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A

♦ Acute Conjunctivitis

An acute type of “conjunctivitis,” which causes inflammation in the area covering the white part of the eye and the reverse side of the eyelid (conjunctiva). Acute conjunctivitis is largely categorized by the cause into “viral” one with adenovirus as its major cause, “bacterial” one with hemophilus influenza as its major cause and “allergic” one with pollens and fungi as its major causes. Except allergic one, acute conjunctivitis is transmitted between humans and is characterized by redness in the white part of the eye because of bleeding in the conjunctiva. You should wash your hands and avoid touching your eyes to prevent the disease. There are approximately 20 million patients with acute conjunctivitis in Japan. The condition of persistence of acute conjunctivitis is called “chronic conjunctivitis.”

♦ Antibacterials

Drugs that help treat infections caused mainly by bacteria. A collective term for antibiotics made from artificially synthesized chemicals and those made from microorganisms such as penicillium. Antibacterials suppress proliferation of or kill bacteria as their major actions. There are many types of antibacterials, including “penicillin,” the antibacterial discovered for the first time in the world. In recent years, development of drug-resistant strains of bacteria, which have resistance to antibacterials, has been greatly problematic.

♦ Antibiotic

Chemical types of “antibiotics” out of “antibiotics” including both artificially synthesized chemicals and chemicals made from microorganisms such as penicillium. Many substances have been discovered and used in pharmaceuticals and other products since verification of therapeutic effect of “penicillin,” which has an inhibitory effect on the growth of other microorganisms and living cells. Antibiotics are also called “antibiotic drugs” or “antibiotic substances.” Attention should be paid to the use of antibiotics because of side effects such as diarrhea and decreased effectiveness when taken with other drugs or food.

♦ Antiepileptics

A synonym of anticonvulsants

→　To the explanation of "anticonvulsants"

♦ Antipyretic anti-inflammatory analgesics

Drugs that alleviate pain such as headache, toothache and menstrual cramps. The major ingredients of antipyretic anti-inflammatory analgesics include “aspirin,” which is an essential drug for medical use for the treatment of heart disorders because of its effect to resolve blood clots, “acetaminophen,” which is a global standard of a cold medicine with especially high antipyretic potency and “ibuprofen,” which has analgesic, antipyretic and anti-inflammatory effects in a balanced manner and also works against inflammation. Many of antipyretic anti-inflammatory analgesics contain caffeine and put a strain on the stomach to a certain extent. Therefore, attention should be paid to the use of the drugs. They are used for supportive care in principle.

♦ Anticonvulsants

Drugs that are mainly used for the treatment of “epilepsy,” which is a brain disease repeatedly causing seizures. Anticonvulsants control seizures, for example, by suppressing electrical excitation of the brain nerve cells, which is possibly a factor of seizures. Appropriate anticonvulsants will be selected according to the type of seizure (seizure of the overall brain [generalized seizure] or seizure of some part of the brain [partial seizure]), age and sex. Approximately one million people are suffering from epilepsy in Japan, but only a few of them die directly from epilepsy. Epilepsy is treated mainly with medication. Approximately 80% of the patients no longer experience seizures after starting treatment with anticonvulsants and lead their lives as normally as healthy individuals do. Anticonvulsants are also called “antiepileptics.”

D

♦ Drug Eruption

A collective term for a disease that causes rash and other clinical manifestations on the skin and mucosal membranes because of a drug taken into the body orally, by injection or as a suppository. The disease is sometimes caused by examination or dietary supplements and also causes disorders in the liver and the blood. In some cases, patients have signs and symptoms throughout the body. In most cases, the disease is allergic but non-allergic in some cases. The time to onset differs in each patient and ranges from several days to several months after the use of the drug. Mild drug eruption can resolve only with discontinuation of the causative drug. However, patients may receive treatment under hospitalization in severe cases.

♦ Dry Eyes

A disease that causes a “quantitative abnormality” of reduced tear volume and a “qualitative abnormality” of decreased tear quality/ability leading to abnormalities on the surface of the eye. Dry eye can be regarded as a disease of tears. The causes of dry eye include aging and the use of air conditioners, computers, smartphones and contact lenses. There are approximately 8 million to 22 million patients in Japan. Some reports say that one out of three office workers have dry eye. When your eyes are affected by Stevens-Johnson syndrome (SJS), you may have the severest dry eye as a sequela.

