Bone metastases occur in patients who have developed prostate cancer, and severely compromise the patient's quality of life. Here, we evaluated the quality of life in our inpatients diagnosed with prostate cancer with multiple bone metastases and bone pain. In our study, we evaluated pain using a pain diary, investigated the palliative effects of opioid dose, and assessed the quality of life using SF-36. The administration of chemotherapy and zoledronic acid (ZA) resulted in pain palliation, an anti tumor effect and improvements in the quality of life. We suggest that the administration of ZA might be an effective clinical strategy for multimodality advanced solid cancer therapy. We conclude that a 'combined' examination, in which a pain diary evaluating pain is considered in association with an SF-36 assessment evaluating quality of life is crucial to patient care. Palliat Care Res 2008 ; 3(2) : 308-315

Based on the assessment of the home health care services provided by our hospital over the past five years and the results of a survey of the people concerned, we studied the problems of home care and dwelt on what it should be in the future. An alarming fact was brought to light: Many of those who look after patients in their homes are stress-ridden. Even among those who said they are satisfied with the present care system, not a few expressed uncertainty about the future. Many were of the opinion that without option of putting the patients in hospitals or nursing homes if need be, the home health care system would not hold water.
Our hospital admits only those patients who are badly in need of hospital treatment, and technically many cases cannot be referred to general practitioners. To add to the development of home health care, it is necessary to establish a coll aborative system between hospitals and neighborhood clinics. Under the system, patients will be screened according to the degree of their need for medical care, and visiting nurses will be able to show their skill fully and provide care confidently while keeping close contact with physicians.

Intrinsic or acquired resistance to cisplatin (CDDP) is a problem for its use in cancer chemotherapy. This resistance has been reported to correlate with expression of the human copper transporter 1 and two copper export pumps, ATP7A and ATP7B. In the current study, we investigated the correlation between the expression of these transporters and sensitivity to CDDP using four cell lines derived from each of high invasive oral squamous cell carcinoma (OSCC) and low invasive OSCC. We found that the amount of CDDP accumulated in high invasive OSCC cell lines (Yamamoto-Kohama criteria: grade 4C and 4D) with strong intrinsic tolerance was lower than in low invasive OSCC cell lines (grade 3) with weak intrinsic tolerance. Additionally, overexpression of ATP7B mRNA in cell lines derived from high invasive OSCC conferred low sensitivity to CDDP. Furthermore, the accumulation and sensitivity of CDDP was higher in HOC313 cells transfected with the ATP7B siRNA than in cells transfected with the nonsense siRNA. These results suggest that the overexpression of ATP7B results in the export of and, therefore, resistance to CDDP. Furthermore, ATP7B may be a key determinant of the intrinsic resistance to CDDP.

Taking charge of in-vitro fertilization and embryo transfer in the laboratory per se amounts to a form of clinical support. To infertile patients, it would be of great benefit if laboratory technicians make direct contact with them and give a full account of the procedure.The apprehensions entertained by them regarding infertility treatment would be removed by hearing what they want to know.In hopes of dispelling the patients' fears and doubts, we have recently started to dialogue with the patients. The face-to-face interview has made us feel confident in what we are doing aside from the lab work and feel a sense of responsibility. Moreover, we have become aware of the need to further devote ourselves to reproductive medicine in order to improve the treatment outcome.One third of the questions frequently asked by patients concerns the quality of embryos and the risk of birth defects, which are issues that challenge us involved in reproductive medicine. To give answers to these and other questions most aptly, it is necessary to share all the up-to-date information, data and knowledge among members of the staff concerned.As the tasks to be grappled with fromnow on, there are problems with unsuccessful cases after repeated IVF trials and an increasing number of patients rangingin age from 45 to 49 years. Where the infertility treatment stops is yet to bedecided in the case of elder women.For providing information and psychological support sought by patients, we keenly felt that there is a necessity to establish a closer collaborative inter-departmental relationship.
Clinical ; Fertilization ; Laboratory culture ; Support ; therapeutic aspects

OBJECTIVE: The aim of the study was to establish a predictive model of survival period after bone metastasis from cervical cancer. METHODS: A total of 54 patients with bone metastasis from cervical cancer were included in the study. Data at the time of bone metastasis diagnosis, which included presence of extraskeletal metastasis, performance status, history of any previous radiation or chemotherapy, the number of bone metastases, onset period, and treatment were collected. Survival data were analyzed using Kaplan-Meier method and Cox proportional hazards model. RESULTS: The median survival period after diagnosis of bone metastasis was 22 weeks (5 months). The 26- and 52-week survival rates after bone metastasis were 36.5% and 15.4%, respectively. Cox regression analysis showed that extraskeletal metastasis (hazard ratio [HR], 6.1; 95% CI, 2.2 to 16.6), performance status of 3 to 4 (HR, 7.8; 95% CI, 3.3 to 18.2), previous radiation or chemotherapy (HR, 3.3; 95% CI, 1.4 to 7.8), multiple bone metastases (HR, 1.9; 95% CI, 1.0 to 3.5), and a bone metastasis-free interval of <12 months (HR, 2.5; 95% CI, 1.2 to 5.3) were significantly and independently related to poor survival. A prognostic score was calculated by adding the number of each significant factor. The 26-week survival rates after diagnosis of bone metastasis were 70.1% in the group with a score ≤2, 46.7% in the group with a score of 3, and 12.5% in the group with a score ≥4 (p<0.001). CONCLUSION: This scoring system provided useful prognostic information on survival of patients with bone metastasis of cervical cancer.
Adult ; Aged ; Aged, 80 and over ; Bone Neoplasms/*mortality/*secondary/therapy ; Female ; Humans ; Kaplan-Meier Estimate ; Middle Aged ; Neoplasm Staging ; Proportional Hazards Models ; Survival Rate ; United States/epidemiology ; Uterine Cervical Neoplasms/*pathology/therapy

