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PubMed1996

Effect of Hay's separation principle on the energy metabolism.

A cross-over experiment was conducted with 8 adult, nonpregnant sows in order to test whether feeding according to the principle of Hay's separation diet exerts a stimulant effect on thermogenesis. The protein part of the daily ration was offered at the morning feeding, the other ration components in equal amounts at two further feedings. The control group received the daily ration in three equal portions. The levels of all nutrients in the rations matched the maintenance requirement based on the initial weight of the sows and remained unchanged throughout the experiment. In both 3-week metabolism periods a complete balance was undertaken for each animal using the collection technique (feed, feces, urine) and 48-hour measurement of the gas exchange in a respiration chamber. The body weight of the sows fed the separation diet was 178.3 kg and that of the control 178.6 kg. Oxygen and carbon dioxide were reduced by 1.5% with separation. The respiratory quotient remained unchanged. The experimental treatment had no effect on energy digestibility and metabolizability. Heat production of the animals on the separation diet was 20.6 versus 20.1 MJ/day on the control diet. The result was reversed for energy retention, namely 0.6 versus 0.0 MJ/day. The daily energy exchange profile, represented by thermogenesis plotted at 5-min intervals, showed slightly lower values than the control after the protein meal and only random differences between the two treatments for the remainder of the day. It can be concluded from the results that separation of the protein and carbohydrates in the diet within 1 day, rather than stimulating thermogenesis, is more likely to reduce it.

Animal Nutritional Physiological Phenomena↗
PubMed1992

Leukocytapheresis: evaluation of a new procedure for the blood cell separator Fresenius AS 104.

For granulocyte separation from peripheral blood with the Fresenius blood cell separator AS 104 a new procedure and a new tubing set were developed and evaluated. Separation is done in cycles of 400 ml of whole blood processed, with continuous blood flow of 50-55 ml/min, speed 750 rpm. HES-450 is added for sedimentation acceleration together with citrate, ratio 1:10. At the end of each cycle granulocytes were pumped out of the separation chamber into the collection container. After processing 13 cycles of 400 ml whole blood/HES-citrate-volume a total yield of 9.20 +/- 2.80 x 10(9) white cells were collected in volumes of 125 ml. 47 +/- 9% of the leukocytes collected were granulocytes, this corresponds to collection of 1.05 +/- 0.09 x 10(9) granulocytes per liter of processed blood. The efficacy of granulocyte collection is 22.5 +/- 5.6%, viability is more than 95%. With this procedure it is possible to collect granulocytes with the blood cell separator Fresenius AS 104 in therapeutical doses.

Blood Component Transfusion↗
PubMed1995

Plateletpheresis-induced increase in platelet reactivity using different cell separators.

OBJECTIVE: Since plateletpheresis is being used increasingly, it is important to regard quality control to check health risks for donors and to exclude these. DESIGN: Controlled randomised prospective open comparative study. SETTING: Department of Transfusion Medicine of a University Clinic. PARTICIPANTS: 112 platelet donors were examined. INTERVENTIONS: Prior to and after plateletpheresis platelet reactivity was determined. The platelet concentrates in the two groups of 56 donors each were produced using either the cell separator 'CS-3000' and the collecting chamber PLT 30TM with the Omnix system (group I) or the cell separator 'AS-104' (group II). RESULTS: In group I five donors showed a pathologically increased platelet reactivity (p = 0.1297) after plateletpheresis. In group II there were 10 donors with a pathologically increased platelet reactivity (p = 0.0046) after plateletpheresis. The mean concentration of platelets was reduced by separation using the CS-3000 Omnix from 238 +/- 49 x 10(3)/microliters to 172 +/- 32 x 10(3)/microliters (68 +/- 27 x 10(3)/microliters) and from 243 +/- 53 x 10(3)/microliters to 180 +/- 31 x 10(3)/microliters (63 +/- 33 x 10(3)/microliters) using the AS-104. In the first case the platelet yield was 3.9 x 10(11) platelets/concentrate, in the latter case it was 2.9 x 10(11) platelets/concentrate. The 'CS-3000 Omnix' is significantly more effective in separating (58.4 +/- 15.5%) than the 'AS-104' with 44.2 +/- 7.2% (p < 0.0001). CONCLUSIONS: Since both donor groups were comparable regarding all factors recorded--especially the cardiovascular risk factors--the separation process could be responsible for the different traumatisation of platelets.

