This retrospective case series enrolled 13 patients who underwent posterior fixation with both transdiscal screws for diffuse idiopathic skeletal hyperostosis (TSDs) and pedicle screws (PSs) to treat spinal injury accompanied by diffuse idiopathic skeletal hyperostosis (DISH).

This retrospective case series enrolled 13 patients who underwent posterior fixation with both transdiscal screws for diffuse idiopathic skeletal hyperostosis (TSDs) and pedicle screws (PSs) to treat spinal injury accompanied by diffuse idiopathic skeletal hyperostosis (DISH).

Objectives: First steps to promote the proper use of medicines in remote islands and rural areas are as follows: (1) recognition of the profession of “pharmacist” from secondary-remote-island residents who do not have a pharmacy or drugstore or the opportunity for pharmacist contact and (2) an understanding by remote-island residents of the advantages of having a “family pharmacist.”
Methods: Repeated “medicine information and consultation sessions” for secondary-remote-island residents of Japan’s Nagasaki Prefecture were held.  Residents were then surveyed for changes in awareness of or demand for pharmacists and the nature of such changes.
Results: Before the information sessions, 29.7% of residents did not recognize the profession of pharmacy, but the extent of their recognition increased after information sessions were concluded.  They were asked “Who explains medicines in a way that is easy to understand ?”; more than half responded “doctors” before the information session, but after information sessions were concluded, those who said “pharmacists” increased.
Conclusion: Conducting “medicine information and consultation sessions” for residents of secondary-remote islands and rural areas enabled them to understand the profession of pharmacy.  The initiatives in the present study are first steps toward promoting proper use of medicines by residents of remote islands and rural areas who use “family pharmacies/pharmacists.”

This is a rare case report of systemic allergic reaction to fish allergen ingested through breast milk. Mother ate raw fish more than 3 times a week. Her consumption of fish was associated with urticaria and wheeze in an infant via breast-feeding. Fish-specific IgE antibodies were detected by skin prick test but not by in vitro IgE test. This case demonstrates that fish protein ingested by mother can cause an immediate systemic allergic reaction in offspring through breast-feeding. Although fish intake is generally recommended for prevention of allergy, one should be aware that frequent intake of fish by a lactating mother may sensitize the baby and induce an allergic reaction through breast-feeding.
Allergens ; Antibodies ; Breast ; Fishes ; Humans ; Hypersensitivity ; Immunoglobulin E ; In Vitro Techniques ; Infant ; Milk, Human ; Mothers ; Skin ; Urticaria

PURPOSE: Few reports have been made on the therapeutic effects as well as pathological features of an antithrombin preparation in patients diagnosed with septic disseminated intravascular coagulation (DIC) by the diagnostic criteria for acute DIC. MATERIALS AND METHODS: A total of 88 sepsis patients who had received inpatient hospital care during the period from January 2000 through December 2008 were divided into two groups, an antithrombin group and a non-antithrombin group, to study the outcomes. Furthermore, the relationship between sepsis-related factors and DIC in 44 patients was studied. RESULTS: The antithrombin group contained 34 patients, and the non-antithrombin group contained 54 patients. The outcomes were significantly better in the antithrombin group. The levels of protein C were low in DIC patients. CONCLUSION: Our results suggest that early administration of antithrombin might improve outcomes of septic DIC patients in the diagnostic criteria for Japanese Association for Acute Medicine acute DIC.
Aged ; Disseminated Intravascular Coagulation/complications/diagnosis/*drug therapy ; Female ; Fibrinolytic Agents/*therapeutic use ; Humans ; Male ; Middle Aged ; Sepsis/complications/diagnosis/*drug therapy ; Time Factors ; Treatment Outcome

We report a case of rheumatoid arthritis (RA) that showed improvement after treatment with Daiseiryu-to-kadaiou. The patient was a 77-year-old woman diagnosed with RA in 1988. She had been visiting our department regularly since 1994. Oral steroids were used for two weeks in May 1994, but were discontinued due to a bacterial infection of the artificial femoral head. Thereafter, treatment was continued with bucillamine, nonsteroidal anti-inflammatory drugs, and various Kampo medicines. Joint pain worsened in November 2001. She was hospitalized on **********, as the CRP level had elevated to 15.2mg/dl. She had been taking bucillamine for seven years, but it had already been assessed as ineffective. It was discontinued upon hospitalization, and treatment with Daiseiryu-to-kadaiou was immediately begun. By ******, the patient judged the pain in both knees to have improved by about 50 percent. Moreover, the CRP level decreased to 2.4mg/dl by *******. The Lansbury index also improved from 100 percent to 69 percent during her hospitalization, and she was discharged on *******. Based on this experience, it is suggested that the prescription of Daiseiryu-to-kadaiou be considered in the treatment of RA patients.

