1.Effect of Hericium erinaceum (Yamabusitake) and Grifola frondosa (Maitake) on the Suppression of EL4-Tumor Cell Growth
Mikiko SUZUKI ; Mayumi SHIBANUMA ; Terumi KATORI ; Michitaka SHIMIZU ; Shuichi KIMURA
Japanese Journal of Complementary and Alternative Medicine 2010;7(1):11-16
The objectives of this study were to investigate the effects of Hericium erinaceum (Yamabusitake) and Grifola frondosa (Maiteke) on the proliferation for EL4-tumor and immunoregulatory function by flow cytometory.
It was found that Yamabushitake and Maitake tend to inhibit the proliferation of EL4-tumor individually. In the flow cytometory analysis, Maitake-treatment showed the preserve effect against the depression effect by bearing EL4-tumor on cytotoxic T cell and NK-cell from spleen cell. This effect was shown more clear in the group of mixture Yamabusitake and Maitake.
2.Influence of Moxibustion Stimulus on the Amount of Blood flow to the Sacral Area
Takeshi MATSUMOTO ; Tomoaki KIMURA ; Shuichi KATAI ; Yoshiro HATANO
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 2005;68(2):96-101
The purpose of this study was to determine if Moxibustion stimulus influence on the circulation in the sacral area.
In the first phase of this study, the influence of indirect Moxibustion stimulus (using‹SEN-NEN-KYU›) on the amount of blood flowing to the sacrum was investigated using laser Doppler Perfusion Imager PeriScan PIM II.
Significant increase in the amount of blood flow in radial directions were observed around the area where Moxibustion was applied. Immediately after the stimulus, significant differences in the amount of blood flow were observed within 2.5cm to the right and left and 1.5cm above and below the stimulated spot.
With increasing time after the Moxibustion stimulus, the amount of blood flow gradually decreased concentrically returning to the original state over time. However, the amount of blood flow at the Moxibustion spot was significantly higher than the original state 32 minutes and 52 seconds after the Moxibustion treatment.
Increased blood flows to pressure ulcers area induced by Moxibustion stimulus are considered to restrict or arrest the progress of pressure ulcers (according to Stage I of the International Association for Enterostomal Therapy (IAET) classification) on in-home care.
3.Where Should I Play an Active Part?-In the Era of increasing Number of Acupuncturist Rapidly-
Takayoshi OGAWA ; Shuichi KATAI ; Tomomi SAKAI ; Kimiyo ITO ; Susumu KOYAMA ; Ken-ichi KIMURA
Journal of the Japan Society of Acupuncture and Moxibustion 2005;55(5):670-683
Rapidly increasing numbers of acupuncturists in Japan has caused our places of activity to become increasingly important.
A symposium was held by acupuncturists who play an active role in various areas of acupuncture. We all came together with the purpose of examining our clinical conditions and to make recommendations for the future. The necessity of how to expand the capacity and locations of acupuncture practice cannot be overestimated.
The chairperson of the symposium reported that due to the increasing number of acupuncturists, it is hard to find employment for graduates, and reported the results of a questionnaire (initiated by The Japanese Journal of Acupuncture & Manual Therapies (IDO NO NIPPON-SHI) demonstrating that some practitioners are changing the conditions of their professions.
The first panelist, who had experienced practicing acupuncture in a hospital, reported on the role and characteristics of acupuncture practice and ways to maintain relationships with doctors, nurses and other medical care staff members. Also he addressed the issue of prospects for the future among other topics.
The second panelist, who had not been able to find a useful place for on-the-job training following graduation, told of her experience making home-visits and practicing at a clinic. At first, she had found attracting patients to her home-visits quite difficult, so she advertised herself with a local TV station to increase her name recognition, and then she succeed to practice her own clinic. Now she thinks it is necessary to acquire clinical and academic knowledge as well as technical skills.
The third panelist, who specialized in acupuncture in the field of sports disorders, was eager to improve and expand the methods and techniques in this field to better demonstrate the merits of acupuncture treatment for sports disorders. Moreover, he insisted on the importance of acquiring knowledge concerning athletic rehabilitation and technical skills. Also, clinical practice is imperative.
The last panelist, a university teacher, suggested that it is necessary to set up high educational standards and faculty development activities supported by the school. Accordingly, improved standards at schools as well as more research justifying acupuncture efficacy would facilitate greater social demand for acupuncture and thereby setting reasonable expectations for patients and other medical professionals.
