Sleep disturbance is often observed among patients with diabetes and poor sleep is associated with higher HbA 1 c levels. Therefore, treatment of sleep disturbance is important. We experienced two cases in which sansoninto was useful in the treatment of insomnia with type 2 diabetes mellitus. A 58-year-old man had been treated with insulin for 10 years and a 79-yerar-old man had been treated oral hypoglycemic agents for 15 years. We administered sansoninto in each patient, after which sleep disturbance disappeared gradually. These results suggest that sansoninto is useful for sleep disturbance in patients with diabetes.

Finger dermatitis among perilla workers have been reported since 1970 in Japan. The agricultural chemicals used for perilla culture and the allergic effects of the perilla itself are discussed as for the causative factors of the dermatitis.
In this report, epidemiological survey and dermatological examination were carried out, with special concern for the prevalence of hazards of each fingers of the workers in relation to their work process, especially picking perilla leaves. Subjects were all of 152 workers who engaged in perilla culture in 2 area in Nankoku, Kochi Prefecture. And the skin patch testing for 32 workers (17 ones with dermatitis and 15 ones without dermatitis) and 20 controls was done using samples of the leaves cultivated without agricultural chemicals for more than 3 weeks and perilla oil extracted from them.
Results were as follows.
1. Skin hazards of the fingers, such as erosion, fissure, desquamation, thickening or bleeding were observed among about half of the workers.
2. The hazards were more frequently observed among the workers whose working hours for perilla culture and picking perilla leaves were longer.
3. The hazards were more frequently observed in the fingers touching the reverse sides of the leaves which had the secreting glands than in those touching the surface sides, on which might be contaminated by agricultural chemicals.
4. The perilla oil acted as the irritating substance for almost all of the examinee, and the skin patch testing demonstrated that both the perilla leaves and their oil caused allergic reactions to the workers with dermatitis.
5. It was considered that the perilla leaves and their oil had played an important role of a cause of the dermatitis among the perilla workers.

In this study, we examined changes in the amplitude of differential digital photoplethysmogram (ΔDPG) and the power spectral changes of EEG at rest during cold water immersion of the contralateral fingers (2°C), and after alcohol intake (0.3 g/kg) in 8 male subjects. This experiment showed that the ΔDPG amplitude decreased at rest and finger blood pressure was increased during the cold water stimulation, but there was no signifincant change in heart rate and EEG power spectrum. On chronological measurements for 30 minutes after alcohol intake, ΔDPG amplitude decreased slightly and finger blood pressure increased. Heart rate also tended to increase, and the alpha 1 power (8.0-9.8 Hz) on EEG gradually increased. The ODPG and finger blood pressure responses to cold water stimulation every 10 minutes was decreased after alcohol intake, whereas heart rate was not affected. However, a decrease in the alphal power after stimulation was revealed. From these results, it may be concluded that during 5-10 s of cold water stimulation, increased skin sympathetic nerve activity was one of the factors that raises blood pressure.

No abstract available.
Asian Continental Ancestry Group* ; Curriculum* ; Humans ; Schools, Medical*

Resistance exercise in the elderly and patients with a cardiovascular disorder has been thought to have a high cardiovascular risk, because it has the tendency to cause an excessive rise in blood pressure and induce serious arrhythmia. But recently, resistance exercise has been introduced into physical therapy because the safety of such exercise has been confirmed in subjects without a cardiovascular disorder.
The purpose of this study was to investigate the safety of lower extremity resistance exercise in middle-aged or elderly subjects with hypertension and receiving medical treatment (n=24), and those without hypertension (n=40), by measuring cardiovascular response during resistance exercise of different loads (40% and 60% 1 RM), and usefulness of respiratory guidance during such exercise.
As a result, there was no difference in diastolic blood pressure between those with and without hypertension ; but systolic blood pressure and rate pressure product both at rest and during exercise were significantly greater in patients with hypertension. However, neither group showed symptoms of angina, ischemic signs in ECG, or serious arrhythmia ; and there was no difference in the frequency of excessive rise in blood pressure between the groups (2 subjects with hypertension and 1 subject without hypertension) . Blood pressure during exercise was significantly lowered by respiratory guidance.
These results show that it is important to measure blood pressure during exercise before resistance exercise training regardless of the presence of hypertension, although an excessive rise in blood pressure occurred in only a few subjects. Furthermore, it is important to exhale slowly and not hold one's breath during exercise.

