1.The State of Traditional Chinese Medicine (TCM) School in Singapore
Takanori MATSUOKA ; Toru MURASAKI ; Hideki KURIBAYASHI
Kampo Medicine 2008;59(3):507-510
This is a report on schools of Traditional Chinese Medicine (TCM) and the state of the traditional education system in Singapore. School texts made in the People's Republic of China were used in Singaporean schools. In 1994, however, the Minister of Health appointed a committee to review TCM practices, and recommended measures to safeguard patients' interests and safety. The committee's report published in 1995 recommended that TCM practices in Singapore should be regulated, and recommended steps to upgrade training standards. In compliance with said committee, TCM schools have added basic western medical science to their curricula. And TCM school requirements in Singapore were revised to 3 years full-time curricula or 6 years part-time curricula. In 2000, the TCM Practitioners Act was passed. Singapore is small country with a population of 4.16 million. However, it promotes traditional medical education projects and studies enterprisingly, receiving WHO support and NCCAM grants.
Singapore
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Schools
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Medicine, Chinese Traditional
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seconds
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Review [Publication Type]
2.Development of a Quick High-Yield Method for the Preparation of Decoctions, Inspired by the “Zhu san Fa” of the Song Period (Part 2)
Tsukasa FUEKI ; Toshiaki MAKINO ; Takanori MATSUOKA ; Masashi BEPPU ; Takao SUNAGA ; Koichiro TANAKA ; Takao NAMIKI
Kampo Medicine 2016;67(2):114-122
The IPCD (Immersing Powdered Crude Drugs) method, inspired by the “zhu san fa” which was widely used in the Song period of China, has been developed to prepare Kampo decoctions quickly and easily, with highyield extract from crude drugs. One trouble with the IPCD method occurs when separating the decoction from the muddy residue of the crude drug powder. When powdered ephedra herb is packed in a nonwoven fabric bag and immersed in hot water, yield of the marker compounds is much lower than that obtained when ephedra herb powder is dispersed freely in hot water without a nonwoven fabric bag. Thus the use of a nonwoven fabric bag was shown to be unsuitable with the IPCD method. In investigating an easy and more efficient separation method, we tried decanting with a commercially available wine carafe to separate the decoction and residue. With IPCD followed by decantation using the wine carafe, yields of about 80% decoction volume were obtained as compared with those when cut crude drugs are decocted and filtered using a tea strainer, in 6 of the 7 formulas tried. We find that decantation using a wine carafe is a more practical way of separation in the IPCD method.
3.Immunological Abnormalities in the Pathogenesis of Inflammatory Bowel Disease.
Tadakazu HISAMATSU ; Yohei MIKAMI ; Katsuyoshi MATSUOKA ; Takanori KANAI ; Toshifumi HIBI
Intestinal Research 2012;10(4):317-323
Crohn's disease and ulcerative colitis represent two distinct forms of inflammatory bowel diseases (IBD). In this paper, we discuss how immunological mechanisms contribute to the pathogenesis of IBD. Intestinal homeostasis is sustained by various kinds of cells, such as epithelial cells, lymphocytes, antigen presenting cells, and other innate immune cells. We pay special attention to intestinal CD14+ macrophages. Intestinal macrophages play a central role in the regulation of immune responses against commensal bacteria. In the physiological condition, intestinal macrophages lack the expression of innate-immune receptor CD14 and do not produce proinflammatory cytokines. We identified a unique macrophage subset of IBD in the human intestine, which expressed both macrophage (CD14, CD33, CD68) and dendritic cell (DC) markers (CD205, CD209) and produced larger amounts of proinflammatory cytokines, such as interleukin (IL)-23 and tumor necrosis factor (TNF)-alpha. In addition, the CD14+ macrophages contributed to interferon (IFN)-gamma production rather than IL-17 production by lamina propria mononuclear cells dependent on IL-23. We discuss herein this IL-23/IFN-gamma-positive feedback loop in IBD patients. We also discuss IFN-gamma and IL-17 production from mucosal T cells and natural killer (NK) cells. Here, we show our recent findings about the plasticity of T helper cells in colitis. Th 17 cells express T-bet, and finally lose the expression of retinoic acid-related orphan receptor (ROR)gammat, the master regulator of Th 17 cells, and are differentiated 'alternative Th 1 cells.' In addition to Th 1 cells, mucosal NK cells are also important sources of IFN-gamma. Some of our ideas may be provocative, but we hope this review paper will provide new and firm understanding of the pathogenesis of IBD.
