We report four cases which were successfully treated with keishikyokeikabukuryobyakujutsuto. Case 1 was a 53-year-old female who presented with a 15-year history of fatigue, headache and shoulder stiffness. After 1 month's treatment with keishikyokeikabukuryobyakujutsuto, her complaints improved remarkably. Case 2 was a 29-year-old female who was suffering from allergic rhinitis. After 6 month's treatment with keishikyokeikabukuryobyakujutsuto, her symptoms completely resolved. Case 3 was a 37-year-old female who was diagnosed with Meniere's disease. Some formulas had been prescribed before, but provided no relief. After the start of treatment with keishikyokeikabukuryobyakujutsuto, however, the patient's symptoms resolved completely within 2 weeks. Case 4 was a 50-year-old female who presented with tension headache. After 2 week's treatment with keishikyokeikabukuryobyakujutsuto, her headache had almost completely resolved. Most of the cases presented with slight epigastric tenderness and superficial-like symptoms such as headache and shoulder stiffness. Many of them also showed symptoms suggestive of fluid imbalances in the body, such as dizziness, rhinorrhea and teeth marks on both sides of the tongue. Keishikyokeikabukuryobyakujutsuto is a useful formula for patients with superficial-like symptoms accompanied by disorders of the body fluid homeostasis.
symptoms <1> ; seconds ; therapeutic aspects ; Female ; Headache

Standardizing Kampo medical findings is a significant challenge in Kampo medical circles. These findings are fundamental to Kampo diagnosis. This paper introduces our attempt to standardize these findings in a specialized Kampo medical service facility.
We started our project with verbal standardization. Nine medical doctors, all of whom were Kampo advisors or Kampo specialists, discussed issues such as subjective and objective findings, including those of the tongue, pulse, and abdomen, as well as the selection of target items, criteria for judgments on each item, and associated issues. When discussing the above issues, descriptions in prominent traditional Kampo texts were given most importance, and the wisdom of famous Kampo doctors since the Showa period was also given weight. In addition, we focused attention on clarifying the criteria for making judgments.
One hundred and twenty items were selected as subjective Kampo findings. We selected 12, 6 and 10 items as objective Kampo findings in the tongue, pulse, and abdomen, respectively, and provided criteria for judgments with each.
Our next challenge is to spread these standardizations in Kampo medical circles.

Introduction: Though the animal assisted therapy and the animal assisted activity with animal visiting are widely introduced to general hospitals in Japan, the report of those activities in palliative care units (PCU) of general hospitals are few. Methods: In June 2013 therapy dogs started to visit our PCU with the help of NHO Japan Animal Association. We discussed on the effects and the problems as a part of the palliative care about this activity. Results: Three therapists with 3 therapy dogs came to our hospital twice a month and the total number of 487 patients took part in 73 sessions until September 2016. Those activities made the patients and their families felt better and their communications with staffs were improved. No adverse effects concerning the safety and health were observed in those activities. Discussion: The reliable training and infection control of animals can make easy the introduction of animal therapy to the PCU of a general hospital. Visiting of therapy dogs can provide the healing to not only the patients and their families, but also the staffs in the PCU.

Background: Arbekacin (ABK) is an aminoglycoside that exhibits anti-methicillin-resistant Staphylococcus aureus (MRSA) and anti-Pseudomonas aeruginosa activities. Therefore, for patients with febrile neutropenia (FN) and concurrent pneumonia suspected to be caused by MRSA, ABK may be sufficiently effective even as a single agent. Materials and Methods: Patients with hematologic malignancies treated with ABK who met the following criteria were included: 1) fever during neutropenia or functional neutropenia, 2) FN complicated by pneumonia, and 3) possible infection by antimicrobial-resistant Grampositive cocci. Results: This study encompassed 22 episodes involving 19 patients, of which, 15 (68.2%) were successfully treated with ABK. Of the nine episodes showing inadequate response to other anti-MRSA drugs, eight were successfully treated with ABK. Grade 2 or worse adverse events included acute kidney injury (13.6%) and increased transaminase levels (9.1%). Conclusion The present study demonstrated that ABK is effective and safe in patients with FN and concurrent pneumonia caused by antimicrobial-resistant Gram-positive cocci. ABK may also be effective in patients who are unresponsive to other anti-MRSA drugs. Therefore, ABK may be beneficial in the treatment of pneumonia caused by antimicrobial-resistant Gram-positive cocci in patients with FN.

