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.

Ovomucoid (OMC) is the most prominent allergen causing hen's egg allergy, containing disulfide (S-S) bonds that may be responsible for its allergic action. As S-S bonds may be reduced during electrolysis, this study was undertaken to evaluate modulation of the allergic action of OMC after electrolysis. Electrolysis was carried out for 1% OMC containing 1% sodium chloride for 30 minutes with a voltage difference of 90 V, 0.23 A (30 mA/cm2). Protein assays, amino acid measurement, and mass spectrometry in untreated OMC and OMC on both the anode and cathode sides after electrolysis were performed. Moreover, 21 patients with IgE-mediated hen's egg allergy were evaluated by using the skin prick test (SPT) for untreated OMC and OMC after electrolysis. The allergic action of OMC was reduced after electrolysis on both the anode and cathode sides when evaluated by the SPT. The modifications of OMC on electrolysis caused the loss of 2 distinct peptide fragments (57E-63K and 123H-128R) as seen on matrix-associated laser desorption/ionization time-of-flight mass spectrometry. The total free SH groups in OMC were increased on the cathode side. Although the regions of S-S broken bonds were not determined in this study, the change in S-S bonds in OMC on both the anode and cathode sides may reduce the allergenic activity.
Egg Hypersensitivity ; Electrodes ; Electrolysis* ; Humans ; Mass Spectrometry ; Ovomucin* ; Peptide Fragments ; Skin ; Sodium Chloride

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.

This report presents the case of a patient demonstrating multicentric Castleman's disease (MCD) with a lung lesion that was successfully treated with an anti-interleukin-6 receptor antibody, tocilizumab in combination with corticosteroid and tacrolimus. A 43-yr-old female with abnormal shadows on a chest X-ray was referred to the hospital for further examination. She was diagnosed as having MCD based on the characteristic pathology of inguinal lymph node, lung lesions, laboratory data, and undifferentiated arthritis. Corticosteroid and rituximab therapy did not fully ameliorate the symptoms; thus, the therapeutic regimen was changed to include tocilizumab, oral corticosteroid and tacrolimus. This regimen resulted in clinical remission and the dose of tocilizumab and corticosteroid could be tapered. Tocilizumab in combination with corticosteroid and tacrolimus may therefore be a beneficial treatment regimen for lung lesions associated with MCD.
Adrenal Cortex Hormones/therapeutic use ; Adult ; Antibodies, Monoclonal/*therapeutic use ; Drug Therapy, Combination ; Female ; Giant Lymph Node Hyperplasia/*diagnosis/drug therapy/radiography ; Humans ; Immunosuppressive Agents/therapeutic use ; Lung Diseases, Interstitial/*drug therapy/pathology ; Lymph Nodes/pathology ; Receptors, Interleukin-6/antagonists & inhibitors ; Tacrolimus/therapeutic use ; Tomography, X-Ray Computed

BACKGROUND/AIMS: Several studies have shown the usefulness of endoscopic nasogallbladder drainage (ENGBD) in patients with acute cholecystitis. However, the procedure is difficult, and factors that affect technical success have not yet been clarified. We conducted a prospective study to evaluate the technical feasibility, efficacy, and predictive factors for the technical success of ENGBD in patients with acute cholecystitis. METHODS: All patients with moderate or severe acute cholecystitis who were enrolled underwent ENGBD between April 2009 and April 2011. Patients with surgically altered anatomy or pancreatobiliary malignancies were excluded. The primary outcomes included technical success, clinical success, and complications. Factors that could affect the technical success were also examined. RESULTS: Of the 27 patients who underwent ENGBD during the study period, technical success was achieved in 21 (78%) and clinical improvement was achieved in 20 (95%). Early complications were encountered in four patients (15%). Gallbladder wall thickness (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.08 to 2.47) and age (OR, 1.16; 95% CI, 1.00 to 1.35) were effective predictors of technical failure. CONCLUSIONS: ENGBD was effective in resolving acute cholecystitis; however, this modality was technically challenging and had a limited success rate. Because of technical difficulties, ENGBD should be reserved for limited indications.
Age Factors ; Aged ; Aged, 80 and over ; Cholecystitis, Acute/*surgery ; Drainage/*methods ; Endoscopy, Gastrointestinal/*methods ; Feasibility Studies ; Female ; Gallbladder/pathology/*surgery ; Humans ; Male ; Middle Aged ; Odds Ratio ; Postoperative Complications/epidemiology ; Prospective Studies ; Sphincterotomy, Endoscopic ; Treatment Outcome

