We herein report a case of a 19-year-old male patient who presented with traumatic alopecia and was successfully treated with Kampo formulation saikoseikanto (Ikkando). This patient was referred to the Kampo outpatient department of Hoshi General Hospital from a neurosurgery hospital located near his workplace. The reason for the consultation was alopecia with subcutaneous hemorrhage that appeared several days after a blow to his parietal region. The patient presented with kyokyokuman on the right side along with chronic pharyngitis. We suspected that the alopecia was caused by folliculitis, so we prescribed saikoseikanto. The results of this medication were dramatic ; his alopecia and pharyngeal inflammation resolved within three months. His depressive mental state and his irritability improved significantly. We recognized that this Kampo formulation controlled both physical and mental disorders.

We herein report a case of a 72-year-old man who complained of recurrent hyperalgesia in the right big toe, which was successfully treated with the Kampo formulation ninjin’yoeito. The unusual pain felt like being cut with a utility knife whenever his skin was lightly scraped with a toothpick. There was mild tactile loss at this area, however, there were no other sensory disturbances in the sense of pain, cold, or vibration. This patient’s hobby was Iaido, a type of Kendo, which places stress on the soles of the feet. Therefore, we speculated that the clinical disorder in this case was related to his exercise. This patient exhibited a pattern of qi and blood deficiency with qi uprising, which suggested the use of ninjin’yoeito. After taking this Kampo formulation, his abnormal hyperalgesia with coldness in the big toe resolved. There have been no prior reports of ninjin’yoeito effectively treating unusual hyperalgesia.

Purpose: To visually impress upon school students that medicine should be taken with a full glass of cool or lukewarm water as part of medical education on pharmaceuticals, we conducted an experiment in which pharmaceutical drugs were added to juice and the foaming behavior was observed.　However, the degree of foaming differed depending on the type of juice and medicine, and consistent experimental results could not be obtained. Therefore, a basic study was conducted to elucidate the selection criteria for juices and medicines suitable for this experiment. Method: 3.0 grams of reagent-grade sodium bicarbonate (NaHCO3) was added to about 100 mL of various types of juice, and the height of the foam was measured promptly with a ruler for comparison. In addition, we added one packet of different medicines containing NaHCO3 to grapefruit juice (GFJ), and measured the foam height for comparison. Furthermore, we conducted experiments to test 3.0-5.0 grams of food-grade NaHCO3. We also examined their convenience, cost, and portability. Results and Discussion: The study suggested that 100% GFJ may lead to significant foaming, and this foaming volume seems to be influenced by the number of moles of acidic groups in the juice neutralized by NaOH. Higher NaHCO3 in one packet content produced a greater amount of foam. A large amount of food-grade NaHCO3 also increased the amount of foaming. These results led to the creation of our experiment protocol. We believe that it is possible to implement effective medical education utilizing this protocol.

We herein report the case of a 68-year-old female patient whose branch-type intraductal papillary mucinous neoplasm (IPMN) regressed during thirteen years of Kampo treatment. The Kampo treatment was not aimed at treating IPMN but rather at addressing her complex complaints, such as menopausal disorders, chronic headaches and abdominal pain. During this period, her IPMN was monitored by MRCP every year without any medication or surgical intervention. The regression of IPMN is extremely rare. Therefore, we report this case by presenting the course of MRCP images along with an overview of Kampo treatment over these thirteen years.

We herein report three patients who complained atypical febrile diseases associated with painful whole body (Case 1), general fatigue (Case 2), and a sense of general discomfort (Case 3). All cases were not accompanied by dizziness and a shaky feeling which are commonly associated in shimbuto-sho i.e. indication of shimbuto, but presented severe tenderness at the left paraumbilical region which was suggested as indicative point of shimbuto by Yoshiko Takagi. We made a diagnosis in these three cases as shimbuto-sho based on the Takagi's tender point. Through these clinical experiences we propose that a new type of shimbuto-sho, which are completely different from the fixed idea of inherited knowledge. This new type of shimbuto-sho consists of following signs ; fever with chill, floating and feeble pulse, no sweating, general fatigue or body pain, and severe pain at Takagi's tender point.

The current study examined the antimicrobial resistance of Chlamydia Trachomatis (CT) genital infection during pregnancy in Japan. We requested 2,146 obstetrical facilities that are members of Japan Association of Obstetricians and Gynecologists to provide information of CT screening tests and antimicrobial resistance in pregnant women between April 2020 and March 2021. The prevalence of CT genital infection in Japan was 2.1%. The antimicrobial resistance was recognized in 2.0 and 2.4% of the cases using azithromycin and clarithromycin, respectively. There were no significant differences in the antimicrobial resistance rate between the 2 analogues (P = 0.28). In Japan, azithromycin and clarithromycin have effectively treated genital CT infections during pregnancy.

