[Background] Moxibustion has contributed to better health outcomes of the Japanese people. But only a small number of reports are available regarding the current practice of moxibustion in recent years. We therefore surveyed moxibustion practitioners.[Methods] Through academic societies, professional organizations, and other associations related to the disciplines of acupuncture and moxibustion, practitioners were asked to respond to the questionnaire via Google Forms. [Results] Valid responses were obtained from 1,507 practitioners with the following demographics: 67.8% had been engaged in clinical practice for less than 20 years; 71.9% ran their own clinics; 43.6% belonged to academic societies; 69.3% belonged to industrial organizations, etc. The proportion of practitioners conducting various methods of moxibustion were as follows: 66.3% warming moxibustion and 53.4% for heating-through moxibustion, and regarding processed moxibustion, 79.5% included moxibustion with tube and 37.0% used smokeless moxibustion. Regarding the effectiveness of moxibustion, 98.9% responded as "highly effective" or "moderately effective." The proportion of respondents who experienced "patient's refusal of moxibustion" was 45.6% before patients experienced moxibustion and 33.2% after their experience. The patients refused it primarily because of "heat," "burns," and "uncomfortableness with smoke." Regarding the activities necessary to promote the spread of self-care moxibustion, "proving effectiveness through clinical research" (75.6%), "providing scientific evidence through basic research" (68.3%), and "awareness-building activities" (63.9%) were indicated among 1,495 respondents.[Discussion] The survey revealed that, due to the shift in societal awareness, there is also a shift in the use of moxibustion from direct moxibustion to more indirect moxibustion. Many clinical practitioners of moxibustion conducted the therapy because they considered it effective. The survey reconfirmed that heat, burns, and smoke represent major reasons why patients do not want to receive the moxibustion therapy. The challenging issues to be addressed for the purpose of spreading and developing moxibustion include maintenance of "safety," research to prove "clinical efficacy" and provide "scientific evidence," and "awareness-building activities."

Collaboration between medical institutions and community pharmacies is crucial for sharing patient’s treatment status and chemotherapy regimens in order to give safe and effective cancer chemotherapy for outpatient. In Kagoshima Medical Association Hospital, we established a framework for sharing this information with community pharmacies through a multidisciplinary approach. We conducted a questionnaire survey among community pharmacists to evaluate the usefulness of patient’s treatment status and chemotherapy regimens available on our hospital’s website. Most respondents found these resources “very useful.” Furthermore, respondents expressed a desire for additional information on chemotherapy regimen that was not currently available on our website but accessible from other institutions. This survey helped us understand the specific information required by community pharmacists regarding patient treatment status and chemotherapy regimens from medical institutions.

Objective: We conducted a questionnaire survey to comprehend the situation regarding the collection, provision, and utilization of drug safety information at hospitals.  In addition, we asked pharmaceutical companies how they select medical institutions to provide drug safety information.  We also investigated the current situation of information provision to Tokyo Medial Center by pharmaceutical companies.
Method: A questionnaire was mailed to all hospitals in Japan.  The survey was conducted between January 13 and February 10, 2011.  Moreover, we asked thirteen pharmaceutical companies by telephone and e-mail about the implementation status of the provision of information and performed a survey at Tokyo Medical Center on the current situation of information provision by pharmaceutical companies regarding revisions to precaution sections in package inserts.
Results: The results of the questionnaire survey (response rate: 41.2%) showed that the major information sources for hospitals were medical representatives (77.8%), Drug Safety Update (50.3%) and direct mails (49.3%).  Furthermore, in the case of drugs prescribed exclusively for extramural dispensing, fewer hospitals responded that medical representatives of the pharmaceutical companies provided drug safety information and more hospitals responded that they did not obtain any drug safety information at all, compared with drugs listed in the hospital formularies.
Conclusion: To minimize the risks of drugs, healthcare professionals must collect a wide range of drug safety information and must utilize this information in their medical practice.  Therefore, it is important that pharmaceutical companies and regulatory authorities make an effort to provide suitable information dissemination to medical institutions.  Furthermore, medical institutions must also strengthen their systems for collecting drug safety information and providing such information to healthcare professionals.