In addition, two other acupuncturists and a student from an acupuncture school made speechesabout theirmisgivings regarding their future prospects. One has been working in a hospital for two years since his graduation; the other is a student at a teacher training institution. The student entering her second-year of acupuncture school became a mother. These acupuncturists and a student all expressed their concerns and hopes for the future of their profession.
4.Standardization development in ISO/TC 249 related to acupuncture and moxibustion
Toshihiro TOGO ; Tomoaki KIMURA ; Shuichi KATAI ; Takeshi MATSUMOTO ; Ryoichi NAKANO ; Yoshifumi KANEYASU
Journal of the Japan Society of Acupuncture and Moxibustion 2014;64(2):90-103
It has been five years since TC 249 was established as a new Technical Committee (TC) at the International Organization for Standardization (ISO), specializing in the field of Chinese traditional medicine. In the second Plenary Meeting held in Den Haag (2011), five working groups (WGs) were established within the TC, two of which specialize in standard development of acupuncture needles (WG3) and other medical devices used in traditional medicine (WG4). Japanese delegates have participated in the discussion within these WGs, paying close attention so as to keep the proposals under discussion consistent with existing Japanese standards and certification standards regulated by the Ministry of Health, Labour and Welfare. However, since most of the participants in TC 249 are clinicians or researchers engaged in medical practices, and not experts on domestic/international standards, discussions on harmonization of the submitted projects often become complicated. In this manuscript, four experts (two from academia and two from companies that manufacture acupuncture needles and moxibustion devices) who attended the fourth plenary meeting held in Durban, South Africa, in May 2013, report on the stage of progress of standardization development in WG3and WG4.
5.Surgical Site Infection by Methicillin-Resistant Staphylococcus aureus after Cardiovascular Operations: An Outbreak and Its Control
Masayoshi Umesue ; Hiromi Ando ; Fumio Fukumura ; Ichirou Nagano ; Noriko Boku ; Satoshi Kimura ; Jiro Tanaka ; Shuichi Okamatsu ; Kenichi Nakamura ; Rumiko Yoshida
Japanese Journal of Cardiovascular Surgery 2005;34(1):14-20
We encountered 15 cases of surgical site infection (SSI) by Methicillin-resistant Staphylococcus aureus (MRSA) among 153 patients who underwent a cardiovascular operation in 2000. SSIs consisted of 5 mediastinal infections, 9 surface wound infections and 1 artificial graft infection after an abdominal aortic surgery. All infected cases had been operated on between June and December 2000. Eighty-three cases, which underwent cardiovascular operations during this period, were divided into SSI or no-SSI groups and their clinical data were analyzed. The data included age, gender, preoperative diabetes, urgency, preoperative usage of a device like Swan-Ganz catheter or IABP, preoperative albumin level, preoperative physical state by ASA score, National Nosocominal Infections Surveillance index, duration of operation, usage of a cardiopulmonary bypass, duration of bypass, type of operation, and number of distal anastomoses in CABG operations. Multivariate analysis showed gender (male), diabetes, and emergency operation as independent risk factors for the incidence of SSI by MRSA. One patient, who suffered a mediastinal infection after CABG, had confirmed as demonstrating the colonization of MRSA in sputum preoperatively. Microbiological screening of medical staff showed 2 of the 6 surgical doctors and 3 of the 25 ward nurses exhibited colonization with MRSA. DNA analysis of MRSA, harvested from 5 infected patients, indicated at least 2 strains of MRSA and 1 of the 2 strains was identical to the MRSA that was detected in a doctor. We applied prophylactic measures with reference to the guideline for prevention of surgical site infection announced by CDC in 1999, which included the following: routine work-up of MRSA-colonization, and treatment of all MRSA colonized patients and those undergoing emergency operations with Mupirocin. Preoperative patients were isolated from MRSA-infected or colonized patients. MRSA-colonized surgical personnel were treated with Mupirocin ointment. Cephazoline was administered shortly before and after the operation as a prophylactic antibiotic. Vancomycin was added to Cephazoline in patients with a history of MRSA-colonization or infection. Through hand washing before and after daily contact with patients was emphasised to all medical staff. SSI surveillance conducted by an infection control team was implemented. After the introduction of the prophylactic measurements, one MRSA-SSI was observed among 113 cases who underwent a cardiovascular operation between January and September 2001.
