Abstract
Introduction : There are few reports of long-term medical support activities in disaster areas. We analyzed drug-related data using medical records and prescriptions obtained during the long-term medical support of patients impacted by the Great East Japan Earthquake, which occurred on March 11, 2011.
Methods : Using medical records and prescriptions, the dispensing frequency of each drug was calculated and usage trends of the top three most frequently dispensed drugs are described here. All data was collected from March 26, 2011 onwards after the medical support activity commenced.
Results : In the first week of data acquisition, a total of 166 patients visited the medical support team (median 48.5, range 14-166). Following that, the number of patients decreased with a median of 24 people per day (range 0-47). The number of prescriptions for common cold medication was the highest, followed by antihypertensive and anti-allergic medications, respectively. The usage of antihypertensive drugs and common cold medications decreased over time, whereas anti-allergic medications were prescribed on a continuous basis.
Conclusion : Disaster medical support teams should not only be prepared to support the acute phase but also long-term phase, which depends heavily on the restoration of local medical services. The earlier the intervention to provide support, the greater the likelihood that the disaster medical support team will require to provide treatment for both acute and chronic illness.

Methods: We retrospectively evaluated 54 hands of 40 girls with AIS who visited Nara Medical University Hospital from 2000 to 2015 using previously collected radiographs. The examiners included a spine surgeon and a pediatric orthopedic surgeon, each with over 10 years of experience. The reliability of the DRU and sTW3 was evaluated using the kappa coefficient. Results: The left-hand radiographs of 40 female patients with AIS (mean age, 13.9±1.7 years; N=54 hands) were evaluated by two blinded examiners using the sTW3 and DRU methods. The highest inter-observer and intra-observer reliabilities (kappa, 0.64 and 0.62, respectively) for radius evaluation were determined. Radius evaluation by the DRU showed the highest agreement rate and smallest error between the inter- and intra-observer examinations. Conclusions The DRU was the most reliable assessment tool, and it has the potential to be useful for precisely determining the stage of skeletal maturity in outpatient clinics.

The purpose of this study was to evaluate the osteogenesis ability of osteogenic matrix cell sheets (OMCS) derived from old donor cells. Bone marrow stromal cells (BMSC) were obtained from young (7-week-old) and old (1-year-old) Fischer344 rats donors and cultured with modified Eagle's medium (MEM group) alone or containing dexamethasone (Dex; 10 nM) and ascorbic acid phosphate (AscP; 0.28 mM) (Dex/AscP group). We prepared four in vitro experimental groups: (1) young MEM, (2) young Dex/AscP, (3) old MEM and (4) old Dex/AscP. Cell proliferation and osteogenic marker mRNA expression levels were evaluated in vitro. To assess bone formation in vivo, the cells of each group were combined with beta tricalcium phosphate (TCP) disks followed by implantation in recipient rats. The in vitro study showed significant differences in the mRNA expression of osteocalcin, ALP, and BMP2 between MEM and Dex/AscP groups. Bone formation following implantation was observed upon histological analyses of all groups. TCP combined with OMCS (OMCS/TCP group) resulted in enhanced bone formation compared to that following combination with BMSC (BMSC/TCP). The osteocalcin content of the OMCS/TCP group 4 weeks after implantation was significantly higher than that in the BMSC/TCP construct for both young and old donors. The present study clearly indicated that OMCS could be generated from BMSCs of old as well as young donors using a mechanical retrieval method. Thus, through its usage of OMCS, this method may represent a potentially effective therapeutic option for cell-based therapy in elderly patients.
Aged ; Animals ; Ascorbic Acid ; Bone and Bones ; Bone Marrow ; Cell Proliferation ; Dexamethasone ; Humans ; In Vitro Techniques ; Mesenchymal Stromal Cells ; Methods ; Osteocalcin ; Osteogenesis ; Rats ; RNA, Messenger ; Tissue Donors

