In the last several years most diagnostic imaging systems which were screen-film systems have been replaced with digital systems. However, mammography has not advanced as much toward digitization. The most important factor against digitization of mammography is detectability of micro-calcifications, which are essential in diagnosing breast cancer. Digital images have low special resolution relative to screen-film for the limited pixel sizes.
Recently, with the aim of improving this situation, high resolution CR systems with a pixel size of 50μm (half the pixel size of conventional CR systems) and full field digital mammography systems with a flatpanel-detector (FPD) pixel size of 100μm have been developed and made commercially available.
In this report, we describe the current state of digital imaging system development for mammography. The purpose of this report is to survey the future of digital mammography from comparisons of the results of the physical imaging properties and contrast-detail characteristics between digital mammography (FPD and high resolution CR) and screen-film (Min-R2000/Min-R2000) systems.

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We investigated the changes of subjective QOL in Duchenne muscular dystrophy by comparing data for the years 1992 and 2004. The subjects were 41 hospitalized DMD patients in Suzuka National Hospital (age 19.1±4.3 years, M±SD) in 1992 and 32 patients (24.8±6.7) in 2004. The questionnaire consisted of 30 yes-or-no questions which were divided into six categories. The ratio of satisfaction in each category for each respective year was as follows: A) Self Perception-77.6% in 1992 and 76.9% in 2004; B) Medical Care-65.9% and 76.9%; C) Past, Present & Future-47.7% and 60.0%; D) Psychological State-43.9% and 63.8%; E) Family & Friends-70.2% and 78.8%; F) Vitality in Life-71.2% and 73.8%. There were significant increases of ratio of satisfaction from 1992 to 2004 in categories B (p<0.05), C (p<0.05) and D (p<0.01). The improvement of subjective QOL of DMD seems to be a result of progress in medical and the care environment in the recent era such as mechanical respirator, electric wheelchairs which can be easily handled by DMD patients, and IT technology.

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Alzheimer's disease (AD) is a neurodegenerative disorder characterized by loss of memory and other intellectual faculties that occurs in the elderly. The extracellular deposition of amyloid β-protein (Aβ) and the intracellular formation of neurofibrillary tangles (NFTs), which are composed of paired helical filaments (PHF), are the diagnostic hallmarks of AD. The major component of PHF is hyperphosphorylated tau, which is a microtubule-associated protein. The accumulating evidence shown by great numbers of molecular and biochemical studies have established an amyloid cascade hypothesis, which is widely accepted idea to explain pathophysiology of AD development. That is, Aβ deposition induces tau pathology and neurodegeneration, leading to dementia. Based on this idea, several approaches have been performed to prevent and inhibit this cascade.

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Universal hope of human being is healthy and productive aging, aging intervention, especially in our modern Japanese society. In this review, I want to introduce possible methods of aging intervention with our latest studies.

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Periodontal disease is a disorder that affects about 80% of Japanese adults. However, the etiology has not been fully elucidated. Periodontal disease is considered a disorder in which the host-parasite relationship is most important for the etiology. However, the importance of systemic factors and environmental factors, such as aging and lifestyle habits, in the etiology of periodontal disease has not been clarified. Not only impairments of vasculature and gingival tissue by aging and accumulation of lifestyle habit but also evolution of vascular inflammation and blood coagulation by periodontopathic bacteria Porphyromonas gingivalis are involved in the etiology. Gingipains, which are trypsin-like proteinases produced by P. gingivalis, activate several blood coagulation factors such as factor X. Activated factor X (FXa) and gingipains induce expressions of proinflammatory cytokines and matrix metalloproteases and then evoke vascular inflammation and blood coagulation, both locally and systemically. The immune-pathological activity of periodontopathic bacteria is important for considering periodontal disease as a systemic disease. In addition, regulation of the protease cascade activated by P. gingivalis gingipains may be a new strategy for treatment of periodontal disease.

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Many types of medical equipment have been developed with the aim of realizing noninvasive/minimally-invasive procedure so as to improve the quality of life (QOL) of patients. At the clinical stage where blood sugar level measuring instruments are used, blood glucose levels are measured by using an enzyme called glucose-oxidase which does hydrolysis of glucose in a specific way. The representative measuring methods include the light-reflex magnitude measurement and immobilized enzyme electrode method. Meanwhile, some new developments have recently been made such as skin-gas biochemical analysis method to estimate blood sugar level though analysis of gaseous chemical substances rising from the body surface, and a new type of compound sensor. A new noninvasive/minimally-invasive test method is introduced in an instrument which estimates blood sugar level based on various physiologic parameters such as living-body metabolism related heat energy, oxygen supply, and blood flow volume. The phase-contrast method and X-ray dark-field method, which use radiant light, provide a new method of observing soft tissues such as cartilage, breast cancer cells, and cerebellum, which is not possible with conventional radiography. Moreover, as for radiation cancer therapy based on femto-technology, the focus has shifted to trial-based therapy using heavy particles such as carbon ion and neon ion and there are high expectations regarding their use.

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The targets for advanced medicine in geriatrics and gerontology are numerous and the factors assessed in comprehensive geriatric assessment (CGA) should cover them. Ways need to be devised to obtain the best outcome from the viewpoint of total cure and care of the elderly. The department of advanced medicine in National Center for Geriatrics and Gerontology is going to develop novel ways for successful aging and organize useful information in this field nationwide and internationally.

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[in Japanese]

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