A 27-year-old female had swelling, hotness and pain on her right clavicle. She was diagnosed as having chronic osteomyelitis and received bone curettement. However, even after this therapy, she occasionally suffered from recurrence of osteomyelitis. In the middle of July 1992, she was pregnant and had a low grade fever and pain from the right clavicle to the right upper arm. On **********, she visited our department and was diagnosed as having deterioration of the chronic osteomyelitis with pregnancy, based on the symptoms and laboratory data. In Kampo diagnosis, she was in the initial stage of Yang diseases with ectodermal symptoms, since she had headache and fever with slight chills and her pulse was floating. She received Keishi-mao-kakuhan-to and acupuncture therapy. The therapy gradually improved the symptoms and laboratory data. The present case suggests that Oriental medicine is one approach to the treatment of chronic osteomyelitis. Furthermore, the fact that the present therapy was effective during pregnancy without any adverse effects supports the clinical usefulness of Oriental medicine, especially since administration of massive amounts of antibiotics or surgery is often not advisable for pregnant women.

In recent years, due to the rapid changing social structure, thedemands for medical services are also changing. There is a need to explore the future direction of acupuncture and moxibustion. Therefore, using the keyword "patient"as the focus of medicalservices, we discussed the question, "What is meant by 'patient-centered'Acupuncture and Moxibustion?"
Our results indicate that the numerous clinical treatments, education, and research that occurred throughout the long history of acupuncture and moxibustion in Japan were in fact all done "for the patient."However, we note that there is still room for improvement in verification method and cooperation between each field, and we confirmed that there is a need to build Acupuncture and Moxibustion methods that truly represent "patient-centered medicine."

Since ancient times, acupuncture and moxibustion have been widely administrated for any emergency case. In this country, they have been endeavored at establishing the harmony between Kampo and Modern medicine. Based on such background, we report two cases of colic pain attack of lithiasis successfully treated with contact needle therapy established by Bunkei Ono.In case one, ureterolithiasis brought colic back pain. Symptoms were improved with satisfaction for one session and the stone discharged via following Kampo-medication.In case two, the patient suffered from colic epigastralgia of choledocholithiasis complicated by severe appetite loss. Although one session successfully extinguished the symptoms, blood chemistry revealed implying signs of cholangitis. A laparotomy with T-tube drainage was performed eventually.These cases pronounced the efficacy of contact needle therapy in the treatment of colic pain and invited deliberate estimation with Modern medicine. The harmony between Kampo and Modern medicine was considered as a prerequisite for clinical practice.

Patients with the best supportive care often get worse and worse, and it is very difficult to improve their symptoms. As cancer is currently a leading cause of death in Japan, and adequate control of the cancer-associated pain is important to improve the quality of life (QOL) in cancer patients. Pain caused by bone metastasis is particularly difficult to control, and the strong analgesic medication which it requires is generally difficult to control. Such metastases result in reduced mobility and markedly reduced activities of daily living (ADL) and the QOL of patients. Our patient was a 67-year-old man who had been treated for metastasis from the left kidney to cancer of the right pelvic bone ; palliative chemotherapy and mild treatment were provided for his sharp pain, but control of his sharp pain was insufficient. Here we expand on our experience in a patient with bone metastasis caused by renal cell carcinoma successfully treated with Kampo medicine, using acupuncture and decoction extract.

Sho-syndrome was analyzed by cluster analysis of answers to a set of questionnaire presented to first-visit patients at a hospital of Japanese-Oriental (Kampo) medicine. The answers from 270 new patients were classified into 3 groups by hierarchical cluster analysis, with a total of 202 non-female related items. We looked at which Sho-syndromes of metabolic (Mb: “Kan-” _??_-), gastrointestinal (Gi: “Hi” _??_-), respiratory (Rp: “Hai-” _??_-), or water and mineral-balance (Wm: “Zin-” _??_-) deficiency (“Kyo” _??_) disorders were included, in one of the groups at high frequencies. Water and mineral-balance deficiency disorders were in Group II and III, while metabolic deficiency disorders were in Group III. We conclude that the results of this analysis support the rationale for the empirical determination of Sho-syndrome, in addition to pulse diagnosis by Kampo-clinicians who examine patients.

