Objective: In the instructions for package inserts (PI) of prescription drugs revised in June 2017, the section “persons with reproductive potential” was established under “precautions concerning patients with specific backgrounds.” The description rules associated with contraceptive duration were modified in these. In this study, we investigated descriptions of contraceptive duration in PI that were prepared based on the revised instructions, interview forms (IF), and other proper use materials (PM).Methods: We collected PI, IF, and PM of prescription drugs containing a new active ingredient approved from April 2017 to March 2022 for which the PI were prepared based on the revised instructions and investigated descriptions of PI, contraceptive duration, and its evidence in each information material.Results: Of the 181 drugs studied, 43.1 and 12.7% required females and males to use contraception during the period of drug consumption, respectively. Among these, the ratio of drugs that had descriptions of contraceptive duration were 15.4 and 0% for females and males at PI, respectively; 51.3 and 39.1% for female sand males at IF, respectively. Anticancer drugstended to describe contraceptive duration in the PM rather than PI or IF. For some drugs, there was no description of contraceptive duration in any of the materials. Contraceptive durations ranged from the period of administration of that drug to over a year for females and approximately one week to six months for males. The reasons for these contraceptive durations were diverse.Conclusion: Contraceptive information in the PI based on revised instructions were not sufficient for use by healthcare workers, even when the IF and PM were confirmed. These results suggest that there is a need for standardizing the descriptions, types of materials to be described, and choice of evidence for contraceptive duration.

Gastric cancers that fulfill the Japanese criteria for curative endoscopic resection show a low risk of lymph node (LN) metastasis. Here, we report a case of LN metastasis from early gastric cancer that fulfilled the curative criteria. A 74-year-old Japanese woman was referred to our hospital for treatment of early gastric cancer identified at the site of a hyperplastic polyp that had been diagnosed 10 years prior to presentation. Contrast-enhanced computed tomography did not show any lymphadenopathy and laparoscopy-assisted distal gastrectomy was performed. Histopathological examination revealed a predominantly moderately differentiated adenocarcinoma that measured 15 mm in size and was confined to the mucosa. However, a single metastatic regional LN was observed. A few cancer cells showed positive staining for alpha-fetoprotein. It should be noted that early gastric cancer can be accompanied by LN metastasis even if it fulfills the criteria for curative endoscopic resection.
Adenocarcinoma ; Aged ; alpha-Fetoproteins ; Asian Continental Ancestry Group ; Female ; Gastrectomy ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Mucous Membrane ; Neoplasm Metastasis ; Polyps ; Stomach Neoplasms

Several prospective studies on laparoscopy-assisted distal gastrectomy for early gastric cancer have been initiated, but no prospective study evaluating laparoscopy-assisted total gastrectomy or laparoscopy-assisted proximal gastrectomy has been completed to date. A non-randomized confirmatory trial was commenced in April 2015 to evaluate the safety of laparoscopy-assisted total gastrectomy and laparoscopy-assisted proximal gastrectomy for clinical stage I gastric cancer. A total of 245 patients will be accrued from 42 Japanese institutions over 3 years. The primary endpoint is the proportion of patients with anastomotic leakage. The secondary endpoints are overall survival, relapse-free survival, proportion of patients with completed laparoscopy-assisted total gastrectomy or laparoscopy-assisted proximal gastrectomy, proportion of patients with conversion to open surgery, adverse events, and short-term clinical outcomes. The UMIN Clinical Trials Registry number is UMIN000017155.
Anastomotic Leak ; Asian Continental Ancestry Group ; Conversion to Open Surgery ; Gastrectomy* ; Humans ; Japan* ; Laparoscopy ; Medical Oncology* ; Non-Randomized Controlled Trials as Topic ; Prospective Studies ; Stomach Neoplasms*

We report a case of Muir-Torre syndrome (MTS) with a very rare combination of cancers, involving bilateral eyelid cancers and breast cancer. A 71-year-old female with a history of breast cancer from 18 years prior presented with bilateral eyelid tumors. One of her siblings had lung cancer, and another had pancreatic cancer. She underwent excisional biopsy of the eyelid tumors and histopathology revealed sebaceous carcinoma of the right eyelid and basal cell carcinoma of the left. She was diagnosed with MTS: a skin cancer associated with visceral malignancy. Immunohistochemical tests for mutS homolog 2 showed a lack of expression in both eyelid carcinomas.
Aged ; Breast Neoplasms/*pathology ; Eyelid Neoplasms/*pathology ; Family Health ; Female ; Humans ; Muir-Torre Syndrome/*pathology ; Neoplasms, Multiple Primary/*pathology

Objective: To develop an effective and safe therapeutic strategy, we studied the effect of the clinical characteristics of patients with acute drug intoxication on the duration of hospitalization.
Subjects and Methods: The subjects were 89 patients hospitalized for acute drug intoxication. They were divided into two subgroups; the short hospitalization group (duration of hospitalization < 7 days) and the long hospitalization group (duration of hospitalization ≥ 7 days). We compared age, sex, vital signs, drugs, and therapy between the two groups.
Results: There were no significant differences in sex or severity of consciousness disturbance between the short- and long-hospitalization groups. Age in the latter group was higher than that in the former, and age was significantly and positively correlated with the duration of hospitalization. Prolongation of hospitalization in patients with Japan Coma Scale (JCS) I or II is associated with psychiatric disease, and in patients with JCSIII, with physical disease. We used direct hemoperfusion (DHP) to treat patients with severe acute drug intoxication. The duration of hospitalization in patients treated by DHP tended to be shorter than those not so treated.
Conclusions: The present results suggest that aging is associated with prolongation of hospitalization and the onset of physical disease among patients with acute drug intoxication. When elderly patients with acute drug intoxication are treated in a primary-care setting, the question of whether or not physical diseases are present as complications should be considered. The appropriate use of DHP for the treatment of patients with severe acute drug intoxication requires further study.

