Flavor assessment of a lactic fermented vinegar described in Japanese books from the Edo period (1603-1867).

Aims: Rice vinegar is a traditional fermented seasoning in Japan, and its production remained unchanged for over 800 years until the Edo period. However, based on the available information regarding rice vinegar production methods from this period and the results of reproduction experiments, we speculated that unlike the modern-day acetic fermented vinegar, rice vinegar produced during the Edo period was lactic fermented. Main methods: To verify this assumption, we analyzed the flavor components of Honcho, a lactic fermented product prepared using a method described in books, including "Honchoshokkan" from the Edo period, by capillary electrophoresis/time-of-flight mass spectrometry, high-performance liquid chromatography, gas chromatography mass spectrometry, and taste sensor analysis. Sensory evaluation was also conducted to assess validation as a seasoning. Results: Honcho contains 2 % lactic acid, which gives it its acidity, and small amounts of other nonvolatile acids, but significantly lower levels of acetic acid (0.188 ± 0.015 g/100 mL, p < 0.01). It contains more than double the free amino acids of Kurozu, a modern rice vinegar, and more glutamic acid. Boiling to remove ethanol from yeast fermentation concentrated the free amino acids 1.5 times. Sensor taste analysis showed Honcho had weaker acidity but stronger umami taste than commercial rice vinegar. The volatile compounds related to acetic acid fermentation were significantly different between Honcho and Kurozu. Boiling increased Honcho's acidity, mainly through non-volatile acids. Significance: These findings provide evidence to indicate that Honcho was an acidic seasoning for heat-cooking, which is uncommon in Japanese cuisine today and is mentioned in Edo period books. This seasoning contains many amino acids, implying that it adds umami flavor, not only the sourness of modern vinegar.

Development of a two-dimensional LC-MS/MS system for the determination of proline and 4-hydroxyproline enantiomers in biological and food samples.

A two-dimensional LC-MS/MS system has been developed for the enantioselective determination of proline (Pro), cis-4-hydroxyproline (cis-4-Hyp) and trans-4-hydroxyproline (trans-4-Hyp) in a variety of biological samples. The amino acids were pre-column derivatized with 4-fluoro-7-nitro-2,1,3-benzoxadiazole (NBD-F), and the NBD-derivatives were separated by a reversed-phase column (Singularity RP18) as their D plus L mixtures in the first dimension. The collected target fractions were then introduced into the second dimension where the enantiomers were separated by a Pirkle-type enantioselective column (Singularity CSP-001S) and determined by a tandem mass spectrometer (Triple Quad™ 5500). The method was validated by the standard amino acids and also by human plasma, and sufficient results were obtained for the calibration, precision and accuracy. The method was applied to human plasma and urine, bivalve tissues and fermented food/beverages. D-Pro was widely found in the human physiological fluids, bivalves and several fermented products. Although trans-4-D-Hyp was not found in all the tested samples, cis-4-D-Hyp was present in human urine and tissues of the ark shell, and further studies focusing on the origin and physiological significance of these D-enantiomers are expected.

Lactic acid induces HSPA1A expression through ERK1/2 activation.

Heat shock protein (HSP) A1A protects cells from various stressors. The concentrated liquid of the traditional Japanese rice black vinegar Kurozu increased HSPA1A expression in normal rat liver RLN-10 cells. Lactic acid, the primary component of concentrated Kurozu, induced HSPA1A expression in a concentration-dependent manner. Induction with 4 m m lactic acid increased HSPA1A expression by three times compared with that in the absence of lactic acid. The induction was inhibited by staurosporine or a selective MEK1/2 inhibitor (SL327). The phosphorylation of ERK1/2 was increased by lactic acid. These results suggest that lactic acid induces HSPA1A expression by activating ERK1/2. As well as lactate, 3,5-dihydroxybenzoic acid (DHBA), a ligand for G protein-coupled receptor 81 (GPR81), also induced HSPA1A at lower concentrations than lactate. The increased effect of DHBA on HSPA1A expression as compared with lactate may be related to the higher affinity of DHBA for GPR81 than of lactate.