6.Lack of integrative control of body temperature after capsaicin administration.
Tai Hee LEE ; Jae Woo LEE ; Toshimasa OSAKA ; Akiko KOBAYASHI ; Yoshio NAMBA ; Shuji INOUE ; Shuichi KIMURA
The Korean Journal of Internal Medicine 2000;15(2):103-108
BACKGROUND: Body temperature is usually regulated by opposing controls of heat production and heat loss. However, systemic administration of capsaicin, the pungent ingredient of hot peppers, facilitated heat production and heat loss simultaneously in rats. We recently found that the capsaicin-induced heat loss and heat production occur simultaneously and that the biphasic change in body temperature is a sum of transient heat loss and long-lasting heat production. Moreover, suppression of the heat loss response did not affect capsaicin-induced heat production and suppression of heat production did not affect capsaicin-induced heat loss. These observations suggest the independent peripheral mechanisms of capsaicin-induced thermal responses. Thus, the capsaicin-induced thermal responses apparently lack an integrated control. METHODS: Male Wistar rats were maintained at an ambient temperature of 24 1 degrees C on a 12 h on-off lighting schedule at least for two weeks before the experiments. They were anesthetized with urethane (1.5 g/kg, i.p.) and placed on a heating pad, which was kept between 29 and 30 degrees C. Skin temperature(Ts) was measured with a small thermistor, which was taped to the dorsal surface of the rat's tail, to assess vasoactive changes indirectly. Colonic temperature(Tc) was measured with another thermistor inserted about 60 mm into the anus. O2 consumption was measured by the open-circuit method, and values were corrected for metabolic body size (kg0.75). Capsaicin (Sigma) was dissolved in a solution comprising 80+ACU- saline, 10+ACU- Tween 80, and 10+ACU- ethanol, and injected subcutaneously at a dose of 5 mg/kg. Each rat received a single injection of capsaicin because repeated administration of capsaicin renders an animal insensitive to the subsequent administration of capsaicin. Laminectomy was performed at the level of the first and second cervical vertebrae to expose the cervical spinal cord for sectioning. The brain was transected at 4-mm rostral from the interaural line with an L-shaped knife. RESULTS: After administration of capsaicin, O2 consumption increased from 13.5 0.4 mL/min/kg0.75 at 0 min to a peak of 15.9 0.4 mL/min/kg0.75 at 71 min and gradually declined but remained higher than the basal value until the end of the 4-h observation period. Ts also immediately increased from 27.7 0.2 degrees C to 31.9 0.3 degrees C at 39 min, and it returned to the baseline level within 90 min after the capsaicin administration. Tc initially decreased from 37.1 0.1 degrees C to 36.8 0.2 degrees C at 43 min and then gradually increased over the baseline level and remained at 37.6 0.2 degrees C until the end of the experiment. In spinalized rats, the capsaicin-induced increases in O2 consumption was largely attenuated, while the basal O2 consumption was similar to that of control rats. The basal Ts of spinalized rats was 32.4 0.3 degrees C, which was higher than that of control rats. Capsaicin increased Ts by less than 1 degree C, and Tc did not change after the capsaicin administration. O2 consumption of decerebrated rats was statistically higher than that of control rats after the injection of capsaicin. However, capsaicin did not increase Ts, showing a lack of a vasodilatory response. Decerebration between the hypothalamus and midbrain prevented the capsaicin-induced heat loss but not the heat production response. CONCLUSION: These results show that the capsaicin-induced heat production and heat loss are controlled separately by the brainstem and by the forebrain, respectively, and suggest that the body temperature regulation is performed without an integrative center.
Animal
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Body Temperature Regulation/drug effects+ACo-
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Brain/physiology
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Brain/drug effects
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Capsaicin/pharmacology+ACo-
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Decerebrate State
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Male
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Oxygen Consumption/drug effects
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Rats
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Rats, Wistar
7.Understanding the factors associated with initiation and adherence of osteoporosis medication in Japan: An analysis of patient perceptions.
