市販の感冒薬「改源」服用後に発疹および肝内胆汁うっ滞の症状を呈した1症例に遭遇したので報告する.症例は31歳の女性で,発熱および咽頭痛のため「改源」3包(2,100mg)を2日間内服した.その後,発疹,全身倦怠感,食思不振を訴え,ついで黄疸が出現した.この黄疸はさらに増強し,GOT, GPT, Alk-P, LAPおよびγ-GTPの上昇がみられたために入院したが,黄疸消失後もAlk-P, LAPおよびγ-GTPは高値を持続した.肝生検像では,主として小葉中心帯に胆栓および肝細胞内に胆汁色素を認め,また,グ鞘に軽度の細胞浸潤を認めた.患者末梢血単核細胞を分離して,キャリア蛋白とともに改源に含まれている桂皮末を加えて培養する際,インターロイキン-2を添加すると,リンパ球幼若化反応が陽性に発現した.このため,本症は桂皮成分による薬物アレルギー性肝炎と診断した.

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Background: The use of high-density barium sulfate was recommended by the Japan Society of Gastroenterological Cancer Screening (JSGCS) in 2004. We evaluated the diagnostic validity of gastric cancer screening that used high-density barium sulfate.
Methods: The study subjects were 171 833 residents of Osaka, Japan who underwent gastric cancer screening tests at the Osaka Cancer Prevention and Detection Center during the period from 1 January 2000 through 31 December 2001. Screening was conducted using either high-density barium sulfate (n = 48 336) or moderate-density barium sulfate (n = 123 497). The subjects were followed up and their medical records were linked to those of the Osaka Cancer Registry through 31 December 2002. The results of follow-up during 1 year were defined as the gold standard, and test performance values were calculated.
Results: The sensitivity and specificity of the screening test using moderate-density barium sulfate were 92.3% and 91.0%, respectively, while the sensitivity and specificity of the high-density barium test were 91.8% and 91.4%, respectively. The results of area under receiver-operating-characteristic (ROC) curve analysis revealed no significant difference between the 2 screening tests.
Conclusions: Screening tests using high- and moderate-density barium sulfate had similar validity, as determined by sensitivity, specificity, and ROC curve analysis.

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San-Zhong-Kui-Jian-Tang (SZKJT; Japanese name: Sanshu--to), a traditional Chinese medicine prescription, has been used for treating patients with various cancers. This study first investigates the anticancer effect of SZKJT in two human breast cancer cell lines, MCF-7 and MDA-MB-231. SZKJT exhibited effective cell growth inhibition by inducing cancer cells to undergo G0/G1 phase arrest and apoptosis. Blockade of cell cycle was associated with increased p21/WAF1 levels, and reduced amounts of cyclinD1, cyclinD2 in a p53-independent manner. SZKJT treatment triggered the mitochondrial apoptotic pathway indicated by changing Bax/Bcl-2 ratios, cytochrome c release and caspase-9 activation, but did not act on Fas/Fas ligand pathways and the activation of caspase-8. Further investigation revealed that SZKJT's inhibition of cell growth effect was also evident in a nude mice model. Taken together, our study suggests that the induction of p21/WAF1 and activity of the mitochondrial apoptotic system may participate in the antiproliferative activity of SZKJY in human breast cancer cells.

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Objective Gastroptosis is recognized by its characteristic appearance on barium studies. The present prospective study assessed the relationship between gastroptosis and dyspeptic symptoms.
Methods Japanese subjects underwent health screening, and gastroptosis was diagnosed by barium studies. Consecutive subjects (500 women and 167 men) with gastroptosis were identified and the same number of age-matched subjects without gastroptosis were selected as controls. Dyspepsia was classified as reflux-like (heartburn and belching), dysmotility-like (bloating and fullness), or ulcer-like dyspepsia (epigastralgia) based on the Rome II criteria.
Results Body mass index was significantly lower in women with gastroptosis than in controls [19.7±1.83 (SD) vs. 23.4±3.70, p<0.0001], and also in men (19.7±2.00 vs. 23.9±2.89, p<0.0001). The incidence of dyspepsia was significantly lower in women with gastroptosis than in controls (56/500 vs. 87/500, p<0.01) and also in men (10/167 vs. 25/167, p<0.05), especially in women with ulcer-like dyspepsia (15/500 vs. 32/500, p<0.05) and in men with reflux-like dyspepsia (2/167 vs. 12/167, p<0.05). By logistic regression analysis, gastroptosis was associated with a lower risk of dyspepsia (odds ratio: 0.62, 95% CI: 0.405-0.941, p=0.025) and ulcer-like dyspepsia (odds ratio: 0.36, 95% CI: 0.177-0.726, p=0.004) in women.
Conclusion Dyspeptic symptoms were significantly less common in subjects with gastroptosis. Accordingly, gastroptosis may protect against dyspeptic symptoms, rather than causing functional dyspepsia.

