1.Effects of Electro Acupuncture on the Sensory Nerve Conduction Velocity.
Masaaki SUGAWARA ; Keishi YOSHIKAWA ; Akihiro OGATA
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 2001;64(3):150-154
Electro-nerve stimulation is an Electro Acupuncture (EA) method that is clinically applied to treat periphral neuropathy. We examined the effects of electro-nerve stimulation on the Sensory Nerve Conduction Velocity (SCV). The changes in SCV caused by applying electro-nerve stimulation to the peripheral nerves were measured.
Al-Hz EAT was applied for 10min to the right upper arms of healthy adult volunteers (n=12). The SCV in the median nerve and the skin temperature of the forearm were measured before and after the application. The SCV and skin temperature were found to exhibit asignificant decrease after the electricity was turned on. Therefore, we concluded that EAT caused the decrease in skin temperature of the forearm and, as a result, lowered the SCV in the median nerve.
2.Comparison of efficacies of once-daily dose multimatrix mesalazine and multiple-dose mesalazine for the maintenance of remission in ulcerative colitis: a randomized, double-blind study.
Haruhiko OGATA ; Akihiro OHORI ; Haruo NISHINO ; Seiichi MIZUSHIMA ; Atsushi HAGINO ; Toshifumi HIBI
Intestinal Research 2017;15(3):358-367
BACKGROUND/AIMS: This study compared the efficacy of once-daily administration of multimatrix mesalazine 2.4 g/day with multiple-dose mesalazine for the maintenance of remission. METHODS: In this multicenter, randomized, double-blind study, 203 patients with ulcerative colitis in remission received multimatrix mesalazine 2.4 g/day once-daily or time-dependent (controlled-release) mesalazine 2.25 g/day 3 times-daily for 48 weeks. The primary efficacy endpoint was the proportion of patients without rectal bleeding. RESULTS: The proportion of patients without rectal bleeding during the 48-week treatment period in the per protocol set was 84.8% (84/99) in the multimatrix mesalazine 2.4 g/day group and 78.0% (78/100) in the controlled-release mesalazine 2.25 g/day group. The difference between the 2 treatment groups was 6.8% (two-sided 95% confidence interval, −3.9% to 17.6%). The noninferiority margin of −10% was met in the comparison of multimatrix mesalazine 2.4 g/day once-daily with controlled-release mesalazine 2.25 g/day. Multimatrix mesalazine 2.4 g/day once-daily demonstrated consistent efficacy in all subgroups. There was no difference between the 2 treatment groups with regard to safety. CONCLUSIONS: A once-daily dose of 2 multimatrix mesalazine tablets (2.4 g) was not inferior to controlled-release mesalazine 2.25 g/day 3 times-daily in maintaining absence of rectal bleeding in ulcerative colitis.
Colitis, Ulcerative*
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Double-Blind Method*
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Hemorrhage
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Humans
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Mesalamine*
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Tablets
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Ulcer*
3.Clinical study on the prevention of recurrent tonsillitis by acupuncture (II)
Keishi YOSHIKAWA ; Kazushi NISHIJO ; Kazuhiro YAZAWA ; Hidetoshi MORI ; Tomomi SAKAI ; Kazuo SASAKI ; Akihiro OGATA ; Toshikazu SHIMA ; Katsumi KURIHARA ; Takeshi TOMIYASU ; Shuichi KATAI ; Yoshitsugu OHIRA ; Seiichi KOBAYASHI ; Akemi YAMAMOTO
Journal of the Japan Society of Acupuncture and Moxibustion 1984;34(1):8-14
We have continued a study on the preventive effects of acupuncture on recurrent tonsillitis. Among 239 patients with tonsillitis examined in 1980, 200 were included in the category of recurrent tonsillitis, showing a fever four or more times a year.
The preventive effects of acupuncture in these 200 patients are reported in this paper.
The subjects were 200 patients with recurrent tonsillitis treated in our department in 1980. The frequency, number of days and severity of fever and other symptoms (conditions of the nose and throat, snoring, colds and general condition) were followed for one year after the acupuncture treatment.
Of the 200 patients, 171, excluding the 29 in whom the results of research could not be obtained, were analyzed. With regard to the frequency of fever, the number of patients with a fever 12 or more times a year decreased from 102 before acupuncture therapy to nine after the treatment. The number of patients who did not have any fever and who had a fever one to three times after treatment was 30 and 69, respectively. Thus, 40.4% were not included in the category of recurrent tonsillitis, even though fever was present. In addition, there was a decrease in the severity and number of days of fever.
