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Objectives: : Although numerous risk prediction models have been proposed, few such models have been developed using neural network-based survival analysis. We developed risk prediction models for three cardiovascular disease risk factors (diabetes mellitus, hypertension, and dyslipidemia) among a working-age population in Japan using DeepSurv, a deep feed-forward neural network., Methods: : Data were obtained from the Japan Epidemiology Collaboration on Occupational Health Study. A total of 51 258, 44 197, and 31 452 individuals were included in the development of risk models for diabetes mellitus, hypertension, and dyslipidemia, respectively; two-thirds of whom were used to develop prediction models, and the rest were used to validate the models. We compared the performances of DeepSurv-based models with those of prediction models based on the Cox proportional hazards model., Results: : The area under the receiver-operating characteristic curve was 0.878 [95% confidence interval (CI) = 0.864-0.892] for diabetes mellitus, 0.835 (95% CI = 0.826-0.845) for hypertension, and 0.826 (95% CI = 0.817-0.835) for dyslipidemia. Compared with the Cox proportional hazards-based models, the DeepSurv-based models had better reclassification performance [diabetes mellitus: net reclassification improvement (NRI) = 0.474, P  ≤ 0.001; hypertension: NRI = 0.194, P  ≤ 0.001; dyslipidemia: NRI = 0.397, P  ≤ 0.001] and discrimination performance [diabetes mellitus: integrated discrimination improvement (IDI) = 0.013, P  ≤ 0.001; hypertension: IDI = 0.007, P  ≤ 0.001; and dyslipidemia: IDI = 0.043, P  ≤ 0.001]., Conclusion: : This study suggests that DeepSurv has the potential to improve the performance of risk prediction models for cardiovascular disease risk factors., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

The liverwort Marchantia polymorpha has been utilized as a model for biological studies since the 18th century. In the past few decades, there has been a Renaissance in its utilization in genomic and genetic approaches to investigating physiological, developmental, and evolutionary aspects of land plant biology. The reasons for its adoption are similar to those of other genetic models, e.g. simple cultivation, ready access via its worldwide distribution, ease of crossing, facile genetics, and more recently, efficient transformation, genome editing, and genomic resources. The haploid gametophyte dominant life cycle of M. polymorpha is conducive to forward genetic approaches. The lack of ancient whole-genome duplications within liverworts facilitates reverse genetic approaches, and possibly related to this genomic stability, liverworts possess sex chromosomes that evolved in the ancestral liverwort. As a representative of one of the three bryophyte lineages, its phylogenetic position allows comparative approaches to provide insights into ancestral land plants. Given the karyotype and genome stability within liverworts, the resources developed for M. polymorpha have facilitated the development of related species as models for biological processes lacking in M. polymorpha., (© The Author(s) 2022. Published by Oxford University Press on behalf of American Society of Plant Biologists.)

Drug-induced allergy (DIA), an unexpectedly triggered side effect of drugs used for therapeutic purposes, is a serious clinical issue that needs to be resolved because it interrupts the treatment of the primary disease. Since conventional allergy testing is insufficient to accurately predict the occurrence of DIA or to determine the drugs causing it, the development of diagnostic and predictive tools for allergic reactions is important. We demonstrated a novel method, termed high-sensitive allergy test (HiSAT), for the rapid diagnosis of allergy (within 1 hr; with true-positive diagnosis rates of 89% and 9% for patients with and without allergy-like symptoms, respectively). HiSAT analyzes the cell kinetics as an index against chemotactic factors in a patient's serum, as different from the diagnosis using conventional methods. Once allergy has occurred, HiSAT can be used to determine the causative medicine using culture supernatants incubated with the subject's lymphocytes and the test allergen. This test is more efficient (60%) than the lymphocyte transformation test (20%). Furthermore, in HiSAT, cell mobility significantly increases in a dose-dependent manner against supernatant incubated with lymphocytes from a subject with pollinosis collected at a time when the subject is without allergic symptoms and the antigen. The result demonstraed that HiSAT might be a promising method to rapidly diagnose DIA or to determine with high accuracy the antigen causing allergy., Competing Interests: The authors have declared that no competing interests exist.

