The most common mandibular fractures involve the condyloid process. It is necessary to diagnose and treat the cases of mandibular condylar fracture carefully, because the temporomandibular joint is complicated anatomically and functionally.
A clinical study was made in 72 patients with mandibular condylar fracture referred to the Department of Oral and Maxillofacial Surgery, Gunma University Hospital from April 1991 to March 1995.
The results were as follows:
1. Mandibular condylar fracture occurred in 42.6% of the mandibular fractures. The male-to-female ratio was 2 to 1. The largest age group of patients was from 10 to 19 years (31.9%).
2. The most frequent cause of the injury was falls (50.0%). Of all the patients 84.7% visited our department within 2 weeks after injury.
3. Fifty-nine cases (81.9%) were unilateral fractures and 13 (18.1%) were bilateral. Of the total, thirty-six cases (50.0%) were combined with other fractures of the mandible and/or maxillofacial fractures.
4. As for the fracture level and position of fragment, fractures with deviation were most frequently observed in the subcondylar region (20.5%).
5. Of the 67 cases treated at our department, 62 (92.5%) were treated with a conservative therapy for mandibular condylar fracture, primarily by maxillomandibular fixation followed by functional rehabilitation. The remaining 5 (7.5%) cases were treated surgically.
6. Fifty-nine patients were recalled after more than 6 months. As for the treatment outcome in 54 nonsurgical cases, 46 cases (85.2%) showed excellent prognosis, 6 (11.1%) had disorder I and 2 (3.7%) had disorder II. In 5 surgical cases, 3 cases showed excellent prognosis and 2 had disorder II. Most of the patients treated nonsurgically had relatively good results.

Chronic obstructive pulmonary disease (COPD) causes severe respiratory dysfunction and severely limits patients' daily activities. We report a case of the patient with COPD whose respiratory symptoms were successfully improved by acupuncture. A 70-year-old man visited Meiji University of Oriental Medicine Hospital complaining of dyspnea during exercise on _??_. Despite strictly controlled medication and a regimen of home oxygen therapy (HOT), his general condition continued to worsen. Then a series of acupuncture treatment was started on _??_. The severity of dyspnea of the patient before acupuncture treatment was determined as level V according to Hugh-Jones classification, and spirometry showed severely disturbed respiratory functions (%VC: 63.5%, FEV₁%: 29.4%, PEFR: 84.8 1/min in the morning and 93.5 1/min at night). The basic combination of meridian points for the treatment of the case was LU1 (Zhongfu), CV12 (Zhongwan), CV4 (Guanyuan), LU5 (Chize), and BL13 (Feishu). The acupuncture needles were retained for ten minutes in each session. The single-subject research design (A-B-A method) was applied to detect the specific effect of the acupuncture treatment on the respiratory functions or the symptoms of the subject. “A” and “B” mean “treatment period” and “no treatment period” respectively. After 60 acupuncture treatments during a 14-month period, both the respiratory symptoms and the VAS for dyspnea showed improvement, which were specifically observed during the intervention period. Improvement was also reflected in the level of the Hugh-Jones classification and respiratory function test. It was suggested that acupuncture treatment might be effective for advanced cases of COPD.

We report a rare case of a giant celiac aneurysm complicated with nosocomial acute aortic dissection and idiopathic thrombocytonenic purpura (ITP). A 75-year-old man with ITP complained of abdominal swelling. Enhanced computed tomography (CT) showed a giant celiac aneurysm 72 mm in size. Surgery repair was scheduled and platelet count increased by intravenous administration of immunoglobulin. After admission, he complained of back pain. CT showed aortic dissection (DeBakey classification : IIIb) and a celiac aneurysm enlarged to 78 mm. He underwent surgical repair for a giant celiac aneurysm and splenectomy after management with medial therapy.

Introduction : We report the effect of adaptive servo ventilation (ASV) treatment on heart failure in a home care setting.
Methods : For eight home care patients aged ≥75 with heart failure, we diagnosed sleep-disordered breathing (SDB) by using a simplified monitor and implemented ASV treatment. We assessed its effect on heart failure by using NT-proBNP. We also assessed its effects on SDB by using apnea hypopnea index (AHI).
Results : Three patients dropped out because they felt fear of putting on the mask. Among the other five patients, we observed a significant decrease rate of NT-proBNP (mean : -0.43, 95% confidence interval (CI) : -0.64, -0.22) after the ASV treatment. With regard to AHI, we observed a decreasing tendency (mean : -20.4 /hour, 95% CI : -41.2/hour, 0.4/hour).
Conclusion : This study suggests that ASV treatment is effective for a treatment of heart failure in a home care setting.