Adult↗
PubMed1992

Effect of pulse separation between two sequential biphasic shocks given over different lead configurations on ventricular defibrillation efficacy.

BACKGROUND: Two sequential biphasic shocks delivered over separate lead configurations markedly improve defibrillation efficacy compared with a single shock alone. We investigated the effect of varying the intershock interval between sequential biphasic shocks on defibrillation. METHODS AND RESULTS: Defibrillation thresholds (DFTs) were obtained in six dogs for shock separations ranging from 0.2 to 125 msec. The first shock was given from a catheter electrode in the right ventricular apex to a patch on the left lateral thorax; the second was from a small patch on the left ventricular apex to a catheter electrode in the right ventricular outflow tract. When the interval between shocks was less than or equal to 10 msec or greater than or equal to 75 and less than or equal to 125 msec, the mean DFTs were less than that previously found for the first shock by itself (4.2 versus 7.4 J, p = 0.002). At a separation of 50 msec, however, there was a marked rise in the DFT to 27 J. The mean DFT for the second shock at a delay of 50 msec was not different from the mean DFT previously found for the second shock by itself (7.2 versus 7.0 J). These results were confirmed in another six dogs using defibrillation probability-of-success curves. In 12 other dogs, probability-of-success curves were generated for delays between shocks as a percentage of the activation interval during ventricular fibrillation. Minimum defibrillation energy requirements were at two separations, 0.2 msec and 90% of the activation interval. CONCLUSIONS: The optimal intershock interval between two sequential biphasic shocks is either less than or equal to 10 msec or greater than or equal to 75 and less than or equal to 125 msec. The marked rise in the DFT at a shock separation of 50 msec, requiring more energy than that for the first shock alone, suggests that the second shock at this time delay is likely to reinduce fibrillation after it is halted by the first shock until the second shock is strong enough to defibrillate independently of the first shock.

Animals↗
PubMedDate not supplied

Effect of flow split on separation and stagnation in a model vascular bifurcation.

This is a study of the flow disturbance in a plastic model of an asymmetric vascular bifurcation. A sidearm was attached to the mainlimb at an angle of 15 degrees to the inlet flow axis. Water at steady flow was used and flow patterns were demonstrated by a dye injection technique. The proportion of inlet flow (Qi) exiting from the sidearm (Qs) was varied and flow patterns were recorded photographically. A laser Doppler anemometer (LDA) was used to measure near-wall velocity. At a physiologic Reynolds' number of 500, no flow disturbance occurred in the mainlimb when the sidearm was completely occluded. When the fraction of flow exiting from the sidearm (Qs/Qi) reached 0.19, a region of boundary layer separation developed along the wall of the mainlimb opposite the flow divider. This region of nearly static fluid spread circumferentially around the mainlimb as Qs/Qi increased. Near-wall velocity within the separation decreased and became negative when Qs/Qi = 0.31. When Qs/Qi reached 0.38, the separation enveloped the wall of the entire bifurcation with a shell of slowly moving fluid. At the same time, the rapidly moving mainstream impinged directly on the flow divider. There is a similarity between the region of separation seen in this model and the site of formation of atherosclerotic plaque at the carotid bifurcation. Separation may contribute to atherogenesis by creating a region of low wall shear at bifurcations.

Biomechanical Phenomena↗
PubMed2005

A computational analysis of separating motion signals in transparent random dot kinematograms.

When multiple motion directions are presented simultaneously within the same region of the visual field human observers see motion transparency. This perceptual phenomenon requires from the visual system to separate different motion signal distributions, which are characterised by distinct means that correspond to the different dot directions and variances that are determined by the signal and processing noise. Averaging of local motion signals can be employed to reduce noise components, but such pooling could at the same time lead to the averaging of different directional signal components, arising from spatially adjacent dots moving in different directions, which would reduce the visibility of transparent directions. To study the theoretical limitations of encoding transparent motion by a biologically plausible motion detector network, the distributions of motion directions signalled by a motion detector model (2DMD) were analysed here for Random Dot Kinematograms (RDKs). In sparse dot RDKs with two randomly interleaved motion directions, the angular separation that still allows us to separate two directions is limited by the internal noise in the system. Under the present conditions direction differences down to 30 deg could be separated. Correspondingly, in a transparent motion stimulus containing multiple motion directions, more than eight directions could be separated. When this computational analysis is compared to some published psychophysical data, it appears that the experimental results do not reach the predicted limits. Whereas the computer simulations demonstrate that even an unsophisticated motion detector network would be appropriate to represent a considerable number of motion directions simultaneously within the same region, human observers usually are restricted to seeing not more than two or three directions under comparable conditions. This raises the question why human observers do not make full use of information that could be easily extracted from the representation of motion signals at the early stages of the visual system.