In angiosperms, the phase transition from vegetative to reproductive growth involves the de-repression of the squamosa promoter-binding-protein-like (SPL) class of transcription factors, which is negatively regulated by the specific microRNAs (miRNAs/miRs) miR156/529 [1]. Non-vascular land plants also undergo growth-phase transition to the reproductive state, but knowledge regarding the controlling mechanisms is limited. Here, we investigate the reproductive transition in the liverwort Marchantia polymorpha, focusing on the roles of miR529c [2-4] and MpSPL2. First, we established mir529c-null mutants using CRISPR/Cas9. Even in the absence of far-red light-supplemented long-day condition, which is usually needed to induce reproductive development [5, 6], the mutant thalli developed sexual reproductive organs (gametangia) and produced gametes. Transgenic plants expressing a miR529-resistant MpSPL2 transgene also showed a similar phenotype of reproductive transition in the absence of inductive far-red light signals. In these mutants and transgenic plants, the MpSPL2 mRNA abundance was elevated. Mpspl2 ko mutant plants showed successful gamete development and fertilization, which suggests that MpSPL2 is involved in, but not essential for, sexual reproduction in M. polymorpha. Furthermore, analysis of Mpspl2 ko mutant and its complemented lines suggests that MpSPL2 may have a role in promotion of reproductive transition. These findings support the notion that the transition to reproductive development in liverworts is controlled by a system similar to that in angiosperms, and the miR156/529-SPL module has common significance in the control of the vegetative-to-reproductive transition during development in many land plants, including liverworts., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Rivastigmine patches exhibit stable effects when attached once a day, and may reduce Alzheimer's disease (AD) patient's or caregiver's burden. On the other hand, it was reported that adverse events, such as dermal disorder, frequently appeared after the start of rivastigmine administration. We retrospectively investigated medical records in 120 patients with moderate or mild AD in whom rivastigmine administration was started in the Department of Neurology, Fukuoka University Hospital between July 2011 and June 2014 (43 males, 77 females, mean age: 76.9±8.0 years). In 72 patients (60.0%), rivastigmine administration was discontinued within 52 weeks after its start. In 45 of these, it was discontinued before reaching a dose of 18 mg/d which was proven to be effective for AD patients. A primary reason for discontinuation was the appearance or deterioration of adverse events in 64 patients. Of these, 43 complained of dermal disorder, accounting for the highest percentage. To clarify factors influencing the continuous administration of rivastigmine, multivariate analysis was performed in 114 patients meeting criteria. Combination therapy with memantine was extracted as a factor (p=0.008). The results of this study suggest that adherence to combination therapy with rivastigmine and memantine is more favorable than that to monotherapy with rivastigmine.

Background Target trough concentrations are recommended for teicoplanin (TEIC) to minimize its adverse effects and to maximize efficacy in sepsis caused by grampositive cocci, including methicillin-resistant Staphylococcus aureus infection. However, optimal doses to attain proper trough values in patients with sepsis have not yet been well established for TEIC. Objective This study investigated whether the systemic inflammatory response syndrome (SIRS) score could predict the pharmacokinetics of TEIC in patients with sepsis. Setting This study was conducted at Fukuoka University Hospital in Japan. Methods We retrospectively reviewed the records of patients using TEIC between April 2012 and March 2015. SIRS positive was defined as infection with a SIRS score ≥2. Estimates of pharmacokinetic parameters were calculated using a Bayesian method. Creatinine clearance rates were estimated by the Cockcroft-Gault formula (eCcr). Main outcome measure Change of TEIC loading dose requirement for incremental increases of SIRS score. Results In total, 133 patients were enrolled: 50 non-SIRS patients and 83 patients with SIRS. The TEIC plasma trough concentration was significantly lower in SIRS than non-SIRS patients (15.7 ± 7.1 vs. 20.1 ± 8.6 μg/mL; P < 0.01), although there was no significant difference in the loading dose administered. Moreover, SIRS scores were increasingly predictive of eCcr and TEIC clearance in a stepwise manner. To achieve the target trough concentration (15-30 μg/mL), the optimal doses required in non-SIRS versus SIRS patients were 12-24 versus 18-30 mg/kg/day, respectively, during the first 48 h. Conclusions These findings suggest that the pharmacokinetics of TEIC are altered in SIRS patients, who required higher doses than non-SIRS patients to achieve the target trough concentration. We suggest that the SIRS score can become a new modality to determine the initial TEIC loading dose.

