Since 2005, one of our clinical technologists has been involved in providing assisted reproductive technology (ART) services ranging from egg retrieval to embryo transfer, which were previously performed only by doctors at our hospital. In 2011, the clinical technologist was certified as a clinical embryologist by the Japanese Society of Clinical Embryologists. Around 2020, insurance coverage for ART related to infertility treatment began to be considered. Consequently, the training and development of ART-supporting clinical technologists became an urgent issue. In response, we developed a training program for ART-supporting clinical technologists that covers egg retrieval assistance, fertilization, culture, embryo freezing/thawing, and embryo transfer. By the end of fiscal year 2022, we had successfully trained two new ARTsupporting clinical technologists, bringing the total to three.

Collaboration between medical institutions and community pharmacies is crucial for sharing patient’s treatment status and chemotherapy regimens in order to give safe and effective cancer chemotherapy for outpatient. In Kagoshima Medical Association Hospital, we established a framework for sharing this information with community pharmacies through a multidisciplinary approach. We conducted a questionnaire survey among community pharmacists to evaluate the usefulness of patient’s treatment status and chemotherapy regimens available on our hospital’s website. Most respondents found these resources “very useful.” Furthermore, respondents expressed a desire for additional information on chemotherapy regimen that was not currently available on our website but accessible from other institutions. This survey helped us understand the specific information required by community pharmacists regarding patient treatment status and chemotherapy regimens from medical institutions.

Congenital fetal abnormalities, typically structural abnormalities, are found about 3-5% of all pregnancies. The prenatal detection of these abnormalities are especially important in providing optimal perinatal management for neonates. In many obstetric hospitals and clinics in Japan, fetal ultrasound screening is provided by obstetricians at regular pregnancy checkups. There were few reports on fetal ultrasound performed by medical technologists. Therefore, we conducted a retrospective investigation to determine the efficacy and accuracy of fetal ultrasound performed by medical technologists in our hospital. In total, 2,289 pregnancy women underwent fetal ultrasound screening. We excluded cases that were a second or subsequent scan, had gestational age of <22 weeks at the time of ultrasound screening, or had missing perinatal and neonatal outcomes. The remaining of 2,186 cases, including 65 cases of twins, were investigated. Abnormal findings were noted in 79 cases (3.6%): 31 for the heart, 14 for head, and 11 for urogenital organs. In those cases, congenital abnormalities were found in 39 neonates (1.8%). There were 95 cases (4.3%) in which abnormal finding were absent in fetal ultrasound screening but congenital abnormalities were diagnosed in neonates, including ventricular aneurysm, interruption of the vena cava, cerebellar medulloblastoma, atrial septal defect, and cleft palate. In conclusion, for detecting structural abnormalities, fetal ultrasound screening performed by medical technologists is an important alternative to ultrasound screenings performed by obstetricians. To increase the accuracy of fetal ultrasound screening, continuous improvement of fetal ultrasound skills is important.

To clarify the functions of Coix-seed Reactive Derivatives(CRD), we analyzed 13 kinds of phenolic compounds and coixol(an alkaloid) in CRD powder by using Liquid Chromatography/Mass Spectrometry(LC-MS).The following are the results: p -Coumaric acid 275.0 (μg/g), p -Hydroxybenzaldehyde 50.2 (μg/g), Caffeic acid 36.9 (μg/g), Protocatechuic acid 31.9 (μg/g), Ferulic acid 27.1 (μg/g), Quercetin 16.2 (μg/g), Syringaldehyde 12.1 (μg/g), Chlorogenic acid 11.3 (μg/g), Naringenin 11.1 (μg/g), Vanillin 9.2 (μg/g), trans -Coniferylaldehyde 9.1 (μg/g), Tricin 0.7 (μg/g), Luteolin 0.5 (μg/g) and Coixol(6-Methoxy-2-benzoxazolinone) 5.5 (μg/g). CRD is composed of many substances other than these phenoic compounds. Therefore, further studies are needed to understand the various clinical features associated with CRD intake.

