BACKGROUND/AIMS: This study assessed the efficacy and safety of high-dose multimatrix mesalazine once-daily (QD) compared to another form of high-dose mesalazine. METHODS: In this multicenter, randomized, double-blind study, 280 patients with mildly to moderately active ulcerative colitis (UC) received multimatrix mesalazine 4.8 g/day QD or pH-dependent-release mesalazine 3.6 g/day three times daily for 8 weeks. The primary endpoint was the change in the UC-Disease Activity Index (UC-DAI) at the end of the treatment period. RESULTS: The change in the UC-DAI (mean±standard deviation) in the per-protocol set was −2.6±2.47 in the multimatrix mesalazine 4.8 g/day group (n=134) and −1.8±2.64 in the pH-dependent-release mesalazine 3.6 g/day group (n=129). The difference in the mean change between the 2 groups was −0.7 (two-sided 95% confidence interval, −1.3 to −0.1). The noninferiority of multimatrix mesalazine 4.8 g/day to pH-dependent-release mesalazine 3.6 g/day was verified within the noninferiority margin (1.1). The superiority of multimatrix mesalazine 4.8 g/day to pH-dependent-release mesalazine 3.6 g/day was also investigated and confirmed in the full analysis set, according to the study protocol. In subgroup analyses, the effectiveness of multimatrix mesalazine 4.8 g/day was consistent in all subgroups. There was no difference in safety between the 2 treatment groups. CONCLUSIONS: Multimatrix mesalazine 4.8 g/day has higher efficacy and shows no difference in safety in mildly to moderately active UC, in comparison with pH-dependent-release mesalazine 3.6 g/day.
Colitis, Ulcerative* ; Double-Blind Method* ; Humans ; Mesalamine* ; Ulcer*

Exposure of humans to unusual spaces is effective to observe the adaptive strategy for an environment. Though adaptation to such spaces has been typically tested with vision, little has been examined about adaptation to left–right reversed audition, partially due to the apparatus for adaptation. Thus, it is unclear if the adaptive effects reach early auditory processing. Here, we constructed a left–right reversed stereophonic system using only wearable devices and asked two participants to wear it for 4 weeks. Every week, the magnetoencephalographic responses were measured under the selective reaction time task, where they immediately distinguished between sounds delivered to either the left or the right ear with the index finger on the compatible or incompatible side. The constructed system showed high performance in sound localization and achieved gradual reduction of a feeling of strangeness. The N1m intensities for the response-compatible sounds tended to be larger than those for the response-incompatible sounds until the third week but decreased on the fourth week, which correlated with the initially shorter and longer reaction times for the compatible and incompatible conditions, respectively. In the second week, disruption of the auditory-motor connectivity was observed with the largest N1m intensities and the longest reaction times, irrespective of compatibility. In conclusion, we successfully produced a high-quality space of left–right reversed audition using our system. The results suggest that a 4-week exposure to the reversed audition causes optimization of the auditory-motor coordination according to the new rule, which eventually results in the modulation of early auditory processing.
Ear ; Fingers ; Hearing* ; Humans ; Magnetoencephalography* ; Reaction Time ; Sound Localization

  Our palliative care team intervened in a patient with sciatica resulting from metastasis to sacral bone after surgery for rectal cancer. Rapid pain control and a change in the route of rescue drug administration from the stoma were needed. Partial opioid rotation was performed. The dose of 25.2 mg in 72 hours in a transdermal fentanyl patch decreased to 16.8 mg in 72 hours, and the dose of 3.6mg in an hour by continuous intravenous injection of morphine was added. The change in the rescue root to intravenous administration by a patient-controlled analgesia pump gave the patient relief from his pain. He was able to attend his daughter's wedding. His family were all pleased with the relief provided. The advantages of this partial opioid rotation are summed up in the following three points: (1) The required time is relatively short; (2) It can be expedient for analgesia due to the addition of different opioids; and (3) The partial opioid rotation produces fewer adverse effects than a full opioid rotation. Adjustment of the amount of drugs for pain relief in cancer patients is important with the situations of the patient and the family taken into consideration fully.