Transdermal patches containing rotigotine, a dopamine agonist (DA) for treatment of Parkinson disease, continuously exert stable effects when applied once daily. Therefore, they are expected to reduce the patient burdens due to complications such as wearing-off and dysphagia. However, dosing is occasionally reduced or discontinued after application because of several reasons such as skin reactions or unsatisfactory efficacy. To identify the risk factors involved in the reduced or discontinued use of rotigotine patches, a retrospective study was conducted with reference to the medical records of patients with Parkinson disease who received rotigotine patches in our hospital. 85 patients were involved in this study. Dosing of rotigotine was reduced or discontinued in 53 patients during the study period. The factors associated with charges in treatment included combination therapy with clonazepam and oral administration of another DA before the application of rotigotine. The reduction or discontinuation rate of rotigotine patches in patients who reduced the equivalent dose of DA on the introduction of rotigotine patches was 94.7%, showing a significantly higher rate compared with 61.3% in the increased dose group. To improve adherence to rotigotine patch therapy, physicians need to carefully consider concomitant drugs and total dose of DAs. (Received December 7, 2015; Accepted February 22, 2016; Published June 1, 2016).

Tissue plasminogen activator (tPA) is the only approved therapy for acute ischemic stroke. However, delayed tPA treatment increases the risk of cerebral hemorrhage and can result in exacerbation of nerve injury. ADAMTS13, a von Willebrand factor (VWF) cleaving protease, has a protective effect against ischemic brain injury and may reduce bleeding risk by cleaving VWF. We examined whether ADAMTS13 has a longer therapeutic time window in ischemic stroke than tPA in mice subjected to middle cerebral artery occlusion (MCAO). ADAMTS13 (0.1mg/kg) or tPA (10mg/kg) was administered i.v., immediately after reperfusion of after 2-h or 4-h MCAO for comparison of the therapeutic time windows in ischemic stroke. Infarct volume, hemorrhagic volume, plasma high-mobility group box1 (HMGB1) levels and cerebral blood flow were measured 24h after MCAO. Both ADAMTS13 and tPA improved the infarct volume without hemorrhagic complications in 2-h MCAO mice. On the other hand, ADAMTS13 reduced the infarct volume and plasma HMGB1 levels, and improved cerebral blood flow without hemorrhagic complications in 4-h MCAO mice, but tPA was not effective and these animals showed massive intracerebral hemorrhage. These results indicated that ADAMTS13 has a longer therapeutic time window in ischemic stroke than tPA, and ADAMTS13 may be useful as a new therapeutic agent for ischemic stroke., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Chronic obstructive pulmonary disease (COPD) shows progressive, irreversible airflow limitation induced by emphysema and lung inflammation. The aim of the present study was to determine if COPD conditions induce blood-brain barrier (BBB) dysfunction. We found that the intratracheal administration of porcine pancreatic elastase (PPE; 3 U) induced alveolar enlargement, increased neutrophil number in bronchoalveolar lavage fluid, and decreased blood oxygen saturation in mice at 21 days after inhalation. In parallel with these lung damages, BBB permeability to sodium fluorescein and Evans blue albumin was markedly increased. Our findings demonstrate that COPD conditions are associated with risk for BBB impairment., (Copyright © 2015 The Authors. Production and hosting by Elsevier B.V. All rights reserved.)

Disruption of beta-amyloid (Aβ) transport across the blood-brain barrier is thought to cause Aβ accumulation in the brain, thus leading to the development of Alzheimer's disease (AD). As AD patients show increased serum tumor necrosis factor-α (TNFα) levels, we examined the effect of TNFα on the function and expression of Aβ transport-related proteins including cellular prion protein (PrP(C)) in the mouse brain microvascular endothelial cell line MBEC4. TNFα decreased PrP(C) levels and intracellular radiolabeled Aβ. Similarly, anti-prion protein antibody also decreased radiolabeled Aβ. These results suggest that TNFα lowers PrP(C) levels, which in turn, reduces Aβ in the brain endothelium., (Copyright © 2014 Federation of European Biochemical Societies. Published by Elsevier B.V. All rights reserved.)

Oral mucositis is a frequent adverse event in patients receiving concurrent chemoradiotherapy for head and neck cancer. Although the management of oral mucositis is essential to improve treatment completion rates, no detailed studies on the time of oral mucositis appearance have been reported. We conducted a retrospective study on the timing of the appearance of oral mucositis induced by concurrent chemoradiotherapy with S-1 for head and neck cancer. A total of 11 patients with head and neck cancer who received concurrent chemoradiotherapy with S-1 were examined. All patients developed oral mucositis within 13.8 ± 5.6 days after the initiation of radiotherapy (20.4 ± 8.1 Gy). In addition, the effects of pain-associated symptoms caused by oral mucositis on the patients' nutritional status, including reduction in caloric intake (24.4% ± 31.1%), weight loss (5.2% ± 5.2%), and duration of a regular diet (24.5 ± 17.1 days), were observed and lasted until the completion of radiation therapy. The delineation of the timing of oral mucositis appearance has become a key motivator for the patients to perform oral care proactively to limit severity and serves as a necessary index for monitoring oral health and managing pain and nutrition.

