[A Trial of Practical Training on Online Medication Instructions in Clinical Preparatory Education: Development of Human Resources to Provide New Forms of Medical Care after the COVID-19 Pandemic].

The coronavirus disease 2019 (COVID-19) pandemic has considerably affected several social services. The Ministry of Health, Labour, and Welfare has partially revised the Pharmaceuticals and Medical Devices Law and established legislations on permanent online medication instructions. Based on these social needs, the development of human resources to provide online medication instructions is vital. Therefore, we developed a training program for providing online medication instructions in preparatory clinical education. Pharmacy students who had conducted medical interviews with standardized patients participated in the training. Educational outcomes were evaluated using an objective multiple-choice test and free description before and after practical training. The median number of correct answers on objective tests on the legislation on online medication instructions increased significantly. Based on the free description analysis, students were able to comprehend the influence of communication environment on the quality of medication instructions. Based on the results of the direct evaluation using objective testing and indirect evaluation by analyzing the free descriptions, they also acquired the skills necessary for providing online medication instructions. Therefore, this training program can contribute to mastering the provision of online medication instructions.

Hepatoprotective Activity of Yellow Chinese Chive against Acetaminophen-Induced Acute Liver Injury via Nrf2 Signaling Pathway.

Glutathione, the most abundant intracellular antioxidant, protects cells against reactive oxygen species induced oxidative stress and regulates intracellular redox status. We previously demonstrated that yellow Chinese chive (ki-nira) increased the intracellular glutathione levels. Acetaminophen (APAP) is a commonly used analgesic. However, an overdose of APAP causes severe hepatotoxicity via depletion of the hepatic glutathione. In this study, we investigated the hepatoprotective effects of yellow Chinese chive extract (YCE) against APAP-induced hepatotoxicity in mice. YCE (25 or 100 mg/kg) was administered once daily for 7 d, and then APAP (700 mg/kg) was injected at 6 h before the mice were sacrificed. APAP treatment markedly increased the serum biological markers of liver injury such as alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, and alkaline phosphatase. Pretreatment with YCE significantly prevented the increases in the serum levels of these enzymes. Histopathological evaluation of the livers also revealed that YCE prevented APAP-induced centrilobular necrosis. Pretreatment with YCE dose-dependently elevated glutathione levels, but the difference was not significant. Nuclear factor erythroid 2-related factor 2 (Nrf2) plays a critical role in APAP-induced hepatotoxicity by regulating the antioxidant defense system. Therefore, we investigated the expression of Nrf2 and its target antioxidant enzyme. YCE led to an increased expression of Nrf2 and its target antioxidant enzymes, NAD(P)H quinone oxidoreductase 1 (NQO1), glutathione peroxidase (GPx), cystine uptake transporter (xCT), especially hemeoxygenase-1 (HO-1) in mice livers. These results suggest that YCE could induce HO-1 expression via activation of the Nrf2 antioxidant pathway, and protect against APAP-induced hepatotoxicity in mice.

Protective Effects of Rice Peptide Oryza Peptide-P60 against Oxidative Injury through Activation of Nrf2 Signaling Pathway In Vitro and In Vivo.

We previously showed that commercially available rice peptide Oryza Peptide-P60 (OP60) increased the intracellular glutathione levels. This study aimed to evaluate the antioxidant potential of this peptide and assess its mechanism of action. Pretreatment of HepG2 cells with OP60 reduced the cytotoxicity caused by H2O2 or acetaminophen (APAP) (47.7 ± 1.3% or 12.2 ± 1.3% of the cytotoxicity for 5 mg/mL OP60 pretreatment compared to that in H2O2- or APAP-treated groups, respectively; p < 0.01) through the restoration of glutathione homeostasis. Moreover, OP60 elevated the mRNA level of genes encoding heavy and light subunits of γ-glutamylcysteine synthetase (γ-GCS) by 2.9 ± 0.1-fold and 2.7 ± 0.2-fold (p < 0.001), respectively, at 8 h and also increased the level of mRNA encoding other antioxidant enzymes. Besides, OP60 promoted Nrf2 nuclear translocation by 2.2 ± 0.3-fold (p < 0.05) after 8 h. Conversely, knockdown of Nrf2 inhibited the increase of the intracellular glutathione levels and suppressed the induction of antioxidant enzyme expression by OP60. In animal studies, OP60 prevented APAP-induced liver injury by suppressing glutathione depletion (from 0.19 ± 0.02 mmol/mg protein to 0.90 ± 0.02 mmol/mg protein; p < 0.01, by pretreatment with 500 mg/kg OP60) and increasing heavy subunit of γ-GCS and heme oxygenase-1 expression in the liver. Our results indicated that OP60 exhibits a cytoprotective effect via the Nrf2 signaling pathway and is one of the few peptides with excellent antioxidant properties.

