Prof F. Shirota passed away on Jan 23rd in 2005 at the age 63. We, the trainees instructed by him at the Oriental Medicine Training Center, Nissan Tamagawa Hospital, have been stray sheep ever since.
I am very happy to have the chance to report on the true value of acupuncture & moxibustion clinic taught by him at the 55th Annual Meeting.
To understand this theme, I asked the help of colleagues taught by him at the Center for 26 years and got a final report in cooperation with them. The report is composed of his books, his speeches, his words of instruction at the clinical site, his special lecture as his last words at the 50th Annual Meeting at Kobe, and reports and suggestions given to me by 18 former trainees at the Center.

In order to know the present state of mass survey for large-bowel cancer in rural areas, we gathered the results of colorectal screening in 1989 from 45 hospitals or cancer detection center related to agricultural cooperatives of all over Japan.
In all of the 45 institutions, method of screening was fecal occult blood test, and in most of them, the stool study was immunological, of one day, and without meal restriction. Methods of further precise examination such as barium enema, total colonoscopy, sigmiodoscopy, or proctoscopy, solely or combined, were employed depending to the facilities.
The total number of examinees were 194, 834, and 8, 523 (4.4%) had a positive reaction for occult blood. Further precise examinations were performed in 4, 351 (59.7%) examinees, and 148 cases of large-bowel cancer were detected. The detective rate of cancer in total examinees was 0.08%. Among these 148 cases of colorectal cancer, 43 cases (51.8%) were in early stage. Examinees in their fifties were the most in number, and both the rate of positive reaction and the rate of cancer detection were increased as the age gets older.

Therapeutic procedure

Goto mentioned that we should consider the Continuing Education Unit (CEU) system, or the additional training after graduation which fulfills the conditions for the practitioner of acupuncture and moxibustion to function as a national health care provider. There he entertained another proposal that it was necessary to also consider some special education before the graduation. Moreover, he proposed considering the license renewal nature as appeal into society. Yamada said that the essence of an acupuncture and moxibustion therapy was to alleviate the general malaise. That is, a home practitioner of acupuncture and moxibustion in stead of a family physician. It was said that the establishment of the CEU system required that a consorted effort of acupuncture colleges, the industry, and the academia. Kitakouji introduced their CEU system developed with the cooperation of the Meiji College of Oriental Medicine Teaching Hospital and the Acupuncture and Moxibustion Center. The content of trainings after the graduation is set to teach how to communicate and work accordingly with the physicians. Ogawa suggested that we should make a new advanced licensure system (license to practice). Yamaoka introduced the after graduation training program at the Foundation for Oriental Medicine Research, Ehime Prefectural Central Hospital. Following are the the contents of training- (1) Moxibustion Technique and Care, (2) Approach from the point of the Whole Person Medicine (Chronological Health Analysis), etc.

Objectives: To evaluate the efficacy of tegafur–uracil (UFT), a prodrug of 5-fluorouracil, plus cisplatin and dexamethasone in patients with docetaxel-refractory prostate cancers.

Methods: Twenty-five patients with docetaxel-refractory prostate cancer were administered oral UFT plus intravenous cisplatin (UFT-P therapy) and dexamethasone. Treatment responses were assessed monthly via prostate-specific antigen (PSA) level measurements. Treatment-related adverse events and overall survival were also assessed.

Results: UFT-P therapy resulted in decreased PSA levels in 14 (56%) patients and increased PSA levels in 11 (44%). In patients with increased PSA levels, 7 (64%) of the 11 patients displayed decreased PSA doubling times. The UFT-P therapy response rate was 84% (21/25 patients). Imaging studies revealed that tumor shrinkage during UFT-P therapy occurred in 1 patient in whom bilateral hydronephrosis caused by lymph node metastasis improved. The median survival time from docetaxel initiation was 36 months. In UFT-P-treated patients, the median PSA progression and overall survival times were 6 and 14 months, respectively. UFT-P treatment-related adverse events were mild diarrhea, general fatigue, and anorexia. Treatment was not discontinued for any of the patients. UFT-P therapy did not cause serious hepatic or renal dysfunction or pancytopenia.

Conclusions: UFT-P therapy is a safe and effective treatment for patients with docetaxel-refractory prostate cancer, although large-scale, multicenter, prospective studies are needed to validate these findings.

BACKGROUND/AIMS: Tacrolimus is effective for refractory ulcerative colitis in adults, while data for children is sparse. We aimed to evaluate the effectiveness and safety of tacrolimus for induction and maintenance therapy in Japanese children with ulcerative colitis.METHODS: We retrospectively reviewed the multicenter survey data of 67 patients with ulcerative colitis aged < 17 years treated with tacrolimus between 2000 and 2012. Patients’ characteristics, disease activity, Pediatric Ulcerative Colitis Activity Index (PUCAI) score, initial oral tacrolimus dose, short-term (2-week) and long-term (1-year) outcomes, steroid-sparing effects, and adverse events were evaluated. Clinical remission was defined as a PUCAI score < 10; treatment response was defined as a PUCAI score reduction of ≥ 20 points compared with baseline.RESULTS: Patients included 35 boys and 32 girls (median [interquartile range] at admission: 13 [11–15] years). Thirty-nine patients were steroid-dependent and 26 were steroidrefractory; 20 had severe colitis and 43 had moderate colitis. The initial tacrolimus dose was 0.09 mg/kg/day (range, 0.05–0.12 mg/kg/day). The short-term clinical remission rate was 47.8%, and the clinical response rate was 37.3%. The mean prednisolone dose was reduced from 19.2 mg/day at tacrolimus initiation to 5.7 mg/day at week 8 (P< 0.001). The adverse event rate was 53.7%; 6 patients required discontinuation of tacrolimus therapy.CONCLUSIONS: Tacrolimus was a safe and effective second-line induction therapy for steroid-dependent and steroid-refractory ulcerative colitis in Japanese children.
Adult ; Asian Continental Ancestry Group ; Biological Factors ; Child ; Colectomy ; Colitis ; Colitis, Ulcerative ; Female ; Humans ; Immunologic Factors ; Japan ; Prednisolone ; Remission Induction ; Retrospective Studies ; Tacrolimus ; Ulcer

Objectives: We compared cancer patients who were discharged home from inpatients hospices (Home), and who died at hospices (PCU) as a comparison group regarding patients’ quality of life, to clarify the patients’ experience after discharge home. Methods: We send self-reported questionnaires to bereaved families of cancer patients who were discharged home from 12 Japanese nation-wide hospices and died without readmission to the hospicies during Janually 2010 and August 2014. We used bereaved families’ data of patients who died at the same hospices during the same period of J-HOPE3 study. Results: We sent 495 questionnaires (returned 47.3%) and analyzed data of 188 as Home. The data of 759 bereaved families of J-HOPE3 study were also analyzed as PCU. In Good Death Inventory, Home was associated with higher score on some items (staying at favorite place, having pleasure, staying with families and friends, being valued as a person), and PCU was associated with higher score on being free from pain or other physical distress. Conclusions: Patients who were discharged home from inpatient hospices had good environmental QOL, but hospices may be better in palliation of symptoms.