We administered Seki-gan-ryo to 24 patients with severe asthenia and cold syndrome as judging by Japanese traditional Kampo medicine. The patients were separated into responder, and non-responder groups. There were 12 patients in the non-responding group. We investigated the clinical indicators of Seki-gan-ryo with special reference to the type of cold and pulse diagnosis. The type of cold wass divided into three groups; heat in the upper and cold in the lower, and limbs type. Pulses superficialis-profundus and excess-efficiency were graded from the diagram.
Seven of the 11 patients in the non-responder group appeared to have a general type of cold. There was, however, no statistical difference between the responders and the non-responders, in their type of cold. All patients in the responder group presented with relatively strong pulses (excess: 1, relative excess: 4, and balance: 5). On the other hand, the strength of pulses in the non-responder group appeared to vary.
If patients with severe asthenia and cold syndrome present with a relatively strong pulse, Seki-gan-ryo may be thought of as discriminating formula.

　　Epidermal growth factor receptor (EGFR) gene mutation examination is now performed in most medical institutions in order to select the molecular targeted medicine for lung cancer. It became clear that the positive rate of the biopsy material was lower than that of the surgical sample in this hospital. The cause was attributed to false negatives due to low tumor cell content in biopsy specimens. We investigated the presence of the mutation using surgical samples and preoperative biopsy specimens from the same patients in 13 cases. Furthermore, we investigated the tumor cell content of the biopsy specimens by cell counting. Results showed that 3 of 6 biopsy specimens that were associated with positive surgical samples were judged to be negative. The tumor cell content was less than 5% in all negative cases. Regarding EGFR gene mutation examination, we should carefully determine tumor cell content when using biopsy specimens.

Background/Aims: Symptoms of irritable bowel syndrome (IBS), a common gut-brain interaction disorder, deteriorate patients’ quality of life and increase medical needs; therefore, IBS represents a significant global burden. The estimated global prevalence is approximately 10%; however, accumulated evidence shows international heterogeneity. In this study, we have described and compared the prevalence of IBS in 3 East Asian countries: Japan (Tokyo and Fukuoka), China (Beijing), and South Korea (Seoul). Methods: We conducted an internet-based cross-sectional survey of the urban population aged > 20 years in the abovementioned countries. We recruited equal numbers of age- (20s-60s) and sex-matched participants (3910 residents). IBS was diagnosed according to the Rome III criteria, and the subtypes were analyzed. Results: The overall prevalence of IBS with 95% CI was 12.6% (11.6-13.7); the prevalence was significantly different across Japan, China, and South Korea (14.9% [13.4-16.5], 5.5% [4.3-7.1], and 15.6% [13.3-18.3], respectively) (P < 0.001). Furthermore, 54.9% of patients were male. IBS-mixed was the most prevalent subtype; the prevalence of other subtypes varied. Conclusions The overall prevalence of IBS in the 3 countries was slightly higher than the global prevalence, and it was significantly lower in China than in Japan and South Korea. IBS prevalence was the highest and lowest among individuals in their 40s and 60s, respectively. Male individuals had a higher prevalence of IBS with diarrhea. Further studies are needed to elucidate the factors associated with this regional heterogeneity.

Academic dissertations on Kampo medicine have a certain peculiarity about them, when they are drawn up by the rules of western medical writing. Compared to western medicine, oriental medicine tends to employ more subjective terms, because of its many humanistic elements.Study objectives, methods, results and discussions however, need to be stated objectively in a way that makes a paper easy to understand for both referees and readers. Although it would be ideal to use designated terms when making objective statements, there are in fact many terms that have multiple meanings, which need to be clarified in a paper. And when presenting new evidence, one must declare how far any problems have been resolved, as clearly as possible.We have explained the recent changes to our regulations for contributors, regarding Kampo formulae naming conventions, abstract word counts, and contributions by mail. Here we discuss how our editing work proceeds, and our thoughts on how papers are re-reviewed or rejected.
Medicine, Kampo ; Medicine ; Academic Dissertations [Publication Type] ; counts ; Review [Publication Type]

