Evaluation and Interpretation of 9 Body Constitution Scores of CCMQ-J by Seven Independent Questionnaires / 日本補完代替医療学会誌

In this study, we proposed an approach to interpret the classification of body constitution based on the Japanese Version of Constitution in Chinese Medicine Questionnaire (CCMQ-J) in terms of an augmented questionnaire combining seven independent questionnaires. The augmented questionnaire consists of 254 questions in terms of seven categories of attributes, which are the (i) basic information (BI), (ii) disease (DI), (iii) social factors (SO), (iv) mental factors (ME), (v) dietary habits (DH), (vi) sleeping state (SL), and (vii) sub-health (SH). The partial least square (PLS) regression has been adopted to model the correlations between the scores of body constitutions and the questions, and their results show that the body constitution can be represented by the linear combination of the questions substantially (correlation coefficients between the true and predicted constitutions are all above 0.7). Moreover, by using the crowdsourcing technique in data collection, a total of 851 samples (350 males and 501 females between 20 and 85 years old) samples with diverse geographical backgrounds in Japan have been collected, from which new medical implications have been extracted through the discussion in a Traditional Chinese Medicine standpoint. This study serves as a crucial step for validating the philosophy of ancient Chinese medicine by the state-of-the-art information science techniques and facilitating the use of the CCMQ-J in public healthcare.

Determination of Optimum Number of Groups on the Crowdsourcing Survey in Japanese People Interpreted by Physical Constitution Defined by CCMQ-J / 日本補完代替医療学会誌

Chinese Medicine Questionnaire (CCMQ-J) consists of sixty independent questionnaires and 9 physical constitutions called subscales. One type is balanced constitution (i.e., gentleness), and the following eight types represent unbalanced constitution: Qi-deficiency constitution, Yang-deficiency constitution, Yin-deficiency constitution, Phlegm-dampness constitution, Damp-heat constitution, Stagnant Blood constitution, Stagnant Qi constitution, and Inherited Special constitution. In this study, we proposed to determine optimal number of groups in 851 participants recruited from crowdsourcing answered CCMQ-J questionnaire consisting of 60 questions. In the present study, we applied k-means clustering with gap statistics to the questionnaire data and the number of optimal groups was estimated by five. The five groups are mainly characterized by 3 subscales in CCMQ-J, i.e. (i) two subscales corresponding to Yang-deficiency and Qi-depress, (ii) three subscales corresponding to gentleness, Yang-deficiency and Qi-depress (iii) Yang-deficiency, (iv) gentleness, and (v) Qi-depress. In the crowdsourcing survey, two subscales, Yang-deficient and Qi-depress are the most frequently occurred in current Japanese people.

Survey on Usage of Medical Referral Information in Japanese Physicians / 대한의료정보학회지

OBJECTIVES: The purpose of this survey was to explore physicians' opinions to identify an adequate time range for clinical information to be provided with a referral that would help minimize wasteful retesting. METHODS: In 2011, we conducted a questionnaire survey of 193 physicians. Examining the degree of utilization of provided medical information, we determined the range of clinical information of referral documents. RESULTS: Less than three months of prescription history and blood sample test results in patient referral was most frequent. Less than one year of image information was most frequent. Most doctors answered there is no need to repeat the same type of blood test in their institute when they had information less than half a month old. Less than half to one month of image information was most frequent. Also, it appeared many doctors think “fundamentally they do not change their mind from their own medical department standpoint.” At the actual site, those who would even review referral clinical notes accounted for about 30% of all participants. CONCLUSIONS: Medical referral eventually takes place after the establishment of mutual communication and should consider the workflow and system environment of the receiver of the information.

