A case of progressive systemic sclerosis (PSS) with peripheral circulation disturbance, pulmonary fibrosis and stenosis of esophagus-cardia (E-C) junction, was treated with acupuncture and traditional Chinese medicine. The patient had digital pitting scar due to the peripheral circulation disturbance. Effect of acupuncture was examined using laser Doppler velosimetry (LDV). Acupuncture treatment was operated 3 times a week and laser therapy, once a week. And Chinese medicine was administered. The LDV measurements were done before and after acupuncture. In the total 9 times of measurements, 8 were increased in peripheral blood flow. Two times from the measurements of peripheral blood flow after acupuncture reached in the normal flow level. After the treatment of 2 months, polyarthralgia was reducted, vomiting was disappeard, and the stenosis of the E-C junction was improved. Present data suggest that the acupuncture therapy to the PSS patient is effective.

Osaka City has the highest tuberculosis (TB) notification rates in Japan. In the period 1999–2003, the TB control programme was strengthened, and the Stop TB Strategy was implemented to reduce the number of notified cases. The objective of this study was to assess the effect of these control activities in Osaka City, including the implementation of directly observed treatment (DOT), by analysing TB surveillance and routinely collected data. We reviewed the surveillance data of all sputum smear-positive pulmonary tuberculosis (PTB) cases registered in the Osaka City Public Health Office from 2001 to 2008 and data collected from the routine TB programme. The DOT implementation rate increased from 0% in 2001 to 68% in 2008 for smear-positive PTB cases of the general public and to 61% for all PTB cases of the homeless. The proportion of smear-positive PTB cases that had treatment failure and default combined, declined from 8.0% (52 of 650) in 2001 to 3.6% (20 of 548) in 2006. The proportion of cases among the homeless with previous treatment declined from 28% in 2001 to 15% in 2008. The proportion of cases with multidrug resistant-TB (MDR-TB) among those without previous treatment declined from 1.7% in 2001 to 0.9% in 2008. It is logical that reduction in the failure and default rate would lead to the reduction of cases with previous treatment and TB transmission, including resistant TB, therefore to the reduction of MDR-TB rates.

Purposes: We performed a white coat ceremony for medical students, because there had not been a definite passage ceremony to create the desire to serve and the awareness of being physician. Opinions about the ceremony were with a questionnaire survey. Methods: The ceremony of white coat conferment was performed for the first time for 112 fourth-year medical students on January 11, 2001, just before the start of clinical training. A white coat and an identification badge with photograph were presented to the medical students, who were taking the first step to becoming a physician. A questionnaire survey was performed the next day to evaluate students' feelings. The questionnaire asked about student's 1) sense of responsibility to be engaged in medical practice, 2) feelings of kindness to patient, 3) love for of their school, 4) attachment to the white robe, 5) consciousness of being a professional, 6) sense of mission as a physician, 7) motivation to learn, 8) feelings of seriousness, and 9) desire to live ethically. A listening survey for the school staff and students was also included. Results: Clear improvements in consciousness were recognized in all items of the questionnaire (P>.0001). Approximately 80% of students approved of the ceremony being performed annually from the following year. The ceremony had had no established form, but many people acknowledged its significance. However, some students who did not realize the significance of the ceremony because it was performed in the middle of the semester. Conclusions: Although this was the first experience for us, many students and teaching staff were understanding and responded favorably to this passage ceremony. The ceremony to instill medical professionalism in student doctors will be improved with further efforts and experiences.

Laser-Doppler velocimetry was used to evaluate the effects of acupuncture stimulation on peripheral circulation disturbance in patients with collagen disease, progressive systemic sclerosis (PSS) and systemic lupus erythematosus (SLE). The response to acupuncture stimulation to shou-san-li was recorded in 8 patients with PSS and 6 patients with SLE. The digital pitting scars and Raynaud's phenomenon were observed in all the patients. The mean of laser-Doppler flow values in fingertips at room temperature 23°C was 4.83 (V) in normals (n=11), 2.82 (V) in patients (n=14). Patient group showed significantly lower values than normals (p<0.01). Ten minutes after acupuncture stimulation to shou-san-li, the flow values increased in 7, and decreased in 1 out of 13 patients (p<0.05). In normals no significant change was observed after the same stimulation. Present data suggest that the acupuncture therapy to the patients with PSS or SLE who suffered from peripheral circulation disturbance is effective.

Laser-Doppler velocimetry (LDV) was used to evaluate the effects of low energy laser irradiation on peripheral circulation disturbance in patients with collagen diseases, progressive systemic sclerosis (PSS) and systemic lupus erythematosus (SLE).
Using a commercially available LDV flometer (Periflux, Perimed KB, Sweden), the response to laser irradiation at the acupuncture points of Tian zhu, Feng chi, Jian jing, Shou san li, Jing qu, He gu, Stellate ganglion, was recorded in 4 patients with PSS and 6 with SLE. The digital pitting scars and Raynaud's phenomenon were observed in all the patients. The low energy of 10mW laser was irradiated for 1 minute at each acupuncture points, and LDV flow values ware recorded in fingertips at room temperature 25±0.5°C. Ten minutes after the laser irradiation, the LDV flow values increased significantly (p<0.5).
Present data suggest that the low energy laser irradiation to patients with PSS or SLE who suffered from circulation disturbance is effective.