Intramural Needle Ablation for Refractory Premature Ventricular Contractions.

BACKGROUND: Frequent premature ventricular contractions (PVCs) are often amenable to catheter ablation. However, a deep intramural focus may lead to failure due to inability of standard ablation techniques to penetrate the focus. We sought to assess the efficacy and safety of infusion needle ablation (INA) for PVCs that are refractory to standard radiofrequency ablation. METHODS: Under 2 Food and Drug Administration approved protocols, INA was evaluated in patients with frequent PVCs that were refractory to standard ablation. Initial targets for ablation were selected by standard mapping techniques. INA was performed with a deflectable catheter equipped with an extendable/retractable needle at the tip that can be extended up to 12 mm into the myocardium and is capable of pacing and recording. After contrast injection for location assessment, radiofrequency ablation was performed with the needle tip using a temperature-controlled mode (maximum temperature 60 °C) with saline infusion from the needle. The primary end point was a decrease in PVC burden to <5000/24 hours at 6 months. The primary safety end point was incidence of procedure- or device-related serious adverse events. RESULTS: At 4 centers, 35 patients (age 55.3±16.9 years, 74.2% male) underwent INA. The baseline median PVC burden was 25.4% (interquartile range, 18.4%-33.9%) and mean left ventricular ejection fraction was 37.7±12.3%. Delivering 10.3±8.0 INA lesions/patient (91% had adjunctive standard radiofrequency ablation also) resulted in acute PVC elimination in 71.4%. After a mean follow-up of 156±109 days, the primary efficacy end point was met in 73.3%. The median PVC burden decreased to 0.8% (interquartile range, 0.1%-6.0%; P<0.001). The primary safety end point occurred in 14.3% consisting of 1 (2.9%) heart block, 1 (2.9%) femoral artery dissection, and 3 (8.6%) pericardial effusions (all treated percutaneously). CONCLUSIONS: INA is effective for the elimination of frequent PVCs that are refractory to conventional ablation and is associated with an acceptable safety profile. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT01791543 and NCT03204981.

Persistence of left atrial abnormalities despite left atrial volume normalization after successful ablation of atrial fibrillation.

BACKGROUND: Left atrial volume index (LAVI) of >34 mL/m2 is the cutoff value for identifying an enlarged left atrium. The definition of left atrial (LA) reverse remodeling after atrial fibrillation (AF) ablation is undetermined. We hypothesized that patients with LA dilatation who achieve normal LA volume (LAVI<34 mL/m2) after AF ablation have better long-term outcomes than those who do not. Furthermore, we investigated whether patients with a normal LA volume can also achieve normal LA function with AF ablation. METHODS: We enrolled 140 AF patients with baseline LAVI of ≥34 mL/m2, without AF recurrence for 1 year after the initial AF ablation. We acquired conventional and speckle-tracking echocardiographic parameters within 24 hour and at 1 year after the procedure. To define the normal range of LA function, age- and sex-matched controls without a history of AF were also enrolled. RESULTS: After restoration of sinus rhythm, LA structural and functional parameters significantly improved, and 75 patients (54%) had normal LA volume. During a median follow-up of 44 (31-61) months, 32 patients (23%) experienced a late recurrence of AF (AF recurrence >1 year). Patients who achieved normal LA volume after AF ablation had fewer late recurrences than those who did not (P < .01). However, LA abnormalities, especially LA dysfunction, persisted in AF patients even when the LA volume was normalized compared with controls. CONCLUSION: Patients who achieved normal LA volume had better long-term outcomes of AF ablation than those who did not; however, LA abnormalities persisted even after successful ablation of AF.

Different Attitudes of Patients and Psychiatrists Toward Benzodiazepine Treatment.