Pulmonary rehabilitation is a common therapy for improving both exercise tolerance and quality of life (QoL) in patients with chronic obstructive pulmonary disease (COPD) . Although exercise is an important rehabilitation strategy, walking, treadmill use, bicycling and respiratory muscle training can be monotonous. A comprehensive exercise program that includes recreational activities may be a more effective means to decrease the occurrence of dyspnea during daily activities and improve QoL in patients with COPD. The purpose of this study was to investigate the effects of our exercise therapy, including recreational activities and respiratory muscle training, on dyspnea and health related QoL (HRQL) in COPD patients. Thirty-eight male patients with COPD were randomly assigned to a control (C) (70.1±6.4yr) (n=12) . pulmonary rehabilitation (PR) (70.3±8.3yr) (n= 16), or exercise (EX) (68.7±4.6yr) (n=10) group. The following evaluations were performed at baseline and at 8 weeks: (1) cycle ergometer test ; (2) 6-min walking distance : (3) physical fitness (4) pulmonary function ; (5) dyspnea : and (6) HRQoL (SF-36) . The C group showed no significant changes in physical fitness, pulmonary function, dyspnea, and HRQoL scores throughout the observation period. There was a significant (P<0.05) improvement in 6-min walking distance. physical fit-ness, maximum rnspiratory pressure (MIP), and HRQoL for the PR group. The EX group demons-trated a significant (P<0.05) improvement in physical fitness, maximum expiratory pressure (MEP), dyspnea, and HRQoL. Moreover, the degree of improvement in each variable was greater for EX than for PR. There were significant (P<0.05) correlations between MIP and FEV_1.0 (r=0.65), and between MEP and FEV_1.0 (r=0.43) . Based on these results, it appears that our comprehensive exercise program, including recreational activities and respiratory muscle training, improves physical fitness, pulmonary function, dyspnea, and quality of life in COPD patients.

The purpose of this study was to examine the validity of physical performance tests (test battery) for assessing functional fitness required for activities of daily life in older persons with chronic disease. This test battery consisted of 4 items: arm curl, walking around two cones, moving beans with chopsticks, and functional reach. Seventy-one persons (aged 66.7±7.8 yr) with either hemiplegia, Parkinson's disease (PD), or chronic obstructive pulmonary disease (COPD) served as subjects. There were significant differences among standard test scores in each rate of progression of the disease in all hemiplegia groups (Stages III, IV, V), and COPD groups (Stages 1, 2, 3) (Kruskal-Wallis'H=22.3 and 7.3, respectively) . In PD groups, there was no significant difference between standard scores in Stages II and III (Mann-Whitney's U=4.0) . However, the rank order correlation coefficient between the ranking in standard test score and the ranking in physical independence assessed by a medical doctor and a public health nurse was significant (ρ=0.57, P<0.05) . All tests were safely applied for all subjects. These results suggest that our test battery may be applicable to a majority of older persons with various chronic diseases. Furthermore, the variability of standard test scores was greater than the clinical subjective ratings by Stage, which suggests that such a classification may provide a better description of disease progress/functional fitness.

A 7-year-old boy suffered from isolated interruption of the aortic arch without any other complications or cardiovascular malformations. Cardiac murmur, which had been apparent since one month of age, had been left untreated because of the absence of any symptoms of heart failure. Isolated interruption of the aortic arch was noted during a routine physical examination at school and the patient was referred to our hospital for a complete medical evaluation. Blood-pressure difference was recognized not only between the right side and the left side of the upper extremities but also between the upper and lower extremities. On the basis of the results obtained via magnetic resonance angiography (MRA) and aortography, a definitive diagnosis of isolated interruption of the aortic arch was made. Reconstruction of the aortic arch by synthetic implant was indicated. The blood-pressure difference disappeared and the postoperative course was satisfactory.