Ovomucoid (OMC) is the most prominent allergen causing hen's egg allergy, containing disulfide (S-S) bonds that may be responsible for its allergic action. As S-S bonds may be reduced during electrolysis, this study was undertaken to evaluate modulation of the allergic action of OMC after electrolysis. Electrolysis was carried out for 1% OMC containing 1% sodium chloride for 30 minutes with a voltage difference of 90 V, 0.23 A (30 mA/cm2). Protein assays, amino acid measurement, and mass spectrometry in untreated OMC and OMC on both the anode and cathode sides after electrolysis were performed. Moreover, 21 patients with IgE-mediated hen's egg allergy were evaluated by using the skin prick test (SPT) for untreated OMC and OMC after electrolysis. The allergic action of OMC was reduced after electrolysis on both the anode and cathode sides when evaluated by the SPT. The modifications of OMC on electrolysis caused the loss of 2 distinct peptide fragments (57E-63K and 123H-128R) as seen on matrix-associated laser desorption/ionization time-of-flight mass spectrometry. The total free SH groups in OMC were increased on the cathode side. Although the regions of S-S broken bonds were not determined in this study, the change in S-S bonds in OMC on both the anode and cathode sides may reduce the allergenic activity.
Egg Hypersensitivity ; Electrodes ; Electrolysis* ; Humans ; Mass Spectrometry ; Ovomucin* ; Peptide Fragments ; Skin ; Sodium Chloride

Episodic angioedema with eosinophilia (EAE) is an idiopathic condition characterized by recurrent symptoms such as angioedema, urticaria, and eosinophilia. We report a case of a 25-year-old woman with the non-episodic variant of this condition (NEAE) who was treated with acupuncture.
The patient presented with a two-week history of generalized itching and angioedema. Erythema, bilateral limb edema, and swelling and pain of both wrists and ankles were noted. As antiallergic medication administered for several days was ineffective, she was admitted to our hospital. Hematologic investigations revealed a white blood cell count of 11850/mm³ with 64.2% eosinophils (7610/mm³). Histopathologic examination of a cutaneous biopsy specimen indicated an eosinophilic infiltration localized around blood vessels in the superficial dermal layers. NEAE was diagnosed on the basis of these findings. Acupuncture treatment was performed according to Traditional Chinese Medical theory. Itching was alleviated following acupuncture treatments and relapsed on days when acupuncture was not administered. However, edema and itching gradually diminished between acupuncture treatments, in parallel with resolution of the peripheral eosinophilia. In this case, acupuncture treatment was effective for alleviating itching in NEAE.

[Objective] It is necessary to administer anti-cholinergic agents or glucagon during gastroscopy for inhibition of gastric peristalsis. However, application of these drugs are limited in patients with glaucoma, hypertension, benign prostate hyperplasia, heart disease, or diabetes mellitus because of possible adverse events.
Based on the report that acupuncture stimulation at CV 12 (Zhonguan, Chukan) inhibited gastric activity, we studied whether the acupuncture at CV 12 could be applicable as an alternative to these drugs.
[Method] Subjects in the present study were 60 patients who underwent gastroscopy at Meiji University of Oriental Medicine Hospital. They were allocated into two groups; acupuncture group (mean [SD] age, 66 [10]) and drug group (mean [SD] age, 64 [13])
Patients in the acupuncture group were given manual stimulation at CV 12 with an acupuncture needle for 10 minutes before examination and during gastroscopy.
After examination, a gastroscopist evaluated the magnitude of the peristalsis and disturbance during the examination using the visual analogue scale (VAS) and a 4-grade categorical scale.
Patients in the drug group were pre-administered anti-cholinergic drug or glucagon, and evaluated with the same scale.
[Results and Discussion] Inhibition score in the acupuncture group was lower but not statistically significant, as compared with the drug group, and the effect of acupuncture stimulation was acceptable to allow examination of the patients without severe disturbance.
Acupuncture may be a useful non-pharmacologic alternative to anti-cholinergic drugs and glucagon to inhibit gastric movement during gastroscopy, when these drugs could not be administered.

[Background/aim] Irritable bowel syndrome (IBS) is one of the most common gastrointestinal disorders, affecting more than 15 % of Western populations. It is characterized by a wide variety of persistent symptoms (abdominal pain or discomfort, bloating, transit disorders) without any clear organic causes. Because medical treatments are sometimes ineffective, some patients with IBS seek alternative therapies to manage the condition. The aim of the present study was to investigate the clinical effect of acupuncture treatment in patients with IBS.
[Method] Four patients with IBS were treated with acupuncture according to the way of Traditional Chinese Medicine. We employed reversal single-case study design in which an acupuncture treatment period (“period B”) was alternated with no treatment period (“period A”). Ten or twenty times acupuncture therapies were performed during the “period B” and the length of the “period A” was comparable with the “period B” GSRS, frequency of defecation, softness of the stool, intensity of abdominal pain or abdominal fullness, and POMS were recorded over the periods.
[Results] During the “period B”, three patients showed a remarkable improvement in lower abdominal pain, abdominal fullness and QOL evaluated with GSRS, while the psychological condition evaluated with POMS showed inconsistent changes without a remarkable improvement.
[Conclusion] The result of our study indicated that acupuncture might be useful for the management of IBS.