Sake lees hydrolysate protects against acetaminophen-induced hepatotoxicity via activation of the Nrf2 antioxidant pathway.

Acetaminophen is a commonly used analgesic. However, an overdose of acetaminophen causes severe hepatotoxicity via depletion of hepatic glutathione. Here, we investigated the protective effects of sake lees hydrolysate against acetaminophen-induced hepatotoxicity in mice. Sake lees hydrolysate was administered orally to ICR mice for seven days. Six hours after acetaminophen treatment, the mice were sacrificed, and blood and liver samples were collected for analysis. Treatment with acetaminophen markedly increased the levels of serum alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, and alkaline phosphatase. Pretreatment with sake lees hydrolysate significantly prevented the increases in the serum levels of these enzymes and inhibited acetaminophen-mediated glutathione depletion. In addition, histopathological evaluation of the livers also revealed that sake lees hydrolysate prevented acetaminophen-induced centrilobular necrosis. The expression of γ-glutamylcysteine synthetase (γ-GCS), hemeoxygenase-1 (HO-1) and nuclear factor erythroid 2-related factor 2 (Nrf2) in the liver were decreased after acetaminophen treatment, whereas pretreatment with sake lees hydrolysate led to an increased expression of all three proteins. Furthermore, sake lees hydrolysate induced the expression of these proteins in HepG2. These results suggested that sake lees hydrolysate could induces HO-1 and γ-GCS expression via activation of the Nrf2 antioxidant pathway, and protects against acetaminophen-induced hepatotoxicity in mice.

Hepatoprotective effects of rice-derived peptides against acetaminophen-induced damage in mice.

Glutathione, the most abundant intracellular antioxidant, protects cells against reactive oxygen species induced oxidative stress and regulates intracellular redox status. We found that rice peptides increased intracellular glutathione levels in human hepatoblastoma HepG2 cells. Acetaminophen is a commonly used analgesic. However, an overdose of acetaminophen causes severe hepatotoxicity via depletion of hepatic glutathione. Here, we investigated the protective effects of rice peptides on acetaminophen-induced hepatotoxicity in mice. ICR mice were orally administered rice peptides (0, 100 or 500 mg/kg) for seven days, followed by the induction of hepatotoxicity via intraperitoneal injection of acetaminophen (700 mg/kg). Pretreatment with rice peptides significantly prevented increases in serum alanine aminotransferase, aspartate aminotransferase, and lactate dehydrogenase levels and protected against hepatic glutathione depletion. The expression of γ-glutamylcysteine synthetase, a key regulatory enzyme in the synthesis of glutathione, was decreased by treatment with acetaminophen, albeit rice peptides treatment recovered its expression compared to that achieved treatment with acetaminophen. In addition, histopathological evaluation of the livers also revealed that rice peptides prevented acetaminophen-induced centrilobular necrosis. These results suggest that rice peptides increased intracellular glutathione levels and could protect against acetaminophen-induced hepatotoxicity in mice.

[Gender equality activity in the Bioimaging Society].

Gender equality activity in the Bioimaging Society was initiated in 2005 when it joined the Japan Inter-Society Liaison Association Committee for Promoting Equal Participation of Men and Women in Science and Engineering (EPMEWSE). The Gender Equality Committee of the Bioimaging Society is acting on this issue by following the policy of the EPMEWSE, and has also been planning and conducting lectures at annual meetings of the society to gain the understanding, consents, and cooperation of the members of the society to become conscious of gender equality. Women's participation in the society has been promoted through the activities of the Gender Equality Committee, and the number of women officers in the society has since increased from two women out of 40 members in 2005 to five out of 44 in 2013. The activities of the Gender Equality Committee of the Japanese Association of Anatomists (JAA) have just started. There are more than 400 women belonging to the JAA. When these women members join together and collaborate, women's participation in the JAA will increase.