BACKGROUND: Concern regarding the benefit/risk ratio of the long-term use of benzodiazepines (BDZs) and Z-drugs is increasing. To prevent the risk of dependence in BDZ long-term use, it is essential to understand the attitudes of patients and psychiatrists toward BDZ treatment. The aims of this investigation were to 1) obtain information on patients' attitudes with long-term BDZ use and their referring psychiatrists' attitudes toward BDZ treatment, including their perception of the difficulty of reducing the dose of BDZs, and 2) identify discrepancies between patients' and psychiatrists' perceptions. METHODS: A brief questionnaire was constructed to investigate the attitudes of patients receiving BDZ treatment and their referring psychiatrists. Our sample comprised 155 patients who received BDZ treatment for more than one year and their referring eight psychiatrists. Both the patients and their psychiatrists completed our questionnaire between August 2017 and December 2017. RESULTS: Of the patients, 13% felt that it was more difficult to reduce the dose of BDZs than their referring psychiatrists (type A discrepancy), while 25% felt that it was less difficult (type B discrepancy). In the multivariate logistic regression analysis, the female sex and both the patients' ("psychotherapy plus BDZs was necessary" and "it was necessary to increase the dose of BDZs") and psychiatrists' beliefs ("short-term prescription was justified") were associated with type A discrepancies. Type B discrepancies were associated with psychiatrists' beliefs that the patient's wishes justified the use of BDZs and that the cessation of treatment with BDZs would lead to the deterioration of their rapport with their patients. CONCLUSION: To overcome the discrepancies in the attitudes of patients and psychiatrists toward the cessation of BDZ treatment, it is necessary to promote patient-centered care involving patient psychoeducation and practice guidelines for the decision-making process. Further studies investigating the promotion of patient-centered care to reduce BDZ use are needed.

Microbial Contamination of Rubber Ducks Floating in Bathtubs of Bathing Facilities, and an Evaluation of Their Washing Methods.

Microbiological contamination inside rubber ducks floating in the bathtub at a "duck bath" of a bathing facility was analyzed by examining bacterial and amoebic counts. The results of microbial tests, such as standard plate count, heterotrophic plate count and Legionella-LAMP (Loopmediated isothermal amplification) , showed that microbial contamination increased in the rubber ducks over time. When the ducks were washed with sodium hypochlorite, those microbial contaminations were not detected; but when the ducks were washed with an electrolyzed water, the standard plate counts and the heterotrophic plate counts were detected in the amount of 103 per duck in the wipe samples. Without proper washing of rubber ducks, bacteria and free-living amoeba can grow and colonize biofilms, and can thereby cause infection in humans. Also, microbial contamination inside ducks may reduce chlorination of the entire bathtub and cause bacterial infection such as Legionellosis from the bathtub water.

The Induction of Heat Shock Protein 70 after Oral Administration of Concentrated Brewed Rice Vinegar Kurozu in Mice.

Heat shock protein 70 (HSP70) is induced by various stresses. Since HSP70 has a protein refolding activity and an anti-inflammatory activity, the HSP70 induction will help cells from harmful acute stresses. Feeding a diet containing concentrated brewed rice vinegar Kurozu (CK) diet for 5 wk resulted in an increase of HSP70 in the brains of mice. In the present study, we evaluated whether oral feeding of 25 µL CK induces HSP70 mRNA in brain and other tissues. HSP70 mRNA was significantly increased in the esophagus, small intestine, liver, and brown adipose tissue within 1 h after the oral administration of CK. A weaker induction of HSP70 mRNA was demonstrated in the stomach, large intestine, and brain. HSP70 mRNA induction returned to basal levels within 3 h after feeding. We doubted that the induction of HSP70 mRNA was caused by manual restraint of the mice during CK administration. Manual restraint of the mice did not influence HSP70 mRNA expression in intestine 1 h after these treatments. Our results suggest that transient HSP70 mRNA induction by oral feeding of CK was not caused by retention stress. There are some compounds in CK that increase HSP70 mRNA in various tissues.

Impact of right ventricular contractile reserve during low-load exercise on exercise intolerance in heart failure.

