1.A Method for Extracting Pharmacokinetics Properties from Package Inserts: Usage of Interactive Artificial Intelligence Systems
Tsuyoshi ESAKI ; Keiko OGAWA ; Kazuyoshi IKEDA
Japanese Journal of Drug Informatics 2024;26(2):80-91
Objective: Research and development for drug discovery is time-consuming and expensive. Artificial intelligence (AI) technologies, such as machine learning are attracting the attention of researchers as tools for efficiently advancing drug discovery. However, the use of AI technology requires a high amount of data, and the scope of application and accuracy of prediction depend on data quality. Therefore, the development of technology for efficiently collecting drug information data is required. The present examined an interactive AI system for extracting absorption, distribution, metabolism, and excretion (ADME) data from clinical practice documents. Methods: Attachments for five drugs were collected from the Pharmaceuticals and Medical Devices Agency (PMDA) for properties influencing pharmacokinetics, including dosage, maximum concentration (Cmax), half-life (T1/2), time to peak drug concentration (Tmax), area under the curve (AUC), and clearance (CL). Data were collected directly from PDFs using ChatGPT Plus, SciSpace, and ChatPDF as interactive AI systems capable of performing this task, and variations in these properties were compared. In addition, we compared the variations in the prompting outputs. Results: ChatGPT Plus was able to retrieve some pharmacokinetic properties including the values in the tables, whereas SciSpace and ChatPDF were unable to retrieve pharmacokinetic information. In addition, the ChatGPT Plus output changed depending on the prompt, whereas the results obtained using SciSpace and ChatPDF did not change significantly based on the prompt. Therefore, ChatGPT Plus was the most appropriate system for collecting ADME data. Conclusion: Based on the results of collection of ADME characteristics from documents using the three interactive AI systems, ChatGPT Plus is the most effective method for obtaining the desired characteristics, although several issues need to be addressed. Interactive AI will be an indispensable technology for data collection in drug research, and could contribute significantly to drug discovery in the future.
2.A Case of Atypical Ménière’s Disease with Frequent Urination Successfully Treated with Choreitogoshimotsuto
Kampo Medicine 2023;74(4):342-347
Ménière’s Disease is an unexplained inner ear lymphedema disease. We report a case of atypical Ménière’s Disease with frequent urination in which choreitogoshimotsuto (CRTST) was effective. A 47-year-old woman had repeated bilateral tinnitus and hearing loss for the past 3 years, and was diagnosed with an atypical case of Ménière’s Disease at a local otolaryngologist. She continued oral administration of isosorbide, but repeated exacerbations and remissions. Given the pathology of fluid retention, blood deficiency, static blood, and yin deficiency, we prescribed her CRTST referring to the symptom of frequent urination. The symptoms of frequent urination and tinnitus subsequently improved and CRTST was naturally discontinued after 1 year and 3 months. CRTST has the effects of fluid regulation, heat clearance, nourishment of yin, tonifying blood, and resolving blood stasis. Goreisan and Saireito are generally used for Ménière’s Disease because inner ear lymphedema is regarded as fluid retention. This case shows that CRTST can be an effective option for treatment of Ménière’s Disease caused by pathological conditions such as fluid retention, blood deficiency, static blood, and yin deficiency.
3.A Case of Response to Keishikajutsubuto for Stump Pain after Both Femoral Amputation
Yoshito HAMANAMI ; Junsuke ARIMITSU ; Keiko OGAWA-OCHIAI ; Yoshinobu MATSUMORI ; Ryuichi SAURA
Kampo Medicine 2023;74(4):348-352
We have experienced a case of response to keishikajutsubuto for stump pain after both femoral amputations. There are few reports on the use of Kampo medicines for stump pain after amputation. In this case, the critical lower-limb ischemia that led to the amputation was due to severe stenosis and occlusion caused by arteriosclerosis in both limbs. From the perspective of Kampo medicine, ischemia is considered to have cold and blood status as a result of deficiency and stagnation of yang qi due to circulatory failure. In this case, we regarded blood stasis as a secondary product of ischemia, and we mainly considered a prescription to remove cold and bring yang qi to the eliminative organs, which was effective for the pain. For stump pain after amputation that is poorly responded to general analgesics, the combination of keishikajutsubuto is expected to provide rapid analgesic effect, suggesting that it is useful for pain control.
