1.The Efforts of Acupuncturists to Promote Multidisciplinary Cooperation at our Institute
Keizo EBIKO ; Kumiko TAKATA ; Takashi ITO ; Yoko KIMURA ; Hiroshi SATO
Kampo Medicine 2016;67(1):85-92
This study reports the efforts of acupuncturists to promote multidisciplinary cooperation in our laboratory. We conducted a questionnaire survey involving all employees of our laboratory in December 2013 to investigate problems regarding multidisciplinary cooperation, and identified a lack of information and problems concerning treatment plans and costs. After implementing measures to tackle these problems between January and November 2014, we conducted the questionnaire survey again. As the results, 79% of the employees responded that they had gained more information about acupuncture compared to the previous year, and 72% of them responded that treatment plans and costs were appropriate. Compared to the number of new patients who sought acupuncture treatment between January and November 2013 (n = 273), there was an increase of 40% in the same period of 2014 (n = 385). These results showed that employees' understanding of acupuncture and multidisciplinary cooperation were promoted.
2.Comparison of Treatment Effects between Electro-Acupuncture and in Situ Acupuncture in Patients with Intractable Hunt Syndrome
Keizo EBIKO ; Saori TANBA ; Makoto KIKKAWA ; Naoko KIKUCHI ; Yasuko ARAI ; Hiroshi SATO
Kampo Medicine 2006;57(6):781-786
We retrospectively compared the treatment effects of electro-acupuncture against in situ acupuncture, in 15 Hunt's Syndrome patients who underwent acupuncture therapy in our institution between August 1996, and June 2004, and who had fulfilled 3 electroneurography (ENoG) criteria with a value of 0% within 90 days after onset, had a paralysis score of <20, and could be followed up for 6 months after onset. Electroacupuncture therapy was performed on the paralysis side of the faces of 8 patients (the electro-acupuncture group), while in situ acupuncture therapy was performed on the remaining 7 (the in situ acupuncture group). No significant differences were observed in the background factors between the two groups. Treatment results were evaluated using the 40-point paralysis score described by Yanagihara, as well as a sequela score, which was a modified method of the sequela assessment developed by Nishimoto and Murata et al. Changes in paralysis scores from first acupuncture therapy, out to 6 months post-onset were compared using repeated ANOVA measures, and Mann-Whitney U tests respectively. Recovery of paralysis scores did not significantly differ between the two groups (p=0.0507), although slightly better recovery was observed in the electroacupuncture group, as compared with the in situ acupuncture group. Additionally, sequelae scores did not significantly differ between the two groups (p=0.51). In recent years, many have been of the opinion that lowfrequency stimulation is contraindicated. In this study, however, the incidence of sequelae did not differ significantly between the electro-acupuncture therapy and the in situ acupuncture therapy groups, although slightly better paralysis recovery was observed in the former.
3.NUTRITIONAL STATUS OF JAPANESE MALE COLLEGIATE ATHLETES
KUMIKO MINATO ; YUKO SATO ; SHUHEI KOBAYASHI ; FUMIHIKO KARIYA ; KEIZO KOBAYASHI ; MITSUO NARUSAWA ; TOSHIO OHMORI
Japanese Journal of Physical Fitness and Sports Medicine 2006;55(Supplement):S189-S192
The purpose of this study was to assess the status of nutrients intake in male Japanese collegiate athletes. Each 20 of baseball (B), soccer (S), volley ball (V), and long distance (L) athletes participated in this study. The B, S, and V athletes lived by themselves, whereas the L athletes lived in an athletes dormitory with provided meal. The nutritional status was assessed for 2 days. Mean energy intakes in the B, S, V, and L groups were 43.6, 53.7, 47.0, and 55.0 kcal/kg body weight, respectively. Mean protein intakes were 1.2, 1.6, 1.3 and 2.4 g/kg, respectively. In B athletes, skipping of breakfast was recognized frequently. Most of micronutrients intakes in the B, S, and V groups were less than the recommended dietary allowances for athletes. We suggest that a provided meal system is a better system for collegiate athletes and more nutritional education is necessary for Japanese male collegiate athletes, in particular, those living by themselves.
