By means of indirect sphygmomanometer called “volume compensation technique” systolic and diastolic blood pressure in finger arteries were noninvasively and continuously measured during and after the “doshi” which is the acupuncture of the carotid sinus. After 15-min resting, 2-min puncture of the right and left carotid sinus was carried out in 23 healthy subjects (8 males and 15 females, aged 18-55). Finger arterial blood pressure was measured during the rest and the in-situ puncture, and then at 30 minutes after the withdrawing. For the control the dodged puncture of the carotid sinus was also made in other 6 healthy subjects (2 males and 4 females, aged 23-55).
Decreasing in blood pressure were observed during and after the doshi in 87% of the subjects. The mean magnitude of the decrease in the systolic and diastolic pressure at 15-21 minutes after the withdrawal of the needle were 12 and 10mmHg, respectively. Pulse pressure and heart rate showed little changes during the experiment. To the control dodged puncture, the maximum change in the systolic and diastolic pressure were 3.4 and 5.0mmHg, respectively, which were within the range of the physiological blood pressure variation. These data suggests that the blood pressure response to the “doshi” may not be induced by the vagal cardiac inhibition but by the change in peripheral vascular resistance.

During and after the “Toshi” which is the acupuncture of the carotid sinus, systolic and diastolic blood pressure were measured in the basal pharanx of finger arteries by means of indirect sphygmomanometer called the “volume compensation method”. After 15 minutes resting, 2 minutes acupuncture on both sides of the carotid sinus was carried out in 16 hypertensive subjects. Finger arterial pressure showed a significant decrease by about 14mmHg (mean) in systolic pressure and by 9mmHg (mean) in diastolic pressure during and after the acupuncture (p<0.05). The decrease in blood pressure showed a maximum at 15-20 minutes after the withdrawal of needles. Pulse pressure and heart rate did not show a significant change. These results were almost similar to those obtained in normotensive subjects. These data suggests that hypertensive subjects are also responsible to “Toshi” and that this effect may not be caused by the cardiac inhibition refrex but the change in vascular tonus.

During and after the LI4 and LI10 Acupuncture, the volume elastic modulus Ev in the basal phalanx of finger arteries were measured. Ev values were noninvasively obtained using a new type of plethysmograph called the “electric impedance-cuff” which can detect indirect arterial pressure and volume change in the artery. After 15 minutes of rest, 2 minutes acupuncture on LI4 and LI10 were carried out in 16 healthy subjects, respectively. Volume elastic modulus showed a significant decrease (p<0.01) during and after the LI10 Acupuncture. Its decrease were maintained at least 20 minutes after the withdrawal of the needle. While the Ev values did not show the typical change during and after the LI4 acupuncture. These date suggest that the elasticity of the peripheral wall was lagely affected by the LI10 acupuncture, and the effect was caused not only by peripheral reflex but by other factors.

Objective: Crimes related to falsified medicines for medical use are of international concern and becoming increasingly sophisticated. Therefore, in this study, we investigated information on education and training/enlightenment activities on falsified medicines worldwide that are open to the public on the Internet to contribute to medical/pharmaceutical professionals’ and consumers’ education regarding falsified medicines in Japan.Methods: In April 2023, we searched the information written in English and Japanese on education and training/enlightenment activities on falsified medicines using the Internet.Results: We surveyed several countries and obtained important findings. In particular, the World Medical Association (WMA), the International Pharmaceutical Federation (FIP), and the World Health Professions Alliance (WHPA) released programs for healthcare professionals. The US news programs, the US Department of Justice, and the Council of Europe released consumer warning videos. Japan issued the “Guidelines for Good Distribution Practice (GDP)” to the pharmaceutical distribution industry in 2018. Additionally, US and UK medicine regulators and the International Criminal Police Organization (ICPO) offered programs for professionals such as police and customs officers, and public prosecutors.Conclusion: These programs contain useful information not only for medical/pharmaceutical professionals in Japan but also for consumers. However, many are provided by foreign governments or international organizations, while few are from Japan. Therefore, to prevent the distribution of falsified medicine in Japan, educational institutions must further strengthen education and training/enlightenment activities and develop and publish educational tools for falsified medicines.