Effect of risedronate on osteoblast differentiation, expression of receptor activator of NF-κB ligand and apoptosis in mesenchymal stem cells.

Nitrogen-containing bisphosphonates (BPs) are antiresorptive drugs used for the treatment of metabolic bone diseases. Bone marrow stromal cells such as mesenchymal stem cells (MSCs) and MSC-derived osteoblasts that originate from MSCs are known to regulate osteoclast differentiation and activation via the expression of receptor activator of NF-κB ligand (RANKL). Although the effects of nitrogen-containing BPs on osteoclasts and osteoblasts have been well investigated, their effects in MSCs have not been clarified. In this study, we investigated the effects of risedronate (RIS), a nitrogen-containing BP, on osteoblast differentiation, RANKL expression and apoptosis in human and rat MSCs. RIS suppressed the formation of mineralized nodules and mRNA expression of differentiation marker genes such as bone sialoprotein and osteocalcin in MSC-derived osteoblasts. The RANKL expression induced by 1,25-(OH)(2) vitamin D(3) was not affected by RIS in human MSC-derived osteoblasts. In addition, treatment with high-concentration RIS induced chromatin condensation, an apoptosis feature, in MSCs. RIS-induced chromatin condensation was suppressed by a pan-caspase inhibitor zVAD-FMK and a cell-permeable isoprenoid analogue geranylgeraniol. These results indicate that RIS suppressed osteoblast differentiation and induced caspase- and isoprenoid depletion-dependent apoptosis and suggest that the antiresorptive effect of RIS is not mediated by a decrease in the RANKL expression in MSC-derived osteoblasts.

Characterization of proteins secreted from a type III secretion system of Edwardsiella tarda and their roles in macrophage infection.

The Type III secretion system is essential for intracellular replication of Edwardsiella tarda in phagocytes of fish and mammals. We identified the secreted proteins of the Type III secretion system by comparing the wild-type strain and the Type III mutant mET1229. The wild-type strain secreted 55, 25, and 22 kDa proteins into the culture supernatant, whereas the Type III mutant did not. These proteins were identified as EseB, EseC, and EseD and are similar in sequence to Salmonella SseB, SseC, and SseD that function as a translocon. The EseB, EseC, and EseD knockout mutants did not replicate in murine macrophages, suggesting that these proteins are essential for intracellular replication of E. tarda. Highest secretion of EseBCD proteins was observed when bacterial cells were cultured in neutral and alkaline pHs but not in acidic pH. When the pH of the phagosomes was examined using an acidotropic probe, the phagosomes containing the wild-type strain showed neutral pH, whereas those containing the Type III mutant exhibited acidic pH. These results suggest that the Type III-dependent interference with formation of the acidic environment in phagosomes is essential for intracellular replication of bacteria in murine macrophages.

Mechanism of 3-nitropropionic acid-induced membrane permeability transition of isolated mitochondria and its suppression by L-carnitine.

3-Nitropropionic acid (3NP) functions as an irreversible inhibitor of succinic acid dehydrogenase (complex II) and induces neuronal disorders in rats similar to those in patients with Huntington's disease. It is well known that L-carnitine (LC), a carrier of long chain fatty acid into the mitochondrial matrix, attenuates the neuronal degeneration in 3NP-treated rats. From these findings it has been suggested that 3NP induces certain neuronal cell death through mitochondrial dysfunction and that LC preserves the neurons against the dysfunction of mitochondria caused by 3NP. However, the detailed mechanism of cell death by 3NP and the protective actions of LC against the mitochondrial dysfunction have not been fully elucidated yet. Thus, we studied the molecular mechanism of the effects of 3NP and LC on isolated rat liver mitochondria. 3NP inhibited succinate respiration and the decreased respiratory control ratio of isolated mitochondria without affecting oxidative phosphorylation. 3NP induced a membrane permeability transition (MPT), which plays an important role in the mechanism of apoptotic cell death. 3NP stimulated Ca2+ release from mitochondria, decreased membrane potential, induced mitochondrial swelling, and stimulated cytochrome c release from mitochondria. 3NP-induced swelling was suppressed by bovine serum albumin, inhibitors of phospholipase A(2) and by an inhibitor of classic MPT, cyclosporin A. Furthermore, LC suppressed the changes brought about by 3NP in mitochondrial functions in the presence of ATP. These results suggest that MPT underlies the mechanism of 3NP-induced cell death, and that LC attenuates mitochondrial MPT by decreasing long chain fatty acids generated by phospholipase A(2).

