To improve the quality of palliative care in the Kyoto region, we thought that closely connecting hospice and palliative care units (PCU) is necessary. Subsequently, we established the Kyoto PCU Liaison Committee in September 2017. This committee was created as a place to casually discuss the problems that individual PCU facilities have, deliberate on their worries together, grow and develop, and support newly launched facilities. Furthermore, discussions were held on current topics (emergency hospitalization, blood transfusion, smoking, bereaved family meetings, etc.) at the liaison meetings. While meetings were adjourned in 2020 due to the COVID-19 pandemic, we continued to exchange opinions on infection control, PCU management, etc., using the email network at first. Later, these meetings resumed via web conference systems. Thus, by having face-to-face relationships on a daily basis, we were able to maintain cooperation between PCUs even during the pandemic, and collaborate with cancer treatment hospitals. Overall, by forming a team of PCUs in Kyoto Prefecture, we aim to enable patients and their families to live with peace of mind wherever they are.

Objective: The purposes of this trial were to demonstrate the feasibility and effectiveness of the hybrid of intracavitary and interstitial brachytherapy (HBT) for locally advanced cervical cancer patients in the phase I/II prospective clinical trial. Methods: Patients with FIGO stage IB2-IVA uterine cervical cancer pretreatment width of which was ≥5 cm measured by magnetic resonance imaging were eligible for this clinical trial. The protocol therapy included 30–30.6 Gy in 15–17 fractions of whole pelvic radiotherapy concurrent with weekly CDDP, followed by 24 Gy in 4 fractions of HBT and pelvic radiotherapy with a central shield up to 50–50.4 Gy in 25–28 fractions. The primary endpoint of phase II part was 2-year pelvic progression-free survival (PPFS) rate higher than historical control of 64%. Results: Between October 2015 and October 2019, 73 patients were enrolled in the initial registration and 52 patients proceeded to the secondary registration. With the median follow-up period of 37.3 months (range, 13.9–52.9 months), the 2- PPFS was 80.7% (90% confidence interval [CI]=69.7%–88%). Because the lower range of 90% CI of 2-year PPFS was 69.7%, which was higher than the historical control ICBT data of 64%, therefore, the primary endpoint of this study was met. Conclusion The effectiveness of HBT were demonstrated by a prospective clinical study. Because the dose goal determined in the protocol was lower than 85 Gy, there is room in improvement for local control. A higher dose might have been needed for tumors with poor responses.

In order to utilize the results of genetic tests for mental and behavioral changes aimed at disease prevention, it is important to acquire the right knowledge about genetic information. Learning the basics of genetic testing and information at school may help in taking adequate precautions against illness. In this study, to improve the knowledge on central dogma (flow of genetic information) and mutation, which are the basics of genetic testing, among children in the upper grades of elementary school, we devised an illustrative video and conducted educational activities through a test-linked illustrative video lecture (TLIV lecture). In addition, the degree of comprehension and the effectiveness of the TLIV lecture were evaluated using tests conducted before and after the lecture. Both fifth and sixth graders showed a low level of comprehension (50 points or less) before the lecture. On performing the same test after the TLIV lecture, both groups showed a high degree of understanding (65 points or more), a significant increase. From the above results, it was shown that the TLIV lecture that we devised could be used as an effective tool for improving knowledge on the above-mentioned content for fifth graders and above.

　　Laryngeal cancer is a malignant disease that occurs at a high incidence rate as compared with other forms of cancer of the head and neck, and its treatment is commonly conducted at a regional central hospital from diagnosis to recovery. In this study, we summarized the outcomes of first-line treatment for laryngeal cancer over the past 10 years at our hospital.　　The subjects consisted of 121 patients who received a first-line treatment for squamous cell carcinoma of the larynx between January 2000 and April 2010. Of these, 115 were male and six were female, with a mean age of 67.9 years. There were 56 cases of stage I laryngeal cancer, 30 of stage II, 14 of stage III, and 21 of stage IVa. Cases of stage IVc cancer with distal metastasis were excluded.　　The disease-specific 5-year survival rate was 100% in stage I, 81.8% in stage II, 100% in stage III, and 72.5% in stage IVa, respectively. Moreover, the laryngeal preservation rates was 93.7% in stage I, 69.4% in stage II, 34.2% in stage III, and 42.6% in stage IVa, respectively.　　Although the disease-specific 5-year survival rate in stage III was 100%, the laryngeal preservation rate was the lowest at 34.2%. In cases of stage III cancer, although the survival rate was certainly high when total laryngectomy was performed, we believe that in the future, radiation therapy and partial laryngectomy should be introduced to preserve the larynx.　　There were only three cases of stage II subglottic cancer in which both the laryngeal preservation rate and survival were low.

