Although the fees for the implementation of antimicrobial stewardship (AS addition) were newly established in the 2018 revision of medical fees, more detailed activities and issues of pharmacists at facilities calculating AS addition have not been clarified so far. Therefore, to understand the current status of AS activities and problems, we conducted a questionnaire survey of facilities that calculate the additional fee for infection prevention measures 1 and investigated whether there are differences in AS activities between facilities where pharmacists are full-time employees and facilities where non-pharmacists are full-time employees. The results showed that the number of antimicrobial agents used by full-time pharmacists was larger than that by non-pharmacists. In addition, the frequency of AS was lower for non-full-time workers than for full-time workers, with most full-time workers performing AS every day, while non-full-time workers performing AS two to three days a week. In addition, non-full-time workers lacked human resources and work time, and did not have sufficient work materials. The survey revealed that AS activities’ current status and problems differ between full-time and non-full-time employees.

No abstract available.
Crohn Disease* ; Food, Formulated* ; Humans ; Infliximab*

　　Nutritional support for patients who develop cancer is necessary to increase their food intake, which is often insufficient due to the adverse effects of anticancer drugs and radiation treatment. In December 2011, our center introduced Bocchiri meals for cancer patients to improve their quality of life and support ongoing treatment. In this study, we examined the efficacy of Bocchiri meals, which were developed to help increase the amount of food intake during cancer treatment. Target patients were those who could eat half or less than half of their daily required food intake, averaged over 3 days.Patients could order the meal 2 h before serving time and it was served at the temperature and amount that individual patients requested.We evaluated age, sex, main disease, use of anticancer drugs, radiation treatment, time taken to eat the Bocchiri meals, number of orders made, average energy intake before and after eating the Bocchiri meals, and rate of eating a Bocchiri Meal with a side menu order. Average energy intake was increased from 226.6±14.8 kcal with regular meals to 294.1±15.3 kcal with Bocchiri meals. Furthermore, a strong correlation was seen after the Bocchiri meals were introduced between the rate of eating Bocchiri meals with a side menu order and average energy intake. These results suggest that Bocchiri meals may be an effective supportive nutritional measure to enhance food intake among cancer patients.

Fecal microbiota transplantation (FMT) is a treatment designed to correct gut dysbiosis by administration of feces from a healthy volunteer. It is still unclear whether FMT for children with ulcerative colitis (UC) is effective or hazardous. Here we describe a young patient to have received FMT for UC. A three-year-old girl was admitted to our hospital with severe active UC, and treated with aminosalicylates and various immunosuppressive drugs. As remission was not achieved, we decided to try FMT before colectomy. We administered donor fecal material a total of six times by retention enema (×2) and via a nasoduodenal tube (×4) within 10 days. The patient developed abdominal pain and pyrexia after each FMT session. Analyses revealed the transferred donor fecal microbiota had not been retained by the patient, who ultimately underwent colectomy. The severity of the UC and/or timing of FMT may have partly accounted for the poor outcome.
Abdominal Pain ; Child* ; Colectomy ; Colitis, Ulcerative* ; Dysbiosis ; Enema ; Fecal Microbiota Transplantation* ; Feces ; Female ; Fever ; Gastrointestinal Microbiome ; Healthy Volunteers ; Humans ; Inflammatory Bowel Diseases ; Microbiota ; Tissue Donors ; Ulcer*

In cancer chemotherapy, it is very important to take into account the patient’s background. In recent years, a simple suspension method has attracted increased attention as a method that prevents changes in the stability and safety of various drugs. However, of 135 oral anticancer drugs, only 28 have been examined using this method, as of April 2013. In this study, we carefully investigated whether 53 oral anticancer drugs could be adapted to the simple suspension method, except for the 28 drugs that had already been previously reported. The results showed that most of these oral anticancer drugs could be adapted to the simple suspension method. Of seven drugs that were not adapted, six were generic drugs. In addition, it was clear that the evaluation of bicalutamide tablets was significantly different from our expected results. In conclusion, we were able to qualitatively assess all 53 oral anticancer drugs. This is equivalent to half of 107 untested drugs. These results provide useful information to cancer patients using oral anticancer drugs prepared using the simple suspension method.