4.Effects of Acupuncture on Refractory Bell's Paralysis and Hunt's Syndrome
Keizo EBIKO ; Saori TANBA ; Makoto KIKKAWA ; Naoko KIKUCHI ; Yasuko ARAI ; Hiroshi SATO
Kampo Medicine 2009;60(3):347-355
We retrospectively investigated the effects of acupuncture on refractory peripheral facial paralysis. Among patients with Bell's palsy or Ramsay Hunt syndrome (type II) who underwent acupuncture between August 1996 and June 2004, were 29 patients with a minimum electroneuronography (ENoG) percent response of 0%, and NET scale-out (14 patients with Bell's palsy, 15 with Ramsay Hunt syndrome). Demographically, they 21 males and 8 females, with a mean age of 44.3±12.8 years. Their disease duration, and paralysis score assessed using the 40-point method (Yanagihara's method) were 43.2±23.9 days and 10.2±2.7 points, respectively. To evaluate treatment response, we employed the paralysis score, and a sequela score assessed using a modification of the sequela evaluation method designed by Nishimoto and Murata et al. The paralysis score exceeded 36 points within 6 months after onset. Five patients (17.2%) without sequelae were regarded as having achieved complete recovery, and 24 (82.8%) as having achieved incomplete recovery. When the minimum ENoG is 0%, recovery within 6 months beyond onset is considered impossible. The results suggest, however, the efficacy of acupuncture.
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5.Making of the Condition Change Scenario Programs Aiming at Problem-based Learning using a Patient Simulator and Enforcement of the Workshop
Jin Tokunaga ; Naoya Haraguchi ; Norito Takamura ; Kenji Ogata ; Nao Setoguchi ; Keizo Sato
Japanese Journal of Social Pharmacy 2013;32(2):18-26
We developed a program to generate scenarios of pathological changes for problem-based learning (PBL) in a physical assessment workshop using the patient simulator, "Physiko®”. With these programs, PBL-style case experiencing also became possible by actually performing physical assessment on “Physiko®” using a stethoscope while presenting information such as the patient background. The results of a survey conducted during the physical assessment workshop showed that participants were significantly interested in simulation-based education. However, the results also revealed a lack of understanding of technical terms used in physical assessment, suggesting the need to urgently facilitate not only the acquisition of basic skills to monitor vital signs but also that of symptomatology knowledge in order to understand technical terms and pathological characteristics.
6.A Case of Hunt Syndrome Responding to a Combination of Acupuncture and Rehabilitation
Keizo EBIKO ; Naoko KIKUCHI ; Makoto KIKKAWA ; Saori TANBA ; Yasuko ARAI ; Hiroshi SATO
Kampo Medicine 2011;62(5):643-648
We report a 74-year-old woman who developed right-sided Hunt syndrome on July 3, XXXX, and who received stellate ganglion block and an infusion of aciclovir while hospitalized. Steroids were not used due to her diabetes. After discharge, she continued taking vitamin B12, and received stellate ganglion block three times a week, but the paralysis did not show a tendency toward recovery. Following a combination of acupuncture and rehabilitation starting on October 6 (post-onset day 95), the paralysis score, which was 4 points on day 95, showed a tendency toward recovery : 32 points on day 186, and 36 points or more (within the normal range) on day 246. No apparent synkinesis was seen one year after the onset. Although Hunt syndrome appeared to be refractory due to her advanced age, presence of diabetes, unused steroids, complete paralysis with a paralysis score of 8 points or less, and no tendency to recover for three months or more, the results suggested that she responded to the combination of acupuncture and rehabilitation.
7.Preventive Education on Osteoporosis Awareness for Local Residents
Akio Kawachi ; Erisa Tomishige ; Fuminori Esaki ; Ryoichi Miyako ; Mika Nakagawa ; Junichiro Sonoda ; Keiko Narumi ; Keizo Sato ; Toshiro Motoya
Japanese Journal of Social Pharmacy 2013;32(2):27-32
As of 2011, about 12.8 million people in Japan had osteoporosis, which is a social issue in that it increases the number of patients who are bedridden or require residential care and its poor prognosis increases the mortality rate. We delivered a presentation on osteoporosis prevention to residents;the presentation consisted of ultrasound bone densitometry readings followed by a slide show, based on the readings. This report summarizes the presentation and considers whether it was effective in enhancing awareness of osteoporosis. The presentation was given to 39 residents, who were asked to complete a questionnaire before and after it. Of the 31 female respondents, 16.1 percent had bone density in the “low or caution” range;for all eight male respondents, it was “sufficient” or “average.” After the presentation, over 90 percent of respondents selected “agree” or “slightly agree” in response to the statements “I want to have regular exercise and participate in sports,” “I want to eat nutritionally sound meals,” and “understanding one’s bone density is useful for the prevention of osteoporosis.” In addition, 97.4 percent of the residents responded that the lecture was “useful” or “somewhat useful,” and 94.9 percent indicated satisfaction with it. The presentation was considered to be useful in enhancing residents’ awareness of osteoporosis.
