More than 3 years have passed since the guideline for infection prevention at acupuncture and moxibustion clinics was issued. We studied changes in the attitude toward sanitization of the environment and consciousness about infection prevention at acupuncture and moxibustion clinics during this period. The subjects were members of the Acupuncture and Moxibustion Societies of Kyoto and Osaka (n=349). About 70% of the subjects felt anxiety about infections, and nearly 80% of them were interested in sanitizing the clinics. More than half (57%) of the subjects were using both disposable and reusable needles, and about half the subjects disposed of used needles without sterilization. Concerning the linen, pillow covers were changed for every patient by about 70% of the subjects, but towels and sheets were changed by only 20% and 10%, respectively. White coats were changed within 1 week by about 70% of the subjects. Most subjects answered that the clinics were cleaned everyday, but less than a half of them sterilize slippers. About half the subjects answered that curtains were washed every 3-6 months. Autoclaves were placed in only 90% of the clinics. Attention to preventive measures against infection of therapists tended to diminish with increase in the clinical experience.

The representative endoscopic features of primary intestinal follicular lymphoma are well known as small whitish polypoid nodules, but a magnified view has only been described in a few case reports. Herein, we report a case with intestinal follicular lymphoma in which magnifying endoscopy with narrow band imaging was helpful for prompt diagnosis. A 57-year-old Japanese woman underwent surveillance esophagogastroduodenoscopy. The endoscopic examination revealed confluent whitish granules in the duodenum, distinct from the nodules or polyps that are typical findings of intestinal follicular lymphoma. Magnifying endoscopy visualized whitish enlarged villi, and narrow band imaging emphasized an elongated and coiled vascular pattern. Based on these features, intestinal follicular lymphoma was highly suspected, and subsequent histological study confirmed the diagnosis. This case demonstrates that magnifying endoscopy with narrow band imaging was useful for the detection and prompt diagnosis of intestinal follicular lymphoma. The pathological features of intestinal follicular lymphoma are also discussed.
Asian Continental Ancestry Group ; Duodenal Neoplasms ; Duodenum ; Endoscopes, Gastrointestinal ; Endoscopy ; Endoscopy, Digestive System ; Female ; Humans ; Lymphoma, Follicular ; Narrow Band Imaging ; Polyps