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

We examined whether wiping acupuncture needles with cotton could remove Hepatitis C viruses (HCV) adhering to the needles. The needles were incubated in the serum from patients infected with HCV, then the needles were wiped with dry cotton or cotton soaked in 80% ethanol. RNA was extracted from these needles and the HCV genome was amplified by reverse transcription-polymerase chain reaction (RT-PCR). The results indicated that the HCV genome was not detected when the needles were wiped with dry cotton. However, in one of two experiments, the HCV genome was detected after wiping the needles with cotton soaked in ethanol. We also examined the HCV contamination on the needles extracted from patients infected with HCV. The HCV genome was detected on extracted needles that were not wiped with cotton, but the genome was not found on needles wiped with cotton at the time of extraction. Therefore, wiping acupuncture needles with cotton might effectively remove HCV on the contaminated needles, but the viruses could not always be re-moved by simply wiping the needles with cotton.

Collagen-induced arthritis (CIA) in DBA/1J mice is an autoimmune model driven by the combination of humoral and cellular immunity against cartilage type II collagen. It has been proven to be a useful model for human rheumatoid arthritis (RA). This study was designed to obtain experimental evidence of Kampo medicine Dokkatsu-kisei-to (DKT) in the treatment of RA by using mouse CIA. As positive control, prednisolone was given. The significant suppressive effect of DKT as measured by arthritis score persisted upon cessation of treatment on day 42 and remained until the termination of the experiment on day 63. The amelioration of inflammatory articular lesions was confirmed by radiological and histo-pathological findings. We also observed significantly decreased concentrations of serum TNF-α on day 28 and levels of serum IgG antibody against bovine type II collagen on day 49. These results suggest that DKT has important effects on immuno-inflammatory response and may be useful in the prevention of the onset and severity of arthritis.

The Oriental medical therapies are increasingly used in medical treatment in conjunction with the Western medical health care system in our country. As Oriental medicine and Western medicine are based on different scientific systems, there is no curriculum of Oriental medicine in Western medical school education. In 1996, we investigated opinions about Oriental medicine among medical students and teachers at Showa University. A mini follow-up survey was done in 1999 and 2000. Awareness of Oriental medicine was still limited, but those surveyed were remarkably interested in Oriental medicine. Moreover, they recognized Oriental medicine as an important and useful tool for the care of illnesses that do not respond to Western medicine. About 40% of the medical doctors at Showa University hospitals used Oriental medicine with their patients in 1996, and traditional knowledge was learned in its own way. According to the pharmaceutical department of Showa University, both the number and variety of Kampo prescriptions increased between 1996 and 2000. These results suggest that it is necessary to properly learn Oriental medicine from the foundations during medical school. More research on Oriental medicine in terms of clinical and basic science is necessary, and the opportunity to exchange information about Oriental medical diagnosis and treatments should be included in postgraduate curricula.

Previous studies have been reported on the properties of moxa and the effect it has on the self defense mechanism of the body. To study the characteristics of acupoints, the study this time is from the point of whether there are any differences in biological responses if the same stimuli (5mg/body and 15mg/body of moxa) are applied to different acupoints. The acupoints chosen were KIMON, which is the therapeutic acupoint of liver, and DAIO, which is the spleen meridian acupoint located on the same vertical line and which has no effect on the liver. Male ddy mice (6 weeks old) were used as experimental animals. A comparison of the clinical biochemical values of serum 1, 3, 6 and 24 hours after application was conducted. The amount of invasion on body function from each moxibustion stimulus through the strength and progress of biological response was studied. Increases in serum Amylase, LDH, CK, GOT, and GPT in the DAIO group were obtained as compared to that of the KIMON group. There was also a decrease in serum CHE in the DAIO group as compared to that of the KIMON group. It was suggested that there were difference in biological responses between different application points, even with the application of the same stimuli.

