Objective: Incidents, such as disturbance of consciousness due to adverse reactions of medications during automobile driving, could cause a serious accident.  Although automobile driving is indicated to be “prohibited” in the package inserts of many drugs, no explicit guidelines are available in Japan on specific guidance to patients.  Therefore, we attempted to prepare guidelines for medication guidance regarding automobile driving.
Methods: We investigated the number of incidents involving traffic accidents and the disturbance of consciousness cases reported in “Japanese Adverse Drug Event Report” database by “Pharmaceuticals and Medical Devices Agency (PMDA).”  We also analyzed descriptions regarding automobile driving found in package inserts and guidelines to determine a risk level for each medication.
Results: Guidelines for medication guidance were prepared based on four-level classification of drugs for which “prohibition” of automobile driving was indicated in their package inserts; these levels are “conform to pertinent guidelines,” “strictly prohibited,” “prohibited,” and “conditionally prohibited.”  The contents of the guidance prepared for some drugs were different from their package inserts.
Conclusions: The guidelines prepared in this study can be expected to become a support tool to ensure close attention to cautions regarding automobile driving.  Because some contents of the guidance are different from that described in the package inserts, it is desirable to obtain agreement with physicians in hospitals adopting these guidelines.  In addition, guidelines based on a broader range of information should be prepared in the future.

Objective: When vehicular accidents occur as a result of impaired consciousness etc., because of adverse drug reactions, there is a risk that third parties may be harmed.  Till date, at Nagoya City East Medical Center (hereinafter, our hospital), the warnings about driving motor vehicles while taking drugs has varied depending on the doctor or pharmacist who provides the guidance.  Therefore, throughout our hospital, we aimed to standardize these warnings and to introduce measures to strictly enforce them.
Methods: Among all the drugs used at our hospital, we identified those with warnings on the package insert about driving motor vehicles and classified them in accordance with “The Drug Administration Guidance Criteria Regarding the Driving of Vehicles,” created by our hospital on the basis of descriptions on the package insert and the level of risk of taking drugs.  We then standardized the warnings about driving motor vehicles while taking drugs, throughout our hospital.
Results: Of the 1,416 drugs used at our hospital, we identified 294 (21%) with warnings about driving motor vehicles on the package insert, and more than half of these (158 drugs) had warnings about the prohibition of driving motor vehicles on the package insert.  As a result of classifying the drugs according to “The Drug Administration Guidance Criteria Regarding the Driving of Vehicles,” we identified 53 drugs with warnings about the prohibition of driving motor vehicles.  By the classification of the level of risk of taking drugs while driving motor vehicles and the hospital-wide standardization of the warnings about driving motor vehicles while taking drugs, we are now able to provide drug administration guidance in the form of warnings that are customized to the level of risk of using each drug.
Conclusion: These measures have clarified the level of risk of taking each drug and warnings about driving motor vehicles while taking them.  In the future, we intend to cooperate with local pharmacies to intervene in the prescription of drugs outside well as inside hospitals.

Objectives: Deep seawater (DSW) utilization technology has been developed for the fields of medicine and health, among others. To clarify the health effects of DSW as compared with surface seawater (SSW) or tap water (TW), we investigated the changes of immune cell distribution of the peripheral blood, or subjective judgment scores, after hot water bathing. Methods: Ten healthy young men were immersed for 10 min in DSW, SSW and TW heated to 42°C. Blood samples were collected before bathing, immediately after bathing and 60 min after bathing. Total and differential numbers of leucocytes and lymphocyte subsets (CD3, CD4, CD8, CD19, CD16, and CD56) were examined using an automated hematology analyzer and a flow cytometer, respectively. The subjective judgment scores were obtained by an oral comprehension test. Results: Since the pre-bathing leukocyte count in the TW group was significantly different from those in the DSW and SSW groups, we excluded the findings of TW bathing from consideration. In hot DSW bathing, CD8-lymphocytes increased significantly immediately after bathing (p<0.05), in contrast to hot SSW bathing, in which no significant changes were detected in the lymphocyte subsets. Additionally, there were no significant changes between repeated measurements in the subjective judgment scores, though the score of thermal sensation in SSW bathing showed a significantly higher value immediately after bathing than before bathing (p<0.01). Conclusions: Our findings suggest that increased CD8-lymphocytes in hot DSW bathing may improve human immune function as well as hot springs do, as compared with SSW bathing. Although hot DSW bathing may have the ability to change human immune cell distribution, well-designed studies are needed to clarify the health effects including not only DSW and SSW but also TW.
Bathing self care ; Treated with ; Cells ; Deep ; Antigens, CD8