AIMS: Traditional criteria for heart transplantation by cardiopulmonary exercise testing (CPX) include peak oxygen uptake (VO2 ) < 14 mL/kg/min. Reaching a sufficient exercise load is challenging for patients with refractory heart failure (HF) because of their exercise intolerance. Recently, a substantial impact of right ventricular (RV) dysfunction was highlighted on urgent heart transplantation and mortality. This study aims to investigate the impact of RV contractile reserve, assessed by low-load exercise stress echocardiography (ESE), on exercise intolerance defined as peak VO2  < 14 mL/kg/min, in patients with HF. METHODS AND RESULTS: We prospectively examined 67 consecutive patients hospitalized for HF who underwent ESE and CPX under a stabilized HF condition. Although low-load ESE was defined as 25 W load exercise, an increment in RV systolic (s') velocity was regarded as the preservation of RV contractile reserve. All patients completed low-load ESE. During low-load ESE, the variation in RV s' velocity significantly correlated with peak VO2 (r = 0.787, P < 0.001). The change in RV s' velocity during low-load ESE accurately identified patients with peak VO2  < 14 mL/kg/min (area under the curve, 0.95; sensitivity, 92%; specificity, 85%). The intraclass correlation coefficient for intra-observer and inter-observer agreement for the change in RV s' velocity was 0.96 (95% confidence interval, 0.88-0.99, P < 0.001) and 0.86 (95% confidence interval, 0.64-0.95, P < 0.001), respectively. The RV-to-pulmonary circulation (PC) coupling, which was assessed by the slope of the relationship between RV s' velocity and pulmonary artery systolic pressure at rest and low-load exercise, was worse in the low-peak VO2 group (<14 mL/kg/min) than the preserved-peak VO2 group (≥14 mL/kg/min). CONCLUSIONS: The change in RV s' velocity during low-load ESE could estimate the exercise capacity in HF patients. The assessments of RV contractile reserve and RV-to-PC coupling could be clinically beneficial to distinguish high-risk HF patients.

Atrial tachycardia with multiple reconductions across the surgical incision.

Incisional atrial tachycardia (AT) with multiple penetrating points on one surgical incision has not been reported yet. We present a case of incisional AT following mitral valve annuloplasty with a superior transseptal approach, in which two reconduction sites were parts of the reentrant circuit. Radiofrequency ablation at the reconduction site successfully terminated the tachycardia. A total of four penetrating points were found on the incision line, and radiofrequency ablation at these sites was completed. Detailed mapping of possible reconduction sites along the incision line should be performed to avoid further instances of AT following open heart surgery.

Cost-Effectiveness of Obstructive Sleep Apnea Screening and Treatment Before Catheter Ablation for Symptomatic Atrial Fibrillation.

Background: Although management of obstructive sleep apnea (OSA) has been recommended to improve outcomes of catheter ablation (CA) in patients with symptomatic atrial fibrillation (AF), the most cost-effective way of preprocedural OSA screening is undetermined. This study assessed the cost-effectiveness of OSA management before CA for symptomatic AF. Methods and Results: A Markov model was developed to assess the cost-effectiveness of 3 OSA detection strategies before CA: no screening; Type 3 portable monitor (PM)-guided screening; and polysomnography (PSG)-guided screening. The target population consisted of a hypothetical cohort of patients aged 65 years with symptomatic AF, with 50% prevalence of OSA. We used a 5-year horizon, with sensitivity analyses for significant variables and scenario analyses for lower and higher OSA prevalence (30% and 70%, respectively). In the base-case, both types of OSA screening were dominant (less costly and more effective) relative to no screening. Although PSG-guided management was more effective than PM-guided management, it was more costly and therefore did not show clear benefit. These findings were replicated in cohorts with lower and higher OSA risks. Conclusions: OSA screening before CA is cost-effective in patients with symptomatic AF, with PM screening being the most cost-effective. Physicians should consider OSA management using this simple tool in the decision making for treatment of symptomatic AF.

Sex Differences In Psychoeducation For Patients With Depression: A Comparison Of Frequency And Efficacy Of Psychoeducation.

