Introduction：There are few detailed evaluations of upper extremity function in Japan, especially for cervical spinal cord injury (CSCI). The capabilities of upper extremity test (CUE-T) evaluates upper extremity function, is specialized for CSCI, and is internationally used；however, there are few reports from Japan. This study verified the reliability, validity, and responsiveness of the CUE-T in Japan.Methods：We determined the interrater reliability, internal consistency, weighted kappa coefficient, intraclass correlation coefficient, and Cronbach's α coefficient for acute and chronic CSCI. The correlation coefficient with other evaluations was calculated and validated. Furthermore, the evaluation was performed twice at regular intervals, and the correlation between the change in CUE-T and other evaluations and the sensitivity to change using the standardized response mean (SRM) were verified.Results：The weighted kappa coefficient was 0.61-1.00, intraclass correlation coefficient was ≥0.9, and Cronbach's α coefficient were ≥0.9. The CUE-T and other evaluation methods showed moderate to strong correlations. In addition, the amount of change between CUE-T and the other evaluations were significantly correlated, and the SRM was ≥0.8.Discussion：In Japan, the CUE-T has been suggested to have good reliability, validity, responsiveness, and interpretability as an evaluation of upper extremity function in patients with CSCI. We will continue to verify the interpretability of the CUE-T and consider its dissemination in Japan.

Introduction：There are few detailed evaluations of upper extremity function in Japan, especially for cervical spinal cord injury (CSCI). The capabilities of upper extremity test (CUE-T) evaluates upper extremity function, is specialized for CSCI, and is internationally used；however, there are few reports from Japan. This study verified the reliability, validity, and responsiveness of the CUE-T in Japan.Methods：We determined the interrater reliability, internal consistency, weighted kappa coefficient, intraclass correlation coefficient, and Cronbach's α coefficient for acute and chronic CSCI. The correlation coefficient with other evaluations was calculated and validated. Furthermore, the evaluation was performed twice at regular intervals, and the correlation between the change in CUE-T and other evaluations and the sensitivity to change using the standardized response mean (SRM) were verified.Results：The weighted kappa coefficient was 0.61-1.00, intraclass correlation coefficient was ≥0.9, and Cronbach's α coefficient were ≥0.9. The CUE-T and other evaluation methods showed moderate to strong correlations. In addition, the amount of change between CUE-T and the other evaluations were significantly correlated, and the SRM was ≥0.8.Discussion：In Japan, the CUE-T has been suggested to have good reliability, validity, responsiveness, and interpretability as an evaluation of upper extremity function in patients with CSCI. We will continue to verify the interpretability of the CUE-T and consider its dissemination in Japan.

We herein report a patient who complained persistent exudate at navel in spite of adequate antibiotics therapy after laparoscopic cholecystectomy was successfully treated with Kampo therapy. The pharmacological effect of this Kampo formulation i.e. senkinnaitakusan is still unknown, but this formulation has been used for persistent infectious diseases. According to the description in the classic textbook, this formulation is suggested to encourage metabolic function and exhibit anti-inflammatory function. There have been no reports of Kampo therapy for the superficial incisional site infection associated with laparoscopic surgery. The authors propose that Kampo medicine is another promising option in the management of surgical site infection (SSI).

Growing evidences indicate that the development of mesenteric phlebosclerosis (MP) is associated with long-­term gardenia fruit (GF) intake. Besides duration and total dosage of GF ingestion, other factors associated with the development of MP or the symptoms of MP have not been known. We searched for previous case reports of MP from Japan. MP patients were divided into two groups : asymptomatic group without abdominal symptoms or symptomatic group. Age, gender ratio, body size, and duration of GF ingestion of the both groups were statistically analyzed. We evaluated concomitant diseases that can cause elevated venous pressure in the both groups. Colectomy rate were compared between symptomatic men and symptomatic women. Severe symptoms including ileus, stenosis peritonitis, and perforation were also compared between men and women. Age and sex were analyzed in all 164 cases. The gender ratio of women to men in the symptomatic group was higher than that in the asymptomatic group. However, colectomy rate in the symptomatic group was similar between men and women. Ileus, stenosis, peritonitis, and perforation were similarly found in both men and women. We found 15 symptomatic MP patients with concomitant diseases that can cause phlebostasis. None of the asymptomatic had these diseases. Concomitant diseases that can cause elevated venous pressure might be associated with symptomatic MP. The severity of MP seems to be similar between men and women. Association of gender difference with the development of MP symptoms was uncertain.

BACKGROUND/AIMS: Noninvasive objective monitoring is advantageous for optimizing treatment strategies in patients inflammatory bowel disease (IBD). Fecal calprotectin (FCP) is superior to traditional biomarkers in terms of assessing the activity in patients with IBD. However, there are the differences among several FCP assays in the dynamics of FCP. In this prospective multicenter trial, we investigated the usefulness of FCP measurements in adult Japanese patients with IBD by reliable enzyme immunoassay using a monoclonal antibody. METHODS: We assessed the relationship between FCP levels and disease or endoscopic activity in patients with ulcerative colitis (UC, n=64) or Crohn’s disease (CD, n=46) compared with healthy controls (HCs, n=64). RESULTS: FCP levels in UC patients strongly correlated with the Disease Activity Index (rs =0.676, P < 0.0001) and Mayo endoscopic subscore (MES; rs =0.677, P < 0.0001). FCP levels were significantly higher even in patients with inactive UC or CD compared with HCs (P=0.0068, P < 0.0001). The optimal cutoff value between MES 1 and 2 exhibited higher sensitivity (94.1%). FCP levels were significantly higher in active UC patients than in inactive patients (P < 0.001), except those with proctitis. The Crohn’s Disease Activity Index tended to correlate with the FCP level (rs =0.283, P=0.0565). CONCLUSIONS: Our testing method using a monoclonal antibody for FCP was well-validated and differentiated IBD patients from HCs. FCP may be a useful biomarker for objective assessment of disease activity in adult Japanese IBD patients, especially those with UC.
Adult* ; Antibodies, Monoclonal ; Asian Continental Ancestry Group* ; Biomarkers ; Colitis, Ulcerative ; Crohn Disease ; Humans ; Immunoenzyme Techniques ; Inflammatory Bowel Diseases* ; Leukocyte L1 Antigen Complex* ; Methods ; Multicenter Studies as Topic ; Proctitis ; Prospective Studies*

