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Background Methods Results Conclusion More than 500 randomized controlled trials (RCTs) were selected from various databases by the evidence‐based medicine committee of the Japan Society for Oriental Medicine (JSOM). Their structured abstracts have been published in Japanese and English in “Evidence Reports of Kampo Treatment.”From among these RCTs, “Kampo Best RCTs” were selected according to impact factor and number of Google Scholar citations.Four of the authors in this article presented their data at a symposium at the 74th Congress of the JSOM in June 2024. Kazunari Tominaga was elected as the No. 1 author among the best RCTs. His two articles described the effects of rikkunshito on functional dyspepsia and non‐erosive gastroesophageal reflux disease, respectively. Hidekazu Suzuki was elected as No. 2. His article described the effect of rikkunshito on functional dyspepsia. The No. 3 author, Toshimi Kaido, and No. 4 author, Chu Matsuda, described the effects of daikenchuto on adult gastrointestinal disorder following liver transplant and the effects of hangeshashinto on chemotherapy‐induced stomatitis, respectively. These four articles were all based on double‐blind RCTs. Although a range of hardships were encountered during the studies, these RCTs were reported in original articles, providing clinical evidence of high international reputation.Here, we describe the details and the hardships encountered by the authors, identify points to note in the interpretation of clinical trial results, and finally mention the current status and future prospects of Kampo RCTs. [ABSTRACT FROM AUTHOR]

Background: The "Yasui Classification" categorizes the indication for Kampo medicine into four main types in the medical field where standard treatment of Western medicine exists regardless of the school of Kampo medicine. We aimed to elucidate how Kampo case reports are presented from the viewpoint of the Yasui Classification. Methods: Using the general presentations at the 69th Japan Society for Oriental Medicine (JSOM) Academic Meeting held in Osaka in June 2018, the contents of each abstract were analyzed with the Yasui Classification. Results: There were 289 abstracts. The numbers of included abstracts was 140 (48.4%), and their breakdown was as follows: Type 1: 97, Type 2: 27, Type 3: 12, and Type 4: 4. Therefore, Kampo monotherapy yielded the greatest number of presentations where Western medicine‐refractory cases were treated with Kampo medicine. In Type 2, which is the combination of Kampo and Western medicines, there were various applications of Kampo medicine in clinical fields such as pain control, respiratory, cardiovascular, and psychiatric subspecialties. Furthermore, in Type 3, which is also the combination of Kampo and Western medicines, 7 of 12 presentations were related to the alleviation of the side effects of cancer therapy. Conclusions: Kampo monotherapy is most popularly reported at the Congress of JSOM in various fields of medicine, whereas the concurrent use of Kampo and Western medicines is also reported in a variety of clinical subspecialties. A new horizon of clinical significance for Kampo medicine will be opened with the Yasui Classification. [ABSTRACT FROM AUTHOR]

Aim: The Japanese government defined integrative/integrated medicine (IM) as "medical practice led by physicians, cooperating with other specialists." Therefore, the basics of comprehensive medical education should be provided in medical universities. We investigated the situation of IM with special reference to Kampo medicines in the national core curricula, national examination standards and the syllabuses for lectures published on the universities' websites. Methods: In the published documents regarding the core curriculum, national examination standards and syllabuses in the academic year 2018, we analyzed whether they include IM. Results: Four kinds of universities offered "Kampo medicine" (Japanese traditional herbal medicine) as their core curriculum. Pharmaceutical universities included "health food", and nursing universities included "alternative medicine". National examination standards for dentists and pharmacists included Kampo medicine, but those for doctors and nurses did not. In the syllabuses of medical universities, 85% included Kampo medicine, but the percentage for IMs was low. The situation was similar in dental universities. All pharmaceutical universities included Kampo medicines and health foods; other IMs were low. The number for all IMs in nursing universities was lower than half. Conclusion: Based on the definition of IM in this paper, we investigated the actual situation of IM education including Kampo in all universities. There were considerable differences between all the faculties. For medical doctor, the Kampo medicines listed in the model core curriculum that are not included in the national examination standard should be rectified. For pharmacists, it is important to deepen the educational contents in this field. [ABSTRACT FROM AUTHOR]