Blood lactate kinetics is an important physiological determinant of endurance exercise performance. Recently, some studies reported that the blood glucose transition point can also be observed (blood glucose threshold; GT) and the GT is consistent with the lactate threshold (LT). However, we have recently reported that blood glucose kinetics and blood lactate kinetics were different during two sets of incremental running tests in the same day. This result suggested that influence of low glycogen storage on GT and LT are different. This study was intended to clarify the effect of low glycogen storage on the blood glucose and the blood lactate kinetics during incremental running test performed two successive days. Eight male endurance runners participated in incremental running test performed two successive days. The main finding was that the blood glucose was significantly lower in the second day than the first day during incremental test, although blood glucose was not different at rest in both days. However, blood lactate was not different form rest to fifth stages in both days, significantly lower only at the final stage in the second day than the first day. Respiratory exchange ration were lower in the second day compared to the first day. GT was significantly higher in the second day than the first day, but LT was not different in both days. We concluded that low glycogen storage effected blood glucose kinetics more than blood lactate kinetics, and resulted in only the change of GT.

We have been successful in preventing induced cavities in rats using acupuncture stimulation. In order to more profoundly understand one aspect of that preventative mechanism, we studied rises in natural antibody values and special antibody values using the Jerne method. In so doing, we proved that when D-phenylalanine (DPA) is administered 30 minutes proir to acupuncture stimulation the rise which occurrs in antibody counts with acupuncture is great and the duration of the period of increase is lengthened. Such reports about acupuncture effects on the living body are many. That acupuncture strengthens the stability of the living body is an unquestionable fact.
In an effort to study the preventative effects of acupuncture or acupuncture supplemented by DPA, we performed the following experiment. We planted Sarcoma-180, a homotransplantable tumor which often displays an immune resistant effect in mice and observed the immunity level rises produced by acupuncture and acupuncture supplemented by the administration DPA.
ICR mice (male, 3 weeks old) were divided into 5 groups: I-control grop, II-treatment with carboxymethyl cellulose sodium (CMC) III-treatment with CMC and DPA, IV-treatment with CMC and acupuncture, V-treatment with CMC, DPA and Acupuncture
Sarcoma-180 cells were administered to all the rats subcutanously in a ratio 10⁶ cells/0.1ml after which cells were administered every 3rd day for a total of 4 times. DPA combined with 1% CMC was administered into the abdominal cavity in a concentration of 250mg/kg.
All of the mice were sacrificed on the 13th following the cancer transplant and the weight of the cancer, the liver and the spleen measured. Upon examinig for significant differences it was found that sigificant differences were indicated between Groups I and III, and I and V with a 1% danger rate, and I and IV with a 5% rate of danger. No signicant differnce was obseved between I and II.
It can be said that in the mice which received the Sarcoma-180 transplants macrophage funcctional insufficiency occured in a relatively early stage with decreased T lymph corpuscle functions occuring in the later stages. It can be assumed that in the process of interference with the functional in sufficiency, a preventative effect comes into play. In future studies we'd like to investingate the meaning of acupuncture for resistance to infection, etc.

The present study was conducted to obtain basic information about blood glucose fluctuation and relation with race performance during 100 km marathon. Subcutaneous glucose of one well-trained runner was measured by continuous glucose monitoring system (CGMS) at 5 min interval and blood samples for biochemical analysis were drawn at pre, middle and post of the race. Energy balance during one week prior to the 100 km race was recorded, and the whole energy and fluid intake during the race was analyzed. Blood glucose fluctuated reflecting duration of exercise and energy supply during the race. During the latter part of the race (65–70 km), abrupt declines in blood glucose level, which reflected insufficient carbohydrate intake before the race (119 g), were accompanied by decrease in running speed. The present report suggests that continuous glucose monitoring supplemented with standard nutritional and physiological measurement provides precise and valuable information on runner’s energy state during the ultra-endurance race, and that athletes need to reassess their preparation for the race and planning of energy intake during the race.