Objective: To clarify how and when Japanese family physicians assess families in their daily practice.Methods: Participants were Japanese family physicians with over one year of experience of full-time work in their clinics, and who were able to join the focus group discussions (FGD) and member checking. The study employed a qualitative research design with semi-structured FGD. Two analysts examined video recordings of the FGD, and the results were verified through member checking and the checking by external members.Results: Physicians assessed families naturally while examining patients for common cold, during vaccination, and during registration in the Japanese care insurance system.Additionally, the physicians assessed the families when they observed or suspected something strange regarding the patient and/or the family.Families were assessed based on how they spent their time during special Japanese events that the family members attended together (e.g., Bon festival or Japanese style New Year holidays), the patient's illness behavior in non-reserved outpatient clinics, and their communication patterns. Furthermore, the family photograph technique for family therapy was also used for assessment.Conclusion: Participants utilized skills of family therapy such as communication patterns and family photographs. They also employed unique skills such as assessment of the families' sharing time during traditional events, assessment of the patient's illness behavior, and general assessments regarding the Japanese care insurance system.

Objective: To clarify the involvement of Japanese family physicians with patients and their families in their daily practice.Methods: Participants were Japanese family physicians with over one year of experience of full-time work in their clinics, and who were able to join the focus group discussions (FGD) and member checks. The study employed a qualitative research design with semi-structured FGD. Two analysts examined video recordings of the FGD, and the results were verified through member checks and external checks.Results: Eight physicians participated at first, but five of them dropped out because of job commitments or death. The involvement by Japanese family physicians consisted of three stages. The first stage was "the approach of repeated hypothesis testing and normalizing" as safety interventions. The second stage was "reevaluation of the family" utilizing family genograms, family conferences, and others. After exhausting all other efforts, they engaged in "accepting the one who comes to them" in collaboration with the patient and families. The outcomes included awareness of patients, their smiles due to feeling accepted, and their expressed emotions. They did not explicitly boast that they were able to engage with family members. In addition, they also needed case studies of instances of "failure." Conclusion: Japanese family physicians engaged in three-stage involvement with families.

BACKGROUND: Lymphaticovenous anastomosis is an important surgical treatment for lymphedema, with lymphaticovenous side-to-end anastomosis (LVSEA) and lymphaticovenous end-to-end anastomosis being the most frequently performed procedures. However, LVSEA can cause lymphatic flow obstruction because of regurgitation and tension in the anastomosis. In this study, we introduce a novel and simple procedure to overcome this problem. METHODS: Thirty-five female patients with lower extremity lymphedema who underwent lymphaticovenous anastomosis at our hospital were included in this study. Eighty-five LVSEA procedures were performed, of which 12 resulted in insufficient venous blood flow. For these 12 anastomoses, the proximal lymphatic vessel underwent clipping after the anastomotic procedure and the venous inflow was monitored. Subsequently, the proximal ligation after side-to-end anastomosis recovery (PLASTER) technique, which involves ligating the proximal side of the lymphatic vessel, was applied. A postoperative evaluation was performed using indocyanine green 6 months after surgery. RESULTS: Despite the clipping procedure, three of the 12 anastomoses still showed poor venous inflow. Therefore, it was not possible to apply the PLASTER technique in those cases. Among the nine remaining anastomoses in which the PLASTER technique was applied, three (33%) were patent. CONCLUSIONS: Our findings show that achieving patent anastomosis is challenging when postoperative venous inflow is poor. We achieved good results by performing proximal ligation after LVSEA. Thus, the PLASTER technique is a particularly useful recovery technique when LVSEA does not result in good run-off.
Edema ; Female ; Humans ; Indocyanine Green ; Ligation ; Lower Extremity ; Lymphatic Diseases ; Lymphatic Vessels ; Lymphedema ; Microsurgery