Background: Cancer has been the number one cause of death in Japan since 1981. Advanced or recurrent cancers need strong chemotherapies to control their growth. On the other hand, tumor‐bearing patients experience pain, fatigue, anorexia, cold sensation, sarcopenia, and frailty. Surgery and radiation therapy also cause adverse events such as ileus, infection, oral mucositis and diarrhea. Problems: Cancer supportive care includes all measures to prevent or ameliorate side effects of any treatments including anti‐cancer agents, with physical, mental, social, and spiritual care (survivorship care). Neutropenia and nausea/vomiting are generally well controlled in clinical settings owing to the progress in granulocyte‐colony stimulating factors and anti‐emetics. However, anorexia, general malaise, and peripheral neuropathy are refractory to modern medical care. Solutions: Recently, evidence is accumulating on the efficacy of Kampo medicines in the management of refractory symptoms. Furthermore, action mechanisms of each Kampo formula and its components have been elucidated by basic research. Conclusions: In this symposium, we learned state‐of‐the art progress in basic and clinical research in the field of cancer supportive care. In addition to the reports on the Japanese situation, we listened to German viewpoints on this theme. [ABSTRACT FROM AUTHOR]

Objective/background: The Evidence‐Based Medicine Special Committee of the Japan Society for Oriental Medicine was launched in 2001. We summarize the task force‐specific activities of this committee over the past 20 years. Task forces: The Evidence Reports Task Force compiles randomized controlled trials and meta‐analyses on Kampo extract products. Since 2007, the collated list is available on the Japan Society for Oriental Medicine website. As of 1 February 2021, there are 478 trials and three meta‐analyses. The Clinical Practice Guidelines Task Force identifies descriptions of Kampo medicines in such guidelines. As of 1 February 2021, there are 135 guidelines (9.6%) on Kampo extract products among 1411 guidelines published in Japan. These guidelines can be classified into three types: type A (n = 40), references, evidence grades, and recommendation gradings; type B (n = 51), only references; and type C (n = 44), no references. The Standards of Reporting Kampo Products Task Force manages the website (http://mpdb.nibiohn.go.jp/stork/) and provides information on the characteristics of 148 Kampo products marketed in Japan, acting as a simple, comprehensive reference for Kampo formulae, and promoting uniform understanding among authors, reviewers, and readers. The Best‐Case Task Force compiled remarkably effective cases as evidence of Kampo treatment in 2006. The "Kakkonto Project" collected best‐case series of kakkonto. The project ended in 2011 because of the number of cases was limited. Conclusion: The committee established significant landmarks for evidence‐based Kampo medicine and collected a reliable information resource. The guidelines repository is continuously updated with new information. A standard platform for referencing Kampo formulae in research articles is also well established. [ABSTRACT FROM AUTHOR]

Aim: Little information is available on the incidence per population of adverse drug reactions (ADR) to Kampo medicines. We estimated the incidence of ADRs for each Kampo medicine and examined the crude drug components of Kampo medicines that may cause ADRs. Methods: We extracted information on ADRs caused by Kampo medicines from the Japanese Adverse Drug Event Report database (JADER) between fiscal years 2008 and 2014. The number of people who took Kampo medicines was estimated based on the production value of the Kampo formulation, the drug price, and the duration of administration. Results: The incidences of interstitial pneumonia and liver disorder were highest for formulations that contained Scutellaria root. However, 33% of interstitial pneumonia and 39% of liver disorder cases were reported for formulations that did not contain Scutellaria root. The majority of pseudoaldosteronism cases were caused by formulations that contained Glycyrrhiza. Mesenteric phlebosclerosis occurred most commonly in response to formulations that contained Gardenia fruit. The incidences of these ADRs varied among formulations containing these crude drugs. Odds ratio analysis indicated that additional crude drugs may have also been responsible for these ADRs. In addition, some crude drugs may prevent these ADRs. Conclusion: Estimation of the incidence of ADRs caused by Kampo medicines could be a prelude to a new risk management plan, and may focus attention on formulations and crude drug components associated with previously unindicated risks. [ABSTRACT FROM AUTHOR]

