Relationship between the Duration of Stay in Japan of Malaysian Subjects and the Suppression of Sweat Gland Sensitivity by lontophoretically Applied Acetylcholine

Tropical African and Thai Subjects regulate core temperature with less amount of sweat against heat compared to temperate Japanese subjects. Reduced sweating in tropical subjects was attributed to suppression of both central and peripheral sudomotor mechanisms. The objective of the study is to compare the local sweating response activated by acetycholine (ACh) applied iontophoretically among the Malaysians (n=12) of varying duration of stay in Japan. Based on their length of stay, Malaysian subjects were divided into 2 groups, MS (n=6) with a duration of stay of 3 to 15 months and ML (n=6) with 27 to 60 months. ACh, the primary transmitter for sudomotor innervation, was iontophoretically administered on the forearm. Sweating response elicited directly (DIR) and indirectly via axon reflex (AXR) were evaluated by quantitative sudomotor axon reflex test. Although the sweat onset time was tend to reduce with longer duration of stay among Malaysian subjects, there was no significant difference among the two groups. AXR (1), sweat volume elicited by axon reflex for 0-5 min was 0.96ﾂｱ0.11 mg/cm2 in MS and 1.40ﾂｱ0.23 mg/cm2 in ML. AXR(2), that for 6-11 min, was 1.09ﾂｱ0.13 mg/cm2 and 1.45ﾂｱ0.20 mg/cm2. DIR, sweat volume directly induced by ACh for 6-11 min, was 3.40ﾂｱ0.18 mg/cm2 and 3.96ﾂｱ0. 24 mg/cm2 in MS and ML , respectively. A slight positive correlation between DIR and the duration of stay in Japan was observed in Malaysian subjects, though not significant (p=0.14). From these results, suppressed neuroglandular response to ACh was confirmed in Malaysians. It is suggested that long-term heat-acclimatization acquired in tropical subjects may decay after immigration to temperate area

Evaluation of the Applicability of Infrared and Thermistor-Thermometry in Thermophysiology Research

The accuracy and reliability of temperature measuring devices in thermal physiology research and clinical practice has been subject of various investigations. Research data have been conflicting in some cases. Further investigations are therefore needed to elucidate the reliability and sensitivity of these devices under different temperature settings. The aim of this study was to evaluate the reliability and sensitivity of the tympanic thermistor (TT), infrared tympanic thermometer (ITT) and oral thermistor (OT) in the detection of body temperature changes in adults exposed to heat load. A single set of three simultaneous temperatures i.e. oral, left and right tympanic membrane were measured. At rest, core temperature (Tc) measured by TT was 0.45℃ and+0.10～-0.12℃ (changed range) higher than that measured with OT and ITT respectively. At the end of 30min 43℃ water bath leg immersion, Tc measured by TT was 0.48℃ and 0.04℃ higher than that measured with OT and ITT. This showed that when subjects were exposed to heat load, there was no difference in Tc measured by TT and ITT, although both were significantly higher than that measured with OT. From these results, it might be thought that the sensitivity for Tc detection increased in the order tympanic thermistor>infrared thermometer>oral thermistor. Further-more, in addition to the merits of infrared thermometer, the hazards and difficulties of tympanic temperature measurement were discussed from the view of development of the various kinds of thermometers

Epidemiology of Coronavirus Disease Outbreak among Crewmembers on Cruise Ship, Nagasaki City, Japan, April 2020

In April 2020, a coronavirus disease (COVID-19) outbreak occurred on the cruise ship Costa Atlantica in Nagasaki, Japan. Our outbreak investigation included 623 multinational crewmembers onboard on April 20. Median age was 31 years; 84% were men. Each crewmember was isolated or quarantined in a single room inside the ship, and monitoring of health status was supported by a remote health monitoring system. Crewmembers with more severe illness were hospitalized. The investigation found that the outbreak started in late March and peaked in late April, resulting in 149 laboratory-confirmed and 107 probable cases of infection with severe acute respiratory syndrome coronavirus 2. Six case-patients were hospitalized for COVID-19 pneumonia, including 1 in severe condition and 2 who required oxygen administration, but no deaths occurred. Although the virus can spread rapidly on a cruise ship, we describe how prompt isolation and quarantine combined with a sensitive syndromic surveillance system can control a COVID-19 outbreak

Safety and Effectiveness of Lenvatinib in Patients with Unresectable Hepatocellular Carcinoma in Real-World Clinical Practice: An Observational Post-Marketing Study in Japan

Abstract Background Lenvatinib was approved for use in unresectable hepatocellular carcinoma (uHCC) in Japan in 2018. Patients with diverse clinical characteristics receive lenvatinib treatment in clinical practice. Thus, it is crucial to evaluate the safety and effectiveness of lenvatinib in real-world clinical settings. Objective This study aimed to evaluate the real-world safety and effectiveness of lenvatinib for uHCC in clinical practice in Japan. Patients and Methods Between July 2018 and January 2019, patients with uHCC who were administered lenvatinib for the first time were enrolled in this prospective, multicenter, observational post-marketing study (NCT03663114). Patients were orally administered lenvatinib and followed up for 12 months. For safety, adverse drug reactions (ADRs) were evaluated. For effectiveness, the objective response rate (ORR) was calculated to evaluate tumor response. Overall survival (OS) was estimated using the Kaplan–Meier method. Results Data of 703 patients (median age, 73 years; 80.2% males) were analyzed. The median (range) treatment duration was 25.3 (0.3–68.9) weeks. The mean ± standard deviation initial dose was 7.37 ± 1.65 mg in patients with body weight  10%) were decreased appetite, fatigue, hypertension, proteinuria, palmar-plantar erythrodysesthesia, hypothyroidism, and diarrhea. The median OS of the 703 patients was 498.0 days. In 494 patients assessed using the modified Response Evaluation Criteria in Solid Tumors (mRECIST), the ORR was 39.5% (95% confidence interval: 35.1–43.9%). Patients with better liver or renal function at baseline achieved significantly higher ORR than those with worse liver or renal function. Conclusions In patients with uHCC in real-world clinical practice in Japan, treatment with lenvatinib was generally well tolerated, and no new safety concerns were identified. The ORR and median OS were similar to or better than the results of the Japanese subset of the global Phase III REFLECT trial. Our results demonstrated that clinically meaningful treatment responses were achieved with lenvatinib in real-world clinical practice