Computer Simulation↗
PubMed1989

Acceptability, compliance, and adverse reactions when isoniazid, rifampin, and pyrazinamide are given as a combined formulation or separately during three-times-weekly antituberculosis chemotherapy.

In Hong Kong, 627 adult Chinese patients with newly diagnosed pulmonary tuberculosis received, for the first 2 months of chemotherapy, streptomycin together with isoniazid, rifampin, and pyrazinamide allocated at random to be given either as a combined formulation or separately. Each tablet of the combined formulation, which was designed for intermittent use, contained 125 mg of isoniazid, 100 mg of rifampin, and 375 mg of pyrazinamide. Patients weighing 42 kg or less received 5 tablets per dose, 43 to 57 kg, 6 tablets per dose, and 58 kg or more, 7 tablets per dose. The dosage of each drug was very similar whether it was given combined or separately. During the 2 months, spontaneous complaints, the commonest of which were nausea and vomiting, were made by 38% of patients receiving the combined and 39% receiving the separate formulations; 1% compared with 5%, respectively, complained that the tablets or capsules were too many, too large, difficult to swallow or that they stuck in the throat (p less than 0.05), and 32% compared with 45% regularly brought their own drink (usually milk or fruit juice) to the clinic to help them swallow their medicament (p less than 0.01). Only 14% of patients in each group missed one or more doses through default. Reported adverse reactions were mainly trivial, 4% of patients receiving the combined and 7% receiving the separate formulations having the administration of one or more drugs terminated. Thus, the differences between the combined and separate formulations showed a small advantage to the combined formulation in terms of acceptability to patients.

Drug Administration Schedule↗
PubMed1986

Mobile phase optimisation in the separation of antiepileptic drugs by high-performance liquid chromatography.

A simple method is described for adjusting the mobile phase composition to obtain optimum separation of commonly prescribed antiepileptic drugs by high-performance liquid chromatography. The drugs are separated, in less than 6 min, on a column of Hypersil ODS 5 microns (100 mm X 5 mm i.d.) with a high mobile phase flow rate. The final mobile phase composition is a mixture of methanol, acetonitrile, tetrahydrofuran and water, adjusted to give the best separation with our laboratory conditions. The method is described and evidence of precision and accuracy presented. The improved separation resolves the major metabolites of carbamazepine which have been ignored in most methods for antiepileptic drugs. The advantages of mobile phase optimisation to improve the separation of antiepileptic drugs are discussed.

Anticonvulsants↗
PubMedDate not supplied

Spontaneous separation in idiopathic vitreomacular traction syndrome associated with contralateral full-thickness macular hole.

PURPOSE: Vitreomacular traction syndrome (VMTS) and full-thickness macular hole are two different well-known entities that on follow-up may be subjected to clinical modifications. Precisely, a spontaneous separation of idiopathic VMTS occurred in three eyes of three patients relieving in addition traction of the posterior hyaloid that had led also to a focal macular retinal pigment epithelial detachment (RPE). An association to a full-thickness macular hole was observed in the contralateral eye of one of the patients. METHODS: This is a retrospective study of three patients evaluated with fluorescein angiography and documented with optical coherence tomography using the Stratus (OCT) model 3000, with scans analysis and protocols analysis, measuring the size and shape of vitreomacular adhesions, macular thickness changes before and after the spontaneous separation of the tractional posterior hyaloid adhesion. In addition, the vitreous was evaluated with contact lens slit lamp biomicroscopy and ultrasound. The associated contralateral macular hole in one of the patients was surgically treated. RESULTS: Two of the three eyes with spontaneous separation of the VMTS recovered 20/25 central visual acuity; the other eye maintained the initial 20/50 visual acuity. The treated macular hole recovered 20/100 corrected visual acuity. CONCLUSIONS: Spontaneous separation of posterior hyaloid is a possible outcome during follow-up of idiopathic VMTS that can be well evaluated and documented with OCT while macular fluorescein angiography may be silent in cases like these presently reported. Central vision recovery can be excellent following the spontaneous separation, which releases anterior-posterior traction including on the retinal pigment epithelium and decreases macular thickness as measured with OCT. Therefore, regarding management, the indication for vitrectomy should be delayed awaiting the spontaneous release of vitreomacular traction in 4 to 6 months. The association between idiopathic VMTS in one eye and full-thickness macular hole in the opposite eye of one patient is an important pathophysiologic consideration.

