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Objective Patients in whom coronavirus disease 2019 (COVID-19) was suspected or confirmed between January 1, 2020, and October 31, 2021, were enrolled from Japanese hospitals in this multicenter, retrospective, observational study. Methods Data on the treatment administered (including conventional and Kampo medicine) and changes in common cold-like symptoms (such as fever, cough, sputum, dyspnea, fatigue, and diarrhea) were collected from their medical records. The primary outcome was the number of days without a fever (with a body temperature37 °C). The secondary outcomes were symptomatic relief and the worsening of illness, defined as the presence of a condition requiring oxygen inhalation. The outcomes of patients treated with and without Kampo medicine were compared. Patients We enrolled 962 patients, among whom 528 received conventional and Kampo treatment (Kampo group) and 434 received conventional treatment (non-Kampo group). Results Overall, after adjusting for the staging of COVID-19 and risk factors, there were no significant between-group differences in the symptoms or number of days being afebrile. After performing propensity score matching and restricting the included cases to those with confirmed COVID-19 who did not receive steroid administration and initiated treatment within 4 days from the onset, the risk of illness worsening was significantly lower in the Kampo group than in the non-Kampo group (odds ratio=0.113, 95% confidence interval: 0.014-0.928, p=0.0424). Conclusion Early Kampo treatment may suppress illness worsening risk in COVID-19 cases without steroid use. Further randomized controlled studies are needed to confirm the clinical benefit of Kampo medicine for COVID-19.

There exist certain behaviors that people tend to do in disaster situations before evacuation. Such behaviors include warning confirmation behavior (for example, seeking information) and family-oriented behavior (for example, contacting one’s family). Identifying factors that affect these behaviors is of particular importance in building a better understanding of why people often fail to respond quickly to evacuation orders. For this purpose, the present study employed some of the established factors affecting evacuation behavior as predictor variables along with the timing of an evacuation order. A total of 518 participants took part in a 12-item online questionnaire survey that contained a hypothetical disaster scenario. The results of ordinal logistic regression analyses revealed that only risk area residence and disaster preparedness were associated with warning confirmation behavior, while gender, age, disaster preparedness, and risk perception had some associations with family-oriented behavior. Also, the participants were not more likely to engage in these behaviors in the morning and the afternoon than the evening in the hypothetical scenario. These findings imply the possibility that people engage in warning confirmation behavior and family-oriented behavior before evacuation regardless of individual characteristics and the circumstances surrounding them.

Aim: We present the study protocol of a multicenter, retrospective observational study that aims to investigate the efficacy of the actual treatment (the efficacy of conventional and Kampo medicines) of patients with mild to moderate or suspected coronavirus disease (COVID-19) Methods: This study is designed as a multicenter, retrospective observational study Outpatients and inpatients will be recruited from Japanese hospitals The inclusion criteria are as follows: having or suspected to have COVID-19, mild to moderate COVID-19, symptomatic, ≥20 years of age, male or female, able to communicate in Japanese, and treated with conventional and Kampo medicine The exclusion criteria are: unable to provide informed consent due to dementia, psychosis, or psychiatric symptoms, severe COVID-19, or determined unsuitable for this study The sample size is set at 1000, as this number of people can be treated at the collaborating medical institutions during the study period Results: The main outcome is the number of days without fever, with a body temperature of less than 37°C The secondary outcome is set at common cold-like symptoms other than fever (fatigue, cough, shortness of breath, sputum, diarrhea) and severity of illness and hospitalization up to 14 days after the visit Trial registration: The trial was registered in the University Hospital Medical Information Network (Reservation No UMIN000041301) on August 4, 2020 Conclusion: Our study will explore the contribution of conventional and Kampo medicine in the treatment of patients with mild and moderate COVID-19