The residue levels of three kinds of organochlorines, BHC, DDT and PCB, in the serum were determined in farmers (40-59 years old, n=211), non-farmars (40-59 years old, n =27) and high school students (15-18 years old, n=56) to clarify the factors that contributed to the accumulation of those three compounds in the blood of farmers and rural inhabitants. The average values of those compounds were found to be 9.1±5.0 ppb for B-BHC, 9.2±6.3 ppb for pp'-DDE and 7.1 ±5.7 ppb for PCB. There was marked difference in the value between districts in which the subjects live. The subjects could be divided into the lower concentration group and higher concentration group, showing high discrimination ratio (72-83%) by Hayashi's quantification theory II. Statistical analysis showed that the factors contributing to the accumnlation of those compounds in the present subjects are related with digestion of chicken and fish, Hb concentration, serum cholinesterase activity, liver function and serum trigliceride and cholesterol levels, and use of organochlorines and other pesticides, duration and the mumber of days of pesticide spraying, experience of pesticide poisoing, cultivation of specific crops. Those results, in greater part, supported the general recognition that organochlorine residues in human body might be regulated by changning eating patterns and avoiding those food items containing those chemical compounds. On the other hand, attention should be focused on the exposure of those compounds through the use of specific pesticides including those compounds. And further investigation is necessary for clarifying the contributing factors to the accumulation of those compounds in human body especially in the higher residue group discriminated in the present study.

A questionnaire survey was conducted to clarify the actual states of pesticide poisoning (disorders) and its related factors amang 178 male and 232 female farmers.
The results were as follows.
1) Of the subjects 30.7% complained of some health disturbance from pesticides, without significant difference in prevalence between males and females.
2) The most comman symptom was skin hazard (39.7%), followed by nausea (34.9%) and headache (32.5%).
3) Captafol (21.4%) and methomyl (12.7%), which are contained in common pesticides, were recognized as the cause of poisoning.
4) The highest prevalence of health disturbance from pesticides were seen in [orange only] growers (72.7%) among mixed crop groups, followed by [rice+ orange] producers (71.4%), and [rice+ sugar cane +sweet potato] cultivators (55.9%). These higher prevalence groups were also estimated to be the users of the higher amount of pesticide.
5) Significant coefficient correlations were seen between the prevalence of health disturbance from pesticides and the duration and yearly times of pesticide spraying and daily spraying hours.
6) A relatively larger proportion of farmers has a knowledge about pesticide poisonig. However a few of them take effective protective measures at pesticide handling.
The reverse correlation was seen between the prevalence of health disturbance from pesticides and the degree of reliance on effectiveness of pesticides.
The present study indicates that more effective education for safty use of pesticides to both producers and users, and development of non-pesticide use agriculture are essential to protect agricultural workers from health distubance from pesticides.

The outbreak of skin hazards from okra cultivation was studied by a field survey. About a half (46.2 %) of 186 workers investigated (male, 76 ; female, 110) reported to have experienced pastly or annually skin hazards from okra cultivation.The sites of lesion complained were mostly the arms (47.5%), neck (41.3%), fingers (32.5%) and so forth in total number. The degree of lesions were generally itching (85.0%) and flare (61.3%), but severe cases like vanishing fingerprints (16.3%) and fissures on the fingers (11.3 %) were also revealed. Portion of okra responsible for skin hazards seemed to be mainly leaves, trichomes and pods.
Positive patch test reactions with preparations of immature okra pods in 46 workers (male, 12 ; female, 34), compared to 112 control subjects (male, 84 ; female, 28), were significantly higher in okra workers than in controls, which were 25% in males and 20% in total group.
These results show that okra components cause irritant contact dermatitis and allergic contact dermatitis as well.

