Background We have studied the rate of emergence of anitibiotic-resistant Streptococcus pneumoniae (S. pneumoniae) and Haemophilus influenzae (H. influenzae) and the subsequent antibiotic use in host patients of those isolates at the Department of Pediatrics, Soma General Hospital, Fukushima. Moreover, we carried out several studies investigating the risks and benefits of antibiotic-free treatment for children with respiratory infections. In this report, we summarize our research and suggest better treatment options for pediatric patients with respiratory infections. Methods We investigated the necessity of antibiotic use in the treatment of pediatric inpatients with respiratory syncytial virus (RSV) infection, and tested our hypothesis that antibiotic-free treatment for common cold will reduce the number of resistant S. pneumoniae strains in the pediatric nasopharynx. Therefore, we restricted prescribing antibiotics for pediatric patients with respiratory infections. The rates of resistant S. pneumoniae and H. influenzae and the medication history of the host patients before and after the intervention were compared. Results We found that most of the RSV-infected patients recovered without antibiotic treatment, and that the antibiotic-free treatment inhibited the emergence of antibiotic-resistant strains. The rate of penicillin-resistant S. pneumoniae decreased but the rate of ampicillin-resistant H. influenzae did not change significantly during the study. Conclusion We concluded that patients with respiratory infections can be treated without antibiotics, under careful examination and observation. Continued monitoring of such new interventions as well as recommending their use to other caregivers and physicians will help inhibit the spread of resistant strains.
Symptomatic induction of disc herniation involves both mechanical compression and chemical factors. Inhibitors of tumor necrosis factor-alpha (TNF-α) are known to reduce pain-related behavior in experimental models. Animals were divided into mechanical compression (MC) group; a stainless steel rod was inserted on the dorsal root ganglion, nucleus pulposus (NP) group: NP was harvested from the coccygeal vertebral disc, MC and NP group; rats were received stainless rod and NP, and sham group; rats were received neither rod nor NP. Rats in the MC group received a TNF-α antibody (10 mg/kg) (antibody group) or were not treatment (untreated group). The withdrawal thresholds of the MC, NP and MC+NP groups decreased significantly compared with the sham group. In the antibody group, the threshold was significantly higher than that of the untreated group. An anti-TNF-α antibody reduced allodynia caused by DRG compression.
Objective: To explore the effect of additional administration of tacrolimus to rheumatoid arthritis patients treated with biologics, in whom the effect of biologics is unsatisfactory. Methods: Tacrolimus was administered if the effect of biologics was unsatisfactory for 24 weeks at least in terms of laboratory data or DAS28 level: ESR, CRP level and DAS28 level were not below 15 mm/h, 0.2 mg/dl or 2.6, respectively. Results: Tacrolimus administered in addition to biologics was significantly effective for suppressing the activity of rheumatoid arthritis in our study. The significant effect of tacrolimus appeared at the 4th week. The effect of tacrolimus achieved quite significant level at the 54th week (p< 0.0001). Conclusion: Tacrolimus may be a promising candidate to suppress the disease activity of rheumatoid arthritis refractory to the conventional treatment with biologics.
We investigated whether peppermint oil (PO) is useful for endoscopic diagnosis of gastric tumors without magnifying endoscopy. Twenty-six patients diagnosed with gastric tumors were examined. Endoscopic images were recorded by white light (WL) and narrow band imaging (NBI) without magnifying endoscopy. After PO administration, images were recorded again by WL and NBI (PO+WL and PO+NBI). The clarity of tumor margins and the effect of PO on the clarity of tumor margins were scored. The mean scores for clarity of tumor margins were 3.6 points in WL, 4 in NBI, 4.3 in PO+WL, and 4.3 in PO+NBI. The scores of WL and NBI showed a tendency to rise by PO. The mean scores for the effect of PO on the clarity of tumor margins were 2.7 in WL and 2.5 in NBI. Therefore, we conclude that PO is useful for endoscopic diagnosis of the margin of gastric tumors.
Two patients who underwent thoracic epidural neurolysis after titration using local anesthetic are reported. Case 1 suffered serious back and epigastric pain arising from metastasis of lung cancer and Case 2 was not relieved right chest pain by costal metastasis from urethral cancer only by morphine. Block therapies improve the patients' quality of life if these underwent in opioid resistant pain or moving pain. Among them subarachnoid neurolytic blockage or epidural continuous blockage are usually selected in terminal stage. Subarachnoid blockage is potent but usually induces paresthesia and hypesthesia and patient has to keep lateral position under affected site intraoperatively. Epidural block is easy to treat but is difficult to continue because of infection and decrement of efficacy attributed adhesion of epidural space, stress arose from immobilization. We operate epidural neurolytic blockage for these patients and they were relieves from pain without suffer from the side effect.