4.A Case of Chronic Kidney Disease Stage G4 Successfully Treated with Yojinkodakuto
Hirofumi HIRANA ; Kazuhiko SHIMIZU ; Akihiro FUTAMURA ; Kazuyuki HIRATANI ; Yukie INOUE ; Keiko OGAWA
Kampo Medicine 2023;74(4):353-364
We report a case of 2X-year-old man with G4 chronic kidney disease (CKD G4). He had a decline in estimated glomerular filtration rate (eGFR) after the initiation of BEP (cisplatin, etoposide, bleomycin) therapy followed by VelP (ifosfamide, cisplatin, vinblastine) therapy for mixed germ cell testicular tumor. The patient’s eGFR did not recover during 59 months after chemotherapy, but showed a tendency to improve after treatment with yojinkodakuto. Yojinkodakuto was prepared by the IPCD (immersing powdered crude drugs) method. The IPCD method was adopted to ensure convenience and good quality prescription herbal medicines. Although eGFR fluctuated after yojinkodakuto treatment, at 3 years, serum creatinine (sCr) and eGFR progressed well, with sCr reducing from 3.98 mg/dL at initiation to 2.6 mg/dL and eGFR increasing from 16 mL/min/1.73 m2 to 25.4 mL/min/1.73 m2. In addition, a long-term eGFR plot analysis confirmed the 3-year improvement trend.
5.A Case of Combined Use of Kampo, Japanese Herbal Medicine and Acupuncture/Moxibustion for Chronic Facial Pain of Unknown Cause with Mental Anxiety
Sakura MATSUMOTO ; Mako IWAHASHI ; Ryouta KIYOMATSU ; Takae TAKEBE ; Akiko SHIRAI ; Masao OGAWA ; Masaki TSUDA ; Keiko OGAWA
Kampo Medicine 2022;73(2):190-196
Usually, chronic pain is difficult to treat because this is often accompanied by none-organic factors such as psychiatric symptoms, which complicate the pathological condition. For this reason, the guidelines also call for coping with peripheral symptoms except pain. This time, we report that facial pain as well as peripheral symptoms such as mental anxiety gradually improved by a combination of decoction extract and acupuncture and moxibustion. The case was a man in his 60s, who received all kinds of treatments such as taking Western medicines and blocking trigger points for chronic facial pain of unknown cause with mental anxiety. However, even after one year the side effects were strong and the treatment was ineffective. Acupuncturists and Kampo specialists made the diagnosis and treatment based on a common concept of Kampo medicine. Treatment focused on shin abnormalities and oketsu suppressed the vicious cycle of pain and improved psychiatric symptoms and QOL. It was suggested that Kampo medicine based on the idea “the same in mind and body” is effective for chronic pain in which various symptoms are intricately intertwined.
6.Report of the 71st Annual Meeting of the Japan Society for Oriental Medicine Special Program 1-“Pre-and Post-Graduation Education of Kampo Medicine for the Next Generation”: Standard Lecture on Kampo Medicine
Shin TAKAYAMA ; Takahide MATSUDA ; Yoshihide YAKAZU ; Makoto ARAI ; Takao NAMIKI ; Keiko OGAWA ; Juichi SATO ; Tomoaki ISHIGAMI ; Go ITO ; Tadamichi MITSUMA
Kampo Medicine 2022;73(3):247-262
At the 71st Annual Meeting of the Japan Society for Oriental Medicine held in August 2021, we conducted a special program, “Pre-graduation and post-graduation Kampo medical education for the next generation,” focusing on Kampo medical education. We summarize and report a mock lecture on standard Kampo medicine conducted jointly with the Japan Council for Kampo Medical Education (JCKME) for the purpose of faculty development. The lecture contents were based on the “Basic Curriculum for Pre-Graduate Education in Kampo Medicine 2016” established by the JCKME, and the common model slides prepared by the JCKME were used. The lectures were pre-recorded for 240 minutes on the “History of Kampo medicine,” “basic theory of Kampo medicine,” “physical examination of Kampo medicine,” “composition and effects of typical Kampo medicines, effects and side effects of typical herbal medicines,” “usefulness of Kampo and clinical cases that were effective,” and “overview of acupuncture and moxibustion treatment,” and were delivered from seven days before to seven days after the annual meeting. This was the first nationwide educational activity for the general meeting of the society. These lectures were viewed 1,017 times nationwide, by medical students, educators, and members of the society.