Antigen-Presenting Cells
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Bacteria
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Child
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Child, Orphaned
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Colitis
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Colitis, Ulcerative
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Crohn Disease
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Cytokines
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Dendritic Cells
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Epithelial Cells
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Homeostasis
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Humans
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Inflammatory Bowel Diseases
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Interferons
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Interleukin-17
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Interleukin-23
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Interleukins
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Intestines
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Killer Cells, Natural
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Lymphocytes
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Macrophages
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Mucous Membrane
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Plastics
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T-Lymphocytes
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T-Lymphocytes, Helper-Inducer
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Tumor Necrosis Factor-alpha
4.Diet, microbiota, and inflammatory bowel disease: lessons from Japanese foods.
Takanori KANAI ; Katsuyoshi MATSUOKA ; Makoto NAGANUMA ; Atsushi HAYASHI ; Tadakazu HISAMATSU
The Korean Journal of Internal Medicine 2014;29(4):409-415
The incidence and prevalence of inflammatory bowel diseases (IBDs) including ulcerative colitis and Crohn disease are rapidly increasing in Western countries and in developed Asian countries. Although biologic agents targeting the immune system have been effective in patients with IBD, cessation of treatment leads to relapse in the majority of patients, suggesting that intrinsic immune dysregulation is an effect, not a cause, of IBD. Dramatic changes in the environment, resulting in the dysregulated composition of intestinal microbiota or dysbiosis, may be associated with the fundamental causes of IBD. Japan now has upgraded water supply and sewerage systems, as well as dietary habits and antibiotic overuse that are similar to such features found in developed Western countries. The purpose of this review article was to describe the association of diet, particularly Japanese food and microbiota, with IBD.
Animals
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*Asian Continental Ancestry Group
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Diet/*ethnology
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Evidence-Based Medicine
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Food Habits/ethnology
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Humans
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Incidence
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Inflammatory Bowel Diseases/diagnosis/diet therapy/*ethnology/immunology/*microbiology
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Intestines/immunology/*microbiology
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Japan/epidemiology
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*Microbiota
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Prevalence
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Probiotics/therapeutic use
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Prognosis
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Risk Factors
5.The Historical Development of Theories on Night Sweat Pathophysiology
Oto MIURA ; Takanori MATSUOKA ; Yoshinari KONO ; Hidetoshi ITAKURA ; Koichiro TANAKA ; Mikumo UEMATSU ; Kazuhiko NARA ; Keiko SERIZAWA ; Asuka NAKAYAMA ; Makoto HASHIGUCHI ; Atsushi FUKUSHIMA ; Takaaki KOSUGE ; Teruo SAITO
Kampo Medicine 2012;63(1):1-14
Until the Sui Dynasty in China, night sweat and spontaneous perspiration had been thought to be caused by same pathophysiology, that is, lowered superficial resistance by deficiency of Qi.In the Tang Dynasty, these were considered to have different pathophysiologies and a new principle indicated that pathogenic heat caused night sweat.In the Song and Jing Dynasties, deficiency of blood and pathogenic heat by deficiency of Yin was also considered to cause night sweat.In the Jing Dynasty, exogenous pathogens, such as Cold were considered to cause night sweat, which indicated the principle that not only the deficiency syndrome but also the excess syndrome caused night sweat.In the beginning of the Yuan and Ming Dynasties, it was concluded that the deficiency of Yin caused night sweat and the deficiency of Yang caused spontaneous perspiration.In the middle of the Ming Dynasty, another new theory indicated that deficiency of Yang also possibly caused night sweat; therefore we should diagnose abnormal sweat depending on the pathophysiology in each case.In the Qing Dynasty, new theories were established stating that not only exogenous pathogens but also Damp-heat, undigested food and stagnation of blood, all of which are included in excess syndrome, cause night sweat, and that based on which part of the body sweats occurred we might understand pathophysiology of night sweat. The night sweat by Warm-heat, which is different from the one by Wind-cold, was considered to be caused with deficiency of Yin.Thus we conclude that the theories of night sweat developed over time, based on Chinese medical classics.