Three ultrasound parameters-broad band ultrasound attenuation (BUA), speed of sound (SOS) through the heel and average of standardized BUA and SOS (stiffness)-were measured with a LUNAR Achilles system (Lunar Corporation, Madison, WI, USA) in 9459 normal Japanese women (mean±SD 54.7±11.3yr, 15-90 yr) who have no history of ovariectomy, and 260 men (58.1±16.5 yr, 15-86 yr).
The bone mass values peaked in women aged 15-17 years (BUA 116±9, SOS 1572±23 and stiffness 97±11), and in men aged 15-16 (SOS 1590±20, stiffness 107±11) and in the age span 22-29 years (BUA 124±14).
The rates of bone loss were high in women aged 51-55 (stiffness 1.0%/yr), significantly high in the women who had been menopausal for less than 5 years (stiffness 2.0% yr).
We compared the mean values of the parameters in women with early menopause (≤45 yr) and late menopause (≥53 yr) more than 5 years after the menopause. In the early menopausal women, the mean BUA values at age 58-62, and those of BUA, SOS and stiffness at age 63-67 were significantly low (P<0.02) compared with the age-matched values in the late menopausal women, whereas no significant difference was observed between those in either of the two groups after 68 years of age.
There were significantly positive correlations between the 3 ultrasound parameters and height, body weight and obesity index, but SOS was not significantly correlated with body mass index.
These results indicate that the maximal bone mass in the os calcis is attained in very young women aged 17 or less and that loss in the calcaneus bone quality appears to be more dependent on menopause than aging in women 58-67 years old. In the older women, however, the loss of bone seems to be age-related.

Anti-lipopolysaccharide (LPS) antibody administration has the potential benefits of neutralizing and consequently controlling rumen-derived LPS during subacute ruminal acidosis. Four Holstein bulls were used in this crossover study with a 2-week wash-out period. Anti-LPS antibody (0 or 4 g) was administered once daily for 14 days. Significantly lower ruminal LPS and higher 1-h mean ruminal pH were identified in the 4 g group. However, blood metabolites, acute-phase proteins, cytokines, and hepatic transcriptomes were not different between the two groups. Therefore, anti-LPS antibody administration mitigated ruminal LPS release and pH depression without accompanying responses in acute-phase inflammation or hepatic transcriptomic expression.

Anti-lipopolysaccharide (LPS) antibody administration has the potential benefits of neutralizing and consequently controlling rumen-derived LPS during subacute ruminal acidosis. Four Holstein bulls were used in this crossover study with a 2-week wash-out period. Anti-LPS antibody (0 or 4 g) was administered once daily for 14 days. Significantly lower ruminal LPS and higher 1-h mean ruminal pH were identified in the 4 g group. However, blood metabolites, acute-phase proteins, cytokines, and hepatic transcriptomes were not different between the two groups. Therefore, anti-LPS antibody administration mitigated ruminal LPS release and pH depression without accompanying responses in acute-phase inflammation or hepatic transcriptomic expression.

Background: The relationships between the postpartum subacute ruminal acidosis (SARA) occurrence and predicted bacterial functions during the periparturient period are still not clear in Holstein cows. Objectives: The present study was performed to investigate the alterations of rumen fermentation, bacterial community structure, and predicted bacterial functional pathways in Holstein cows. Methods: Holstein cows were divided into the SARA (n = 6) or non-SARA (n = 4) groups, depending on whether they developed SARA during the first 2 weeks after parturition.Reticulo-ruminal pH was measured continuously during the study period. Reticulo-ruminal fluid samples were collected 3 weeks prepartum, and 2 and 6 weeks postpartum, and blood samples were collected 3 weeks before, 0, 2, 4 and 6 weeks postpartum. Results: The postpartum decline in 7-day mean reticulo-ruminal pH was more severe and longer-lasting in the SARA group compared with the non-SARA group. Changes in predicted functional pathways were identified in the SARA group. A significant upregulation of pathway “PWY-6383” associated with Mycobacteriaceae species was identified at 3 weeks after parturition in the SARA group. Significantly identified pathways involved in denitrification (DENITRIFICATION-PWY and PWY-7084), detoxification of reactive oxygen and nitrogen species (PWY1G-0), and starch degradation (PWY-622) in the SARA group were downregulated. Conclusions The postpartum SARA occurrence is likely related to the predicted functions of rumen bacterial community rather than the alterations of rumen fermentation or fluid bacterial community structure. Therefore, our result suggests the underlying mechanisms, namely functional adaptation of bacterial community, causing postpartum SARA in Holstein cows during the periparturient period.