Visualization and dynamic size evaluation of nanoparticles in solution by single optical fiber-illuminated video microscope analysis.

AIM: It is hoped that nanoparticles will become ever more useful in the development of nanomedicine. To evaluate the behavior of nanoparticles in solution, we aimed to establish a single optical fiber-illumination method that is easy to integrate with a conventional microscope at low cost. METHODS: Solutions of gold nanoparticles and carbon nanotubes were analyzed in a single optical fiber-illuminated video microscope and the tracks of Brownian motion of these nanoparticles were traced using video images. Their diffusion coefficient was measured by the mean square displacement of the movement. Using the diffusion coefficient in the Stokes-Einstein equation, the hydrodynamic diameter of the nanoparticles in solution was evaluated. RESULTS: The visualization of gold nanoparticles clearly in a high signal-to-noise ratio was achieved. The evaluated particle sizes of gold nanoparticles were similar to those obtained by a transmission electron microscope and the aggregation process of the carbon nanotubes following incubation was also observed and similar size estimation of the aggregates was performed. CONCLUSION: The single fiber-illumination method was applicable to visualize nanoparticle movement clearly and to estimate their sizes in solution. This simple method is suitable for the in situ observation of the nanoparticle-binding process to target cells.

gamma-Tubulin-like molecules in the mouse duodenal epithelium.

A mouse monoclonal antibody (G9, Horio et al. in Cell Motil Cytoskel 44:284-295, 1999) that was raised against the gamma-tubulin from a fission yeast, Schizosaccharomyces pombe, showed a unique staining in the mouse small intestine. Similar to another anti-gamma-tubulin antibody that is commercially available, G9 showed typical dot-like staining corresponding to the microtubule-organizing center in the free cells of the epithelium and the connective tissue under it. In addition, G9 stained the cell-cell contacts in the epithelium. This stained region was not bicellular but tricellular junctions of the enterocytes. This staining was unique to G9 and was diminished on the sample of the mouse small intestine, which had lost most of its filamentous microtubules through the preparation process. The tricellular junction is thought to be the weakest point of the epithelial barrier, and no other junctional structures have been identified except for the central sealing elements extending from the tight junctions between the two cells. Our results suggest the existence of a new molecule underlying the tricellular junctions, which may relate to gamma-tubulin and the microtubules.

The Hoshino wooden skeleton, the first wooden model of a human skeleton, made during the Edo era in Japan.

The wooden model of the human skeleton, called the wooden skeleton, is a distinguished original craft object from the Edo era, in Japan, when medical doctors were unable to keep a human skeleton for study and teaching purposes. There are three types of wooden skeletons: (i) Hoshino made in 1792; (ii) Kagami made by 1810; and (iii) Okuda made around 1820. The former two are of adult males and the latter is of a female. The wooden skeletons were made with surprising accuracy compared with figures that appeared in the medical books available in Japan at that time, which suggests a scientific readiness of the doctors and the skill of the craftsmen. In the cases of the Hoshino and Kagami wooden skeletons, it is hard to consider that all wooden bones were assembled to show the entire body. Conversely, the Okuda wooden skeletons were made for showing in the sitting position. The skull of the Hoshino wooden skeleton is of special interest: the skull cap was not cut, yet the internal structures of the skull, such as the sella turcica, foramina for nerves and vessels, and the sulci for venous sinuses, were made with considerable accuracy. The skull caps of the Kagami and Okuda wooden skeletons were cut, as those used in modern medical education.

Intracellular replication of Edwardsiella tarda in murine macrophage is dependent on the type III secretion system and induces an up-regulation of anti-apoptotic NF-kappaB target genes protecting the macrophage from staurosporine-induced apoptosis.