PURPOSE: Due to adverse events, dose reduction or withdrawal of adjuvant chemotherapy is required for some patients. To identify the predictive factors for tolerability to postoperative adjuvant S-1 monotherapy in gastric cancer (GC) patients, we evaluated the predictive values of blood indicators. MATERIALS AND METHODS: We analyzed 98 patients with pStage II/III GC who underwent postoperative adjuvant S-1 monotherapy. We retrospectively analyzed correlations between 14 parameters obtained from perioperative routine blood tests to assess their influence on the withdrawal of postoperative adjuvant S-1 monotherapy, within 6 months after discontinuation. RESULTS: Postoperative adjuvant chemotherapy was discontinued in 21 patients (21.4%) within 6 months. Univariable analysis revealed that high preoperative albumin-bilirubin (ALBI) scores had the highest odds ratio (OR) for predicting the failure of adjuvant S-1 chemotherapy (OR, 6.47; 95% confidence interval [CI], 2.08–20.1; cutoff value, –2.696). The high ALBI group had a significantly shorter time to failure of postoperative adjuvant S-1monotherapy (hazard ratio, 3.48; 95% CI, 1.69–7.25; P=0.001). Multivariable analysis identified high preoperative ALBI score as an independent prognostic factor for tolerability (OR, 10.3; 95% CI, 2.33–45.8; P=0.002). CONCLUSIONS: Preoperative ALBI shows promise as an indicator associated with the tolerability of adjuvant S-1 monotherapy in patients with pStage II/III GC.
Chemotherapy, Adjuvant ; Drug Therapy ; Gastrectomy ; Hematologic Tests ; Humans ; Odds Ratio ; Retrospective Studies ; Stomach Neoplasms

In neurosurgical procedures that may cause visual impairment in the intraoperative period, the monitoring of flash visual evoked potential (VEP) is clinically used to evaluate visual function. Patients are unconscious during surgery under general anesthesia, making flash VEP monitoring useful as it can objectively evaluate visual function. The flash stimulus input to the retina is transmitted to the optic nerve, optic chiasm, optic tract, lateral geniculate body, optic radiation (geniculocalcarine tract), and visual cortical area, and the VEP waveform is recorded from the occipital region. Intraoperative flash VEP monitoring allows detection of dysfunction arising anywhere in the optic pathway, from the retina to the visual cortex. Particularly important steps to obtain reproducible intraoperative flash VEP waveforms under general anesthesia are total intravenous anesthesia with propofol, use of retinal flash stimulation devices using high-intensity light-emitting diodes, and a combination of electroretinography to confirm that the flash stimulus has reached the retina. Relatively major postoperative visual impairment can be detected by intraoperative decreases in the flash VEP amplitude.
Anesthesia, General* ; Anesthesia, Intravenous ; Electroretinography ; Evoked Potentials, Visual* ; Geniculate Bodies ; Humans ; Intraoperative Period ; Monitoring, Intraoperative* ; Neurosurgical Procedures ; Occipital Lobe ; Optic Chiasm ; Optic Nerve ; Optic Tract ; Propofol ; Retina ; Retinaldehyde ; Vision Disorders ; Visual Cortex

BACKGROUND/AIMS: Peyer's patches (PPs) are aggregates of lymphoid follicles that are mainly located in the distal ileum; they play a major role in mucosal immunity. We recently reported that patients with ulcerative colitis (UC) have alterations in PPs that can be detected using narrow-band imaging with magnifying endoscopy (NBI-ME). However, the usefulness of NBI-ME in UC treatment as a whole is still unknown. METHODS: We collected NBI-ME images of PPs from 67 UC patients who had undergone ileocolonoscopy. We evaluated changes in the villi using the "villi index," which is based on three categories: irregular formation, hyperemia, and altered vascular network pattern. The patients were divided into two groups on the basis of villi index: low (L)- and high (H)-types. We then determined the correlation between morphological alteration of the PPs and various clinical characteristics. In 52 patients who were in clinical remission, we also analyzed the correlation between NBI-ME findings of PPs and clinical recurrence. RESULTS: The time to clinical recurrence was significantly shorter in remissive UC patients with H-type PPs than in those with L-type PPs (P<0.01). Moreover, PP alterations were not correlated with age, sex, disease duration, clinical activity, endoscopic score, or extent of disease involvement. Multivariate analysis revealed that the existence of H-type PPs was an independent risk factor for clinical recurrence (hazard ratio, 3.3; P<0.01). CONCLUSIONS: UC patients with morphological alterations in PPs were at high risk of clinical relapse. Therefore, to predict the clinical course of UC, it may be useful to evaluate NBI-ME images of PPs.
Colitis, Ulcerative* ; Endoscopy* ; Humans ; Hyperemia ; Ileum ; Immunity, Mucosal ; Multivariate Analysis ; Peyer's Patches* ; Recurrence* ; Risk Factors ; Ulcer*