Herb-induced liver injury due to Kampo formulae is a clinically relevant adverse effect, which may be associated with formulae containing Scutellariae Radix. We explored this incident relationship further by surveying outpatients treated with a Kampo formula containing Scutellariae Radix (KFCSR) at our clinic.We included patients who had been treated with a novel KFSCR formulation between November 2014 and October 2015. The participants underwent liver injury-related blood tests (examining the aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, gamma-glutamyl transpeptidase, and total bilirubin levels, as well as the percentage of eosinophils in the white blood cell count) before and after treatment to evaluate its efficacy.In total, 43 of the 363 patients treated during the study period received KFCSRs and 37 underwent blood tests before and after treatment. Liver injury occurred in four patients (10.8%) and all patients recovered quickly after cessation of the formula.We found that 10.8% of patients treated with KFCSR developed liver injury, which was higher than that reported previously. We believe that herb-induced liver injury should be seriously considered as a risk factor for KFCSRs. Further investigation is warranted to verify these results.

Background and Aims Recent findings suggest that acute kidney injury (AKI), which occurs frequently but is believed to be completely reversible, is an important factor driving chronic kidney disease (CKD) pathogenesis or progression. We have investigated Astragalus membranaceus (AM), which has been shown to have various pharmacological effects on several organs (see http://nccih.nih.gov/health/astragalus). However, up to now, little evidence of its effectiveness against CKD has been provided. We hypothesized that AM could target AKI and that sustainable prevention of AKI by AM might delay pathogenesis and progression of CKD. Here we focused on AKI as a promoter of CKD progression in order to examine the effects of AM histologically and histochemically in mice. Method Here we used two groups of female C57BL/6 mice: one that was aged 12 weeks and one that was aged 52 weeks. After the first blood collection (of approximately 0.2 ml), the two age groups of mice were administered AM powder mixed with sterilized 0.5% methylcellulose 400 (w/v) (the AM-administered group) or sterilized 0.5% methylcellulose 400 (the control group), respectively. Two hours after the administration, 0.5 mg/ml cisplatin (20 mg/kg or 14 mg/kg) or 0.9% NaCl were injected intraperitoneally. Three days after injection, blood was collected and kidneys were harvested. We measured blood urea nitrogen (BUN) and creatinine (CRE) to detect AKI, and assessed histological change in dissected kidney sections stained with Hematoxylin-Eosin and Periodic acid-Schiff and histochemical change in sections stained with anti-CD3 and anti-CD68 antibodies. Generally, 20 mg/kg cisplatin was used to induce AKI in the experimental model. Results Injection with 20 mg/kg cisplatin was shown to induce AKI pathology in young mice and shorten survival in old mice, and AM administration was unable to improve AKI pathology in young mice or survival in old mice. Next, we injected mice in both age groups with 14 mg/kg cisplatin. We found that this dose significantly increased serum BUN or CRE and caused histological damage in renal tubule epithelial cells and glomeruli in old mice but not in young mice, which showed no pathological change. And Astragalus treatment in advance almost totally prevented these pathological changes in old mice. The AKI generated in old mice with 14 mg/kg of cisplatin was significantly normalized by pretreatment with AM. Next, histochemical analysis of renal CD3- and CD68-positive cells revealed both were increased in the murine AKI model induced by injection with 20 mg/kg cisplatin. Interestingly, in old mice, 14 mg/kg cisplatin-AKI increased CD3-positive cells but not CD68-positive cells. These findings suggest that AM may improve daily minor disturbances, such as AKI, that cause pathogenesis and progression of CKD especially in old age. Conclusion AM administration, at least in part, can reduce day-to-day AKI occurrence, but is ineffective in young kidneys. However, sustained use of AM could play a critical role in prolonging the activity of aged kidneys. Acknowledgments We thank the Education and Research Support Center, Tokai University, for technical assistance. This work was supported by a grant from the Japan Society for Promotion of Science JSPS KAKENHI KIBAN-C (Grant Number 16K09259) and by Tokai university general research organization grant.

