Kampo medicine has been incorporated into Japan's medical curriculum nationwide. However, it has not been adopted into its postgraduate medical education. The present study assessed Kampo medicine educational needs for residents in Japanese postgraduate training programs. A questionnaire-based survey was conducted in residents at Japanese Red Cross Ishinomaki Hospital, regarding their experience in prescribing Kampo formulae and the Kampo medicine curriculum they expect in their postgraduate education. Twenty-one residents completed the questionnaires. Seventy-five percent of junior and all senior residents had used Kampo medications. They were mostly provided with on-the-job instruction by attending doctors, senior residents, and fellows during their residency rotations. All residents needed Kampo medicine education opportunities. They expected guidance with respect to the basics of Kampo medicine, and the treatment of common diseases with Kampo formulae. The results of our study demonstrates that residents believe Kampo medicine education should be provided in postgraduate training programs.

The number of patients with novel coronavirus infections (COVID-19) continues to increase with Omicron now the predominant strain, even amidst the three-dense (close-in, dense, and close-out) avoidance and vaccination strategies. In collaboration with the local government, Tohoku University Hospital has provided a large-scale vaccination center, drive-through outpatient PCR testing clinic, outpatient assessment, support for management of residential care facilities for the mildly ill, support for elderly care facilities, and an antibody cocktail center, to minimize deaths due to COVID-19. In residential care facilities for the mildly ill and others in need of medical support, we established an information sharing and house call system. Furthermore, we developed DX in cooperation with a wide-area IT system and have so far continued to achieve zero fatalities in residential care facilities. In addition, the Japanese Society for Oriental Medicine has conducted clinical research using Kampo medicine for the prevention of disease onset, treatment in the acute stage, and treatment of prolonged symptoms, with results suggesting that Kampo medicine has some effect in reducing disease severity in the acute stage. The COVID-19 response is a long-term effort to update the knowledge and techniques in Western, traditional, and Future Medicine. The response and updating of combined knowledge and skills will continue over the longterm. It is also necessary to continue to disseminate and share information among various professions, and give back information in the field and make steady and continuous efforts among multiple professions.

Europe has a long history with its own traditional medicines. In Germany, the practice of traditional European and Asian medicine along with modern medicine is called Integrative Medicine. The pain clinics at Munich University, TCM Klinik Bad Kotzting, Immanuel Klankenhaus and Zen Haus Klinik are well-known centers of Integrative Medicine in Germany. We visited these hospitals and clinics and report on the state of their treatment.
Four-week programs in chronic pain, traditional Chinese medicine, natural therapy, and traditional Japanese medicine with aromatherapy are given at these facilities. Moreover, Complementary and Alternative medicines are widely covered by public or private insurance. And one reason for the spread of Integrative Medicine may be these social conditions, in addition to historical background.

CD57 (synonyms: Leu-7, HNK-1) is a well-known marker of nerve elements including the conductive system of the heart, as well as natural killer cells. In lung specimens from 12 human fetuses at 10–34 weeks of gestation, we have found incidentally that segmental, subsegmental, and more peripheral arteries strongly expressed CD57. Capillaries near developing alveoli were often or sometimes positive. The CD57-positive tissue elements within intrapulmonary arteries seemed to be the endothelium, internal elastic lamina, and smooth muscle layer, which corresponded to tissue positive for a DAKO antibody reactive with smooth muscle actin we used. However, the lobar artery and pulmonary arterial trunk as well as bronchial arteries were negative. Likewise, arteries in and along any abdominal viscera, as well as the heart, thymus, and thyroid, did not express CD57. Thus, the lung-specific CD57 reactivity was not connected with either of an endodermal- or a branchial arch-origin. CD57 antigen is a sugar chain characterized by a sulfated glucuronic acid residue that is likely to exist in some glycosphingolipids. Therefore, a chemical affinity or an interaction might exist between CD57-positive arterioles and glycosphingolipids originating from alveoli, resulting in acceleration of capillary budding to make contact with the alveolar wall. CD57 might therefore be a functional marker of the developing air-blood interface that characterizes the fetal lung at the canalicular stage.
Acceleration ; Actins ; Antigens, CD57 ; Arteries* ; Arterioles ; Bronchial Arteries ; Capillaries ; Endothelium ; Fetus ; Glucuronic Acid ; Glycosphingolipids ; Heart ; Humans* ; Killer Cells, Natural ; Lung* ; Muscle, Smooth ; Pregnancy ; Thymus Gland ; Thyroid Gland ; Viscera