  An inquiry was made into the health of 10 one-time asbestos workers now living in the southern part of Akita Prefecture who had taken screening tests for asbestosis on a regular basis. The purpose of this study was to provide pertinent information and better health support to these people at high risk of developing asbestos-related diseases. The average number of years they served as asbestos workers was 11.1±2.12 years and 29.8±4.64 years had passed sincefirst exposure. All the subjects were found to have had no idea about guarding against exposure to asbestos while at work. Neither had they been told to protect themselves from this fibrous mineral by their employers. What motivated them to take examinations for asbestosis was news reports provided by newspapers and other mass media about pulmonary disorders caused by earlier contact with asbestos fibers. Half of the subjects did not know anything about qualifications for receiving the health card for retired asbestos workers. They expressed apprehensions about their health. One subject said, “I may be taken ill anytime,” another said, “The psychological burden of always taking meticulous care of my health is overwhelming,” and still another said, “There is no way of knowing whether I am suffering from asbestosis because there is no symptom.” The latest statistics showed that the number of officially acknowledged victims of asbestos-related pulmonary diseases is increasing across the nation together with the incidence of mesothelioma. To allay the anxiety of former asbestos workers about their health, this study suggested that as the responsibilities of the medical profession, we should (1) get acquainted with the relief system and related laws, (2) help the patients maintain their quality of life by following up the their problems over a long period of time, and (3) continue research activities and make the results public so as to contribute to the relief of the patients.

We report on a case of severe generalized pain due to fibromyalgia syndrome, which was successfully treated with a variation of byakkoto. A 65-year-old Japanese woman had severe generalized pain which grew worse in warm environments, such as during the summer or when bathing. She also had pollakidipsia. We utilized a variation of byakkoto on the assumption that she was suffered from high inner heat. Her severe generalized pain resolved with this therapy. Although bushi-zai and saiko-zai are common prescriptions for fibromyalgia syndrome, byakkoto-variations may also be effective in cases where conditions are worsened by heat effect.
Fibromyalgia ; Pain ; Treated with ; Generalized aches and pains ; Syndrome

Aims : To clarify any difficulties that pharmacists and nurses may have when prescribing Kampo medicines to newly-admitted patients with a survey questionnaire at a local hospital ward.Methods : Questions for pharmacists on the handling of Kampo herbs, any perceived risks in the preparation of Kampo formulae powder extracts/pills, or in explaining Kampo medicines, based on their experiences. Also questions for nurses on the handling of Kampo medicines, as compared to western medicines, and any perceived risks in their administration at their ward.Result : All 7 pharmacists and 14 out of the 16 nurses surveyed completed their questionnaires. The pharmacists pointed out that Kampo preparation takes more time, although none perceived an increased risk with Kampo medicines, as compared to western medicines. Only 1 pharmacist had ever had experience explaining Kampo medicines to patients. The nurses, on the other hand, felt that Kampo treatments were somewhat more difficult to use, and perceived similar risk in their administration to patients.Conclusion : Both the pharmacists and nurses surveyed believed that the handling of herb medicines was somewhat difficult, but that these difficulties could be overcome with risk management. This suggests that pharmacist, nurse and office personnel education would be useful before Kampo medicines are administered to newly-admitted hospital patients.
Medicine, Kampo ; perceived risk ; seconds ; Therapeutic procedure ; Risk

Lower limb skin ulcers due to arteriosclerosis obliterans are severe ischemic lesions, and if preservation therapies such as antiplatelet and anticoagulant treatments are not effective, lower limb amputation may be necessary.We report the case of 73 year-old male patient suffering from intermittent claudication and skin ulcers on the heel of the left foot, who was successfully treated with keishibukuryogan and daisaikoto prepared in hospital. This case suggests that improvement of micro circulation with the addition of keishibukuryogan and daisaikoto to anticoagulant and antiplatelet therapies, safely promoted an improvement of ischemic lesions due to arteriosclerosis obliterans.
Skin Ulcer ; Intermittent Claudication ; Hospitals ; seconds ; Lower

OBJECTIVESTo investigate the prevalence of non-alcoholic fatty liver disease (NAFLD) in children and its relationship to metabolic syndrome, insulin resistance, and waist circumference (WC).

