Introduction: Our palliative care staff began the support activity in opioid introduction for outpatients with cancer at Komaki City Hospital in March 2018, because it was difficult to make them understand about proper use of opioid analgesics and misinterpretation about abuse at the time of opioid introduction in outpatient settings. This study aimed to evaluate the effects of the activity (patient education on pain control, telephone follow up, and assessment of the symptom). Method: Outpatients with cancer receiving strong opioids for pain relief from January 2017 to March 2019 were eligible. We retrospectively investigated the difference of the variables between baseline and after the activity as follows; the ratios of prescribing immediate-release opioids, antiemetics, and laxatives when opioids were prescribed and side effects due to opioid analgesics appeared. Results: The study included 122 patients. The prescribing ratios of immediate-release opioids antiemetics and laxatives all increased from 90.7 to 98.5%, from 63.0 to 70.6%, and from 61.1 to 70.6%, respectively. The side effect incidence due to opioids with STAS-J 2 or more decreased from 12 (22.2%) to 9 (13.2%). Discussion: The activity could contribute to the provision of drug treatments and counselling needed for opioid therapy.

Objective: The objective of this study was to validate the Japanese version of the STOP-Bang test for risk assessment of obstructive sleep apnea syndrome (OSAS).Methods: We retrospectively evaluated inpatients who underwent nocturnal pulse oximetry for OSAS screening at the internal medical wards.Results: One hundred and forty-four subjects were included the study, and 57 subjects who had a 3% oxygen desaturation index ≥10/hr underwent polysomnography. Seventeen and 29 subjects were diagnosed with moderate and severe OSAS, respectively. According to the receiver operating characteristic (ROC) curve analysis, the STOP-Bang test had a higher diagnostic value using a cutoff of 30 kg/m2 for BMI than using a cutoff of 35 kg/m2. A STOP-Bang score of 3 or greater had a sensitivity of 95.7% and specificity of 42.9% for detecting moderate-to-severe OSAS.Conclusion: The STOP-Bang test is a simple and useful tool for the risk assessment of OSAS.

OBJECTIVEThe changes in serum adipokines and cytokines related to oxidative stress were examined during 3 months 'Off to On' and 'On to Off' periods using negatively charged particle-dominant indoor air conditions (NCPDIAC).

METHODSSeven volunteers participated in the study, which included 'OFF to 3 months ON' periods (ON trials) for a total of 16 times, and 'ON to 3 months OFF' (OFF trials) periods for a total of 13 times.

RESULTSWith the exception of one case, serum amyloid A (SAA) levels decreased significantly during the ON trials.

CONCLUSIONConsidering that SAA is an acute phase reactive protein such as C reactive protein (CRP), this observed decrease might indicate the prevention of cardiovascular and atherosclerotic changes, since an increase in high-sensitive CRP is associated with the subsequent detection of these events.

Adult ; Air ; analysis ; Air Pollution, Indoor ; Environmental Monitoring ; Female ; Housing ; Humans ; Male ; Serum Amyloid A Protein ; metabolism

To screen for additional treatment targets against tongue cancer, we evaluated the contributions of extracellular signal-related kinase (ERK), AKT and ezrin in cancer development. Immunohistochemical staining showed that ERK and ezrin expressions were significantly higher in invasive squamous cell carcinoma than in carcinoma in situ. To investigate the roles of ERK and ezrin in cancer development, we used the non-woven silica fibre sheet Cellbed with a structure resembling the loose connective tissue morphology in a novel 3D culture system. We confirmed that the 3D system using Cellbed accurately mimicked cancer cell morphology in vivo. Furthermore, cell projections were much more apparent in 3D-cultured tongue cancer cell lines than in 2D cultures. Typically, under conventional 2D culture conditions, F-actin and cortactin are colocalized in the form of puncta within cells. However, in the 3D-cultured cells, colocalization was mainly observed at the cell margins, including the projections. Projections containing F-actin and cortactin colocalization were predicted to be invadopodia. Although suppressing ezrin expression with small interfering RNA transfection caused no marked changes in morphology, cell projection formation was decreased, and the tumour thickness in vertical sections after 3D culture was markedly decreased after suppressing ERK activity because both the invasion ability and proliferation were inhibited. An association between cortactin activation as well as ERK activity and invadopodia formation was detected. Our novel 3D culture systems using Cellbed™ are simple and useful for in vitro studies before conducting animal experiments. ERK contributes to tongue cancer development by increasing both cancer cell proliferation and migration via cortactin activation.
Carcinoma in Situ ; metabolism ; pathology ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Cell Culture Techniques ; methods ; Cell Movement ; Cell Proliferation ; Cytoskeletal Proteins ; metabolism ; Extracellular Signal-Regulated MAP Kinases ; metabolism ; Humans ; Neoplasm Invasiveness ; pathology ; Phosphorylation ; Podosomes ; pathology ; Proto-Oncogene Proteins c-akt ; metabolism ; Silicon Dioxide ; Tongue Neoplasms ; metabolism ; pathology ; Tumor Cells, Cultured

OBJECTIVEThe custom-homebuilding company, Cosmic Garden Co. Ltd., located in Okayama City, Japan was established in 1997 and uses specific natural ore powder (SNOP) in wall materials and surveys customers in order to improve allergic symptoms.

METHODSTo investigate the biological effects of SNOP, patients with a pollen allergy were recruited to stay in a room surrounded by cloth containing SNOP (CCSNOP), and their symptoms and various biological parameters were compared with those of individuals staying in a room surrounded by control non-woven cloth (NWC). Each stay lasted 60 min. Before and immediately after the stay, a questionnaire regarding allergic symptoms, as well as POMS (Profile of Mood Status) and blood sampling, was performed. Post-stay minus pre-stay values were calculated and compared between CCSNOP and NWC groups.