[Aim] Acupuncture has traditionally been used in Japan in the treatment of bronchial asthma and is being increasingly applied. However, although there are many published studies on acupuncture and asthma, few meet the scientific criteria necessary to prove the effectiveness of acupuncture. Therefore, this study presents the clinical results of acupuncture treatment for adult bronchial asthma.
[Design] Single-subject research design (N-of-1 method).
[Setting] Department of Internal Medicine, Acupuncture and Moxibustion Center, Meiji University of Oriental Medicine, Japan.
[Participants] Six patients of both genders (mean age, 49.0 years old) with moderate-to-severe persistent bronchial asthma.
[Intervention] Six patients received 10 sessions of acupuncture treatment (once per week) for 10 weeks. The basic combination of meridian points for the treatment of the patients were LU 1 (Zhongfu), LU 5 (Chize), LU 9 (Taiyan), CV4 (Guanyuan), CV 12 (Zhongwan), BL 13 (Feishu), BL20 (Pishu) and BL23 (Shenshu).
[Measurements] Primary outcome was the symptom of asthma at the end of the 10 treatment sessions. Secondary outcomes were the Dyspnea Visual Analogue Scale (DVAS), respiratory function, Peak Expiratory Flow Rate (PEFR), blood, the use of asthma drugs. The effect of the intervention on eosinophils in blood was assessed.
[Main results] Late effects of asthma patients showed significantly better results compared with the base line on outcome measures after the 10 weeks. In this study, symptoms of asthma and dyspnea VAS in patients with asthma were significantly improved by acupuncture.
[Conclusion] This study indicated that acupuncture was effective in asthma symptoms and respiratory functions.

A 60-year-old male patient visited the Oriental Medicine Research Institute of the Kitasato on ***** because of abdominal discomfort. Hangeshashin-to was administered to him and the abdominal discomfort was relieved. He continued to take Hangeshashin-to from June to August 1997. He had chills, high fever, and fatigue from ********. He stopped Hangeshashin-to and took Shosaiko-to for five days because of liver dysfunction. He was admitted to our hospital on ********. Antibiotics and stronger neo-minophagen C were administered to him. A chest roentgenogram revealed a ground-glass shadow on the left upper lung, and Shosaiko-to was discontinued. The patient began to complain of dyspnea and had fine crackles on the chest. A chest roentgenogram and chest CT showed interstitial pneumonitis. Oral predonisolone therapy was started for hypoxemia and the patient improved. A drug lymphocytes stimulation test revealed that lymphocytes were stimulated by Shosaiko-to and its components, Saiko and Ogon. A chest roentgenogram just before ingesting Hangeshashin-to revealed the interstitial change of the lung. Taken all together, this patient suffered from druginduced hepatitis and pneumonitis as a result of ingesting Hangeshashin-to and Shosaiko-to.

Effects of environmental (cold) stress and aging on cells in monocyte/macrophage lineage were investigated. We demonstrated that immune suppressive states seen in acute cold-stressed mice (8-10 weeks of age) is attributable to FcγRIIbright suppressor macrophages. Serum corticosterone levels were markedly increased in acute cold-stressed mice. In addition, expression of glucocorticoids (GC) receptor mRNA was observed in FcγRIIbright cells from these mice. The increase of FcγRIIbright cells in peritoneal exudate cells caused by acute cold stress was inhibited by adrenalectomy or administration of a saturating amount of the GC antagonist RU 38486 (mifepristone). On the contrary, administration of the GC agonist, dexamethasone, markedly increased the proportion of FcγRIIbright cells in peritoneal exudate cells of control mice. These results suggest that the generation of FcγRIIbright suppressor cells of monocyte/macrophage lineage by acute cold stress was mediated by action of GC through the GC receptor. We likewise found that the proportion of FcγRIIbright suppressor macrophages is increased in aged mice (22-24 months of age). Meanwhile, activated macrophages which function as antigen presenting cells were decreased in aged rats. Both the basal corticosterone concentrations in serum and the expression of mRNA for GC receptor in peritoneal macrophages increased significantly in aged animals, suggesting that these populational and functional changes of macrophages in aged animals were mediated, in part, by the increased basal levels of GC. This is probably being responsible for immunosenescence.
Neisseria gonorrhoeae ; Laboratory mice ; Acute ; Macrophages ; receptor