ABSTRACT: Aim: Japanese kampo medicines have a long history of empirical use but have not been clinically validated. Therefore, information about the incidence of adverse drug reactions (ADR) is usually lacking. We estimated the incidence of ADR from reports of randomized controlled trials of kampo products. Methods: Trials of kampo products from the evidence reports of the kampo treatment database were examined to determine the number of patients treated with kampo products, and the number and type of ADR. Results: Data for 20 340 users of kampo products were analyzed. Of ≥1000 patients who took kampo products, the proportions of those with ADR were as follows: bakumondoto, 2/2167 patients (0.09%); maobushisaishinto, 8/1201 patients (0.67%); saireito, 21/1131 patients (1.86%); daikenchuto, 5/1131 patients (0.44%); and rikkunshito, 23/1126 patients (2.04%). Five patients (0.02%) developed pseudoaldosteronism; all had received shakuyakukanzoto. Liver injury was reported in 32 patients (0.16%) and was approximately threefold higher in those treated with Scutellaria root formulae (15/4206; 0.36%) than in those treated with non‐Scutellaria formulae (17/16134; 0.11%). Of the Scutellaria root formulae, orengedokuto produced the highest incidence of liver injury (1.97%). No cases of interstitial pneumonia or mesenteric phlebosclerosis were reported. The ADR data for some formulae were similar to data from post‐marketing ADR surveys. Conclusion: Examining data from a large number of trials is a useful way of estimating the incidence of kampo medicine ADR. [ABSTRACT FROM AUTHOR]

Objective: Little is known about the social problems experienced by cancer patients in non-Western countries. The aims of this study were (1) to explore the characteristics and frequencies of social problems in cancer outpatients, as well as their associations with the need for help, and (2) to take the initial steps to develop an instrument for the assessment of cancer-related social problems in Japan.Methods: A cross-sectional group of 109 patients completed the Social Problem Checklist and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30. Participants rated the levels of the problem severity and the need for help on each item. Factor structure, internal consistency, and construct validity were also assessed.Results: In total, 72.5% of the participants encountered ≥1 problem, and 33% experienced ≥1 serious problem. The amount of help needed tended to be lower than problem severity, especially for family and social life issues. The most common reason for not needing help, as reported by approximately 40% of patients who experienced problems, was the preference for self-management. A 3-factor model was extracted that included financial matters, medical information, and family and social life. Excellent internal consistencies for each factor and convergent correlations between the relevant subscales of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 and Social Problem Checklist were confirmed.Conclusions: A substantial proportion of participants had cancer-related social problems, but they had ambivalent help-related needs. Interventions that enhance the patient's abilities for self-care could be essential to help cancer outpatients manage social problems in Japan. [ABSTRACT FROM AUTHOR]

Molecular-targeted drugs are generally effective against tumors containing driver oncogenes, such as EGFR, ALK, and NTRK1. However, patients harboring these oncogenes frequently experience a progression of brain metastases during treatment. Here, we present an in vivo imaging model for brain tumors using human cancer cell lines, including the EGFR-L858R/T790M-positive H1975 lung adenocarcinoma cells, the NUGC4 hepatocyte growth factor ( HGF)-dependent gastric cancer cells, and the KM12 SM colorectal cancer cells containing the TPM3- NTRK1 gene fusion. We investigated the efficacy of targeted drugs by comparison with their effect in extracranial models. In vitro, H1975 cells were sensitive to the third-generation epidermal growth factor receptor inhibitor osimertinib. Moreover, HGF stimulated the proliferation of NUGC4 cells, that was inhibited by crizotinib, which has anti- MET activity. KM12 SM cells were sensitive to the tropomyosin-related kinase-A inhibitors crizotinib and entrectinib. In in vivo H1975 cell models, osimertinib inhibited the progression of both brain and subcutaneous tumors. Furthermore, in in vivo NUGC4 cell models, crizotinib remarkably delayed the progression of brain tumors, and that of peritoneal carcinomatosis. Interestingly, in in vivo KM12 SM cell models, treatment with crizotinib delayed the progression of liver metastases, but not that of brain tumors. Conversely, treatment with entrectinib discernibly delayed the progression of both tumor types. Thus, the effect of targeted drugs against brain tumors can differ from the one reported in extracranial tumors. Moreover, the same multikinase inhibitory drug can display different efficacies in brain tumor models containing different drivers. Therefore, our in vivo imaging model for brain tumors may prove useful for preclinical drug screening against brain metastases. [ABSTRACT FROM AUTHOR]