Favorable effects of the treatment on symptoms other than fever, such as conditions of the nose and throat, snoring, resistance to colds and general condition, were noted in more than 50% of the patients who did not have any fever after treatment or had a fever half as frequently as before treatment.
When the preventive effects on fever were determined according to age, improvement was observed in all age groups. From the viewpoint of the prevention of repetition of a high fever, the best results were obtained in patients 6-11 years of age, followed by those five years old or less.
Acupuncture treatment for recurrent tonsillitis is not so effective as tonsillectomy. However, we consider that acupuncture treatment is worth using prior to tonsillectomy to prevent the relapse of recurrent tonsillitis, taking into account operative stress on the living body and economic and personal problems arising from tonsillectomy.
4.The Clinical Studies of the Protective Effects of Acupuncture on the Habitual Tonsilitis
Keishi Yoshikawa ; Kazushi Nisijo ; Kazuhiro Yazawa ; Hidetoshi Mori ; Tomomi Sakai ; Kozo Nemoto ; Kiyomi Gennai ; Kazuo Sasaki ; Akihiro Ogata ; Kyoko Oda ; Toshikazu Shima ; Kiyokazu Kubota ; Hiroshi Mineta ; Hideko Kamio ; Akemi Yamamoto
Journal of the Japan Society of Acupuncture and Moxibustion 1982;31(4):372-380
We administered electro-acupuncture with the purpose of preventing repeated attacks of repetitive tonsillities.
The majority of the 77 subjects were kindergarden and elementary shool children, who had high fiver more then 4 times a year.
The treatment method was as follows: 1Hz low frequency stimulation between Co 4 and lu 6 (and this bilateral) for 20 to 30 minutes.
The treatment interval was once a week, with 3 weeks constituting a treatment course.
And depending on the results of 1 course, the treatment was repeated or not. 53 patients followed 1 course, 24 patients followed 2 course.
The evaluaton of the results is based on a 1 year observation period.
RESULTS:
-9 patients (11.68%) didn't got any high fever.
-49 patients (63.63%) noticed a decrease of the high fever frequency [39 patients (50.64%) got less then 3 times a year a high fever.]
-19 patients (24.67%) didn't notice any effect [6 patients (7.79%) got tonsillectomy.]
This study showed the usefulness of acupuncture and as it's a general and easy to apply therapy, we can consider acupuncture as a first choice therapy for the prevention off repetitive tosillitis.
5.Clinical study on the prevention of recurrent tonshillitis by acupuncture (III)
Keishi YOSHIKAWA ; Kazushi NISHIJO ; Kazuhiro YAZAWA ; Hidetoshi MORI ; Tomomi SAKAI ; Akihiro OGATA ; Kazuo SASAKI ; Toshikazu SHIMA ; Hiroki SUGA ; Mikio NAKAMURA ; Shuichi KATAI ; Katsumi KURIHARA ; Takeshi TOMIYASU ; Masahiro KIMURA ; Takanori KAWANO ; Koki KOBAYASHI ; Koichi WADA ; Harumi TAKETANI ; Akemi YAMAMOTO
Journal of the Japan Society of Acupuncture and Moxibustion 1984;34(1):15-22
We have conducted acupuncture treatment for prevening the relapse of recurrent tonsillitis. We previously noted the effectiveness of this treatment in 121 of 239 patients treated in 1980, especially in elementary school children. In the present study, we compared the annual days of absence from school and the body dimensions of children with tonsillitis given acupuncture treatment with those having tonsillar hypertrophy chosen by a school study, although there is a question on the latter's propriety as a control group in a strict sense, in order to investigate the degree of spontaneous healing included in the preventive effects of acupuncture treatment on the relapse of recurrent tonsillitis.
By May 1983, our reseach was completed in 22 children with tonsillitis given acupuncture treatment and 19 with tonsillar hypertrophy not given such therapy. In children with tonsillitis given acupuncture treatment, the average annual days of absence from school before treatment was 14.0, which was more than that for all children in the S elementary school, and that in the year after treatment was 6.5, approximating that for all children in the school. In children with tonsillar hypertrophy not given acupuncture treatment, the average number of days of absence was close to that for all children in the S elementary school in both years.
Among 14 children with tonsillitis given acupuncture treatment, lower values of height and weight were noted in eight and 12 children, respectively, at the beginning of treatment, as compared with the national averages. The body dimensions of children with tonsillar hypertrophy not given acupuncture treatment were similar to the national averages. Of 14 children with tonsillitis given acupuncture treatment, an increase to a value exceeding the national average was observed with both the height and weight in six children, the height in two and the weight in one within the year after treatment.