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　酸性水とグルタールアルデヒドを使用した内視鏡洗浄消毒により内視鏡外面のコーティング部が2,000例を超える頃よりざらざらした手触りの変化が見られたことから，そのざらつきの成分を分析した。1．ざらざらになった内視鏡の表面を50倍のデジタルマイクロスコープにより観察し，新しい内視鏡の表面と比較した。2．内視鏡外面をフーリエ変換赤外線分光光度計により分析して比較した。3．ざらざらになった内視鏡を廃棄して切断しざらざらの部分の表面を走査型電子顕微鏡により50倍，500倍，5,000倍にて観察した。4．剥離された物質の溶解のために有効な物質を検討し，次亜塩素酸ナトリウムが有効であり，劣化物質を溶解して中和，塩析，フリーズドライ法で粉末状として分析した。結論1．次亜塩素酸ナトリウムに溶解された物質は16種類のアミノ酸が定量された。これらの検索により内視鏡表面の硬く層状に重積した被膜は洗浄の際にわずかに残った蛋白質とグルタールアルデヒドが重合したものと考えられた。酸性水がどのように関与したかは判明できなかった。2．この硬い被膜の除去には，次亜塩素酸ナトリウムが有効であり，つやつやしたコーティング面が再現できた。今後は消毒前の洗浄に中性洗剤や酵素洗剤を用いるべきであり，グルタールアルデヒドの使用も見合わせるべきである。

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  Stomatitis frequently occurs during chemotherapy and radiotherapy for cancer. Because of its pharmacological properties including anti-inflammatory activity and stimulatory effects on endogenous prostaglandin synthesis, rebamipide has been suggested as a potentially effective treatment against stomatitis. In the present study we tested the stability of oral rebamipide solutions prepared in our hospital pharmacy using sodium alginate as a thickener to increase retention of this agent in the oral cavity, and the addition of different flavoring mixtures intended for use in enteral diets to reduce the bitterness of rebamipide and sodium alginate. Samples of oral rebamipide solution prepared with 13 kinds of flavoring and sodium alginate were evaluated in terms of their appearance, redispersibility, pH, viscosity, and rebamipide content immediately after preparation and 1, 3, 7, and 10 days after storage at room temperature under ambient light or in a cool, dark place. After 10 days of storage, favorable stability was observed in four sample solutions supplemented with green apple, pineapple, yogurt, and tomato flavoring mixtures intended for use in Elental^® diets. These oral solutions may have potential clinical application.

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The gastric emptying of indigestible solids is affected by the size, specific gravity, shape, consistency and the compressibility of the indigestible solids and depends largely on the composition of the meal. The threshold size is about 3.0mm in canine. But it is reported that the estimates made for dogs may not apply to humans. I evaluated whether the size of indigestible solids affects gastric emptying in healthy subjects with food which had the same specific gravity as the indigestible solids. We used three sets of 20 ring shaped radiopaque markers, which had the same specific gravity (1.2), shape, consistency, and compressibility, but different diameters (2.0mm, 4.5mm and 7.0mm). After the subjects ingested the three sets of 20 markers with food, the number of markers evacuated from the stomach was counted every 15min until all the markers were evacuated. The median numbers of discharged markers of 2.0mm, 4.5mm and 7.0mm were 5 (0-5), 1 (0-3) and 3 (0-4) at 60min, 15 (3-18), 10 (6-9) and 13 (11-16) at 120min (median, 25th-75th percentile), respectively. There was no statistically significant difference between the numbers of the three types of discharged markers during observation. The lag time (the period from the time of ingestion of the markers to the time when the first marker left the stomach) of the 2.0mm, 4.5mm and 7.0mm markers was 52.5 (45-105), 67.5 (60-105), and 52.5 (45-105) min, respectively, and there was no statistically significant difference. In conclusion, the radiopaque markers of different diameters (below 7.0mm) left the stomach in the same pattern.

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We attempted to clarify in detail the conditions of disinfection using electrolyzed strongly acidic water (ESW) against Mycobacteria, and the recovery of the disinfection potential of inactivated ESW by re-electrolysis. We mixed ESW containing 10, 20, and 30 ppm free chlorine with M. bovis cells (10⁵–10⁸ CFU/mL) for 0–7 min. The disinfection potential of ESW positively correlated with free chlorine concentration, and negatively correlated with the initial density of bacterial cells. To clarify the recovery of the disinfection potential of inactivated ESW by re-electrolysis, we mixed ESW containing 10 ppm free chlorine with M. bovis cells (10⁷ CFU/mL) for 1 min. The number of viable cells decreased to 1/10³, but the cells were still detected. After re-electrolysis for 7 min, viable cells were not detected. Moreover, we confirmed by reusing the re-electrolyzed water against M. bovis cells that it regained its disinfection potential. These findings indicate that ESW once inactivated during disinfection can be re-activated by re-electrolysis. In conclusion, we were able to clarify in detail the conditions of ESW against Mycobacteria, and found the recovery of the disinfection potential of inactivated ESW by re-electrolysis.

