People with high health knowledge tend to use information and communication technology (ICT) to obtain, maintain, and promote information necessary for health management. Therefore, experts hypothesize that improving health knowledge will increase the use of online medication guidance via ICT. In this study, we investigated the relationship between health knowledge and willingness to use online medication guidance among Iwaki Health Promotion Project health checkup subjects. The 736 examinees participating in this project in 2022 were surveyed on age, gender, number of people living with them, whether they exercise, drink alcohol, or smoke, whether they use smartphones, whether they use medication registers, their health knowledge score, and whether they take any medications. The presence/absence of desire for online medication guidance (1/0) was used as the objective variable to identify influencing factors. Univariate and multivariate analyses showed that independence was found for four factors: age (OR: 0.975, P<0.001), gender (male) (OR: 1.914, P<0.001), smartphone use (OR: 2.156, P＝0.004) and health knowledge score (OR: 1.405, P<0.001). This study found that health knowledge plays a role in the intention to use online medication guidance. In order to improve health knowledge, it will be necessary to enhance skills to obtain and use high-quality health information and to improve the environment for using ICT-based communication devices.

Methods: A total of 14 patients with unilateral radicular symptoms and five healthy subjects were subjected to simultaneous apparent T2 mapping and neurography with nerve-sheath signal increased with inked rest-tissue rapid acquisition of relaxation enhancement signaling (SHINKEI-Quant) using a 3-Tesla magnetic resonance imaging. The Visual Analog Scale (VAS) score for neck pain and upper arm pain was used to evaluate clinical symptoms. T2 relaxation times of the cervical dorsal root ganglia of the brachial plexus were measured bilaterally from C4 to C8 in patients with radicular symptoms and from C5 to C8 in healthy controls. The T2 ratio was calculated as the affected side to unaffected side. Results: When comparing nerve roots bilaterally at each spinal level, no significant differences in T2 relaxation times were found between patients and healthy subjects. However, T2 relaxation times of nerve roots in the patients with unilateral radicular symptoms were significantly prolonged on the involved side compared with the uninvolved side (p<0.05). The VAS score for upper arm pain was not significantly correlated with the T2 relaxation times, but was positively correlated with the T2 ratio. Conclusions In patients with cervical radiculopathy, the SHINKEI-Quant technique can be used to quantitatively evaluate the compressed cervical nerve roots. The VAS score for upper arm pain was positively correlated with the T2 ratio. This suggests that the SHINKEI-Quant is a potential tool for the diagnosis of cervical nerve entrapment.

Objective: The purpose of this study was to assess the treatment outcome in patients with chronic hepatitis C (CHC) using the current standard antiviral therapy when patient were treated in collaboration between hepatologists and primary care physicians (PCPs).Patients and Methods: One hundred and ten patients with CHC were treated with a combination therapy of peginterferon-alpha 2b and ribavirin. Among them, 25 patients were treated by a collaboration between hepatologists and PCPs (collaboration group), whereas 85 patients were treated with exclusively by hepatologists (noncollaboration group). The duration of the therapy was 48 weeks for 58 'difficult- to-treat' patients (genotype 1 with a high load of HCV-RNA; 1H patients) and 24 weeks for the remaining 52 patients (non-1H patients). In the collaboration group, antiviral therapy was initiated and adjusted, if needed, by hepatologists (visits every four weeks), whereas the weekly administration of peginterferon-alpha 2b was performed by PCPs. Clinical characteristics and the treatment outcome were compared between these two groups.Results: The two groups had similar baseline characteristics. By intention to treat, the two groups showed similar rates of treatment-related serious adverse effects (0% vs. 1%, respectively) and dropout rates for adverse effects (8% vs. 13%, respectively). Sustained virologic response rates were also similar between the two groups, being 42% vs. 39% in the 58 1H patients (NS) and 62% vs. 64% in the 52 non-1H patients (NS), respectively.Conclusions: Collaboration between hepatologists and PCPs may be a valid treatment alternative to treat patients with CHC using the current standard antiviral therapy.

