Objective: Self-medication is promoted to extend healthy life expectancy. Accordingly, it is important for general consumers to properly use over-the-counter drugs. We investigated whether graphical symbols to visually aid the understanding of drug information (i.e., precautions and instructions to consult with a medical professional) provided in over-the-counter drug package inserts are easily understood in light of the International Organization for Standardization (ISO) criterion of 66％ comprehension. Methods: First, two questionnaire surveys were conducted with pharmacy students to calculate their comprehension level of the illustrations. The first round was for modifying illustrations that did not meet the ISO standard, and the second round was for seeing if comprehension had improved. Then, a questionnaire survey targeting general consumers was conducted to see if these illustrations functioned as graphical symbols. Results: When the referent of “Do not take this medicine if your experience falls under the following conditions” was placed in the upper left corner of the symbol, some students answered that this meant, “If you do not take this medicine, you will be under the following conditions,” but when it was placed in the lower right corner, many students accurately understood the intended information. In the student surveys, one illustration each for “cannot be taken/under treatment/heart,” “cannot be taken/under treatment/stomach,” “cannot be taken/under treatment/liver,” and “cannot be taken/under treatment/kidney” all exceeded 66％. Since none of the illustrations exceeded the 66％ comprehension in the survey of general consumers, it was found to be difficult for general consumers to understand drug information from the present illustrations. However, there were several illustrations that improved in comprehension compared to the previous study, which makes the continuation of this study significant. Conclusion: Although there were no illustrations exceeded 66％ comprehension of general consumers, the study shows that continued improvement may result in establishing pictograms for general consumers.

Objective: The worldwide spread of the COVID-19 pandemic since 2020 led to a lack of information even at Japanese pharmacies, which are at the forefront of community medicine. Therefore, the Kyoto University Graduate School of Public Health Pharmacy Information Group has developed information materials related to COVID-19 for pharmacies0and released them on the COVID-19 countermeasure website, which was launched in haste. However, these days in the information society, the amount of information distributed is explosively expanding. Therefore, it is not possible to reach the target people just by publishing the countermeasure website. Therefore, we set up a public relations team to carry out publicity activities for pharmacists and analyzed the effectiveness of these activities by focusing on changes in the number of page views (PV) on the countermeasure website.Methods: PV and public relations(Facebook, industry media , e-mail) activities during the first 18 days(EARLY period), which is half of the total PV, and the remaining 164 days(MIDDLE period), covering 182 days from the day before the countermeasure website was opened. The changes in quantity were compared. Furthermore, we also compared the changes in the level of interest in the new coronavirus during the target period using Google Trends.Results: PV was remarkably large in the EARLY period, and the amount of public relations activity was generally concentrated in the EARLY period and PV. The number of searches for related words on Google Trends was almost the same as PV except for some. Conclusion: The study revealed the importance of establishing a pandemic countermeasure website for pharmacists at an appropriate time and conducting intensive public relations activities in the early stages.

[Objective] To clarify the utilization of characteristics and reactions of acupuncture points, and the frequency of using acupuncture points in acupuncture and moxibustion treatment in Japan.[Methods] We conducted a questionnaire survey involving members of the Japan Society for Oriental Medicine and those of the Japan Society of Acupuncture Course in Universities. The contents of the questions included age, sex, profession, length of clinical experience of acupuncture/moxibustion, treatment method, utilization of characteristics and reactions of acupuncture points, and frequency of using acupuncture points in both acupuncture and moxibustion treatment.[Results] The number of valid questionnaires was 59 (59 for acupuncture treatment and 50 for moxibustion treatment). The respondents were as follows : average age of 52 ± 12 years, 45 males and 14 females, 13 medical doctors and 46 acupuncturists, clinical experience of 21.1 ± 11.5 years. Most practitioners utilized ill ness-specific features of acupuncture points, de qi, and reactions they feel with their needling and pressing hands. Ten acupuncture points were used in 50% of patients in acupuncture treatment, and ST 36 and SP 6 were the most frequently used. On the other hand, no single acupuncture point was used in more than 50% of patients in moxibustion treatment. Thirteen acupuncture points were used in 30% of patients in moxibustion treatment, and BL 23, SP 6, and ST 36 were the most frequently used.[Conclusion] Our survey clarified the usage of acupuncture points in acupuncture and moxibustion treatment in Japan.