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Glycation stress is a concept of biological stress caused by excess sugars, aldehyde and its subsequent reactions in the body. Especially, it is thought that accumulation of Advanced Glycation End products (AGEs) cause skin yellowing, deep wrinkles and a decrease in skin elasticity due to crosslinking to collagen or elastin in the dermis.

We have reported that phlorotannins, polyphenols unique to brown algae, could inhibit the formation of N-ε-carboxymethyllysine resulting from glycation of collagen.

The aim of this study was to investigate the anti-glycation and skin protection effects against UV exposure by long-term intake of the brown algae extract powder containing phlorotannins as a supplement.

This study have performed a randomized, double-blind, placebo-controlled, parallel group study.

Forty-two healthy Japanese adult female were randomly divided into two groups: one group consuming supplements containing brown algae extract powder (Phlorotannins intake group) and the other group consuming supplements not containing brown algae extract powder (placebo group). In both groups, each supplement was consumed daily, and blood AGEs concentration and Minimal Erythema Dose were measured every 4 weeks. In addition, the condition of skin was analyzed by using the skin image analyzer.

In this presentation, we will introduce the skin protection effect against UV exposure and the anti-glycation effects by consuming the brown algae extract powder for eight weeks.

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We previously reported that cascade stomach was associated with reflux symptoms and esophagitis. Delayed gastric emptying has been believed to initiate transient lower esophageal sphincter relaxation (TLESR). We hypothesized that cascade stomach may be associated with frequent TLESR with delayed gastric emptying. Eleven subjects with cascade stomach and 11 subjects without cascade stomach were enrolled. Postprandial gastroesophageal manometry and gastric emptying using a continuous ¹³C breath system were measured simultaneously after a liquid test meal. TLESR events were counted in early period (0–60 min), late period (60–120 min), and total monitoring period. Three parameters of gastric emptying were calculated: the half emptying time, lag time, and gastric emptying coefficient. The median frequency of TLESR events in the cascade stomach and non-cascade stomach groups was 6.0 (median), 4.6 (interquartile range) vs 5.0, 3.0 in the early period, 5.0, 3.2 vs 3.0, 1.8 in the late period, and 10.0, 6.2 vs 8.0, 5.0 in the total monitoring period. TLESR events were significantly more frequent in the cascade stomach group during the late and total monitoring periods. In contrast, gastric emptying parameters showed no significant differences between the two groups. We concluded that TLESR events were significantly more frequent in persons with cascade stomach without delayed gastric emptying.

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Electron probe X-ray microanalysis of the lung specimens were performed in both the two autopsy cases where the patients aspirated mistakenly barium sulfate used as a radiographic contrast medium for the gastrointestinal tract. The results obtained revealed that irregularly shaped, electron-dense granules filling up macrophages in “barium granuloma” corresponded to Ba SO₄.

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Using a single-group time-series design, we determined that osmotic diarrhea caused by maltitol ingestion was suppressed by the addition of not only soluble but also insoluble dietary fiber in healthy humans. We then clarified that cellulose delayed gastric emptying in rats. Twenty-seven healthy volunteers ingested maltitol step-wise at doses of 15, 20, 25, 30, 35, 40 and 45 g from small to large amounts. Within that range of ingested amounts, 22 out of 27 subjects experienced osmotic diarrhea from maltitol ingestion, and the minimal dose level of maltitol that induced osmotic diarrhea (MMD) was established for each subject. When 5 g of cellulose was added to the MMD, osmotic diarrhea was suppressed in 13 out of 19 subjects (68.4%), while partially hydrolyzed alginate-Na (PHA-Na), a soluble dietary fiber, suppressed osmotic diarrhea in 10 out of 20 subjects (50.0%). When a mixed solution of cellulose and maltitol was administered to rats, the gastric emptying of maltitol was significantly delayed at 30 and 60 min after administration (p=0.019, p=0.013), respectively. PHA-Na also significantly delayed gastric emptying at 30 min (p=0.013). In conclusion, cellulose can suppress the osmotic diarrhea caused by maltitol ingestion in humans and delay the gastric emptying of maltitol in rats. A new physiological property of cellulose was clarified in this study.

