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To test whether the leukotriene antagonist ONO-1078 (pranlukast) prevents asthma exacerbations during reduction of high-dose inhaled corticosteroid, we conducted a randomized, double-blind, placebo-controlled study in 79 asthma patients requiring high doses (1,500 microg/d or more) of inhaled beclomethasone dipropionate (BDI) for clinical control (duration of asthma, 11.0 +/- 3.1 yr; duration of BDI treatment, 0.5 +/- 0.3 yr; FEV1 percentage of predicted, 80.7 +/- 2.0%). After a 2-wk run-in period, the doses of BDI were halved, while the patients were assigned to receive orally ONO-1078, 450 mg twice daily, or placebo. In the placebo group FEV1 decreased by 0.33 +/- 0.20 L after 6 wk (p < 0.001). Likewise, morning and evening PEF decreased by 46 +/- 7 L/min and 18 +/- 6 L/min, respectively. By contrast these variables were sustained above baseline in the ONO-1078 group. The number of daytime and nighttime asthma symptoms and the use of beta2-agonist increased in the placebo group, whereas they remained unchanged in the ONO-1078 group. In the placebo group concentrations of serum eosinophil cationic protein and exhaled nitric oxide increased (p = 0.007 and p = 0.025, respectively), compared with no change in the ONO-1078 group. Therefore, the leukotriene antagonist ONO-1078 prevents the asthma deterioration provoked by a 6-wk reduction of the dose of inhaled BDI into half.

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The mechanical deformation of a human fingertip pressed on a flat plate was numerically analyzed using a three-dimensional human fingertip model based on CT images of a human index finger. The fingertip model consisted of three components: the distal phalanx, the nail, and the soft tissue composed of skin and subcutaneous tissue. The analyses were performed for seven different values of Young's moduli in the range 34 to 200 kPa, and for five different values of Poisson's ratios in the range 0.3 to 0.5. The numerical results obtained were compared with reported experimental data for a human fingertip. The numerical results showed that the deformation around the nail and the distal fingertip was generated subsequent to the generation of a large deformation of the pulp. The numerical deformation results showed a similar pattern as the experimental data. Using the numerical results, we calculated the length of the contact area from the lateral view and the width of the contact area from the axial view in order to qualitatively estimate the deformation. By comparing the numerical and experimental results, we found that there were no unique values of Young's modulus and Poisson's ratio for expressing the experimental results. These results suggest that the epidermal, the dermal, and the fat tissue constituting the soft tissue may influence the mechanical deformation by different amounts.

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