The present study was conducted to obtain basic information about blood glucose fluctuation and relation with race performance during 100 km marathon. Subcutaneous glucose of one well-trained runner was measured by continuous glucose monitoring system (CGMS) at 5 min interval and blood samples for biochemical analysis were drawn at pre, middle and post of the race. Energy balance during one week prior to the 100 km race was recorded, and the whole energy and fluid intake during the race was analyzed. Blood glucose fluctuated reflecting duration of exercise and energy supply during the race. During the latter part of the race (65–70 km), abrupt declines in blood glucose level, which reflected insufficient carbohydrate intake before the race (119 g), were accompanied by decrease in running speed. The present report suggests that continuous glucose monitoring supplemented with standard nutritional and physiological measurement provides precise and valuable information on runner’s energy state during the ultra-endurance race, and that athletes need to reassess their preparation for the race and planning of energy intake during the race.

This study was intended to clarify 1) the difference of the exercise intensity at blood lactate threshold (LT) and blood glucose threshold (GT), 2) the effect of exercise duration on the LT and GT during two sets of incremental running test. Ten male runners (age 25.0±3.2 yr, height 171.2±5.5 cm, body mass 57.9±4.0 kg, VO_2max 64.6±3.0 ml/kg/min) completed two sets of incremental running test (each set was set to run ten stages at 60-90% VO_2max). Second set was repeated after 8 min recovery. LT and GT speed were investigated at the first set. Lactate minimum (LM) and glucose minimum (GM) speed were selected where the blood lactate and glucose concentration were at the lowest during the second set. Using the indirect calorimetry (VO₂, VCO₂), fat and carbohydrate oxidation rates were calculated. GT was observed in all runners. VO₂ and energy expenditure were similar between the two incremental running tests, however, fat oxidation was significantly higher and carbohydrate oxidation was significantly lower during the first half of the second set. This change was regarded as the influence of the exercise duration in the first set. Furthermore, GM speed was significantly lower than GT speed, but LM speed and LT speed were not different. It was considered that the shift of GT was affected by the substrate utilization change during prolonged exercise.

Since distal femoral varus osteotomy (DFO)
Asian Continental Ancestry Group ; Humans ; Japan ; Knee ; Osteoarthritis ; Osteotomy ; Tibia ; Weight-Bearing

OBJECTIVE: To assess actual rates of late vaginal stenosis and identify predisposing factors for complications among patients with previously untreated cervical cancer following high-dose-rate brachytherapy. METHODS: We performed longitudinal analyses of 57 patients using the modified Dische score at 6, 12, 18, 24, 36, and 60 months after treatment, which consisted of 15 interstitial brachytherapys and 42 conventional intracavitary brachytherapys, with a median follow-up time of 36 months (range, 6 to 144 months). RESULTS: More than half of the patients developed grade 1 (mild) vaginal stenosis within the first year of follow-up, and grade 2 (97.5%, moderate) to grade 3 (severe) stenosis gradually increased with time. Actual stenosis rates for grade 1, 2, and 3 were 97.5% (95% confidence interval [CI], 92.7 to 97.5), 60.7% (95% CI, 42.2 to 79.3), and 7.4% (95% CI, 0 to 18.4) at 3 years after treatment. Pallor reaction grade 2-3 at 6 months was only a statistically significant predisposing factor for grade 2-3 late vaginal stenosis 3 years or later with a hazard ratio of 3.48 (95% CI, 1.32 to 9.19; p=0.018) by a multivariate Cox proportional hazard model. Patients with grade 0-1 pallor reaction at 6 months showed a grade > or =2 vaginal stenosis rate of 53%, whereas the grade 2-3 pallor reaction group achieved a grade > or =2 vaginal stenosis rate at 3 years at 100% (p=0.001). CONCLUSION: High-dose-rate brachytherapy was associated with high incidence of late vaginal stenosis. Pallor reaction grade 2-3 at 6 months was predictive of late grade 2-3 vaginal stenosis at 3 years after treatment. These findings should prove helpful for patient counseling and preventive intervention.
Adult ; Aged ; Aged, 80 and over ; Brachytherapy/*adverse effects/methods ; Constriction, Pathologic/etiology/pathology ; Female ; Humans ; Iridium Radioisotopes/therapeutic use ; Middle Aged ; *Pallor ; Prognosis ; Prospective Studies ; Radiopharmaceuticals/therapeutic use ; Retrospective Studies ; Uterine Cervical Neoplasms/*radiotherapy ; Vaginal Diseases/*etiology/pathology