An earthquake, Tohoku region Pacific Coast earthquake, occurred on the 11th of March, 2011, and subsequent Fukushima nuclear power plant accidents have been stirring natural radiation around the author's office in Fukushima Medical University (FMU). FMU is located in Fukushima city, and is 57 km (35 miles) away from northwest of the Fukushima Daiichi nuclear power plant. This paper presents three types of radiation survey undertaken through the unprecedented accidents at the campus and the hospital of FMU. First, a group of interested people immediately began radiation surveillance; the group members were assembled from the faculty members of “ Life Sciences and Social Medicine” and “ Human and Natural Sciences.” Second, the present author, regardless of the earthquake, had serially observed natural radiations such as gamma radiation in air with NaI scintillation counter, atmospheric radon with Lucas cell, and second cosmic rays with NaI scintillation. Gamma radiation indicated most drastic change, i.e., peak value (9.3 times usual level) appeared on March 16, and decreased to 1.7 times usual level after two months. A nonlinear least squares regression to this decreasing data gave short half-life of 3.6 days and long half-life of 181 days. These two apparent half-lives are attributed to two groups of radioisotopes, i.e., short half-life one of I-131 and long half-life ones of Cs-134, Cs-137 and Sr-90. Also, atmospheric radon concentration became high since a stop of ventilation, while second cosmic rays did not show any response. Third, late April, 2011, a team of radiation dosimetry under the direct control of Dean, School of Medicine, was established for the continuation of radiation survey in the campus and the hospital of Fukushima Medical University.
The Great East Japan Earthquake on March 11th, 2011, severely damaged the Fukushima Daiichi Nuclear Power Plant resulting in the diffusion of many radioactive substances throughout Fukushima prefecture. To examine these substances, we have carried out investigations for several months since immediately after the accident. We revealed that environmental high-level radiation spread northwesterly from the nuclear plant and several areas in Nakadori, the region located in the central part of the prefecture between Hamadori (east part of the prefecture) and Aizu-chihou (west part), was contaminated with mid-level radiation. We also analyzed radionuclides in soil and estimated future radiation levels. The importance of topsoil removal for decontamination has become an obvious countermeasure since many radioactive substances have settled on the surface. In addition, we investigated residential areas and their surroundings to find where high-level doses were likely to be detected for lowering the risk of exposure among residents. When little information was available, the investigations were implemented and the results contributed to both administrative policies and civil life.
The Chernobyl disaster on April 26th, 1986, led to the emission of radioactive substances such as iodine-131 and radioactive cesium. As the Soviet Union did not control food distribution and intake, residents were exposed to high levels of internal radiation, leading to the internal radiation exposure of the thyroid gland by iodine 131. As a result, the number of people who had thyroid cancer increased drastically among those who had been under 15 years old at the time of the accident. The age predilection is about to move to 25 or older. However, there has been no scientific evidence of impacts for solid tumor other than thyroid cancer, leukemia, benign diseases, or inheritance including unborn babies. On the other hand, the accident was thought to have caused social unrest and mental damage which had far more impact than that caused by radiation exposure. In this paper, we would like to summarize the impacts on the health of the people in Chernobyl compared to those caused by the accident at the Fukushima Daiichi Nuclear Power Plant.
A magnitude 9.0 earthquake and tsunami originating off the east coast of Japan triggered the explosive release of radioactive isotopes from one of four nuclear power plants in the affected area. This event has been compared with the 1986 nuclear accident at Chernobyl, the 1945 atomic bombing of Hiroshima and Nagasaki, and the intervening era of atmospheric nuclear weapons testing. The credibility of any comparison depends on the source, for which reason various specialists were invited to address an audience of media, healthcare, and disaster response professionals on July 18, 2011 in Fukushima City, Fukushima Prefecture. This article is based on a presentation given July 18, and interprets the Fukushima nuclear crisis from the perspective of an American doctor who grew up downwind of an atomic bomb test site, and who now works at Fukushima Medical University.
When evaluating cancer risk of low-dose radiation, it is difficult to distinguish the actual effect from that of chance, bias, and confounding as they become relatively large. This is why the relation between radiation doses of less than 100 mSv and cancer risk is considered unknown. Based on data of atomic bomb survivors in Hiroshima and Nagasaki, the cancer risk at 100 mSv is calculated at 1.05 times. On the other hand, the risk ratio for the relation between passive smoking and lung cancer is estimated at approximately 1.3 and judging the actual effects faced difficulties. It is almost impossible for epidemiology research alone to show that the risk ratio of 1.05 is the actual effects of radiation. The ICRP estimation, “ exposure to 100 mSv increases cancer risk by 0.5%” , has been frequently cited, however, it is not a simple excess lifetime risk of death. It will be more appropriate to indicate a value with clear definition to people in general, such as excess lifetime risk of death or excess lifetime risk of morbidity rather than the value obtained from such complicated process. Radiation epidemiology equally uses ratio and difference to indicate degrees of risk increase. Difference largely changes depending on effects of background factors whereas ratio is often relatively stable. Therefore the use of ratio would be more appropriate when comparing other cancer risk factors.