Aged↗
PubMed2004

An integrative review of separation in the context of victimization: consequences and implications for women.

Given the number of divorces that occur each year as well as the high rates of intimate partner violence, it is critical that divorce/separation and victimization be considered in research and in clinical practice with women. However, the separation/divorce research and victimization research has often been conducted independently, with limited attention to integration. The integration of these two domains is critically important in facilitating the understanding of these issues for women. This article has 5 main purposes: (a) to review the research on the general consequences of separation; (b) to review the research on the consequences of separation when children are involved; (c) to review the research on the consequences of victimization; (d) to integrate the separation and victimization research to examine separation in the context of victimization; and (e) to discuss the implications of separation in the context of victimization for practice and research.

Battered Women↗
PubMed1982

The relation of childhood separation experiences to adult depressive and anxiety states.

The relation of childhood separation experiences to adult depression, anxiety and 'general psychological morbidity' was assessed in a random population survey. Four causes of separation were examined in each of three age groups: childhood illness, parental illness, parental marital discord and wartime evacuation. Childhood separations occurring up to five years of age bore no relation to depression, anxiety nor to incidence of morbidity generally. From five to ten years of age, separations caused by parental illness and marital discord were related to morbidity, and in the latter instance were more likely to cause depression than anxiety. From 11 to 15 years, only separations due to parental illness were related to morbidity generally.

Adolescent↗
PubMed1989

Separation of parathyroid hormone-like activity from transforming growth factor-alpha and -beta in the canine adenocarcinoma (CAC-8) model of humoral hypercalcemia of malignancy.

A canine adenocarcinoma model (CAC-8) of humoral hypercalcemia of malignancy was evaluated for transforming growth factors (TGF)-alpha and -beta, PTH-like activity [adenylate cyclase-stimulating activity (ACSA)], and in vitro bone-resorbing activity. Biological activities present in CAC-8 were separated by reverse phase or cation exchange HPLC. TGF alpha in tumor extract was separated from TGF beta and ACSA by reverse phase HPLC. TGF alpha eluted between 26-30% acetonitrile and was identified by RIA. After the initial reverse phase separation, TGF beta and ACSA in tumor extract coeluted between 36-38% acetonitrile. Sequential cation exchange followed by reverse phase HPLC separated TGF beta from ACSA. Evaluation of fractions containing ACSA using an in vitro bone-resorbing assay demonstrated copurification of ACSA and bone-resorbing activity. The PTH receptor antagonist [Nle8,18,Tyr34]bovine PTH-(3-34)-amide, but not [Nle8,18,Tyr34]bovine PTH-(7-34)-amide, completely inhibited ACSA in column eluates. Conditioned cell culture medium from CAC-8 primary cultures contained predominantly latent TGF beta that could be activated by acidification. These findings indicate that the CAC-8 model of cancer-associated hypercalcemia produces a PTH-like factor, TGF alpha, and TGF beta that were separable by reverse phase or cation exchange HPLC. This feature should be useful to investigate the role of TGFs and PTH-like proteins in the pathogenesis of humoral hypercalcemia of malignancy.

Adenocarcinoma↗
PubMed2006

Successful separation of craniopagus parasiticus.

OBJECTIVE: Craniopagus parasiticus is an extremely rare condition. The first attempt to separate such twins was performed in the Dominican Republic in 2004. The infant died 7 hours after surgery. The aim of this report is to present a case in which surgical separation was successfully performed on February 18, 2005. In February 2006, the child was still alive and in relatively good health. METHODS: The authors operated on a patient with craniopagus parasiticus at Benha Pediatric Hospital in Egypt, 45 km north of Cairo. The child was 10 months old when the surgery was performed. By minimizing the time of surgery and adequate control of intraoperative bleeding, a successful surgical separation was achieved. Computed tomography, magnetic resonance imaging, magnetic resonance angiography, and computed tomographic angiography provided the information necessary to perform surgery. RESULTS: The child underwent operation at the age of 10 months; the duration of surgery was 9 hours. Bleeding was the most serious problem, with the child receiving four liters of blood. The main arterial supply to the parasite was via the middle cerebral artery and was ligated in the Sylvian fissure. Bleeding, however, was mostly venous and was mainly controlled by diathermy and thrombin soaked packs of Surgicel, as well as clipping. After separation of the parasitic head, the dura was repaired using artificial dural grafts. Free bone flaps from the parasite were used to cover the osseous defect in the autosite. Skin flaps from the parasite were also used to cover the cranium. CONCLUSION: This is the second case of craniopagus parasiticus in which separation was attempted. The first patient, operated on in the Dominican Republic, died 7 hours after surgery. In the present case, the child is still alive and without neurological deficit.