Dengue hemorrhagic fever in a Japanese traveler who had preexisting Japanese encephalitis virus antibody

A patient, an adultJapanese traveler who had just returned from Thailand, had developed denguehemorrhagic fever (DHF). A primary infection of dengue virus (DENV) wasconfirmed, in particular, DENV serotype 2 (DENV-2) via the detection of the virusgenome, a significant increase in its specific neutralizing antibody and the isolationof DENV-2. DHF is often observed following a secondary infection from another serotypeof dengue virus, particularly in children, but this case was a primaryinfection of DENV. Japan is a non-endemic country of dengue disease. Instead,only Japanese encephalitis (JE) is known to be an endemic flavivirus family. Inthis study, IgG antibody against Japanese encephalitis virus (JEV) was detected.JEV belongs to the family of dengue virus and prevails in Japan, particularly inKyushu. Among many risk factors for the occurrence of DHF, a plausiblecandidate could be a cross-reactive antibody-dependent enhancement (ADE)mechanism by JEV antibody. This indicates that most Japanese travelers, wholive in non-endemic areas of dengue, particularly in Kyushu, should payattention to the occurrence of DHF.

Dengue Hemorrhagic Fever in a Japanese Traveler with Pre-existing Japanese Encephalitis Virus Antibody

An adult Japanese man who had just returned from Thailand developed dengue hemorrhagic fever (DHF). A primary infection of dengue virus (DENV) was confirmed, specifically DENV serotype 2 (DENV-2), on the basis of the detection of the virus genome, a significant increase in the neutralizing antibody and the isolation of DENV-2. DHF is often observed following a secondary infection from another serotype of dengue virus, particularly in children, but this case was a primary infection of DENV. Japan is a non-endemic country for dengue disease. In fact, only Japanese encephalitis (JE) is known to be a member of the endemic flavivirus family. In this study, IgG antibody against Japanese encephalitis virus (JEV) was detected. JEV belongs to the family of dengue virus and prevails in Japan, particularly Kyushu. Among many risk factors for the occurrence of DHF, a plausible candidate could be a cross-reactive antibody-dependent enhancement (ADE) mechanism caused by JEV antibody. This indicates that most Japanese travelers who living in dengue non-endemic areas, particularly Kyushu, should be aware of the occurrence of DHF.

D*D:Analytical Clinical Information Retrieval System based on Hospital Information System-Overview and Use Examples- / 薬剤疫学

<b>Objective:</b> Standardized clinical data are invaluable for secondary use of medical information. We constructed a standardized database and a data warehouse called D*D, based on the Standardized Structured Medical Information Exchange(SS-MIX)scheme. D*D enables physicians and researchers to perform complex searches with combined conditions, e.g. time to event. It contains data from 1999 for approximately 400,000 individual patients. The objective of this study was to provide an overview of the features of this database system, especially from the perspective of drug safety research.<br><b>Methods:</b> Three models of research questions were identified from established drug-risk combinations:1)gatifloxacin and hypoglycemia;2)statins and rhabdomyolysis;and 3)oral 5-fluorouracil S-1 and hepatotoxicity. D*D was searched using predefined keywords and conditions.<br><b>Results:</b> 1)A total of 3,635 patients were treated for diabetes. Among 20 diabetic patients prescribed gatifloxacin, hypoglycemia was recorded in one patient(1/38 prescriptions). 2)Among 5,926 patients who had been prescribed any statin within 10 years in our hospital, 6 patients(0.1%)experienced rhabdomyolysis. The incidence was similar to that for fibrate (1/740, 0.1%). The most confounded diagnosis was stiff shoulder. 3)Among 244 patients prescribed S-1, 19 patients(7.8%) experienced hepatotoxicity higher than CTCAE grade3 within 2 months from the prescription.<br><b>Conclusion:</b> With limited data items and search keys in standardized data storage, definitions of exposures and outcomes require careful assessment during protocol development. Considering that the system can be implemented at more than half of the hospitals that have already installed ordering systems, D*D can be one of the Japanese models for distributed research network.