We developed a new electrothermo-acupuncture instrument which employs a curved heating plate, and we compared this new one and the old hitherto used electrothermo-acupuncture instrument in terms of radiation temperature, using two male volunteers. The results showed that the 2nd step in the old instrument equaled the fifth channel in the new one. The radiation temperature increase of 140°C seen in 10 minutes was the same, between the two instruments, but the old one continued to increase its temperature, whereas the new one held at a plateau of about 140°C. Therefore, we considered that the new electrothermo-acupuncture instrument is safer than old one.
Next, we investigated the relation between effective Kampo formulas and endurance time in the fifth channel of the new electrothermo-acupuncture instrument, in nineteen patients. We found that Kampo formulas used in the resistant phase of Yang-syndrome disease, is effective in less than 10 minutes of endurance time, and the Kampo formula containing Aconite Tuber is effective for over 30 minutes.
We considered, because of the relation between endurance time and Kampo diagnosis, that the new electrothermo-acupuncture instrument can be useful in a supplementary way in deciding Kampo diagnosis.

During the perioperative period after total hip arthroplasty (THA), much attention has been recently paid to deep venous thrombosis, yet there are few reports concerning stroke after THA and there is no such data at all in Japan at present. The purpose of this retrospective study was to elucidate the occurrence rate and the characteristics of stroke cases during the THA perioperative period. A total of 1,551 primary THAs performed between January 1999 and December 2008 were investigated. Cerebral infarction occurred in three patients (0.19%) during three weeks after THA. Concerning the related factors, one male had foramen ovale, one female had untreated diabetes and atrial fibrillation, and one female had severe stenosis of the internal carotid artery. Cerebral infarction occurred at Day 1 in one male, at Day 2 in one female, and at Day 5 in the other female, and they underwent anticoagulant therapy just after their diagnosis. In all three patients, motor paralysis fully improved and they came back to the THA rehabilitation program within Day 9. One male was discharged at 4 weeks, and another two females were discharged at 8 weeks. Because many people eating a more European diet are now getting older in Japan, prophylaxis for not only DVT but also stroke after THA should be emphasized.

Case1was a 91-year old man diagnosed with multiple cerebral infarctions. He had undergone percutaneous endoscopic gastrostomy in the same year. One year later, we initiated acupuncture treatment because of recurrent respiratory tract infections. The acupuncture points selected were LU 5, Chize and KI 13, Taixi. Before acupuncture, the frequencies of antibiotics-use and feverish days were 6.3 days and 2.7 days per month on average. During acupuncture therapy, these frequencies were reduced to 1.2 days and 0.6 days per month, respectively.Case 2 was an 81-year old man diagnosed with right thalamic hemorrhage. He underwent percutaneous endoscopic gastrostomy in the same year. After 6 months, we began acupuncture treatment, also because of recurrent respiratory tract infections. The acupuncture points were the same as in Case 1.Prior to acupuncture, antibiotics-use and feverish days were 8 days and 4.5 days per month, which were then reduced to1and 0.6 days per month, respectively.Case 3 was a 93-year old man diagnosed with dementia. He was being fed via nasoenteric tubes. After 3 months, again because of recurrent respiratory tract infections, acupuncture treatment was begun. The acupuncture points were the same as in Cases 1 and 2.His use of antibiotics and feverish condition were 9 days and 10 days per month on average before acupuncture, but with acupuncture therapy these were improved to 2 days and 1.3 days per month.Based on this experience, it is suggested that acupuncture be considered for the treatment of recurrent respiratory tract infections in elderly, tube-fed patients.
Acupuncture ; days/month ; Respiratory ; therapeutic aspects ; Cases