Brain pericytes are involved in neurovascular dysfunction, neurodegeneration and/or neuroinflammation. In the present study, we focused on the proinflammatory properties of brain pericytes to understand their participation in the induction of inflammation at the neurovascular unit (NVU). The NVU comprises different cell types, namely, brain microvascular endothelial cells, pericytes, astrocytes and microglia. Among these, we found pericytes to be the most sensitive to tumor necrosis factor (TNF)-α, possessing a unique cytokine and chemokine release profile. This was characterized by marked release of interleukin (IL)-6 and macrophage inflammatory protein-1α. Furthermore, TNF-α-stimulated pericytes induced expression of inducible nitric oxide synthase and IL-1β mRNAs, as an index of BV-2 microglial cell activation state, to the highest levels. Based on these findings, the possibility that brain pericytes act specifically as TNF-α-sensitive cells and as effectors of TNF-α through the release of proinflammatory factors, and that, as such, they have a role in inducing brain inflammation, should be considered., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

To investigate the molecular mechanisms of lung cancer-induced bone metastasis, we established a bone-seeking subclone (HARA-B4) from a human squamous lung cancer cell line (HARA) using an in vivo selection method. We compared comprehensive gene expression profiles between HARA and HARA-B4, and identified the critical factors for the formation of bone metastasis using in vitro and in vivo assays. The number of bone metastatic colonies in the hind legs was significantly higher in HARA-B4-inoculated mice than in HARA-inoculated mice at 4 weeks after inoculation. In addition, visceral (adrenal) metastases were not found in HARA-B4-inoculated mice at autopsy, suggesting an increase in cancer cell tropism to bone in HARA-B4. Based on a comprehensive gene expression analysis, the expression level of CXC chemokine ligand 14 (CXCL14) was 5-fold greater in HARA-B4 than in HARA. Results of a soft agar colony formation assay showed that anchorage-independent growth ability was 4.5-fold higher with HARA-B4 than with HARA. The murine pre-osteoblast cell line MC3T3-E1 and the pre-osteoclast/macrophage cell line RAW264.7 migrated faster toward cultured HARA-B4 cells than toward HARA cells in a transwell cell migration assay. Interestingly, CXCL14 was shown to be involved in all events (enhancement of cancer cell tropism to the bone, anchorage-independent growth and/or recruitment of bone marrow cells) based on siRNA experiments in HARA-B4 cells. Furthermore, in clinical specimens of lung cancer-induced bone metastasis, expression of CXCL14 was observed in the tumor cells infiltrated in bone marrow in all specimens examined. CXCL14 was able to promote bone metastasis through enhancement of cancer cell tropism to the bone and/or recruitment of bone marrow cells around metastatic cancer cells.

When teicoplanin (TEIC) is injected at the maintenance dose, a long period is required for achievement of the target plasma trough concentration because of its long elimination half-life. An initial loading dose is necessary for rapid achievement of an effective plasma trough concentration. Thus, we proposed that it is necessary for a pharmacist determine the initial loading dose of TEIC to reach an effective plasma trough concentration rapidly after its administration to a patient. In the present study, we evaluated the effectiveness of initial loading dose determination by pharmacists and physicians by comparing the achievement rate of target plasma trough concentrations (>15 μg/mL) and expression of adverse effects. Among 61 patients, 34 were treated according to an initial loading dose determined by a pharmacist (pharmacist intervention) and 27 were treated according to the treating physician's discretion (non-pharmacist intervention). The achievement rate of target concentrations was 91.2% (plasma trough concentration 23.3±5.3 μg/mL) in the pharmacist intervention group and 25.9% (plasma trough concentration 14.0±5.9 μg/mL) in the non-pharmacist intervention group. There was no difference in the incidence of adverse effects between the two groups. Also, we found that systemic inflammatory response syndrome (SIRS) may have a correlation with plasma trough concentrations of TEIC. We suggest that the SIRS score could become a means way of determining initial loading dose. These findings suggest that it is potentially effective for a pharmacist to determine this initial dose in order to rapidly achieve the target plasma trough concentration of TEIC.

