There were 651 deliveries and 4 maternal deaths at Christian Hospital Chandraghona between October 2000 and August 2001. Eleven eclampsia patients were admitted and the mean age was 22.1 years. Ten patients were primipara and 1 patient was multipara. Among those eclampsia cases, 2 maternal deaths were observed and 10 patients delivered babies (8 live babies and 2 stillbirths). Delivery methods were 8 normal deliveries, 1 forceps delivery and 1 cesarean section. Ten patients had never consulted a doctor before eclampsia occurred. Eclampsia occurred at the third trimester of pregnancy in 9 patients and after delivery in 2 patients. Nine patients came to the hospital within 5 hours after the onset of eclampsia. Those who came late to the hospital progressed to be maternal death. To reduce maternal death, it is necessary to promote antenatal checkup and provide education about obstetrical complications at the grassroots level.

This study aimed at clarifying the effects of a lifestyle intervention using an activity monitor with game functions on daily physical activity. A 12-week randomized crossover study was conducted in 23 healthy volunteers (31 ± 11 yrs). The subjects were randomly assigned to Group A (a 6-week game intervention and then a 6-week normal intervention) and Group B (a 6-week normal intervention and then a 6-week game intervention). In the game intervention period (G), the subjects wore two different activity monitors, namely a normal activity monitor (Lifecorder EX) and an activity monitor with game functions (Yuuhokei). On the other hand, in the normal intervention period (N), the subjects wore only a normal activity monitor. Daily steps were significantly higher in the G than in the N (G: 10417 ± 2358 vs. N: 8744 ± 2180 steps/day, P < 0.001). Amount of physical activity (i.e., daily total METs · hour = Ex/day) at the intensity of 3 METs or more was significantly higher in the G than in the N (G: 3.1 ± 0.9 vs. N: 2.4 ± 0.8 Ex/day, P < 0.001). Our results indicate that the lifestyle intervention using an activity monitor with game functions would more effectively increase daily physical activity such as steps and physical activity amount, than a normal intervention using an activity monitor. These findings therefore have important implications for reaching more easily the goals (i.e., 23 Ex/week or 10,000 steps/day) and the use of an activity monitor with game functions in the field of exercise or physical activity instructions.

This study aimed to examine a new walking method to fulfill the Physical Activity Reference for Health Promotion in Japan in a shorter time, which can be performed as a non-exercise activity (NEA) such as walking during commuting. Eleven healthy subjects performed normal walking (NW) and knee-up walking (KU) for eight minutes without load (0%) and with loads of 5, 10, and 20% of body mass in a backpack carried on the back (NW-0, 5, 10, and 20; KU-0, 5, 10, and 20) on a treadmill at a speed of 5 km/h at 0% tilt. Oxygen uptake, blood lactate levels, and ratings of perceived exertion (RPE) were measured in the last two minutes of each walking stage. Metabolic equivalents (METs) were also calculated from the resultant oxygen uptake. METs in NW-20 and all weight conditions of KUs were significantly greater (P < 0.01) than those in NW-0 (3.8 ± 0.1 METs). RPE in both KU-10 and KU-20 was above 15 (i.e., indicating Hard). Blood lactate levels in the KU-20 (4.5 ± 0.7 mmol/L) were above the Onset of Blood Lactate Accumulation. On the other hand, NW-20, KU-0, and KU-5 were physical activity level of moderate- to vigorous- intensity that could be performed as a NEA. These data suggest that our new walking methods such as NW-20, KU-0, and KU-5 can satisfy the Physical Activity Reference in a shorter time rather than normal walking, and could be continuously performed in daily life.