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Lymphatic malformations that occur in the head and neck are often difficult to treat. Sclerotherapy using polidocanol, which has little tissue damage, can be treated with minimal dysfunction and complications. In particular, it is considered an effective treatment for superficial lesions that bleed from the mucosal surface. In this study, we performed sclerotherapy using polidocanol for a 17-year-old woman with lymphatic malformations with blood containing lymphorrhea in the pharynx and larynx. A total of 3 sclerotherapy treatments were performed, and lesion reduction and bloody lymphorrhea control were observed. At 1 year after treatment, the course of treatment was good with no re-enlargement of the lesions.

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近年，地球温暖化の影響による夏季の気温上昇のため，熱中症対策グッズとして涼感デバイスの需要が高まっている。中でも，ペルチェ素子を用いた生体用冷却装置の研究，開発が盛んであり，モバイルバ ッテリーを装置に内蔵し，ウェアラブル生体用冷却装置として実用化されている。ペルチェ素子は電圧を加えると，一方の面から他方の面へ熱移動が生じる薄型板状の熱電変換デバイスである。小型・軽量で騒音や振動がなく，温度制御が可能であるという特徴をもつ一方，ペ ルチェ素子は外気温変化によって素子両面の温度差に変化が生じるため，温度制御性能の低下が起きやすい。また消費電力が大きく，実用化されているウェアラブル冷却装置では，モバイルバッテリーへの負荷が大きいため，使用可能時間の減少が問題として考えられる。その問題点に対応するために断熱材などを用いたハードウェアでの対策が行われているが，装置の小型化が困難であり，コストの増加を招く。そこで本研究では，安価で対策が可能なソフトウェアでの対策を行う。タグチメソッドによる PID 制御パラメータ設計により，ロバ スト性と省エネ性能の向上を目指す。タグチメソッドを採用した理由は，外気温の変化という誤差条件下にて制御パラメータ設計ができ，制御性能をSN比によって定量的に評価できるためである。直交表実験で得られた消費電力量の値とSN比の値から81通りの推定値の計算を行う。そして，求めたSN比と消費電力量の推定値から散布図の作成を行い，直交表実験から得られた平均消費電力量を下回るSN比が最も高い制御パラメータの組み合わせを選択することでロバスト性と省エネ性能の両立化を図る。提案手法により設計した制御パラメータで温度制御実験を行った結果，市販商品のソフトウェアよりもタグチメソッドにより設計した制御パラメータで温度制御を行った方が，制御および省エネ性能において良好な結果を示すことを確認した。

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We investigated whether peppermint oil (PO) is useful for endoscopic diagnosis of gastric tumors without magnifying endoscopy. Twenty-six patients diagnosed with gastric tumors were examined. Endoscopic images were recorded by white light (WL) and narrow band imaging (NBI) without magnifying endoscopy. After PO administration, images were recorded again by WL and NBI (PO+WL and PO+NBI). The clarity of tumor margins and the effect of PO on the clarity of tumor margins were scored. The mean scores for clarity of tumor margins were 3.6 points in WL, 4 in NBI, 4.3 in PO+WL, and 4.3 in PO+NBI. The scores of WL and NBI showed a tendency to rise by PO. The mean scores for the effect of PO on the clarity of tumor margins were 2.7 in WL and 2.5 in NBI. Therefore, we conclude that PO is useful for endoscopic diagnosis of the margin of gastric tumors.

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A 58-year-old man with liver cirrhosis and renal failure was diagnosed with esophageal varices (EVs) and a gastric cardia varix (GCV) by esophagogastroduodenoscopy (EGD).　The patient also exhibited early gastric cancer (EGC) in the upper gastric body adjacent to the GCV.　The EVs and GCV were treated using endoscopy before endoscopic submucosal dissection (ESD) of the EGC to prevent variceal bleeding during ESD.　Endoscopic variceal ligation (EVL) was performed to treat the EVs.　In addition, extra-variceal polidocanol injection and argon plasma coagulation (APC) were performed after EVL.　Follow-up EGD two months after APC revealed that the GCV had diminished in size.　Then, ESD was performed with polidocanol injection into the submucosa around the GCV to prevent bleeding.　During ESD, the EGC was resected en bloc without severe bleeding.　Complications were not observed after ESD.　Histopathological examination of the ESD specimens indicated that the resection was curative.

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The objective of this study was to calculate the effective radiation dose to patients undergoing barium enema. Participants were 200 patients who underwent barium enema at the Osaka Center for Cancer and Cardiovascular Disease Prevention from April 1 to December 28, 2005. The dose-area products of the fluoroscopy dose, imaging dose, and total dose for each examination using a computed radiography digital X-ray television fluoroscopy system were calculated. The effective dose was obtained by inputting the average value of the dose-area products into Monte Carlo simulation software. The results showed that the effective dose was 5.12 mSv for fluoroscopy and 4.43 mSv for radiography. Therefore, the effective dose to the patient in barium enema was 9.55 mSv.

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