METHODSThis was a population-based cross-sectional, case-control study. Cases were selected among students of a primary and junior high school, respectively, and age- and sex-matched control subjects were selected randomly (ratio of cases to control subject was 37:113).

RESULTSOf the 846 students, aged between 6 and 15 years, enrolled in the study and screened by ultrasonography, 37 children were diagnosed as having NAFLD (score >/= 1). There was a significant sex difference in the prevalence of NAFLD(P = 0.003). The trend test revealed a strong dose-response relationship (P < 0.001) between pediatric NAFLD and the number of the proposed components of pediatric metabolic syndrome in Japan (MetS-JC), such as a clustering of the components of MetS-JC. Additionally, the linear trend of the odds ratios (ORs) with increasing percentile of the homeostasis model assessment-insulin resistance (HOMA-IR) was statistically significant (P < 0.001). However, when WC was added to the logistic model, the ORs were no longer significant, whereas WC turned out to be an independent risk factor for NAFLD regardless of the HOMA-IR index.

CONCLUSIONThe prevalence of NAFLD in children and adolescents is closely related to metabolic syndrome, insulin resistance, and WC.

The literary source of seishitsuketanto, which has been used for intercostal neuralgia, and similar pain in the chest and back, is the text Shou shi bao yuan. We prescribed seishitsuketanto to 5 patients suffering from coldness and/or pain of the thorax. As a result, seishitsuketanto was effective for 4 patients, and not effective for 1 patient. An investigation of the effective cases, an invalid case and references suggest that findings indicating seishitsuketanto have the following features; migratory coldness of the thorax, significant symptoms of disorder in body fluid metabolism, sphygmopalpation without floating pulse, and thoracic pain due to inflammation based on pulmonary insufficiency.
Thorax ; Pain ; Cases ; symptoms <1> ; findings

Along with hemodialysis, continuous ambulatory peritoneal dialysis (CAPD), which performs the work of the kidneys, is used in treating chronic renal failure. CAPD (hereafter referred to as PD) can be conveniently done at the patient's home.Other advantages of it include less adveres effects on the cardiovascular system as homeostasis of body fluid is maintained;less dietary restriction;reduction in the frequency of outpatient treatment;availability of a system suited to the patient's lifestyle;and being comparatively easy to return to work. Nonetheless, home PD patients remain at risk of peritonitis, exit-site infection, and undernutrition due to protein-losing enteropathy. Moreover, patients may feel that they have gotten wary of taking care of themselve. Recently, we have come upon a case of end-stage renal failure in a 59-year-old articular rheumatic who was unable to exchange dialysis bags because her finger joints were deformed. So, we applied a PD system using the SMAP method to the patient with the result that she became able to manage to operate the PD by herself.Our patient wished to take it upon herself to perform PD using a UV-F twin-bag system. Ordinarily, bags have to be exchanged four times a day and every time bags are exchanged, several clamping procedures are required. It was impossible for her to exchange bags because of deformed finger joints. To make the impossible possible, a supplementary device for exchanging bags had to be fixed. It was also necessary for her to learn how to manipulate the newly attached device in addition to the existing device. With the SMAP method, there is plenty of time before PD gets started. So it was possible to examine the self-management method thoroughly and learn the trick of operating the new device. Our experience showed that PD by the SMAP method is useful to articular rheumatic patients with finger joint deformities.
PUPILLARY DISTANCE ; Patients ; Peritoneal Dialysis, Continuous Ambulatory ; Fingers ; Joints