Craniotomy↗
PubMed1989

Altered expression of spatially regulated embryonic genes in the progeny of separated sea urchin blastomeres.

We have examined the importance of the extracellular environment on the ability of separated cells of sea urchin embryos (Strongylocentrotus purpuratus) to carry out patterns of mRNA accumulation and decay characteristic of intact embryos. Embryos were dissociated into individual blastomeres at 16-cell stage and maintained in calcium-free sea water so that daughter cells continuously separated. Levels of eleven different mRNAs in these cells were compared to those in control embryos when the latter reached mesenchyme blastula stage, by which time cells in major regions of the intact embryo have assumed distinctive patterns of message accumulation. Abrogation of interactions among cells resulted in marked differences in accumulation and/or turnover of the individual mRNAs, which are expressed with diverse temporal and spatial patterns of prevalence in intact embryos. In general, separated cells are competent to execute initial events of mRNA accumulation and decay that occur uniformly in most or all blastomeres of the intact embryo and are likely to be regulated by maternal molecules. The ability of separated cells to accumulate mRNAs that appear slightly later in development depends upon the presumptive tissue in which a given mRNA is found in the normal embryo. Messages that normally accumulate in cells at the vegetal pole also accumulate in dissociated cells either at nearly normal levels or at increased levels. In one such case, that of actin CyIIa, which is normally restricted to mesenchyme cells, in situ hybridization demonstrates that the fraction of dissociated cells expressing this message is 4- to 5-fold higher than in the normal embryo. In contrast, separated cells accumulate significant levels of a message expressed uniformly in the early ectoderm but are unable to execute accumulation and decay of different messages that distinguish oral and aboral ectodermal regions. These data are consistent with the idea that interactions among cells in the intact embryo are important for both positive and negative control of expression of different genes that are early indicators of the specification of cell fate.

Animals↗
PubMed1992

Changes in the metaphase transit times and the pattern of sister chromatid separation in stamen hair cells of Tradescantia after treatment with protein phosphatase inhibitors.

Stamen hair cells from the spiderwort plant, Tradescantia virginiana, exhibit remarkably predictable metaphase transit times, making them uniquely suitable for temporal studies on mitotic regulation. In this study, we describe two kinds of experiments that test whether protein phosphatase activity is a necessary prerequisite for entry into anaphase in living, mitotic cells. We treated cells at specific points during prophase, prometaphase and metaphase with the broad-spectrum protein phosphatase inhibitor, alpha-naphthyl phosphate (administered by microinjection), or with the naturally occurring, potent phosphatase inhibitors okadaic acid, microcystin-LR or microcystin-RR (administered by perfusion), and we have observed changes in the metaphase transit time that are primarily dependent on the time of initial exposure to the inhibitor. Maximal extensions of the metaphase transit time result from alpha-naphthyl phosphate microinjections initiated in mid-metaphase, 10-20 min after nuclear envelope breakdown. Perfusions with okadaic acid started during a specific interval in mid-metaphase, 15-20 min after nuclear envelope breakdown, resulted in a statistically significant extension of the metaphase transit time. Perfusions with either microcystin-LR or microcystin-RR initiated 15-26 min after nuclear envelope breakdown extended the metaphase transit times significantly. Treatments of cells with okadaic acid or with either of the microcystins initiated outside this mid-metaphase interval either were without effect or, alternatively, resulted in a significant shortening of the metaphase transit time. In addition to their effects on the timing of anaphase onset, treatments with these protein phosphatase inhibitors also resulted in a remarkable change in the way in which these cells enter anaphase. Sister chromatid separation in stamen hair cells typically requires only 5 seconds, but after treatment with any of these inhibitors some, but not all, of the chromatids split apart at anaphase onset. Those that split begin to migrate toward the spindle pole regions, while those that fail to split remain at the metaphase plate. Later, more of the paired chromatids split apart and begin moving toward the spindle pole regions. Those that fail to separate remain at the metaphase plate. This process can be repeated several times before all of the chromatids have separated. Thus, entry into anaphase becomes extremely asynchronous, and as much as 30 min can transpire between the centromeric separation of the first and last chromosomes. Some of the chromosomes complete their anaphase movements before others have even split apart at the metaphase plate. Asynchronous separation did not result in a permanent segregation anomaly.(ABSTRACT TRUNCATED AT 400 WORDS)

