Background/Aims: Since the usefulness of neoadjuvant chemo(radiation) therapy (NAT) for pancreatic cancer has been demonstrated, recurrent biliary obstruction (RBO) in patients with pancreatic cancer with a fully covered self-expandable metal stent (FCSEMS) during NAT is expected to increase. This study investigated the impact of sarcopenia on RBO in this setting. Methods: Patients were divided into normal and low skeletal muscle index (SMI) groups and retrospectively analyzed. Patient characteristics, overall survival, time to RBO (TRBO), stent-related adverse events, and postoperative complications were compared between the two groups. A Cox proportional hazard model was used to identify the risk factors for short TRBO. Results: A few significant differences were observed in patient characteristics, overall survival, stent-related adverse events, and postoperative complications between 38 patients in the normal SMI group and 17 in the low SMI group. The median TRBO was not reached in the normal SMI group and was 112 days in the low SMI group (p=0.004). In multivariate analysis, low SMI was the only risk factor for short TRBO, with a hazard ratio of 5.707 (95% confidence interval, 1.148–28.381; p=0.033). Conclusions Sarcopenia was identified as an independent risk factor for RBO in patients with pancreatic cancer with FCSEMS during NAT.

Introduction: Research was carried out using a mixed method approach in order to evaluate the educational effects of medical students' visit of an elderly home.Methods: Focus group interviews were conducted with 5 medical students and 5 elderlies. All interviewees had experienced the visitation program more than three times. Self-administrative questionnaires were built based on the results of the focus group interview. The questionnaire was then distributed to medical students and elderlies who participated in the program.Results: A total of 84 medical students and 30 elderlies provided informed consent to participate in the study and returned the questionnaire. Nearly 70 percent of the students answered that they had gotten to know about the life of elderly people and sixty percent of the elderlies answered they had experienced some favorable changes after joining the program. While ninety percent of the elderly were satisfied with the program, only half of the students showed positive comments toward it.Discussion: To help all students participate in this program more actively, more organized planning is necessary so that students can have more chances to build communication skills and clarify their own objectives when visiting the elderly.

Objective: In late 1970s, occupational exposure to antineoplastic agents was reported. Various countries, including Japan, have published guidelines for handling antineoplastic agents. Surveys are still being conducted to determine the levels of environmental exposure to antineoplastic agents at individual hospitals, and incidents of contamination are often reported. This study provides details regarding a literature survey conducted to evaluate the actual state of environmental contamination by antineoplastic agents and identify the related issues in order to promote environmental monitoring.Methods: The literature search was carried out from January 1, 1990 to July 31, 2017. PubMed and Ichushi-Web were searched with the following keywords: “antineoplastic agents,” “occupational exposure,” “surface contamination,” and “environmental monitoring.”Results: Following the literature search, 117 papers were included in the analysis. The findings showed that contamination by antineoplastic agents was widely reported in hospitals and places where antineoplastic drugs were not handled. The findings of this study regarding the actual state of environmental exposure are partial, as there is a lack of information on retail pharmacies and homes of outpatients who have received chemotherapy.Discussion: Therefore, further investigation is warranted. In addition, according to the current Japanese guidelines, published in 2015, environmental surveillance is not required to reduce contamination by antineoplastic agents. To promote environmental monitoring, we feel that it is necessary to determine a new survey method and the clarify optimum interval of environmental monitoring.