E

♦ Erosions

In the field of dermatology, erosion means a state where the defect of the epidermis/superficial layer of the skin/mucosal membranes has resulted in exposure of the lower tissues. When the damage due to sore or erosion gets severer, it is called an “ulcer.” Erosion is caused not only by skin damage such as rupture of blisters infections, compression, irritation or heat but also by burns or atopic dermatitis in quite a few cases. “Stevens-Johnson syndrome (SJS)” and “toxic epidermal necrolysis (TEN)” are known as serious diseases with multiple erosive lesions.

♦ Erythema

A condition where the surface of the skin turns red because of reasons such as capillary dilatation. Erythema disappears with compression, which is characteristic in this condition. You will usually have no sense of heat in the skin but may have a sense of heat in the skin if you have concomitant conditions such as arterial dilatation. The types of erythema include “nodular erythema,” which causes bumps with a diameter of 1 cm or larger in the lower thigh (from the knee to the ankle), “infectious erythema,” which is also called “fifth disease” and “multiform exudative erythema,” which has blisters on it. Erythema is caused by infections, acne, allergies, skin massage, sunburn or hair plucking. However, there are many things that have still been unrevealed.

♦ Eye Discharge

A secretion from the eye. A medical term for eye boogers. A mixture of mucus secreted from the conjunctiva (the white part of the eye) and other parts and waste products in tears. Eye discharge is usually flushed out of the eye with tears when you blink. On the contrary, you are likely to have eye discharge while you are sleeping without blinking. The causes of eye discharge include changes in the physical condition, pollens, dust, air quality and ingrowing eyelashes. Wash your hands and do not rub your eye with your hand to prevent eye discharge. If you have a large volume of eye discharge or severe itching, you may have conjunctivitis of a type or vernal conjunctivitis (severe allergic conjunctivitis).

G

♦ Combined cold medicines

Drugs that help alleviate and suppress signs and symptoms of cold and are actually known as cold medicines. Many of combined cold medicines contain fever reducers/painkillers, antitussives and antihistamines in combination as ingredients to reduce fever, suppress pain and inflammation of the throat or inhibit cough and nasal discharge. Over-the-counter combined cold medicines do not contain antibiotics. In recent years, serious or fatal cases of “Stevens-Johnson syndrome (SJS)” have been reported as a side effect of combined cold medicines and are considered problematic.

H

♦ Hyperemia

Redness of the area covering the white part of the eye and the reverse side of the eyelid (conjunctiva) due to inflammation caused by the impact of allergies, bacteria, diseases, injury, fatigue or contact lens. Hyperemia is largely categorized by its clinical presentations and site (the white part of the eye and the reverse side of the eyelid [conjunctival hyperemia], the peripheral area of the cornea, which is the transparent membrane covering the iris [ciliary hyperemia] and damage to capillaries under the conjunctiva [subconjunctival hyperemia]). Redness of the eye is not always hyperemia and sometimes causes no problems if left untreated for a while. However, careful attention should be paid because hyperemia occasionally requires emergency treatment.

I

♦ Oral corticosteroid

“Steroids” produced in the organ called adrenal glands are used for treatment as hormonal drugs to inhibit inflammation in the body. Among the steroids, “corticosteroid,” which has a strong anti-inflammatory action and an immunosuppressive action, is taken by mouth or used for systemic treatment. In particular, corticosteroid taken by mouth is called “oral corticosteroid.” Systemic administration of corticosteroid is used for the treatment of the diseases such as “Stevens-Johnson syndrome (SJS)” and “toxic epidermal necrolysis (TEN).”

J

♦ Japan Intractable Diseases Information Center

An information center operated by Japan Intractable Diseases Research Foundation as a subsidized project by the Ministry of Health, Labour and Welfare to eliminate or relieve worries and concerns and support recuperation of patients with intractable diseases such as “Stevens-Johnson syndrome (SJS)” and “toxic epidermal necrolysis (TEN).” Japan Intractable Diseases Information Center mainly provides educational activities. It collects information on the results of specific disease surveillance/research projects, latest medical information and information on medical institutions and consultation services and provides such information to patients with intractable diseases and their related persons. It also provides other services such as e-mail consultation and staff training.