BACKGROUND/AIMS: Fundic gland polyps (FGPs), hyperplastic polyps (HPs), and xanthomas (XTs) are common benign gastric lesions that can be diagnosed by endoscopic appearance alone in most cases. The aim of this study was to evaluate associations between gastric cancer and these benign lesions. METHODS: Two expert endoscopists reviewed a series of gastroscopy images. FGPs, HPs, and XTs were diagnosed by endoscopic appearance, whereas all gastric cancers were confirmed pathologically. RESULTS: Of the 1,227 patients reviewed, 114 (9.3%) had a concurrent or past history of gastric cancer. The overall prevalences of FGPs, HPs and XTs were 9.4%, 6.3% and 14.2%, respectively. HPs and XTs coexisted in 1.6% of patients, whereas other combinations were rarer. XTs were observed in 39.3% and 11.5% of patients with and without gastric cancer, respectively (p<0.001). In contrast, no gastric cancer patients had FGPs, whereas 10.4% of patients without cancer had FGPs (p<0.001). The prevalence of HPs was similar between the two groups (8.8% and 6.0% of patients with and without cancer, respectively, p=0.29). Multivariate and Mantel-Haenszel analyses demonstrated that XTs were positively associated and FGPs were negatively associated with gastric cancer. CONCLUSIONS: XTs and FGPs might be useful as endoscopic risk indicators for monitoring gastric cancer.
Gastroscopy ; Humans ; Polyps ; Prevalence ; Stomach Neoplasms ; Xanthomatosis

The inhibitory effects of the freeze-dried powder of the aqueous extract of black tea leaf (JAT) on α-glucosidase activity were investigated. We initially examined the effects of JAT addition on yeast α-glucosidase activity. JAT significantly and dose-dependently inhibited α-glucosidase activity and more strongly inhibited the activity than acarbose, the positive control. Then, we examined the effects of oral administration of JAT on sucrose tolerance in type 2 diabetes mellitus model db/db mice. Both JAT and acarbose administered groups showed a dose-dependent decrease in plasma glucose levels after the sucrose loading compared with the control group. Notable was that the plasma glucose levels of the 500 mg/kg JAT administered group exhibited a significant decrease 30 min or longer after the sucrose loading. On the other hand, no significant difference in plasma insulin levels was seen between the JAT administered group and the control group. We also measured small intestinal sucrase activity in db/db mouse at 30 min after JAT oral administration. Compared to control mice, small intestinal sucrase activity was significantly decreased in the 500 mg/kg JAT administered mice. These findings indicate that JAT may be a useful natural material for the prevention and therapy of type 2 diabetes mellitus.

Objective: We investigated the effects and the mechanism of the acupuncture. Methods: Nishijo/Mori and colleagues studied the function of the autonomic nervous system (ANS) with the instantaneous heart rate (IHR) as indicator. With the ANS blockers we also revealed the response of ANS when we insert needles to human body. For example, in our study of 1991, we conducted an experimental study on humans and elucidated that the physical stimulation promoted the resilience and the homeostasis of our body. Our recent study (2013) showed the physical stimulation (not acupuncture) on the lower thighs (mainly the bottom of the feet) also enhanced the above mentioned effects. Results and Discussion: 1.　The subjects sat on the chairs and they were given the acupuncture stimulation on their wrists (the skin and subcutaneous tissues) at the expiration. The stimulation for the duration of 15 consecutive breaths increased the function of the parasympathetic nerve (PN). At the same time that of the sympathetic nerve (SN) also enhanced. In short, firstly that of PN enhanced and secondly that of SN followed. Thus, it was observed that the physical stimulations promoted the resilience and the homeostasis of our body and we may regard that this is the first mechanisms. 2.　In our recent study (2013) the subjects sat on the chairs and there were given the stimulation (50 times of fist-strikes) on the sole of the feet. Immediately after the stimulation the result of Floor Finger Distance test （FFD) was improved. At the same time IHR, the indicator of the function of ANS, showed that those of SN (adrenaline β stimulus) and PN were simultaneously increased as soon as the stimulation started. The same result was obtained from the study of the body vibration (the SOUND healing). This process of 2013 was different from that of 1991, however, both of them provided the effect; the promotion of the resilience and the homeostasis of our body. Therefore, we could regard it as the second mechanism of the physical stimulations which promotes the resilience and the homeostasis of our body. Conclusion: In this way, there are two mechanisms of the physical stimulation in promoting the resilience and the homeostasis of our body.

OBJECTIVE: Many studies have reported pre-processing effects for brain volumetry; however, no study has investigated whether non-parametric non-uniform intensity normalization (N3) correction processing results in reduced system dependency when using an atlas-based method. To address this shortcoming, the present study assessed whether N3 correction processing provides reduced system dependency in atlas-based volumetry. MATERIALS AND METHODS: Contiguous sagittal T1-weighted images of the brain were obtained from 21 healthy participants, by using five magnetic resonance protocols. After image preprocessing using the Statistical Parametric Mapping 5 software, we measured the structural volume of the segmented images with the WFU-PickAtlas software. We applied six different bias-correction levels (Regularization 10, Regularization 0.0001, Regularization 0, Regularization 10 with N3, Regularization 0.0001 with N3, and Regularization 0 with N3) to each set of images. The structural volume change ratio (%) was defined as the change ratio (%) = (100 x [measured volume - mean volume of five magnetic resonance protocols] / mean volume of five magnetic resonance protocols) for each bias-correction level. RESULTS: A low change ratio was synonymous with lower system dependency. The results showed that the images with the N3 correction had a lower change ratio compared with those without the N3 correction. CONCLUSION: The present study is the first atlas-based volumetry study to show that the precision of atlas-based volumetry improves when using N3-corrected images. Therefore, correction for signal intensity non-uniformity is strongly advised for multi-scanner or multi-site imaging trials.
Adult ; Atlases as Topic ; Brain Mapping/*methods ; Female ; Humans ; Image Enhancement/methods ; Image Processing, Computer-Assisted/*methods ; Magnetic Resonance Imaging/*methods ; Male ; Middle Aged ; Software ; Statistics, Nonparametric