BACKGROUND: Sedentary behaviors have recently become an important public health issue. We aimed to investigate the relationship between screen time and nutrient intake in children and adolescents. METHODS: The present study was conducted in 2013. Data were collected from children and adolescents aged between 6 and 15 years old in Shika town. Questionnaires were distributed to 1459 subjects, 1414 of whom participated in the study (96.9%). Sedentary behaviors were assessed based on participants' screen behaviors (television (TV) viewing, personal computer (PC) use, and mobile phone (MP) use). The main outcomes were the intake of nutrients from a validated food frequency questionnaire. Analysis of covariance (ANCOVA) was used to examine the significance of differences in nutrient intake estimates. Multivariate linear regression analyses, adjusting for age, BMI, and physical activity, were used to provide parameter estimates (β) and 95% CI for the relationship between screen time and nutrient intake. RESULTS: In boys, longer TV viewing times correlated or tended to correlate with a lower intake of protein, potassium, calcium, iron, vitamin K, vitamin B-2, and total dietary fiber. In girls, longer TV viewing times correlated with a lower intake of protein, sodium, calcium, vitamin D, and vitamin B-2. Longer TV viewing times correlated with a higher intake of n-6 fatty acids in girls. PC use was related or tended to be related to a lower intake of potassium, iron, vitamin K, and folic acid in boys, but not in girls. A relationship was observed between MP use and a lower intake of vitamin K in boys, and MP use and a higher intake of vitamin D in girls. CONCLUSIONS The present results revealed that longer TV viewing times are associated with less protein, minerals, vitamins, and total dietary fiber intake in children and adolescents. It was also revealed that boys with PC use have less minerals and vitamins. These results support the need to design intervention programs that focus on decreasing TV viewing time in both sexes and PC use in boys while encouraging adherence to dietary guidelines among children and adolescents.
Adolescent ; Body Mass Index ; Child ; Cross-Sectional Studies ; Diet ; Energy Intake ; Exercise ; Female ; Humans ; Japan ; Male ; Screen Time ; Sedentary Behavior ; Sex Factors ; Socioeconomic Factors

Yokukansan (YKS), one of the traditional Japanese “Kampo” medicines, is a mixture of extract powders from seven kinds of medicinal herbs (Atractylodis Lanceae Rhizoma, Hoelen, Cnidii Rhizoma, Uncariae Uncis Cum Ramulus, Angelicae Radix, Bupleuri Radix, and Glycyrrhizae Radix). YKS has been administered to fragile habitus patients who show symptoms such as emotional irritability, neurosis and insomnia, and to infants who suffer from night crying and convulsions. In recent years, YKS has been reported to be effective against pain disorders such as headache and chronic pain, but the mechanism underlying these beneficial effects is still unclear. In this study, the effect of YKS on chronic inflammatory pain and stress caused by pain were investigated using rats with adjuvant arthritis.
Male Wistar rats were injected with complete Freund's adjuvant into the plantar surface of the right hindpaw, and then pain thresholds and stress markers were measured. The thermal pain threshold measured with the plantar test significantly decreased, and the level of salivary chromogranin A (CgA), which is used as a mental stress marker, was significantly increased in this model. The administration of YKS controlled the activation of spinal microglia involved in the expression of chronic pain, and significantly reduced a decrease in the pain threshold. Moreover, an increase in the level of salivary CgA was significantly inhibited. The authors concluded that YKS has effects in reducing chronic inflammatory pain and the stress caused by pain.

It has been reported that the effect of shoseiryuto, a traditional Japanese “Kampo” medicine, on allergic rhinitis depends on several mechanisms. Previously, we reported that shoseiryuto administered in an allergic rhinitis rat model, inhibited increases of substance P (SP) and calcitonin gene-related peptide (CGRP) in the nasal mucus, which in turn are involved in the exacerbation of rhinitis symptoms and allergic symptoms. In the present research, we looked into whether the secretion of SP and CGRP are directly inhibited by the administration of shoseiryuto.
Histamine solution 5µl (10 mg/ml) was instilled in both nostrils of healthy, male SD rats, thereby inducing allergic symptoms, and for the group to which shoseiryuto had been pre-administered, increase in the concentration of SP and CGRP in the nasal mucus was significantly inhibited. Moreover, upon investigating SP and CGRP production in the trigeminal ganglia by means of immunostaining, it was found to be similarly significantly inhibited. The above results indicate that shoseiryuto directly inhibits the secretion of SP and CGRP in the C-fibers of nasal mucosa.

A 81-year old woman had hypertensive heart failure. She had a history of intermittent claudication for 5 years. Her ankle brachial pressure index (ABI) was 0.53 on the right and 0.58 on the left side. Coarctation of the descending aorta with severe calcification was found by a whole body CT. After medical therapy for heart failure, axillo-bifemoral artery bypass using an 8 mm ringed expanded polytetrafluoroethylene (ePTFE) graft was performed. Postoperatively, ABI improved to 0.83 on the right and 0.87 on the left side. The patient is doing well without any signs of heart failure or intermittent claudication. Although it is a palliative operation, axillo-bifemoral artery bypass is an effective and less-invasive procedure and appropriate for elderly patients.

