In kampo medicine, an illness is considered to affect the entire body, even if the symptoms appear only in the abdomen. Abdominal palpation is considered an important diagnostic physical examination in kampo medicine. Because learning the kampo style of abdominal palpation is difficult, we attempted to simplify the process by developing typical models of 6 important kampo abdominal diagnoses (shinka-hiko, kyokyo-kuman, fukuchokukin-renkyu, shofuku-fujin, shofuku-koman, and shinkabu-shinsuion).1) When we discussed abdominal palpation in lectures on kampo medicine for clinicians we also assessed the opinions and impressions of participants about the abdominal palpation simulators. 2) We administered an anonymous questionnaire survey about interest in kampo medicine, the understanding of abdominal palpation in the kampo style, and an evaluation of the abdominal palpation simulators. We obtained 149 replies from participants of the 11 lectures. 3) Of the participating physicians, 85.2% were interested in kampo medicine. However, 23.5% of physicians were not familiar with abdominal palpation in the kampo style. 4) Furthermore, 58.4% of physicians thought that kampo-style abdominal palpation was explained well or very well in the lecture with the abdominal palpation simulators. The abdominal palpation simulators were judged to be useful or very useful by 72.2% of the physicians. 5) In conclusion, the abdominal palpation simulators were considered to be useful for learning abdominal palpation in the kampo style, even though these simulators have some shortcomings. These models may be useful for simplifying the learning of abdominal palpation by students of kampo medicine.

In Kampo medicine, sickness is regarded as affecting the whole body even though the symptoms may appear obvious only in the abdomen. This makes abdominal palpation an important means of physical examination, and diagnosis. Because learning abdominal palpation in the Kampo style is very difficult, we attempted to simplify learning by building typical anatomical abdomen models for training. To create six abdominal models : Shinka-hiko, Kyokyo-kuman, Fukuchokukin-renkyu, Shofuku-fujin, Shofuku-koman, and Shinkabu-sinsuion, we employed several materials, including artificial leather for epidermal tissue, pile fabric for subcutaneous tissue, cotton cloth or jersey cloth for membrane tissue, polyurethane or natural rubber for muscle tissue, specialized polyester resin for costae, and cotton for internal organs. We employed a harder polyurethane, for example, in Shinka-hiko to simulate resistance in the region beneath the heart, in Kyokyo-kuman to simulate resistance in the subcostal region, and in Shofuku-koman to simulate horseshoe-shaped resistance in the lower abdominal region. Otherwise, in Shofuku-fujin, a lack of resistance was simulated by a defect in the polyurethane at the center of the lower abdominal region. Shinkabu-sinsuion was modeled using a water dabbling sound via a water-filled balloon that could be gently shaken with the fist in the region above the navel. Fukuchokukin-renkyu was modeled as excessive strain of the rectus abdominis muscles via the use of natural rubber. We tried to represent the tenderness on pressure at the para-umbilical region, cecal region, and sigmoid region in the Shofuku-koman model by making a specialized switch with conducting rubber, and using electric device and battery. We believe these models are useful teaching devices, in that they simplify Kampo abdominal palpitation training.
Medicine, Kampo ; Cancer resistance to treatment ; Training ; Tissues ; Palpation

Two hemodialysis patients underwent coronary artery bypass grafting. Emergency coronary artery bypass grafting was performed in one patient with unstable angina and acute left ventricular failure. The other patient underwent a combined operation of coronary artery bypass grafting and replacement of abdominal aortic aneurysm. In both patients, hemofiltration was used during cardiopulmonary bypass. In the early postoperative periods, peritoneal dialysis and extracorporeal ultrafiltration method (ECUM) were used in Case 1, while Case 2 was treated by hemofiltration and ECUM. Postoperative coronary angiography showed that all grafts of both patients were patent, and both patients weve discharged from hospital without angina.

