The purpose of this study is to clarify factors related to the effect of daikenchuto on constipation during pregnancy. The subjects were 21 patients who had constipation during pregnancy and received 15 g/day of daikenchuto. Based on the constipation score that was created independently, the score values before administration, 2 weeks and 4 weeks after administration were retrospectively investigated. Furthermore, from the outcome of the oral status at 4 weeks, we divided the patients into 2 groups (12 in the improvement group and 11 in the non-improvement group), and attempted to extract factors that were considered to be related to efficacy. The total constipation score decreased significantly before and after administration of daikenchuto, and the concomitant symptoms of constipation scores were low, especially such as abdominal distension and abdominal pain. A comparison of the backgrounds of the improved group and the non-improved group revealed that the proportion of the patients with a history of surgery (laparotomy or laparoscopic surgery) was significantly higher in the improvement group. In addition, there were no particular problems with the pregnancy and delivery course of the 23 patients. Daikenchuto was considered to be highly effective against constipation during pregnancy, especially in pregnant women with a history of surgery.

Background/Aims: Several studies have assessed the effect of cool temperature on colonic peristalsis. Transient receptor potential melastatin 8 (TRPM8) is a temperature-sensitive ion channel activated by mild cooling expressed in the colon. We examined the antispasmodic effect of cool temperature on colonic peristalsis in a prospective, randomized, single-blind trial and based on the video imaging and intraluminal pressure of the proximal colon in rats and TRPM8-deficient mice. Methods: In the clinical trial, we randomly assigned a total of 94 patients scheduled to undergo colonoscopy to 2 groups: the mildly cool water (n = 47) and control (n = 47) groups. We used 20 mL of 15°C water for the mildly cool water. The primary outcome was the proportion of subjects with improved peristalsis after treatment. In the rodent proximal colon, we evaluated the intraluminal pressure and performed video imaging of the rodent proximal colon with cool water administration into the colonic lumen. Clinical trial registry website (Trial No. UMIN-CTR; UMIN000030725). Results: In the randomized controlled trial, after treatment, the proportion of subjects with no peristalsis with cool water was significantly higher than that in the placebo group (44.7% vs 23.4%; P < 0.05). In the rodent colon model, cool temperature water was associated with a significant decrease in colonic peristalsis through its suppression of the ratio of peak frequency (P < 0.05). Cool temperaturetreated TRPM8-deficient mice did not show a reduction in colonic peristalsis compared with wild-type mice. Conclusion For the first time, this study demonstrates that cool temperature-dependent suppression of colonic peristalsis may be associated with TRPM8 activation.

We aimed to clarify the significance of using Kampo therapy centered on kamishoyosan and tokishakuyakusan together with general infertility treatment. The subjects were 41 women who visited a Kampo outpatient clinic for infertility and received general infertility treatment with Kampo therapy (Kampo group). The control group was 781 women who received only general infertility treatment at the same time (non-Kampo group). In comparing both groups, we conducted a retrospective survey on the pregnancy rate by cycle and the pregnancy rate by prescription. The pregnancy rate in the first cycle was 24.4% in the Kampo group and 8.5% in the non-Kampo group, and the pregnancy rate was higher in the Kampo group (P = 0.003). There was no difference in pregnancy rates after the second cycle. The pregnancy rate by prescription was 26.7% for kamishoyosan, 22.2% for tokishakuyakusan, and 8.5% for the non-Kampo group. In the comparison between the first cycle pregnant group and the non-pregnant group, the qi counter flow score was clearly higher in the first cycle pregnant group (P = 0.012). It is suggested that combined use of Kampo therapy including kamishoyosan and tokishakuyakusan may be effective from an early stage. Meanwhile, if pregnancy does not occur even after the combined use of Kamp therapy, it would be an opportunity to consider stepping up as Western medical therapy.

Here, we report a case of adolescent woman with secondary amenorrhea complicated with polycystic ovary syndrome, which had a normal menstrual period after prescribed shokenchuto under the therapy based on Kampo diagnosis. The case is 14-year-old woman, who had already hormonal therapy due to the secondary amenorrhea, and was difficult to treat because of edema and weight gain. Secondary amenorrhea, multiple cysts in the ovary, and hypertestosteroneemia were confirmed, and the patient was diagnosed with polycystic ovary syndrome. Abdominal pattern was weak and the abnormalities of the abdominal strength were prominent. Therefore, we administered her shokenchuto. After two weeks, menstruation began, and thereafter the menstruation had progressed without any irregularities. Blood examination also showed normal testosterone level. It was suggested that it would be important to focus on the preparation for digestive function and to treat the secondary amenorrhea of adolescent women.

Conventional footplates place physical burden on helpers due to various incidents with the footplates and the need to bend over to operate the footplate. Therefore, we examined the introduction of a semi-automated retractable footplate with a ratchet mechanism (hereafter, semi-automated retractable footrest) and investigated its safety and convenience. Both patients and staff reported that the semi-automated retractable footrest was useful. We also found that the semi-automated retractable footrest was free of incidents, reduced physical burden, and enabled helpers to avoid contamination of their hands. However, we also found aspects of the semi-automated retractable footrest that need to be improved.

