More than 3 years have passed since the guideline for infection prevention at acupuncture and moxibustion clinics was issued. We studied changes in the attitude toward sanitization of the environment and consciousness about infection prevention at acupuncture and moxibustion clinics during this period. The subjects were members of the Acupuncture and Moxibustion Societies of Kyoto and Osaka (n=349). About 70% of the subjects felt anxiety about infections, and nearly 80% of them were interested in sanitizing the clinics. More than half (57%) of the subjects were using both disposable and reusable needles, and about half the subjects disposed of used needles without sterilization. Concerning the linen, pillow covers were changed for every patient by about 70% of the subjects, but towels and sheets were changed by only 20% and 10%, respectively. White coats were changed within 1 week by about 70% of the subjects. Most subjects answered that the clinics were cleaned everyday, but less than a half of them sterilize slippers. About half the subjects answered that curtains were washed every 3-6 months. Autoclaves were placed in only 90% of the clinics. Attention to preventive measures against infection of therapists tended to diminish with increase in the clinical experience.

We report a case of systemic sclerosis complicated with primary biliary cirrhosis successfully treated with orengedokuto (wanbinghuichun) and sekiganryo. The patient was a 68-year-old female. She had been diagnosed with systemic sclerosis 20 years previously, and primary biliary cirrhosis 17 years previously. She received modern Western medical treatment for skin itching and scleroderma, but her symptoms showed little improvement. Therefore, she consulted our clinic in order to receive Kampo therapy. We prescribed orengedokuto (wanbinghuichun), and the skin itching improved in 5 days. As a result of administering sekiganryo in addition to orengedokuto (wanbinghuichun) for severe coldness, the scleroderma was also ameliorated. We consider this to be a case of diseases overlapping between yin and yang syndrome.

Trigger finger develops because of stenosis around the A1 annular ligament, which causes inhibition of smooth expansion and contraction of the finger. It is effectively treated by an anti-inflammatory analgesic and/or steroid infusion, and by Western style medical surgery. Here, we report 3 cases of trigger finger effectively treated with unkeito. The first case was a 71-year-old female who had been treated with Kampo medicine for an enlarged feeling in the abdomen. She complained of trigger finger, in the knuckle of her right third finger, dry lips, and hot flashes in her hands and feet. The second case was a 56-year-old female who had been treated with Kampo medicine for polyarticular pain in her fingers. She complained of trigger finger of the left fourth finger and hot flashes in her hands. The third case was a 71-year-old female who had been treated for chronic renal failure. She complained of trigger finger in the left first finger and dry skin but had neither hot flashes in the hands nor dry lips. One of the target symptoms of unkeito is hot flashes in the hands and dry lips. Unkeito is composed of herbs which improve ketsu deficiency, oketsu, inflammation, and dry skin. It is possible that these actions of unkeito are effective in trigger finger as well.

The use of orento for dermatosis is commonplace. We report herein the effective treatment of five cases of facial erythema and flushing using orento, based on the observation of heat symptom patterns in the upper part of the body and cold symptoms in the middle part of the body. Few reports have described specific symptoms of upper heat and middle cold ; however, interpreting ‘facial erythema and flushing exacerbated by warming',‘red face', ‘hot flashes', ‘hot sweats' and ‘yellow fur on the tongue' as “upper heat” , and ‘preference for warm drinks', ‘diarrhea exacerbated by cold drinks', and ‘objective coldness in the epigastric region' as “middle cold” enabled the application of orento for dermatosis in our experience.

BACKGROUND/AIMS: Decreased trough levels of infliximab (TLI) and antibodies to infliximab (ATI) are associated with loss of response (LOR) in Crohn's disease. Two prospective studies were conducted to determine whether TLI or ATI better correlates with LOR (Study 1), and whether TLI could become a predictor of mucosal healing (MH) (Study 2). METHODS: Study 1 was conducted in 108 patients, including those with LOR and remission to compare ATI and TLI in discriminating the 2 conditions based on receiver operating characteristic (ROC) curve analyses. Study 2 involved 35 patients who were evaluated endoscopically. RESULTS: In Study 1, there were no differences between the 2 assays in ROC curve analyses; the TLI cutoff value for LOR was 2.6 µg/mL (sensitivity, 70.9%; specificity, 79.2%), and the ATI cutoff value was 4.9 µg/mL (sensitivity, 65.5%; specificity, 67.9%). The AUROC (area under the ROC curve) of TLI was greater than that of ATI. AUROC was useful for discriminating between the 2 conditions. In Study 2, the TLI was significantly higher in the colonic MH group than in the non-MH group (2.7 µg/mL vs. 0.5 µg/mL, P=0.032). CONCLUSIONS: TLI is better than ATI for clinically diagnosing LOR, and a correlation was observed between TLI and colonic MH.
Antibodies ; Cohort Studies* ; Colon ; Crohn Disease* ; Humans ; Infliximab* ; Prospective Studies* ; ROC Curve ; Sensitivity and Specificity

Aged ; Aged, 80 and over ; Androgen Antagonists/therapeutic use* ; Biomarkers, Tumor/blood* ; Dehydroepiandrosterone Sulfate/blood* ; Humans ; Male ; Middle Aged ; Prostatic Neoplasms/mortality* ; Prostatic Neoplasms, Castration-Resistant/mortality* ; Survival Analysis ; Treatment Outcome