We provided inpatient rehabilitation treatment and return-to-school guidance to a junior high school student with medulloblastoma and pervasive developmental disorder (autism spectrum disorder). Here we describe the rehabilitation treatment for patients with physical and developmental disabilities. A 13-year-old boy who was diagnosed with pervasive developmental disorder at 4 years of age was able to perform activities of daily living independently and attend junior high school. However, he was admitted to our hospital with new-onset ataxia. Magnetic resonance imaging revealed a cerebellar tumor. After total tumor excision was performed, pathological analysis revealed medulloblastoma, which was treated initially with radiation therapy and then chemotherapy for 1 year. Rehabilitation was initiated 2 days post-surgery. We evaluated his communication abilities. He showed stereotypical behavior owing to the autism spectrum disorder；therefore, we performed low-intensity repetitive exercises. The functional independence measure score at discharge was 67/126 (motor 44/91, cognitive 23/35). We taught his teachers how to properly assist him, and he successfully returned to school post-discharge. Although this was a case in which the child had multiple disabilities, ataxia caused by the medulloblastoma aggravated his developmental disability. Thus, understanding the characteristics of communication and its strengths was vital in determining a treatment plan that enabled his return to school.

We provided inpatient rehabilitation treatment and return-to-school guidance to a junior high school student with medulloblastoma and pervasive developmental disorder (autism spectrum disorder). Here we describe the rehabilitation treatment for patients with physical and developmental disabilities. A 13-year-old boy who was diagnosed with pervasive developmental disorder at 4 years of age was able to perform activities of daily living independently and attend junior high school. However, he was admitted to our hospital with new-onset ataxia. Magnetic resonance imaging revealed a cerebellar tumor. After total tumor excision was performed, pathological analysis revealed medulloblastoma, which was treated initially with radiation therapy and then chemotherapy for 1 year. Rehabilitation was initiated 2 days post-surgery. We evaluated his communication abilities. He showed stereotypical behavior owing to the autism spectrum disorder；therefore, we performed low-intensity repetitive exercises. The functional independence measure score at discharge was 67/126 (motor 44/91, cognitive 23/35). We taught his teachers how to properly assist him, and he successfully returned to school post-discharge. Although this was a case in which the child had multiple disabilities, ataxia caused by the medulloblastoma aggravated his developmental disability. Thus, understanding the characteristics of communication and its strengths was vital in determining a treatment plan that enabled his return to school.

The import of medicines for personal use by physicians for aesthetic-related medical treatments in Japan is limited to cases such as a medical emergency and when substitutes are unavailable in the country. However, the real reasons why doctors import these products and their safety have not been investigated. Therefore, to contribute to future countermeasures, we investigated the circumstances for personal import of these medicines. We found that 60 of 177 (33.9%) physicians in the cosmetic surgery, plastic surgery, and dermatology departments had experience of importing medicines. Although only medically urgent medicines can be imported, 11.7% of physicians who imported medicines cited price differences between Japan and other countries as the reason for importing. Botulinum toxin injections (25.0%) were the most commonly imported medicines. Furthermore, 11 physicians (18.3%) responded that there was some defect in the products. This proportion was significantly higher among physicians who experienced a product efficacy or safety issue (68.8%) than among those who had never experienced it (0.0%) (P<0.001). This survey revealed that the import of aesthetic-related medicines that are not suitable for personal import is rampant. In addition, there could be an association between the defects of these products and their efficacy/safety. Therefore, to prevent health damage caused by these medicines, it is important to strengthen the regulatory system for collecting and providing information to ensure thorough confirmation (regarding specifications and package insert) at the time of delivery and use in patients and to tighten administrative checks about reasons for import.

Owing to the fear of worsening their relationship with physicians, several pharmacists hesitate to contact physicians regarding prescription-related questions. We investigated the personal factors of pharmacists contributing to their hesitation to contact physicians regarding prescription-related questions. We analyzed the responses of 213 pharmacy pharmacists. A comparison of the degree of hesitation to contact physicians regarding prescription-related questions revealed that the most hesitant questions were pertaining to “the same prescription content from before”; insurance questions (3.37) were higher than medical questions (3.20) (P＝0.006). The multiple regression analysis results revealed that “pharmacy work is busy and there is no time” was influenced by regular employees (medical (β＝−0.181, P＝0.030) and insurance (β＝−0.257, P＝0.002)). “A co-pharmacist said no questions needed” was influenced by the sex of pharmacists (medical (β＝0.194, P＝0.011) and insurance (β＝0.177, P＝0.020)). Overall, type of questions (medical or insurance) and individual backgrounds (prescription issuing medical institution, pharmacy scale, location, age, sex, employment type, years of service, current management pharmacist, and hospital work experience) have a complex effect on the pharmacists’ psychology. To facilitate pharmacists to contact physicians regarding prescription-related questions, physicians and pharmacists should share information and communicate on a daily basis, such as actively participate in joint training programs. It is also important to create an environment where regular employees and female pharmacists can work comfortably. The smooth resolution of prescription-related questions by relieving the psychological pressure of pharmacists will improve patient safety.