6.Differences in Water Hardness when preparing Ephedrae Herba Decoctions : Special Focus on a Comparison of Tap Water in Japan and China
Tsukasa FUEKI ; Takanori MATSUOKA ; Masashi BEPPU ; Hidetoshi YAMAGUCHI ; Hideyuki NAKATA ; Kenshu RAI ; Yumi SAKAI ; Kazuhiko NAGASAKA ; Toshiaki MAKINO ; Takao NAMIKI ; Kenkichi OKADA ; Yusen IWAI ; Kazuhiro MAKIZUMI
Kampo Medicine 2012;63(5):313-321
Decoctions of Ephedrae Herba were prepared using tap water sampled in Changping District, Beijing City(China), tap water sampled in Niigata City (Japan) and some mineral water samples sold in markets. Various dissimilarities were found between drug extracts prepared using tap water in Japan and China, and the extraction efficiency of the alkaloids with Beijing tap water was approximately 80% of that with Niigata tap water. It is suggested that these dissimilarities result from concentrations of temporally hard components, such as calcium and magnesium bicarbonate salts, in the water. In addition, when Zizyphi Fructus and Ephedrae Herba were decocted together in hard water, the state of the decoction, ephedra-alkaloid content included, was found to come close to that of single Ephedrae Herba decoctions prepared using soft water. It was suggested that Ziziphi Fructus might possibly play roles as a softening agent in decoctions prepared using hard water.
7.On Ryokyu ARIMA, Tenmin NAMIKAWA's Mentor
Takanori MATSUOKA ; Hideki KURIBAYASHI ; Masashi BEPPU ; Hidetoshi YAMAGUCHI ; Hideyuki NAKATA ; Tamie ANAN ; Tsukasa FUEKI ; Kenju RAI ; Hidetoshi ITAKURA ; Koichiro TANAKA ; Yoshinari KONO ; Mikumo UEMATSU ; Kazuhiko NARA ; Keiko SERIZAWA ; Kenkichi OKADA ; Yusen IWAI ; Kazuhiro MAKIZUMI ; Oto MIURA ; Takao NAMIKI ; Tetsuo AKIBA
Kampo Medicine 2012;63(6):417-427
Tenmin NAMIKAWA (並河天民) thought the Shanghanlun (傷寒論) was an important text. He also taught his pupils the importance of prescribing Zhongjing ZHANG's (張仲景) medicines. Ryokyu ARIMA (有馬凉及) was a physician-teacher, who prescribed Chengqitang (承気湯) for the emperor without conferring with other doctors. His chengqitang formulary was derived from medical texts by Zhongjing ZHANG. Kyugo GODA (合田求吾) on the other hand, was a pupil of Ikkannsai MATSUBARA (松原一閑斎), who wrote in the Idokikigaki (医道聞書) : theKoho (古方) school started by Ryokyu ARIMA. He was a hero who was punished by the Goseiin (後西院) emperor. He taught Koho to Tenmin. This therefore reveals that Ryokyu ARIMA was a teacher who taught the importance of the Shanghanlun.
8.The Weights in Ben Cao Jing Ji Zhu (Dun Huang Version) and the Volume of a Fang Cun Bi (One Cun Square Spoon) : Weights and Measures in the Period when the Shan Han Lun was Written
Tsukasa FUEKI ; Takanori MATSUOKA ; Toshiaki MAKINO ; Takao NAMIKI ; Masashi BEPPU ; Hidetoshi YAMAGUCHI ; Hideyuki NAKATA ; Kenshu RAI ; Keisuke HAGIHARA ; Koichiro TANAKA ; Kazuhiko NAGASAKA ; Takao SUNAGA ; I-JUNG LEE ; Kenkichi OKADA ; Yusen IWAI ; Kazuhiro MAKIZUMI
Kampo Medicine 2014;65(1):38-45
For the purpose of investigating weights in the era when the Shan Han Lun was set forth, the weight and measures described in the Ben Cao Jing Ji Zhu, written in the period slightly after the Shan Han Lun, were studied. Some descriptions of the metrological standards are confusing in the Ben Cao Jing Ji Zhu. We focused on the measuring container, whose volume is equal to that of the one cun square spoon (fang cun bi), shown in the dun huang version of the Ben Cao Jing Ji Zhu. The volume of this measuring container was calculated on the assumption that the measures in this text follow those of the Han Shu Li Li Shi, and a result of 5.07 cm3 was obtained. The result was confirmed by using the actual measured values of the crude drugs. The result was also considered to support measurements of the volume in the Ben Cao Jing Ji Zhu as following the Han Shu Li Li Shi. With those results, descriptions of the density of honey and lard were examined, and the weight in the Ben Cao Jing Ji Zhu was clarified to follow that in the Han Shu Li Li Shi.
