Effects of single moxibustion on platelet aggregation and ATP-release in mice have been studied. Male ddY mice (6 weeks old) were used as experimental animals. 15mg and 5mg of moxa were divided into 6 cones and mice were treated by each 3 cones at right and left LV-14. The electronic aggregometer was used for measuring platelet aggregation and ATP-release using whole blood. Platelet aggregation and ATP-release activities were determined by collagen (final concentration; 2μg/ml) and ADP (final concentration; 20μM) as inducers.
No significant changes on platelet and red blood cell numbers were found after the moxibustion with 15mg of moxa. However, white blood cell numbers were decreased at 1hr and increased at 24hr after the moxibustion.
After the moxibustion with 15mg of moxa, platelet aggregation activity induced by collagen showed no change, but the mild shortness of lag time was observed from 1 to 5hr. While, the mild suppressive effect on platelet aggregation induced by collagen was observed at 1 and 5hr after the moxibustion with 5mg of moxa.
After the moxibustion with 15mg of moxa, mild increase in platelet aggregation activity at 24hr and in ATP-release activity from 1 to 5hr was found. After the moxibustion with 5mg of moxa, an apparent increase in ATP-release activity was observed at 1 and 3hr.
These results suggested that the mild changes in platelet functions were closely related with the response of the coagulation and the fibrinolytic activity in mice.

Objective: We investigated subjective effects of a lactoferrin (LF) -containing supplement on cold-like symptoms and gastroenteritis symptoms.
Method: Healthy women were divided into a LF-consumption group and a non-consumption group. The former intaked LF-containing tablets for 90 days. Subjects filled out questionnaires about cold-like symptoms, gastroenteritis symptoms, and drug use.
Results: Significant decreases were found in the onset of cold-like symptoms and gastroenteritis symptoms in the LF-consumption group compared with non-consumption group.
Conclusion: These results suggest the possibility that LF intake inhibits the onset of common cold and gastroenteritis.

Background: Re-revision of the Ethical Guidelines for Clinical Study (EGCS) in Japan is planned in 2013. It is important to ascertain the current situation of physicians' understanding to conduct clinical trials. It seems that the difference in regulatory processes between commercial and non-commercial clinical trials has caused significant confusion for physicians in conducting clinical trials in Japan.
This survey was undertaken in order to improve awareness of the differences between both types of clinical trials. Furthermore, this survey examined whether it was effective to promote about clinical trials under newly introduced regulatory guidelines and to examine the subsequent willingness of physicians to conduct such clinical trials.
Methods: From 24^th March to 24^th April 2009 inclusive, a questionnaire survey was conducted targeting 286 physicians working at Shiga University of Medical Science Hospital. A follow-up survey was conducted among 109 participants at a lecture about clinical trials on 8^th July 2009.
Results: Physicians who had prior knowledge of the regulations, purposes, or support systems for commercial and non-commercial clinical trials responded positively that they were more likely to conduct clinical trials, while physicians who had no prior knowledge of them responded negatively. Both groups reported that their daily working pressures and cumbersome regulatory processes prevented them from conducting clinical trials.
Conclusion: Japanese physicians lack knowledge and information about clinical trials, leading to negative perceptions and reduced willingness to conduct such studies. Thus, the introduction of any strict and complex regulations should be approached carefully when the environment for clinical trials has not yet been established.

