[Effect on duration of antibiotic therapy and drug cost by introducing critical pathway for patients with CAP in Japan].

The aim of this study was to assess whether Marrie's critical pathway is an effective approach to reduce the duration of antibiotic intravenous therapy and drug cost in patients with community-acquired pneumonia (CAP) in Japan. We conducted a retrospective cohort study in patients with CAP who were admitted to a community hospital or a university hospital. We collected clinical and economic data from medical records and medical fee receipts and estimated drug cost for switching the dosage form using Marrie's critical pathway.

Immunological evaluation of vaccination of peptides derived from epithelial cancer-related antigens in two patients with hematological malignancy.

Recent advances in tumor immunology have resulted in identification of many epithelial cancer-related antigens and peptides applicable to specific immunotherapy. We and others have reported that several epithelial cancer-related antigens are also expressed in hematological malignancies. Two patients with hematological malignancy (multiple myeloma and chronic lymphocytic leukemia) were vaccinated with peptides derived from epithelial cancer-related antigens to evaluate the immune responses to peptides under a personalized peptide vaccination regimen.

Blastoid variant of mantle cell lymphoma with lactic acidosis: a case report.

Approximately 20% of mantle cell lymphomas (MCL) present with the blastoid variant associated with poor prognosis. Lactic acidosis complicated with hematologic malignancies is seen infrequently and is associated with a poor outcome. Here we report the case of a patient with the blastoid variant of MCL complicated by lactic acidosis and who achieved complete remission through chemotherapy combined with rituximab therapy.

[Classification of pharmaceutical services from the viewpoint of patient satisfaction/dissatisfaction].

A survey was conducted to examine what the public expects of pharmacists. We created 26 questions based on 26 different situations that patients encounter at pharmacies in order to assess patient satisfaction/dissatisfaction. Some questions were designed to compare pairs of symmetrical situations.

IkB-alpha-specific transcript regulation by the C-terminal end of c-Rel.

The NF-kB family transcription factor c-Rel is a critical molecule for inducing expression of cytokine genes by T cells. Here, we report that a deletion of the C-terminal end, similar to the deletion in the highly oncogenic chicken v-Rel gene, renders c-Rel hyperactive toward cytokine gene promoters. At the same time, this mutation dramatically reduced c-Rel activity in induction of IkB-alpha mRNA expression.

[Randomized controlled study on the effectiveness of community pharmacists' advice for smoking cessation by Nicorette--evaluation at three months after initiation].

We conducted a randomized, controlled study to evaluate whether pharmacists' advice on smoking cessation would result in a higher smoking cessation rate using Nicorette (nicotine gum preparation). Fourteen pharmacies in Tokyo, Kanagawa, and Nagano participated. Smokers who visited pharmacies to buy Nicorette from March 1, 2002, through August 31, 2002, were recruited and randomly assigned to two groups.

[A systematic review of the clinical effectiveness of azathioprine in patients with ulcerative colitis].

To clarify the effectiveness and safety of azathioprine (AZA) and 6-mercaptopurine (6MP) in the induction and maintenance of remission in ulcerative colitis (UC) by using a systematic review of published studies. Studies were searched for from within the 1966 to March 2003 MEDLINE database, Cochrane Library 2003 issue 1, and the 1981 to March 2003 Japana Centra Revuo Medicina database. References from published studies and reviews were also obtained.

Comparison of cilostazol and ticlopidine for one-month effectiveness and safety after elective coronary stenting.

Purpose: To compare the oral antiplatelets, phosphodiesterase III inhibitor cilostazol and the thienopyridine ticlopidine, for one-month effectiveness and safety as an adjunctive therapy after coronary stenting.

Methods: Published studies retrieved through Medline and other databases from 1966-2002. Meta-analyses evaluated effectiveness and adverse side effects for one-month administrations of aspirin plus cilostazol or aspirin plus ticlopidine therapy after coronary stenting.

CD4(-)c-kit(-)CD3epsilon(-)IL-2Ralpha(+) Peyer's patch cells are a novel cell subset which secrete IL-5 in response to IL-2: implications for their role in IgA production.