Hajime ORIMO ; Masayo SATO ; Shuichi KIMURA ; Keiko WADA ; Xuelu CHEN ; Shigeto YOSHIDA ; Bruce CRAWFORD
Osteoporosis and Sarcopenia 2017;3(4):174-184
OBJECTIVES: This study aimed to identify factors associated with initiation and adherence of osteoporosis medication from a patient perspective. METHODS: A web-based survey was developed based on health behavior theories. Descriptive analyses were conducted for all survey items. Analyses in a structural equation modeling framework were conducted to identify factors associated with treatment initiation and adherence. RESULTS: Five hundred forty-five women completed the questionnaire. A majority were currently receiving medications for osteoporosis (n = 376, 69.0%) and 25.0% of these patients (n = 94) were considered adherent to their treatment. Knowledge was strongly associated with osteoporosis treatment initiation (standard error [SE], 0.58). Greater knowledge of disease was associated with increased likelihood of initiating medication. Medication complexity (SE, 0.49) and perceived susceptibility to fracture and loss of independence (SE, −0.37) were also associated with initiation. Perceived barriers (SE, −0.85) such as inconvenience, lack of efficacy and financial burden were observed to be the greatest obstacle to adherence. The greater the perceived barriers, the less likely patients were to adhere to medication. Patients' perception of self-efficacy (SE, 0.37) also affected adherence. The greater the patient perception of ability to independently manage their medication, the more likely they were to adhere to the medication. CONCLUSIONS: Different factors were found to be associated with initiation and adherence of osteoporosis medication. Patient knowledge of their disease and the perception of barriers were found to be the most influential. Empowering patients with the knowledge to better understand their disease and decreasing the perception of barriers through education initiatives may be effective in improving patient outcomes.
Education
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Female
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Health Behavior
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Humans
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Japan*
;
Osteoporosis*
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Patient-Centered Care
8.Clinical study on the prevention of recurrent tonshillitis by acupuncture (III)
Keishi YOSHIKAWA ; Kazushi NISHIJO ; Kazuhiro YAZAWA ; Hidetoshi MORI ; Tomomi SAKAI ; Akihiro OGATA ; Kazuo SASAKI ; Toshikazu SHIMA ; Hiroki SUGA ; Mikio NAKAMURA ; Shuichi KATAI ; Katsumi KURIHARA ; Takeshi TOMIYASU ; Masahiro KIMURA ; Takanori KAWANO ; Koki KOBAYASHI ; Koichi WADA ; Harumi TAKETANI ; Akemi YAMAMOTO
Journal of the Japan Society of Acupuncture and Moxibustion 1984;34(1):15-22
We have conducted acupuncture treatment for prevening the relapse of recurrent tonsillitis. We previously noted the effectiveness of this treatment in 121 of 239 patients treated in 1980, especially in elementary school children. In the present study, we compared the annual days of absence from school and the body dimensions of children with tonsillitis given acupuncture treatment with those having tonsillar hypertrophy chosen by a school study, although there is a question on the latter's propriety as a control group in a strict sense, in order to investigate the degree of spontaneous healing included in the preventive effects of acupuncture treatment on the relapse of recurrent tonsillitis.
By May 1983, our reseach was completed in 22 children with tonsillitis given acupuncture treatment and 19 with tonsillar hypertrophy not given such therapy. In children with tonsillitis given acupuncture treatment, the average annual days of absence from school before treatment was 14.0, which was more than that for all children in the S elementary school, and that in the year after treatment was 6.5, approximating that for all children in the school. In children with tonsillar hypertrophy not given acupuncture treatment, the average number of days of absence was close to that for all children in the S elementary school in both years.
Among 14 children with tonsillitis given acupuncture treatment, lower values of height and weight were noted in eight and 12 children, respectively, at the beginning of treatment, as compared with the national averages. The body dimensions of children with tonsillar hypertrophy not given acupuncture treatment were similar to the national averages. Of 14 children with tonsillitis given acupuncture treatment, an increase to a value exceeding the national average was observed with both the height and weight in six children, the height in two and the weight in one within the year after treatment.
The above results show that children with tonsillitis have a problem from the educational and developmental standpoint, even if they do not have a focal tonsil. We think that acupuncture treatment is worth attempting prior to tonsillectomy, although it is not so surely effective as tonsillectomy, when the severity of operative stress on the living body due to tonsillectomy and the burden of medical expenses and the load on the patient's family caused by hospitalization are taken into consideration.
