The assessment of suffering in cancer patients affected by dementia can be challenging. We report a patient with advanced skin cancer and dementia who was admitted to our hospital without appropriate diagnosis as having cerebral infarction at previous hospitals. Case:An 85-year-old woman presented with existing cognitive dysfunction from 2009 and progression of a left facial skin tumor existing from 2013. She was admitted to hospital A for facial skin tumor with dysphagia, and diagnosed as having advanced skin cancer with dementia in June 2014. After palliative therapy for the skin tumor, she was transferred to hospital B. The physicians at both hospitals explained the presenting symptoms as complications of her advanced skin cancer and dementia. She was admitted to our hospital at 36 days after symptom onset, and we diagnosed subacute cerebral infarction based on head CT and MRI examinations. In this case, the patient’s advanced cancer and dementia might have interfered with the recognition of her symptoms of cerebral infarction. A detailed interview on admission might have contributed to our decision for further examination. Although the diagnosis of cerebral infarction could not palliate her physical symptoms, it might assist the family to recognize her suffering or to provide care perceiving her poor prognosis. Additionally, the diagnosis might have an effect for emotional satisfaction of the family.

Objective: By using human liver microsomes (HLM), we analyzed the effects of 14 known components of A.senticosus Harms on the activities of CYP2C9 and CYP3A4.
Methods and Results: Sesamin and quercetin inhibited both enzyme activities, whereas quercitrin strongly inhibited CYP3A4 activity. The 50% inhibitory concentrations (IC₅₀s) of sesamin and quercetin on CYP2C9 activity were approximately 124- and 59-fold higher and the IC₅₀s of sesamin, quercetin, and quercitrin on CYP3A4 activity were approximately 427-, 135-, and 22-fold higher than that of A. senticosus Harms extract (ASE), respectively. All these components inhibited both CYP3A4 and CYP2C9 in a non-competitive manner. However, these components are present in small amounts in ASE.
Conclusion: Therefore, the food-drug interactions caused by A. senticosus Harms are presumed to be due to the additive or synergistic interaction of these components or the other existing components, including their metabolites.

The therapeutic effect of artificial CO₂ pack on pressure sores of five patients with neurological diseases was confirmed using an infrared thermometer.
The artificial CO₂ pack was prepared by dissolving a 5-g KAO-BABU tablet in 250ml of water at 50°C.
It was proven that the pressure sore recovered faster after treatment with artificial CO₂ hot-pack than that with plain water hot-pack.
In addition, the skin temperature in the area around the pressure sore became lower than the temperature just before the treatment presumably because of the steal phenomenon of blood flow under the skin.

In recent years, due to the rapid changing social structure, thedemands for medical services are also changing. There is a need to explore the future direction of acupuncture and moxibustion. Therefore, using the keyword "patient"as the focus of medicalservices, we discussed the question, "What is meant by 'patient-centered'Acupuncture and Moxibustion?"
Our results indicate that the numerous clinical treatments, education, and research that occurred throughout the long history of acupuncture and moxibustion in Japan were in fact all done "for the patient."However, we note that there is still room for improvement in verification method and cooperation between each field, and we confirmed that there is a need to build Acupuncture and Moxibustion methods that truly represent "patient-centered medicine."

The purpose of this study was to examine effects of moderate-intensity endurance exercise on reactive oxygen species production and leukocyte activation markers in young and middle-aged persons. Blood samples were collected before and after the jogging of 10 km. Although cytokines recruiting and priming neutrophils and monocytes were released into the circulation and functional after the jogging of 10 km, reactive oxygen metabolites-derived compounds (d-ROMs) were not significantly increased. It was indicated that chemokines and leukocyte activation markers at rest were increased with aging, and that might be accompanied by the higher level of d-ROMs in the elderly.

This study clarified practices in end-of-life care for non-malignant chronic illness patients by expert nurses in general hospitals. Interviews with 7 chronic illness specialist nurses on practice cases were conducted, and final labels were elicited using a qualitative synthesis method（KJ method）. As patients’ conditions deteriorated, nurses defined the necessary interactions to support patients’ decision-making for living their own way of life and accompany patients and families based on their experience, and using patients’ restoration of self-esteem, sense of satisfaction, and acceptance as indices. In general hospitals, measures to cope with pain for patients not receiving life-prolonging treatment were insufficient;and while it was difficult to agree on care between medical professionals and to maintain care in other facilities, expert nurses grasped patients’ wishes on a daily basis and made arrangements for them to permeate through family and community care systems. In end-of-life care in treatment settings, it is necessary to be supportive so that the family and medical professionals can continue the patient’s care. Medical professionals who have been involved from the initial diagnosis stage need to improve their awareness and support skills as medical professionals to be involved purposefully from an early stage to the final stage.