The purpose of this study was to examine the effects of aquatic exercise training on the trunk muscles function and activities of daily living in abdominal obese women. Nineteen abdominal obese (abdominal circumference: 90 cm or more) and fifteen age-matched non-obese women were recruited as participants in this study. The aquatic exercise training (60 min/day, three days/week for 8 weeks) based on abdominal twists for activating the trunk muscle function. Physical parameters, biochemical characteristics, arteriosclerotic parameters and activities of daily living scores were assessed before and after the training period. In both groups showed abdominal circumference, percent of body fat, blood pressure and lower extremity muscle strength increased significantly after aquatic exercising training. In particular, endurance capacity of abdominal and back muscles increased significantly and activities of daily living scores were significantly improved in the obese group. Moreover, the improvement in the strength of lower extremities and improvement in the activities of daily living scores, such as climbing and descending stairs, in the obese group tended to be higher than non-obese women. Additionally, in abdominal obese group, the amount of the reduction of abdominal circumference was significantly associated with that of the increase in the strength of lower extremities. Taken together, these findings suggest the possibilities that the present aquatic exercise training based on trunk muscle exercise improving the function of trunk and lower extremity muscles with reduction in the abdominal obesity, contributing to improve activities of daily living in abdominal obese women.

Purpose : To investigate the cooling effect on muscles prior to continuous isometric muscle contraction. Furthermore, tissue compliance, pressure pain threshold, deep tissue temperature, and tissue circulation volume were measured to investigate the cooling effect on a physical reaction. Method : The biceps brachii muscle was contracted isometrically and continuously at the 90(-) degree in flexion position with 40% of maximum contraction. The task was ceased when subjects could not keep over 70 degrees of elbow flexion. An injection type cooling stimulator was used on the biceps brachii muscle as a cooling modality. Results : The continuous contraction time in the cooled group increased significantly compared with the control group. In addition, tissue compliance and pressure pain threshold showed significant differences between the two groups. Conclusion : This study suggested that the isometric continuous contraction time in cooled muscles can be extended to 40% of MVC. The inhibition of muscle metabolism, an increase in the pressure pain threshold, and tissue compliance may affect muscle endurance.

OBJECTIVESTo clarify whether di (2-ethylhexyl) phthalate (DEHP) has immunotoxic effects on both the expression of surface molecules (CD3, CD4, CD8 and CD28) on T cells of the thymus and spleen in male C57BL/6 mice.

METHODSAnimals were orally administered a 0.1% or 0.2% DEHP-containing diet for 10 or 20 days. Dietary corn oil was used as the vehicle for DEHP in preparing the diet.

RESULTSSignificant hepatic hypertrophy was clearly observed in the DEHP-exposed groups, while no atrophy was seen in the thymus or spleen in any treatment groups. In the thymus and spleen, no variation in the proportions of both T cells expressing CD3, CD4 and CD8 was shown with cytometry analysis. The surface expression of CD3, CD4, CD8 and CD28 on both T cells was also invariable in all analyzed stages of thymic differentiation and in the spleen. No effect of DEHP on mitogenesis was shown in the splenic T cells with anin vitro [(3)H]-thymidine-incorporation technique.

CONCLUSIONSDEHP is probably not an immunosuppressor, particularly for T cells.

1. 5-HT inhibits spontaneous fluid secretion as well as stimulated secretion with secretin (cAMP mediated) or ACh (Ca2+ mediated) in the isolated guinea pig pancreatic ducts. 2. The inhibitory effect of 5-HT is reversible and is dependent on the concentration in the range 0.01-0.1 microM, which is much lower than those that affect intestinal motility and secretion. 3. The 5-HT3 receptor in duct cells appears to mediate the inhibitory effect of 5-HT. 4. [Ca2+]i is unlikely to mediate the inhibitory effect of 5-HT.
5-Methoxytryptamine/pharmacology ; Acetylcholine/pharmacology ; Animal ; Calcium/metabolism ; Guinea Pigs ; Pancreatic Ducts/metabolism* ; Pancreatic Ducts/drug effects ; Secretin/pharmacology ; Serotonin/pharmacology ; Serotonin/metabolism* ; Serotonin/analogs & derivatives* ; Vasodilator Agents/pharmacology

With an increasing number of patients suffering from chronic renal failure, the question of how to prolong the period before starting hemodialysis therapy has been attracting great attention. Kremezin^® and Daio-Kanzo-To, which have been reported to produce good clinical results, were administered to two patients with chronic renal failure in the preservation phase. When the treatment started, renal function tended to deteriorate, and hemodialysis had to be introduced in both patients. We investigated possible causes of this deterioration, and the effect of the combined use of Kremezin^® and Daio-kanzo-To the renal function could not be denied. This combination therapy needs to be studied very carefully.