BACKGROUND/AIMS: Several studies have shown the usefulness of endoscopic nasogallbladder drainage (ENGBD) in patients with acute cholecystitis. However, the procedure is difficult, and factors that affect technical success have not yet been clarified. We conducted a prospective study to evaluate the technical feasibility, efficacy, and predictive factors for the technical success of ENGBD in patients with acute cholecystitis. METHODS: All patients with moderate or severe acute cholecystitis who were enrolled underwent ENGBD between April 2009 and April 2011. Patients with surgically altered anatomy or pancreatobiliary malignancies were excluded. The primary outcomes included technical success, clinical success, and complications. Factors that could affect the technical success were also examined. RESULTS: Of the 27 patients who underwent ENGBD during the study period, technical success was achieved in 21 (78%) and clinical improvement was achieved in 20 (95%). Early complications were encountered in four patients (15%). Gallbladder wall thickness (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.08 to 2.47) and age (OR, 1.16; 95% CI, 1.00 to 1.35) were effective predictors of technical failure. CONCLUSIONS: ENGBD was effective in resolving acute cholecystitis; however, this modality was technically challenging and had a limited success rate. Because of technical difficulties, ENGBD should be reserved for limited indications.
Age Factors ; Aged ; Aged, 80 and over ; Cholecystitis, Acute/*surgery ; Drainage/*methods ; Endoscopy, Gastrointestinal/*methods ; Feasibility Studies ; Female ; Gallbladder/pathology/*surgery ; Humans ; Male ; Middle Aged ; Odds Ratio ; Postoperative Complications/epidemiology ; Prospective Studies ; Sphincterotomy, Endoscopic ; Treatment Outcome

PURPOSE: Recent reports have posed doubts about the effect of preradiosurgical embolization in brain arteriovenous malformation (AVM) because it makes the planning of stereotactic radiosurgery (SRS) difficult and has the risk of recanalization out of the target. We investigated whether the performance and quality of embolization may influence the success of SRS based on a retrospective case cohort study. MATERIALS AND METHODS: Seventy-three patients who underwent embolization followed by SRS between 2003 and 2012 in eight institutes with neurointerventionists were considered. They were divided into the following two groups at 3 years of follow up after the final SRS: “successful occlusion group” (S group), with radiologically complete occlusion of AVM; and “non-successful occlusion group” (N group) with persistent remnant nidus or abnormal vascular networks. Patient background, AVM profile, embolization performance grade and complications were compared in each group. The quality of embolization was evaluated with the new grading system: embolization performance grade (E grade), specializing the achievement of nidus embolization. E grade A was defined as sufficient nidus embolization with more than half of the total number of feeders achieving nidus penetration. E grade B was defined as less than half achievement of nidus embolization, and E grade C was defines as failure to perform nidus embolization. RESULTS: Forty-three patients were included in the S group, and 29 patients were included in the N group. The size and Spetzler-Martin grade of AVM and the rate of diffuse type was higher in the N group without statistical significance. The embolization performance level according to E grade indicated a significantly higher rate of successful embolization with more than 50% of nidus penetration in the S group (P<0.001). This difference was also confirmed in the subanalysis for limited cases, excluding smaller AVMs with complete occlusion with SRS alone (P=0.001). CONCLUSION: The cause of the unsuccessful result of post-embolization SRS might be the large, diffuse angioarchitecture, but proper embolization with a high rate of nidus penetration to avoid recanalization is more important. Effective embolization is essential to contribute to and promote the effect of radiosurgery.
Academies and Institutes ; Arteriovenous Malformations* ; Asian Continental Ancestry Group* ; Brain ; Cohort Studies ; Follow-Up Studies ; Humans ; Radiosurgery ; Retrospective Studies*