L

♦ Lyell's Syndrome

A Synonym for "Toxic Epidermal Necrolysis (TEN)"

→　To the explanation of "Toxic Epidermal Necrolysis (TEN)"

M

♦ PMDA

PMDA stands for “Pharmaceuticals and Medical Devices Agency.” It was established in 2004 and has three main roles: “health injury relief” consisting of relief of health injury such as side effects of pharmaceuticals and infections via biological products, “review for approval” consisting of approval, instructions and review regarding quality, efficacy and safety of pharmaceuticals and medical devices and “safety activities” consisting of collection, analysis and provision of information on the post-marketing safety. PMDA mainly targets contribution to better health and improved safety domestically and internationally.

♦ Medical expense-subsidy program for patients with specific diseases

A subsidy program for patients with intractable diseases under investigation and research because of their unknown causes and unestablished treatments for which treatment methods cannot be developed without public financial assistance because of a small number of affected patients in spite of their severe clinical conditions. The governors select medical institutions and entrust investigation and research to them. This program applies to patients with a disease included in the 56 target diseases of the specific disease treatment and research project who are currently under treatment and have to pay their copayments for health insurance treatment. “Stevens-Johnson syndrome (SJS)” and “toxic epidermal necrolysis (TEN)” are regarded as intractable diseases in their acute phase within 6 months after the onset.

♦ Mycoplasmal Infection

An infection with “mycoplasma,” which is a pathogen accounting for 10% to 20% of pneumonia. Mycoplasma infection often causes severe diseases such as bronchitis in groups of ages with strong immunity between infancy and youth. The incubation period of mycoplasma is 2 to 3 weeks. The clinical presentations commonly begin with fever, headache and/or fatigue, which are followed by severe cough that develops in a few days. Mycoplasma infection is mainly treated with antibiotics. No outbreak has been noted except in 1984 and 1988. In association with the decreased number of cases of bacterial pneumonia in recent years, the ratio of mycoplasma pneumonia to all types of pneumonia has been increasing. Mycoplasma infection is one of frequent infections in the field of pediatrics.

N

♦ NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)

A collective term for drugs involved in anti-inflammatory, pain-killing and fever-reducing actions. All anti-inflammatory drugs containing no steroid that are categorized into hormonal drugs. A synonym of fever reducer/painkiller, which is used for the treatment of pain and fever. The major indications of NSAIDs include rheumatoid arthritis, headache, toothache, trauma and fever. Aspirin and loxoprofen are NSAIDs prescribed mainly at hospitals, and the over-the-counter NSAIDs mainly include ibuprofen and ethenzamide.

P

♦ Plasma exchange therapy

A therapeutic method to exchange only liquid component of blood excluding blood cells such as red blood cells and white blood cells contained in the blood (plasma). Plasma exchange therapy is performed to eliminate substances in the blood causing the disease or aggravating the condition or to supplement necessary volume of plasma or when there is no other way to remove certain blood components. Plasma exchange therapy includes “simple plasma exchange,” where blood is filtered using a special device to remove a harmful substance causing the clinical presentations, and only the components that effectively work in the body are returned to the body.

R

♦ Relief System for Sufferers from Adverse Drug Reactions

A system in which medical and other expenses are provided by the government in case of severe side effects requiring treatment under hospitalization in spite of proper use of drugs prescribed at hospitals and clinics or purchased at drugstores. There are seven types of benefits of different amounts, including medical expenses, disability pension and bereaved family pension, according to the details of treatment and the outcome of the side effect (e.g., disability, death). Patients who suffer from the health injury or their bereaved families can make an application for the relief to the Pharmaceuticals and Medical Devices Agency (PMDA) by sending a medical certificate, a medication certificate and a hospital visit certificate.

S

♦ Serious Drug Eruption

Drugs cure diseases while they may cause side effects. Rash caused by drugs that have been orally taken or injected (drug eruption) is one of such side effects. Drug eruptions range from ones with mild itching to severe ones such as “Stevens-Johnson syndrome (SJS)” and “toxic epidermal necrolysis (TEN),” which threaten the life because of a high fever, rash on the skin and mucosal membranes throughout the body and/or visceral disorders. Drug eruptions of especially severe types are called severe drug eruptions.

♦ Severe multiform exudative erythema

A series of diseases that cause multiple rashes and burn-like blisters on the skin throughout the body and oral and eye mucosa and general or localized erythema, blisters and hyperemia of the eyeball and the conjunctiva, along with a high fever and fatigue. Severe multiform exudative erythema also causes general signs and symptoms such as fever and general fatigue. Severe multiform exudative erythema mainly include “Stevens-Johnson syndrome (SJS)” and “toxic epidermal necrolysis (TEN).”

