Patterns of Drug Prescription for Japanese Cedar Pollinosis Using a Clinical Vignette Questionnaire

ABSTRACTBackgroundAlthough prescribed drugs directly affect patient outcome, the variation in physicians' attitudes towards drug therapy for cedar pollinosis has not been quantitatively assessed. This research investigated the prescription patterns of drugs for cedar pollinosis by ear, nose, and throat specialists (ENTs), general physicians (GPs) and internal medicine doctors (IMs) in Yamanashi Prefecture, Japan.MethodsA cross-sectional study was conducted by mailing questionnaires to 532 physicians in autumn 2006. The main part of the questionnaire constituted clinical vignettes of pollinosis cases with nasal and ocular symptoms ranging from mild to severe. We requested that the physicians fill out prescription medications they considered appropriate for each vignette.ResultsResponses from 172 physicians (32%) for six clinical vignettes were analyzed. The number of drugs prescribed by ENTs was significantly higher than that by GPs and IMs for vignettes representing moderate to severe cases (p < 0.004). The percentage of physicians who said they would prescribe nasal corticosteroid and eye drops was higher in the ENT group compared to the other two groups in these vignettes. In terms of second-generation antihistamines, no differences were observed between the three groups for all vignettes.ConclusionsOur investigation suggested that, compared to ENTs, GPs and IMs have a lower tendency to concomitantly prescribe drugs for localized treatment such as nasal corticosteroids and eye drops with oral medication. There may be differences in prescription patterns of drugs for pollinosis between ENTs and non-specialist physicians

Nasopharyngeal carcinoma presenting with rapidly progressive severe visual disturbance: a case report

INTRODUCTION: Nasopharyngeal carcinoma is one of the most difficult tumors to diagnose correctly at the initial phase because of the occasional lack of nasal symptoms. The perineural spread of the trigeminal nerve is one of the most common and important routes in the intracranial paracavernous extension of nasopharyngeal carcinoma, but visual loss is very rare. CASE PRESENTATION: We report the case of a 54-year-old Japanese man with nasopharyngeal carcinoma, who presented with rapid and severe disturbance of left monocular visual acuity and eye movement with a 10-month history of ipsilateral otitis media and facial pain. Magnetic resonance imaging revealed a lesion in the left fossa of Rosenmüller, pterygopalatine fossa, sphenoid and ethmoid sinus, and the left cavernous sinus extending to the orbital apex through the superior orbital fissure. The histopathological diagnosis was nonkeratinizing undifferentiated nasopharyngeal carcinoma. Epstein–Barr virus was detected by in situ hybridization. Although focal radiotherapy induced remarkable tumor shrinkage and relieved ocular motor disturbance and facial pain, his visual acuity did not improve. CONCLUSION: The awareness of cranial nerves in addition to intracranial and orbital apex involvement, as in this case, is important for appropriate diagnosis and treatment planning of nasopharyngeal carcinoma

Simple Algorithm for Factorized Dynamics of g_n-Automaton

We present an elementary algorithm for the dynamics of recently introduced soliton cellular automata associated with quantum affine algebra U_q(g_n) at q=0. For g_n = A^{(1)}_n, the rule reproduces the ball-moving algorithm in Takahashi-Satsuma's box-ball system. For non-exceptional g_n other than A^{(1)}_n, it is described as a motion of particles and anti-particles which undergo pair-annihilation and creation through a neutral bound state. The algorithm is formulated without using representation theory nor crystal basis theory.Comment: LaTex2e 9 pages, no figure. For proceedings of SIDE IV conferenc

Soliton Cellular Automata Associated With Crystal Bases

We introduce a class of cellular automata associated with crystals of irreducible finite dimensional representations of quantum affine algebras U'_q(\hat{\geh}_n). They have solitons labeled by crystals of the smaller algebra U'_q(\hat{\geh}_{n-1}). We prove stable propagation of one soliton for \hat{\geh}_n = A^{(2)}_{2n-1}, A^{(2)}_{2n}, B^{(1)}_n, C^{(1)}_n, D^{(1)}_n and D^{(2)}_{n+1}. For \gh_n = C^{(1)}_n, we also prove that the scattering matrices of two solitons coincide with the combinatorial R matrices of U'_q(C^{(1)}_{n-1})-crystals.Comment: 29 pages, 1 figure, LaTeX2

Development of a Si/CdTe semiconductor Compton telescope

We are developing a Compton telescope based on high resolution Si and CdTe imaging devices in order to obtain a high sensitivity astrophysical observation in sub-MeV gamma-ray region. In this paper, recent results from the prototype Si/CdTe semiconductor Compton telescope are reported. The Compton telescope consists of a double-sided Si strip detector (DSSD) and CdTe pixel detectors, combined with low noise analog LSI, VA32TA. With this detector, we obtained Compton reconstructed images and spectra from line gamma-rays ranging from 81 keV up to 356 keV. The energy resolution is 3.8 keV and 7.9 keV at 122 keV and 356 keV, respectively, and the angular resolution is 9.9 degrees and 5.7 degrees at 122 keV and 356 keV, respectively.Comment: 12 pages, 14 figures, submitted to SPIE conference proceedings vol. 5501, "High-Energy Detectors in Astronomy", Glasgow UK, 6/21-6/24 200

Effectiveness of Domain-Based Intervention for Language Development in Japanese Hearing-Impaired Children: A Multicenter Study

Objective: Decreasing language delay in hearing-impaired children is a key issue in the maintenance of their quality of life. Language training has been presented mainly by experience-based training; effective intervention programs are crucially important for their future. The aim of this study was to confirm the efficacy of 6-month domain-based language training of school-age, severe-to-profound hearing-impaired children. Methods: We conducted a controlled before-after study involving 728 severe-to-profound prelingual hearing-impaired children, including an intervention group (n = 60), control group (n = 30), and baseline study group (n = 638). Language scores of the participants and questionnaires to the caregivers/therapists were compared before and after the intervention. Average monthly increase in each language score of the control group and baseline study group were compared with those of the intervention group. Results: Language scores and the results of the questionnaire of the intervention group showed a significant improvement (P < .05). The average monthly language growth of the intervention group was twice that of the control group and 3 to 4 times that of the baseline study group (P < .05). The effect size was largest in communication (1.914), followed by syntax (0.931). Conclusion: Domain-based language training improved the language development and daily communication of hearing-impaired children without any adverse effects