Episodic angioedema with eosinophilia (EAE) is an idiopathic condition characterized by recurrent symptoms such as angioedema, urticaria, and eosinophilia. We report a case of a 25-year-old woman with the non-episodic variant of this condition (NEAE) who was treated with acupuncture.
The patient presented with a two-week history of generalized itching and angioedema. Erythema, bilateral limb edema, and swelling and pain of both wrists and ankles were noted. As antiallergic medication administered for several days was ineffective, she was admitted to our hospital. Hematologic investigations revealed a white blood cell count of 11850/mm³ with 64.2% eosinophils (7610/mm³). Histopathologic examination of a cutaneous biopsy specimen indicated an eosinophilic infiltration localized around blood vessels in the superficial dermal layers. NEAE was diagnosed on the basis of these findings. Acupuncture treatment was performed according to Traditional Chinese Medical theory. Itching was alleviated following acupuncture treatments and relapsed on days when acupuncture was not administered. However, edema and itching gradually diminished between acupuncture treatments, in parallel with resolution of the peripheral eosinophilia. In this case, acupuncture treatment was effective for alleviating itching in NEAE.

[Purpose] We report a case treated by acupuncture in a health care facility for the elderly to evaluate the effect of acupuncture on severe pulmonary emphysema.
[Case and methods] A 88 year-old man visited Meiji University of Oriental Medicine Hospital with dyspnea in March 2000 and was diagnosed with pulmonary emphysema. He was hospitalized in October 2002 because his chronic respiratory failure was worsening : oxygen therapy was started. After discharge from hospital, he entered a health care facility for the elderly and acupuncture treatment for lumbago was initiated. Thereafter, acupuncture treatment for dyspnea and stiff shoulder started. He was determined to be grade V according to Fletcher-Hugh-Jones classification of dyspnea. Spirometry of the patient before acupuncture for dyspnea showed 88.0 % in %VC, 38.2 % in FEV 1 %, and 30 % in %FEV 1, and the patient was diagnosed with chronic obstructive pulmonary disease of serious grade. Acupuncture treatment was performed once or twice a week, and acupuncture treatment for dyspnea was performed 21 times (total of 33 treatments).
[Results] Subjective symptoms of lumbago, stagger of the legs, and shoulder stiffness were evaluated with Numerical Scale or Pain Scale. The state of dyspnea was evaluated with Numerical Scale and Borg Scale, and exercise tolerance was evaluated with 6 min of walking. After 33 acupuncture treatments, dyspnea on exertion, exercise tolerance, and the findings of spirometry were not improved. But dyspnea on rest had disappeared with improvement in lumbago, stagger of the legs, and shoulder stiffness. These results indicate that acupuncture as a general treatment is effective for the improvement of dyspnea, especially in elderly patients whose general state of health is not good because of restriction in their ability to exercise in the course of daily life due to dyspnea of exercise such as lumbago, stagger of the legs, and shoulder stiffness.

[Objective] The effect of indirect moxibustion on cold symptoms was examined in elderly subjects living in a nursing home.
[Design] A single-case experimental design that enables clinical trials in small a number of subjects was used in this study.
[Methods] Two elderly subjects living in a nursing house participated for 16 weeks. The experimental periods were allocated at random as treatment periods and control periods of eight weeks each. During the treatment periods, subjects were treated with indirect moxibustion GV 14 and BL 12 (both sides) 3 units each, 3 times a week. Rating scores with 4 and/or 5 grades were used to evaluate common cold symptoms.
[Results] Concerning the presence of common cold, there were no significant differences between the treatment and control periods. Moreover, concerning common cold symptoms, there were no significant differences between treatment and control periods.
[Conclusion] Effects of an indirect moxibustion on the common cold symptoms were not detected in this study. We speculated that the living environment of these subjects and the intensity of stimulation were factors. Furthermore, we suspected that a single-case experimental design was unsuitable for common cold research.

