Introduction: Polypharmacy is the practice of prescribing many medications. In this study, we assessed the current status of polypharmacy among elderly patients and cases of inappropriate prescription (IP) at the Department of General Internal Medicine (GIM) at Sendai Medical Center.Methods: We retrospectively surveyed 136 inpatients who were over 65 years old between April 2015 and March 2016 at the Department of GIM.We examined the patient's current medications and used the STOPP (screening tool of older person's potentially inappropriate prescriptions) criteria version 2 to analyze potentially inappropriate medication (PIM) cases.Results: Of 136 study patients, 77 (56.6%) patients were taking more than 6 medications. For patients over 75 years old, the average number of current medications increased.In addition, 33 cases of PIM were confirmed and the number increased in proportion to the number of current medications. Furthermore, there were 4 cases of adverse reactions in which the STOPP criteria version 2 were not applied.Conclusion: In this study, we confirmed polypharmacy in the examined patients.In order to solve the problem of polypharmacy, all medical staff must cooperate and review the prescriptions of individual patients.General physicians should assume the leading role in the distribution and improvement of polypharmacy and IP.

The aim of this study was to investigate the effects of acupuncture to SP 3 on the quadriceps femoris during knee extension in patients with musculoskeletal diseases by applying the meridian concept.
The subjects included 10 healthy individuals with a mean age of 23.1 years, and all of whom provided informed consent for participation. During knee extension, each subject underwent three different types of acupuncture stimuli : 1) stimulation to SP 3, 2) stimulation to SP 4, and 3) no stimulation. For each stimulation,the subjects performed isometric contraction with 40% of maximum voluntary contraction with knee flexion to 60°. Surface electromyography (EMG) of the vastus medialis obliquus, vastus medialis longus, rectus femoris,and the four sites within the vastus lateralis was performed during knee extension before acupuncture stimulation ; immediately after starting stimulation ; and 5, 10, and 15 min after starting stimulation. Relative-integrated EMG data was recorded during and after acupuncture stimulation and compared to data that were recorded before acupuncture as reference values.
The results showed that after 15 min of acupuncture stimulation to SP 3, the relative-integrated EMG data on the vastus medialis obliquus was significantly increased compared to the data obtained without stimulation (p < 0.05).
Therefore, in conclusion, after 15 min of acupuncture stimulation to SP 3, the relative-integrated EMG data on the vastus medialis obliquus exhibited suppressed muscle function.

This study was aimed to evaluate the inhibitory effect of astaxanthin on 7 types of CYP enzymes (CYP1A2, CYP2B6, CYP2C8, CYP2C9, CYP2C19, CYP2D6 and CYP3A4) by using human liver microsomes and to evaluate the inducing effect of astaxanthin on 3 types of CYP (CYP1A2, CYP2B6 and CYP3A4) by using cryopreserved human hepatocytes.Resuts indicated that astaxanthin does not inhibit CYP enzymes within the normal doses and astaxanthin does not induce CYP enzymes within the normal doses.

We performed a retrospective study of the effects of steroids and the factors that deteriorate renal function in 30 patients with primary focal segmental glomerular sclerosis. The mean observation periods from the onset of proteinuria and from the histological diagnosis by renal biopsy were 6.1 ± 5.0 years and 3.9 ± 3.01 respectively. 87% of the patients had been recerving steroid therapy with or without other drugs. In this study, the patients were divided into 3 groups by the initial dose of steroids. A multivariate analysis was performed on the laboratory findings of the 3 groups. In a short-term observation, there were no significant defferences among the groups. However, in a long-term observation (more than one year) it was clarified that the patients who had been given high doses of steroids tend to maintain their renal functoin. We also found that the patients responding to steroids showed a significantly better prognosis than steroid-resistant patients upon examination their nephrotic status and renal functoin.
This statistical analysis confirmed that the factors deteriorating the renal function are hypertension and hyperlipidemia.
In addition, it was revealed that hyperuricemia, is responsible for the renal dissease, failure?

Objective: Early life events connected with the risk of later disease can occur not only in utero, but also in infancy. In study of the developmental origins of health and disease, the relationship between infantile growth patterns and adolescent body mass index and blood pressure is one of the most important issues to verify.
Materials and Methods: We analyzed the correlation of current body mass index and systolic blood pressure of 168 female college students with their growth patterns in utero and in infancy.
Results: Body mass index and systolic blood pressure in adolescence showed positive correlations with changes in weight-for-age z scores between 1 and 18 months but not with those between 18 and 36 months. Stepwise multiple regression analysis showed that both change in weight-for-age z scores from 1 to 18 months and body mass index at 1 month were significantly and independently associated with systolic blood pressure in adolescence. Body mass index at 36 months was positively correlated with body mass index in adolescence, while body mass index at birth was negatively correlated with body mass index in adolescence.
Conclusion: Our findings shows that restricted growth in utero and accelerated weight gain in early infancy are associated with the cardiovascular risk factors of high systolic blood pressure and high body mass index in adolescence. In Japan, an increasing proportion of low birth weight infants and accelerated catch-up growth after birth have been observed in recent decades. This might be an alarming harbinger of an increase in diseases related to the developmental origins of health and disease in Japan.