No report of newly enrolled medical students discusses their attitudes toward traditional Japanese medicine (TJM), Kampo medicine, or acupuncture and moxibustion (AM), or their changes over the course of medical school. This study evaluates these changing attitudes.At Tokai University School of Medicine, from 2006 through 2015, 852 students were analyzed 3 times, pre-1st-year introduction Kampo lecture, pre-4th-year 6-hour lectures, and post-3-hour experience-based learning (EBL) course. The 7-item questionnaire included: general impression about Kampo medicine, interest, learning motivation, future involvement, and image, interest in AM, and learning motivation.Their attitudes toward TJM became positive during the 3 years even without TJM education. The 4th-year TJM lectures and EBL course significantly changed their attitudes toward more positive. Females' attitudes were more positive regarding TJM from the 1st year than were the males which became more positive after the EBL course. Students with TJM learning or work experience had positive attitudes from their 1st year and throughout medical school. Students with less positive attitudes became more active in TJM and positive at graduation.Appropriate TJM education and standard medical education in preclinical years of medical school has helped make students' attitudes toward Kampo medicine and AM more positive.

Objective We aimed to test our hypothesis that traditional Japanese (Kampo) medicine, hochuekkito (Hochu-ekki-to: HET) has a preventive effect for the symptoms on COVID-19. Trial design The study is designed as a multi-center, interventional, parallel-group, randomized (1:1 ratio), investigator sponsored, two-arm study. Participants Six thousand participants will be recruited from healthy hospital workers in 7 Japanese University Hospitals. Inclusion criteria: 1. Age from 20 to 75 years old at the time of registration 2. Asymptomatic and body temperature below 37°C at the time of registration 3. Capable of eating orally Exclusion criteria: 1. Previous upper respiratory inflammation due to viral infection (including suspected COVID-19) 2. Taking immunosuppressants 3. Allergic to the Kampo medicines used in this study 4. History of hypokalaemia, severe hypertension, severe liver dysfunction, and interstitial pneumonia 5. Regularly taking other Kampo medicines 6. Pregnant or possibly pregnant 7. Participating in other research 8. Judged to be unsuitable for this study by the doctor in charge Intervention and comparator Kampo group: participants receive HET in 9 tablets 2 times per day for 8 weeks. Control group: participants receive placebo in the same dosage as the Intervention group - 9 tablets 2 times per day for 8 weeks. Placebo tablets are identical in appearance and package to HET. Taste of placebo is different from that of HET. The Ohsugi Pharmaceutical Co. Ltd, Osaka, Japan manufactured the placebo and HET. Main outcomes Primary outcome: Number of patients with a SARS-CoV-2 RNA by ploymerase chain reaction (PCR) positive result with at least one symptom (fever, cough, sputum, malaise, shortness of breath) during the 12-week study period (including the 4-week observation period after oral administration). Secondary outcomes: 1. Period from infection to onset 2. Period from the appearance of symptoms to the disappearance of PCR positive 3. Number of days until the appearance or improvement of symptoms 4. Severe stage: presence of hospitalization 5. Shock stage: ICU management required for mechanical ventilation, shock vitals or failure of organ(s) other than lungs Safety endpoints include numbness in the hands and/or feet, edema, skin rash or other allergic symptoms, and gastric discomfort. Randomisation Patients are randomized (1:1 ratio) to each group using minimization implemented with the Electric data capture system (DATATRAK Enterprise Cloud), with balancing of the arms with age range (under 50 years of age or not) and having a history of risk factors for COVID-19 (cardiovascular disease, hypertension, diabetes, respiratory diseases). Blinding (masking) Only participants will be randomized. Numbers to be randomised (sample size) The main research hypothesis of this study is that Kampo medicines significantly prevent the onset of COVID-19. It is assumed that the infection rate before the administration of the drug under consideration will be 0% and that the incidence of COVID-19 thereafter will be 2- 3%, of which 70%-80% will show symptoms of COVID-19. Assuming that the pharmaceutical effect of the drug will be effective in 50% of patients and that the incidence rates in the placebo and drug groups will be 1.4%-2.4% and 0.7%-1.2%, respectively, the placebo is calculated at 2%, and the study drug at 1%. Since the frequency of verification is low and the number of cases will be large, we set a total of 10 analyses (9 interim analyses and a final analysis). Since the number of cases at the time of the final analysis will be 4,986 under the conditions of α = 0.05 and a power of 80% by the Peto method. We set at 600 cases in each interim analysis with an estimated dropout rate of 16.9%. Finally, the total number of cases is set to 6,000 with 3,000 in the placebo group and 3,000 in the HET group. Trial status Protocol version 1.3 of October 23rd , 2020. Recruitment start (expected): December 1st, 2020. Recruitment finish (expected): December 31st, 2022. Trial registration This trial is registered in the Japan Registry of Clinical Trials (jRCT) (jRCTs031200150) on 14 October 2020. Full protocol The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest of expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.