Fatigue is a common symptom of long COVID. Fatigue can majorly disrupt daily life and be challenging to treat. Herein, we describe the effect of saikokeishito, a Kampo medicine, on fatigue in patients with long COVID.Between October 2020 and March 2023, we prescribed saikokeishito to 22 patients with long COVID in the general medicine outpatient department of our hospital. Among them, seven patients (age: 15-58 years, two females) had fatigue, a previously confirmed diagnosis of COVID-19, and no concomitant use of other Kampo formulas. We compared their condition at the start of saikokeishito administration to that 3 months later. Five patients had a slight fever, and four had inflammatory findings on blood tests. Within 3 months, all patients had a 20% or greater reduction in fatigue on a visual analogue scale. Six patients had a 20% or greater increase in health-related QOL and were able to return to society. On the other hand, one patient required a transition to an alternative medication, and one patient's follow-up was prematurely discontinued. Fatigue after COVID-19 may be improved by saikokeishito, especially for the treatment of patients with slight fever or inflammatory findings.

The Great East Japan earthquake and tsunami disaster that occurred on March 11, 2011 seriously destroyed Japanese social activities the medical system included. We provided medical support to the damaged area, and mainly performed Oriental medicine. Traditional methods using physical diagnoses and the treatments with herbs, acupuncture, and massage were effective, where any infrastructure had suffered or any modern medical facilities had been destroyed. Acute phase infectious disease, common colds, and hypothermia were dominant. Allergies increased two weeks later, and there was much mental distress, and chronic pain symptoms one month later. We prescribed Kampo herbal medicines for common colds, hypothermia, allergies, and mental distress. Moreover, we also performed acupuncture and kneaded patients' body to reduce pain, stiffness, and edema. These treatments were effective for both physical and mental distress. Thus we believe that Oriental medicine is valuable in disaster situations.

Since students who would like to study Kampo medicine more have no opportunity to communicate each other in Northern Japanese Universities, we newly started joint study conferences held by medical students in 2013. The objectives of this paper are to report on these annually held student-based Kampo study conferences in the Hokkaido and Tohoku areas, and the ways each university studies Kampo medicine. In the conference, the students reported on their club activities. Then they studied the history of Kampo medicine and simulation of abdominal diagnosis, and performed group work on case reports together. The number of student participants in these conferences has tripled over 3 years from 18 to 58 (for a total of 111 participants). All members were satisfied with the content. And this reflects medical students' need for a wider perception of Kampo medicine, rather than a limited one gained in their university club activities. We hope this conference will play a major role in other nationwide student-based Kampo study conferences in the years to come.

Background  The number of foreign tourists visiting Japan has increased to about 30 million people per year. 1.5% of them were injured or became sick during their travelin Japan and had to undergo medical treatment. Among the foreign tourists, 27% were not covered by travel health insurance.Case  A 40-year-old man from Southeast Asia who was visiting his relative in Japan experienced sudden hemiparesis and was diagnosed with cerebral infarction. During the initial treatment, it was found that the patient did not have health insurance and the relatives could not afford to pay the treatment costs. No other source of financial support was available to him During our consultations with the patient and his relatives about the medical treatment including medical expenses, he continued to be treated as an outpatient and it was aimed at an early return to his home country.Discussion  Foreigners, who are not covered under travel health insurance, could fall ill or sustain an injury during their stay in Japan. Appropriate medical care should be provided regardless of their ability to pay. However, a situation that could lead them to incur huge medical expenses from availing medical care should be avoided. For medical consultations of non-insured foreigners, it is better to consult the available systems and pay attention about feasible medical expenses. There is a need for a long-term vision of medical care to make a smooth transition from medical treatment in Japan to treatment in their home country.Conclusion  Although medical institutions can offer only a limited response, it is necessary to accumulate case examples from across the nation and prepare specific countermeasures and counselors.

In 2015, the Japan Council for Kampo Medical Education was established to create a basic curriculum for Kampo medical education that could be implemented in medical schools nationwide. After conducting a needs assessment, we decided on a lecture time of 240 minutes. To set learning objectives, we formed groups for “history,” “examination methods and patterns,” “effects of Kampo medicine,” “clinical cases,” “acupuncture and moxibustion,” and “evaluation.” The teaching contents were incorporated. Then, model slides and lecture guides containing these teaching contents were created, and textbooks based on these contents were published in 2020. In 2021, these overall efforts and contents were made public nationwide, providing an opportunity for the introduction of this curriculum at each university.