BACKGROUND: We hypothesized that cross-clamping of the descending thoracic aorta (CcDTA) would result in significant changes in plasma propofol concentrations (Cp) proximal and distal to the cross-clamp. We investigated the effect of CcDTA on Cp centrally and distally, including the pulmonary artery and the cardiopulmonary bypass (CPB) cannula. METHODS: The bispectral index (BIS) was recorded during CcDTA in eight patients undergoing thoracic aortic surgery using target-controlled total intravenous anesthesia with propofol. The calculated Cp was maintained at 3 microg/ml. Cp was measured in blood samples drawn from the right radial artery, left dorsalis pedis artery, pulmonary artery, and the long venous CPB cannula. RESULTS: Complete data were obtained from six patients. BIS decreased significantly in all cases 5 minutes after initiating CcDTA. BIS continued to decrease in association with increasing propofol concentrations. During CcDTA, Cp in samples from the radial and pulmonary arteries (3.5 +/- 0.50 and 2.9 +/- 0.63 microg/ml, mean +/- SD) was significantly higher than in samples from the dorsalis pedis artery and the venous cannula (1.1 +/- 0.22 and 1.4 +/- 0.02 microg/ml) (P < 0.05). CONCLUSIONS: The results suggest that almost all of the blood returning from the superior vena cava during CcDTA directly enters the pulmonary circulation without mixing with blood from the inferior vena cava. Observed changes in anesthetic blood concentrations could be due to the presence of a split circulation and asymmetrical distribution of propofol induced by CcDTA and CPB.
Anesthesia, Intravenous ; Aorta, Thoracic ; Arteries ; Cardiopulmonary Bypass ; Catheters ; Humans ; Plasma ; Propofol ; Pulmonary Artery ; Pulmonary Circulation ; Radial Artery ; Vena Cava, Inferior ; Vena Cava, Superior

　　We report a case of vaginal cuff dehiscence after total laparoscopic hysterectomy that was successfully managed by a newly developed vaginal double-layer circular incision-closure method through a transvaginal approach. The nulligravid postmenopausal patient with cervical cancer received a diagnosis of vaginal evisceration on postoperative day 24. The eviscerated small intestine was pushed back after vaginal douching with normal saline before the procedure. The vaginal mucosa was incised circularly in two layers at the levels of 10 mm and 15 mm from the vaginal stump, and the edges apposed with double-layer closures. She was discharged on postoperative day 3 and followed up for 5 years, with no recurrence of cancer or vaginal dehiscence. This operative method is especially useful for a nulligravida with a small vagina.

Background/Aims: Although risk factors of reflux esophagitis (RE) have been investigated in numerous cross-sectional studies, little is known about predictive factors associated with future onset of RE. We investigated time courses of clinical parameters before RE onset by a longitudinal case-control study using health checkup records. Methods: We used health checkup records between April 2004 and March 2014 at 9 institutions in Japan. A multivariate logistic regression analysis was performed to evaluate associations of baseline clinical parameters with RE. The time courses of the clinical parameters of RE subjects were compared with those of non-RE subjects by the mixed-effects models for repeated measures analysis or longitudinal multivariate logistic analysis. Results: Initial data were obtained from 230 056 individuals, and 2066 RE subjects and 4132 non-RE subjects were finally included in the analysis. Body mass index, alanine aminotransferase, smoking, acid reflux symptoms, hiatal hernia, and absence of atrophic gastritis at baseline were independently associated with RE. The time courses of body mass index, fasting blood sugar, triglyceride, aspartate aminotransferase, alanine aminotransferase, γ-glutamyl transpeptidase, percentages of acid reflux symptoms, feeling of fullness, and hiatal hernia in the RE group were significantly worse than in the non-RE group. Conclusions The RE group displayed a greater worsening of the clinical parameters associated with lifestyle diseases, including obesity, diabetes, hyperlipidemia, and fatty liver for 5 years before RE onset compared with the non-RE group. These results suggest that RE is a lifestyle disease and thus lifestyle guidance to at-risk person may help to prevent RE onset.

We report a case of ureteral endometriosis thought to have developed following relapse of pelvic peritoneal endometriosis after laparoscopic surgery. The patient was a woman in her late 40s who had undergone laparoscopic right adnexectomy for an endometrial cyst 5 years earlier. Electrocoagulation was performed for residual endometriosis of adherent cyst wall on the right sacrouterine ligament. The normal left ovary was preserved and she received no postoperative hormonal therapy. She developed right back pain during menstruation 5 years after the surgery. Pyeloureterography revealed stenosis of the ureter to the right of the uterus. Urinary cytology revealed endometrial cells with no atypia. Conservative management was opted for because malignant transformation of endometriosis was considered unlikely and she was expected to reach menopause within a few years. She is now doing well 24 months after initiation of progestin treatment with placement of a ureteral stent. Postoperative hormonal therapy is recommended for patients who are considered to have possible lesions of residual endometriosis and for whom ovarian function is preserved.