With the introduction of digital medical examination vehicles, we intended to increase the efficiency of the mass health screening services by building up an environment convenient to study radiographic images and to make them available promptly for diagnosis and treatment. However, the result was not as good as we had expected. A number of problems came up. Although high precision monitoring devices were installed for radiographic interpretations, lists of examinees expressed only in figures for identification and texts superimposed on radiographic images became so small in type size that the risks of making medical errors and mistaking one examinee for another were increased.　　Therefore, we connected a laptop computer as a portable MWM server to the console to take in information about the examinee when he or she has an X-ray. If the examinee had no hospital ID cards, we issued a provisional ID. To differentiate the examinee with the provisional ID from the individual on the list of the examinees, the running numbers were issued, using the accession numbers indicating the date and time of examination and the kind of modality. Thanks to these new systems, it has been made possible to include information about individuals such as ID, name and sex on X-ray photos. Thus, the reliability of radiologic interpretation has been assured.

The nuclear hormone receptor PPARgamma is activated by several agonists, including members of the thiazolidinedione group of insulin sensitizers. Pleiotropic beneficial effects of these agonists, independent of their blood glucose-lowering effects, have recently been demonstrated in the vasculature. PPARgamma agonists have been shown to lower blood pressure in animals and humans, perhaps by suppressing the renin-angiotensin (Ang)-aldosterone system (RAAS), including the inhibition of Ang II type 1 receptor expression, Ang-II-mediated signaling pathways, and Ang-II-induced adrenal aldosterone synthesis/secretion. PPARgamma agonists also inhibit the progression of atherosclerosis in animals and humans, possibly through a pathway involving the suppression of RAAS and the thromboxane A2 system, as well as the protection of endothelial function. Moreover, PPARgamma-agonist-mediated renal protection, especially the reduction of albuminuria, has been observed in diabetic nephropathy, including animal models of the disease, and in non-diabetic renal dysfunction. The renal protective activities may reflect, at least in part, the ability of PPARgamma agonists to lower blood pressure, protect endothelial function, and cause vasodilation of the glomerular efferent arterioles. Additionally, anti-neoplastic effects of PPARgamma agonists have recently been described. Based on the multiple therapeutic actions of PPARgamma agonists, they will no doubt lead to novel approaches in the treatment of lifestyle-related and other diseases.
Animals ; Atherosclerosis/prevention & control ; Humans ; Hypertension/drug therapy ; Hypoglycemic Agents/*pharmacology ; Kidney Diseases/etiology ; PPAR gamma/*agonists ; PPAR-beta/agonists

[Objectives] In this study, we examined the effects of acupuncture stimulation on short latency reflexes (SLR) and long latency reflexes (LLR) to determine the site of acupuncture stimulation in modulating motor reflexes. Further, we investigated the relationship between changes in LLR and changes in the N20 somatosensory evoked potential (SEP) component induced by acupuncture stimulation and examined changes in central motor conduction time (CMCT).[Subjects and Methods] Sixteen healthy and right-handed adults (11 males and 5 females; 28.9 ± 6.6 years old; upper limb length 54.9 ± 3.2 cm) participated in this study. The experiments were performed under three conditions: (1) control (no acupuncture stimulation), (2) acupuncture stimulation of right-sided Hegu (LI4), and (3) acupuncture stimulation of left-sided LI4. An acupuncture needle (0.18 mm in diameter) was inserted up to a depth of 10 mm at the right- or left-sided LI4. Electrical stimulation was delivered to the median nerve in the right hand joint at a 120% intensity compared with the threshold to produce an M-wave. SLR and LLR were recorded from the opponens pollicis muscle of the right hand. The frequency and amplitude ratio of SLR (latency, approximately 20-30 ms) and LLR (latency, approximately 40-70 ms) were analyzed. SEP was produced by electrical stimulation delivered to the median nerve. The amplitude from baseline and mean latency of N20 waves were measured. F-wave in the evoked electromyography was evoked by electrical stimulation of the median nerve of the right hand at supramaximal intensity to elicit an M-wave and recorded from the opponens pollicis muscle of the same hand. We analyzed the mean latency and calculated the CMCT using the mean latencies of LLR, N20, F-wave, and M-wave.[Results] The frequency and amplitude ratio of SLR were reduced by acupuncture stimulation of left- and right-sided LI4, respectively. LLR frequency and amplitude ratio were reduced by acupuncture stimulations on either side. A correlation was observed between changes in the LLR amplitude ratio and changes in the N20 SEP amplitude ratio induced by acupuncture stimulation. No effect of acupuncture stimulation was observed on CMCT. [Discussion and Conclusion] SLR is the reflex potential of the spinal cord, and LLR is the motor reflex of the central nervous system via supraspinal pathways. These findings suggest that acupuncture stimulation inhibits motor nerve reflexes via both spinal and supraspinal modulation systems.

Background/Aims: Gastric acid secretion is suspected to be a pivotal contributor to the pathogenesis of functional dyspepsia. The present study investigates the potential association of the gastric acid secretion estimated by measuring serum pepsinogen with therapeutic responsiveness to the prokinetic drug acotiamide. Methods: Dyspeptic patients consulting participating clinics from October 2017 to March 2019 were prospectively enrolled in the study. The dyspeptic symptoms were classified into postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS). Gastric acid secretion levels were estimated by the Helicobacter pylori infection status and serum pepsinogen using established criteria and classified into hypo-, normo-, and hyper-secretion. Each patient was then administered 100 mg acotiamide thrice daily for 4 weeks, and the response rate to the treatment was evaluated using the overall treatment efficacy scale. Results: Of the 86 enrolled patients, 56 (65.1%) and 26 (30.2%) were classified into PDS and EPS, respectively. The estimated gastric acid secretion was not significantly different between PDS and EPS. The response rates were 66.0% for PDS and 73.1% for EPS, showing no significant difference. While the response rates were stable, ranging from 61.0% to 75.0% regardless of the estimated gastric acid secretion level among subjects with PDF, the rates were significantly lower in hyper-secretors than in non-hyper-secretors among subjects with EPS (42.0% vs 83.0%, P = 0.046). Conclusion Although acotiamide is effective for treating EPS as well as PDS overall, the efficacy is somewhat limited in EPS with gastric acid hypersecretion, with gastric acid suppressants, such as proton pump inhibitors, being more suitable.