We have been successful in preventing induced cavities in rats using acupuncture stimulation. In order to more profoundly understand one aspect of that preventative mechanism, we studied rises in natural antibody values and special antibody values using the Jerne method. In so doing, we proved that when D-phenylalanine (DPA) is administered 30 minutes proir to acupuncture stimulation the rise which occurrs in antibody counts with acupuncture is great and the duration of the period of increase is lengthened. Such reports about acupuncture effects on the living body are many. That acupuncture strengthens the stability of the living body is an unquestionable fact.
In an effort to study the preventative effects of acupuncture or acupuncture supplemented by DPA, we performed the following experiment. We planted Sarcoma-180, a homotransplantable tumor which often displays an immune resistant effect in mice and observed the immunity level rises produced by acupuncture and acupuncture supplemented by the administration DPA.
ICR mice (male, 3 weeks old) were divided into 5 groups: I-control grop, II-treatment with carboxymethyl cellulose sodium (CMC) III-treatment with CMC and DPA, IV-treatment with CMC and acupuncture, V-treatment with CMC, DPA and Acupuncture
Sarcoma-180 cells were administered to all the rats subcutanously in a ratio 10⁶ cells/0.1ml after which cells were administered every 3rd day for a total of 4 times. DPA combined with 1% CMC was administered into the abdominal cavity in a concentration of 250mg/kg.
All of the mice were sacrificed on the 13th following the cancer transplant and the weight of the cancer, the liver and the spleen measured. Upon examinig for significant differences it was found that sigificant differences were indicated between Groups I and III, and I and V with a 1% danger rate, and I and IV with a 5% rate of danger. No signicant differnce was obseved between I and II.
It can be said that in the mice which received the Sarcoma-180 transplants macrophage funcctional insufficiency occured in a relatively early stage with decreased T lymph corpuscle functions occuring in the later stages. It can be assumed that in the process of interference with the functional in sufficiency, a preventative effect comes into play. In future studies we'd like to investingate the meaning of acupuncture for resistance to infection, etc.

Introduction: Amyloidosis is a variety of symptoms, such as organ failure and peripheral neuropathy amyroid protein is deposited in the systemic organs. We report a case of ketamine was effective for vulba referred pain in end stage. Case report: A 72-year-old male patient in end-stage primary generalized amyloid light-chain amyloidosis experienced excruciating pain in his genitalia about four times daily, lasting from tens of seconds to three minutes. No abnormal findings were noted in the genitalia. Bowel movement and large amounts of peritoneal dialysis fluid triggered excessive traction of the glans penis, which caused the excruciating pain. Referred pain originating from the pelvic plexus was suspected. Continuous infusion of ketamine was started at 50 mg/day for pain relief, which eliminated his pain, and the patient passed away 17 days later. Conclusion: The reason a small dosage of ketamine was effective, we consider there is a possibility of recovery from central sensitization effect of NMDA receptor antagonist worked effectively.

Objectives : A pharmacotherapeutic system for safe and proper use of warfarin was developed through physician-pharmacist cooperative practice ; its effects on patient adherence to therapeutic regimens and the therapeutic benefit of warfarin were assessed.
Methods : Subjects were 12 outpatients or home-care patients receiving warfarin. Patients' level of understanding of warfarin therapy and time in therapeutic range (TTR) were used as indices of adherence and therapeutic benefit, respectively. Before the physician examination, patients were interviewed by pharmacists using point-of-care testing with the CoaguChek ^®XS to check their prothrombin time-international normalized ratio (PT-INR). Pharmacists reported status of warfarin administration, any adverse effects, and medication management status to each patient's physician using the medication record or inter-institute information exchange sheet. Patient adherence was assessed before and after the pre-examination interview and changes in TTR were evaluated.
Results : Levels of understanding of warfarin therapy were significantly higher after pharmacists provided medication counseling (immediately before 4.8±1.9 vs 24 weeks after 6.8±2.4 ; P=0.0079, Wilcoxon signed-rank test). TTR significantly improved at 24 weeks after the interview (pre-interview 20.9±29.8% vs post-interview 60.5±30.5%, respectively ; P=0.0024, Wilcoxon signed-rank test).
Conclusion : The results suggest that patients'adherence to warfarin regimens and the therapeutic benefit of warfarin is improved by pharmacists'obtaining information on PT-INR before patients'medical examinations, as well as by utilizing this information to establish a cooperative pharmacotherapeutic system for good TTR management, as supported by a common protocol across pharmacies and medical institutions.