RESULTSResults indicated that some symptoms, such as nasal obstruction and lacrimation, improved, and POMS evaluation showed that patients were calmer following a stay in CCSNOP. Relative eosinophils, non-specific Ig E, epidermal growth factor, monocyte chemotactic protein-1, and tumor necrosis factor-α increased following a stay in CCSNOP.

CONCLUSIONThis ore powder improved allergic symptoms, and long-term monitoring involving 1 to 2 months may be necessary to fully explore the biological and physical effects of SNOP on allergic patients.

Adult ; Chemokine CCL2 ; immunology ; Clothing ; Female ; Geologic Sediments ; chemistry ; Humans ; Immunoglobulin E ; immunology ; Japan ; Male ; Pollen ; immunology ; Rhinitis, Allergic, Seasonal ; immunology ; therapy ; Tumor Necrosis Factor-alpha ; immunology

Objective: A hospital Formulary (HF) is useful not only for providing a list of formulary drugs, but also for drug safety management and clinical practice in hospitals.  Our Pharmacy Division serves as a clinical training facility for the Faculty of Medicine and offers a bedside learning (BSL) program that allows students to participate in medical services.  Providing medical students with a requisite understanding of pharmacotherapy in order to effectively provide medical services is the goal of the core curriculum of medical education and HF use in BSL may be effective in achieving this goal.  We conducted a survey in order to examine the usefulness of an HF for medical students during clinical training and to determine what drug information is required by students.
Methods: Between April 2012 and March 2013, a questionnaire survey was conducted on 88 fifth-year medical students    who participated in a 1-day BSL program using an HF.
Results: The response rate was 100%.  All students responded that they understood how to use the HF and believed it was useful in BSL.  However, the level of satisfaction with the explanatory notes was significantly lower than that of other sections providing clinically useful additional information such as monographs or supplementary tables (p<0.05).  More than 80% of the students considered monographs to be useful for obtaining information on side effects, warnings and contraindications, dosage and administration, indications, dosing in renal impairment, and drug name.  Students generally considered supplementary tables useful for obtaining information on serious side effects and their early identification, points of drug use in renal dysfunction, appropriate drug use in cancer chemotherapy, insulin and diabetes treatment, calculations of pediatric dosing, and a list of clinically used abbreviations.
Conclusion: These results suggest that medical students believe an HF is useful in BSL.  When medical students participate in pharmacotherapy during BSL programs outside the Pharmacy Division, an HF that not only lists drugs but also contains supplementary tables of clinically useful information may be required.

[Objective] To determine the long-term effect of Kampo medicine on patients with primary open angle glaucoma (POAG).
[Patients] Patient 1 was a 17-year-old male with POAG at his initial visit, having been treated using Kampo for 34 years. Patient 2 was a 56-year-old female, diagnosed with POAG 30 years before visiting our clinic, who had continued Kampo treatment for 19 years. At their first visit, these two patients had a very high risk of becoming blind, but, after long-term treatment using Kampo, their visual function was maintained and their intraocular pressure was well controlled. Patient 3 was a 23-year-old female at her initial visit, who we have been following for 27 years. During this period, her intraocular pressure returned to normal while she was taking Kampo medicine regularly, and conversely elevated when she stopped.
[Discussion] We cannot indicate the specific Kampo prescription which reduces intraocular pressure, but Kampo medicines prescribed according to the usual pattern identifications may be able to improve the intraocular pressure in the presence of POAG. In addition, Kampo medicine may be effective in maintaining the visual function of POAG patients.
[Conclusion] Kampo medicine may reduce intraocular pressure, and be effective as an add-on therapy when combined with standard treatment in patients with POAG.

Objective：The previous study was to develop the“Itamikei”, a small machine which patients can use to record their subjective level of pain. And new assessment tool“Tablet PC application for Pain Memory”, which enable the user to visualize and record the pain levels both instantly and over time. The purpose of this study was to examine the effectiveness of Pain Memory as a pain assessment tool for patients with cancer pain. Method：12 inpatients prescribed analgesics for cancer pain, were instructed to input their pain level into Pain Memory over a 2-week period, and the resulting graph was reviewed by the patient and staff. They also completed a questionnaire evaluating the design, function and pain assessment of the tool. Result：The patients input their pain level into Pain Memory 5.25 times／day（Md）, which provided increased opportunities to ascertain the patient’s pain level compared to that“Itamikei”. The design and function of the Pain Memory were given approximately rate 4 using a 5 point scale by both patients and staff members. Moreover, using Pain Memory, the patients highly rated the parameter“I understood changes in pain”, and the staff members highly rated the parameter“Patients participating in the treatment of pain”. Conclusion：We found Pain Memory could be useful in the assessment of pain. It provided more opportunities to ascertain the pain level of patients, and enabled the visualization of the pain level through a graph.

Introduction: Tramadol (TRM) has been included as a weak opioid at the second step of the WHO analgesic ladder and has been widely used in palliative medicine. Here we report a case of amelioration of cancer pain by TRM therapy in a female patient with myasthenia gravis (MG). Case:The patient was a 70’s woman who was diagnosed with advanced endometrial carcinoma and suffered from chest pain caused by chest metastasis. 25 mg of a TRM capsule was orally administered three times a day. The dose was increased to 50 mg twice a day. It was resulted in sound pain relief with transient muscle weakness but without a myasthenic crisis.