View ; Japanese language ; Acupuncture

PREAVOID is pharmaceutical intervention that is utilized to illustrate pharmacists’ contributions to medical care.  Currently, there is a great need for pharmacists to provide good medical services to inpatients; as a result, many pharmacists conduct pharmaceutical management in hospital wards.  However, pharmacists who have limited experience in working in the ward do not know exactly what they should check with respect to pharmaceutical management.  To resolve this problem, we determined 16 pharmaceutical-management items based on PREAVOID that was conducted at Nagara Medical Center.  Moreover, we conducted a pre-questionnaire survey assessing whether pharmacists who had worked in the ward for fewer than 4 years attended to these 16 check items in their daily work prior to our introducing the list to them.  The results indicated that pharmacists who had fewer than 2 years of experience working in wards attended to the 16 check items less than those who had more than 2 years of experience, and approximately half of the pharmacists had not received adequate guidance before beginning work at the ward.  In addition, most pharmacists indicated that clear check points were useful for conducting pharmaceutical management and the 16 check items were useful for their daily work.  These results indicate that the 16 check items are a useful educational tool for enabling pharmacists to conduct high quality pharmaceutical management from the initial stage and that using the 16 check items is superior to pharmacists only gaining this ability via prolonged experience working in the ward.

A 58-year-old man was admitted for pneumonia after several business trips to Thailand, Vietnam, and Malaysia. Despite resolution of pneumonia on chest X-ray, high fever persisted. CT scan revealed a juxtarenal, atypical-shaped abdominal aortic aneurysm of 4.5cm in size, and this was thought to be the cause of persisting fever. After prolonged antibiotic treatment, surgical resection and prosthetic tube replacement of the aneurysm was performed. The aneurysm was a pseudoaneurysm, and histological examination showed chronic inflammation with no atherosclerotic change. It was thought to be of mycotic origin. On the 12th day after operation, he became febrile, and an arterial blood culture yielded Burkholderia pseudomallei. Antibiotics chosen according to sensitivity tests, were given. He was finally discharged with no exidence of persisting infection, on the 55th day after operation.

The CCR4-NOT complex is a highly conserved, multifunctional machinery controlling mRNA metabolism. Its components have been implicated in several aspects of mRNA and protein expression, including transcription initiation, elongation, mRNA degradation, ubiquitination, and protein modification. In this review, we will focus on the role of the CCR4-NOT complex in mRNA degradation. The complex contains two types of deadenylase enzymes, one belonging to the DEDD-type family and one belonging to the EEP-type family, which shorten the poly(A) tails of mRNA. We will review the present state of structure-function analyses into the CCR4-NOT deadenylases and summarize current understanding of their roles in mRNA degradation. We will also review structural and functional work on the Tob/BTG family of proteins, which are known to interact with the CCR4-NOT complex and which have been reported to suppress deadenylase activity in vitro.
Animals ; Humans ; Multiprotein Complexes ; chemistry ; genetics ; metabolism ; Protein Conformation ; RNA, Messenger ; genetics ; metabolism ; Transcription Factors ; chemistry ; genetics ; metabolism

Magnetic resonance imaging (MRI) for diagnostic evaluation of the breast was performed in 61 patients who visted the Breast Clinic of our hospital and were suspected to have malignant tumors by physical examination and mammography between January and December 1999. In 58 patients undergoing histological diagnostic tests (8 with benignancy and 50 with breast cancer), we compared the imaging characteristics and the time-signal intensity curves acquired by dynamic imaging between benign and malignant lesions, and evaluated the usefulness of analyzing enhancement patterns on contrast MRI. Contrast MRI revealed strong tumor enhancement in all patients; the mean time required for the signal intensity to reach a peak was about 7 min in patients with benign tumors and about 2 min in those with breast cancer. Peripheral ring enhancement was observed in 40 of the 50 patients with breast cancer (80.0%), while such enhancement was not noted in any of the patients with benign tumors.
Although diagnosis of breast disease by imaging has primarily relied on mammography and ultrasonography, the pattern of contrast enhancement on dynamic MRI also appears to be useful for determining the treatment method of breast tumors.

  On July 7, 2010, a 74-year-old man came to our hospital, complaining that he had a nagging pain in his chest that started the preceding day. After performing electrocardiography, blood tests and electrocardiography, we diagnosed the case as acute myocardial infarction. At first, it was thought that blood flow could be restored in due course of time, antiplatelet and anticoagulant agents were used. Intracardiac catheterization was not included in our initial treatment plan. Three days after the initiation of the treatment, the patient had pain in his left inguinocrural region. Computed tomography and magnetic resonance imaging reveled hematoma in his left iliopsoas muscle. We stopped administering antiplatelet and anticoagulant agents to him. But anemia progressed from Hb14.1g/dL to 9.8 g/dL, so blood transfusions had to be given. After that, the patient underwent a rest cure. With the passage of time, the pain and swelling of the left iliopsoas muscle went down. Regarding the cardiac condition, however, the pain in the chest did not abate even when he was taking a rest. The antiplatelet therapy was resumed, with one type of agent given at first and then with another type added. Examinations using a coronary CT and a cadiac catheter found 90% stenosis at the proximal left anterior descending coronary artery. So, a bare metal stent was placed in the near-closed artery. Ever since, there has been no recrudescence of chest pain and no recurrence of iliopsoas muscle hematoma. The extravascated blood mass seemed to be dissolved spontaneously.

