Sokeikakketsuto was administered to 33 patients with recurrent cramps of the calf appearing once a week or more and persisting for 2 weeks or more. Treatment response was evaluated 1 month after the start of drug therapy. Patients whose cramps disappeared immediately after starting were regarded as showing a complete response, those with disappearance after 1 month as showing a partial response, those with a reduction to <50% after 1 month as showing a slight response, and those in whom 50% or more of cramps persisted after 1 month as showing no response. A complete response was achieved in 12 patients, a partial response in 11, a slight response in 9, and no response in 1. In 23 (69.6%) of the 33 patients, cramps disappeared within 1 month after the start of drug therapy. In 32 (96.9%), there was a reduction to <50%. In 29 (87.8%) of the 33 patients, cramps disappeared within 3 months, suggesting the efficacy of this drug. Two-package administration in the evening/at bedtime was more effective than 1-package administration for controlling cramps of the calf at night until early in the morning. The intensive pre-attack administration of 2 packages before sleep was the most effective. Sokeikakketsuto may be useful for treating recurrent cramps of the calf.

Objective: To assess the characteristics and influencing factors of sleep during a prehospitalization period in liver cancer survivors with frequent recurrences. Methods: A sleep pattern and mental health were analyzed in 12 patients who had recurrences of hepatocellular carcinoma during a pre-hospitalization period. Subjective sleep quality was assessed by PSQI-J, and objective sleep quality was measured with a actigraphic method. Results: The mean age of the subjects was 74.1 years and the mean number of recurrence episodes was 3.7. The mean PSQI total score was 6.7. The subjective assessment showed that 50% of the patients had a poor sleep pattern, required more time to fall asleep, had a shorter duration of sleep, and had poor sleep quality. The objective assessment showed that 50% of the patients slept for less than 360 minutes and that the patients did not have disturbance of sleep induction with a sleep latency of 3 to 29 minutes. The mean time of awakening episodes was 3.3. The hypnotic agent, severe fatigue, and poor mental health were identified as factors of the poor sleep pattern, as assessed by the subjective measures, and the hypnotic agent shortened and influenced the time spent awake after falling asleep. The subjective evaluation of sleep demonstrated inconsistency with the objective evaluation of sleep. Namely the patients with poor sleep pattern had higher sleep efficiency and significant short awakening times. Conclusion: The sleep pattern in liver cancer survivors was influenced by the hypnotic agent, mental health, and fatigue.

We have determined the plasma 8-hydroxy-deoxyguanosine (8-OHdG) levels during endurance exercise. Eight untrained male subjects completed a 10-km run. Plasma 8-OHdG, total coenzyme Q10 (CoQ10), ubiquinol, and thiobarbituric acid (TBA) concentrations were measured after exercise. Plasma 8-OHdG concentrations significantly decreased immediately after (0.21±0.13 ng/ml, p<0.01) and 1 hr after (0.23±0.09 ng/ml, p<0.05) the run compared to the resting values (0.36±0.09 ng/ml). Both plasma CoQ10 and ubiquinol concentrations significantly increased (p<0.05) immediately after the run compared to the resting values. On the other hand, plasma TBA concentrations did not change significantly at any point after the run. These results suggest that, during and after submaximal endurance exercise in this study, an augmented antioxidant defence system such as CoQ10 might thus play a role in the decrease of 8-OHdG in the plasma, and that exercise might stimulate the repair of oxidative damage to DNA.

Objective: Several drugs can cause analytical interference in clinical laboratory tests.  To prevent errors in clinical judgment as a result of false data, we investigated the information available on the interference of ethical drugs in these tests.
Methods: We examined the information available by collecting and evaluating information in package insert leaflets, collecting and evaluating clinical data on three drugs (bucillamin, captopril, and epalrestat) which affect clinical laboratory test results, and conducting a questionnaire survey of healthcare workers.
Results: From the information available on package inserts, 227 drugs were identified as having the potential to interfere with the chemical reactions used in clinical laboratory tests.  However, the insert information is not sufficient for use in clinical settings because the frequency rate and causative factors of interference are not stated clearly.  The clinical survey results reveal that 40% of patients taking bucillamine and 20% of patients taking epalrestat tested false-positive for urinary ketones.  According to the questionnaire results, medical technologists were more interested than pharmacists and physicians in how drugs affect clinical laboratory tests.
Conclusion: The information currently available on the interference of drugs in clinical laboratory tests is problematical, and it is therefore necessary to collect more clinical data for the proper interpretation and evaluation of abnormal laboratory values.