Our aim was to study the scan protocol of 16 DAS (Data Acquisition System) multidetector-row CT (MDCT) and to ascertain whether we could reduce radiation exposure and scanning time, while maintaing image quality in the Virtual endoscopy (VE).We made a mimic gastrointestinal tract and examined the result by changing a scan protocol of 16 DAS MDCT.We found that a reduction of radiation exposure and scanning time depended on slice width, angle of the table, rotation time, table speed, mAs/slice and resolution.The study confirmed that it was possible to use the scan protocol of MDCT with a radiographic dose of 40% and scanning time of 50%, without changing image quality in the VE.
Radiation ; amsonic acid ; Protocols documentation ; Endoscopy ; Accident due to exposure to weather conditions

Background
The national tuberculosis (TB) control program established Phnom Penh as a pilot area for TB and human immunodeficiency virus (HIV) infection collaborative activities because of the high prevalence of HIV among patients with TB.
Process
In 2005, we provided transportation fees so that patients could travel to an operational district referral hospital for HIV counseling and testing by dispatched counselors. However, only around 10.3 patients with TB (range 0-21) per month in all 4 operational districts made use of this service. In 2006, we modified the program by providing HIV counseling and testing by four trained TB/HIV coordinators in TB wards. Thereafter, in-depth, individual, semi-structured interviews were conducted with the TB staff (not the coordinators) of 18 health facilities from April through November 2006 to identify problems in the current TB/HIV collaborative activities in Phnom Penh and to investigate ways for further improving the program.
Results
TB staff members encouraged their patients to undergo an HIV test under directly observed treatment, short course. Some TB staff lacked confidence to discuss HIV issues because they lacked sufficient HIV/ acquired immunodeficiency disease syndrome (AIDS) knowledge. Furthermore, there was no formal referral structure between TB and HIV services or sharing of information on the treatment of patients co-infected with TB/HIV with the antiretroviral treatment clinic.
Conclusions
We started the program to enable TB patients to receive HIV counseling and testing at the same venue as they received TB treatment. However, problems such as low confidence among TB staff in discussing HIV/AIDS and weak collaboration between TB and HIV services were identified. We found that training of TB staff, development of Information, Education and Communication (IEC) materials, regular meetings among stakeholders, and encouragement for the TB/HIV coordinators to supervise all TB/HIV activities in their operational districts were needed to improve the program.

Purpose: From shortly after the fentanyl patch became commercially available, we have been using it as part of our armamentarium for cancer therapy to produce a reliable analgesic effect from the active treatment period to the terminal stage in patients who are expected to develop resistance to oral analgesics. To confirm the usefulness of fentanyl patch, a retrospective study was conducted to determine its efficacy and safety. Method: A survey was conducted of 28 cancer patients who were undergoing pharmacological pain control. The following parameters were recorded: opioids administered prior to fentanyl patch use, reasons for switching to fentanyl patch, duration of administration and dosage of fentanyl patch, pain score before switching to fentanyl patch, adverse effects (nausea, vomiting, constipation and drowsiness), and the results of clinical tests. Results: The major reasons for switching to fentanyl patch were: "pain control with oral agents was expected to become difficult in future" and "adverse effects of chemotherapy were noted or were likely to develop". The mean duration of fentanyl patch use was 133 days, during which time the pain score and the constipation symptom were significantly reduced. No significant difference was found with nausea, vomiting, drowsiness or the results of clinical tests. Conclusion: It is concluded that fentanyl patch is a highly useful opioid for analgesia when administered during chemotherapy for cancer and continued to the terminal stage.