BACKGROUND: We aimed to reveal sex differences in depression comprehension by reanalyzing data from a previous study of patients who were administered antidepressants. METHODS: A total of 424 outpatients were enrolled in the study. Participants were provided an original self-administered questionnaire that comprised eight items: depressive symptoms, course of depression, cause of depression, treatment plan, duration of antidepressant use, how to discontinue antidepressants, side effects of antidepressants, and psychotherapy. Each item consisted of the following two questions: "Have you received an explanation from the doctor in charge?" and "How much do you understand about your treatment?" The level of patients' comprehension of these questions was rated on a scale of 0-10 (11 anchor points). Symptoms were evaluated using the Quick Inventory for Depressive Symptomatology, Japanese version, and other scales. Patients were divided on the basis of sex, regardless of whether they were in remission. RESULTS: Compared with male patients, female patients with depression exhibited lower levels of depression and did not receive adequate psychoeducation from their physicians. While depression comprehension of female patients might not necessarily be associated with remission, male patients in remission received more explanations about depression and understood more compared with female patients. CONCLUSION: Depression comprehension of male patients might be associated with remission, and psychoeducation should be sex-oriented to improve treatment responses.

Substrate mapping for scar-related ventricular tachycardia in patients with resynchronization therapy-the importance of the pacing mode.

PURPOSE: Targets for substrate-based catheter ablation of scar-related ventricular tachycardia (VT) include sites with fractionated and late potentials (LPs). We hypothesized that in patients with cardiac resynchronization therapy (CRT), the pacing mode may influence the timing of abnormal electrograms (EGMs) relative to the surface QRS complex. METHODS: We assessed bipolar EGM characteristics in left ventricular low bipolar voltage areas (< 1.5 mV) from 10 patients with coronary disease and a CRT device undergoing catheter ablation for VT. EGMs at 81 sites were analyzed during three different pacing modes (biventricular (BiV), right ventricular (RV)-only, and left ventricular (LV)-only) pacing. RESULTS: Stimulus to end of local electrogram duration (Stim-to-eEGM) depended significantly on the stimulation site (BiV, LV, or RV, p = 0.032). Single-chamber pacing unmasked LPs, not present during BiV pacing, in three patients. In another three patients, a concomitant increase in stimulus to end of surface QRS duration caused by single-site pacing compensated for the increase in Stim-to-eEGM duration, thereby prohibiting LP unmasking. CONCLUSION: The sequence of ventricular activation, as determined by the pacing site in patients with CRT devices, has a major influence on the detection of late potentials during substrate-guided ablation. Further study is warranted to define the optimal approaches, including the rhythm, for substrate mapping, but our findings suggest that BiV pacing may be most likely to obscure detection of late potentials as compared to single-site pacing.

Infusion Needle Radiofrequency Ablation for Treatment of Refractory Ventricular Arrhythmias.

BACKGROUND: Catheter ablation is effective for eliminating most drug-refractory ventricular arrhythmias (VA). However, a major reason for procedural failure is arrhythmia originating deep within the myocardium where it is inaccessible to conventional endocardial or epicardial approaches. Affected patients have limited therapeutic options. OBJECTIVES: The objective of this study was to assess the safety and outcome of a novel radiofrequency ablation catheter that used an extendable/retractable 27-g needle capable of targeting deep arrhythmia (intramural) substrate. METHODS: Patients who failed at least one prior catheter ablation procedure for sustained ventricular tachycardia (VT) or nonsustained VA with associated left ventricular dysfunction were enrolled at 3 centers. The target was sustained monomorphic VT in 26 patients, including 8 with recent VT storm or VT requiring intravenous medication, and 5 with incessant VA associated with ventricular dysfunction. RESULTS: Needle ablation was performed in 31 patients (median of 2 failed prior ablation procedures; 71% nonischemic heart disease). After a median of 15 needle lesions/patient, ablation abolished at least 1 inducible VT in 19 of 26 VT patients (73%), and suppressed ambient arrhythmia in 4 of 5 nonsustained arrhythmia patients. At the 6-month follow-up, 48% of patients were free of recurrent arrhythmia and another 19% were improved. Procedure-related complications included a single pericardial effusion treated with percutaneous drainage and a left ventricular pacing lead dislodgement with no deaths. CONCLUSIONS: In patients with recurrent ventricular arrhythmias refractory to medications and conventional catheter ablation, intramural needle radiofrequency ablation offers significant arrhythmia control with an acceptable procedural risk.