Report on the 2nd “Hwa To” International Symposium / 全日本鍼灸学会雑誌

The 2nd Hwa To International Symposium (Integration of Eastern & Western Medicine) was held in Amsterdam on the 23rd & 24th of September 2006. “Hwa To” is a name of a famous ancient Chinese doctor, and the sponsor of this symposium is “Hwa To International University of T.C.M.” in Amsterdam. About 200 members participated from 19 countries, and as Japanese speakers Mr. Seino and Watanabe were invited. As the drawing up of the abstract book was not in time for the opening of the symposium, the contents of presentations were not clear except the name of speakers and their themes. Most of the presentations were lecture, and almost all of the lectures were expressed in English, and there were no loss of time by translation from Chinese to English which is usual in the assemblies of WFAS.<br>The atmosphere of the symposium or the titles of the card of Prof. Rangkuti suggested me that the European society of acupuncture has a tendency to keep aloof from WFAS.

The Clinical Utility of Diffusion Tensor Imaging and Fiber Tractography for evaluating Diffuse Axonal Injury / The Japanese Journal of Rehabilitation Medicine

Diffuse axonal injury (DAI) is identified as one of the most important causes of cognitive disorders in patients with traumatic brain injury. Radiologic recognition of DAI can help in understanding the clinical syndrome and in making treatment decisions. However, CT and conventional MRI are often normal or demonstrate lesions that are poorly related to the cognitive disorders present. Recently, diffusion tensor imaging (DTI) and fiber tractography (FT) have been shown to be useful in detecting various types of white matter damage. The aim of this study was to evaluate the feasibility of using DTI and FT to detect lesions in DAI patients, and to correlate these DAI lesions with the patients' cognitive disorders. We investigated 9 normal volunteers and 9 patients with DAI. The DAI patients had impaired intelligence, as well as attention, memory and executive function disorders that restricted their activities of daily living. In the DAI patients, DTI showed abnormal brain areas in the corpus callosum, fornix, frontal and parietal lobe white matter, and FT revealed interruptions of the white matter fibers in the corpus callosum and the fornix when compared with the normal volunteers, while no lesions were found on conventional MRI. DTI and FT can directly visualize DAI lesions, which cannot be reliably detected by conventional methods. Accordingly, both DTI and FT may be useful techniques for the evaluation of DAI, and may have the potential to be applied to planning rehabilitation therapy, and predicting the neurologic prognosis in DAI patients with cognitive disorders.

Characteristics of the antibiotic resistance gene of S.pneumoniae isolated from nasopharyngeal swab of the pneumonia patients in Ha Noi

Background: Acute lower respiratory tract infection, mainly pneumonia, were the main reasons cause death for children under 5 years old. Objectives: Determine the isolated rate of bacteria inpatients under 5 years old with acute lower respiratory tract infection in Ha Noi and antibiotic resistance of pneumococcal isolated form patients. Subjects and method: Patients under 5 years old with acute lower respiratory tract infection in National hospital of pediatrics and Bach Mai hospital from 01/2002. Using quantitative culturedand PCR method. Results: Out of total 164 patients with lower respiratory tract infection, there were 91 diagnosed pneumonia by chest X-ray, 73 cases of acute bronchitis. 73,6% of the pneumococcal isolated were penicillin resistance (gPRSP) with different genes such as pbp 1a+2x+ab. Most of the S.pneumoniae strains were serotype 19F or 23F. There were no statistic differences by comparison charactersistics of weight, vessel, subclinical symptoms such as: dissolved oxygen level (S\xac\xacp\xac\xac\xac\xacO\xac2\xac), the amount of leucocyte in blood. However, temperature of pneumonia patients was higher than bronchitis patients, breathing of pneumonia patients was also faster than bronchitis patients. Isolated bacteria with amount \ufffd?106 cfu/ml was H.influenzae, S.pneumoniae and Moraxell catarrhalis in pneumonia group, bronchitis group was 28,8% and control group was 17,1%. Conclusion: Penicillin, erythoromycin and co-trimoxazole resistance rate of S.pneumoniaein patients with acute lower respiratory tract infection was high. Quantitative cultured method has prognostic value in diagnosis pneumonia.