Some gel types have been reported to prevent left ventricular (LV) remodeling in myocardial infarction (MI) animal models. In this study, we tested biodegradable thermoresponsive gels. Poly(L-lactic acid)-poly(ethylene glycol) (PLLA-PEG) and poly(D-lactic acid)-poly(ethylene glycol) (PDLA-PEG) were synthesized by the polycondensation of Land D-lactic acids in the presence of PEG and succinic acid. Each of these block copolymers was used to prepare particles dispersed in an aqueous medium and mixed together to obtain a PLLA-PEG/PDLA-PEG suspension, which was found to show a sol-to-gel transition around the body temperature by the stereocomplex formation of enantiomeric PLLA and PDLA sequences. In the present study, the G' of the PLLA-PEG/PDLA-PEG suspension in the rheological measurement remained as low as 1 Pa at 20 ℃ and increased 2 kPa at 37 ℃. The sol-gel systems of PLLA-PEG/PDLA-PEG might be applicable to gel therapy. The effect of the PLLA-PEG/PDLA-PEG gel injection was compared with that of a calciumcrosslinked alginate gel and saline in a rat MI model. The percent fractional shortening improved in the PLLA-PEG/ PDLA-PEG (20.8 ± 4.1%) and alginate gel (21.1 ± 4.8%) compared with the saline (14.2 ± 2.8%) with regard to the echocardiograph 4 weeks after the injection (p<0.05). There were reduced infarct sizes in both PLLA-PEG/PDLA-PEG gel and alginate gel compared with the saline injection (p<0.05). Moreover, a greater reduction in LV cavity area was observed with the PLLA-PEG/PDLA-PEG gel than with the alginate gel (p = 0.06). These results suggest that the PLLA- PEG/PDLA-PEG gel should have high therapeutic potential in gel therapy for LV remodeling after MI.
Animals ; Body Temperature ; Gels ; Lactic Acid ; Models, Animal ; Myocardial Infarction* ; Rats* ; Succinic Acid ; Ventricular Remodeling*

BACKGROUND/AIMS: Few reports have described the long-term treatment outcomes of the anti-tumor necrosis factor-α antibody for Japanese Crohn’s disease (CD) patients. The aim of this study was to evaluate them and clarify the clinical factors that affect the long-term prognosis of the anti-tumor necrosis factor-α treatments. METHODS: This was a retrospective, observational, single-center cohort study. Japanese CD patients treated with either infliximab or adalimumab as a first-line therapy were analyzed. The cumulative retention rates of the biologics, relapse-free survival, and surgery-free survival were analyzed using Kaplan-Meier methods. The clinical factors associated with the long-term outcomes were estimated by both the log-rank test and Cox proportional hazard model. RESULTS: The cumulative retention rate was significantly higher in the group with a concomitant elemental diet of ≥900 kcal/day, baseline C-reactive protein (CRP) levels < 2.6 mg/dL, and baseline serum albumin levels ≥3.5 g/dL, respectively. The baseline serum albumin levels were also associated with both relapse-free and surgery-free survival. The lack of concomitant use of an elemental diet ≥900 kcal/day was identified as the only independent risk factor for the withdrawal of the biologics. CONCLUSIONS: Baseline CRP levels and serum albumin levels could affect the long-term outcomes in CD patients. Concomitant elemental diet of ≥900 kcal/day could have a positive influence on clinical treatment course.
Adalimumab ; Antibodies ; Asian Continental Ancestry Group ; Biological Products ; C-Reactive Protein ; Cohort Studies ; Crohn Disease ; Food, Formulated ; Humans ; Infliximab ; Necrosis ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Serum Albumin