Differences in etiological beliefs about schizophrenia among patients, family, and medical staff.

OBJECTIVES: To determine whether etiological beliefs are different among schizophrenia patients, their family, and medical staff. PATIENTS AND METHODS: A cross-sectional study was performed at five hospitals and one mental clinic and included 212 patients, 144 family members, and 347 medical staff other than psychiatrists. A questionnaire about the possible etiological causes of schizophrenia was used. RESULTS: There were significant differences in response scores among the three groups on using Angermeyer's and Goulding's classifications. Factor analyses revealed the following four subscales: Psychosocial, Biological, Environmental, and Cultural connotations. The structure varied among patients, family, and medical staff. CONCLUSION: The perspectives of schizophrenia etiology were different among patients, family, and medical staff.

2.8-Å crystal structure of Escherichia coli YidC revealing all core regions, including flexible C2 loop.

YidC/Alb3/Oxa1 family proteins are involved in the insertion and assembly of membrane proteins. The core five transmembrane regions of YidC, which are conserved in the protein family, form a positively charged cavity open to the cytoplasmic side. The cavity plays an important role in membrane protein insertion. In all reported structural studies of YidC, the second cytoplasmic loop (C2 loop) was disordered, limiting the understanding of its role. Here, we determined the crystal structure of YidC including the C2 loop at 2.8 Šresolution with R/Rfree = 21.8/27.5. This structure and subsequent molecular dynamics simulation indicated that the intrinsic flexible C2 loop covered the positively charged cavity. This crystal structure provides the coordinates of the complete core region including the C2 loop, which is valuable for further analyses of YidC.

Impact of Number of Oral Antiarrhythmic Drug Failures Before Referral on Outcomes Following Catheter Ablation of Ventricular Tachycardia.

OBJECTIVES: This study sought to examine the relationship between the number of oral antiarrhythmic drug (AAD) failures before referral for ventricular tachycardia (VT) ablation and subsequent clinical outcomes. BACKGROUND: Failure of AADs prompts referral for VT ablation. METHODS: Consecutive patients (n = 669) with sustained VT who were referred for a first-time ablation were divided into 2 groups according to the number of oral Class 1 or 3 AAD failures before referral: single-drug failure (≤1 AAD; n = 256) or multidrug failure (>1 AADs; n = 413). Outcomes were stratified according to underlying disease type (no structural heart disease [SHD] [n = 87]; ischemic cardiomyopathy [ICM] [n = 368]; and ischemic cardiomyopathy [NICM] [n = 214]) and reported at a mean follow-up of 35 ± 46 months. RESULTS: Patients with multidrug failure, compared with patients with single-drug failure, had more advanced SHD and required more extensive ablation to control arrhythmia. Multidrug failure, compared with single-drug failure, was associated with lower ventricular arrhythmia-free survival in ICM (46 ± 4% vs. 58 ± 6%; p = 0.03) and NICM (26 ± 5% vs. 49 ± 6%; p = 0.008), but not in the absence of SHD (71 ± 8% vs. 85 ± 7%; p = 0.10). Overall survival was lower in multidrug failure versus single-drug failure groups in patients with ICM (71 ± 3% vs. 84 ± 4%; p = 0.03) and NICM (70 ± 5% vs. 88 ± 4%; p < 0.001). Multidrug failure was independently associated with a higher risk of ventricular arrhythmia recurrence (hazard ratio: 1.6; p = 0.01) and mortality in NICM (hazard ratio: 2.6; p = 0.008), but not in ICM. CONCLUSIONS: Patients with SHD and failure of multiple oral AADs before VT ablation referral have more advanced heart disease and worse clinical outcomes following ablation, especially in NICM.

The characteristics of understanding of depression among older patients treated with antidepressants: a comparison between older and younger patients.

