In order to synthesize biocompatible materials that are used for artificial organs, hybridization of materials with biologically active substances seems to be most effective. To prevent coagulation upon blood/materials contact, hybridization with the materials of the repressor of coagulation factors or platelet and the activator of fibrinolysis has been done. Simultaneous hybridization of two kinds of biologically active substances has also been found effective. Recently, cell/materials hybridization is particularly popular. For this type of hybridization composite materials have been developed that are convenient for cell lining or in vivo compatible with living cells. This method will lead to the control of cell functions with suitable materials and a future development is expected.

Previous studies have shown that the process of recovery after disuse muscle atrophy varies in different experimental models. We investigated the process of recovery of M, soleus atrophy after immobilization, with special reference to changes in structural and soluble proteins by means of electrophoresis and histochemical changes using myosin-ATPase staining. After rabbits had been subjected to 3 weeks of hindlimb immobilization, the changes were investigated immediately after the termination of immobilization, and at 1, 2, 3, 4 and 6 weeks of recovery. Just after the termination of immobilization, the wet weight of the M. soleus was 32.7±14.0% that of the opposite limb. The wet weight recovered rapidly and returned to the same level as that of the opposite side by 4 weeks. The amount of structural proteins decreased after immobilization, but did not return to the control level at 6 weeks after recovery. No new bands appeared in the electrophoretic patterns of the structural and soluble proteins at any of the stages of recovery. Furthermore, the special features of the bands of myosin light chains (MLCs-1, MLCs-2) also showed no change. ATPase staining showed that the area of type 2 fibers increased, and occupied 45.2±12.6% of the total area at 3 weeks after recovery, whereas that of muscle from controls occupied 17.3±5.7%. The area did not return too the control level by 6 weeks of recovery. The discrepancy between the histochemical changes and the changes in structural or soluble proteins during the recovery process appeared to be due to differences in the turnover ratio of each protein. It appears that the process of recovery of disuse muscle atrophy after immobilization is variable and compley, and differs according to the method of observation.

The aim of the current nationwide survey was to investigate the Kampo medicine experiences of Japanese physicians working at hospitals designated as core cancer centers by the Ministry of Health, Labour and Welfare. Among the 900 physicians surveyed, 92.4% reported having prescribed Kampo medications, of whom 73.5% reported having prescribed them for cancer patients. Despite this high percentage, only 28.7% of the physicians had studied Kampo medicine.
This survey found that over 40% of physicians in each generation had no intention of learning Kampo medicine. When asked to categorize their expectation of Kampo efficacy, about 30% said they had an ‘expectation’, a ‘no and yes expectation’, and ‘no expectation’ respectively.
However, physicians who had experience learning Kampo medicine had more expectation than physicians who had not. And the same expectation tendency for prophylaxis treatment was shown in physicians with that experience and those without. This difference is disadvantageous to patients. We therefore believe it necessary to create an environment in which physicians can learn Kampo medicine and methodology, which engenders cooperation between Kampo specialists and Japanese physicians in the treatment of cancer.

This study was conducted to assess the appropriateness of preparation fees for dispensing herbal medicines, which were revised in 2006. We investigated the amount of time needed to dispense herbal, and general medicines. For prescriptions of1to 15 days length, the average time needed for herbal prescriptions was 13.4 minutes, which was about 3 times longer than for other prescriptions, which took only 4.4 minutes. For prescriptions of over 30 days length, this was about 7 times longer. Next we comparatively investigated fees charged per minute to prepare herbal medicines, with those for other medicines. Fees for all prescriptions of 1 to 15 days length were nearly equal, while fees for herbal prescriptions of over 15 days length were approximately 1/3 to 1/5l ess. Finally, we investigated the number of prescriptions filled out at one university hospital. In 2003 the number of herbal prescriptions exceeding 30 days length was 2.7% overall, while in 2008 this had increased approximately 14 times, to 42%. We would like to recommend an increase in herbal medicine preparation fees, based on the number of days a prescription is for, as the number of long-term prescriptions is increasing.

Background: On receiving chemotherapy, extravasation of drugs is a severe problem. The extravasations occur more commonly in patients who are elderly, have a poor performance status, have diabetes mellitus complications or have repeatedly received chemotherapy. Also, cancer patients usually require repeated venous punctures for this treatment. Purpose and methods: For the purpose of evaluating the efficacy and safety of peripherally inserted central catheters (PICCs) for intravenous chemotherapy, we retrospectively reviewed all the cancer patients for whom PICC were inserted for chemotherapy from April 2008 to December 2010. Patients' background, duration of PICC insertion and complications were evaluated in this study. Results: Ten patients (male 4, female 6) were reviewed in this study. The median age was 59 years (17∼69). A total of 13 PICCs were inserted in 10 patients. The most common underlying disease was abdominal rhabdomyosarcoma (n=3, 30%) followed by lung cancer (n=2, 20%) and hematologic tumor (n=2, 20%). The average catheter span was 46 days. Catheter-related infections were seen in 2 cases (15.4%). No phlebitis or thrombosis usually associated with venous route was detected in PICC used for chemotherapy. Conclusions: PICC might reduce patients' discomfort such as repeated venous punctures or complications associated with chemotherapy. We suggest that PICC would be one of the effective tools in chemotherapy. Palliat Care Res 2011; 6(2): 233-236