In this study, we examined which cell population contributes to IL-5 production by Peyer's patch (PP) cells. Thy1.2(-) fraction of PP cells, but not those of splenocytes, secreted IL-5 in response to IL-2.

Costimulation via glucocorticoid-induced TNF receptor in both conventional and CD25+ regulatory CD4+ T cells.

The glucocorticoid-induced TNF receptor (GITR), which is a member of the TNF receptor family, is expressed preferentially at high levels on CD25+CD4+ regulatory T cells and plays a key role in the peripheral tolerance that is mediated by these cells. GITR is also expressed on conventional CD4+ and CD8+ T cells, and its expression is enhanced rapidly after activation. In this report we show that the GITR provides a potent costimulatory signal to both CD25+ and CD25- CD4+ T cells.

Studies on the effectiveness and safety of cilostazol, beraprost sodium, prostaglandin E1 for the treatment of intermittent claudication.

To study the effectiveness for the treatment of intermittent claudication (IC) of three drugs with antiplatelet effects, cilostazol, beraprost sodium, and prostaglandin E(1) (PGE(1)), by using a systemic review of literature and a meta-analysis. A search was undertaken for studies reported between 1966-2002 in the MEDLINE database, and references in published articles and reviews were obtained. Data for maximum walking distance (MWD), pain-free walking distance (PFWD), and adverse clinical events were extracted from the articles that met the inclusion criteria.

Establishing a comprehensive questionnaire for detecting drug-induced extrapyramidal symptoms.

Objective: Drug-induced extrapyramidal symptoms (DIEPS) often substantially compromise quality of life (QOL) of patients receiving drugs with central antidopaminergic activities. A lack of comprehensive screening method based upon patients' subjective symptoms for detecting DIEPS appears to have prevented pharmacists from delivering satisfactory pharmaceutical care for these patients. Thus, we have attempted to develop a comprehensive questionnaire for screening patients having higher risks of developing DIEPS.

CD11b+ Peyer's patch dendritic cells secrete IL-6 and induce IgA secretion from naive B cells.

Peyer's patch (PP) dendritic cells (DCs) have been shown to exhibit a distinct capacity to induce cytokine secretion from CD4(+) T cells compared with DCs in other lymphoid organs such as the spleen (SP). In this study, we investigated whether PP DCs are functionally different from DCs in the SP in their ability to induce Ab production from B cells. Compared with SP DCs, freshly isolated PP DCs induced higher levels of IgA secretion from naive B cells in DC-T cell-B cell coculture system in vitro.

B-Flow contrast US with Levovist in hepatic tumors: preliminary results.

Usefulness of Levovist contrast ultrasonography by the B-Flow method was evaluated in cases of hepatic tumor. Subjects included 14 patients with moderately differentiated hepatocellular carcinoma and 4 patients with hepatic hemangioma. Each patients had a single tumor mass.

Patient perspectives on provision of drug information services in Japan.

Today pharmacists provide indispensable drug information to patients, however, few studies have examined the kind of information that patients want, or their satisfaction with pharmacists' advice. Therefore, we have examined a variety of factors, including individual patient characteristics, in order to identify ways to provide useful and appropriate drug information on an individual basis. In short, the aim of this study was to develop a drug information service that addresses patient needs.

Prognostic significance of the F-box protein Skp2 expression in diffuse large B-cell lymphoma.

The F-box protein Skp2 positively regulates the G1-S transition by promoting degradation of the cyclin-dependent kinase inhibitor p27(kip1) (p27). Recent evidence has suggested an oncogenic role of Skp2 in not only carcinogenesis but also lymphomagenesis. In this study, we performed immunohistochemical analysis on the cell-cycle-associated proteins, Skp2, p27, and Ki-67, in 27 patients with de novo diffuse large B-cell lymphoma (DLBCL), evaluating the correlation between the clinical characteristics and expression levels of these proteins.

Decrease in expression of alpha 5 beta 1 integrin during neuronal differentiation of cortical progenitor cells.

