We examined the clinical effects of the administration of Saiboku-to (TJ-96 7.5g/day) on 14 patients suffering from chronic bronchial asthma. The observation period was from 22 to 52 weeks, and the administration period 26 to 52 weeks. Eight out of 14 cases (57.1%) showed slight improvement or better with respect to asthmatic points and clinical phenomenon. A Steroid-sparing effect was evident in 6 out of 14 cases (42.9%). From urinary excretions following the administration of Saiboku-to, we detected the magnolol component of magnoliae cortex. Effective cases showed increased free magnolol in urine, suggesting the value of combined magnolol as a clinical parameter. We also investigated the function of 11β-hydroxysteroid dehydrogenase (11-HSD) inhibition, one of the mechanisms of the steroid-sparing effect, in healthy subjects using three Saiko-zai. Saiboku-to lowered the activity of 11-HSD and increased the concentration of prednisolone (PSL), while Sairei-to had no influence on the metabolism of PSL. Shosaiko-to, on the other hand, increased the activity of 11-HSD and lowered the concentration of PSL. Thus the three Saiko-zai showed different results.

BACKGROUND: In general practice, though patients often stop visiting ambulatory clinics of their own vo-lition despite the need for ongoing medical treatment, there is little reported research on the reasons for nonattendance in Japan. In this study, we investigated whether the patient/doctor relationship influences nonattendance rates in general practice. In addition, we investigated the reasons why patients stopped visiting the hospital.
METHODS: We collected data from 115 patients (58 males, 57 females; age range: 16 to 94 years old, median age: 52 years old) whose initial diagnoses were made in our department from June to July 2000. We classified the patients into five groups based on the level of their complaints concerning the initial consultation (‘A’ representing the highest degree of complaint, ‘E’ representing the lowest) and determined the relationship between the strength of complaints and the non-attendance rate. Furthermore, we investigated the reasons for non-attendance concerning 28 patients who stopped visiting the hospital from April 2000 to November 2001.
RESULTS: The non-attendance rates were 0% (014) for group A, 14.3% (2114) for group B, 5.6% (5189) for group C, 33.3% (216) for group D, and 50% (1/2) for group E. The rate tended to be higher in groups with fewer complaints. The reasons for non-attendance were the following: remission of symptoms (9 patients), request for another hospital or department (6 patients), relief due to consultation at the university hospital (6 patients), and lack of time to come to the particular hospital (5 patients) . In contrast, the most common reason for satisfaction at the time of consultation was ‘enough explanation and listening to complaints well’ in 7 of 11 patients who were satisfied with the consultation.
CONCLUSIONS: The level of patient's complaints at the time of consultation is related to the non-attendance rate. However, sufficient explanation about symptoms and careful listening to complaints are important for establishing a good patient/doctor relationship.

1) We investigated the patients'evaluations of the students, our management of the medical training, and the patients' recognition of our outpatient clinic education. We then requested the patients to give their opinions regarding such interviews.
2) The patients'evaluations of the outpatient clinic and the patients'recognition of our outpatient clinic education were relatively good, but some patients complained about the short duration of medical care and also expressed anxiety over the students'medical interview.
3) Many patients expressed the desire to positively participate in medical education because the patients had high expectations of the medical students.In addition, this interview training fulfilled the patients'desire to be listened to and have their concerns acknowledged.