Spinal cord injury after successful operation of the thoraco-abdominal aorta is an unpredictable complication which negatively affects the patient's quality of life. The main cause of spinal cord injury has been reported to be peroxidation of lipids. Edaravone, a free radical scavenger, has been used in the acute phase of cerebral infarction to ameliorate the brain damage. The aim of the present study was to evaluate the protective effect of edaravone on the neurological and histological outcome, and to examine the method of its administration so as to obtain the better effect, using animal models with ischemic spinal cord. Three groups of rabbits underwent surgical exposure of the abdominal aorta that was clamped for 20min to achieve spinal cord ischemia. Group A (n=6, control group) was given no medication. In group B (n=6), edaravone (3mg/ml saline/kg body weight) was administered intravenously 30min after reperfusion. In group C (n=6), the same dose of edaravone was administered at 30min, 24h and 48h after reperfusion. Neurological status was clinically assessed, using Tarlov's score, at 24h, 48h and 1week after reperfusion. Somatosensory evoked potential was measured preoperatively, at 20min after ischemia, at 30min after reperfusion, and at 24h, 48h and 1week after operation. Spinal cord sections were examined histologically to determine the degree of neuronal damage given by ischemic-reperfusion. Group A presented paraplegia with marked neuronal necrosis. Groups B and C maintained better neurogical function than Group A (p<0.001), and Group C was much better than Group B (p<0.05). In the model rabbits with 20min of ischemia-reperfusion, systemic repetitious administration of edaravone was found to have a more protective effect than a single administration on the spinal cord neurons and glia cells both neurologically and histologically.

The purpose of present study was to examine validity of accelerometer (Lifecorder ; LC) and to assess the free-living physical activity (PA) in Japanese elementary school students used by LC method. Firstly, to examine validity of LC, twelve children, aged 11.2±1.0 years, were measured total energy expenditure (TEE) by doubly labeled water method and resting energy expenditure (REE) by the expired gas analysis. Physical activity energy expenditure (PAEE) is calculated as 0.9 TEE minus REE. At the same time, PA was evaluated by both daily walk count (WC) and vigorous activity time (LC7-9) using LC method. PAEE per 1 kg body weight significantly correlated with WC (r=0.785, p<0.005) and LC7-9 (r=0.828, p<0.001). Secondly, 140 boys and 167 girls, aged 8-11 years were measured PA by LC method. WC and LC7-9 each were 13000-18000 counts and 16-32 minutes in week-day, and 8000-12500 counts and 8-18 minutes in week-end. PA analyzed by MANOVA were significantly higher in boys than in girls, and lower in week-end than in week-day, and decreased in proportion as grade. Present study suggests that LC method is a good measure of PA in free-living condition for elementary school students.

The purpose of this study was to examine total energy expenditure (TEE) in Japanese men under free-living conditions using various field methods, and compare these methods with the doubly labeled water method (DLW) . Ten Japanese men, aged 24.2±1.8 (mean±SD) yrs, were studied for 14 consecutive days. TEE was assessed by DLW, activity record method (AR ; using relative metabolic rate and calculated basal metabolic rate), heart rate monitoring methods (Two-line and FLEX-HR methods), and accelerometer method (AC) . Energy intake (EI) was also evaluated over the same period. Although TEE estimated by AR (2730±139 kcal⋅day^-1), Two-line (2925±433 kcal⋅day^-1), and FLEX-HR (2949±506 kcal⋅day^-1) did not differ significantly from the TEE determined by DLW (2910±524 kcal⋅day^-1), there was no significant relationship between each of these methods and DLW. In addition, El (2963±482 kcal⋅day^-1) and TEE determined by DLW were similar, and there was a significant correlation (r=0.809, P<0.01) . Compared with DLW, AC (2697±541 kcal⋅day^-1) underestimated TEE at the group level ; however, AC was the only method to show a significant correlation with DLW (r=0.871, P<0.001) . Therefore, it seems possible that AC would accurately estimate TEE at the individual level by improving both the instrument and its methodology.

Authors evaluated which factor among age, sex and season influences each Ryodoraku, and to what extent, using socalled healthy children.
METHOD
Ryodorakumeasurement was conducted on the same subjects in two different seasons. Comparison was done between groups divided according to their sex andage. The measured value of skin electro-resistance at the Ryodoraku representative measuring points and excitation-inhibition frequency were analyzed using single- and multi-variate data analysis.
RESULT
1) Each group showed slightly different Ryodoraku characteristics.
2) The differences among each group were greatest between the two seasons and rather big between years, however, small between male and female.
3) These tendencies werejobserved in both analyses using the measured values and using frequency.