8.A Drug Utilization Study on Off-Label Uses
Nobuyuki GOTO ; Kazuo SATO ; Masaki SHIRAHASE ; Hisao HATTA ; Mikio MASADA ; Kazuhisa MATSUBA ; Yoshihiro KATAGIRI ; Masahiro NAKANO ; Keizo ISHIMOTO ; Takeo MINAMI ; Shikifumi KITAZAWA
Japanese Journal of Pharmacoepidemiology 1999;4(1):1-8
Objective : Heparin lock flush solution is diluctes and divided into vials before its use while it is used in quantity in Japan. Then, we carried out the research on use of heparin lock flush solution.
Methods : We executed the nationwide questionnaire investigation concerning making heparin lock flush solution.
Results : The recovery of the nationwide questionnaire investigation was as high as 78% (64/82) indicating general concern for the problem.
Heparin lock flush solution was made in 97% (246/253) of wards. 69% (174/253) of wards had a standard for preparation. Therebon, it is thought that the standardization of heparin lock flush solution is possible. The use concentration employed most frequently for the peripheral intravenous injection was 10 units/ml and that for the central vein injection was 100/ml units. In many wards the amount used at 1 time for the peripheral intravenous injection was 5 ml or 10 ml and that for the central vein injection, was 5 ml, 10 ml, or 20 ml.
84% of nurses requested marketing of heparin lock flush solution.
Conclusion : We investigated the use realities and the problem of heparin lock flush solution from a past report etc. Heparin lock flush solution is listed to the pharmacopeia in the United States and Britain. Heparin lock flush solution should be supplied as the goods on the market immediately even if it is seen from the profit, the safety, the medical economy.
9.A Drug Utilization Study on Off-Label Uses
Nobuyuki GOTO ; Kazuo SATO ; Masaki SHIRAHASE ; Hisao HATTA ; Mikio MASADA ; Kazuhisa MATSUBA ; Yoshihiro KATAGIRI ; Masahiro NAKANO ; Keizo ISHIMOTO ; Takeo MINAMI ; Shikifumi KITAZAWA
Japanese Journal of Pharmacoepidemiology 1999;4(1):9-19
Objective : Percutaneous ethanol injection (PEIT) for hepatocellular carcinoma is basic treatment of hepatocellular carcinoma. However, it is off-label uses to use ethanol for this treatment in the current state. Then, we executed the drug utilization study of Absolute ethanol injections at this time.
Methods : We executed the drug utilization study of Absolute ethanol injections at this time.
Results : The recovery of the questionnaire was high with 84.4% (151/179 medical institutions). The ethanol injections was made by 85% (129/151 facilities). Facilities where 100 or more ethanol injections was made annually were 76%. The raw material for making the ethanol injections was the reagent which was not the medicine in 44% of facilities. Information on safety and effectiveness concerning the ethanol injections was hardly offered from pharmacy. Finally, 96% (124/129 facilities) demanded marketing the ethanol injections.
Conclusion : We investigated the research report number by using “ICHUSHI” CD-ROM version (1988-1998) which was the medical literature data base. We were able to collect reports concerning PEIT of hepatocellular carcinoma of 636 reports. We were able to collect reports which used PEIT as a treatment method of hepatocellular carcinoma by as many as 636 reports. It has been understood that PEIT is enforced in Japan. Next, we reviewed the document and collected and evaluated information on effectiveness and safety concerning the ethanol injections used for PEIT. The treatment object, the usage, and the dosage have been decided at the relating academic meeting. Moreover, there was a report concerning a lot of effectiveness and safety in the PEIT treatment method of hepatocellular carcinoma. The ethanol injections used for PEIT is one of the medicines where information and scientific evidence concerning effectiveness and safety are accumulated. Moreover, a large amount of ethanol injections are nationally made in the pharmacy in the hospital. However, it has been proved that there are a lot of problems about the making. The ethanol injections is the medicine which should be supplied and made by the pharmaceutical company.
10.Safety of Retained Acupuncture With the Planar Electric Heater at Our Institute
Keizo EBIKO ; Kumiko TAKATA ; Takashi ITO ; Yoko KIMURA ; Hiroshi SATO
Kampo Medicine 2018;69(4):402-406
Our institute performs retained acupuncture for cold-related symptoms using planar electric heaters. After placing retained acupuncture needles at 8 points on the lower back, the site is covered with a planar electric heater and heated for 20 minutes, with the 6-channel dial of the device set at 5, the second highest temperature. Using this method, we treat and examine patients with cold-related symptoms. If patients feel discomfort during the heating process, the procedure is continued when heat is used for treatment and immediately terminated in the case of examination. On examining related adverse events in 75 cases (224 sessions) within the 8-month period between March and October 2016, there was soreness/irritation of the skin surface in 5 (2.2%), itching in 3 (1.3%), and physical deconditioning in 1 (0.4%). However, all of these events were mild and temporary, supporting the safety of the method. As a future challenge, it may be necessary to expand this study to clinical research on traditional Chinese medicine and acupuncture/moxibustion.