A 46-year-old man who developed fever and general fatigue was referred to our hospital with suspicion of infective endocarditis. A ventricular septal defect had been previously diagnosed. Transthoracic echocardiography revealed vegetation on the aortic, mitral, and pulmonary valves, and each valve had significant regurgitation. An emergency operation was performed because of congestive heart failure. The aortic and mitral valves were replaced with mechanical valves. The pulmonary valve was repaired ; the anterior leaflet was resected and replaced by glutaraldehyde-treated autologous pericardium. The patient's postoperative course was uneventful. Recurrence of infection was not observed for 3 years after the operation. Triple-valve endocarditis, especially that involving a combination of the aortic, mitral, and pulmonary valves, is rare. Involvement of multiple valves on both sides of the heart may be attributed to a congenital intracardiac shunt. Early surgical intervention may be useful to control infection and heart failure, as in the present case.

OBJECTIVE: Autistic spectrum traits are postulated to lie on a continuum that extends between individuals with autism and individuals with typical development. The present study was carried out to investigate functional and network abnormalities associated with autistic spectrum trait in healthy male subjects. METHODS: Subjects were 41 healthy male subjects who underwent the social responsiveness scale-adult (SRS-A) and magnetic resonance imaging. RESULTS: There was significant positive correlation between the total score of SRS-A and the regional cerebral blood flow (CBF) in posterior cingulate cortex (PCC). Also, there were changes in functional network such as in cingulate corti, insula and fusiform cortex. Further, we also found the significant difference of functional networks between the healthy male subjects with high or low autistic spectrum trait, and these points were congruent with the previous perceptions derived from autistic-spectrum disorders. CONCLUSION: These findings suggest a biological basis for the autistic spectrum trait and may be useful for the imaging marker of autism symptomatology.
Autism Spectrum Disorder ; Autistic Disorder ; Cerebrovascular Circulation* ; Gyrus Cinguli ; Humans ; Magnetic Resonance Imaging ; Male* ; SRS-A

PURPOSE: Intracranial administration of lipopolysaccharide (LPS) is known to elicit a rapid innate immune response, activate glial cells in the brain, and induce depression-like behavior. However, no study has focused on the changes in glial cells induced by intraperitoneal injection of LPS in vivo.METHODS: Ten adult male Fischer F344 rats underwent [¹¹C]PK11195 PET before and 2 days after intraperitoneal injection of LPS to evaluate the changes in glial cells. The difference in standardized uptake values (SUV) of [¹¹C]PK11195 between before and after injection was determined.RESULTS: There was a cluster of brain regions that showed significant reductions in SUV. This cluster included the bilateral striata and bilateral frontal regions, especially the somatosensory areas.CONCLUSIONS: Changes in activity of glial cells induced by the intraperitoneal injection of LPS were detected in vivo by [¹¹C]PK11195 PET. Intraperitoneal injection of LPS is known to induce depression, and further studies with [¹¹C]PK11195 PET would clarify the relationships between neuroinflammation and depression.
Adult ; Animals ; Brain ; Depression ; Electrons ; Humans ; Immunity, Innate ; Injections, Intraperitoneal ; Lipopolysaccharides ; Male ; Neuroglia ; Positron-Emission Tomography ; Rats ; Rats, Inbred F344

PURPOSE: Intracranial administration of lipopolysaccharide (LPS) is known to elicit a rapid innate immune response, activate glial cells in the brain, and induce depression-like behavior. However, no study has focused on the changes in glial cells induced by intraperitoneal injection of LPS in vivo. METHODS: Ten adult male Fischer F344 rats underwent [¹¹C]PK11195 PET before and 2 days after intraperitoneal injection of LPS to evaluate the changes in glial cells. The difference in standardized uptake values (SUV) of [¹¹C]PK11195 between before and after injection was determined. RESULTS: There was a cluster of brain regions that showed significant reductions in SUV. This cluster included the bilateral striata and bilateral frontal regions, especially the somatosensory areas. CONCLUSIONS Changes in activity of glial cells induced by the intraperitoneal injection of LPS were detected in vivo by [¹¹C]PK11195 PET. Intraperitoneal injection of LPS is known to induce depression, and further studies with [¹¹C]PK11195 PET would clarify the relationships between neuroinflammation and depression.