Objective: Caffeine may cause dependence and sleep disturbance, and interact with psychotropic drugs.　Therefore, the caffeine intake of patients with mental disorders should be monitored.　However, in Japan, there is no report on the effects of caffeine in mental disease patients or on their caffeine intake.　Therefore, we conducted a questionnaire survey to clarify the perception of caffeine for psychiatric outpatients.Methods: We conducted an anonymous survey on caffeine recognition for outpatients at 8 medical institutions that advocate psychiatry.Results: We collected questionnaires from 180 people.　The knowledge of foods containing caffeine tended to be high in those who had a positive attitude toward caffeine.　More than 90% of those surveyed knew that coffee contains caffeine, but cocoa and jasmine tea were recognized by less than 25%.　Of those surveyed, 39.4% consumed caffeine‐containing beverages at night.　In addition, the rate of consumption of caffeine‐containing beverages tended to be higher at night because they had a positive attitude toward caffeine.Conclusion: The knowledge and intake situation of caffeine by patients with mental disorders differed depending on their interests and way of thinking about caffeine.　As caffeine intake may influence psychiatric treatment, correct knowledge regarding caffeine is important.

Due to the rapid pandemic of the new coronavirus infection, a state of emergency was declared in Japan in April 2020, which had a great impact on people's lives. Under these circumstances, the development of COVID‒19 Vaccine (ChAdOx1‒S［recombinant］) (VaxzevriaTM Intramuscular Injection) was started by Oxford University for the purpose of preventing COVID-19, and then AstraZeneca took over it. That vaccine was approved in the UK in December 2020. In Japan, an application for manufacturing and marketing approval was submitted in February 2021, and granted a Special Approval for Emergency for the indication of “prevention of infectious diseases caused by SARS-CoV-2” for people aged 18 or older in May 2021. For post-marketing safety measures conducted in COVID-19 pandemic, it includes the Early Post-marketing Phase Vigilance (EPPV), General Use Result Study following the priority survey (by the Scientific Research Group of the Ministry of Health, Labour and Welfare) at the initial stage of administration of the COVID-19 vaccination, Specific Use Result Study targeting vaccinated people with the special background, and the periodic submission of data about post-marketing safety information in and outside Japan. This contribution will describe the safety measures conducted by an unconventional method in the post-marketing setting. Especially, in COVID-19 pandemic, conducting EPPV via Medical Representative (MR) as usual is assumed to lead to a risk to increase the threat of infection to the overwhelmed healthcare professionals； therefore, the interactive EPPV avoiding the direct contact with the healthcare professionals was conducted on the basis of discussion with the regulatory authority prior to the approval, and would be introduced here.

In dentistry, it is empirically known that the acute exacerbation of periodontal disease often occurs at the time of fatigue, but scientific verification has never been made about the relationship of fatigue and bleeding. In Kampo medicine, there is the concept of spleen failing to control the blood as bleeding at the time of fatigue. Kihito and kamikihito are often used for this condition. Spleen failing to control the blood means that lack of vital energy causes the bleeding. Kamikihito is most often used in the treatment of idiopathic thrombocytopenic purpura. Moreover, there have been some reports on the use of kamikihito in the treatment of gynecological fraud bleeding and aplastic anemia. However, there has been no report on the use of it in the treatment of gingival bleeding. In this case, neither cytopenia nor obvious coagulopathy was recognized. In Kampo medicine, not only spleen failing to control the blood but also blood stasis or blood heat is considered to be the cause of bleeding, but the effectiveness of kamikihito for this case suggested pathophysiology of spleen failing to control the blood. Kamikihito could be a choice to treat gingival bleeding at the time of fatigue.

Although the descriptions of shigyakukachotanto in “Waitaimiyaofang” and tsumyakushigyakukachotanjuto in “Songban Shanghanlun” are quite similar to each other, the specifications of the dosages of crude drugs and the water volume in the books were considerably different. Focused on the specified water volume to decoct these formulas, each reasonable decocting period was estimated, then the decoctions were prepared using hard water that was common in mainland China. The dosages of aconite root were 2­-fold different between these two formulas, but the contents of aconitine-­type diester alkaloids (ADA) in both decoctions were found in the range of 1.2—1.4­-fold. It was suggested that in order to control the efficacy and the safety of aconite, the decocting period was well regulated by the specification of water volume for decocting at this ancient era. Moreover, the dosages of aconite root and glycyrrhiza in bukuryoshigyakuto (BSGT) formula of “Songban Shanghanlun” are equal to those of shigyakuto (SGT) but the specified water volume to begin decocting is as about twice as that of SGT. When prepared using hard water, BSGT resulted to make the contents of ADA lower and those of non-­ester alkaloids higher compared with those of SGT decoction. It was suggested the spe­cific water volume for each formula prescribed in classical Chinese medicine had considerable significance to determine the dosages of chemical ingredients in the decoctions especially in the circumstances using hard water to prepare them.