BACKGROUND/AIMS: Peyer's patches (PPs) are aggregates of lymphoid follicles that are mainly located in the distal ileum; they play a major role in mucosal immunity. We recently reported that patients with ulcerative colitis (UC) have alterations in PPs that can be detected using narrow-band imaging with magnifying endoscopy (NBI-ME). However, the usefulness of NBI-ME in UC treatment as a whole is still unknown. METHODS: We collected NBI-ME images of PPs from 67 UC patients who had undergone ileocolonoscopy. We evaluated changes in the villi using the "villi index," which is based on three categories: irregular formation, hyperemia, and altered vascular network pattern. The patients were divided into two groups on the basis of villi index: low (L)- and high (H)-types. We then determined the correlation between morphological alteration of the PPs and various clinical characteristics. In 52 patients who were in clinical remission, we also analyzed the correlation between NBI-ME findings of PPs and clinical recurrence. RESULTS: The time to clinical recurrence was significantly shorter in remissive UC patients with H-type PPs than in those with L-type PPs (P<0.01). Moreover, PP alterations were not correlated with age, sex, disease duration, clinical activity, endoscopic score, or extent of disease involvement. Multivariate analysis revealed that the existence of H-type PPs was an independent risk factor for clinical recurrence (hazard ratio, 3.3; P<0.01). CONCLUSIONS: UC patients with morphological alterations in PPs were at high risk of clinical relapse. Therefore, to predict the clinical course of UC, it may be useful to evaluate NBI-ME images of PPs.
Colitis, Ulcerative* ; Endoscopy* ; Humans ; Hyperemia ; Ileum ; Immunity, Mucosal ; Multivariate Analysis ; Peyer's Patches* ; Recurrence* ; Risk Factors ; Ulcer*

The Medication Guides for Patients (MGPs) are being offered as information on prescription drugs for patients by the Ministry of Health, Labour and Welfare (MHLW). The MHLW published the Risk Management Plan in April, 2012, and it noted that the MGPs should be utilized in usual risk minimization activities. It is not clear, however, whether the MGPs are efficiently utilized in actual settings. Hence, we conducted a questionnaire survey of the pharmacists in the pharmacies with dispensing and the hospitals in Mie and Yamagata prefectures to investigate the actual circumstances of MGPs utilization and to understand the existing barriers associated with the use of the MGPs as medication instructions for patients. We sent the questionnaires by mail and obtained responses from 444 facilities (33.9%) of 1,309 facilities. The recognition level of the MGPs was about 30 percent in the dispensing pharmacies, and about 50 percent in the hospitals. The MGPs were utilized as a common communication tool with the patients in approximately 20 percent of the facilities. Many respondents requested that the frequency of important and other adverse reactions should be described in the MGPs, and wider ranges of MGPs should be further implemented.
Moreover, our data suggests the problem is that the present MGPs are mainly applied to special types of patients, such as those with higher literacy level or those who requested a detailed explanation. Thus, it is apparent that it is necessary to review the MGPs contents again to improve their practical benefits and disseminate them more widely.

  We demonstrated the clinical features and outcome of 87 children with idiopathic thrombocytopenic purpure (ITP). Most of them were younger children with severe thrombocytopenia; 71.3% were under 5 years old and 49.4% had platelet counts below 1×10⁴/μl. Initial treatment consisted of high-dose intravenous immunoglobulin in 60 (69.0%), steroid in 10 (11.5%), and no therapy in 17 (19.5%). More than 90% of the children with platelet counts below 2×10⁴/μl received treatment, but most children with platelet counts above 2×10⁴/μl were observed without treatment. No patients had complications with CNS hemorrhage. Chronic ITP was noted in 17 patients (19.5%). Their mean age was 6 years 3 months compared with 2 years 8 months for the acute patients (p<0.01). But there were no significant differences in sex, platelet count, and initial treatment between chronic ITP and acute ITP. Six (35.3%) out of 17 children with chronic ITP subsequently achieved a spontaneous recovery. As of today, only 3 patients (3% of all patients, and 17.6% of patients with chronic ITP) have platelet counts below 5×10⁴/μl. The overall prognosis and quality of life were excollent. Helicobacter Pylori (H. pylori) infection was found in 7.1% of the chronic patients and 5.3% of the acute patients, but platelet counts of them returned to normal without H. pylori eradication thrapy. It seemed that H. pylodi infection played a minor role in pediatric ITP.