9.Clinical Features and Surgical Outcomes of Lower Lumbar Osteoporotic Vertebral Collapse with Symptomatic Stenosis: A Surgical Strategy from a Multicenter Case Series
Takayoshi SHIMIZU ; Shunsuke FUJIBAYASHI ; Soichiro MASUDA ; Hiroaki KIMURA ; Tatsuya ISHIBE ; Masato OTA ; Yasuyuki TAMAKI ; Eijiro ONISHI ; Hideo ITO ; Bungo OTSUKI ; Koichi MURATA ; Shuichi MATSUDA
Asian Spine Journal 2022;16(6):906-917
Methods:
We investigated patients who underwent surgical intervention for LL-OVC (L3, L4, and/or L5) with symptomatic foraminal and/or central stenosis from eight spine centers. Only patients with a minimum follow-up duration of 1 year were included. We developed new criteria to grade vertebral collapse severity (grade 1, 0%–25%; grade 2, 25%–50%; grade 3, 50%–75%; and grade 4, 75%–100%). The clinical features and outcomes were compared based on the collapse grade and surgical procedures performed (i.e., decompression alone, posterior lateral fusion [PLF], lateral interbody fusion [LIF], posterior/transforaminal interbody fusion [PLIF/TLIF], or vertebral column resection [VCR]).
Results:
In this study, 59 patients (average age, 77.4 years) were included. The average follow-up period was 24.6 months. The clinical outcome score (Japanese Orthopaedic Association score) was more favorable in the LIF and PLIF/TLIF groups than in the decompression alone, PLF, and VCR groups. The use of VCR was associated with a high rate of revision surgery (57.1%). No significant difference in clinical outcomes was observed between the collapse grades; however, grade 4 collapse was associated with a high rate of revision surgery (40.0%).
Conclusions
When treating LL-OVC, appropriate instrumented reconstruction with rigid intervertebral stability is necessary. According to our newly developed criteria, LIF may be a surgical option for any collapse grade. The use of VCR for grade 4 collapse is associated with a high rate of revision.
10.Prognostic Factors after Surgical Treatment for Spinal Metastases
Kazuhiro MUROTANI ; Shunsuke FUJIBAYASHI ; Bungo OTSUKI ; Takayoshi SHIMIZU ; Takashi SONO ; Eijiro ONISHI ; Hiroaki KIMURA ; Yasuyuki TAMAKI ; Naoya TSUBOUCHI ; Masato OTA ; Ryosuke TSUTSUMI ; Tatsuya ISHIBE ; Shuichi MATSUDA
Asian Spine Journal 2024;18(3):390-397
Methods:
A retrospective multicenter study was conducted. The study participants included 345 patients who underwent surgery for spinal metastases from 2010 to 2020 at nine referral spine centers in Japan. Data for each patient were extracted from medical records. To identify the factors predicting survival prognosis after surgery, univariate analyses were performed using a Cox proportional hazards model.
Results:
The mean age was 65.9 years. Common primary tumors were lung (n=72), prostate (n=61), and breast (n=39), and 67.8% (n=234) presented with osteolytic lesions. The epidural spinal cord compression scale score 2 or 3 was recognized in 79.0% (n=271). Frankel grade A paralysis accounted for 1.4% (n=5), and 73.3% (n=253) were categorized as intermediate or high risk according to the new Katagiri score. The overall survival rates were -71.0% at 6 months, 57.4% at 12, and 43.3% at 24. In the univariate analysis, Frankel grade A (hazard ratio [HR], 3.59; 95% confidence interval [CI], 1.23–10.50; p<0.05), intermediate risk (HR, 3.34; 95% CI, 2.10–5.32; p<0.01), and high risk (HR, 7.77; 95% CI, 4.72–12.8; p<0.01) in the new Katagiri score were significantly associated with poor survival. On the contrary, postoperative chemotherapy (HR, 0.23; 95% CI, 0.15–0.36; p<0.01), radiation therapy (HR, 0.43; 95% CI, 0.26–0.70; p<0.01), and both adjuvant therapy (HR, 0.21; 95% CI, 0.14–0.32; p<0.01) were suggested to improve survival.
Conclusions
Surgical indications for patients with Frankel grade A or intermediate or high risk in the new Katagiri score should be carefully considered because of poor survival. Chemotherapy or radiation therapy should be considered after surgery for better survival.