Cancer supportive care includes all measures to prevent or ameliorate side effects of any treatments including anti-cancer agents, with physical, mental, social, and spiritual care (survivorship). In recent years, the application of traditional Japanese medicine, "Kampo medicine", to cancer supportive care has attracted attention to improve the results of cancer treatment and the quality of medical care [3]. In recent years, chemotherapy, surgical treatment, radiation and immune checkpoint therapy have been used for the treatment of cancer patients. [Extracted from the article]

Since telomerase expression is highly prevalent in human cancers, the quantitation of serum/plasma hTERT (human telomerase reverse transcriptase) mRNA levels may be useful for early detection of PCa (pancreatic cancer). To analyse the correspondence between exhTERT (extracellular hTERT) mRNA levels and hTERT expression, we designed a cell culture system to investigate factors modulating the extracellular levels of hTERT mRNA in media conditioned by eight PCa cell lines. We found that the level of exhTERT mRNA was dependent on cell growth rate. MIAPaCa-2, PANC-1, KLM-1 and PK-9 cells expressed high levels of exhTERT mRNA, independent of cell density, whereas proliferating PK-59, BxPC-3 and PK-45H cells released low levels of exhTERT mRNA. The augmented release of mRNA by spontaneous dead MIAPaCa-2 cells was further increased at postconfluence. In Capan-1 cells, low correspondence of marker was also due to RNase secretion. Upon reaching confluence, some PCa cell lines showed down-regulation of hTERT expression. Following cell-cell adhesion, as shown by E-cadherin engagement, PK-59 cells showed levels of extracellular message below the limits of detection, a loss not due to an increase in message degradation. These results suggest that the levels of exhTERT mRNA in the medium of PCa cell lines are altered not only in response to cell growth rate and cell destruction, but are responsive to extracellular cues such as RNases and cell density. A cell-free assay for exhTERT mRNA may therefore not be useful for early detection of PCa. [ABSTRACT FROM AUTHOR]

We report a rare case of an epidermoid cyst in an accessory spleen at the pancreatic tail with producing CA19-9. A 55-year-old female was admitted to our hospital, Cancer Research Institute, Kanazawa University, for close examination of a cystic lesion at the pancreatic tail and a high serum CA19-9-value (176 U/mL). There were almost no abdominal symptoms related to the cystic lesion. A cystic tumor approximately 3 cm in diameter and composed of multilocular cysts without a protruding portion of the inner surface was found at the pancreatic tail by ultrasound sonography, computed tomography, and magnetic resonance imaging. Endoscopic retrograde pancreatography revealed that the main pancreatic duct shifted at the pancreatic tail and there was no communication between the main pancreatic duct and cystic lesion. Based on a preoperative diagnosis of mucinous cystic tumor, distal pancreatectomy with splenectomy was performed. Histological findings suggested an epidermoid cyst (3.5 × 3.0 cm) originating from an intrapancreatic accessory spleen. Immunohistochemical analysis of CA19-9 in the epidermoid cyst showed clear staining of the inner epithelium of the cyst and amorphous or hyalinous cystic contents. The serum CA19-9 value was confirmed to decline to normal 2 months after resection. Physicians should not forget this disease during differential diagnosis related to pancreatic cystic lesions with elevated levels of serum tumor markers, such as CA19-9 or carcinoembryonic antigen, although this disease is extremely rare. [ABSTRACT FROM AUTHOR]