Cardiac angiosarcoma is a rare disease which occurs most often in young males and has a remarkably unfavorable prognosis. We experienced one male case aged 46 who had an initial symptom of cardiac tamponade due to rupture of the right ventricle. Hemostasis was made under extracorporeal circulation, and the patient was discharged temporarily. However, a large volume of hemoptysis occurred from right B₆ about 1 month after discharge, because of which resection of the right lower lobe was performed. Tumorous cells identical to those in the perforated cardiac region were detected in the resected tissue, and it was diagnosed histopathologically that the cardiac rupture was caused by angiosarcoma, resulting in pulmonary metastasis. Multiple pulmonary metastases were observed in bilateral lung following fields by CT, but administration of CDDP in iv×2 and in 150mg/day cyclophosphamide, the pulmonary metastases disappeared completely on CT on the 45th day. However, the metastases recurred soon thereafter without responding to chemotherapy, and the patient died 5 months after diagnosis of this disease because of exacerbated dyspnea.

[Aim] Diffuse pan-bronchiolitis (DPB) causes severe respiratory dysfunction and severely limits a patient's daily activities. Case: This paper reports a case of a DPB patient whose respiratory symptoms were successfully improved by acupuncture. In a case report in January 2002, a 62-year-old male visited the Department of Respiratory Internal Medicine at Gifu University Hospital, complaining of cough, pumlent sputum and dyspnea on exercise. His general condition had worsened despite ordinary medical treatment. Thus acupuncture was added to the treatment in August, 2001. Intervention: The patient received acupuncture treatments once a week for 50 weeks. The acupuncture treatment was based on the Chinese medicine theory. Measurements: Outcome measures were respiratory symptoms using the Fletcher-Hugh-Jones (F-H-J) classification, 6-minute walking distance (6 MWD), blood test, arterial blood gas and pulmonary function tests. Computed tomography (CT) was assessed. Each evaluation was done after 15 weeks and 50 weeks later.
[Results] After 15 weeks of acupuncture treatment, cough, pumlent sputum, walking distance, the Borg scale and respiratory function were significantly improved compared with the baseline. Moreover, the effect of the acupuncture treatment continued for 50 weeks.
[Conclusion] This suggests that acupuncture treatment was effective in treating the advanced case of DPB.

[Introduction]Insomnia and anxiety are major symptoms of depression and severely limit the daily activities of depressed patients. We report the case of a depressed patient who had developed liver dysfunction caused by medication and whose depression was successfully managed by acupuncture after discontinuation of antidepressants.
[Case]A 37 years-old male had been taking noradrenergic and specific serotonergic antidepressant (NaSSA) and Chai Fu Jia Long Gu Mu Li Tang Jia Wei Gui pi Tang for insomnia and anxiety due to depression. Although his symptoms had improved by the medication, abnormalities in his liver functions were found after 3months of medication. After he was diagnosed as having drug-induced liver damage, he was admitted to Meiji University's Integrative Medicine Hospital and all medication was replaced by Glycyrrhizin and Glutathione. Consequently his depression and symptoms returned. We then tried to relieve his symptoms by applying acupuncture, which was prescribed according to traditional Chinese medical diagnosis (TCM diagnosis, Heart Yin Deficiency , Liver Qi Stagnation , and Kidney Yin Deficiency ).
[Results]After 4 acupuncture treatments, the patient's duration and depth of sleep considerably improved compared with that before the acupuncture sessions, and comparable results were maintained until discharge. Beck Depression Inventory (BDI) scores were also markedly improved from 'moderate depression'(24 points) at the beginning of treatment to 'minimal depression'(8 points) at the end (9th treatment, 16 days from the first session).
[Conclusion]The results of this case suggest that acupuncture treatment may be an effective alternative for anti-depressants when there is a limitation to administer those drugs.