Exploration of Traditional Production Technique of PAEONIAE RADIX : Digitization and Analysis of Processing Environment / 日本東洋医学雑誌

We focused on the traditional processing method which generates the superior quality of Yamato-shakuyaku. First, we assessed the historical literature written around Edo and Meiji period and rediscovered the traditional air drying method still inherited in Nara Prefecture. Then, we gathered and analyzed the data of medicinal plants production in Nara Prefecture among 1938 and 2019, and investigated the decline of local production and experienced agricultural techniques of peony through the transition of its yield. In order to visualize the ancient knowledge of crude drug manufacturers that contributes to the instruction of the skills for supply of seedlings, cultivation, and processing, we settled the meteorological observation devise at the outdoor drying shelf for 3 years, and recorded the real drying environment. When comparing the meteorological data with other cultivating area of peony using the estimated values of Agro-Meteorological Grid Square Data, the climate of Nara Prefecture was with high temperature and low humidity than other areas, and it seems to be quite suitable for air drying with adequate topography. The wind rose calculated by measured values of wind direction and wind speed showed the wind conditions in Nara that west wind was frequent in daytime and wind conditions are mildly but diversely changing. Among other producing areas of peony, the mechanical drying is major, whereas air-drying with low cost utilizing local environment features is still applied in Nara. We revealed the rationality of traditional methodology by digitization of meteorological factors which can be high added value.

Current status of the diagnosis of chronic pancreatitis by ultrasonographic elastography

Chronic pancreatitis (CP) is pathologically characterized by the loss of exocrine pancreatic parenchyma, irregular fibrosis, cellular infiltration, and ductal abnormalities. Diagnosing CP objectively is difficult because standard diagnostic criteria are insufficient. The change of parenchymal hardness is the key factor for the diagnosis and understanding of the severity of CP. The ultrasonography (US) or endoscopic ultrasonography (EUS) elastography have been used to diagnose pancreatic diseases. Both strain elastography (SE) and shear wave elastography are specific diagnostic techniques for measuring tissue hardness. Most previous studies were conducted with SE. There are three methods of interpreting SE; the method of recognizing the patterns in SE distribution images in the region of interest, the method of using strain ratio to compare the hardness of adipose tissue or connective tissue with that of the lesion, and the method of evaluating the hardness distribution of a target by histogram analysis. These former two methods have been used primarily for neoplastic diseases, and histograms analysis has been used to assess hardness distribution in the evaluation of CP. Since the hardness of the pancreas increases with aging, it is necessary to consider the age in the diagnosis of pancreatic disorders using US or EUS elastography.

Feasibility of Newly Developed Endoscopic Ultrasound with Zone Sonography Technology for Diagnosis of Pancreatic Diseases

BACKGROUND/AIMS: To confirm the feasibility of using newly developed endoscopic ultrasound (EUS) with Zone sonography(TM) technology (ZST; Fujifilm Corp.). METHODS: Seventy-five patients with pancreatic disorders were enrolled: 45 with intraductal papillary mucinous neoplasm; 15 with ductal carcinoma; five with neuroendocrine tumors; three with serous cystic neoplasms; and seven with simple cysts. The endoscopes used were EG-530UR2 and EG-530UT2 (Fujifilm Corp.). Two items were evaluated: visualization depth among four frequencies and image quality after automatic adjustment of sound speed (AASS), assessed using a 5-scale Likert scale by two endosonographers blinded to disease status. Because sound speed could be manually controlled, besides AASS, image quality at sound speeds of 1,440 and 1,600 m/sec were also assessed. RESULTS: In all cases, sufficient images were obtained in the range of 3 cm from the EUS probe. Judgments of image quality before AASS were 3.49+/-0.50, 3.65+/-0.48, respectively. After AASS, A and B scored 4.36+/-0.48 and 4.40+/-0.49 (p<0.0001). There were significant differences in the data before and after AASS and plus 60 m/sec, but no significant difference between the datasets were seen after AASS and at sound speeds manually set for minus 100 m/sec. CONCLUSIONS: EUS with ZST was shown to be feasible in this preliminary experiment. Further evaluation of this novel technology is necessary and awaited.