To examine how Kampo education in Japanese medical schools changed between 2011 and 2019.We administered nationwide postal questionnaire surveys about current characteristics of Kampo medicine education in all 82 Japanese medical schools, directed to the persons responsible for Kampo education at each university. One survey was conducted in 2011 and one in 2019. Analysis used Welch's t-test and a chi-squared test.The average class meeting time was shorter in 2019 than in 2011. The proportion of class meetings that were about Kampo saw a statistically significant increase in the third year and a significant decrease in the fourth and sixth years of medical school. Curriculum standardisation, preparation of simple textbooks, and fostering Kampo medicine instructors were the primary problems in both years. The proportion of mainstream medical education contents focusing on traditional Japanese Kampo medicine did not change over time, nor did the percentage of those considering using standardised textbooks. Other changes were statistically nonsignificant.In Japanese medical schools, the number of class meetings teaching Kampo medicine has increased; however, this number is not statistically significant. Persistent problems in Kampo education, including curriculum standardisation, need to be addressed.

Context: In Japan, many patients who cannot consume food orally are managed using external tube feeding over long periods. Although helpful in nutritional management, tube feeding significantly reduces a patient's quality of life. Aims: We examined the factors that affected the transition from tube to oral feeding in elderly people. Settings and Design: Single-center, retrospective, pilot study conducted from January 1, 2018 to December 28, 2019. Methods and Materials: We recruited patients who attempted to return to oral intake following tube feeding for >12 months at Miyama Hospital. Fourteen participants (male-to-female ratio = 6:8; age = 83.9 ± 2.6 years) attempted to resume oral feeding. We investigated patient diagnoses, duration of tube feeding, sex, swallowing reflex time, and Kohnan consciousness score. Patients with a swallowing reflex >4 s were administered banxia houpu tang. Results: Of the 14 patients, seven managed to resume oral feeding (group 1), while the remaining seven failed (group 2). The two groups of patients showed no significant difference in terms of mean age, duration of tube feeding, swallowing reflex time, and sex. However, the consciousness level of group 1 was significantly higher than that of group 2. Conclusions: Higher consciousness level in patients who successfully resumed oral feeding suggests that oral feeding should be considered in patients with adequate consciousness.

A 67-year-old woman experiencing coughing visited a clinic and was prescribed drugs, including shosaikoto extract, for 4 days. She subsequently suffered from liver injury, but her condition improved after the discontinuation of all medications. Approximately 1 year later, she experienced fatigue, consulted another clinic, and received saikokeishikankyoto extract for 21 days. She subsequently suffered liver injury again. Both shosaikoto and saikokeishikankyoto contain Scutellariae Radix. This case is thought to be one of recurrent drug-induced liver injury caused by the incidental readministration of a Kampo formula containing Scutellariae Radix. An awareness of adverse drug events caused by Kampo formulas, especially those containing Scutellariae Radix, is essential.

This study examined how pervasive disaster myths would be among disaster response professionals (n = 401) compared to lay people (n = 600), as well as sources of disaster myths among them. Results revealed that both of the groups believed five common disaster myths to some extent. Moreover, the mass media had a positive association with only one myth among these professionals, while the media was positively associated with all the five myths among lay people. In summary, the present findings indicated that disaster response professionals were not more insightful into all the myths than lay people, and that the mass media and popular culture were not the principal sources of the disaster myths among these professionals.