Purpose: To report a case of successful treatment using gabapentin against hot flashes due to LH-RH agonist in a patient with advanced prostate cancer. Case summary: A male patient in his seventies with advanced prostate cancer had hot flashes due to LH-RH agonist therapy. The patient began to notice hot flashes within a few months after starting hormone treatment. Oral gabapentin was administered at a starting dose of 400mg/day and was gradually escalated to 1,200mg/day. Within 7 days of administration, the patient achieved a partial improvement of his symptoms. After 17 days of gabapentin therapy, the hot flashes significantly improved. While the patient was taking a maintenance dose of 1,200mg/day, he remained to be asymptomatic. Conclusion: There are only a few reports (none in Japan) that show effectiveness of gabapentin against hot flashes due to hormone treatment in male patients with prostate cancer. Although the mechanism of the hot flash-relieving effect of gabapentin is not fully understood, this case report indicates that gabapentin may help treating patients suffering from intractable hot flashes. Palliat Care Res 2009; 4(2): 334-338

Nosocomial infection management is one of the most important subjects in terms of risk management in a hospital. To achieve the nosocomial infection management appropriately, both public relations and information gathering are important. When it comes to publicity, it is desirable that information is offered quickly and efficiently and the personnel are able to access the information easily anytime and wherever they are. As for information gathering, it is also important to collect the information concerning the nosocomial infection promptly, and to tell it quickly to infection management persons including infection control team members. The infection control committee of our hospital has engaged in both publicity and information gathering by using the committee web site established in the LAN of the hospital since January 2004. The web site carries notifications, organization chart, list of committee members, various manuals, guidance of educational activities, infection management, etc. It is also used for questions and answers, and gathering information concerning nosocomial infection. The number of times the web site was accessed was about 200 every month, and was considerable at night and on holidays. This method of using the web site seems to be useful to promote nosocomial infection management.
Nosocomial Infections ; Infection as complication of medical care ; Information gathering ; Local Area Networks ; Hospitals

The whole spectrum of patients infected with hepatitis C virus (HCV) who visited hospitals has not been fully clarified. It is also unknown whether such patients have visited the hospitals regularly thereafter for a long period. We studied 844 consecutive patients with liver diseases who visited our outpatient clinic located in the southern region of Ibaraki Prefecture. Five hundred eighty-three patients were HCV-infected. Among them, three patients were HBsAg-positive and another patient was IgM anti-HAV positive. Thus, 579 patients (68.6%) were considered to have HCV solely as a hepatotropic virus.Of these HCV patients, 60 were asymptomatic carriers and 15 others were unclassified because of the absence of either biopsy or imaging test records of the liver. As to the rest of the HCV patients, acute hepatitis was diagnosed in one patients, chronic hepatitis in 332 patients, cirrhosis in 130 patients and cancer of the liver in 41 patients.About half of the patients undergoing liver biopsy showed F1 in the degree of liver fibrosis. The rate of virological response to interferon mono-therapy in patients infected with genotype 2 was worse than the national average. The poor response was considered to be due to high viral load. It was suggested that the distribution of patients with each genotype was uneven in this region. After five years, the rate of patients still visiting our clinic were 68.1% for those with chronic hepatitis, and 50% for the healthy carriers. We deemed that it was important to clarify whether patients not visiting our clinic are followed up closely in other hospitals.
Hepatitis C virus ; Liver ; Clinic ; Infection as complication of medical care ; biopsy characteristics

We treated two patients with rheumatoid arthritis (RA) who demonstrated different signs from the perspective of traditional medicine. The first case was a 73-year-old woman. In 1977, she consulted a nearby hospital due to bilateral knee joint pain. Her condition was diagnosed as RA. In 1984, she consulted our department for Stage IV and Class III disease. She was treated with Keishi-ni-eppi-itto-ka-ryojutsubu-kagen, and her condition stabilized. In 1994, she received total replacement of the bilateral knee joints. Her ADL increased, but pain at her bilateral wrist, elbow, shoulder and ankle joints persisted. Although she was treated with Yokuininto, as well as bucillamine and salazosulfapyridine, arthralgia persisted. In 1996, her condition was as follows: general malaise, pain at the bilateral shoulder and elbow joints, severe deformity at the wrist joints, dry skin and slender limbs. She walked with a cane. Therefore, we changed the formula from Keishi-shakuyaku-chimoto to Daibofu-to. Thereafter, her symptoms significantly decreased. The second case was a 50-year-old woman. In 1994, she suffered from pain in the right hand, bilateral feet and knee joints. Her condition was diagnosed as RA at a local hospital. In 1996, polyarthralgia increased and she consulted the department of orthopaedic surgery in our hospital. She was administrated bucillamine, but it was discontinued due to eruptions. Then she consulted our department. She was first treated with Keishi-ni-eppi-itto-ka-ryojutsubu, and then with Yokuininto, which did not change her symptoms. Therefore, we tried several DMARDs; however, her condition worsened. In June 2000, her laboratory data were as follows: RF 860U/ml, ESR 72mm/hr, CRP 4.0mg/dl. Although she complained of pain at the bilateral wrist, elbow and ankle joints, there was no deformity in the bilateral wrist or finger joints of either hand. She was a medium-sized person, and without dry skin or edema at the limbs. The administration of Daibofu-to improved her symptoms as well as laboratory data after 3 months of treatment.
The clinical signs of case 1 were in accordance with the traditional indications for Daibofu-to. In contrast, those of case 2 differed from these indications with regard to blood-deficiency, since there was no dry skin, change in the nail, dizziness or deformity of the joints. These observations suggest that a subset of patients with RA, who have poor deficiency of blood or Ki, may be another population that can be successfully treated with Daibofu-to.