♦ SJS Patient Group

Komiya, the former representative of the group, recruited members according to the instructions from Professor Kazuo Tsubota of the Department of Ophthalmology, Tokyo Dental College Ichikawa General Hospital in 1999. The group has 114 members (as of the end of March 2005). The group has a goal to “save all patients with Stevens-Johnson syndrome (SJS).” The major activities of the group include provision of aids to patients with SJS, upgrading of the patient group to an intractable disease treatment and research project and popularization of the relief system.

♦ Stevens-Johnson Syndrome (SJS)

A disease that is accompanied by a high fever and fatigue and causes a large number of rashes and burn-like blisters on the skin throughout the body and oral and eye mucosa. The signs and symptoms of SJS include general or localized erythema, blisters and hyperemia of the eyeball and conjunctiva. SJS is caused by drugs, viral infections and others. However, there are many things that have still been unrevealed. The treatment methods for SJS include discontinuation of the causative drug, local treatment in the sites of the rashes, prevention of infection, systemic steroid treatment and plasma exchange therapy. SJS develops in 1 to 6 in a million people annually. The mortality is approximately 2% to 3%.

♦ Steroid Pulse Therapy

“Steroids,” which are made in the organ called adrenal glands, are used for treatment as hormonal drugs to inhibit inflammation in the body. “Steroid pulse therapy,” a treatment method more effective than oral steroids, is used for the treatment of connective tissue disease such as rheumatic fever and “Stevens-Johnson syndrome (SJS)” or “toxic epidermal necrolysis (TEN),” which requires anti-inflammatory treatment in the acute phase. However, steroid pulse therapy can cause side effects ranging from mild changes in the facial appearance and mild weight gain to severe hyperglycemia, mental disorders, infections and others.

T

♦ Antihyperuricemics

Drugs used for the treatment of “hyperuricemia,” a condition with a high blood level of uric acid (residues of old cells and substances in the body). Aggravation of hyperuricemia will lead to arthritis and result in so-called “gout.” Drugs that control the level of uric acid are used for the treatment of hyperuricemia, and drugs to alleviate inflammation and pain are used for the treatment of gout. The major drugs are largely categorized into two types: drugs that promote excretion of uric acid, including Urinorm® and drugs that inhibit production of uric acid, including Zyloric®.

♦ Toxic Epidermal Necrolysis (TEN)

A disease that is accompanied by a high fever and fatigue and causes a large number of rashes and burn-like blisters on the skin throughout the body and oral and eye mucosa. The signs and symptoms of TEN include general or localized erythema and hyperemia of the eyeball and conjunctiva. TEN is caused by drugs, viral infections and others. However, there are many things that have still been unrevealed. TEN is an advanced form of “Stevens-Johnson syndrome (SJS).” SJS involves skin detachment in the area of 10% or lower of the body, and TEN involves a larger area. TEN develops in 0.4 to 1.2 in a million people annually. The mortality is approximately 20% to 30%. TEN is also called Lyell's syndrome.

♦ Research into Treatment for Specific Child Chronic Diseases

A project that subsidizes copayment of medical expenses for the treatment of chronic diseases in children such as pediatric cancers, which impose a high amount of medical expenses because of long-term treatment, in order to realize healthy development of children, to establish and popularize treatment methods for the diseases and to reduce the financial burden on the patients’ families because of the medical expenses. This research project is targeted for children aged less than 8 years. The assistance can be extended until the age of less than 20 years if the patient is considered to need treatment continuously. The target diseases include 514 diseases categorized into 11 disease groups, including pediatric cancers and chronic nephritis. This research project is conducted mainly by the prefectures, designated cities and core cities.

V

♦ Visual Impairment

Among “vision disorders,” a collective term for states with decreased visual functions such as visual acuity, visual field and color vision, a state with decreased visual acuity such as near-sightedness, far-sightedness or an abnormality in the regulatory function is mainly called “visual impairment.” During recent years, “cultivated autologous oral mucosal epithelial transplantation,” preparation and transplantation of an epithelial sheet artificially produced from the oral mucosa of the patient, was developed as a new treatment method for improving visual acuity. The transplantation method has been approved for the indications, including severe visual impairment caused by “Stevens-Johnson syndrome (SJS)” or “toxic epidermal necrolysis (TEN).”