Tricuspid and Mitral Valve Replacement in a Patient with Atrioventricular Discordance Long after Functional Biventricular Repair / 日本心臓血管外科学会雑誌

In atrioventricular (AV) discordance, a morphologic tricuspid valve functioning as a systemic AV valve often becomes incompetent and needs to be replaced. However, mitral valve replacement concomitant with tricuspid valve replacement is unusual in the disease. Here, we report a case of successful double AV valve replacement long after functional biventricular repair in AV discordance. A 32-year-old man with AV discordance was admitted with orthopnea. He had undergone the Rastelli procedure at age 10 and removal of the deteriorated conduit valve at age 24. Preoperative examinations revealed not only tricuspid but also mitral regurgitation. Both deteriorated valves were replaced with mechanical valves. In AV discordance after Rastelli procedure, a non-valved conduit may accelerate mitral deterioration because pulmonary hypertension from tricuspid regurgitation increases the afterload of the pulmonary ventricle.

The inhibitive effects of resveratrol on adhesion of neutrophils to HUVECs induced by fMLP / 中国药理学通报

Aim To study the effects of resveratrol(Res)on the release of soluble adhesion molecules from human umbilical vein endothelial cells(HUVECs)induced by N-formyl-methionyl-leucyl-phenylal-anine(fMLP)and the adhesion between neutrophils and HUVECs.Methods The effects of Res on neutrophils adhesion to human umbilical endothelial cell(HUVECs)triggered by fMLP were examined.The soluble intercellular cell adhesive molecule-1(ICAM-1),the soluble vascular cell adhesive molecule-1(VCAM-1)and E-selectin release from fMLP(10 ?mol?L-1)stimulated HUVECs were determined by ELISA kits.The neutrophils isolated from human vein blood were loaded with Fluo-3,a fluorescent indicator,to detect intracellular free calcium concentration([Ca2+]i),and CLA was used as a chemiluminescent indicator to determine superoxide production in neutrophils.Results Res(1~50 ?mol?L-1)significantly inhibited neutrophil adhesion to fMLP-stimulated HUVECs and also obviously downregulated the levels of ICAM-1,VCAM-1 and E-selectin in supernatant of HUVECs culture stimulated by fMLP in the dose-dependent pattern.Res also suppressed fMLP-activated superoxide generation and[Ca2+]i increase in neutrophils.Conclusions Res involved in neutrophil adhesion to HUVECs intermediated by cell adhesive molecules expression trigged by[Ca2+]i and superoxide production in neutrophils,which means a lot to prevent inflammatory diseases.

Surgical Treatment for Active Infective Endocarditis with Sinus of Valsalva and Right Atrium Fistula / 日本心臓血管外科学会雑誌

We report here a surgical case of sinus of Valsalva and right atrium fistula associated with acute infective endocarditis (AIE) without perivalvular abscess cavity or aneurysm of the sinus of Valsalva (ASV). A 51-year-old man, who had been given a diagnosis of rheumatic aortic stenosis and regurgitation (AsR) and mitral stenosis and regurgitation (MsR) and tricuspid regurgitation (TR) by echocardiography, had a high fever 2 months after removal of teeth and AIE was diagnosed. He was referred to our hospital because sinus of Valsalva and right atrium fistula were detected by echocardiography and congestive heart failure (CHF) deteriorated during medical treatment. Perivalvular abscess cavity and ASV were not detected by preoperative echocardiography. Medical treatment was continued after admission, and operation was done after amelioration of the CHF and infection were recognized. The aortic valve was removed together with vegetation, two areas of the aortic wall in which the tissue was fragile were cauterized by electrocautery, patch closure at the sinus of Valsalva was performed using a partial of e-PTFE graft and aortic valve replacement (AVR) and mitral valve replacement (MVR) were done. Though residual aortic-right atrium shunt was detected after the operation, the postoperative course was good with no CHF or signs of infection.