The effect of moxibustion on the endocrinosis elicited by disorders of the autonomic nervous system was investigated in hypophysectomized rat.
Natural gain of body weight was stopped, adrenals and testis became atrophied, urinary output increased, and the rectal temperature slightly dropped after hypophysectomy.
Applying moxibustion did not correct these synptoms.
Furthermore, in spite of electrolyte and amino acid metabolism, significant decrease of Na, K, Cl, Ca and a slight decrease of urea nitrogen and creatinine in urine was recognized. But these were not modify by moxibustion.
With respect to the adrenal cortical study, there were a slight increase of 17-OHCS and a mild decrease of 17-KS in urine. Moxibustion did not effect either 17-OHCS or 17-KS.

Effects of multiple moxibustion on platelet aggregation, blood coagulation and fibrinolytic activity in mice have been studied. Male ddY mice (5 weeks old) were used as experimental animals. 15mg of moxa was divided into 6 cones and mice were treated by each 3 cones at right and left LV-14. The experimental schedules of multiple moxibustions were 5, 10 and 15 treatments of twice a week. The electronic aggregometer was suitable for measuring platelet aggregation using whole blood. However, no significant changes on platelet counts, platelet aggregation and ATP release induced by collagen (final concentration: 2μg/ml) and ADP (final concentration: 20μM) were found after multiple moxibustions. 15 treatments of moxibustion induced the increase in fibrinogen contents and the decrease tendency of factor XIII activity. While 10 treatments of moxibustion showed the increase in PLG content and α2 PI activity. These results suggested that multiple moxibustions induce the reasonable reaction to keep a good homeostasis on blood coagulation and fibrinolytic system in mice.

In our previous studies, blood coagulation and fibrinolytic activity after single moxibustion were found to change within the range of physiological variability in mice. In this paper, the effect of multiple moxibustion on the activity of blood coagulation was examined by using male ddY mice (6 weeks old). 15mg of moxa was divided into 6 cones and mice were treated by each 3 cones at right and left LV-14. The multiple moxibustion schedule was a total of 5, 10 and 15 treatments. There was no effect of multiple moxibustion on body weight and Ht. 5 treatments of moxibustion showed a significant decrease in PT (p<0.05) and 10 treatments showed an increase in the ma value of TEG and in HPT activity. No significant change in PTT nor ATIII activity was found following multiple treatments of moxibustion.
These results showed that the enhancement of blood coagulation did not continue during multiple moxibustion even though single moxibustion stimulated the activity of blood coagulation at 1 and 3hrs. In addition, the increase in HPT activity induced by 10 treatments of moxibustion may have shown an effect of mildly stimulating liver function.

In our previous studies, it was suggested that single moxibustion stimulation activated blood coagulation and fibrinolytic activities within normal range in mice at 1 and 3hrs.
In order to further investigate the mechanism of moxibustion, we have examined the antithrombin III (AT III) and fibrinolytic activities after single moxibustion.
Male ddy mice (6 weeks old) were used as experimental animals. Each mouse was treated with 15mg of moxa divided into 6 cones, 3 each on the right and left LV-14.
We obtained the following results. The plasminogen (PLG) activities and the values of plasma total protein decreased at 1hr after single moxibustion.
The activities of plasma AT III, α2 plasmin inhibitor (α2 PI) and factor XIII, and plasma fibrinogen level remained unchanged at 1 and 3hrs.
The blood coagulation and fibrinolytic activities changed, but they were almost within the range of physiological variability.
These results suggest that blood coagulation and fibrinolysis were activated as part of its defence mechanism while keeping homeostatic balance.

In our previous report on mice, we suggested that single moxibustion stimulation to CHIMEN (LV-14) activated blood coagulation and fibrinolytic activity within normal range.
The purpose of this study is to elucidate the acute effects of moxibustion on blood coagulation activity in healthy adult men 1 and 3 hours after moxibustion. A single moxibustion stimulation to the right and left CHIMEN was made using a dose of 45mg of moxa divided into 30 cones.
The results were as follows:
1) decreased clot formation time (K) of thrombelastography 1 hour after moxibustion.
2) increased activity of hepaplastintest 3 hours after moxibustion.
3) decreased maximum value of platelet aggregation 1 and 3 hours after moxibustion.
4) decreased rate of segmented leucocyte and increased rate of lymphocyte 1 hour after moxibustion.
These results suggest that single moxibustion stimulation to CHIMEN have some influence on coagulation activity (the hepatic function on hepaplastintest), platelet aggregation and percentage of white blood cells.