Case An obese 17-year-old male patient with right hemiparesis secondary to cerebral infarction presented for kampo treatment. The hemiparesis and resultant lack of exercise had led to an increase in bodyweight. Serum alanine aminotransferase (ALT) was elevated and abdominal ultrasound identified fatty liver. The patient was diagnosed with non-alcoholic fatty liver disease (NAFLD). Aspirin and tocopherol acetate (vitamin E), previously prescribed, were continued, and kampo medicines were prescribed. Outcome Two years and 6 months after the initial visit, we prescribed keishikashakuyakuto (Gui Zhi Jia Shao Yao Tang) extract, in addition to keishibukuryogan (Gui Zhi Fu Ling Wan) extract. Thereafter, serum ALT gradually decreased, despite no significant change in bodyweight or blood platelet count. Conclusion Kampo medicine may be effective for the treatment of NAFLD.

Objectives. Traditional Japanese Kampo medicines have been integrated into the Japanese national health-care system. In Japan, the Ministry of Health, Labor, and Welfare’s website discloses adverse drug-event data that have been obtained from medical personnel reports investigated by the Pharmaceutical and Medical Devices Agency. Using these data, we investigated adverse events associated with ethical Kampo formulations. Methods. Reports of adverse events associated with ethical Kampo formulations from the domestic adverse-event data were obtained from July 30, 2003, to March 31, 2018. Adverse events were then categorized, and the relationships between categories of adverse events and crude drugs were analyzed. Results. There were 4,232 reported adverse events associated with ethical Kampo formulations. The numbers of events by category were as follows: events related to liver injury, 1,193; lung injury, 1,177; pseudoaldosteronism, 889; mesenteric phlebosclerosis, 223; drug eruption, 185; and others, 565. Among events related to both liver injury and lung injury, approximately 70% were suspected to be induced by Kampo formulations containing Scutellariae Radix. The pseudoaldosteronism-related events, which are induced by Glycyrrhizae Radix, included several events related to muscle injury, heart failure, and arrhythmia. Events related to mesenteric phlebosclerosis, believed to be induced by long-term use of Kampo formulas containing Gardeniae Fructus, increased remarkably during the study period. Among the events related to drug eruption, approximately 35% were suspected to be induced by Kampo formulations containing Ephedrae Herba. Conclusion. Kampo medicines may cause various adverse events. The present results provide valuable information regarding adverse events associated with Kampo medicines from the viewpoint of patient safety.

The assumption that disasters trigger panic has been widespread among the general public and emergency management personnel. An online convenience sample of 600 Japanese participants, ages 20 to 69 (221 women), responded to a 23-item questionnaire to reveal people’s images of panic during disasters. One goal of the current study was to examine whether lay people’s use of the term “panic” is consistent across various types of emergency situations, ranging from minor everyday events to major disasters. A second goal was to explore the assumed susceptibility to panic across several different emergency situations. Results revealed that participants thought that the term panic was more appropriate for mass emergencies than for personal emergencies. In addition, participants reported that even in mass emergencies the term would include multiple behavioral and emotional responses. Furthermore, participants indicated that others would be more susceptible to panic than they would personally, while the presence of strangers was found to have some unique effects on perceived panic susceptibility. In sum, the findings of the current study imply that it is very likely that whenever and wherever life-threatening mass emergencies occur, people will continue to arbitrarily use the term panic.

Aim Systemic scleroderma is a connective tissue disease of unknown etiology characterized by fibrosis of the skin and internal organs. There are few effective treatments for this disease. In this study, we examined the effectiveness of the traditional Japanese medicines keishibukuryogan (KBG), tokishakuyakusan (TSS), and ogikenchuto (OKT) in treating systemic scleroderma. Methods Dermal sclerosis was induced in mice by daily injection of bleomycin. The mice were randomly divided into five groups based on treatment: KBG, TSS, and OKT groups (250 mg/kg/day), and two groups given water only (the sham and control groups). The sham group received local phosphate-buffered saline injections (without bleomycin), and the control group received local bleomycin injections (without treatment). Kampo treatment groups also received local bleomycin injections. A daily dose of 0.01 mL of either kampo solution or water/g·bodyweight was given orally (through a stomach tube) for 4 weeks. Results On histology at week 4, significantly fewer mast cells had infiltrated into the dermis in the TSS and OKT groups than in the control group; dermal sclerosis was also less severe in these groups. Furthermore, at week 1, the KBG, TSS, and OKT groups had significantly reduced serum transforming growth factor β1 (TGF-β1). OKT and TSS had significantly reduced the level of malondialdehyde in the skin tissue. Conclusion OKT and TSS suppressed the progression of dermal sclerosis by inhibiting mast cell infiltration, as well as by decreasing TGF-β1 and oxidative stress.