OBJECTIVE: Schizophrenia is a mental disorder characterized by severe cognitive impairment. Accumulating evidence suggests a role for oxidative stress in the pathophysiology of schizophrenia. Sulforaphane (SFN) extracted from broccoli sprout is an agent with potent anti-oxidant and anti-inflammatory activity. In this study, we attempted to evaluate the effect of SFN on cognitive impairment in medicated patients with schizophrenia. METHODS: We recruited a total of 10 outpatients with schizophrenia, all of whom gave informed consent. Participants took 3 tablets of SFN, consisting of 30 mg of SFN-glucosinolate per day, for 8 weeks. Clinical symptoms using the Positive and Negative Syndrome Scale (PANSS) and cognitive function using the Japanese version of CogState battery were evaluated at the beginning of the study and at week 8. RESULTS: A total of 7 patients completed the trial. The mean score in the Accuracy component of the One Card Learning Task increased significantly after the trial. However, we detected no other significant changes in participants. CONCLUSION: This result suggests that SFN has the potential to improve cognitive function in patients with schizophrenia.
Asian Continental Ancestry Group ; Brassica* ; Executive Function ; Humans ; Informed Consent ; Learning ; Mental Disorders ; Outpatients ; Oxidative Stress ; Schizophrenia* ; Tablets

The usefulness of individual care of patients in the attitude education of undergraduates was evaluated with questionnaires completed by 4th-year medical students and patients. Ninety-eight percent of students finished performing patient care during a 2-week period. Seventy percent of patients completed questionnaires. The appearance, manner of greeting, and language of the students were considered good by 87% or more of the patients, and the students' consideration for the patients' safety, privacy, and communication was considered good by 86% or more of the patients. The practice was approved by 77% of the patients and was objected to by none. Ninety-nine percent of students completed questionnaires, and 79% of the respondents approved of the practice. Fourteen percent of the student respondents, many of whom had been treated as outpatients, objected to the practice. These results suggest that individual care of patients by medical students is useful for both patients and students.

Background: Appetite loss in older adults raises the risk of malnutrition and frailty. The recent emphasis on psychological and social support for appetite loss reveals the importance of robust social networks. Depression is linked to a decline in appetite and social networks. Social networks may influence appetite directly and indirectly through depression. This exploratory cross-sectional study categorizes social networks into family and friend networks to elucidate their direct and indirect effects. Methods: The study analyzed 193 community-dwelling older adults (women 78.2%; mean age 77.1±5.3 years) who participated in health-checkup events in two cities in Japan. Appetite was assessed using the Japanese version of the Simplified Nutritional Appetite Questionnaire, and family and friend networks were assessed using the Lubben Social Network Scale-6. Depression was assessed using the Geriatric Depression Scale-15. Based on previous research, we constructed a causal model examining the impacts of family and friend social networks and depression on appetite and calculated the direct and indirect effects through structural equation modeling. Results: The family network had a direct effect on appetite (path coefficient=0.18) and an indirect effect via depression (path coefficient=0.0608). Conversely, the friend network was not directly associated with appetite but had an indirect effect through depression (path coefficient=0.095). The model exhibited a good fit. The mechanism of influence on appetite varied between the networks. Conclusion To prevent appetite loss, social networks with family and friends should be assessed separately, and tailored support should be provided for each.

Background: Appetite loss in older adults raises the risk of malnutrition and frailty. The recent emphasis on psychological and social support for appetite loss reveals the importance of robust social networks. Depression is linked to a decline in appetite and social networks. Social networks may influence appetite directly and indirectly through depression. This exploratory cross-sectional study categorizes social networks into family and friend networks to elucidate their direct and indirect effects. Methods: The study analyzed 193 community-dwelling older adults (women 78.2%; mean age 77.1±5.3 years) who participated in health-checkup events in two cities in Japan. Appetite was assessed using the Japanese version of the Simplified Nutritional Appetite Questionnaire, and family and friend networks were assessed using the Lubben Social Network Scale-6. Depression was assessed using the Geriatric Depression Scale-15. Based on previous research, we constructed a causal model examining the impacts of family and friend social networks and depression on appetite and calculated the direct and indirect effects through structural equation modeling. Results: The family network had a direct effect on appetite (path coefficient=0.18) and an indirect effect via depression (path coefficient=0.0608). Conversely, the friend network was not directly associated with appetite but had an indirect effect through depression (path coefficient=0.095). The model exhibited a good fit. The mechanism of influence on appetite varied between the networks. Conclusion To prevent appetite loss, social networks with family and friends should be assessed separately, and tailored support should be provided for each.

Background: Appetite loss in older adults raises the risk of malnutrition and frailty. The recent emphasis on psychological and social support for appetite loss reveals the importance of robust social networks. Depression is linked to a decline in appetite and social networks. Social networks may influence appetite directly and indirectly through depression. This exploratory cross-sectional study categorizes social networks into family and friend networks to elucidate their direct and indirect effects. Methods: The study analyzed 193 community-dwelling older adults (women 78.2%; mean age 77.1±5.3 years) who participated in health-checkup events in two cities in Japan. Appetite was assessed using the Japanese version of the Simplified Nutritional Appetite Questionnaire, and family and friend networks were assessed using the Lubben Social Network Scale-6. Depression was assessed using the Geriatric Depression Scale-15. Based on previous research, we constructed a causal model examining the impacts of family and friend social networks and depression on appetite and calculated the direct and indirect effects through structural equation modeling. Results: The family network had a direct effect on appetite (path coefficient=0.18) and an indirect effect via depression (path coefficient=0.0608). Conversely, the friend network was not directly associated with appetite but had an indirect effect through depression (path coefficient=0.095). The model exhibited a good fit. The mechanism of influence on appetite varied between the networks. Conclusion To prevent appetite loss, social networks with family and friends should be assessed separately, and tailored support should be provided for each.