The above results show that children with tonsillitis have a problem from the educational and developmental standpoint, even if they do not have a focal tonsil. We think that acupuncture treatment is worth attempting prior to tonsillectomy, although it is not so surely effective as tonsillectomy, when the severity of operative stress on the living body due to tonsillectomy and the burden of medical expenses and the load on the patient's family caused by hospitalization are taken into consideration.
6.A Case of Ruptured Pancreatic Pseudocyst Treated With Emergency Distal Pancreatectomy
Akihito OGATA ; Yasuhiro KURUMIYA ; Keisuke MIZUNO ; Ei SEKOGUCHI ; Gen SUGAWARA ; Masaya INOUE ; Takehiro KATO ; Takayuki MINAMI ; Naohiro AKITA ; Hirotake GONDA ; Akihiro SEKIMOTO ; Hirona TODOROKI ; Takuya OSAWA ; Kenta HAMABE ; Kazuki SAKUMOTO ; Saki ISHIYA
Journal of the Japanese Association of Rural Medicine 2022;70(6):649-654
A 48-year-old woman with a history of recurrent alcoholic pancreatitis was found to have a pancreatic pseudocyst. In November 20XX, she visited the emergency department due to sudden abdominal pain. Contrast-enhanced computed tomography showed a pancreatic pseudocyst with a maximum diameter of 67 mm and ascites. A ruptured pancreatic pseudocyst was suspected and abdominal paracentesis was performed. The amylase level in the ascitic fluid was high (3444 IU/L), leading to a diagnosis of acute generalized peritonitis due to rupture of a pancreatic pseudocyst. Intraoperative findings revealed 500 mL of ascites mixed with pancreatic juice and turbid cyst contents, and distal pancreatectomy was performed. The postoperative course was favorable, and the patient was discharged on hospital day 14. Rupture of pancreatic pseudocyst is rare. In this case, it was promptly diagnosed and successfully treated with emergency surgery.
7.Two Pediatric Cases of Laparoscopic Spleen-Preserving Distal Pancreatectomy for Solid Pseudopapillary Neoplasm of the Pancreas
Kosuke INADA ; Yasuhiro KURUMIYA ; Keisuke MIZUNO ; Ei SEKOGUCHI ; Gen SUGAWARA ; Masaya INOUE ; Takehiro KATO ; Naohiro AKITA ; Takayuki MINAMI ; Akihiro SEKIMOTO ; Akihito OGATA ; Akiko OSADA ; Kiyoshi WAKAO
Journal of the Japanese Association of Rural Medicine 2021;70(2):161-167
A 14-year-old girl (Case 1) with respiratory distress during exercise was referred to our department after a pancreatic mass was detected by computed tomography (CT). Contrastenhanced CT scan showed a low-density mass measuring 2.5 × 2 cm in the body of the pancreas. Low signal intensity was seen on T1-weighted magnetic resonance imaging (MRI) and high signal intensity on T2-weighted MRI. We suspected solid-pseudopapillary neoplasm (SPN) of the pancreas and performed laparoscopy-assisted spleen-preserving distal pancreatectomy. The postoperative course was uneventful, and she was discharged on postoperative day 13. A 15-yearold girl (Case 2) with abdominal pain and fever was referred to our department after an abdominal cystic mass was detected by ultrasound examination. Contrast-enhanced CT showed a 4-cm well-circumscribed mass. Higher signal intensity was seen on T2-weighted MRI. We suspected SPN of the pancreas and performed laparoscopic spleen-preserving distal pancreatectomy. The postoperative course was uneventful, and she was discharged on postoperative day 8. Laparoscopic or laparoscopy-assisted surgery should be considered for SPN of the pancreas.