Background: This study aimed to determine whether changes in phase angle during rehabilitation are associated with clinical outcomes such as activities of daily living (ADL), skeletal muscle mass index (SMI), and strength in patients with osteoporotic fractures. Methods: This retrospective observational study included patients with osteoporotic fractures admitted to convalescent rehabilitation wards. Changes in phase angle were defined as the difference between the phase angle values at discharge and on admission. The primary outcome was the Functional Independence Measure motor (FIM-motor) score at discharge. The secondary outcomes were SMI and handgrip strength at discharge. We used multivariate analysis to adjust for confounding factors and examine the association between changes in the phase angle and outcomes. Results: We analyzed a total of 115 patients (97 women, mean age of 81.0±10.0 years), with a median change in phase angle of 0° during hospitalization. We observed increased phase angles in 49 patients (43%), with a median increase of 0.2°. Multiple regression analysis showed that changes in phase angle were independently associated with FIM-motor score at discharge (β=0.238, p=0.027). Changes in phase angle were not significantly associated with SMI (β=0.059, p=0.599) or handgrip strength (β=-0.032, p=0.773) at discharge. Conclusion An increased phase angle during rehabilitation was positively associated with ADL improvement in patients with osteoporotic fractures. These findings may help clinicians make informed decisions regarding patient care and treatment strategies for better outcomes.

Afferent loop syndrome is often difficult to resolve. Among patients with afferent loop syndrome whose data were extracted from databases, 5 patients in whom metal stent placement was attempted were included and evaluated in this study. The procedure was technically successful without any adverse events in all patients. Metal stent(s) was placed with an endoscope in the through-the-scope manner in 4 patients and via a percutaneous route in 1 patient. Obvious clinical efficacy was observed in all patients. Adverse events related to the procedure and stent occlusion during the follow-up period were not observed. Metal stent placement for malignant obstruction of the afferent loop was found to be safe and feasible.
Afferent Loop Syndrome ; Endoscopes ; Follow-Up Studies ; Humans ; Intestinal Obstruction ; Palliative Care ; Self Expandable Metallic Stents ; Stents* ; Treatment Outcome

Although numerous studies have shown that each neuropsychological test is effective for diagnosing mild cognitive impairment (MCI) or Alzheimer’s disease (AD), studies comparing diagnostic accuracies of various neuropsychological tests are relatively rare and practical cutoff values are not available. The present study aimed to investigate the validity of neuropsychological tests and develop cutoff values for each in differentiating healthy control (HC), MCI and AD groups. A total of 84 HC, 187 with MCI and 195 with AD were evaluated by the selected seven neuropsychological tests using receiver operating characteristic (ROC) curve analysis. Logical Memory (LM) delayed recall (cutoff, 7) and Rey Auditory Verbal Learning Test (RAVLT) delayed recall (cutoff, 6) were effective for differentiating HC from MCI. To distinguish MCI and AD, Rey Osterrieth Complex Figure Test (ROCFT) 3 mindelayed recall (cutoff, 6) and LM immediate recall (cutoff, 4) were excellent. Delayed recall of verbal materials, as indexed by LM and RAVLT was sensitive for discriminating MCI from HC. Handling visual memory traces, as indexed by ROCFT and immediate verbal information by LM were sensitive for differentiating MCI and AD.
Alzheimer Disease ; Dementia ; Neuropsychological Tests

Prediction of histology by endoscopic examination is important in the clinical management of non-ampullary duodenal epithelial tumors (NADETs), including adenoma and adenocarcinoma. The use of a simple scoring system based on the findings of white-light endoscopy or magnified endoscopy with narrow-band imaging is useful to differentiate between Vienna category 3 (C3) and C4/5 lesions. Less invasive endoscopic resection procedures, such as cold snare polypectomy, are quick to perform and convenient for small (<10 mm) C3 lesions. Neoplasms with higher grade histology, such as C4/5 lesions, should be treated by endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), or surgery. Although EMR often requires piecemeal resection, the complication rate is acceptable. Excellent complete resection rates could be achieved by ESD; however, it remains a challenging method considering the high risk of complications. Shielding or closure of the ulcer after ESD is effective at decreasing the risk of delayed bleeding and perforation. Laparoscopic endoscopic cooperative surgery is an ideal treatment with a high rate of en bloc resection and a low rate of complications, although it is limited to high-volume centers. Patients with NADETs could benefit from a multidisciplinary approach to stratify the optimal treatment based on endoscopic diagnoses.

Background: Endoscopic ultrasound-guided drainage (EUSD) is an effective treatment for postoperative pancreatic fluid collections (POPFCs); however, standards regarding stents used for EUSD have not been established. This study analyzed the outcomes of EUSD of POPFCs at our hospital and examined the safety and effectiveness of plastic stents/tubes. Methods: This retrospective, single-center study focused on EUSD of POPFCs performed at our hospital. We examined the rates of technical success, clinical success, adverse events, and recurrence. Results: Twenty-seven patients were included in this study. The initial drainage methods comprised one nasocystic plastic tube (NPT) and one double-pigtail plastic stent (DPS) for 19 (70.4%) patients, two DPS for four (14.8%) patients, one NPT for three (11.1%) patients, and one lumen-apposing metal stent for one (3.7%) patient. The technical success and clinical success rates were both 100%. Fourteen of the 19 patients with one NPT and one DPS improved, but five patients required additional interventions and improved with fistula site dilation. Although recurrence occurred in one patient, improvement was achieved with second EUSD. Early adverse events comprised one case of bleeding for which hemostasis was achieved by performing coil embolization. Late adverse events comprised three cases of DPS migration; however, no additional intervention was required. Conclusion The use of plastic tubes/stents is safe and effective for EUSD of POPFCs.