Fukuoka University Hospital began to employ a resident pharmacist system in 2006. In the present study, to evaluate our resident program, we conducted a questionnaire survey of graduates who completed program as well as staff of the Pharmaceutical Department of this hospital. In addition, based on the results of this survey, we examined the current state and future of postgraduate training programs that can be offered to those who have completed a 6-year pharmacy course. The proportion of residents and staff who responded to the survey was 76.5% (13/17) and 100% (42/42), respectively. Of these two groups, the program was rated as beneficial by 92% and 72%, respectively. Regarding the contents of the training program, both residents and staff highly evaluated guidance on drug management on wards and the preparation of drugs (including anti-cancer agents) because these were useful for actual work. The necessity and usefulness of a resident program under the 6-year course system were also suggested. According to those graduating from a 6-year pharmacy course, a training program should include training instructions for students in a long-term internship during the 1st year, and specialty pharmacist education during the 2nd year. The results of our study suggest that it is advisable to begin to provide graduates on a 6-year course who participate in a resident program with specialized education focused on ward duties from the latter half of the 1st year based on their undergraduate education.

The blood-brain barrier (BBB) is formed by brain endothelial cells. Many immortalized brain endothelial cell lines have been established; these have been used as in vitro BBB models. The aim of the present study was to assess the paracellular barrier properties of the immortalized mouse brain endothelial cell lines bEND.3, bEND.5 cells, and mouse brain endothelial cell 4 (MBEC4), and those of the primary mouse brain endothelial cells pMBECs. bEND.3 cells showed low permeability to sodium fluorescein and obvious staining of tight junction proteins (claudin-5, occludin and ZO-1) similar to pMBECs; these barrier properties of MBEC4 and bEND.5 cells were low. In addition, bEND.3 cells expressed the highest level of claudin-5 among all cells. These results suggest that bEND.3 cells are a convenient and useful model for evaluating BBB function, especially the paracellular barrier.

Recently, 3-hydroxy-3-methyl glutaryl coenzyme A (HMG-CoA) reductase inhibitors were reported to induce neurite outgrowth in vitro. However, the mechanism underlying this effect remains unclear. Cellular prion protein (PrP(C)) is a ubiquitous glycoprotein present on the surfaces of various cells, including neurons, and is suggested to be involved in neurite outgrowth. Therefore, the present study aimed to determine whether PrP(C) mediates neurite outgrowth induced by HMG-CoA reductase inhibitors. Atorvastatin, a strong HMG-CoA reductase inhibitor, induced neurite outgrowth and increased PrP(C) levels in Neuro2a cells in a time- and dose-dependent manner. PrP(C) mRNA expression was also increased by atorvastatin. Farnesol, a non-sterol mevalonate derivative, attenuated the atorvastatin-induced neurite outgrowth and increase in PrP(C). Neuro2a cells overexpressing PrP(C) showed a remarkable enhancement of atorvastatin-induced neurite outgrowth compared with mock cells transfected with empty pCI-neo vector. These findings suggest that PrP(C) contributes, at least in part, to atorvastatin-induced neurite outgrowth. This phenomenon may be included among the mechanisms underlying decreased risk of Alzheimer's disease in patients treated with HMG-CoA reductase inhibitors., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)

The model core curriculum for pharmaceutical education specifies the specific behavioral objectives (SBOs) concerning adverse drug reactions, which aims to train pharmacy students to manage adverse drug reactions. Fukuoka University Hospital has developed a problem-based learning (PBL) program concerning adverse drug reactions as long-term practical training to collect adverse event information, identify adverse effects, and acquire management skills. Students' level of satisfaction with the program was high (approximately 90%), and the mean self-evaluation score for the SBOs concerning adverse reaction was 4.4 (5-grade scale), showing a high level of understanding. In addition, students' will of participation to the adverse drug reaction-reporting system was significantly improved after the PBL program, showing the usefulness of this program (p=0.02). However, the results of the PBL program revealed students' insufficient knowledge of adverse reactions and lack of reviewing skills, suggesting the need to improve the education system whereby students can learn adverse drug reactions in clinical settings.

Olanzapine is known to be advantageous with respect to outcome and drug compliance in patients with schizophrenia. However, olanzapine has adverse effects, including a higher incidence of weight gain and metabolic disturbances, when compared with those of other antipsychotic agents. The mechanisms underlying these adverse events remain obscure. Female rats were orally administered olanzapine (2 mg/kg) or vehicle once a day for 2 weeks to ascertain if hypothalamic AMP-activated protein kinase (AMPK) mediates olanzapine-induced weight gain and hyperphagia. Body weight and food intake in each rat were evaluated every day and every two days, respectively. After the termination of drug treatment, we measured the protein levels of AMPK and phosphorylated AMPK in the hypothalamus using western blot analyses. Olanzapine significantly increased body weight and food intake. The phosphorylation levels of AMPK were significantly elevated by olanzapine. These results suggest that activation of hypothalamic AMPK may mediate hyperphagia and weight gain induced by chronic treatment with olanzapine.