Limited evidence was available to support the effect of self-selected activities performed under free-living conditions on postprandial lipaemia, particularly for older adults. Thus, the aim of the present study was to examine the chronic effect of increased physical activity of daily living on postprandial triacylglycerol (TAG) in postmenopausal women. Twenty-eight postmenopausal women, aged 71 ± 4 years (mean ± SD), were randomly divided into two groups: active (n=14) and control (n=14) groups. The participants in the active group were asked to increase their activities above their usual lifestyle levels for 4 weeks; freely deciding the duration and intensity of their chosen activities. The participants in the control group maintained their usual lifestyle for 4 weeks. All participants were asked to wear a uniaxial accelerometer for 4 consecutive weeks. At baseline and after 4 weeks, all participants rested and consumed a standardised breakfast and lunch after a 24-h period of physical activity avoidance. Blood samples were collected in the fasted state (0 h) and at 2, 4 and 6 h after breakfast. After 4 weeks, the participants in the active group increased their step counts by 600 steps/day (from 6979 ± 2057 to 7586 ± 2301 steps/day, p=0.047). There was no difference in the pattern of postprandial TAG response between groups (trial × time interaction, p=0.335). A previous study has suggested that only recent exercise (i.e., 12h before but not 24 h before) appears to facilitate the exercise-induced postprandial TAG lowering effects. Thus, in the present study, postprandial lipaemia was not reduced after performing self-selected activities under free-living in postmenopausal women.

Several studies have reported that molecular hydrogen (H₂) acts as a therapeutic medical gas owing to scavenging reactive oxygen species (ROS). However, little is known about effects of H₂ on exercise-induced oxidative stress. The purpose of this study was to investigate the effects of weekly hydrogen bathing on exercise-induced oxidative stress and delayed-onset muscle soreness (DOMS). Nine healthy and active young men participated in this study, and each subject performed hydrogen bathing trial and placebo bathing trial in a crossover design. The subjects performed downhill running (8 % decline) at 75 % peak oxygen uptake (VO₂peak) for 30 min, and each subjects conducted hydrogen or placebo bathing for 20 min, respectively, 1-6 days after downhill running. Before and after exercise, we measured visual analogue scale (VAS) and collected blood samples (Pre- and 5 min, 60 min after the end of bathing, 1day, 2days, 3days, 7days after downhill running). Blood sample analyses include creatine kinase (CK), myoglobin (Mb), malondialdehyde (MDA), reactive oxygen metabolites (d-ROMs), biological antioxidant potential (BAP), myeloperoxidase (MPO), interleukin-6 (IL-6), interleukin-17a (IL-17a) and lactate concentrations. Weekly hydrogen bathing had no effects of exercise-induced oxidative stress and muscle damage. On the other hand, hydrogen bathing significantly reduced DOMS (VAS) 1 and 2days after downhill running (p=0.033). These findings suggest that hydrogen bath after downhill exercise can be effective for reduction of DOMS.

A 32-year-old woman was referred to our hospital during the 35th week of pregnancy because of chest pain and dyspnea. The cesarean section was performed and a healthy infant was delivered. On the 16th hospital day, she developed heart failure. Echocardiograms revealed protrusion of the mitral valve into the left atrium in systole, vegetation and worsening of mitral regurgitation. CT showed splenic infarction. Mitral valve replacement was performed after inflammatory findings were improved by antibiotics. We reported here a case of infective endocarditis during the perinatal period.

Circadian rhythms have been shown to regulate several physiological functions including body temperature, sleep/wake cycle, physical activity, and cognition. These functions are controlled by circadian clock genes, and the circadian clock system in the body is classified into two clocks which are the central clock in the suprachiasmatic nucleus (SCN) of the hypothalamus and peripheral clocks in peripheral tissues such as the liver and skeletal muscle. Therefore, many researchers are conducting basic and applied research on the relationship between circadian rhythm in peripheral tissues and physiological functions including sports performance and effects of acute exercise and exercise training. On the other hand, it has been shown that abnormal circadian rhythms and disturbance of circadian rhythms can lead to the development of several diseases such as diabetes, cancer, sarcopenia, depression, and dementia. Thus, it is also important to regulate individual circadian rhythm by considering for timing of exercise and daily physical activity. Exercise and physical activity are found to have an influence on circadian rhythms regulation (Chrono-exercise) and accumulate evidences between timing of exercise and health outcomes. This review aims to introduce evidence for chrono-exercise and suggests the importance for considering the timing of exercise and physical activity.