Direct observation of the intravascular atherosclerotic change provides many diagnostic information and supports successful vascular surgery. Angioscopic inspections were performed in the 23 patients who underwent laser angioplasty for the peripheral arteries and 7 patients with aorto-coronary bypass surgery in this study. Useful images could be obtained in 19 (83%) of 23 observations in the peripheral arteries, and the successful rates of angioscopic observation were influenced by the diameter and the degree of kinking of each vessel. On the other hand, intraoperative observation of coronary artery with angioscope could be performed easily in all cases. From these findings, intraoperative application of angioscopy was considered to be useful procedure for the cardiovascular surgery.

BACKGROUNDStudies showed that propentofylline enhances the action of adenosine and protects hippocampal neuronal damage against transient global cerebral ischaemia. Our study was to investigate the effect of propentofylline on hypoxic-ischaemic brain damage in neonatal rat.

METHODSSeven-day-old Wistar rats were subjected to unilateral common carotid artery ligation and hypoxia in oxygen 8 kPa for two hours at 37 degrees C. Propentofylline (10 mg/kg) was administered intraperitoneally one hour after hypoxia-ischaemia (treated group). Control group rats were received an equivalent volume of saline. The effects of propentofylline were assessed by observing the body mass gain, behavioural alteration and neurohistological changes. The rats were sacrificed at 72 hours after hypoxia-ischaemia, and the brain sections were examined after haematoxylin and eosin staining.

RESULTSThe propentofylline-treated rats had better body mass gain and better behavioural response than the paired saline-controls did. In the control group, the rats either lost body mass or had little mass gain after the insult, their average body mass gain was 97.3% at 24 h, 100.3% at 48 h, and 114.1% at 72 h of recovery. In propentofylline-treated group, there was a significant improvement of body mass gain at 24 h (100.2%, P < 0.05) and 48 h (110.3%, P < 0.01) of recovery; the percentage of rats that performed well on behavioural test was significantly higher from 48 h to 72 h of recovery (P < 0.05); the incidence of severe brain damage to the cerebral cortex and dentate gyrus was significantly reduced in propentofylline-treated rats (cortex, 93% - 70.8%, P < 0.01; dentate gyrus 95% - 66.7%, P < 0.01) as compared with control rats.

CONCLUSIONSAdministration of propentofylline 1 hour after hypoxia-ischaemia significantly attenuates brain damage in both the cerebral cortex and dentate gyrus, and also improves the body mass gain as well as behavioural disturbance in 7-day-old rats.

Animals ; Animals, Newborn ; Brain ; pathology ; Female ; Hypoxia-Ischemia, Brain ; drug therapy ; pathology ; Male ; Neuroprotective Agents ; therapeutic use ; Rats ; Rats, Wistar ; Weight Gain ; drug effects ; Xanthines ; therapeutic use

Surrogate decision-making support in the critical care field is a highly challenging form of support owing to its urgency and the fact that families are in crisis situations. Given this context, the diversification of families as a feature of modern society is thought to bring further difficulties to nurses who are involved in surrogate decision-making support. Therefore, this study sought to clarify the content of such support for diverse families that skilled nurses provided in the critical care field. We conducted semi-structured interviews with nine skilled nurses and a qualitative and inductive analysis of the obtained data. We extracted the following five categories of surrogate decision-making support. Even when there was no spare time in the critical care field, skilled nurses operated on the premise that family relationships and values are diverse while (1) “creating a foundation for surrogate decision-making that satisfied families” and (2) “making decisions based on a broad view of family relationships without being bound by preconceptions”, and they realized individualized support by (3) “adjusting the role of surrogate decision-makers based on family characteristics”. In cases where responses were difficult, it became clear that support was provided while (4) “responding to families in accordance with social norms” and demonstrating the ability to (5) “involve medical teams and finds solutions in difficult cases”.[[Please check that this conveys your intended meaning]]