PURPOSE: The pathological mechanism of lumbar spinal stenosis is reduced blood flow in nerve roots and degeneration of nerve roots. Exercise and prostaglandin E1 is used for patients with peripheral arterial disease to increase capillary flow around the main artery and improve symptoms; however, the ankle-brachial index (ABI), an estimation of blood flow in the main artery in the leg, does not change after treatment. Lumbar spinal nerve roots contain somatosensory, somatomotor, and unmyelinated autonomic nerves. Improved blood flow by medication with prostaglandin E1 and decompression surgery in these spinal nerve roots may improve the function of nerve fibers innervating muscle, capillary, and main vessels in the lower leg, resulting in an increased ABI. The purpose of the study was to examine whether these treatments can improve ABI. MATERIALS AND METHODS: One hundred and seven patients who received conservative treatment such as exercise and medication (n=56) or surgical treatment (n=51) were included. Low back pain and leg pain scores, walking distance, and ABI were measured before treatment and after 3 months of conservative treatment alone or surgical treatment followed by conservative treatment. RESULTS: Low back pain, leg pain, and walking distance significantly improved after both treatments (p<0.05). ABI significantly increased in each group (p<0.05). CONCLUSION: This is the first investigation of changes in ABI after treatment in patients with lumbar spinal stenosis. Improvement of the spinal nerve roots by medication and decompression surgery may improve the supply of blood flow to the lower leg in patients with lumbar spinal stenosis.
Adult ; Aged ; Aged, 80 and over ; Alprostadil/therapeutic use ; *Ankle Brachial Index ; Decompression, Surgical/methods ; Female ; Humans ; Low Back Pain/drug therapy/physiopathology/surgery/*therapy ; Lumbar Vertebrae/physiopathology/*surgery ; Male ; Middle Aged ; Pain/surgery ; Spinal Nerve Roots/physiopathology ; Spinal Stenosis/physiopathology/*surgery/*therapy ; Treatment Outcome

PURPOSE: To examine the effects of conservative and surgical treatments for nocturnal leg cramps in patients with lumbar spinal stenosis (LSS). Nocturnal leg cramps is frequently observed in patients with peripheral neuropathy. However, there have been few reports on the relationship between nocturnal leg cramps and LSS, and it remains unknown whether conservative or surgical intervention has an impact on leg cramps in patients with LSS. MATERIALS AND METHODS: The subjects were 130 LSS patients with low back and leg pain. Conservative treatment such as exercise, medication, and epidural block was used in 66 patients and surgical treatment such as decompression or decompression and fusion was performed in 64 patients. Pain scores and frequency of nocturnal leg cramps were evaluated based on self-reported questionnaires completed before and 3 months after treatment. RESULTS: The severity of low back and leg pain was higher and the incidence of nocturnal leg cramps was significantly higher before treatment in the surgically treated group compared with the conservatively treated group. Pain scores improved in both groups after the intervention. The incidence of nocturnal leg cramps was significantly improved by surgical treatment (p=0.027), but not by conservative treatment (p=0.122). CONCLUSION: The findings of this prospective study indicate that the prevalence of nocturnal leg cramps is associated with LSS and severity of symptoms. Pain symptoms were improved by conservative or surgical treatment, but only surgery improved nocturnal leg cramps in patients with LSS. Thus, these results indicate that the prevalence of nocturnal leg cramps is associated with spinal nerve compression by LSS.
Adult ; Aged ; Aged, 80 and over ; Decompression, Surgical ; Female ; Humans ; Leg/*pathology ; Low Back Pain/epidemiology/etiology ; Male ; Middle Aged ; Pain/*epidemiology/*etiology ; Prospective Studies ; Questionnaires ; Spinal Stenosis/*complications/*physiopathology/surgery

Introduction: Due to the advancement of the home-based healthcare, increasing the number of professionals who are able to administer homebased treatments, such as endotracheal suctioning, is an urgent issue.Methods: By measuring the ocular movement of nurses, nursing students and previous researches, an endotracheal suctioning ontology was visualized. It included a multiplex task structure, recognition, and judgment, as well as identifying procedures used during endotracheal suctioning that could contribute to a discussion on educational feasibility.Results: From the hierarchical structure of the constructed endotracheal suctioning ontology, not only the procedural knowledge but also knowledge about medical devices, knowing what options exist when endotracheal suctioning is ineffective, and a wide range of other expertise is needed to perform endotracheal suctioning safely.Discussion: An endotracheal suctioning ontology was created from the ocular movement of nurses. Ontologies are a potential tool for defining minimum requirements and the scope of ability that must be evaluated before clinical practicum.