Objective: The delivery of medicines by the postal service from pharmacies to patients' homes has increased to address medicine supply shortages. However, owing to recent abnormal weather conditions, medicines may be delivered in harsh environments exceeding 40℃. Therefore, this study aimed to measure the temperature at which medicines were mailed in the summer and investigate whether the interview form contained evidence that could guarantee the quality of the medicines mailed under those temperature conditions.Methods: Between August 5 and September 11, 2024, medicines were mailed from 15 postbox locations using a service provided by the Japan Post. The mailing environment was assessed via mean kinetic temperature (MKT) with reference to the United States Pharmacopeia (USP). The medicines in shortage were identified based on information published by the Japan Pharmaceutical Manufacturers Association.Results: Approximately 87.5% of the medicines mailed had an MKT above 25℃ (maximum 28.0℃), which deviates from the USP standard. Some medicines temporarily reached a maximum temperature of 47.5℃. Moreover, the results of the stress tests at temperatures above 40℃ were not listed in the interview form for 78.3% of the medicines that were likely to be mailed due to inventory shortages.Conclusion: To guarantee the medicines quality when mailed in the summer, it is important to consider appropriate measures to protect medicines from excessive heat, even medicines stored at room temperature. Furthermore, it is important to assess the medicine stability by referring to the stress tests (50℃) results listed on the interview forms for the product in question and the original and longlisted drugs. To resolve dissatisfaction between pharmacies and patients due to supply instability, it is necessary to actively publish the results of stress tests on interview forms and make appropriate efforts.

Splenic pseudoaneurysm rupture is a serious condition that sometimes leads to death. Pseudoaneurysm rupture is often treated with transcatheter arterial embolization (TAE), after which the re-rupture rate is 18%–37%. A 59-year-old man presented with back pain, and contrast-enhanced computed tomography (CECT) revealed pancreatic tail cancer with multiple liver metastases. After three courses of chemotherapy, CECT revealed good response with shrinkage of the tumors. However, the patient had back pain and CECT revealed pancreatic pseudocyst with pseudoaneurysm rupture. He underwent angiography, wherein the splenic artery pseudoaneurysm was embolized using TAE. Subsequently, pseudocyst drainage was performed using lumen-apposing metal stent (LAMS) to prevent pseudoaneurysm re-rupture. Thereafter, the pseudocyst shrieked with decreased serum levels of C-reactive protein, allowing the patient to re-institute chemotherapy. Pseudocyst drainage using LAMS was safe and effective when the pancreatic pseudoaneurysm had a high-risk rebleeding due to exposure to pancreatic juice.

Splenic pseudoaneurysm rupture is a serious condition that sometimes leads to death. Pseudoaneurysm rupture is often treated with transcatheter arterial embolization (TAE), after which the re-rupture rate is 18%–37%. A 59-year-old man presented with back pain, and contrast-enhanced computed tomography (CECT) revealed pancreatic tail cancer with multiple liver metastases. After three courses of chemotherapy, CECT revealed good response with shrinkage of the tumors. However, the patient had back pain and CECT revealed pancreatic pseudocyst with pseudoaneurysm rupture. He underwent angiography, wherein the splenic artery pseudoaneurysm was embolized using TAE. Subsequently, pseudocyst drainage was performed using lumen-apposing metal stent (LAMS) to prevent pseudoaneurysm re-rupture. Thereafter, the pseudocyst shrieked with decreased serum levels of C-reactive protein, allowing the patient to re-institute chemotherapy. Pseudocyst drainage using LAMS was safe and effective when the pancreatic pseudoaneurysm had a high-risk rebleeding due to exposure to pancreatic juice.

Splenic pseudoaneurysm rupture is a serious condition that sometimes leads to death. Pseudoaneurysm rupture is often treated with transcatheter arterial embolization (TAE), after which the re-rupture rate is 18%–37%. A 59-year-old man presented with back pain, and contrast-enhanced computed tomography (CECT) revealed pancreatic tail cancer with multiple liver metastases. After three courses of chemotherapy, CECT revealed good response with shrinkage of the tumors. However, the patient had back pain and CECT revealed pancreatic pseudocyst with pseudoaneurysm rupture. He underwent angiography, wherein the splenic artery pseudoaneurysm was embolized using TAE. Subsequently, pseudocyst drainage was performed using lumen-apposing metal stent (LAMS) to prevent pseudoaneurysm re-rupture. Thereafter, the pseudocyst shrieked with decreased serum levels of C-reactive protein, allowing the patient to re-institute chemotherapy. Pseudocyst drainage using LAMS was safe and effective when the pancreatic pseudoaneurysm had a high-risk rebleeding due to exposure to pancreatic juice.

At the 71st Annual Meeting of the Japan Society for Oriental Medicine held in August 2021, we conducted a special program focusing on Kampo medicine education, “Pre-graduation post-graduation Kampo medicine education for the next generation.” The following is a summary report on the practical training in Kampo medicine at each educational facility where the project was conducted. We recorded videos with explanations of topics in advance : “Four examinations,” “Decoction and crude drugs,” and “Acupuncture and moxibustion.” The report on the hands-on training in Kampo medicine was viewed 501 times by medical students, educators, and the society members across the country. This initiative was the first nationwide educational activity of the society.

