Hiroshi Oka

The Long-Term Effects of a Kampo Medicine, Juzentaihoto, on Maintenance of Antibody Titer in Elderly People after Influenza Vaccination

We have performed a broad-ranging analysis of the adjuvant effect of a Kampo medicine, juzentaihoto (JTT), on influenza vaccination in a multicenter randomized controlled trial. In this study, the enhancing effect of JTT on antibody titer after influenza vaccination was studied for 28 weeks in elderly people who were in the high-risk group for influenza infection. In total, 91 subjects over 65 years old were recruited from four long-term-care facilities located in Chiba, Gunma, and Toyama prefectures in Japan. Participants were randomly assigned to the JTT and the control groups. Blood samples were taken at 4 weeks before vaccination, at the time of vaccination, and then at 4, 8, 12, and 24 weeks after vaccination. The hemagglutination inhibition (HI) titers against A/California/7/2009 (H1N1), A/Victoria/210/2009 (H3N2), and B/Brisbane/60/2008 were then manually measured. A significant increase in HI titer against H3N2 was observed at week 8 after vaccination in the JTT group compared with the control group (P = 0.0229), and the HI titer of the JTT group significantly increased from 4 to 24 weeks (P = 0.0468), compared with the control group. In conclusion, our results indicated that JTT increased and prolonged antibody production against A/Victoria/210/2009 (H3N2), in particular, after influenza vaccination.

Effect of Hachimijiogan against Renal Dysfunction and Involvement of Hypoxia-Inducible Factor-1α in the Remnant Kidney Model

In chronic renal failure, hypoxia of renal tissue is thought to be the common final pathway leading to end-stage renal failure. In this study the effects of hachimijiogan, a Kampo formula, were studied with respect to hypoxia-inducible factor (HIF). Using remnant kidney rats, we studied the effects of hachimijiogan on renal function in comparison with angiotensin II receptor blocker. The result showed that oral administration of hachimijiogan for seven days suppressed urinary protein excretion and urinary 8-OHdG, a marker of antioxidant activity, equally as well as oral administration of candesartan cilexetil. In contrast, the protein volume of HIF-1α in the renal cortex was not increased in the candesartan cilexetil group, but that in the hachimijiogan group was increased. In immunohistochemical studies as well, the expression of HIF-1α of the high-dose hachimijiogan group increased compared to that of the control group. Vascular endothelial growth factor and glucose transporter 1, target genes of HIF-1α, were also increased in the hachimijiogan group. These results suggest that hachimijiogan produces a protective effect by a mechanism different from that of candesartan cilexetil.

Keishibukuryogan Reduces Renal Injury in the Early Stage of Renal Failure in the Remnant Kidney Model

The effects of keishibukuryogan on the early stage of progressive renal failure were examined in rats subjected to 5/6 nephrectomy. Keishibukuryogan, one of the traditional herbal formulations, was given orally at a dose of 1% (w/w) and 3% (w/w) in chow. Administration of keishibukuryogan was started at 1 week after 5/6 nephrectomy and was continued for 4 weeks. At the end of the experiment, Azan staining did not reveal any severe histological changes in the kidneys of the nephrectomized rats. On the other hand, significant increases in mRNA expressions of transforming growth factor-β 1 and fibronectin related to tissue fibrosis, as examined by Reverse Transcriptase-Polymerase Chain Reaction, were observed in nephrectomized rats, and they were significantly suppressed by 3% keishibukuryogan treatment. Against gene expressions related to macrophage infiltration, 3% keishibukuryogan treatment significantly suppressed osteopontin mRNA levels, and monocyte chemoattractant protein-1 and vascular cell adhesion molecule-1 mRNA levels showed a tendency to decrease, but without statistical significance. It was also observed that 3% keishibukuryogan attenuated serum urea nitrogen and urinary protein excretion levels. From these results, it was suggested that keishibukuryogan exerts beneficial effects that result in slowing the progression of chronic renal failure.

A Case of Trigeminal Neuralgia Effectively Treated with Jidabokuippo: Hint from Past Injury and Tender Point

a Bayside Clinic, 2-20-11 Minamisaiwai Nishi-ku, Yokohama, Kanagawa 220-0005, Japan b Koiso Clinic, 2-80-9 Kamoi, Yokosuka, Kanagawa 239-0813, Japan c Department of Diabetes and Metabolism, Synthesis Shinkawabashi Hospital, 1-15 Shinkadori, Kawasaki-ku, Kawasaki, Kanagawa 210-0013, Japan d Department of Endocrinology/Diabetes and Metabolism, Yokohama City University Medical Center, 4-57 Urafune, Minamiku, Yokohama, Kanagawa, 232-0024, Japan

A Case of Ascites from Hepatocellular Carcinoma Treated with Boi-shomoku-teireki-daio-gan-ryo

A case of ascites and pitting edema from hepatocellular carcinoma treated with Boi-shomoku-teireki-daiogan-ryo was reported. An 80-year-old female presented progressive gait disturbance and dysuria in April 2002. Neurological examination revealed paraparesis, hypesthesia inferior to lumber level and sphincter dysfunction. An MRI revealed a solid mass arising from lamina at the right Th 12, extending into the spinal canal. Surgery was performed, but paraparesis continued. In addition, the patient developed ascites and pitting edema of the legs. An abdominal CT suggested liver cirrhosis and hepatocellular carcinoma. Some Kampo formulas were not effective. Boi-shomoku-teireki-daio-gan-ryo was administered on the basis of symptoms such as ascites, dry mouth and constipation, and then the pitting edema improved rapidly. In addition, the abdominal CT revealed the decrement of ascites. Unfortunately the treatment was effective for only one month. Ascites with malignant tumor is very difficult to treat. However, Boi-shomoku-teireki-daio-gan-ryo is clearly useful for treatment of ascites and edema.