9.The Investigation of Metrological Standard in “Songban Shanghanlun” :Focus on the Absorbed Liquid in the Decoction Residues and the Extraction Efficiency of Ephedra-alkal
Tsukasa FUEKI ; Takanori MATSUOKA ; Toshiaki MAKINO ; Takao NAMIKI ; Masashi BEPPU ; Hidetoshi YAMAGUCHI ; Hideyuki NAKATA ; Kenshu RAI ; Keisuke HAGIHARA ; Koichiro TANAKA ; Takao SUNAGA ; Kazuhiko NAGASAKA ; Kenkichi OKADA ; Yusen IWAI ; Kazuhiro MAKIZUMI
Kampo Medicine 2014;65(2):61-72
The dosage of crude drugs described in the Shanghanlun has long been discussed, and a conversion ratio for 1 liang in the Songban Shanghanlun into modern grams has not been established yet. Ekisai Kariya, a bibliologist in Edo period Japan, claimed that the formulas in the Songban Shanghanlun could not be decocted when weighed with the “Han shu (lu li zhi)” scale (1 liang = 14 g, “regular scale”), and the weight scale in the text should be “Scale of Shen nong” (1/10 scale of the regular scale). This claim leads to the standards for Kampo prescription dosages. We inspected this matter by focusing on the amount of liquid absorbed by decoction residues, and demonstrated that the formulas in Songban Shanghanlun could actually be decocted when weighed with the “regular scale”. In addition, we calculated the quantities of Ephedra-alkaloids in the one-time dose of “Ma huang tang” of the several books written in the Song period, and the Songban Shanghanlun text, with results showing that Chinese doctors in the Song period recognized 1 liang in the Songban Shanghanlun as 14 grams in modern terms, and that the “regular scale” could be applied clinically. This strongly suggests that the metrological standard in the Songban Shanghanlun should be the “regular scale”.
10.β-(1,3)-Glucan derived from Candida albicans induces inflammatory cytokines from macrophages and lamina propria mononuclear cells derived from patients with Crohn's disease.
Kiyoto MORI ; Makoto NAGANUMA ; Shinta MIZUNO ; Hiroaki SUZUKI ; Mina T. KITAZUME ; Katsuyoshi SHIMAMURA ; Sayako CHIBA ; Akira SUGITA ; Katsuyoshi MATSUOKA ; Tadakazu HISAMATSU ; Takanori KANAI
Intestinal Research 2018;16(3):384-392
BACKGROUND/AIMS: Recent research has highlighted the importance of interactions between commensal fungi and intestinal inflammation. However, there are few studies investigating whether commensal fungi contribute to inflammation in patients with Crohn's disease (CD). The aim of this study is to investigate reveal interactions between commensal fungi and host immune cells in CD. METHODS: CD14-positive monocytes were isolated from peripheral blood mononuclear cells from healthy human volunteers and then differentiated in the presence of macrophage colony-stimulating factor (M-CSF) (referred to as M-macrophages, M-Mϕs) or M-CSF and interferon-γ (IFN-γ) (referred to as M-gamma macrophages, Mγ-Mϕs). Cytokine production by these in vitro differentiated macrophages in response to β-(1,3)-glucan was analyzed by flow cytometry. Expression of Dectin-1 was examined using flow cytometry, western blotting, and quantitative reverse transcription-polymerase chain reaction. Cytokine production by in vitro differentiated macrophages in response to β-(1,3)-glucan was measured in the presence of an anti-Dectin-1 receptor antagonist, anti-Syr, or an anti-Fas-1 antibody. Cytokine production by lamina propria mononuclear cells (LPMCs) derived from CD patients in response to β-(1,3)-glucan was also analyzed. RESULTS: Mγ-Mϕs produced a large amount of tumor necrosis factor-α (TNF-α) and interleukin-6 in response to β-(1,3)-glucan. Dectin-1 expression was significantly higher in Mγ-Mϕs than in M-Mϕs. The increase in TNF-α production by Mγ-Mϕs stimulated with glucan was reversed by blocking Dectin-1, Syr or Fas-1. LPMCs derived from CD patients stimulated with β-(1,3)-glucan produced significantly higher amount of TNF-α than LPMCs derived from UC patients. CONCLUSIONS: These results suggest that commensal fungal microbiota may contribute to the pathogenesis of CD by inducing macrophages-derived pro-inflammatory cytokines.
Blotting, Western
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Candida albicans*
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Candida*
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Crohn Disease*
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Cytokines*
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Flow Cytometry
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Fungi
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Healthy Volunteers
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Humans
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In Vitro Techniques
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Inflammation
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Interleukin-6
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Macrophage Colony-Stimulating Factor
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Macrophages*
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Microbiota
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Monocytes
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Mucous Membrane*
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Necrosis
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Tumor Necrosis Factor-alpha