　　Urinary tract infections (UTIs) are among the most common entities in hospitals, accounting for about 40% of nosocomial infections. It is said that more than 80% of UTIs are associated with the use of catheters. The discharge opening of the Uro Bag, a type of urine storing bag, is alive with bacteria. The microorganisms can enter the bag and then bladder, causing UTIs. It can also be said that the longer the catheters are used, the greater the risk of catheter-related UTIs becomes. Furthermore, Pseudomonas aeruginosa, Staphylococcus aureas, Serratia mareescensand other kinds of bacteria that have acquired the resistance to drugs are increasing. The incidence of mixed infections with different organisms are on the rise. Such being the present situation, to prevent UTIS we think that the proper management of urinary catheterization and right use of urethral catheters are of the primary importance. Those health providers who handle catheters frequently need to take every precaution against inadvertently acting as intermediaries in the incidence of nosocomial infectious diseases including catheter-related UTIs. Recently, we reviewed the prophylactic measures which had been taken by our hospital, assessed the findings using the checklist made by the Nosocomial Infection Prevention Committee. Later, we held a seminar and discussed the standardization of prophylactic measures. As a result, the assessment items which were rated low in June marked 100% in September and March. Thus, our efforts have led the hospital employees to deepen their knowledge and understanding of the need to watch out nosocomial infection constantly. For the guidance of employees, we included in the educational program on-the-job training, which proved to be helpful for the trainees to have imagery. To maintain the effect of infection prevention and to keep up the interest awakened in the hospital staff, the holding of seminars and meetings for reviewing on a regular basis are called for.

BACKGROUND: The purpose of our study was to compare the characteristics of medical practitioners who prefer using the Internet as their information resource and those who prefer using printed materials.
METHODS: From December 2002 to January 2003, a non-anonymous questionnaire was sent out by post to members of the Japanese Medical Association (JMA) and physicians working in hospitals. Contributing factors were examined by using logistic regression analysis.
RESULTS: The response rates for the questionnaires were 18.7% (n=1868) for JMA physicians and 68.0% (n=5901) for hospital physicians. Factors associated with the preference for using the Internet were: ‘younger age’; ‘use of the Internet to solve clinical problems and uncertainties’; ‘use of personal computers at work’; and, ‘use of personal computers at home’.
CONCLUSION: The results of this study show that, although some younger physicians prefer printed materials, providing medical information via the Internet is better suited for younger physicians who are making full use of computers. In contrast, older physicians prefer printed materials because they tend to be less familiar with using computers and may have limited accessibility to the Internet. Therefore, using both the Internet and printed materials to provide medical information is necessary to meet the needs of the larger physician population.

BACKGROUND: physicians' awareness regarding evidence-based medicine (EBM), clinical practice guidelines, and clinical information resources were rarely examined in Japan. We need to know them prior to the initiation of the Medical Information Network Distribution Service (Minds) by the Japan Council for Quality Health Care (JCQHC) .
METHODS: A total of 10, 000 directors/owners of private clinics (CDs: clinic physicians) affiliated with the Japan Medical Association (JMA) and 8682 physicians working for hospitals certified by the JCQHC (HDs: hospital physicians) were randomly selected and surveyed by a mailed questionnaire.
RESULTS: The response rate to the questionnaire was 18.7% (n=1865) among CDs and 67.8% (n=5885) among HDs. The percentage of respondents who uses internet was 39.9% among CDs and 69.3% among HDs. The information resource most commonly used by all respondents was medical journals, followed by textbooks. The percentage of respondents who used medical literature database was 10.8% among CDs and 49.7% among HDs, respectively. Approximately 80% of all respondents approved implementing EBM in daily practice. Fifty percent of all respondents indicated to have used clinical practice guidelines, and 90% of all the guideline users replied that clinical practice guidelines are useful tools for clinical decision-making. Over half of HDs required to access to the abstracts of the literature cited in the guidelines.
CONCLUSIONS: Many physicians who responded to the survey acknowledged that EBM will contribute to improving the quality of medical services. They are positive in using clinical practice guidelines that include a series of recommendations proposed by specialists in the relevant field (s) in accordance to the reviewed evidence.