OBJECTIVESDue to its industrial application and frequent use as a coating material for food containers, bisphenol A (4,4'-isopropylidenediphenol, BPA) is present in abundance in our environment. Data on intake levels of BPA are limited in preadolescent children in Japan. This study was designed to help us better understand the current state of BPA exposure in children in Japan.

METHODSWe followed first graders (n = 104) attending school in a Tokyo suburb from 1998 until the sixth grade (2003), during which time we collected a total of three morning urine samples. Urinary BPA was analyzed using high-performance liquid chromatography isotope-dilution tandem mass spectrometry.

RESULTSNinety-four children were followed for 5 years. Median urinary BPA level was 2.66 ng/mg creatinine (CRE) (range 0.9-38.9) at first grade (1998), 1.52 ng/mg CRE (0.4-11.8) at third grade (2000), and 0.66 ng/mg CRE (0.2-8.5) at sixth grade (2003), showing a significant decrease in urinary BPA levels over a 5-year follow-up study (p < 0.001). No significant difference was seen between boys and girls at each grade.

CONCLUSIONSUrinary levels of BPA were relatively low throughout the study period; however, as the study progressed, we observed a significant decline in levels, the reason behind which is not yet clear.

OBJECTIVESBisphenol A (BPA), a raw material commonly used in the manufacture of resins such as polycarbonate and epoxy, is a possible xenoestrogen that is hypothesized to disrupt the human endocrine system. Humans are widely exposed to BPA. We investigated the urinary concentration of BPA in infertile Japanese women and its possible association with endometriosis.

MATERIALS AND METHODSWe recruited 166 women (aged 20-45) who had complained of infertility and visited a university hospital in Tokyo. The subjects were interviewed and their urine samples were obtained prior to a laparoscopic diagnosis of endometriosis between January 2000 and December 2001. Urinary total BPA concentration in 140 eligible urine samples was then measured using enzymatic deconjugation of glucuronide and sulfate and high-performance liquid chromatography isotope-dilution tandem mass spectrometry.

RESULTSMedian (25th-75th percentile) unadjusted and creatinine-adjusted urinary BPA concentrations were 1.6 (0.69-2.8) μg/L and 0.80 (0.45-1.3) μg/g creatinine. No significant monotonic association of endometriosis with urinary BPA concentration was observed. Median urinary BPA concentration in women with stage 0-1 endometriosis (0.74 μg/g creatinine) did not significantly differ from that in those with stage II-IV endometriosis (0.93 μg/g creatinine) (p for difference=0.24).

CONCLUSIONSThis study, based on a larger number of samples than those in previous studies in Japan and using the most reliable analytical method currently available, showed that urinary concentrations of BPA in women who consulted a physician for infertility were not higher than those in other populations. Moreover, no association between urinary BPA concentration and endometriosis was found in this cross-sectional study.

We investigated the effects of Kampo treatment on the development and progression of diabetic microangiopathy in 141 patients (95 male and 46 female patients, mean±S.D., 61.3±10.1 years) with non-insulin dependent diabetes mellitus. To this purpose, we examined the severity of diabetic microangiopathy with respect to the duration of suffering from diabetes mellitus as well as the duration of the condition after the commencement of Kampo treatment. We obtained the following results. 1) The significantly lighter the severity of diabetic nephropathy was, the longer its duration under Kampo treatment was. 2) In the group of shorter duration of suffering from diabetes mellitus, although there was no statistical significance, the longer the duration under Kampo treatment was, the lighter the severity of diabetic neuropathy and retinopathy was. But, there was no significant difference in the longer duration of suffering. It was suggested that the combination therapy with Kampo treatment was effective for diabetic microangiopathy.

A 72-year-old man was admitted with an abnormal shadow on chest X-ray. Chest CT and aortography showed double saccular aneurysms at the aortic arch and the descending thoracic aorta. Three-dimensional CT was useful to detect the association between the arch aneurysm and neck vessels. Graft replacement, from the distal arch to the descending thoracic aorta, was performed by the lateral approach with hypothermic arrest and open proximal method. The aorta had severe atherosclerotic changes and the intima was absent at the orifices of the aneurysms. Pathological examination showed the aneurysmal wall to be composed of fibrous tissue without medial components. These macroscopic and pathological findings of aneurysms corresponded with double pseudo-aneurysms originating from the penetrating atherosclerotic ulcer.

The therapeutic efficacy of Hachimi jio-gan on pain, weakness, numbness and coldness of the limbs and lower back was investigated in 37 aged patients. After administration for 4 weeks, improvement in the global improvement rating was 55.9%, and improvement in pain, weakness, numbness and coldness were 44.8%, 39.3%, 59.1% and 31.8%, respectively. For the improvement of numbness, more significant improvement was seen in patients 60 years old or greater than in those 59 or less. Such symptoms as hair thinning or hair loss, dimming of the eyes, constipation, pain in the upper limbs, numbness in the lower limbs, coldness of the upper limbs and coldness of the lower limbs showed significant improvement. These results suggest that Hachimi jio-gan is effective in the treatment of pain, weakness, numbness and coldness in aged patients.