8.Three Cases of Successful Conservative Treatment of Ischemic Colitis With Hepatic Portal Venous Gas
Kosuke INADA ; Yasuhiro KURUMIYA ; Keisuke MIZUNO ; Ei SEKOGUCHI ; Gen SUGAWARA ; Masaya INOUE ; Takehiro KATO ; Naohiro AKITA ; Takayuki MINAMI ; Akihiro SEKIMOTO ; Kenji TAKEUCHI ; Akihito OGATA ; Akiko OSADA
Journal of the Japanese Association of Rural Medicine 2021;69(6):612-617
Here, we report 3 cases of conservatively treated ischemic colitis with hepatic portal venous gas. In Case 1, an 84-year-old man visited the emergency department because of fatigue, vomiting, and upper abdominal pain. In Case 2, a 72-year-old man was hospitalized for rehabilitation in another hospital following cervical spine trauma. He had diarrhea and mesogastric pain for 2 days and was transferred to our hospital. In Case 3, an 89-year-old woman visited the emergency department because of upper abdominal pain and vomiting. In all cases, we diagnosed the illness as ischemic colitis with hepatic portal venous gas based on computed tomography findings, and the vital signs of all patients were stable. They were treated conservatively. They were able to resume oral intake and were discharged or transferred to another hospital. Hepatic portal venous gas has been considered a poor prognostic sign of severe diseases such as intestinal necrosis. However, recently, reports of cases treated conservatively have been increasing. Conservative treatment may be selected for ischemic colitis associated with hepatic portal venous gas taking into account the patient’s general condition.
9.A Case of Luminal B Breast Cancer in Which Preoperative Chemotherapy Was Used Due to Ineffective Preoperative Hormone Therapy
Yasuhiro KURUMIYA ; Tae NIWA ; Sakura ONISHI ; Shingo OYA ; Keisuke MIZUNO ; Ei SEKOGUCHI ; Gen SUGAWARA ; Masaya INOUE ; Takehiro KATO ; Naohiro AKITA ; Takayuki MINAMI ; Kosuke INADA ; Kenji TAKEUCHI ; Akihiro SEKIMOTO ; Akihito OGATA ; Akiko OSADA
Journal of the Japanese Association of Rural Medicine 2022;71(1):63-68
A 66-year-old, postmenopausal woman was referred to our hospital because of abnormal breast cancer screening results. A tumor was found in the upper outer part of the left breast. Biopsy revealed papillotubular carcinoma, ER (Allred score total score [TS] 3 = proportion score [PS] 2 + intensity score [IS] 1), PgR (Allred score TS 3 = PS 2 + IS 1), HER2 (2+), fluorescent in situ hybridization 1.1 (negative), and Ki-67 labeling index 15%. In diagnostic imaging, the tumor size was 35 mm. The diagnosis was T2N0M0 Stage IIA, luminal B-like breast cancer. First, letrozole 2.5 mg/day was administered as preoperative hormone therapy. After 2 months of treatment with letrozole, the tumor size had increased to 44 mm and preoperative hormone therapy was discontinued. She was started on preoperative chemotherapy (4 courses of epirubicin plus cyclophsphamide followed by 4 courses of triweekly docetaxel). The tumor size decreased, becoming undetectable. After these preoperative treatments, nipple-sparing mastectomy, sentinel lymph node biopsy, and breast reconstruction with a primary latissimus dorsi flap were performed. As of 3 years and 6 months after the operation, there has been no recurrence. At first, preoperative hormone therapy is performed for Luminal B-like breast cancer as in this case, if the response is insufficient, preoperative chemotherapy after hormone therapy may be a therapeutic option.
10.Two Cases of Laparoscopic Resection of Primary Mesenteric Neuroendocrine Tumor
Akihiro SEKIMOTO ; Yasuhiro KURUMIYA ; Keisuke MIZUNO ; Ei SEKOGUCHI ; Gen SUGAWARA ; Masaya INOUE ; Takehiro KATO ; Naohiro AKITA ; Takayuki MINAMI ; Kosuke INADA ; Akihito OGATA ; Akiko OSADA ; Kiyoshi WAKAO
Journal of the Japanese Association of Rural Medicine 2021;70(4):387-394
Primary mesenteric neuroendocrine tumor is extremely rare. Here we describe 2 cases of this disease. Case 1 was a 66-year-old man with a working diagnosis of gastrointestinal stromal tumor or mesenteric tumor who underwent laparoscopic tumor resection. Immunohistochemically, the final diagnosis was primary mesenteric neuroendocrine tumor G1. There has been no recurrence as of 25 months after surgery. Case 2 was an 80-year-old man with a working diagnosis of gastrointestinal stromal tumor or mesenteric tumor who also underwent laparoscopic tumor resection. Immunohistochemically, the final diagnosis was primary mesenteric neuroendocrine tumor G1. This is recurrence-free as of 36 months after surgery. Several cases of primary mesenteric neuroendocrine tumor have been reported, but most have been treated with open surgery. To date, there has been only 1 case of primary mesenteric NET that was resected in a pure laparoscopic procedure. In all 3 cases (including our 2 cases), the largest tumor diameter was 4 cm. It appears that laparoscopic surgery can be used to treat primary mesenteric neuroendocrine tumor of small size (< 4 cm) with minimal invasion.