7.Two Cases with Foreign Body Sensation of the Throat Treated with Ryokeijutsukanto and Goshuyuto
Kampo Medicine 2022;73(3):325-330
The patients with foreign body sensation in the throat often visit the hospital. However, they have no problem in Western medicine and may be prescribed with anxiolytics. In Kampo medicine, hangekobokuto is effective in most cases for the symptom of qi stagnation. This time, we report that 2 cases, in which hangekobokuto was ineffective, responded to the combination of ryokeijutsukanto and goshuyuto. The combination, which is a mixture of hontonto (Zhouhou fang), bukuryo, jutsu, and taiso, excluding hange, was effective in these 2 cases as running piglet.
8.A Case of the Night Owl and Cancer Pain of Patient with Advanced Cancer Successfully Treated with Kampo
Myungmi OH ; Akiko SHIRAI ; Keiko OGAWA
Kampo Medicine 2020;71(1):48-52
Night owl is one of the painful symptoms for cancer patients. Patients with advanced cancer, who tend to bed on bed rest, often sleep during the day and are awake at night, especially. Night owl may make worse the QOL of patients. We controlled night owl and cancer pain of a patient with advanced cancer by treatment with Kampo, Japanese herbal medicine. The case was a 53-year-old female patient with metastatic head and neck cancer. She tended to be a night owl. So, we administered maobushisaishinto and keishikaryukotsuboreito to her, because we regarded her as qi obstruction. During the night, she was able to sleep successfully. After that, administration of hainosankyuto and bukuryoingohangekobokuto reduced the use of rescue medication. Moreover, Kampo was useful for pain control.
9.Report and Proposals on Participation in International Congress on Complementary Medicine Research (ICCMR) 2019 as the Members of International Committee of Japanese Society for Oriental Medicine
Mitsuyuki TAKAMURA ; Keiko OGAWA
Kampo Medicine 2020;71(2):162-165
The Japan Society for Oriental Medicine has established various committees, which are working every day to disseminate Japanese traditional herbal medicine (Kampo) and support the activities of academic members. As the members of the International Committee and the medical doctors who conduct research and clinical practice of Kampo at the university hospital, the authors participated in the 14th International Congress on Complementary Medicine Research held in Australia in May 2019. To improve the international recognition and international dissemination of Japanese Kampo, we held the Japanese Kampo Symposium on gastrointestinal diseases successfully. While it was realized that there was an international big interest in Japanese Kampo, it seemed that Kampo researchers in Japan lack the ability to dispatch of information at international conferences compared to neighboring countries such as Korea and China.
10.Efficacy of Keishibukuryogankayokuinin for Tinnitus with Blood and Water Stagnation
Akiko SHIRAI ; Junsuke ARIMITSU ; Keiko OGAWA
Kampo Medicine 2020;71(3):228-234
Keishibukuryogankayokuinin (KBGY) is a Kampo formulation that is well known as being suitable for patients with blood and water stagnation. In this study, we retrospectively investigated the efficacy of KBGY for tinnitus patients. The total number of patients was 9 (5 males, 4 females). The average age was 67 years (range : 54-81 years, the median age : 65 years). The progression of 9 patients was cure (1), amelioration (6), no change (2), and deterioration (0). The important pathophysiology of tinnitus in Kampo medicine includes blood stagnation and water stagnation. In these cases, KBGY can single-handedly improve both blood and water stagnation. We recommend KBGY for the treatment of tinnitus caused by the coexistence of blood and water stagnation.


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