 mg/day for relief of her pain. However, she was switched to fentanyl patch at a dose of 1200 µg/day during her hospitalization, which resulted in relief of low back pain. The underlying disease causing the edema was investigated. Based on physical and laboratory findings and medical history, lymphedema associated with retroperitoneal lymph node metastases was diagnosed. On day 31 of hospitalization, the patient was allowed to be temporarily discharged from the hospital because the edema had improved and the activity of daily living around the bed had increased. Treatment methods for lymphedema associated with lymph node metastasis have not been established, but the efficacy of radiotherapy has been reported. We have herein reported a case of lymphedema that was improved by radiotherapy after it was differentiated from other diagnoses.