Biological age based on the assessment of various physiological factors measured in a resting state has been proposed as an appropriate index of aging. We have recently developed an equation for estimation of physical fitness age (PFA), which is composed of eight age-related physical fitness variables. These include oxygen uptake corresponding to lactate threshold (Vo₂@LT), maximal oxygen uptake (Vo₂max), side step, grip strength, vertical jump, foot balance with eyes closed, trunk extension, and trunk flexion. In this study, the validity of PFA as a critical index of physical health and/or aging status was investigated from a longitudinal standpoint on the assumption that exercise habituation does contribute to health promotion. The subjects were 14 Japanese middle-aged and elderly men, aged 50 to 70 years, all of whom were patients with coronary heart disease (CHD) . The subjects participated in a supervised exercise conditioning program for 90 to 120 min each session, 2 times weekly for 4 months. Analyses of the data indicated that the mean PFA of the subjects (66.0±9.0 yr) after conditioning was significantly (P<0.05) lower than the mean PFA (72.8±8.6 yr) obtained before conditioning. After the exercise program, significant increases were documented in Vo₂@LT (17%), Vo₂max (12%), side step (26%), trunk flexion (109%), trunk extension (7%), vertical jump (12%), and foot balance with eyes closed (31%) . Therefore, we conclude that our exercise conditioning program may alter the overall physical fitness of patients with CHD, and that PFA could be a valid physical health and/or aging index.

Objective: This study aimed to enhance Drug Information Practice Experiences (DIPE) in Japan by comparing DIPEs at Tohoku University Hospital (TUH) with Nova Southeastern University (NSU) in the United States, and propose an advanced model of drug information (DI) education in Japan.
Methods: We performed the following: (i) comparison of both DIPEs based on Model Core Curriculum (MCC) content; (ii) identification of practices which were not part of NSU or TUH DIPE; (iii) comparison of students’ DIPE performance based on MCC: (A) students’ performance without the preceptors and their post-performance approval, (A’) students’ performance without the preceptors and their pre-performance approval, and (B) students’ performance under direct preceptor supervision; (iv) highlighting differences between TUH and NSU DIPEs; and (v) proposing an advanced model of DI education in Japan.
Results: (i) The NSU DIPE is similar to the MCC.  An example difference between NSU and TUH learning strategies was that NSU students responded to the inquiries made by the phone whereas TUH students receive assignments and explanation from preceptors.  (ii) DIPE at NSU utilized oral presentations and student interaction in many forms (e.g. journal club, reflection regarding learned topics).  On the other hand, DIPE at TUH helped students learn about Medical Representative jobs and educated them in tablet/capsule identification practices.  (iii) In contrast, the TUH curriculum limits students’ performance to “experience via dissemination with health professional needs and patients’ needs”.  (iv) These clarified points are considered to be differences between DIPE at TUH and NSU.  (v) Following analysis of these points, an advanced model of DI education based on responses to DI phone inquiries and oral presentations including a journal club was proposed.
Conclusions: This study will contribute to improving DI education in Japan.

BACKGROUND/AIMS: Noninvasive objective monitoring is advantageous for optimizing treatment strategies in patients inflammatory bowel disease (IBD). Fecal calprotectin (FCP) is superior to traditional biomarkers in terms of assessing the activity in patients with IBD. However, there are the differences among several FCP assays in the dynamics of FCP. In this prospective multicenter trial, we investigated the usefulness of FCP measurements in adult Japanese patients with IBD by reliable enzyme immunoassay using a monoclonal antibody. METHODS: We assessed the relationship between FCP levels and disease or endoscopic activity in patients with ulcerative colitis (UC, n=64) or Crohn’s disease (CD, n=46) compared with healthy controls (HCs, n=64). RESULTS: FCP levels in UC patients strongly correlated with the Disease Activity Index (rs =0.676, P < 0.0001) and Mayo endoscopic subscore (MES; rs =0.677, P < 0.0001). FCP levels were significantly higher even in patients with inactive UC or CD compared with HCs (P=0.0068, P < 0.0001). The optimal cutoff value between MES 1 and 2 exhibited higher sensitivity (94.1%). FCP levels were significantly higher in active UC patients than in inactive patients (P < 0.001), except those with proctitis. The Crohn’s Disease Activity Index tended to correlate with the FCP level (rs =0.283, P=0.0565). CONCLUSIONS: Our testing method using a monoclonal antibody for FCP was well-validated and differentiated IBD patients from HCs. FCP may be a useful biomarker for objective assessment of disease activity in adult Japanese IBD patients, especially those with UC.
Adult* ; Antibodies, Monoclonal ; Asian Continental Ancestry Group* ; Biomarkers ; Colitis, Ulcerative ; Crohn Disease ; Humans ; Immunoenzyme Techniques ; Inflammatory Bowel Diseases* ; Leukocyte L1 Antigen Complex* ; Methods ; Multicenter Studies as Topic ; Proctitis ; Prospective Studies*

[Objective] We report a successfully treated case by a combined therapy of acupuncture and Kampo medicine for a patient with lower limb pain associated with Guillain-Barre syndrome (GBS).[Case] The patient was a 74-year-old man whose chief complaints were severe lower limb pain, gait difficulty, and hyposthenia. Clinical history: In late September in X year, the patient had a cold infection. On October 14, he became aware of weakness in his lower limbs on both sides, difficulty in walking, and severe pain in his lower limbs. He visited our hospital's general internal medicine department and was diagnosed with GBS. The patient was hospitalized and started to receive intravenous immunoglobulin therapy for GBS. Since pain in the lower limbs continued after treatment, he received analgesics, which was not effective. Therefore, acupuncture treatment was started on October 30 aiming to alleviate lower limb pain. Evaluation: Pain and burning sensation were evaluated using a numerical rating scale (NRS), and Hughes' function grade scale (FG) as an objective evaluation. [Acupuncture treatment] The acupuncture treatment was based on Chinese medicine. The basic combination of meridian points for treatment of the case were LR3 (Taichong), LI4 (Hegu), KI6 (Zhaohai), KI3 (Taixi), ST36 (Zusanli), PC6 (Neiguan), and SI8 (Xiaohai). The patient received acupuncture treatments once a day for 12 weeks.[Progress] The first evaluation of the patient's pain in his lower limbs on both sides was 10 points in NRS and 4 units in FG. Pain was alleviated immediately after acupuncture treatment was started, and a significant improvement in pain was observed by the seventh acupuncture treatment. However, the　patient started to complain of burning sensation on his soles. Therefore, the combined use of Kampo medicine (Choutousan, Rokumijiougan) were introduced in addition to the acupuncture treatment, and his burning sensation disappeared. Since then, rehabilitation was enhanced, and after three months from the start of acupuncture treatment, he was discharged since the FG was improved to 2 units. [Discussion] Lower limb pain and burning sensation in this case were considered to be neuropathic pain associated with GBS, and conventional analgesics were only temporarily effective. In contrast, the combined use of acupuncture and Kampo medicine alleviated the pain and burning sensation, and ADL was improved. Acupuncture and Kampo medicine were effective for lower limb pain and burning sensation from GBS.