We look forward to continue working with you to ensure publication of high quality research. B Reviewers b Amakura, Yoshiaki Amano, Yosuke Amitani, Marie Andoh, Tsugunobu Arai, Ichiro Arai, Makoto Araki, Ryota Arita, Ryutaro Egashira, Nobuaki Fujimoto, Makoto Hoshino, Takayuki Irie, Yasuhito Ishigami, Tomoaki Ishikawa, Shintaro Ito, Go Ito, Naoki Ito, Takashi Iwata, Kentaro Johnin, Kazuyoshi Kainuma, Mosaburo Kaneko, Soichiro Kashima, Masayuki Katayose, Dai Kawanabe, Tadaaki Kikuchi, Akiko Kitamura, Masashi Kogure, Toshiaki Kuboyama, Tomoharu Kuroki, Haruo Maeda, Manabu Makimoto, Fukashi Makino, Toshiaki Mantani, Naoki Masuyama, Shoko Matsumoto, Tsukasa Matsuzaki, Keiichi Mitani, Kazuo Mitsufuji, Takashi Morikawa, Toshio Motoo, Yoshiharu Muramatsu, Shin-ichi Muroga, Kazuhiro Nabeshima, Shigeki Nagai, Atsushi Nagata, Yutaka Nakae, Hajime Nakamura, Takehiro Nakashima, Souichi Namiki, Takao Ninomiya, Kiyofumi Nose, Mitsuhiko Odaguchi, Hiroshi Ohsawa, Minoru Oikawa, Tetsuro Ono, Rie Ono, Takahiko Raimura, Masaki Saito, Natsumi Sasaki, Kazunori Sato, Juichi Segawa, Makoto Sekiguchi, Yuki Shibahara, Naotoshi Shimada, Yutaka Shoyama, Masaru Suzuki, Tatsuhiko Suzuki, Tomoko Takamura, Mitsuyuki Takayama, Shin Terauchi, Masakazu Tohda, Chihiro Toume, Kazufumi Ueda, Keigo Uezono, Yasuhito Wada, Kentaro Watanabe, Tetsuo Yakubo, Shuji Yamada, Kazuo Yamamoto, Shuhei Yamaoka, Denichiro Yoshida, Minoru Yoshimatsu, Kayo Yoshinaga, Ryo Yoshino, Tetsuhiro The Editorial Board, the Japan Society for Oriental Medicine and the Japan Society of Medical and Pharmaceutical Sciences for Traditional Medicine would like to express our sincere gratitude for your excellent contribution to I Traditional & Kampo Medicine i as a Reviewer in 2022. [Extracted from the article]

ABSTRACT- Expression of epidermal growth factor (EGF) and fibroblast growth factor (FGF) was examined in 56 patients with hepatocellular carcinoma (HCC) using an immunohistochemical method. EGF and FGF were expressed on carcinoma cells in 14 (25%) and 23 cases (41%), respectively. In the 23 FGF-positive cases, 11 cases were positive for both acidic and basic FGF, while 18 were positive for acidic FGF, and 16 were positive for basic FGF. In non-cancerous hepatic tissues, FGF was weakly positive in macrophages, hepatocytes and vascular endothelial cells in some cases, while EGF was totally negative. There were no significant correlations between the expression of EGF or FGF on carcinoma cells and the various clinicopathologic factors examined. These data suggest that EGF and FGF are produced by human HCC cells in vivo. The roles of the expression of these growth factors in the development and progression of HCC remain only speculative. [ABSTRACT FROM AUTHOR]

A 50-year-old man developed epigastralgia 1 day later, after eating a raw squid meal. A submucosal tumor-like lesion at the gastric fornix was demonstrated on gastroscopic examination. Manifestations of acute gastritis were also seen. In 5 days (the period between the first and second examinations), the tumor disappeared and a large ulcer was seen endoscopically at the same site. Biopsy specimens revealed eosinophilic infiltration at the site of the lesion. Mild leucocytosis, significant eosinophilia and high serum anti-Anisakis antibodies were also revealed. The patient was closely followed up by endoscopy, endosonography, barium studies and laboratory investigations until the ulcer was completely healed. The lesion was probably caused by gastric anisakiasis and could be categorized as a so-called ‘vanishing tumor of the stomach’. [ABSTRACT FROM AUTHOR]