A new radiation system known as the TomoTherapy Hi-ART system was introduced into our hospital in October 2010. This system combines helical intensity-modulated radiotherapy (IMRT) with an integrated image guidance system by means of a megavoltage-CT. This image-guided IMRT enables us to deliver appropriate doses to tumors with good conformality while avoiding sensitive structures in an accurate manner. Patients having tumors in the head, neck, abdomen and pelvis would be good candidates for this treatment. In our hospital, a total of about 150 patients were treated with the helical tomotherapy in 2011.
  However, in the helical tomotherapy, low-dose areas would be spread wide, compared with conventional radiotherapy.Low dose irradiation to large volumes of the lung would increase the risk of radiation pneumonitis, thus planning for thoracic regions such as chest wall and mediastinum might be difficult. In such cases, another strategy “TomoDirect” might be more useful. That allows us to create treatment plans just like conventional radiotherapy using static gantry positions, combined with simultaneous couch movement. Over 20 patients were treated with TomoDirect in 2011.

Objective: Finger-tip unit (FTU) has been used in Western countries to apply a specific amount of steroid ointment available in tube form.  Although prescription ointments for treating skin disorders are available in Japan, there are no indications for patients regarding the amount to be used.  Therefore, we investigated the factual assessment of patient compliance instructions on using the ointments given by pharmacists and conducted a comparative test on the amount of ointment in 1 FTU using commercially available ointment tube products.
Methods: We conducted a questionnaire survey for 21 hospital pharmacists on patient compliance instructions for ointments.  Using six types of ointments, we measured the aperture area of ointment tube, weight of 1 FTU and squeezing number of tube.
Results: Fewer than 50% of pharmacists explained the application methods and amounts for one-time use when they provided patient compliance instructions.  There were many patients who used an ointment inadequately.  The most were problems about the quantity of application.  Wide variations were found among the amount of ointment in 1 FTU weight and number of available uses.
Conclusion: The survey results demonstrated that the methods used to apply the ointments are items that must also be emphasized by pharmacists when providing patients compliance instructions.  Furthermore, the patient compliance instructions should include the amount of ointment in 1 FTU and number of available uses within pharmaceutical products.

Oxidative stress is thought to be a significant contributing factor of age-related sarcopenia. We tested the hypothesis that long-term dietary antioxidant (astaxanthin) intake attenuates sarcopenia. Wistar strain male rats, aged 45 weeks old, were given either control (Cont) or astaxanthin feed (0.004%, Ax) for 1 year. The soleus muscle weight and muscle weight-to-body weight ratios in Ax group were significantly higher than in Cont group, but tibialis anterior muscle mass was similar between the two dietary groups. The level of ubiquitinated proteins was significantly lower in the soleus muscles of Ax group, but not in tibialis anterior muscles when compared with Cont group. Tibialis anterior levels of cathepsin L, especially, and caspase-3 tended to be lower in Ax group than in Cont group. Cathepsin L levels were significantly lower. Whereas no differences between Cont and Ax were observed in soleus levels. There were no significant differences in Ax supplementation on calpain 1 and 2, UBC3B, Cu/Zn SOD and nitrotyrosine levels in either soleus or tibialis anterior muscles. Our data suggest that long-term dietary astaxanthin intake attenuates age-related muscle atrophy, due in part, to reduction in ubiquitination of myofibrillar protein in slow soleus muscles, but not in fast tibialis anterior muscles.

In the areas of home medical care and self-medication, the role of the pharmacist is growing, partly as a result of Japan’s aging society and the need to reduce medical costs. In response, the Kinki University Faculty of Pharmacy implemented a physical assessment practical training seminar in order to improve the physical assessment skills of practicing pharmacists. A series of questionnaires were conducted among pharmacists to investigate their perceptions of physical assessment practical training seminars. The results of the questionnaires were analyzed using Customer Satisfaction (CS) analysis and text mining. Based on a 5-point scale (1-low∼5-high), questionnaires revealed satisfaction for physical assessment practical training seminars was 4.6±0.6 (Ave.±S.D.). CS analysis revealed that the items “lectures” and “case seminars” had the highest level of satisfaction. However, items showing low levels of satisfaction were “auscultation of respiratory sounds” and “SBAR (Situation, Background, Assessment, Recommendation).” Results of text mining suggested a relationship between “physical assessment” and “difficult”. Analysis of the questionnaires showed a high level satisfaction with physical assessment practical training seminars, notably physical assessment practice methods. However, CS analysis and text mining indicate the finer techniques of physical assessment were difficult to acquire.

