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2009 Volume 58 Issue 11 Pages
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2009 Volume 58 Issue 11 Pages
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Article type: Appendix
2009 Volume 58 Issue 11 Pages
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Kazuhiko Takeuchi
Article type: Article
2009 Volume 58 Issue 11 Pages
1467-1474
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Eiichi Uchio
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2009 Volume 58 Issue 11 Pages
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Article type: Appendix
2009 Volume 58 Issue 11 Pages
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Yuichi Kurono
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2009 Volume 58 Issue 11 Pages
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Setsuko Ito
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2009 Volume 58 Issue 11 Pages
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Ken Ohta
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2009 Volume 58 Issue 11 Pages
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Hidenori Ohnishi, Zenichiro Kato, Takahide Teramoto, Michinori Funato, ...
Article type: Article
2009 Volume 58 Issue 11 Pages
1502-1512
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Koa Hosoki, Mizuho Nagao, Yukiko Hiraguchi, Reiko Tokuda, Takao Fujisa ...
Article type: Article
2009 Volume 58 Issue 11 Pages
1513-1520
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Respiratory syncytial virus (RSV) infections in infancy have been related to the subsequent recurrent wheezing and asthma. However, there are a few reports about the relationship between RSV infection and subsequent wheezing in Japan. We sought to determine the contributing factors for wheezing illness after RSV infection in 99 Japanese patients with RSV-associated hospitalizations by questionnaire and follow up survey. Fifty eight patients, who were aged three years old or younger on admission and could be followed up more than one year, were analyzed. The mean duration from discharge to last survey were 703.6±105.5 days (432〜950 days), the mean age on admission were 9.4±8.8 months (0〜30 months). Wheezing episodes after discharge were reported in 29 of the subjects (50.0%). Univariable and multivariable analysis identified that the subsequent wheezing after RSV infection were related with the history of wheezing before admission and attending a daycare. The patient's age on admission, the patient's atopic profile, history of continuous nocturnal cough before admission, gestational ages, birth weight, length of hospital stay, perinatal abnormality, environmental tobacco smoke, parental history of allergy and asthma, presence of sibling and sibling history of allergy and asthma were not associated with subsequent wheezing. These results suggest that some host factors susceptible to wheezing and chance of infection due to attending a daycare may be related to recurrent wheezing possibly onset of bronchial asthma, after RSV infection.
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Sakiko Fukuda, Takeshi Yoshinaga, Naomi Hirata, Yoichi Ishitsuka, Mits ...
Article type: Article
2009 Volume 58 Issue 11 Pages
1521-1529
Published: November 30, 2009
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Background: Many types of inhaled medications are used for the treatment of asthma; however, inadequate inhalation techniques and poor adherence cause exacerbations of asthma symptoms. It is necessary to therefore provide adequate instruction to acquire correct inhalation techniques. This study aimed to evaluate the usefulness of individualized inhalation instruction in asthmatic outpatients by a community pharmacist for an improvement of the inhalation techniques and asthma control. Methods: Twenty-eight asthmatic outpatients who have developed asthma over a long period and received prescriptions from Kumamoto Chuo Hospital from April to August 2008 were instructed by a pharmacist on inhalation techniques at Shimokawa Hamasen Pharmacy. Individual instruction by the pharmacist consisted of a skill-check with inhalers, followed by the use of a checklist of inhalation technique, a self-evaluation checklist, and visual information for the patients. Outcomes were evaluated based on changes in inhalation technique mastery between their first visit and the subsequent visit. Nineteen of the 28 patients who completed the Asthma Control Test (ACT) were also evaluated for asthma control according to changes in their ACT scores. Results: Twenty patients showed inadequate inhalation techniques. The individualized instruction resulted in significant improvement in the inhalation techniques. Moreover, there were significant improvement in the ACT scores (from 19.1 to 21.4) of 19 patients who received the individualized instruction. Conclusion: The individualized instruction to the asthmatic outpatients enables them to improve the inhalation techniques to mend their asthmatic symptoms. We suggest that coordination with hospital and community pharmacy improves therapeutic outcomes in inhaled medication for the asthmatic outpatients.
