In the present study, we investigated the effects of fracture fixation on joint contracture and disuse muscle atrophy. We surgically fractured the right hind limbs of male Wistar rats, and then fixed the right ankle joints at maximal plantar flexion for two weeks using dorsal splints. Compared with immobilized healthy and sham operated joints, the fractured joints concomitantly showed highly restricted range of motion and significantly higher degrees of disuse atrophy in soleus muscle; decrease of muscle fiber cross sectional area, development of central core lesion and a change in myosin heavy chain isoforms from slow type myosin to fast type myosin. Therefore, it is suggested that orthopedic fracture fixation induces intense disuse muscle atrophy to aggravate joint contracture.

In this study, the danger of dehydration and heatstroke in a walking event in the summer was examined. Subjects were 64 males, 11 females, and the average age was 62.3±7.8 years old. The following were measured before and after 25 km walking : body weight, blood pressure, heart rate, tympanic temperature, and fluid intake. WBGT in the walking event was 22.6℃ mean value. Time of the 25 km walking was 5 hours 45 minutes, and the number of steps were 36,570±2,741 steps. The body weight loss by the walking was 1.36±0.57 kg, 2.24±0.96%. This body weight loss rate increased with the age. The fluid intake was 1,327±608 g, and sweat loss was 2,621±740 g in the walking. The tympanic temperature after walking was 38.02±0.60℃, and increased 0.99±0.67℃ from before walking. In the walking of middle-aged and elderly persons in the summer, there is danger of dehydration and heatstroke, therefore enough water and salt intakes are necessary.

We investigated 58 general medicine outpatients with a questionnaire on sex, BMI, lifestyle habits and the pathological condition of ki. We classified sex, BMI and sleep, diet and exercise as lifestyle habit factors, and classified ki deficiency, ki obstructive depression, ki counter flow as the pathological signs of ki. After we established a disease group and a control group, we calculated ratios for the factors in each group. As a result, there were associations between hours of sleep, and recovery from fatigue with sleep, to ki deficiency. There were also associations between recovery from fatigue with sleep, and sex, to ki obstructive depression and ki counter flow.

Background: Few medical education programs provide hands-on classes using electronic medical charts for a large number of students.
Methods: To simulate a medical interview, third- and sixth-year medical students viewed electronic medical chart samples on a screen, created by FileMaker, and discussed patient management. Following this, they underwent a questionnaire survey.
Results: A total of 63.1 and 76.3% of the third- and sixth-year students responded to the questionnaire, and 87.1 and 78.9% of the responders became interested in the class, respectively, because it focused on hands-on, practical training. A total of 5.6% of third-year students stated that the class was difficult to master but they hoped to continue learning.
Discussion: The adoption of a hands-on class using electronic medical charts interested even junior medical students.

From 1998 to 2001, using questionnaires, we surveyed the use of travel vaccines among Japanese expatriates in developing countries. The percentage of those using more than one type of travel vaccine before departure increased significantly (45.6% in 1998 to 53.4% in 2001 (p<0.001)). In regions such as tropical Africa and South Asia, vaccination rates were high. But the increase was most noticeable in East Asia, the Middle East, and Latin America. Vaccinations against hepatitis A, hepatitis B, and tetanus were high throughout the developing countries. Vaccinations against yellow fever and Japanese encephalitis were high in endemic regions. Vaccination rates were slightly higher for typhoid fever in South Asia and tropical Africa than that in other areas. Vaccination rates for cholera, however, showed yearly declines. These trends seem to reflect a growing awareness among expatriates of the benefits of travel vaccines. Even so, nearly half of those living the countries have not received sufficient vaccination, indicating a need for further education.

No abstract available.
Carcinosarcoma*

BACKGROUND/AIMS: Noninvasive objective monitoring is advantageous for optimizing treatment strategies in patients inflammatory bowel disease (IBD). Fecal calprotectin (FCP) is superior to traditional biomarkers in terms of assessing the activity in patients with IBD. However, there are the differences among several FCP assays in the dynamics of FCP. In this prospective multicenter trial, we investigated the usefulness of FCP measurements in adult Japanese patients with IBD by reliable enzyme immunoassay using a monoclonal antibody. METHODS: We assessed the relationship between FCP levels and disease or endoscopic activity in patients with ulcerative colitis (UC, n=64) or Crohn’s disease (CD, n=46) compared with healthy controls (HCs, n=64). RESULTS: FCP levels in UC patients strongly correlated with the Disease Activity Index (rs =0.676, P < 0.0001) and Mayo endoscopic subscore (MES; rs =0.677, P < 0.0001). FCP levels were significantly higher even in patients with inactive UC or CD compared with HCs (P=0.0068, P < 0.0001). The optimal cutoff value between MES 1 and 2 exhibited higher sensitivity (94.1%). FCP levels were significantly higher in active UC patients than in inactive patients (P < 0.001), except those with proctitis. The Crohn’s Disease Activity Index tended to correlate with the FCP level (rs =0.283, P=0.0565). CONCLUSIONS: Our testing method using a monoclonal antibody for FCP was well-validated and differentiated IBD patients from HCs. FCP may be a useful biomarker for objective assessment of disease activity in adult Japanese IBD patients, especially those with UC.
Adult* ; Antibodies, Monoclonal ; Asian Continental Ancestry Group* ; Biomarkers ; Colitis, Ulcerative ; Crohn Disease ; Humans ; Immunoenzyme Techniques ; Inflammatory Bowel Diseases* ; Leukocyte L1 Antigen Complex* ; Methods ; Multicenter Studies as Topic ; Proctitis ; Prospective Studies*

  To evaluate the current state of the Onsen-Ryoho-Specialist (Broad Certified Fellow in Balneology, Climatology and Physical Medicine) training system, we surveyed the training facilities designated by the Japanese Society of Balneology, Climatology and Physical medicine (BCPM). Of the 24 facilities targeted by the survey, 21 responded (88%). Currently, the training curriculum for Onsen-Ryoho-Specialists consists of 8 units on diseases and 8 units on therapy methods. As shown in Figs. 1 and 2, it is difficult for a single facility on effectively cover all of these units. The most pressing need is to establish and implement a standardized curriculum across all facilities. Until now, each related academic society has selected training facilities based on its own criteria. Moving forwards, the review/accreditation body of the Japanese Medical Specialist Broad will make site visits to establish and review Onsen-Ryoho-Specialist training facilities. These efforts should lead to the development of fully qualified Onsen-Ryoho-Specialist training facilities.

We here report three cases of choroidal metastases with ocular pain and visual symptoms treated with palliative irradiation. Case 1: A 71-year-old woman was treated with chemotherapy for multiple metastases after surgery for right breast cancer. Sixteen years after surgery, a right choroidal metastasis with ocular pain and visual disturbance was detected. Palliative irradiation to this lesion achieved reduction in ocular pain and shrank the tumor. Case 2: A 54-year-old man presented with right ocular pain and abnormal vision and was diagnosed as having right lung cancer with multiple systemic metastases. Palliative irradiation to a right choroidal metastasis achieved reduction in ocular pain and shrank the tumor. Case 3: A 71-year-old woman developed left eye pain 17 months after surgery for lung cancer in the right upper lobe. She was diagnosed as having a left choroidal metastasis. After palliative irradiation, the tumor shrank and the left eye pain temporarily resolved. Palliative radiation therapy for choroidal metastasis with ocular pain and visual symptoms seems to be effective in improving symptoms.