In order to clarify the actual conditions and mechanism of contact dermatitis from pesticides, a field survey including patch testing with 11 pesticides and formaldehyde was carried out on 111 subjects who engaged in farming in the plastic greenhouse mainly. The relationship between skin sensitization due to pesticides and conditions of pesticide exposure was also studied. The results were as follows;
1) About half of subjects (52%) have been suffered from health hazards due to pesticides. Among the symptoms complained, dermatitis was most frequent (32%) as compared with acute poisoning such as headache (12%), general fatigue (9 %) and so on. The causative pesticides of those dermatitis were mainly Difolatan (72%), Daconil (8 %), and Gramoxone (8%).
2) Relatively higher rates of positive reaction of patch testing were observed in Difolatan (43%) in male, and Difolatan (25%), Topsin M (24%), Rovral (24%) in female. A positive reaction with more than one substance tested were seen in 31 males (55%) and 31 females (55%).
3) Among 11 kinds of pesticides tested, positive correlations between the skin reaction of patch testing and the use of corresponding pesticides were found only in Orthocide (r = 0.233) and Daconil (0.203).
4) From the Cluster Analysis, 16 kinds of using pesticides were classified into 3 clusters with similarity to patch test reactions. It was also suggested from the Dendrogram that there might be cross reactions among patch testing pesticides.
5) By Multiple Regression Analysis, no factor which contributed remarkably to skin sensitization was clarified. And, it was suggested that many kinds of factor were complicatedly related to skin sensitization.

An epidemiological survey on allergic conditions of 58 male (aged 38.6±11.8yrs) and 47 female (aged 42.2 ± 9.6yrs) farmers engaged in growing chrysanthemums.
Among the subjects, 47% of males and 62% of females had complaints of at least one of inquired allergic symptoms associated with the work. The immediate type of allergic reaction on nasal and/ or upper respiratory system raised in the process of sorting flowers in the working room and delayed ype of contact dermatitis in pinching the lateral bud of chrysanthemums or spraying agricultural chemicals in the field were the main complaints of those farmers.
Incidence of positive reaction for patch testing to six kinds of chrysanthemums was 5% for males and 17% for females and that of eight kinds at agricultural chemicals was 34% and 45% for each sex. And relatively high incidence was also observed in those subjects from other immunological tests such as determination of serum immunoglobulin, prick testing and calculation of eosinophil in blood and rhinorrhoea.
There were 39 (67%) males and 36 (77%) females who had at least one of the abnormal finding of those test items above mentioned. However, not the particular kind of Chrysanthemum cultivated in that area was found to be strong causative allergen for the observed allergic conditions.
From these results, it is indicated that relatively high incidence of allergic disorders may be found in the chrysanthemum growers due to inhalation and/or contact of some kinds of allergens introduced from the process of growing to forwarding, such allergen as Chrysanthemum itself, agricultural chemicals and other elements.

The physical work load of farmers and dust conditions in the harvesting process of chrysanthemums were investigated for two households (seven workers for A and three for B household, respectively) at mid March in 1984.
The total working hours a day of each household were 3225 min (460 min as average per a worker) for A and 1954 min (652 min) for B, being allotted more times to males than females. However, all of the house keeping hours were carried out only by females.
The intensity of each working load of farmers was not so heavy, as “light” and “moderately heavy” by Christesen's criteria and energy expenditure a day was calculated 2895-3604 kcal for males and 2155-2295 kcal for females.
In this working process farmers were enforced to keep careful handling with chrysanthemums and fixed body posture for 4 to 6 hours a day. Particulary, the working posture of sorting and bundling chrysanthemums may cause over strained load to the muscle and joint of the lower back and legs.
The dust concentrations of the sorting room were not so high. However, the farmers were exposed a large quantity of cilia of chrysanthemum leaves, calculated 37-259 pieces/cm² on the slide grass a day. The numbers of cilia varied with amounts of handling chrysathemums.
It was suggested that the cilia of chrysanthemums may be the most important allergen to the immediate type of allergy of the chrysanthemum growers.

A simple and sensitive method for the determination of residual Nicarbazin (NCZ) by high performance liquid chromatography (HPLC) was examined to apply to livestock products. And the detection of residual NCZ in commercial chickens was also investigated.
1. The method that the acetonitrile extracts of meat homogenate were injected directly into HPLC was able to apply to determine the residual NCZ by adding process of degreasing and dehydration of the extracts. The average recovery of NCZ added to the chicken muscle (0.4 μg/g) were 89.13±6.61%(N =5) and detection limit in this analytical procedure was 0.02μg/g.
2. Using the above method for the analysis of NCZ in commercial samples, the frequency of detection was 13.0% and the range of concentration was 0.03-0.30μg/g in samples collected from Kagoshima city (N =131). The residual NCZ in commercial chickens showed a tendency to increase in summer season. The similar levels of frequency (12.5%) and concentrations (0.03-0.43μg/g) were found in samples collected from other prefectures (N=40).