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Kashin Kobayashi, Takahiko Horiguchi, Naoaki Ban, Kazunobu Kuwabara, H ...
Article type: Article
2009 Volume 58 Issue 11 Pages
1530-1535
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The patient was a 62-year-old female. In June 1999, thiamazole (MMI) was orally administered under a diagnosis of hyperthyroidism. However, drug exanthema developed. In July, oral administration of propylthiouracil (PTU) was started. On October 20, 2005, palpitation and exertional dyspnea occurred. On November 1, bloody sputum was noted, and the patient consulted our hospital on November 8. In addition to severe anemia, chest X-ray and CT revealed diffuse infiltration in the bilateral lungs. The patient was admitted for detailed examination and treatment. After admission, the myeloperoxidase (MPO)-anti-neutrophil cytoplasmic antibody (ANCA) level was 390 EU, suggesting ANCA-associated angitis. PTU was discontinued, and steroid pulse therapy resulted in the disappearance of alveolar hemorrhage and hematuria. Transbronchial lung biopsy suggested alveolar hemorrhage, and kidney biopsy showed glomerular necrosis and interstitial infiltration of inflammatory cells, suggesting PTU-induced ANCA-associated angitis. Posttreatment with prednisolone at 30mg/day gradually decreased the MPO-ANCA level. There has been no relapse during the 2-years follow-up.
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Katsutoshi Ando, Yoshihiro Ohkuni, Masafumi Misawa, Daisaku Yasui, Nob ...
Article type: Article
2009 Volume 58 Issue 11 Pages
1536-1543
Published: November 30, 2009
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A 64-year old hospitalized male for severe bronchial asthma began to complain fatigue and appetite loss. His asthma had been treated with oral bethamethasone. The Chest CT at this time revealed a bilateral consolidation of the lower lung. Despite a week of treatment with antibiotics and antifungals, the patient expired from DIC progression. His premortem sputum and blood culture grew Cryptococcus Neoformans. We concluded his diagnosis as cryptococcal pneumonia and sepsis. Sepsis by Cryptococcus Neoformans is a rare clinical event, and only 20 cases have been reported in Japan. Although 16 of the 20 had preexisting medical conditions, a case with underlying bronchial asthma has never been reported. A comparison of the reported cases of the US and Europe to that of Japan revealed differences in the patients' underlying conditions. We report a case with a brief review of the literature and summarize the 20 cases that have been reported in Japan.
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Taichiro Muto, Masanori Takeda, Mihoko Ohshima, Masaki Futamura, Komei ...
Article type: Article
2009 Volume 58 Issue 11 Pages
1544-1547
Published: November 30, 2009
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Background: A kit, FASTKIT ELISA version II (Egg) (Nippon Meat Packers) is an enzyme-linked immunosorbent assay kit for detecting hen's egg proteins in foodstuffs. This kit is an enhanced version of FASTKIT ELISA (Egg) with a greater efficiency in terms of extraction of egg proteins from heated foodstuffs. However, the property of this kit remains to be fully elucidated. Methods: Using this new kit, we measured the amount of egg proteins in unheated or heated (140℃ or 180℃, 20min) homemade cookies containing whole egg, egg white or egg yolk. Results: The capability for detection of unheated or heated (140℃ or 180℃) whole egg proteins was similar. In addition, there was no significant difference in the detectability between heated (140℃) whole egg and egg white proteins. However, unheated or heated (140℃ or 180℃) egg yolk proteins were not sufficiently measured by this kit. Conclusion: Our data suggest that this new kit is significantly improved for detection of heated egg white proteins as compared to that of old version, but not sufficient for detection of egg yolk proteins.
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Article type: Appendix
2009 Volume 58 Issue 11 Pages
1548-1549
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Article type: Cover
2009 Volume 58 Issue 11 Pages
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