It has been reported that diabetes mellitus is a significant risk factor for adverse outcomes after conventional CABG using cardiopulmonary bypass. However, the effects of diabetes on postoperative outcomes after off-pump coronary artery bypass grafting (OPCAB) are unclear. The effects of diabetes on early and mid-term results were studied by comparing the outcomes between 82 patients (65±5 years) with diabetes and 112 patients (68±11 years) without diabetes. The diabetic group included a greater preoperative presence of renal insufficiency (22.0% vs 8.9%, p=0.011) and history of cerebral vascular accident (25.6% vs 11.6%, p=0.012). Strategies, including graft choice, were not changed by presence of diabetes. The use of bilateral internal thoracic arteries (70.7% diabetes vs 67.0% nondiabetes), and frequency of total arterial bypass were similar in the 2 groups. The number of distal anastomoses was higher in the diabetic group (3.0±0.9 vs 2.7±0.9, p=0.042). The operation time and frequency of blood transfusion were similar in both groups. There was no hospital death in either group. Although mechanical ventilation time and postoperative ICU stay did not differ, hospital stay was significantly longer in the diabetic group (16.2 vs 13.3 days, p=0.0085). Postoperative major complications including atrial fibrillation were not significantly different between the 2 groups. Minor wound infection occurred in 2 patients, 1 in each group. There was no mediastinitis in either group. During the mean follow-up period of 20.8 months (1-39), there were two sudden deaths in the diabetic group, but no other cardiac death in either group. Cardiac event-free rate did not differ between the 2 groups. Although hospital stay in diabetic patients was longer than that in nondiabetic patients, early and mid-term results of OPCAB were not significantly affected by diabetes mellitus.

[Objective]To evaluate the effects of acupuncture treatment for refractory urinary urgency and incontinence after radical prostatectomy.
[Methods]Three patients who had urinary urgency and/or urinary incontinence four months after radical prostatectomy received acupuncture at the BL33(Zhongliao) point. Acupuncture was performed once per week for four weeks. Symptoms were assessed by the International Prostate Symptom Score, IPSS QOL index for subjective evaluation and Frequency-Volume chart for objective evaluation.
[Results]After acupuncture treatment, urinary urgency and urge incontinence were improved, however stress urinary incontinence persisted. The scores for IPSS and IPSS QOL index were improved. Frequency-Volume charts showed that voided volume was increased and frequency of urination decreased after acupuncture treatment.
[Conclusions]Acupuncture at the BL33point might be a useful treatment option for urinary urgency and urge incontinence after radical prostatectomy.

We investigated the history and indications of Toenho, Kinseiho, and Cho-Sanshaku-Shinteiho, which are different formulae with the same name of seishoekkito. According to the description in “Futsugoyakushitsuhokankuketsu” written by Sohaku Asada, Kinseiho exhibits an immediate effect, while Toenho has preventive effects. However, according to the original text, Kinseiho was formulated such that it could be administered regularly in the summer for prophylaxis. Furthermore, Kinseiho is regarded as a simplified formula with the central structure of Toenho. This implies that Kinseiho is composed of selected crude drugs used in Toenho that are responsible for the main effects of Toenho, such as invigorating spleen energy, clearing fever and generating body fluids. Moreover, there is an instruction to arrange Kinseiho to fit each patient’s condition. In this study, it was found that Cho-Sanshaku-Shinteiho described in “Futsugoyakushitsuhokankuketsu” is a modification of Kinseiho prescribed by Katsuki Gyuzan for patients with fever, consistent with the concept of personalized medicine. The medical extract preparation seishoekkito, which is currently widely used, is Kinseiho. We may use it with heat-clearing formula, fluid-regulating formula or some modifications to make the appropriate formulation based on the patient's symptoms.

BACKGROUND: Preventing the need for long-term care (LTC) by identifying physical function risk factors are important to decrease the LTC burden. The objective of this study was to investigate whether grip strength and/or walking speed, which are components of the frailty definition, are associated with LTC in community-dwelling older and oldest people. METHODS: The participants were 1098 community-dwelling older and oldest people who had not received LTC at the baseline. The endpoint was receiving LTC after the baseline survey. The independent variables were grip strength and walking speed, and participants were divided into two groups based on these variables. The confounding factors were age, sex, the Japanese version of the Montreal Cognitive Assessment (MoCA-J), hypertension, diabetes mellitus, stroke, joint diseases, living alone, body mass index, and serum albumin. We calculated the hazard ratio of receiving LTC using the Cox proportional hazard model. RESULTS: Among the 1098 participants, 107 (9.7%) newly received LTC during the follow-up. Regarding the physical function, only slow walking speed was significantly correlated with LTC after adjusting for all confounding factors except the MoCA-J score (HR = 1.74, 95% CI = 1.10-2.75, P = .018). However, slow walking speed was still a risk factor for LTC after adjusting for the MoCA-J score and other confounding factors (HR = 1.64, 95% CI = 1.03-2.60, P = .037). CONCLUSIONS The findings from this study may contribute to a better understanding of slow walking speed as a factor related to LTC, which might be a criterion for disability prevention and could serve as an outcome measure for physical function in older people.
Aged ; Aged, 80 and over ; Exercise ; Female ; Humans ; Independent Living ; statistics & numerical data ; Japan ; Long-Term Care ; statistics & numerical data ; Male ; Proportional Hazards Models