We describe two cases of cardiac failure in elderly patients successfully treated with shimbuto. Case 1 was that of an 84-year-old man with severe aortic stenosis and liver cancer. His cardiac failure led to repeated hospitalization. After taking shimbuto, his pleural effusion decreased and cardio thoracic ratio improved. Case 2 was that of an 84-year-old man who was hospitalized because of cardiac failure and aspiration pneumonia after undergoing an operation for lung cancer. After taking shimbuto, his urine volume increased and cardiac failure improved. No notable adverse events were observed in any of the abovementioned cases. It is important that kanzo is not included in shimbuto to demonstrate risui action, hence the use of other “ho” formulations should be avoided. These cases suggest that shimbuto is indicated for elderly patients with cardiac failure under terminal care.

STUDY DESIGN: Prospective experimental study on humans. PURPOSE: To determine whether postural differences during a low-speed impact are observed in the sagittal and axial views, particularly in a relaxed state. OVERVIEW OF LITERATURE:: Three-dimensional motion capture systems have been used to analyze posture and head-neck-torso kinematics in humans during a simulated low-speed impact, yet little research has focused on the axial view. Since a seatbelt asymmetrically stabilizes a drivers right shoulder and left lower waist into the seat, it potentially creates movement in the axial view. METHODS: Three healthy adult men participated in the experimental series, which used a low-speed sled system. The acceleration pulse created a full sine shape with a maximum acceleration of 8.0 m/s2 at 500 ms, during which the kinematics were evaluated in relaxed and tensed states. The three-dimensional motion capture system used eight markers to record and analyze body movement and head-neck-torso kinematics in the sagittal and axial views during the low-speed impact. Head and trunk rotation angles were also calculated. RESULTS: Larger movements were observed in the relaxed than in the tensed state in the sagittal view. The cervical and thoracic spine flexed and extended, respectively, in the relaxed state. In the axial view, larger movements were also observed in the relaxed state than in the tensed state, and the left shoulder rotated. CONCLUSIONS: During simulated frontal impact, the rotation angle between the head and trunk was significantly larger in the relaxed state. Therefore, we recommend also observing movement in the axial view during impact tests.
Acceleration ; Adult ; Biomechanical Phenomena* ; Head ; Humans ; Imaging, Three-Dimensional ; Male ; Posture ; Prospective Studies ; Shoulder ; Spine* ; Transcutaneous Electric Nerve Stimulation*

The nuclear hormone receptor PPARgamma is activated by several agonists, including members of the thiazolidinedione group of insulin sensitizers. Pleiotropic beneficial effects of these agonists, independent of their blood glucose-lowering effects, have recently been demonstrated in the vasculature. PPARgamma agonists have been shown to lower blood pressure in animals and humans, perhaps by suppressing the renin-angiotensin (Ang)-aldosterone system (RAAS), including the inhibition of Ang II type 1 receptor expression, Ang-II-mediated signaling pathways, and Ang-II-induced adrenal aldosterone synthesis/secretion. PPARgamma agonists also inhibit the progression of atherosclerosis in animals and humans, possibly through a pathway involving the suppression of RAAS and the thromboxane A2 system, as well as the protection of endothelial function. Moreover, PPARgamma-agonist-mediated renal protection, especially the reduction of albuminuria, has been observed in diabetic nephropathy, including animal models of the disease, and in non-diabetic renal dysfunction. The renal protective activities may reflect, at least in part, the ability of PPARgamma agonists to lower blood pressure, protect endothelial function, and cause vasodilation of the glomerular efferent arterioles. Additionally, anti-neoplastic effects of PPARgamma agonists have recently been described. Based on the multiple therapeutic actions of PPARgamma agonists, they will no doubt lead to novel approaches in the treatment of lifestyle-related and other diseases.
Animals ; Atherosclerosis/prevention & control ; Humans ; Hypertension/drug therapy ; Hypoglycemic Agents/*pharmacology ; Kidney Diseases/etiology ; PPAR gamma/*agonists ; PPAR-beta/agonists

We report three cases with somatoform disorder which were considered as “Hontonki” disease, successfully treated with keishikakeito. Case1 was a 34-year old male who was suffering from headache and palpitation. He said ‘Something pierces and it goes up from the chest to the head.' We considered his complaint as Hontonki disease and administered keishikakeito. After one week, the headache disappeared and four weeks later, palpitation and tinnitus were definitely improved. Case2 was a 22-year old male. His complaints were excessive strain and general fatigue. Because he had coldness of lower extremities and spasmodic headache, we interpreted these symptoms Hontonki disease and administered keishikakeito. After that these symptoms and his psychological test scores improved markedly. Case 3 was a 75-year old female. Severe headache and palpitations presented after remodeling her home. Three weeks later taking keishikakeito, her symptoms had disappeared dramatically. Recently, Hontonki disease are often compared with panic disorder, and it is possible that some somatoform disorder cases include Hontonki disease. It is important to consider the possibility of Hontonki disease behind the physical complaints such as headache and palpitation, when we use keishikakeito.