On the Prevention of Infection by Acupuncture / 全日本鍼灸学会雑誌

Infection is one of the most serious complications of acupuncture. But no infection ever appears without contamination, so the best method for preventing infection is to avoid contamination.<BR>There are two causes of contamination by acupuncture, namely, unsatisfactory disinfection of skin and contaminated neeedles. The former involves incomplete skin cleaning and inadequate disinfection. The latter is caused by contact with unsanitary matter. Some factors which are usually considered insignificant, such as contamination by needle tube, finger push technique, needle insertion technique or contamination in the needle case, should be re-examined.<BR>The author never touches the part of the needle which can penetrate the skin. This simple measure can help to prevent contamination of needles and consequent infection.

Transcatheter Embolization of Aortopulmonary Collateral Arteries Prior to Intracardiac Repair in Patients with Congenital Heart Disease / 日本心臓血管外科学会雑誌

Transcatheter embolization of 25 aortopulmonary collateral arteries (7 bronchial arteries and 18 intercostal arteries) was attempted prior to intracardiac repair in 7 patients. The underlying disease was tetralogy of Fallot in 3 patients, pulmonary atresia with ventricular septal defect in 2, double-outlet right ventricle with ventricular septal defect and pulmonary stenosis in 1 and tricuspid stenosis with pulmonary atresia in 1. The intervals between embolization and intracardiac repair ranged from 0 to 17 days (mean 4.5 days). Embolization resulted in total occlusion in 7 bronchial arteries and 17 intercostal arteries, with an overall success rate of 96%. Complications included a coil dislodgement from a collateral artery into the aorta in one patient, necessitating surgical removal of the dislodged coil from the femoral artery, an exacerbation of cyanosis and dyspnea on exercise in 5, and slight fever in 2. In one patient with tetralogy of Fallot, who had 5 collateral vessels, transcatheter embolization caused hypoxemia, bradycardia and hypotension and therefore intracardiac repair was performed immediately after embolization. Aortopulmonary collateral arteries in patients with congenital heart disease can be effectively treated by transcatheter embolization. Embolization should be performed just before intracardiac repair because an excessive decrease in arterial oxygen saturation after embolization may require an emergency operation.

The Efficacy of Ultrafiltration after Cardiopulmonary Bypass without Homologous Blood Transfusion for Pediatric Cardiac Surgery / 日本心臓血管外科学会雑誌

Thirty-four patients with congenital cardiac disease were studied to evaluated the role of ultrafiltration after cardiopulmonary bypass without homologous blood transfusion. We used either polypropylene microporous hollow fiber hemoconcentrator (HC-30M or 100M) or polyacrylonitrile microporous hollow fiber hemoconcentrator (PHC-500). Ultrafiltration was useful in the reduction of fluid overloading after cardiopulmonary bypass with extreme hemodilution. Thirty-two patients tolerated the procedure uneventfully without donor blood transfusion and were discharged from the hospital. The values of hematocrit, serum protein and free hemoglobin increased significantly after ultrafiltration with either type of hemoconcentrator. However the degree of concentration of blood components was significantly higher with polyacrylonitrile hemoconcentrator than those with polypropylene hemoconcentrator. These results indicated that ultrafiltration was useful for maintaining water balance after cardiopulmonary bypass without homologous blood transfusion in pediatric cardiac surgery and that polyacrylonitrile microporous hollow fiber hemoconcentrator should be employed in patients with shorter bypass time and less hemolysis.

A plan of the curriculum of chemistry for medical students / 医学教育

Based on two years working of “the enlarged working group for the curriculum of chemistry for medical education”, a provisional plan of the curriculum of chemistry for medical students is proposed. The article is consist of four sections; namely A: general problems, B: “chemistry” as a general education, C: purpose and specific problems of the general education for medical students, D: a provisional plan of the curriculum of chemistry for medical students.<BR>The main part D is consist of three subsections: namely (1) a plan of the curriculum of physical and inorganic chemistry, (2) a plan of the curriculum of organic chemistry, (3) a plan of the curriculum of experiments.