OBJECTIVES: Complex and diverse factors are related to reproductive health (RH) behavior among adolescents according to the social and cultural context of each countries. This study examined the prevalence of active RH and factors related to active RH behavior among Indonesian adolescents. METHODS: A cross-sectional study was conducted among 1,040 of students who were selected through a multi-stage random sampling technique. A self-administered questionnaire was developed, including the World Health Organization Illustrative Questionnaire for Interview-Surveys with Young People, pubertal development scale, and sexual activity scale, modified in accordance to the Indonesian context. The data were analyzed using descriptive and comparative statistics, as well as logistic regression analyses. RESULTS: The prevalence of active RH behavior were more higher in boys (56.6%; 95% confidence interval [CI], 50.6% to 62.6%) than in girls (43.7%; 95% CI, 37.6% to 49.8%). Negative attitudes towards RH were a factor related to active RH behavior in both boys and girls. Smoking and kind relationship envisioned before marriage (pacaran [courtship] and nikah siri [non-registered marriage]) were factors related to active RH behavior in boys; whereas the absence of access to information on substance abuse was an additional factor in girls. Moreover, an interaction was found between access to information on development and smoking (boys) and attitudes on RH (girls) as independent variables associated with active RH behavior. CONCLUSIONS: Sex education for adolescents in Indonesia, particularly in the context of a health promotion program, should be developed based on prevalent social, cultural, and religious values to prevent active RH behavior. Such programs should focus on the kind of relationship envisioned before marriage and smoking for boys and access to information on subtance abuse for girls.
Access to Information ; Adolescent Behavior ; Adolescent* ; Cross-Sectional Studies* ; Female ; Health Promotion ; Humans ; Indonesia ; Logistic Models ; Marriage ; Prevalence* ; Reproductive Health* ; Sex Education ; Sexual Behavior ; Smoke ; Smoking ; Substance-Related Disorders ; World Health Organization

Objective: Folate receptor α (FRα) is a membrane protein expressed in various solid tumors but has limited expression in normal cells. Therefore, FRα is an attractive target for cancer treatment. This study aimed to investigate the relationship between FRα expression and the clinicopathological characteristics and survivals of cervical cancer. Methods: This retrospective study included patients with cervical cancer who underwent primary surgery between 2000 and 2020 at our institution. Immunohistochemical staining of FRα was performed using an anti-folate-binding protein/FBP antibody. FRα-positive staining was defined as ≥5% of tumor staining and FRα-high as ≥50% tumor staining with ≥2+ intensity. The association between FRα expression and survival was assessed using multivariate Cox regression analysis, adjusting for established prognostic factors. Results: Overall, 123 patients were identified, and 140 tumor samples, including 17 paired primary and metastatic samples, were evaluated. As histological types, 67 patients had squamous cell carcinoma (SCC), and 56 patients had non-SCC. All primary tumors were FRα-positive. High FRα expression was observed in 25% of the cases and differed according to histology (SCC vs. non-SCC, 14.9% vs. 37.5%, p=0.004). FRα expression was significantly higher in metastatic tumors than in primary (170 [IQR, 140–205] vs. 125 [IQR, 110–150], p=0.0006). High FRα expression was significantly associated with worse overall survival (hazard ratio, 6.73; 95% confidence interval, 2.21–20.53; p=0.001). Conclusion In cervical cancer, FRα expression was elevated in metastatic tumors and high expression was associated with a worse prognosis. Our study supports the development of FRα-targeted therapy for advanced cervical cancer.