We implemented a questionnaire survey targeting mothers who are in child care and had participated in consultations regarding drugs and diseases. We examined the future roles of community pharmacists by exploring the mothers’ concerns and, anxieties about child cares and their backgrounds, and their expectations for profession of community pharmacist. Mothers have listed anxiety and concerns of child care about “dermatitis such as rash and atopic eczema”; “food allergies”; “infectious diseases such as measles, chicken pox, and mumps”; and “side effects of vaccination”. In addition, most of them indicated their own concerns and anxiety about “solutions to children’s illnesses.” Despite their anxieties and concerns, however, approximately 60% of the mothers have never consulted with community pharmacists. Among them, approximately a half of them indicated the following three reasons why they have never consulted with pharmacists: “I have nothing to talk about,”, “I do not know what I should talk about,”, and “I was not sure if it was alright to talk about my concerns.”. From these results, we concluded that community pharmacists in the future should improve their communication skills and inform their availability to consult about medicine and disease to local residents.

The expansion of home medical care and the growth in sales of OTC, coupled with Japan’s aging society and the need to reduce medical costs has broadened the role of the pharmacist to include physical assessment. In response, the Kindai University Faculty of Pharmacy, implemented the Physical Assessment Practical Training Course (PAPTC) to improve the physical assessment skills of pharmacy students and practicing pharmacists. In order to investigate pharmacy students’ and practicing pharmacists’ perceptions of PAPTC, a questionnaire using a five-part, forced- choice Lykert type scale was conducted. The results of the questionnaire were analyzed using factor analysis and cluster analysis. The total number of respondents was 456. Three hundred thirteen of the respondents were students, and 143 of the respondents were practicing pharmacists. Factor analysis revealed four factors which we titled, “Physical Assessment Skills”, “Physical Assessment Course”, “Pharmacist Jobs” and, “Knowledge Required by Pharmacist”. Subsequently, cluster analysis identified two distinct groups. Group A which constituted primarily of pharmacy students, and Group B which consisted primarily of practicing pharmacists. Each group displayed notable differences in perceptions related to PAPTC. These differences may be influenced by perceptions toward “skills” and/or “knowledge”. These findings suggest that in order to better address the motivational needs of the participants, PAPTC should be divided into two courses. One, for knowledge-based instruction, and other for skill-based practice.

The expansion of home medical care and the growth in sales of OTC, coupled with Japan’s aging society and the need to reduce medical costs has broadened the role of the pharmacist to include physical assessment. In response, the Kindai University Faculty of Pharmacy, implemented the Physical Assessment Practical Training Course (PAPTC) to improve the physical assessment skills of pharmacy students and practicing pharmacists. In order to investigate pharmacy students’ and practicing pharmacists’ perceptions of PAPTC, a questionnaire using a five-part, forced- choice Lykert type scale was conducted. The results of the questionnaire were analyzed using factor analysis and cluster analysis. The total number of respondents was 456. Three hundred thirteen of the respondents were students, and 143 of the respondents were practicing pharmacists. Factor analysis revealed four factors which we titled, “Physical Assessment Skills”, “Physical Assessment Course”, “Pharmacist Jobs” and, “Knowledge Required by Pharmacist”. Subsequently, cluster analysis identified two distinct groups. Group A which constituted primarily of pharmacy students, and Group B which consisted primarily of practicing pharmacists. Each group displayed notable differences in perceptions related to PAPTC. These differences may be influenced by perceptions toward “skills” and/or “knowledge”. These findings suggest that in order to better address the motivational needs of the participants, PAPTC should be divided into two courses. One, for knowledge-based instruction, and other for skill-based practice.

Flavonoids are by far the most dominant class of phenolic compounds isolated from Morus alba leaves (MAL). Other classes of compounds are benzofurans, phenolic acids, alkaloids, coumarins, chalcones and stilbenes. Major flavonoids are kuwanons, moracinflavans, moragrols and morkotins. Other major compounds include moracins (benzofurans), caffeoylquinic acids (phenolic acids) and morachalcones (chalcones). Research on the anticancer properties of MAL entailed in vitro and in vivo cytotoxicity of extracts or isolated compounds. Flavonoids, benzofurans, chalcones and alkaloids are classes of compounds from MAL that have been found to be cytotoxic towards human cancer cell lines. Further studies on the phytochemistry and anticancer of MAL are suggested. Sources of information were PubMed, PubMed Central, ScienceDirect, Google, Google Scholar, J-Stage, PubChem and China National Knowledge Infrastructure.

Delirium occurs in 30-40% of patients with terminal cancer, and 90% of patients are delirious immediately before death. Symptoms such as agitation and hallucination are often refractory to the standard pharmacological therapy. Also, the medication options for delirium in terminally ill patients are often limited due to a difficulty in swallowing or a lack of intravenous access. We herein report a case series of six patients with terminal cancer whose derilium symptoms were treated by asenapine sublingual tablets during the intervention period by the palliative care team. Asenapine was selected when other antipsychotics were ineffective or unavailable for agitation caused by delirium. All patients suffered dyspnea or choking sensations due to dysphagia or respiratory dysfunction. Sedative effect was observed among all patients without apparent adverse events. Sublingual asenapine could be an option for the management of restlessness due to terminal delirium when both oral and intravenous drug administration routes are not available.