Study of the cartilage matrix production-promoting effect of chicken leg extract and identification of the active ingredient

BACKGROUND/OBJECTIVES: Osteoarthritis (OA) is a major public health issue in Japan and other countries, and foods that prevent or treat OA are in strong demand. Proteins and peptides in chicken meat and bones are known for being rich in functional and nutritional ingredients for the improvement of osteoporosis. We speculated that chicken legs, a food consumed in many regions of the world, may also contain such ingredients. In this study, we aim to (i) evaluate the effect of chicken leg extract (CLE) on the promotion of cartilage matrix production and (ii) identify the active ingredient in CLE that contributes to this function. MATERIALS/METHODS: Artificial CLE digest was prepared, and the acid mucopolysaccharide production-promoting activity of the CLE digest was evaluated by alcian blue staining of ATDC5 cells. CLE was orally administered to rabbits with burr holes in the knee joint of the femur, and the degree of regeneration of cartilage matrix was evaluated. Furthermore, we investigated orally administered CLE-derived peptides in human plasma using LC-MS. From measuring the acid mucopolysaccharide production-promotion activity of these peptides, a molecule considered to be an active ingredient in the CLE digest was identified. RESULTS: CLE digest promoted acid mucopolysaccharide production and facilitated regeneration of cartilage matrix in in vitro and in vivo experiments. Four peptides including phenylalanyl-hydroxyproline (Phe-Hyp) were detected as CLE-derived peptides in human plasma. The effect of CLE was inferred to be due to Phe-Hyp, which was confirmed to be present in the CLE digest. CONCLUSIONS: It was shown that CLE stimulated the production of articular cartilage matrix both in vitro and in vivo, and that CLE could be an effective food for preventing or treating OA. Furthermore, only Phe-Hyp was confirmed as the active compound in the CLE digest, suggesting that the activity of CLE was due to Phe-Hyp.

Contribution of the Slogan “Health and Happiness of Local Residents” to Recoveries in Accounts Receivable Management / 日本農村医学会雑誌

At Anjo Kosei Hospital, all staff has been working concertedly on a project to establish a community hospital in line with our future vision. Hospital staff in charge of the Medical Affairs Division has been involved in measures aimed at achieving the slogan “health and happiness of local residents” as part of this project. To address this, three goals were set as follows: improvement of recoveries in accounts receivable management, a reduction of money held in trust, and a decrease in the number of outsourced transactions. To achieve the goals described above, the following specific measure were carried out: (1) collection of accounts receivable using convenience store settlement; (2) collection of high-cost medical expenses by wider use of Eligibility Certificates for Ceiling-Amount Applications and promotion of the Major Medical Cost Loan System for national health insurance holders; and (3) support in acquiring family registration for nonregistered family members and for health insurance benefits. Recoveries of accounts receivable through convenience store settlement was about 90,000 yen/month, and our support activities for family registration and health insurance benefits provided the recoveries of about 80,000 yen/month. Furthermore, the promoted use of the certificate and loan system resulted in recoveries of about 17 million yen/year. The average commission fee and number of outsourcing was 890,188 yen and 12 cases, respectively, from April to August 2016. However, in 2017, it was 305,615 yen and 10 cases, respectively. Our project aimed at achieving slogan-elicited patient voluntary payment of medical expenses, leading to improved recoveries, with reduced money held in trust and fewer outsourced transactions.

Evaluation of Factors Influencing Addition of Clinically Significant Adverse Reactions Section in Drug Package Inserts / 医薬品情報学

<b>Objective: </b>The aim of this study was to analyze the factors influencing the addition of clinically significant adverse reactions (CSDR) section in drug package inserts in Japan.<br><b>Methods: </b>The summaries of investigation results from August 2011 to July 2014 were evaluated.  The revisions were classified into revisions based only on case reports from Japan ([Revision Y]) and revisions based on other information and/or case reports from Japan ([Revision X]).  The revisions were classified into MedDRA system organ class (SOC).  As index of amount of information from domestic case reports, the number of accumulated cases ([Case A]), cases for which a causal relationship to the product could not be ruled out ([Case B]), and fatal cases ([Case C]) were used.  In each SOC, as index of causal relationship to the product, [Index B/A] ([Case B]/[Case A]) was calculated.  Relationship of [Index B/A] to [Revision X]/all revisions, or to the number of [Case A] in [Revision Y] were evaluated.  Deference of drug lag between [Revision X] and [Revision Y] was evaluated.<br><b>Results: </b>Three hundreds twenty-three revisions with respect to the addition of CSDR section were identified.  [Revision Y] was 203 revisions (63%).  The number of [Case A], ([Case B], and ([Case C]) that were required for [Revision X] (120 revisions) were significantly lower than that were required for [Revision Y] (<i>p</i><0.0001 for all comparisons).  [Index B/A] tended to inversely correlate with [Revision X]/all revisions (<i>r</i>=−0.52, <i>p</i>=0.066), and the number of [Case A] in [Revision Y] (<i>r</i>=−0.61, <i>p</i>=0.025).  Drug lag of [Revision X] was significantly longer than that of [Revision Y] (<i>p</i><0.001).<br><b>Conclusions: </b>In future, it would especially needed to pay attention to adverse reactions with a low [Index B/A] of which revisions relatively depend on other information.

Toward Reducing Doctors' Paper Work with the Aid of Clerks and Computer Software / 日本農村医学会雑誌

  Our hospital with 723 sickbeds takes care of acute diseases. The volume of documents was enormous, exceeding 3,500 titles each month. Paper work chronically puts too heavy a burden on physicians. Although an electronic system of storing medical records has been employed for years and about a half of documents are now processed electronically, there still remains a lot of paper work requiring hand writing.<br>  To lighten the work load of physicians, a type of computer software to make it easy to imput and output patients' medical history has become available recently. The features of the software are as follows:<br>(1) having about 600 formats,<br>(2) capable of inputting patients' personal information automatically,<br>(3) capable of retrieving disease names, dates of hospital admission and discharge, surgical procedures, etc. from the cemtra;computer system with electronic cards, and<br>(4) capable of outputting medical date and printing them.<br>  By dint of these functional capabilities, it has been made easy to issue the written opinions of physicians regarding the nursing care insurance and the medical certificate for life insurance money.<br>  With the revision of the schedule of medical service fees in April 2008, some points were given to physicians' desk jobs. Thanks to the new point system, we could assign five clerks to assist physicians with the paper work. They draw up documents and input non-medical data into the computer.<br>  The deployment of the clerical workers and the introduction of the computer software has shortened the time required for documentation by about 4 days from 11.2 days to 7.2 days. Responding to a questionnaire survey taken 6 months after the start of the new system, eight out of 10 doctors said that the strain on them was eased.

The Changes of Duties after the Introduction of Electronic Chart System and Its Usefulness / 日本農村医学会雑誌

Anjo Kosei General Hospital is a large-scale hospital having 692 beds and located in the central part of Aichi. When the hospital moved into the present adress in April 2002, we introduced an electronic chart system that was not common in Japan at that time. Hospital management changed dramatically because until then we were using exclusively papers, and had not possessed even an electronic ordering system. It was also true in the field of medical office work. We hereby report the changes in routines after the introduction of the electronic chart system and its usefulness.The characteristics of our medical work system are as follows.(1)Data refrieval function (Data Ware House)(2)Credit control system(3)Receipt imaging functionWe are evaluating the various effects of the system from seven points of view as follows.(1)Basic data of medical care(2)Staff placement and personnel expenses(3)Work accuracy and efficiency(4)Patients service(5)Storage space reduction(6)Paper reduction(7)In-house questionnaire survey