Background and Aims: The gastrointestinal motility effects by carbonated water have not yet been sufficiently investigated. The aim of this study was to determine whether single pre-prandial carbonated water administration might have an effect on the rate of liquid gastric emptying using the 13C-acetic acid breath test. Methods: Eight healthy volunteers (F/M; 3/5) participated in this randomized, 3-way crossover study. The subjects fasted overnight and were randomly assigned to receive 200mL of carbonated water before ingestion of the liquid test meal (200 kcal per 200 mL, containing 100 mg 13C acetate) or 200mL of carbonated water before the test meal or the test meal alone. Under all conditions, breath samples were collected for 150 min following the meal. Liquid gastric emptying was estimated by the values of the following parameters: T1/2, Tlag, the gastric emptying coefficient (GEC) and the regression-estimated constants (β and κ), calculated using the 13CO2 breath excretion curve using the conventional formulae. The parameters between the 3 test conditions were compared statistically. Results: Carbonated water significantly decreased k and beta, but T1/2, Tlag and GEC remained unchanged. Conclusions: The present study revealed that carbonated water has dual effects on liquid emptying: an initial acceleration with a subsequent deceleration in asymptomatic volunteers.

We examined the effects of polyphenols on migratory activity of neutrophils into the hydrogel and their production of reactive oxygen species (ROS). Origonol and lychee polyphenol were diluted to medium in wide-range concentrations. Each solution was added on hydrogel, and the mixture of blood and luminol was layered on it in each tube. The ROS production was measured by luminol-dependent chemiluminescence, whereas the cell count in the hydrogel was quantified as migratory activity of neutrophils. The migratory activity of neutrophils was not affected, whereas ROS production of neutrophils was significantly decreased above 100 μg/ml, but increased below the concentration.

Objective: The overproduction of reactive oxygen species leads to oxidative stress, which is related to lifestyle-related disease and cancer. Although antioxidants are considered as one of the countermeasures to oxidative stress, it is necessary to develop the assessment methodology for the antioxidant capacity which is closer to the inner body conditions. In this study, we examined antioxidant actions of plant extracts by using newly-developed neutrophil activity measurement system.
Method: Lemon verbena, Green tea, Camellia japonica and Antiallerge^® were used as plant extracts, and were diluted to medium in wide-range concentrations. Each solution was added on modified Mebiol Gel^® (hydrogel), and the mixture of blood and luminol were set onto the hydrogel in each tube. The amount of reactive oxygen species were measured by luminol-dependent chemiluminescence, whereas the cell count in the hydrogel was quantified as migratory activity of neutrophils.
Result: Lemon verbena and Green tea significantly inhibited reactive oxygen species in a concentration-dependent manner, whereas Camellia japonica and Antiallerge^® did not. The migratory activity of neutrophils was not affected by those plant extracts. Also, damaged cells were not detected.
Conclusion: It was suggested that Lemon verbena and Green tea scavenged reactive oxygen species without causing cell death of neutrophils. This new method for measuring neutrophil activities can be applied not only for assessing the status of inflammation and oxidative stress but also as the screening system for predicting the effectiveness of antioxidant and anti-inflammatory substances.

At present, lifestyle-related diseases are one of the most critical health issues worldwide. It has been reported that lipopolysaccharide derived from a Gram-negative bacteria (IP-PA1) symbiotic with wheat exhibited several advantageous biological effects, such as the reduction of plasma glucose levels in NOD mice and low-density lipoprotein (LDL) levels in WHHL rabbits. In this study, the beneficial effects on plasma glucose and lipids of a tea (SI tea) consisting of IP-PA1 and Salacia (which contains an inhibitor of alpha-glucosidase) were investigated in the KK-Ay/TaJcl type 2 diabetic model mice and in human subjects with premetabolic syndrome in a double-blind, randomized study. SI tea significantly decreased plasma glucose levels in KK-Ay/TaJcl mice. A clinical trial of SI tea was performed with 41 subjects between the ages of 40 and 69, who belonged either to a high plasma glucose group (HG: FPG 100-125 mg/dl) or to a hyperlipidemia group (HL: TG > or = 150 mg/dl, or LDL > or = 120 mg/dl, or HDL < 40 mg/dl). These subjects ingested either Salacia without IP-PA1 (the control) or SI tea. Blood samples were collected at 0, 30, and 60 days after initiating SI tea treatment, and were measured for FPG, HbA1c, TG, LDL, and HDL. These results showed that SI tea reduced FPG and HbA1c more rapidly than the control in the HL group, and also significantly improved LDL and HDL levels in the HG group. Thus, SI tea may be helpful in preventing lifestyle-related diseases.
Animals ; Cholesterol ; Fasting ; Glucose ; Gram-Negative Bacteria ; Humans ; Hyperlipidemias ; Lipoproteins ; Mice ; Mice, Inbred NOD ; Plasma ; Rabbits ; Salacia ; Tea ; Triticum

1) Japan Society for Medical Education launched a committee for the graduate education of medical educationists in Japan. The committee proposed a direction toward establishing the system, by way of discussion among the members, needs assessment, information gathering of overseas master courses, and discussion at the open meeting.2) To promote medical education in Japan, we should establish 2 systems concurrently: (1) a graduate education for medical educationists who have a broad base of theories and can lead future medical education, and (2) a broader certificate system for medical teachers who have good practical teaching skills.