[Background] Elderly people often have disturbances of bowel habits, including irritable bowel syndrome (IBS). IBS is one of the most common gastrointestinal disorders, affecting more than 15% of the general population. It is characterized by a wide variety of persistent symptoms (abdominal pain or discomfort, bloating, transit disorders) without any clear organic causes. Because medical treatments are sometimes ineffective, some patients with IBS seek alternative therapies to manage the condition. There is very little research examining IBS in the elderly. We report two elderly patients with IBS successfully treated with acupuncture.
[Cases and Methods] A 72-year-old woman and an 88-year-old man with IBS were treated with acupuncture according to theory of traditional Chinese medicine. Gastrointestinal Symptoms Rating Scale (GSRS), frequency of defecation, softness of the stool, intensity of abdominal pain or abdominal fullness were recorded over the periods.
During the treatment period, both patients showed a remarkable improvement in lower abdominal pain, bloating and quality of life evaluated with GSRS.
[Result and Discussion] In both cases, acupuncture treatment was effective for alleviating abdominal symptoms with IBS. The result of these cases indicated that acupuncture might be useful for the management of the condition with elderly IBS.

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.

A 69-year-old man, who had undergone coronary artery bypass grafting using the right gastroepiploic artery 2 years previously, was hospitalized with acute epigastralgia. Gastroscopy showed an early gastric cancer in the greater curvature of the corpus and ultrasonography of the abdomen revealed acute cholecystitis due to a stone impacted in the cystic duct. The subtotal gastrectomy and the cholecystectomy with preservation of the right gastroepiploic artery graft were performed. The surgical margin of the resected specimen was negative for cancer. The postoperative course was uneventful. After coronary artery bypass grafting using the right gastroepiploic artery, annual gastroscopy is recommended.

Irritable bowel syndrome (IBS), one of the most common gastrointestinal disorders, and is common in childhood. It is characterized by abdominal pain or discomfort with no organic or metabolic etiology. The abdominal pain and discomfort are associated with changes in defecation or stool form. We report a pediatric patient with IBS, who was successfully treated with acupuncture and moxibustion.
The patient was a 10-year-old girl, who had developed IBS 3 years previously. She had abdominal pain accompanied by bowel movements with soft stool five times per day. The patient was treated with acupuncture and moxibustion according to the theories of traditional Chinese medicine. In addition, we used the Gastrointestinal Symptoms Rating Scale (GSRS) to evaluate her quality of life. She received acupuncture and moxibustion treatment at two sessions/week during the first 6 weeks, followed by only one session/week later. One month after the treatment was started, her GSRS score began to improve and her abdominal pain and bowel movements were reduced. Compared with baseline, her GSRS score was improved at 2 months and 1 year after the acupuncture was started. In conclusion, acupuncture and moxibustion treatment was effective in the present pediatric IBS patient.

[Objective]There are few reports of inpatients who received acupuncture treatment in departments of internal medicine in Japan. The aim of this analysis is to clarify such information by reviewing patients who received acupuncture treatment during admission to our department of internal medicine at Gifu University Hospital. Our department is organized into three subdepartments of cardiology, respirology, and nephrology.
[Methods]We surveyed the chief complaint for acupuncture treatment, basic disease for admission and the number and period of acupuncture treatment of inpatients who received acupuncture treatment in our department from July 2004 through March 2007.
[Results]Two hundred and sixty-six patients received acupuncture treatment and they had 429 symptoms.
The chief complaint was the side effects of chemotherapy for cancer treatment (n = 84), that is, nausea, anorexia, dysethesia and so on. Other symptoms were dyspnea or shortness of breath (n = 49), pain originating from cancer (n = 38), pain originating from skeletal muscle (n = 38), anorexia (n = 25), and general fatigue (n = 18). Several symptoms were cough, edema, constipation or diarrhea, conscious disturbance, insomnia, paralysis, etc.
Of the chief complaints, 86.4%were closely connected with diseases or treatments for admission.
The mean number of patients who received acupuncture was 10.0/day. This was equal to about 20%of all patients (53beds) per day in our department.
[Conclusion]There were many patients whose chief complaints for acupuncture were closely connected with disease for admission. It is suggested that acupuncture treatment is accepted as one of treatments of internal medicine for inpatients in our department.

The purpose of the present study was to discuss the effects of risedronate on osteoarthritis (OA) of the knee by reviewing the existing literature. The literature was searched with PubMed, with respect to prospective, double-blind, randomized placebo-controlled trials (RCTs), using the following search terms: risedronate, knee, and osteoarthritis. Two RCTs met the criteria. A RCT (n = 231) showed that risedronate treatment (15 mg/day) for 1 year improved symptoms. A larger RCT (n = 1,896) showed that risedronate treatment (5 mg/day, 15 mg/day, 35 mg/week, and 50 mg/week) for 2 years did not improve signs or symptoms, nor did it alter radiological progression. However, a subanalysis study (n = 477) revealed that patients with marked cartilage loss preserved the structural integrity of subchondral bone by risedronate treatment (15 mg/day and 50 mg/week). Another subanalysis study (n = 1,885) revealed that C-terminal crosslinking telopeptide of type II collagen (CTX-II) decreased with risedronate treatment in a dose-dependent manner, and levels reached after 6 months were associated with radiological progression at 2 years. The results of these RCTs show that risedronate reduces the marker of cartilage degradation (CTX-II), which could contribute to attenuation of radiological progression of OA by preserving the structural integrity of subchondral bone. The review of the literature suggests that higher doses of risedronate (15 mg/day) strongly reduces the marker of cartilage degradation (CTX-II), which could contribute to attenuation of radiological progression of OA by preserving the structural integrity of subchondral bone.
Animals ; Calcium Channel Blockers/pharmacology/*therapeutic use ; Cartilage/drug effects ; Diphosphonates/therapeutic use ; Etidronic Acid/*analogs & derivatives/pharmacology/therapeutic use ; Humans ; Osteoarthritis, Knee/*drug therapy