Quercetin, a flavonoid, widely distributed in many fruits and vegetables, is well known to have an antitumor effect despite its mutagenicity. In this study, we examined the effect of dietary quercetin on duodenum-tumorigenicity of mice induced by a chemical carcinogen, N-ethyl-N'-nitro-N-nitrosoguanidine (ENNG). Eight-week-old male C57BL/6 mice were divided into 4 groups; ENNG without quercetin (group A), ENNG with 0.2% quercetin (group B), ENNG with 2% quercetin (group C), and 2% quercetin without ENNG (group D). ENNG was given in drinking water for the first 4 weeks, and thereafter quercetin was given in a mixed diet. At week 20, the average number of duodenal tumors per mouse was significantly higher in group C (mean±SE, 7.26±1.75, p<0.05) than in group A (2.32±0.31). The size of the duodenal tumors increased significantly in group B (1.79±0.09 mm, p<0.001) compared with group A (1.43±0.09 mm). In contrast, no duodenal tumor was induced in group D. The present findings suggest that excessive intake of quercetin occasionally is a risk factor for carcinogenesis of some specific organs such as the upper intestine.

Effects of 38°C 30-minute bathing on hemostatic function and autonomic nervous function were studied in 15 48-to-72-year-old patients with cerebral infarction. Blood samples were collected three times: immediately before the bathing, at the end of 30 minutes of bathing, and 30 minutes after the bathing. Hematocrit values and fibrinogen concentrations decreased during bathing and returned to the pre-bathing levels 30 minutes after bathing. This indicates that bathing caused hemodilution due to the fluid shift. During bathing, noradrenaline decreased at a rate significantly higher than that of hemodilution while the sympathetic nervous function, which was evaluated by spectral analysis of sequential variation in arterial blood pressure, was not suppressed. The autonomic nervous system seemed to be inactive in these patients. Coagulation time (PT and APTT) and platelet factor (β-TG and PF4) showed few changes. In the fibrinolytic system, however, tissue plasminogen activator (t-PA) antigen levels increased and plasminogen activator inhibitor type-1 (PAI-1) levels decreased after 30 minutes of bathing. This suggests that fibrinolytic activity was enhanced by 38°C bathing for 30 minutes. Thus, subthermal bathing with comfort may be useful in preventing cerebral infarction.

Quercetin, a flavonoid, widely distributed in many fruits and vegetables, is well known to have an anti-tumor effect despite its mutagenicity. In this study, we examined the effect of dietary quercetin on duodenum-tumorigenicity of mice induced by a chemical carcinogen, N-ethyl-N'-nitro-N-nitrosoguanidine (ENNG). Eight-week-old male C57BL/6 mice were divided into 4 groups; ENNG without quercetin (group A), ENNG with 0.2% quercetin (group B), ENNG with 2% quercetin (group C), and 2% quercetin without ENNG (group D). ENNG was given in drinking water for the first 4 weeks, and thereafter quercetin was given in a mixed diet. At week 20, the average number of duodenal tumors per mouse was significantly higher in group C (mean±SE, 7.26±1.75, p<0.05) than in group A (2.32±0.31). The size of the duodenal tumors increased significantly in group B (1.79±0.09 mm, p<0.001) compared with group A (1.43±0.09 mm). In contrast, no duodenal tumor was induced in group D. The present findings suggest that excessive intake of quercetin occasionally is a risk factor for carcinogenesis of some specific organs such as the upper intestine.
Quercetin ; Upper Case En ; ENNG ; week ; Laboratory mice