We reviewed 223 cases of surgical treatment for abdominal aortic aneurysm in octogenarians in this hospital between 1981 and 2000, and investigated the characteristic features, complications, and indications of the operation. The cases were divided into two age groups. Group O included 23 cases of octogenarians, and Group Y included 200 cases of patients under 80 years old. The average age was 68.6 years old in group Y (33-79 years old), and 83 years old in group O (80-93 years old). The hospital mortality rate was 0% in elective operation cases. In emergency operation case, Group O had a hospital mortality rate of 57.1%, significantly higher than the 6.1% for group Y. The hospital mortality rate was 17% in group O and 0.5% in group Y. The rate of emergency operation case was significantly higher in group O (30.4%) compared to group Y (16.5%). As for the preoperative complications, group O had more cases of renal dysfunction, COPD and gastrointestinal complication. As for the coronary artery disease and other cardiovascular complications, there were no significant differences between the groups. In the postoperative complication, group O had more cases of ileus, pneumonia, and cardiovascular disease. These complications were fatal in group O. These results suggest that surgical treatment for abdominal aortic aneurysm was performed safely in both groups for elective operations. Because the results of emergency operations are poor, early diagnosis and treatment seem to be important for the improvement of operative results.

The approach for the heart and proximal aorta in a patient with a tracheostomy poses difficult problems such as mediastinitis and inadequate operative exposure. We report a case of successful surgical treatment for type A aortic dissection in a patient with tracheostomy using a Y shaped skin incision and median full-sternotomy. A 63-year-old woman with a tracheostomy was referred to our hospital because of type A thrombosed aortic dissection and cardiac tamponade. At first we treated the patient conseservatively, but follow-up CT taken on the 20th day after onset revealed that false lumen of the ascending aorta was patent and the size of ascending aorta had increased to 6cm in diameter. We therefore performed hemiarch replacement (24mm Hemashield gold graft) through a Y shaped skin incision and median full-sternotomy. The postoperative course was uneventful and she was discharged on the 19th postoperative day.

This study aimed to clarify the effects of a lifestyle intervention by the concurrent use of an activity monitor and Twitter on daily physical activity. Twenty-one healthy males and females (37 ± 13 yrs) were randomly assigned to Normal intervention group (N group, n = 10) or Twitter intervention group (T group, n = 11). In both groups, the intervention period was 6 weeks. Participants in N group wore an activity monitor (Lifecorder EX). Meanwhile, participants in T group were asked to tweet about their daily steps or physical activity in addition to wearing an activity monitor, and also an observer read through the tweet from each participant and commented about physical activity. There were no significant differences in daily physical activity (i.e., steps and amount of physical activity (PA)) at week 1 between both groups. In addition, no significant time-course changes in steps and amount of PA were observed in N group. In contrast, steps in T group were gradually increased from week 1 8,542 ± 3,158 steps/day to week 6 12,700 ± 3,935 steps/day (P < 0.01). Amount of PA in T group was also gradually increased from week 1 2.5 ± 1.2 METs·hour/day to week 6 4.6 ± 2.3 METs·hour/day (P < 0.01). Therefore, these findings indicate that the lifestyle intervention by the concurrent use of an activity monitor and Twitter could effectively induce an increase in daily physical activity compared with the intervention using only an activity monitor.

This retrospective observational study aimed to examine the effects of playing Pokémon GO on daily steps of male college students. Twenty-five Japanese male college students (20 ± 1 years) were assigned to Control group (C, n = 11) or Pokémon GO group (P, n = 14) based on their playing Pokémon GO or not. Daily step levels were obtained from the health care app of Apple iPhone from September 2016 to October 2016. In P group, the data for the 4 weeks to determine baseline values and for the 4 weeks of playing Pokémon GO were analyzed. The steps data of C group were also analyzed in the same period of the total 8 weeks. There were no significant differences in steps at baseline level between both groups. In addition, no significant time-course changes in steps were observed in C group. In contrast, steps in P group significantly increased from baseline 8,368 ± 544 steps/day to week 1 10,028 ± 617 steps/day (P < 0.01). The changes in steps from baseline to week 1 were significantly greater in P group than in C group (1,671 ± 345 vs. -81 ± 582, P < 0.01). However, the increased steps returned to baseline level by week 2, and the values did not increase again. Therefore, our findings indicate that playing Pokémon GO increases daily steps only during one week in Japanese male college students.