Neuronal differentiation of embryonic neural progenitor cells is regulated by both intrinsic and extrinsic signals. Since dynamic changes in cell shape typify neuronal differentiation, cell adhesion molecules could be relevant to this process. Although it has been reported that fibronectin-integrin interactions are important for the proliferation of neural progenitor cells, little is known about the contribution of integrins to neuronal differentiation.

Metabolic effects of D-psicose in rats: studies on faecal and urinary excretion and caecal fermentation.

D-psicose (D -ribo-2-hexulose), a C-3 epimer of D-fructose, is one of the "rare sugars" present in small quantities in commercial carbohydrate complex or agricultural products. We investigated the absorption and excretion of D-psicose when orally administrated (5g/kg body weight) to Wistar rats, and the fermentation of D-psicose was measured as caecal short-chain fatty acids (SCFAs) when fed to rats in controlled diets (0, 10, 20 and 30%). Urinary and faecal excretions of D-psicose over the 24 h, following a single oral administration, were 11-15% of dosage for the former and 8-13% of dosage for the latter.

Effects of oral acute administration and subchronic feeding of several levels of D-psicose in rats.

The effects of oral acute administration and subchronic (34 d) feeding of several levels of D-psicose, a C3-epimer of D-fructose, were studied in rats. In the acute administration test, five groups of eight male Wistar rats (3 wk old) were orally given D-psicose in doses of 8, 11, 14, 17, and 20 g/kg. Three rats receiving 14 g/kg, three rats receiving 17 g/kg and eight rats receiving 20 g/kg of D-psicose died within 2 d after administration.

Potentiation of proopiomelanocortin gene expression in cultured pituitary cells by benzodiazepines.

Background: Benzodiazepines are frequently used not only as a part of general anesthesia but also for the purpose of sedation during regional anesthesia. Effects of these drugs on the hypothalamic-pituitary-adrenal axis activity have been studied, but are still controversial. It is not known whether benzodiazepines affect expression of proopiomelanocortin, precursor protein of adrenocorticotropic hormone and related peptides.

Suppressive effect of dietary raffinose on T-helper 2 cell-mediated immunity.

The effects of the dietary oligosaccharide raffinose on immune responses, with special reference to its anti-allergic functions, were examined in vivo. First, feeding a diet supplemented with 50 g raffinose/kg to BALB/c mice significantly (P<0.05) increased interleukin (IL) 12 secretion from isolated Peyer's patch (PP) cells in vitro compared with feeding control diet.

Truncation of CDK5 activator p35 induces intensive phosphorylation of Ser202/Thr205 of human tau.

Hyperphosphorylated tau is a major component of neurofibrillary tangles, one of the hallmarks of Alzheimer's disease. CDK5 is a kinase that phosphorylates the tau protein, and its endogenous activator, p35, regulates its activity. Recently, calpain was found to digest p35 to its truncated product, p25.

Risk factors for antituberculous chemotherapy-induced hepatotoxicity in Japanese pediatric patients.

Objective: Our objective was to clarify risk factors associated with the development of severe hepatotoxicity during antituberculosis chemotherapy in Japanese children.

Methods: In a retrospective analysis in a 350-bed referral children's hospital in a metropolitan area, the medical charts of all pediatric patients who received antituberculosis chemotherapy between January 1995 and November 1999 were surveyed. Univariate and multivariate analyses were performed to find any demographic parameters (ie, sex, age, height, and body weight), clinical characteristics (ie, nutritional or developmental status, co-infection with hepatitis viruses [B or C] or human immunodeficiency virus, presence of extrapulmonary tuberculosis, or medical history of liver disease), or individual antituberculosis agents used that would be associated with the likelihood of development of severe hepatotoxicity during antituberculous chemotherapy.

[Drug use evaluation of antidyslipidemic agents at a community hospital in Japan].

Objectives: In recent years, the therapeutic implications of dyslipidemias have been clarified in large-scale epidemiologic surveys, and the validity of pharmacotherapy has been established. We investigated the practical realities of pharmacotherapy for dyslipidemias at a community hospital in Japan.

Methods: Medical chart surveys were performed retrospectively on 451 dyslipidemic outpatients who visited a community hospital in Japan in July 1997.