Objective: The feasibility of peri-orbital electrodes, which are not invasive and do not induce pain, as a supplemental electrode for detection of ictal discharges in medial temporal lobe epilepsy (MTLE) was examined. Methods: Patients with MTLE, who underwent video-EEG monitoring with simultaneous peri-orbital and sphenoidal electrodes and obtained good outcome following standard anterior temporal lobectomy, were subjects in this study. Initial ictal discharge amplitudes were compared between sphenoidal (Sp1/ 2), standard anterior temporal in 10-20 system (F7/ 8), peri-orbital (superior orbital lateral: SOL, inferior orbital medial: IOM), frontopolar (Fp1/ 2), frontal (F3/4) and ear (A1/ 2) electrodes. Results: A total of 34 consecutive seizures from 20 patients were analyzed, with a maximum amplitude observed at Sp1/2 (57.57±5.59), followed by F7/8 (54.89±5.59), SOL (50.97±5.59), IOM (46.95±5.59), A1/2 (45.07±5.69), Fp1/2 (44.78±5.62), and F3/4 (37.75±5.66) (mean±standard error, μV). There was no statistical difference between Sp1/2, F7/8, SOL, and IOM values. When the sphenoidal electrode was omitted, 13 seizures (13/34, 38.2%) resulted in the highest amplitude at peri-orbital electrodes and 10 seizures (10/ 34, 29.4%) at F7/8. Conclusions: Peri-orbital electrodes could detect ictal discharges in MTLE as well as sphenoidal and standard anterior temporal electrodes in 10-20 system and are useful for supplemental recording for detecting ictal epileptiform discharges in MTLE.

On this coming June 12, 2009, the 2nd JSAM International Symposium on Evidence-based Acupuncture on "Evidence of the Effectiveness of Acupuncture for Low Back Pain"is to be held in Saitama. We briefly outline the background and expected controversial points in this symposium.
There are three sessions including 1) Present status of RCT research on low back pain, 2) Treatment method for low back pain in China, Korea and Japan based on the database research, and 3) Sham acupuncture. When we assess the effectiveness of acupuncture for low back pain within the realm of Evidence-Based Medicine, the following discussions may be expected:
1) Therapeutic effect of sham needling -are we able to distinguish placebo effect?
2) Masking using sham needle -are we able to conduct double-blind trials on acupuncture?
3) Specific treatment technique -which factors contribute to "more effective acupuncture technique"?
Most of invited speakers are specialists who published their papers on RCT or sham needle in top medical journals in the world. We hope that issues, such as working together with other medical professionals and reflecting evidence to medical policies, to be tackled in the future for the development of acupuncture will become clearer in this symposium.

BACKGROUNDEstrogen receptor alpha (ER alpha) is the most important endocrine therapy responsiveness predictor for women with breast cancer. The accuracy of the prediction of the response to endocrine therapy was thought to be affected by involving the estrogen receptor coregulatory proteins and cross-talk between ER and other growth factor-signaling networks. Nuclear corepressor 1 (NCOR1) is one of the ER a transcription repressor. The objective of the study is to investigate the expression of NCOR1 at the protein level and pursue its predictive value for breast cancer endocrine therapy.

METHODSIn the present study, the level of expression of NCOR1 protein has been assessed by immunohistochemistry in 104 cases of invasive carcinoma of the breast. Associations between NCOR1 protein expression and different clinicopathological factors and survival were sought.

RESULTSIt was found that NCOR1 was expressed at significantly higher levels in responsive patients treated with endocrine therapy as first-line treatment on relapse. Responsive patients also had a significantly longer post-relapse survival and overall survival. No NCOR1 expression difference was found between patient by age, tumor size, lymph node status, different histological grade groups and human epidermal growth factor receptor 2 (HER2) status. Multivariate analysis showed that NCOR1 is an independent prognostic factor for over-all survival.

CONCLUSIONSIn breast cancer, NCOR1 protein expression level predicts response to endocrine therapy as first-line treatment for breast cancer patients on relapse and NCOR1 protein level assay may increase the accuracy in the endocrine treatment determination and, therefore, improving the patients survival.

Antineoplastic Agents, Hormonal ; therapeutic use ; Breast Neoplasms ; drug therapy ; metabolism ; Estrogen Receptor alpha ; metabolism ; Female ; Gene Expression Regulation ; Humans ; Immunohistochemistry ; Middle Aged ; Nuclear Receptor Co-Repressor 1 ; metabolism ; Receptor, ErbB-2 ; metabolism ; Receptors, Progesterone ; metabolism ; Tamoxifen ; therapeutic use