Astaxanthin, a red carotenoid, has been known to possess excellent antioxidant activity and various biological activities, thereby attracting attention as a functional food material.The safety of astaxanthin administered orally has been demonstrated in human clinical studies for about ten years.In this review, we summarized the clinical studies related to safety, as well as studies on genotoxicity, and acute and subchronic toxicity, with a focus on AstaREAL, an astaxanthin product derived from Haematococcus pluvialis which has been reported in numerous human clinical studies to be safe and to have multiple health benefits.Furthermore, based on the latest research, we reviewed the effect of astaxanthin on drug-metabolizing enzymes involved in drug interactions, and concluded that the safety of H. pluvialis-derived astaxanthin, AstaREAL has been widely confirmed.

An exploratory open-label human clinical study was performed in healthy adults with shoulder stiffness to evaluate the efficacy of Astaxanthin by means of measuring blood flow change in the shoulders and subjective questionnaires on physical conditions, including alleviation of stiffness before and after treatment. Two capsules containing 3 mg Astaxanthin each (6 mg in total) were administered once daily (6 mg a day) on days 1 to 28 (4 weeks) to 13 patients (3 men/10 women). All patients were assessed for efficacy and the study demonstrated significant improvements in physical conditions such as shoulder stiffness, physical fatigue, sense of mental irritation, sense of coldness in hands and feet, eye fatigue and eye bleariness. Significant increases of blood flow in shoulders were observed at the end of treatment using laser-doppler graphics. Blood tests conducted to confirm safety before and at the end of treatment showed no clinical differences, and no adverse side effects were reported. In conclusion, Astaxanthin appeared to safely alleviate stiff shoulders and improve other physical conditions during a 4-week open-label study.

Objectives: To study the effect of astaxanthin contained drink to skin conditionMethod: The study was conducted to the Japanese females between age over thirty to less than fifty , who had weakening of skin (including aging, sag and dry skin) and skin dullness. In order to conduct the objective evaluation, the comparison between the groups by the double-blind test was taken. Twenty of subjects were randomly allocated to the intake group of astaxanthin contained drink (astaxanthin 3mg contained) and the placebo group. After eight weeks intake of the drink, each group was evaluated with skin water contents, transepidermal water loss, skin elasticity, VISIA and skin texture etc.Result: In between the groups, the intake group of astaxanthin contained drink was greatly excellent in the categories of skin moisture, transepidermal water loss, skin elasticity , erythema dose and skin texture.Conclusion:Astaxanthin has protecting effect of skin barrier and is considered to increase the water retention capability to reduce skin dryness. Astaxanthin is also effective to erythema dose, skin elasticity and skin texture.　As no adverse events resulting from the test drink was seen, such food containing astaxanthin is considered as a safe and useful health functional food material to skin.

STATEMENT OF PROBLEM: Use of the conventional dental impression procedure is problematic in patients who have difficulty opening their mouth, difficulty breathing through their nose or tendency to gag. PURPOSE: It is necessary to make individual trays more comfortable for patients during impression taking procedure. It was reported at the KAP Annual Meeting 2001 Seoul that an improved impression technique was suitable for this purpose. In this study, the accuracy of the improved dental impression method for implant was compared with the conventional dental impression method. MATERIAL AND METHODS: An oral simulator was made from clear acrylic resin block which had similar form of edentulous ridge. For setting up the standard, five fixtures were installed on it. Study casts were made using two kinds of impression techniques. One was the conventional method that was taken using silicone impression material and an individual resin tray under connection of inter-fixture relation. The other was the improved method in which was the connection of the impression coping and the thermoformed polymethyl methacrylate tray. In addition, two different study casts were made from the improved impression body. The coordinates of the fixture on the study model were measured by three-dimensional coordinate measuring equipment. Then the distances between each fixture were calculated and compared with that of oral simulator. Accuracy of the each impression method was also assessed. RESULTS: The differences of inter-fixture dimension between study casts and simulator in the improved impression technique showed 0.014+/-0.016mm and 0.017+/-0.022mm, respectively and that of the conventional method was 0.017+/-0.014mm. There was no significant difference between the improved impression technique and conventional method. CONCLUSION: The improved impression technique is useful for multiple support implants.
Humans ; Mouth ; Nose ; Polymethyl Methacrylate* ; Respiration ; Seoul ; Silicones

Objective: The revised Pharmaceutical Affairs Act that came into force in June 2009 prohibits the sale of nonprescription drugs via mail.  However, as a provisional measure, regular users and inhabitants of remote islands who do not have access to pharmacies or drug stores are allowed to purchase nonprescription drugs via mail until the end of May 2013.  This study involves a survey on the purchasing of nonprescription drugs by Internet-illiterate inhabitants of the remote Goto Islands, Nagasaki Prefecture, Japan.
Methods: Our process began with the distribution of questionnaires via mail to inhabitants of the remote Goto Islands, of whom 3,819 were randomly selected.  The responses were sent between January 22 and February 26, 2011.  We analyzed problems presented by 522 inhabitants who were Internet-illiterate.
Results: The results revealed that 57.3% of the respondents living on large islands—with pharmacies, drug stores, and pharmacists— (e.g., Fukueshima) and 85.3% of respondents living on small islands scattered around large islands—with none of the abovementioned amenities— (e.g., Maeshima) were Internet-illiterate.  Additionally, a majority of the respondents (more than 80%) felt no need to purchase nonprescription drugs over the Internet.  However, considering that a handful of these inhabitants do, or will at some time need to purchase nonprescription drugs over the Internet, we strive to establish an optimal system for supplying medications to these Internet-illiterate inhabitants.
Conclusion: Community pharmacists need to establish close relationships with the Internet illiterate (particularly those living on small islands) and promote the overall appropriate use of medicinal products.