Animals ; Desmin ; analysis ; genetics ; Female ; Immunohistochemistry ; Intermediate Filament Proteins ; analysis ; genetics ; Kidney Glomerulus ; chemistry ; Nephrosis ; metabolism ; Nerve Tissue Proteins ; analysis ; genetics ; Nestin ; Podocytes ; chemistry ; RNA, Messenger ; analysis ; Rats ; Rats, Inbred WKY ; Vimentin ; analysis ; genetics

The human CCR4-NOT deadenylase complex consists of at least nine enzymatic and non-enzymatic subunits. Accumulating evidence suggests that the non-enzymatic subunits are involved in the regulation of mRNA deadenylation, although their precise roles remain to be established. In this study, we addressed the function of the CNOT1 subunit by depleting its expression in HeLa cells. Flow cytometric analysis revealed that the sub G(1) fraction was increased in CNOT1-depleted cells. Virtually, the same level of the sub G1 fraction was seen when cells were treated with a mixture of siRNAs targeted against all enzymatic subunits, suggesting that CNOT1 depletion induces apoptosis by destroying the CCR4-NOT-associated deadenylase activity. Further analysis revealed that CNOT1 depletion leads to a reduction in the amount of other CCR4-NOT subunits. Importantly, the specific activity of the CNOT6L immunoprecipitates-associated deadenylase from CNOT1-depleted cells was less than that from control cells. The formation of P-bodies, where mRNA decay is reported to take place, was largely suppressed in CNOT1-depleted cells. Therefore, CNOT1 has an important role in exhibiting enzymatic activity of the CCR4-NOT complex, and thus is critical in control of mRNA deadenylation and mRNA decay. We further showed that CNOT1 depletion enhanced CHOP mRNA levels and activated caspase-4, which is associated with endoplasmic reticulum ER stress-induced apoptosis. Taken together, CNOT1 depletion structurally and functionally deteriorates the CCR4-NOTcomplex and induces stabilization of mRNAs, which results in the increment of translation causing ER stress-mediated apoptosis. We conclude that CNOT1 contributes to cell viability by securing the activity of the CCR4-NOT deadenylase.
Apoptosis ; Caspases, Initiator ; genetics ; metabolism ; Cell Survival ; Endoplasmic Reticulum ; enzymology ; Enzyme Activation ; Flow Cytometry ; HEK293 Cells ; HeLa Cells ; Humans ; Protein Subunits ; genetics ; metabolism ; RNA Stability ; RNA, Messenger ; analysis ; RNA, Small Interfering ; genetics ; metabolism ; Ribonucleases ; metabolism ; Stress, Physiological ; Transcription Factor CHOP ; genetics ; metabolism ; Transcription Factors ; genetics ; metabolism ; Transfection

OBJECTIVESystemic and myelotoxic effects of 2,3,7,8-tetrabromodibenzo-p-dioxin (TBDD) were examined by the single administration of TBDD by gavage to rats.

METHODSFifteen Wistar rats of both sexes per group received 0, 10, 30, 100 or 300 μg TBDD/kg body weight. Rats surviving to the scheduled necropsy on Days 2, 7 and 36 after TBDD administration were examined for growth rate, organ weight, hematology, histopathology and adipose tissue levels of TBDD.

RESULTSThree 300 μg/kg-dosed females died on Days 21, 23 and 27, and exhibited a marked decrease in body weight, severe thymic atrophy, decreased bone marrow hematopoiesis and hemorrhage in the subarachnoid space of brain and spinal cord. TBDD-dosed surviving rats exhibited growth retardation, decreased bone marrow hematopoiesis, decreases in red blood cell counts, hemoglobin concentrations, and hematocrit values, an increase in reticulocytes and decreases in platelet counts, white blood cell counts and eosinophils. These signs suggested TBDD myelotoxicity. Splenic extramedullary hematopoiesis was increased in both sexes given TBDD, whereas atrophy of the splenic white pulp occurred only in TBDD-dosed females. Marked decreases in body weights and the size and weight of the thymus, severe thymic atrophy and death in TBDD-dosed females suggested a wasting syndrome. The adipose tissue level of TBDD culminated on Day 7 and decreased to 20-30% of the Day 7 level on Day 36.

CONCLUSIONSThe TBDD-induced effects were characterized by a wasting syndrome and myelotoxicity that appeared at the dose levels of 30 μg/kg and higher and caused death in 300 μg/kg-dosed females.

The representative endoscopic features of primary intestinal follicular lymphoma are well known as small whitish polypoid nodules, but a magnified view has only been described in a few case reports. Herein, we report a case with intestinal follicular lymphoma in which magnifying endoscopy with narrow band imaging was helpful for prompt diagnosis. A 57-year-old Japanese woman underwent surveillance esophagogastroduodenoscopy. The endoscopic examination revealed confluent whitish granules in the duodenum, distinct from the nodules or polyps that are typical findings of intestinal follicular lymphoma. Magnifying endoscopy visualized whitish enlarged villi, and narrow band imaging emphasized an elongated and coiled vascular pattern. Based on these features, intestinal follicular lymphoma was highly suspected, and subsequent histological study confirmed the diagnosis. This case demonstrates that magnifying endoscopy with narrow band imaging was useful for the detection and prompt diagnosis of intestinal follicular lymphoma. The pathological features of intestinal follicular lymphoma are also discussed.
Asian Continental Ancestry Group ; Duodenal Neoplasms ; Duodenum ; Endoscopes, Gastrointestinal ; Endoscopy ; Endoscopy, Digestive System ; Female ; Humans ; Lymphoma, Follicular ; Narrow Band Imaging ; Polyps