We measured the concentrations of electrolytes (Na, K, and Cl) contained in Kampo preparations which are frequently used in our hospital and discuss possible clinical problems. The Kampo preparations studied were Kakkon-to, Hachimi-jio-gan, Dai-saiko-to, Sho-saiko-to, Saiko-ka-ryukotsu-borei-to, Hange-syashin-to, Sho-seiryu-to, Sho-hange-ka-bukuryo-to, Toki-shakuyaku-san, Kami-shoyo-san, Keishi-bukuryo-gan, Bakumondo-to, Juzen-taiho-to, Saiboku-to, Unkei-to, Gosha-jinki-gan, and Sairei-to. The electrolytes in these preparations were measured by an autoanalyzer after they were dissolved in distilled water. Potasssium (K) concentrations were 0.18-0.83mEq/L. Relatively lower K concentrations were noted in Sho-hange-ka-bukuryo-to (0.18), Keishi-bukuryo-gan (0.24), and Bakumondo-to (0.34). Relatively high concentrations were observed in Sho-seiryu-to (0.83), Hange-syashin-to (0.79), Gosha-jinki-gan (0.76), and Juzen-taiho-to (0.76). The Kampo preparations we studied do not appear to pose a problem even in patients with renal dysfunction, considering the balance of the formulations with other food and Kampo therapy with decreased doses.

1. 5-HT inhibits spontaneous fluid secretion as well as stimulated secretion with secretin (cAMP mediated) or ACh (Ca2+ mediated) in the isolated guinea pig pancreatic ducts. 2. The inhibitory effect of 5-HT is reversible and is dependent on the concentration in the range 0.01-0.1 microM, which is much lower than those that affect intestinal motility and secretion. 3. The 5-HT3 receptor in duct cells appears to mediate the inhibitory effect of 5-HT. 4. [Ca2+]i is unlikely to mediate the inhibitory effect of 5-HT.
5-Methoxytryptamine/pharmacology ; Acetylcholine/pharmacology ; Animal ; Calcium/metabolism ; Guinea Pigs ; Pancreatic Ducts/metabolism* ; Pancreatic Ducts/drug effects ; Secretin/pharmacology ; Serotonin/pharmacology ; Serotonin/metabolism* ; Serotonin/analogs & derivatives* ; Vasodilator Agents/pharmacology

Purpose: We investigated the activity of our palliative care team over the past five years and how the new coronavirus infection (COVID-19) affects palliative care in our hospital. Methods: We retrospectively compared and analyzed patient data intervened by the Tokyo Medical University Hospital Palliative Care Team from April 2016 to March 2021. Results: There were no major differences in the total number of requests, patient background, reasons for request, and reasons for intervention from FY2016 to FY2020. In FY2020, the number of patients with PS0 at the time of request and who discharged from the hospital at home increased significantly compared to other years. Discussion and Conclusion: From the results of this survey, it was found that the introduction of palliative care from an early stage is progressing. On the other hand, because the outbreak of COVID-19 has restricted visits to inpatients at our hospital, it is possible that the proportion of patients who choose home care is increasing. Intervention requests to the palliative care team did not change significantly over the 5-year period without the impact of the COVID-19 pandemic. Strict visitation restrictions for inpatients have become barriers to the practice of palliative care.

Introduction: The diagnosis of cancer-related neuropathic pain is often difficult for non-pain medicine specialists. We examined whether a Japanese version of a neuropathic pain screening questionnaire (Japan-Q), which was developed for chronic pain, is appropriate for screening cancer-related neuropathic pain. Methods: Our palliative care team screened 104 patients from May 2014 to December 2015 and compared total points of the Japan-Q with diagnosis of the type of cancer pain by specialized pain clinicians. Validity was evaluated using a receiver operating characteristic (ROC) curve. Results: The area under the ROC curve in terms of the total score, sensitivity, and specificity for the Japan Q was 0.82, which indicated a moderate level of diagnostic accuracy. A cut-off value of 3 points was shown to be best (sensitivity: 79%, specificity: 82%). When a cut-off value of 9 points was used as the diagnostic criterion for neuropathic pain, there was greatly reduced sensitivity (sensitivity: 40%, specificity: 97%). Conclusion: Although the Japan-Q shows moderate diagnostic accuracy related to cancer pain, the cut-off value for this tool is lower than that for chronic pain. Cancer-related neuropathic pain should be suspected with a total score of 3 or more in the Japan-Q.

BACKGROUND: The Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) study was launched to investigate risk factors for osteoporotic fractures, interactions of osteoporosis with other non-communicable chronic diseases, and effects of fracture on QOL and mortality. METHODS: FORMEN baseline study participants (in 2007 and 2008) included 2012 community-dwelling men (aged 65-93 years) in Nara prefecture, Japan. Clinical follow-up surveys were conducted 5 and 10 years after the baseline survey, and 1539 and 906 men completed them, respectively. Supplemental mail, telephone, and visit surveys were conducted with non-participants to obtain outcome information. Survival and fracture outcomes were determined for 2006 men, with 566 deaths identified and 1233 men remaining in the cohort at 10-year follow-up. COMMENTS The baseline survey covered a wide range of bone health-related indices including bone mineral density, trabecular microarchitecture assessment, vertebral imaging for detecting vertebral fractures, and biochemical markers of bone turnover, as well as comprehensive geriatric assessment items. Follow-up surveys were conducted to obtain outcomes including osteoporotic fracture, cardiovascular diseases, initiation of long-term care, and mortality. A complete list of publications relating to the FORMEN study can be found at https://www.med.kindai.ac.jp/pubheal/FORMEN/Publications.html .
Aged ; Bone Density ; Cardiovascular Diseases/etiology* ; Cohort Studies ; Geriatric Assessment ; Humans ; Independent Living ; Japan/epidemiology* ; Long-Term Care/statistics & numerical data* ; Male ; Middle Aged ; Osteoporosis/etiology* ; Osteoporotic Fractures/etiology* ; Risk Factors