The conversion of cellular prion protein (PrP(C)) to its protease-resistant isoform is involved in the pathogenesis of prion disease. Although PrP(C) is a ubiquitous glycoprotein that is present in various cell types, the physiological role of PrP(C) remains obscure. The present study aimed to determine whether PrP(C) mediates migration of brain microvascular endothelial cells. Small interfering RNAs (siRNAs) targeting PrP(C) were transfected into a mouse brain microvascular endothelial cell line (bEND.3 cells). siPrP1, selected among three siRNAs, reduced mRNA and protein levels of PrP(C) in bEND.3 cells. Cellular migration was evaluated with a scratch-wound assay. siPrP1 suppressed migration without significantly affecting cellular proliferation. This study provides the first evidence that PrP(C) may be necessary for brain microvascular endothelial cells to migrate into damaged regions in the brain. This function of PrP(C) in the brain endothelium may be a mechanism by which the neurovascular unit recovers from an injury such as an ischemic insult., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

Drug information (DI) services is an essential resource for pharmacists to provide counseling to patients and guide appropriate medication use. We devised a DI practical training course that incorporated an inquiry-based practical training program and evaluated its effectiveness. A total of 91 fifth-year students in Pharmaceutical Sciences at Fukuoka University took part in the following DI sessions based on specific behavioral objectives (SBOs) for DI in the Model Core Curriculum for Practical Training: inquiry practice, simulated pharmacy and therapeutics committee, DI newsletter, use of emergency and safety information, off-label use in clinical trials, PRE-AVOID (Be prepared to avoid the adverse drug reactions), adverse drug reactions, and small group discussions about drug poisoning. The level of understanding of the SBOs for DI training was >4.2 for each item assessed, and the level of satisfaction for each practice was >3.9. This DI practical training successfully facilitated students' ability to provide DI. The number of students interested in DI services significantly increased (p<0.01). After the DI practical training, many students made statements such as "I realized that DI services is a very important job" and "I feel that pharmacists have much to contribute to DI services by evaluating the most appropriate information from a pharmacist's standpoint." It appears that students recognized the pharmacist's role and importance of DI services in clinical practice through the DI training. These results suggest that this DI practical training program was effective.

Cytomegalovirus (CMV) remains the most important pathogen following solid organ transplantation and is the major cause of recipient morbidity and mortality during the first 6 months posttransplantation. To prevent CMV infection and/or to prevent symptomatic CMV disease, immunoglobulin (Ig) G including hyperimmune CMV IgG are used alone or in combination with antiviral medications. The CMV IgG titer, however, has a wide range and frequently depends on the company supplying the Ig preparation even if the preparations come from the plasma pool of a national blood donation agency. In the present study, we therefore simultaneously measured and evaluated the CMV IgG titers in various Ig preparations using two common methods: the neutralizing antibody (NT) and enzyme immunoassay (EIA). The CMV IgG titer in the present study indicated different values using both methods among Ig preparations that were made from the plasma pool of a national blood donation agency (about 3.5- or about 1.7-fold difference using the NT or EIA methods, respectively). Furthermore, there were no correlations in the CMV IgG titer between our findings and published data from the manufacturers, or between the two methods tested here. These findings suggest the importance and necessity of a standard method and/or sample for the measurement and assessment of CMV IgG in Ig preparations.

It is very important for students to undergo early exposure in 6-year pharmaceutical education; through this experience they will understand roles of pharmacists, map out their future career, and increase their motivation for learning. Therefore we had newly recruited pharmacists provide an early exposure program in a hospital. According to the results of a questionnaire survey involving students, educational staff of the Faculty of Pharmaceutical Sciences and the new pharmacists, 99% of the students were satisfied with the program, and their motivation for learning was enhanced. Interestingly, they were more careful regarding their grooming and appearance after completing the program. Educational staff of the Faculty of Pharmaceutical Sciences evaluated the new pharmacists and their teaching very positively, and, in turn, the pharmacists assessed an early exposure program in a hospital as significant. Therefore we conclude that the system for early exposure was useful for both students and new pharmacists.