Edwardsiella tarda is a pathogen with a broad host range that infects both animals and humans. Resistance to phagocytic killing may be involved in the pathogenicity of this bacterium. Here we show that intracellular replication of E. tarda in murine macrophages is dependent on the type III secretion system and induces an anti-apoptotic effect by up-regulating anti-apoptotic NF-kappaB target genes. The wild-type strain replicates within the phagosomal membrane of macrophages; whereas the type III mutant does not. Microarray analysis shows the mRNA expression level of NF-kappaB target genes (e.g. pro-inflammatory cytokines and anti-apoptotic genes) in macrophages infected with the wild-type strain were up-regulated compared to macrophages infected with the type III mutant. Up-regulation of Bcl2a1a, Bcl2a1b, cIAP-2, and TRAF1 genes induced expression of anti-apoptotic proteins to protect macrophages from apoptosis induced by staurosporine. Further, this protection was inhibited by adding kamebakaurin, an inhibitor of NF-kappaB activation and was confirmed using an NF-kappaB reporter gene assay. Up-regulation of anti-apoptotic NF-kappaB target genes is responsible for the anti-apoptotic activity of E. tarda and is required for intracellular replication in murine macrophages.

[Wooden models of human skeleton made in Edo era, Japan, with special reference to Hoshino wooden skeleton].

The wooden model of the human skeleton, called wooden skeleton, is a distinguished original craft object in Edo era (1600-1867), Japan, when medical doctors were unable to keep the human skeleton for their study and teaching purpose. There are three kinds of wooden skeletons, i. e. Hoshino, Kagami and Okuda wooden skeletons made in 1792, 1810 and 1820, respectively. The former two are of adult male and the latter of female. They were made in surprising accuracy as compared with figures appeared in medical books available in Japan at that time, which suggests scientific readiness of the doctors and skills of the craftsmen. A complete set of the skeleton, except for the hyoid bone, has been preserved for Hoshino and Okuda wooden skeletons, while several bones have been missing in Kagami wooden skeleton. Each bone of Hoshino and Kagami wooden skeletons was made separately and connected by a tenon and a corresponding mortise at the articular surface. So it is hardly considered that all wooden bones were assembled into the whole body skeleton on use. Okuda wooden skeleton, on the other hand, was made for being shown in sitting position. The skull of Hoshino wooden skeleton is of special interest: the skull cap is not open, yet the internal structures of the skull, such as the sella turcica, foramina for nerves and vessels, and sulci for venous sinuses were made in considerable accuracy. Moreover, the proper connection of most foramina was proved between the inside and outside of the skull. The skull caps of Kagami and Okuda wooden skeletons are open as those used in the modern medical education.

[Anatomy education in medical and dental schools in Japan].

We studied the anatomy education and the view of anatomy professors on it in medical and dental schools in Japan. In most schools anatomy is taught in the second year. In medical schools, the systematic education separating macroscopic and microscopic anatomy is prevalent. Although the tutorial system has been introduced in 80% of medical schools, its introduction into anatomy education has remained at 30%. The tutorial system is regarded to be more effective by engaged professors than non-engaged. Some kinds of clinical anatomy education have been introduced in half of the medical schools surveyed. In dental schools, on the other hand, macroscopic and microscopic anatomy tend to be taught in combination. One third of the dental schools have introduced clinical anatomy but few schools have a tutorial system. The overwhelming majority of professors are evaluated by students and have regarded the evaluation useful for improving their teaching. They also have thought that the questionnaire and the timing of the evaluation must be considered carefully, and that the evaluation should not be directly used for purposes other than the improvement of education. We have made the proposals for further improvement in anatomy education based upon this study.

Human coronavirus 229E binds to CD13 in rafts and enters the cell through caveolae.