BACKGROUND: To reveal characteristics of understanding of depression among older patients, we reanalyzed the data from a previous study of patients who were administered antidepressants. METHODS: A total of 424 outpatients were enrolled in this study. We used an original self-administered questionnaire consisting of eight items: depressive symptoms, the course of depression, the cause of depression, the treatment plan, the duration of antidepressant use, how to discontinue antidepressants, the side effects of antidepressants, and psychotherapy. Each item consisted of the following two questions: "Have you received an explanation from the doctor in charge?" and "How much do you understand about your treatment?". The level of understanding was rated on a scale of 0-10 (11 anchor points). Subjects were divided into two groups: younger patients who were <65 years of age and older patients who were ≥65 years of age. RESULTS: Older patients with depression showed lower levels of understanding of depression and did not receive sufficient psychoeducation from their physicians, but their understanding of depression might not be associated with their remission. In the younger group, the scores of understanding of the course of depression, the treatment plan, how to discontinue antidepressants, and psychotherapy items, and the total understanding score of remitters, were significantly higher than those of non-remitters. In contrast, there were no significant differences in the items score or total score between remitters and non-remitters in the older group. CONCLUSION: Older patients showed lower levels of understanding of depression and did not appear to receive sufficient psychoeducation, but their understanding of depression might not be associated with their remission.

Inhibitory effect of Japanese black vinegar on IgE-mediated degranulation of RBL-2H3 cells and a murine model of Japanese cedar pollinosis.

Japanese black vinegar (JBV) is a traditional vinegar manufactured with steamed unpolished rice. After screening, beneficial effects of JBV on IgE-mediated allergic responses were found. In this study, acetic acid-free JBV was used to evaluate its antiallergic effects. JBV suppressed degranulation of rat basophilic leukemia RBL-2H3 cells in a dose-dependent manner without cytotoxicity. The inhibitory effect of JBV on the degranulation seemed to be caused by the bioactive ingredients other than proteins, because the activity was not affected by heat treatment or protease digestion. JBV inhibited the elevation in the intracellular Ca2+ concentration induced by antigen. Immunoblot analysis revealed that JBV suppresses degranulation of RBL-2H3 cells by downregulated phosphorylation of PI3K, Akt, and PLCγ1. In addition, oral administration of JBV significantly suppressed passive cutaneous anaphylaxis reaction in mice and an allergic symptom in Cry j1-induced pollinosis model mice. Thus, JBV has a potential as a health-promoting food with the antiallergy effect.

Timing of psychoeducation for patients with depression who were treated with antidepressants: when should patients receive psychoeducation.

BACKGROUND: We analyzed data on the understanding of depression among patients who were prescribed antidepressants to determine when psychoeducation should be provided. PATIENTS AND METHODS: A total of 424 outpatients were enrolled in this study. We used an original self-administered questionnaire consisting of eight categories: (A) depressive symptoms, (B) the course of depression, (C) causes of depression, (D) the treatment plan, (E) the duration of antidepressant use, (F) discontinuation of antidepressants, (G) the side effects of antidepressants, and (H) psychotherapy. Each category was assessed with the following two questions: "Have you received an explanation of this topic from the doctor in charge?" and "How much do you understand about your treatment?" The level of understanding of patients was rated on a scale from 0 to 10 (no understanding to full understanding; 11 anchor points). Symptoms were evaluated using the Quick Inventory for Depressive Symptomatology, Japanese version (QIDS-J) and other scales. Participants were divided into two groups: patients receiving psychoeducation at their first visit vs patients receiving psychoeducation after their first visit. RESULTS: Of the patients who had received an explanation of each psychoeducation item, a greater proportion were in the first visit group than in the after first visit group for nearly all items. Compared with the after first visit group, the first visit group showed a better understanding of each psychoeducation item and significantly lower QIDS scores for those receiving explanations of Items A and C. There was no significant difference between the two groups in remittance rates. CONCLUSION: Psychoeducation on depression, especially regarding the symptoms and causes of depression, should be provided at patients' first visit.