  To the best of our knowledge, there are few reports on acquirement of medical skills of infection control using a scenario simulation program. We report the development of a education program using scenario-based simulation named Infection Control Training Course （ICTC）. The three main aims of this course are basic comprehension of standard precautions and contact precautions, acquirement of skills for wearing and removal of personal protective equipment （PPE）, and precise selection of PPE for various situations.
・For the materials and methods, 225 medical staff members taking part in the ICTC at TMU participated in the study. Investigations using a questionnaire about standard precaution, contact precaution and PPE selection were carried out for the pre-course and post-course of the day. In addition, the satisfaction level was evaluated using free score text.
・The return rates of the completed questionnaire for investigating these areas were 88.4% （pre-course） and 95.1% （post-course）. Among all the items investigated, improvements were verified statistically （Wilcoxon signed-rank test）. The satisfaction level was 94.7 ± 9.4 points.
・In conclusion, the ICTC was considered to be effective for acquiring medical skills of infection control, particularly basic comprehension regarding standard precaution, contact precaution and precise PPE selection using a scenario simulation program.

OBJECTIVETo study the process in vivo of the components in the precipitation of Xiexin decoction.

METHODThe components in the rats' urine samples after oral administration of baicalin, single herb decoction of Radix Scutellariae or the precipitation of Xiexin decoction were analyzed by LC-MS-MS method; and the absorption of baicalin in different samples were calculated by intestinal in situ loop method.

RESULTThe urinary excretion amounts of baicalin in three samples were not obviously different, whereas the time reach elimination-peak of baicalin in them had significant difference. The absorption of baicalin in the precipitation was obviously greater than that in the single herb decoction and single baicalin. We found that wogonoside and 7-O-glucuronide chrysin were the metabolites presenting in the rat urine samples after oral administration of baicalin by LC-MS-MS, which had never been reported.

CONCLUSIONThe resident time in the body of baicalin in the precipitation is prolonged, compared with that in the single herb decoction and single baicalin. The metabolites may be the potential biological components in vivo of baicalin in the precipitation.

Administration, Oral ; Animals ; Chemical Precipitation ; Coptis ; chemistry ; Drug Combinations ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; pharmacokinetics ; pharmacology ; Flavanones ; metabolism ; Flavonoids ; pharmacokinetics ; urine ; Glucosides ; metabolism ; Male ; Plants, Medicinal ; chemistry ; Rats ; Rats, Wistar ; Rheum ; chemistry ; Scutellaria baicalensis ; chemistry

  In Japan, few health care professionals have a basic understanding（core competency）of the design of clinical research and statistical analysis. We developed a blended distance–learning program comprising face–to–face lectures with e–learning for busy health care professionals who work in the clinical settings to achieve core competency in clinical research. The purpose of this study was to examine the educational effects of this program.
1）Four months after the end of the program, 64％ of the participants had started to conduct clinical research.
2）This program may increase the number of research colleagues that can discuss clinical research.
3）This program could enhance the confidence（self–efficacy）of health care professionals in clinical research.

  The Association of Radiologists under the umbrella of the Hokkaido Prefectural Federation of Agricultural Cooperatives for Health and Welfare (Hokkaido Koseiren) set up in 2003 a committee with the aim of improving the accuracy of mass health examinations. Recently, the committee reviewed the results of abdominal examinations by sonography performed at the eight hospitals affiliated with the Koseiren during fiscal 2006 that ended March 31, 2007. Of those individuals who underwent thorough health checkups, 91.3% had their abdomen examined by ultrasound. Something anomalous was detected in 68.1% of the examinees and 4.5% needed to undergo closer checkups, the rate of response to which was 74.5%. The detection ratio of cancer by ultrasonography was worked out at 0.048%. The ratio of patients requiring a closer exam to the total and the cancer detection ratio varied widely from hospital to hospital. The wide dispersion was ascribable to the difference in the standard of judgment for indicating closer examinations and the difference in the number of examinees so far as the cancer detection ratio was concerned, from hospital to hospital. A look at the primary findings of anomalies revealed that fatty liver topped the list accounting for 27.4% followed by cholelithiasis with 3.6%. From this, we realized that the abdominal examinations by sonography served to detect cancer and lifestyle-induced health problems as well. Organ-wise, the cancer cases found during the period from 1998 to 2009 broke down as follows: kidney (79 cases), liver (40 cases), pancreas (30 cases), gall bladder (24 cases), others (8 cases) and spleen (none). The cancer detection ratio per year ranged from 0.03 to 0.05% during the period.