CD13, a receptor for human coronavirus 229E (HCoV-229E), was identified as a major component of the Triton X-100-resistant membrane microdomain in human fibroblasts. The incubation of living fibroblasts with an anti-CD13 antibody on ice gave punctate labeling that was evenly distributed on the cell surface, but raising the temperature to 37 degrees C before fixation caused aggregation of the labeling. The aggregated labeling of CD13 colocalized with caveolin-1 in most cells. The HCoV-229E virus particle showed a binding and redistribution pattern that was similar to that caused by the anti-CD13 antibody: the virus bound to the cell evenly when incubated on ice but became colocalized with caveolin-1 at 37 degrees C; importantly, the virus also caused sequestration of CD13 to the caveolin-1-positive area. Electron microscopy confirmed that HCoV-229E was localized near or at the orifice of caveolae after incubation at 37 degrees C. The depletion of plasmalemmal cholesterol with methyl beta-cyclodextrin significantly reduced the HCoV-229E redistribution and subsequent infection. A caveolin-1 knockdown by RNA interference also reduced the HCoV-229E infection considerably. The results indicate that HCoV-229E first binds to CD13 in the Triton X-100-resistant microdomain, then clusters CD13 by cross-linking, and thereby reaches the caveolar region before entering cells.

Use of taxol and collagenase for better three-dimensional visualization of microtubules in the enterocyte and Brunner's gland cell, with special reference to their relation to the Golgi apparatus.

Cytoskeletal microtubules were visualized in the mouse duodenal mucosa by an improved immunofluorescence method using a microtubule-stabilizing reagent, Taxol, and collagenase as an enzymatic epitope retriever. The improvement in immunostaining was shown morphologically and statistically by comparing fluorescence intensities of specimens prepared with or without Taxol and collagenase treatment. In free cells in the epithelium and in the lamina propria, microtubules radiated from the gamma-tubulin-immunostained organizing center. Enterocytes and Brunner's gland cells double-stained with an anti-alpha-tubulin antibody and a lectin (Helix pomatia agglutinin, soybean agglutinin or Ulex europaeus agglutinin-I) showed that microtubules ran along the cell axis and were abundant between the Golgi apparatus and the apical surface. The microtubules appeared to provide a structural support to hold the Golgi apparatus in position and to act as railways for secretory granules, which are transported towards the apical surface. In addition, gamma-tubulin-like immunoreactivity was associated with the Golgi apparatus in the enterocytes. These results show that the method using Taxol and collagenase is effective for visualizing microtubules in epithelial cells, and that microtubules may play important roles in both positioning of the Golgi apparatus and transport of secretory granules. Our results also support the idea that the Golgi apparatus may act as an organizing center for microtubules.

Gliding movement in Peranema trichophorum is powered by flagellar surface motility.

A colorless euglenoid flagellate Peranema trichophorum shows unique unidirectional gliding cell locomotion on the substratum at velocities up to 30 micro m/s by an as yet unexplained mechanism. In this study, we found that (1) treatment with NiCl(2) inhibited flagellar beating without any effect on gliding movement; (2) water currents applied to a gliding cell from opposite sides caused detachment of the cell body from the substratum. With only the anterior flagellum adhering to the substratum, gliding movement continued along the direction of the anterior flagellum; (3) gentle pipetting induced flagellar severance into various lengths. In these cells, gliding velocity was proportional to the flagellar length; and (4) Polystyrene beads were translocated along the surface of the anterior flagellum. All of these results indicate that a cell surface motility system is present on the anterior flagellum, which is responsible for cell gliding in P. trichophorum.

Immunofluorescence detection of gastric H(+)/K(+)-ATPase and its alterations as related to acid secretion.

Parietal cells in the rat oxyntic mucosa were analyzed by the immunofluorescence pattern of the proton pump. The adult rats were grouped into fasting (C), gastrin-treated (G), and ranitidine-treated (R) groups, gastric pH was measured, and the stomach was processed for immunohistochemistry. The fluorescence of parietal cells showed a reticular, diffuse, or mixed pattern in cytoplasm. Quantitatively, 53% of the total cells showed the reticular pattern in group G (pH 1.9), 44% in group C (pH 2.0), and 0% in group R (pH 6.7). On the other hand, 7.0% of the total cells showed the diffuse pattern in group G, 11.9% in group C, and 56.2% in group R. The results indicated that the staining pattern depended on the activity of acid secretion. In addition, the proportion of parietal cells showing the reticular pattern decreased in the following order, the superficial, middle, and deep third of the mucosa, and the diffuse pattern showed the opposite trend. This suggests that the acid secretion is more active in parietal cells in the superficial part of the mucosa. The double staining with proton pump-specific and cytochrome oxidase-specific antibodies revealed the close relation between reticular fluorescence and mitochondria.