In the subalpine zone on Mt. Hakusan, Japan, Plantago asiatica, an alien plant, and Plantago hakusanensis, a native alpine species, grow sympatrically along with their putative hybrids. Here, their flowering behavior, which affects the frequency of hybridization and the colonizing ability of P. asiatica and its hybrids, is described. The flowering behavior of each species and of two F1 hybrids from different seed parents was determined based on the position of the flower in the inflorescence by using a generalized linear mixed model. The percentage fruit set of individually bagged inflorescences was calculated to corroborate the assumptions of the opportunities for self-pollination. All the flowers were protogynous; however, many P. asiatica anthers dehisced before browning of the stigma in the flower and the sex presentations in the inflorescence were asynchronous. The percentage of fruit set was high. Consequently, P. asiatica has the opportunity for self-pollination within the flower and in the inflorescence. In contrast, the P. hakusanensis anthers dehisced after browning of the stigma in the flower; their sex presentation was synchronous in the inflorescence, showing negligible opportunities for self-pollination, and the fruit set was low. Accordingly, in the field, P. hakusanensis might require pollination among the inflorescences for seed production and be actively outcrossed, while P. asiatica is able to outcross in the early flowering phase. Therefore, P. asiatica and P. hakusanensis have opportunities for hybridization. The F1 hybrids exhibited intermediate flowering behavior and produced fruits, demonstrating the potential to reproduce by selfing.

Banxia Houpu Tang, a traditional Chinese medicine, helped in initiating oral feeding in a stroke patient, after three years of nasogastric tube feeding. This Chinese medicine has potential in eliminating the need for nasogastric feeding and for physical restraints in geriatric individuals after a stroke.

People tend to perceive that crime is widespread in post-disaster situations. This common misconception, also known as the myth of increased crime, was examined based on an online convenience sample of 600 people. A 11-item questionnaire survey was designed to examine what types of criminal acts people assumed would increase in post-disaster situations, as well as whether the amount of media consumption and preferences for media coverage of crime would affect the perceived frequency of post-disaster crime. RESULTS found that people assumed that only theft, fraud, and looting, would increase after disasters, while they did not seem to think that sex offense, assault, and murder, would increase. Also, results of regression analysis found that only age, weekly hours of Internet access, and the person's preference for media coverage of daily crime were found to be significant predictors of the myth, although the present prediction models failed to provide a satisfactory explanation. Unexpectedly, hours of television viewing and one's preference for media coverage of post-disaster crime were found to have no significant effects on the perceived frequency of post-disaster crime. Types of criminal acts misperceived to increase in post-disaster situations and alternative sources of the myth are discussed to some extent.

Purpose– The purpose of this paper is to explore what would make disaster donors different from non-donors, with particular attention paid to differences in two forms of donations: the monetary donation that directly benefits the beneficiary and the charitable donation that is used by charitable organizations to support their disaster relief activities. Differences in the perceived effectiveness of other disaster relief activities, skepticism about charitable organizations, disaster experience, disaster preparedness, and disaster insight were also examined between the two groups.Design/methodology/approach– A total of 300 Japanese participants were asked to complete a14-item questionnaire online. A series of comparative analyses were conducted to examine differences between donors and non-donors in the questionnaire items.Findings– Although non-donors evaluated the effectiveness of the monetary donation more positively than the charitable donation, donors evaluated the effectiveness of all the disaster relief activities more positively than non-donors. Moreover, donors were more prepared for disasters and more insightful into the current situation of the disaster victims than non-donors.Research limitations/implications– Along with the internal and external factors previously found, disaster awareness may be a key to increasing people's intention to donate for disaster victims. Such awareness could be fostered through successful disaster education and appropriate media coverage of disasters.Originality/value– The findings that non-donors generally have a less positive view of disaster relief activities imply that non-donors may be less knowledgeable than donors about how charitable activities can work and benefit disaster victims.