Anaphase↗
PubMed2003

Ventricular haemodynamics in Python molurus: separation of pulmonary and systemic pressures.

Vascular pressure separation by virtue of a two-chambered ventricle evolved independently in mammals and birds from a reptilian ancestor with a single ventricle, and allowed for high systemic perfusion pressure while protecting the lungs from oedema. Within non-crocodilian reptiles, ventricular pressure separation has only been observed in varanid lizards and has been regarded as a unique adaptation to an active predatory life style and high metabolic rate. The systemic and pulmonary sides of the ventricle in Python molurus are well separated by the muscular ridge, and a previous study using in situ perfusion of the heart revealed a remarkable flow separation and showed that the systemic side can sustain higher output pressures than the pulmonary side. Here we extend these observations by showing that systemic blood pressure P(sys) exceeded pulmonary pressure P(pul) almost seven times (75.7+/-4.2 versus 11.6+/-1.1 cm H(2)O). The large pressure difference between the systemic and pulmonary circulation persisted when P(sys) was altered by infusion of sodium nitroprusside or phenylephrine. Intraventricular pressures, measured in anaesthetised snakes, showed an overlap in the pressure profile between the pulmonary side of the ventricle (cavum pulmonale) and the pulmonary artery, while the higher pressure in the systemic side of the ventricle (cavum arteriosum) overlapped with the pressure in the right aortic arch. This verifies that the pressure differences originate within the ventricle, indicating that the large muscular ridge separates the ventricle during cardiac contraction.

Animals↗
PubMed2004

Separation of stereoisomers of some terpene derivatives by capillary gas chromatography-mass spectrometry and high-performance liquid chromatography using beta-cyclodextrin derivative columns.

Gas chromatographic separations of the stereoisomers of menthol derivatives, important intermediates in the synthesis of physiologically active natural products, were carried out on several substituted beta-cyclodextrin (CD) columns, including per-O-methyl-beta-cyclodextrin (PME-beta-CD), heptakis(2,3-di-O-acetyl-6-tert-butyldimethylsilyl)-beta-CD (DIAC-6-TBDS-beta-CD), and heptakis(2,3-di-O-methyl-6-tert-butyldimethylsilyl)-beta-CD (DIME-6-TBDS-beta-CD) as chiral stationary phases (CSPs). With the DIME-6-TBDS-beta-CD column, a separation of the Z- and E-isomers of methylidenementhol was accomplished; no separation was achieved with the other columns. The stereoisomers of methylidenementhol and the corresponding tert-butyldimethylsilyl (TBS) ether were separated on both the beta-CD and the heptakis(2,3,6-tri-O-methyl)-beta-cyclodextrin (TME-beta-CD) columns by high-performance liquid chromatography (HPLC) with a mobile phase involving acetonitrile and H(2)O. For the separation of the Z- and E-isomers of methylidenementhol, the TME-beta-CD column was superior. In contrast, the beta-CD column was preferable in the case of the corresponding TBS ether.

Chromatography, High Pressure Liquid↗
PubMed2003

[Problems of the separation of prescription and dispensing].

By October 2002, the separation of prescribing and dispensing in Japan had already been implemented for 28 years since the system was inaugurated in 1974. Although the separation rate reached 44.5% in 2001, the questions, "Is the separation necessary in Japan?" or "Has the system been working successfully?" are often heard. These questions are raised because people have not noted the advantages of the system yet, and because the separation itself has many problems or shortcomings. These questions are not only from pharmacists, but also from physicians, patients, or medical and educational institutions. If the problem concerns pharmacists, it is assumed to stem from their lack of ability required for the separation. A breakthrough for an early solution of the problem will be found in a change in education, which includes a range of clinical subjects and long-term clinical practices.

Drug Prescriptions↗