PURPOSE: Since oncological outcomes of transanal colorectal tube (TCT) placement, an endoscopic treatment for colorectal cancer (CRC) with acute colorectal obstruction (ACO), remain unknown, this study analyzed long-term outcomes of TCT placement for stage II/III CRC with ACO. MATERIALS AND METHODS: Data were retrospectively reviewed from consecutive patients with distal stage II/III CRC who underwent surgery between January 2007 and December 2011 at two Japanese hospitals. One hospital conducted emergency surgery and the other performed TCT placement as the standard treatment for all CRCs with ACO. Propensity score (PS) matching was used to adjust baseline characteristics between two groups. RESULTS: Among 754 patients with distal stage II/III CRC, 680 did not have ACO (non-ACO group) and 74 had ACO (ACO group). The PS matching between both hospitals identified 234 pairs in the non-ACO group and 23 pairs in the ACO group. In the non-ACO group, the surgical quality was equivalent between the two institutions, with no significant differences in overall survival (OS) and disease-free survival (DFS). In the ACO group, the rate of primary resection/anastomosis was higher in the TCT group than in the surgery group (87.0% vs. 26.1%, p < 0.001). No significant differences were noted between the surgery and the TCT groups in OS (5-year OS, 61.9% vs. 51.5%; p=0.490) and DFS (5-year DFS, 45.9% vs. 38.3%; p=0.658). CONCLUSION: TCT placement can achieve similar long-term outcomes to emergency surgery, with a high rate of primary resection/anastomosis for distal stage II/III colon cancer with ACO.
Asian Continental Ancestry Group ; Colon ; Colonic Neoplasms ; Colorectal Neoplasms ; Disease-Free Survival ; Emergencies ; Humans ; Propensity Score ; Retrospective Studies

Background: The anti-programmed death 1 (PD-1) antibody has led to durable clinical responses in a wide variety of human tumors. We have previously developed the caninized anti-canine PD-1 antibody (ca-4F12-E6) and evaluated its therapeutic properties in dogs with advance-staged oral malignant melanoma (OMM), however, their therapeutic effects on other types of canine tumors remain unclear. Objective: The present clinical study was carried out to evaluate the safety profile and clinical efficacy of ca-4F12-E6 in dogs with advanced solid tumors except for OMM. Methods: Thirty-eight dogs with non-OMM solid tumors were enrolled prospectively and treated with ca-4F12-E6 at 3 mg/kg every 2 weeks of each 10-week treatment cycle. Adverse events (AEs) and treatment efficacy were graded based on the criteria established by the Veterinary Cooperative Oncology Group. Results: One dog was withdrawn, and thirty-seven dogs were evaluated for the safety and efficacy of ca-4F12-E6. Treatment-related AEs of any grade occurred in 13 out of 37 cases (35.1%).Two dogs with sterile nodular panniculitis and one with myasthenia gravis and hypothyroidism were suspected of immune-related AEs. In 30 out of 37 dogs that had target tumor lesions, the overall response and clinical benefit rates were 6.9% and 27.6%, respectively. The median progression-free survival and overall survival time were 70 days and 215 days, respectively. Conclusions The present study demonstrated that ca-4F12-E6 was well-tolerated in nonOMM dogs, with a small number of cases showing objective responses. This provides evidence supporting large-scale clinical trials of anti-PD-1 antibody therapy in dogs.

BACKGROUND: Oral health is thought to be associated with diet quality, and socioeconomic status (SES) affects both oral health and diet. The aim of this study was to investigate the association between the number of teeth and dietary intake as well as nutritional biomarker, considering the subjects' SES. METHODS: We conducted a cross-sectional analysis of data from 2049 individuals aged ≥ 50 years from the National Integrated Project for Prospective Observation of Non-communicable Disease and its Trends in the Aged 2010. The number of remaining teeth was categorized into age-specific quartiles (Q1 to Q4). We assessed the adjusted means and 95% confidence intervals for dietary variables by the number of teeth using analysis of covariance. Stratified analyses by SES were also conducted. RESULTS: The intake of grain products was 31 g higher, and those of vegetables and meat were 30 g and 8 g lower, respectively, in Q1 (fewer teeth) than in Q4 (more teeth). Carbohydrate intake was higher whereas protein, minerals (potassium, magnesium, and zinc), vitamins (vitamins A, E, B, B, β-carotene, and folic acid), and dietary fiber intakes were lower among individuals with fewer teeth. Adjusted mean serum albumin levels were low in Q1. The associations between the number of teeth and dietary intake were more evident in individuals with a low SES. CONCLUSIONS Having few remaining teeth was associated with a low nutrient intake and low serum albumin levels in middle-aged and older Japanese adults, and these associations were more evident in individuals with low SES.
Aged ; Aged, 80 and over ; Carbohydrates ; Cross-Sectional Studies ; Diet ; Energy Intake ; physiology ; Female ; Humans ; Japan ; Male ; Middle Aged ; Nutrients ; Nutrition Surveys ; Nutritional Status ; Serum Albumin ; analysis ; Socioeconomic Factors ; Tooth ; Vegetables