In spite of the evidence that the malignant transformation of gastric hyperplastic polyps (HPs) is a rare event, it must always be taken into account during diagnosis. The aim of the current study was to clarify the mechanism of the malignant transformation of gastric hyperplasia polyps, with focus on phenotypic expression, cell proliferation and p53 overexpression. Immunohistochemistry for mucin phenotypic markers, including MUC1, MUC2, MUC5AC, MUC6, tight junction factors (claudin-3, -4 and -18), an intestinal phenotypic marker [caudal type homeobox 2 (Cdx2)], Ki-67 proliferative index and p53 overexpression, was performed on archival specimens of gastric polyps excised from six patients. Histologically, the intermingled components of several lesions were present in these polyps. Furthermore, the cancer components were predominantly differentiated adenocarcinoma. Immunohistochemically, all hyperplastic components expressed MUC5AC, but did not exhibit positivity for MUC2. Additionally, the majority of hyperplastic components were immunonegative for claudin-3, while claudin-3 positivity was observed in the majority of areas of dysplasia and carcinoma. Expression of claudin-4 was also observed in the majority of cases and claudin-18 was preserved in the hyperplastic, dysplastic and adenocarcinomatous lesions of all cases. Nuclear accumulation of Cdx2 was detected in almost all the samples with dysplasia and carcinoma, while nuclear p53 was detected in 24-80% of the dysplastic areas and >85% of the cancer components. The Ki-67 labeling index appeared to correlate with neoplastic progression. The observations provided evidence that the mechanism underlying malignant transformation of gastric HPs may occur by multistep carcinogenesis, such as the hyperplasia-adenoma (dysplasia)-adenocarcinoma sequence, and these neoplastic cells may acquire various phenotypes during this process.

The present study examined how soon people would make a decision to break existing rules in an anonymous situation, with particular attention paid to the degree of anonymity. A total of 100 participants were randomly assigned to either a self-reward condition or an other-reward condition, in both of which they were asked to flip a coin twice in each of the four coin-flip trials to win the assigned reward. As predicted, the results showed that only participants in the self-reward condition broke the assignment rules for obtaining the reward, and they only did so in the very last coin-flip trial. In sum, the present findings suggest that people do not break existing rules for material gain as soon as they become anonymized, but some may do so at the very last moment.

The present study examined whether psychological self-interest would instigate rule breaking in an anonymous situation. In total, 66 individuals were observed whether they would pursue material or psychological self-interest by breaking existing rules under the cloak of anonymity. Anonymity was defined to minimize accountability for one's behavior, and was strictly manipulated to make all participants equally anonymous during the experiment. Results showed that only participants in the material-reward condition broke the rules, whereas those in the psychological-reward condition did not. Also, there was no difference found between the two conditions in subjective feelings of anonymity and public self-awareness although rule breaking was observed only in the material-reward condition. Implications for socially undesirable behavior in anonymous situations are discussed.

冬季の嘔吐下痢症はノロウイルス感染が原因となる場合が多く，嘔吐，下痢，発熱，腹痛を主症状とする。通常1～3日で治癒するが，高齢者では死亡するケースも報告されている。今回，2005年12月1日から2006年1月31日の2カ月間，福岡県の1老人ホームで多発した嘔吐下痢症に際し，黄芩湯を投与した20例の検討を行った。症状消失までの漢方方剤の投与回数は1～12回で，3回以内が15例と75％を占めていた。うち4例は1回のみの投与であった。症状消失までの時間は24時間未満11例，24時間以上48時間未満6例，48時間以上72時間未満2例，72時間以上96時間未満1例で，48時間未満が17例と85％を占めていた。1例が誤嚥性肺炎を併発したが，入院治療を要する症例はなかった。ノロウイルス感染症は早期から漢方治療を行えば軽症かつ早期に回復する可能性があり，西洋医学的には対症療法のみであるため，漢方治療を行う意義は大きいと考える。