It is theoretically thought that Paeoniae Radix (shakuyaku) has a sour taste and astringent action in traditional Chinese medicine. To examine the practical taste of shakuyaku, 12 volunteers sampled the decoction of Paeoniae Radix Rubra (sekishaku) and Paeoniae Radix Alba (byakushaku). Each volunteer determined how sekishaku and byakushaku taste among “five tastes” : sweet, salty, bitter, sour, or spicy. Most volunteers chose bitter taste and none of them chose sour taste as the foremost taste of shakuyaku. At least in the modern age, shakuyaku may have little sour taste. In this article we discussed the astringent action and the muscle relaxant action of shakuyaku with reference to the sour taste.

BACKGROUND AND OBJECTIVES: There are few reports on renal dysfunction in the remote period after biventricular repair, and biomarkers for early detection of renal dysfunction are not well understood. We examined whether early fluctuation of biomarkers of renal function occurs in the remote period after biventricular repair in patients with congenital heart disease (CHD). METHODS: Fourteen patients with CHD after biventricular repair were included. The examination values obtained by cardiac catheterization test and renal function indices based on blood and urine sampling were compared. RESULTS: The median estimated glomerular filtration rate (eGFR) of creatinine was 113 mL/min/1.73 m2, and the median eGFR of cystatin C was 117 mL/min/1.73 m2. A urine albumin-to-creatinine ratio (UACR) ≥10 mg/gCr was considered a risk factor for cardiovascular disease in 6 (43%) patients. There was a significant difference in right ventricular ejection fraction and deviation in right ventricular end-diastolic volume from the normal value between the 2 groups divided by UACR. Cyanosis before biventricular repair was noted in 2 (25%) patients with UACR < 10 mg/gCr and in 4 (67%) patients with UACR ≥10 mg/gCr. CONCLUSIONS: Increased UACR was noted in 43% of patients. In patients with UACR ≥10 mg/gCr, right heart system abnormality was observed, and several patients had cyanosis before radical treatment. Measurement for UACR may be able to detect renal dysfunction early in the postoperative remote period.
Biomarkers ; Cardiac Catheterization ; Cardiac Catheters ; Cardiovascular Diseases ; Creatinine ; Cyanosis ; Cystatin C ; Glomerular Filtration Rate ; Heart ; Heart Defects, Congenital ; Humans ; Kidney ; Reference Values ; Risk Factors ; Stroke Volume

BACKGROUND AND OBJECTIVES: There are few reports on renal dysfunction in the remote period after biventricular repair, and biomarkers for early detection of renal dysfunction are not well understood. We examined whether early fluctuation of biomarkers of renal function occurs in the remote period after biventricular repair in patients with congenital heart disease (CHD). METHODS: Fourteen patients with CHD after biventricular repair were included. The examination values obtained by cardiac catheterization test and renal function indices based on blood and urine sampling were compared. RESULTS: The median estimated glomerular filtration rate (eGFR) of creatinine was 113 mL/min/1.73 m2, and the median eGFR of cystatin C was 117 mL/min/1.73 m2. A urine albumin-to-creatinine ratio (UACR) ≥10 mg/gCr was considered a risk factor for cardiovascular disease in 6 (43%) patients. There was a significant difference in right ventricular ejection fraction and deviation in right ventricular end-diastolic volume from the normal value between the 2 groups divided by UACR. Cyanosis before biventricular repair was noted in 2 (25%) patients with UACR < 10 mg/gCr and in 4 (67%) patients with UACR ≥10 mg/gCr. CONCLUSIONS Increased UACR was noted in 43% of patients. In patients with UACR ≥10 mg/gCr, right heart system abnormality was observed, and several patients had cyanosis before radical treatment. Measurement for UACR may be able to detect renal dysfunction early in the postoperative remote period.

A thirty-eight-year old woman with facial pain was diagnosed with trigeminal neuralgia, and treated with conventional carbamazepine therapy. Although the pain was alleviated to a certain degree, she visited our clinic to receive Kampo therapy. Judging from her facial injury in an accident thirty years ago, jidabokuippo was administered in addition to carbamazepine. The trigeminal neuralgia was then relieved, and Takagi's tender point in her abdomen was also reduced or disappeared. She could finally stop carbamazepine therapy. This case suggests that neuralgia patients with previous injury and Takagi's tender point can be treated with jidabokuippo.

To estimate the incidence of liver injury related to Kampo medicine containing Scutellaria baicalensis, all medical records in our clinic were retrospectively examined. Among 2,430 patients who took Kampo medicine containing Scutellaria baicalensis, liver blood tests were performed in 1,547 cases (63.7%). The possibility of liver injury related to Kampo medicine containing Scutellaria baicalensis could not be denied in 19 cases (1.2%) among the 1,547 cases. The clinical features of liver injury in 19 cases were not different from those in previous reports. In agreement with the previous literature, this study also suggests that the incidence of liver injury related to Kampo medicine containing Scutellaria baicalensis is about 1%.