Objective: In general, antiallergic drugs, steroids, and autonomic drugs are administered for patients with allergic diseases, but the chronic administration of these medicines may occasionally induce side effects. As such, several complementary and alternative medicine (CAM) are used, even though their effectiveness has not been established by a significant amount of evidence. Health food, herbal medicines, herbal tea, and aromatherapy, etc., are used for the treatment of allergic rhinitis (AR) as CAM. Rosmarinic acid is a type of polyphenol, and is reported to have antiallergic, antioxydative and anti-inflammatory properties. Rosmarinic acid is included in Perilla Herbs, which are used in health foods and herbal medicines (Kampo medicines), Rosemary and Lemon balm, which are used as herbal teas and essential oils of aromatherapy. This study was performed to evaluate the effect of rosmarinic acid on AR using AR model rats.
Methods: Six-week-old male Sprague-Dawley rats were sensitized with toluene 2,4-diisocyanate (TDI) to induce AR. Rosmarinic acid (1 mg/kg i.p. or 3 mg/kg i.p.) is administrated for 21 days. On day 22, the symptom of nasal allergy was evaluated by counting the number of sneezes within 10 minutes. Substance P (SP), calcitonin gene-related peptide (CGRP) and nerve growth factor (NGF) in the nasal lavage fluids were also measured.
Result: SP and CGRP take part in the exacerbation of rhinitis symptoms, and are secreted from the nerve ending following nerve stimulation by chemical mediators such as histamine. The administration of Rosmarinic acid had no effect on NGF, but significantly suppressed increases of sneezes, SP and CGRP dose-relatedly. Conclusion: Rosmarinic acid could control the symptom of nasal allergy, and one of the mechanisms was suppressing of the secretion of SP and CGRP.

[Objective] Physical exercises raise more or less body temperature. A body temperature is regulated constantly generally by homeostasis mechanism. Perspiration is only heat radiation mechanism under high temperature environments. And sudoriferous water is supplied from blood. Blood flow is determined by blood fluidity, blood volume and the cardiovascular system. It was reported that strong stress decreased blood fluidity.In this experiment, we investigated the relation between blood fluidity and water supply in rats loaded with forced exercise in high temperature environment.[Methods] SPF male Wistar rats weighing 150 g were used. All animals were put in high temperature environment (Wet Bulb Globe Temperature; WBGT: 28°C) through whole experimental period. In a group of water supply, distilled water was served before and later exercise by sonde forcibly. The rats were divided into five groups randomly; Rest-Non water intake (RN), Rest-Water intake (RW), Exercise-Non water intake (EN), Exercise-Water intake (EW) and Baseline (B). The blood was collected before or later of exercise and blood fluidity or platelet aggregation was measured.[Results] In the EN, platelet aggregation, lactic acid and corticosterone increased while blood fluidity were decreased significantly compared with the RN, RW and EW. In addition, the hematocrit did not increase even if water equivalent to 8 % of body weight lost it.[Conclusion] We speculate that exercise in high temperature environment decreases blood fluidity. However, the water supply that does not completely make up for quantity of depletion in exercise may improve blood fluidity.

[Objective] Perspiration is almost only heat radiation mechanism under high temperature environments. And sudoriferous water is supplied from blood. Blood flow is determined by blood fluidity, blood volume and the cardiovascular system. It was reported that strong stress decreased blood fluidity.In this experiment, we investigated the relation between blood fluidity and water supply in rats loaded with forced exercise in high temperature environment.[Methods] SPF male Wistar rats weighing 250g were used. All animals were put in high temperature environment (Wet Bulb Globe Temperature; WBGT: 28°C) through whole experimental period. The rats were divided into four groups randomly; Suitable temperature environment-Exercise-Non water intake (SEN), High temperature environment-Exercise-Non water intake (HEN), High temperature environment-Exercise-Water intake (HEW) and Baseline (BL). In a group of water supply, distilled water was served before and later exercise by sonde forcibly. The blood was collected before or later of exercise and blood and erythrocyte suspension fluidity were measured.[Results] In the HEN, hydroperoxides, blood sodium, lactic acid and adrenaline increased while blood and erythrocyte suspension fluidity were decreased significantly compared with the BL. In addition, the hematocrit did not increase even if water equivalent to 4% of body weight lost it.[Conclusion] We speculate that exercise in high temperature environment decreases blood fluidity. However, the water supply in exercise that might not be sufficiently improve blood fluidity.