No abstract

Clinical and epidemiological studies have indicated that the consumption of green tea has a number of beneficial effects on health. Epigallocatechin-3-gallate (EGCg), the major polyphenolic compound present in green tea, has received much attention as an active ingredient. Among the numerous promising profiles of EGCg, the present study focused on the anticancer effects. Apoptosis induced by EGCg and subsequent cell growth suppression have been demonstrated in a number of cell culture studies. However, the underlying mechanism of apoptotic cell death remains unclear. Thus, the aim of the present study was to identify the major molecule that mediates proapoptotic cell death by EGCg. The effect of EGCg on cell proliferation and the induction of mRNA that modulates apoptotic cell death was evaluated in the A549 human non-small-cell lung cancer cell line. In addition, morphological changes were assessed by microscopy in A549 cells that had been treated with 100 μM EGCg for 24 h. The MTT assay revealed that cell proliferation was significantly reduced by EGCg in a dose-dependent manner (3–100 μM). The mRNA expression level of B-cell lymphoma-extra large (Bcl-xL) was decreased in A549 cells following 24 h incubation with 100 μM EGCg. Therefore, the results indicated that the inhibition of cell proliferation by EGCg may be achieved via suppressing the expression of the cell death-inhibiting gene, Bcl-xL.

Purpose：We provided a lecture on medical expenses related to thedispensing feefor health insurance pharmacies for the local residents in order to determine if there was a change in their preferred community pharmaciesʼ pre-and post-lecture. Methods：Questionnaires were provided to 34 participants, pre-and post-lecture, with responses analysed from 29 participants who completed the questionnaires in full.Results：The percentage of respondents who had not observed receipts with National Health Insurance points was 34.5％, while 25.0％ responded that they had paid with the foreknowledge of the existence of such points. Following completion of the lecture,drug administration guidanceshowed an increase of 55.2％, and dispensing , medication history managementandpharmaceutical inquiry to the doctorhad also increased to 27.6％, 27.6％ and 20.7％, respectively.. Reasons for the selection requirements of participantsʼ preferred community pharmaciesʼ showed a decrease of 37.9％ related to there beinga pharmacy in the vicinity of a hospital , whereasa pharmacy with good administration guidanceanda pharmacy with good counseling increased by 72.5％ and 20.7％, respectively.Conclusion：Through the provision of explanation of the medical insurancedispensing feeas explained by community pharmacists to local residents, this may induce favorable effects on their selection requirements for use of community pharmacies.

Residents in the mountainous northern areas of Miyazaki prefecture find it difficult to access medical institutions and care facilities, and they have little contact with healthcare professionals. In this study, we investigated community access to medical services and proper drug use among residents in areas affected by depopulation and aging. We conducted canvassing interviews with elderly people (aged 65 years and older) in an urban district and four mountainous districts. When problems were identified, we gave instructions for proper drug use, and encouraged medical consultations. Although the number of residents who had access to a family physician differed between districts, many residents had a family physician. However, the number of residents who had a family pharmacy was lower than the number of residents who had a family physician in all districts. The role of pharmacies in proper drug use may not have been recognized in some districts. We found that some residents had side effects by multiple prescriptions and there was a lack of understanding about the meaning of medication in mountainous areas. There were problems regarding over-the-counter and household drugs in districts with a high rate of having these drugs, and we also discovered double medications of prescription and over-the-counter drugs. We conclude that the current situation of community access to medicine has become more difficult for residents in mountainous areas. Nevertheless, pharmaceutical interventions are useful for the promotion of proper drug use for residents in mountainous areas.

Optimal blood pressure (BP) control is extremely important because hypertension is a risk factor for stroke, and heart and blood vessel disease. We have been performing periodic health consultations with collaboration among pharmacists and physicians in a doctorless area. We here report three cases in which these consultations contributed to improvement in hypertension. The first consultation involved a woman in her 70s who feared starting an antihypertensive drug after hypertension had been diagnosed during a medical checkup. After introducing interventions based on lifestyle modifications and home BP measurements, her BP stabilized without medication. The second consultation, with a woman in her 50s, had been taking tofisopam and captopril for autonomic nervous symptoms and hypertension, respectively. The consultation occurred after she had redeveloped marked hypertension caused by ceasing tofisopam of her own accord. She agreed to resume taking this drug again, after which her BP dropped to normal levels. The third consultation, with a woman in her 80s, was suspected of having hypertension induced by pseudo-aldosteronism caused by long-term use of an herbal medicine containing licorice. We recommended consultation with a primary care doctor, after which she discontinued taking the herbal medicine. Health interviews, active listening, BP measurement, and recommendations for lifestyle modifications and appropriate drug use provided by pharmacists, as well as coordination with primary care doctors and medical specialists, are useful for managing hypertension in residents of doctorless areas.