SS-MIX is a product of Ministry of Health's healthcare information exchange promotion project. Its standardized storage stores prescription orders, laboratory test results, diagnosed disease classifications in HL7 v2.5 format. This can be connected to any vendorʼs hospital information system, provided that the system can export these information in HL7 format. The storage software can be downloaded from site of SS-MIX consortium. The stored standardized information can be used in many effective ways. Providing the information of the patient in a referral document form is easy. The server can be set in another place for the purpose of providing backup in case of disaster, natural or man-made, like system down, or network failure. Filling case card, like adverse event report, is also easy, by picking up the prescription, lab results, etc. and filling them into appropriate space, which are formerly filled by human hand, on paper, or through EDC. In Japan, SS-MIX standardized storage is in service at more than 116 hospitals (by March 2012). The coverage of patients by these hospitals are estimated around 1,500,000 people. Hospital information system in Japan must comply safety guideline by the Ministry, so that the electronic medical records can be　used instead of paper records. Audit　trails are mandated, and many human factors are recommended. As most hospital information systems in Japan are complying this Ministry　guideline, gap between complying 21 CFR Part 11 is not a hard task for them. (Jpn J Pharmacoepidemiol 2013;18(1):49-56)

Objective: Standardized clinical data are invaluable for secondary use of medical information. We constructed a standardized database and a data warehouse called D*D, based on the Standardized Structured Medical Information Exchange(SS-MIX)scheme. D*D enables physicians and researchers to perform complex searches with combined conditions, e.g. time to event. It contains data from 1999 for approximately 400,000 individual patients. The objective of this study was to provide an overview of the features of this database system, especially from the perspective of drug safety research.
Methods: Three models of research questions were identified from established drug-risk combinations:1)gatifloxacin and hypoglycemia;2)statins and rhabdomyolysis;and 3)oral 5-fluorouracil S-1 and hepatotoxicity. D*D was searched using predefined keywords and conditions.
Results: 1)A total of 3,635 patients were treated for diabetes. Among 20 diabetic patients prescribed gatifloxacin, hypoglycemia was recorded in one patient(1/38 prescriptions). 2)Among 5,926 patients who had been prescribed any statin within 10 years in our hospital, 6 patients(0.1%)experienced rhabdomyolysis. The incidence was similar to that for fibrate (1/740, 0.1%). The most confounded diagnosis was stiff shoulder. 3)Among 244 patients prescribed S-1, 19 patients(7.8%) experienced hepatotoxicity higher than CTCAE grade3 within 2 months from the prescription.
Conclusion: With limited data items and search keys in standardized data storage, definitions of exposures and outcomes require careful assessment during protocol development. Considering that the system can be implemented at more than half of the hospitals that have already installed ordering systems, D*D can be one of the Japanese models for distributed research network.

The Immunosuppressive effects of prostaglandin E₁ (PGE₁) used in cardiopulmonary bypass (CPB) operation were studied. We examined 30 patients, with ischemic heart diseases. The patients were divided into 3 groups: 11 patients given PGE₁ in group PG (G-PG), 10 patients given amurinon, a phosphodiesterase inhibiter, in group A (G-A), and 9 patients not given either of those drugs in the control group (G-C). Immunologically, lymphocyte subpopulations, and adhesion molecule expression on cell membrane and phagocytosis of neutrophils were analyzed before, at the time of, and after the operation until POD 7. The prominent effects of PGE₁ were observed on neutrophils. The expression of CD 62L, an adhesion molecule designated as L-selectin, on the cell surface membrane of neutrophils significantly increased during and after CPB in G-A and G-C, but it remained unchanged in G-PG during the observation period. Moreover, CPB caused an enhancement of the phagocytic activity of neutrophils in all groups, but its degree was much less in G-PG than in the other two groups. Among lymphocyte subpopulations, the number of CD 3⁺T-cells in G-PG rather than that of CD 20⁺B-cells reduced more greatly than those values observed in G-A and G-C. The decrease of T-cell number, throughout the observation period, in G-PG seemed to be mainly due to the decrease of the number of CD 4⁺T-cells designated as helper T-cells, although the number of CD 8⁺T-cells esignated as killer/suppressor T-cells slightly decreased on PODs 3 and 7. Amurinon, as a whole, did not exert any significant effect either on lymphocytes or on neutrophils in our experiments. Taken together, these results show that the treatment of patients with PGE₁ during CPB causes suppressive effects on immunorelevant cells. It may mitigate the activity of neutrophils, which are suspected as a possible culprit causing reperfusion injury. However, these suppressive effects, including the lowered numbers of CD 4⁺T-cells, may render the patients more vulnerable to infection. Much more intensive cares is required in these patients after operations.

Myocardial oxidative stress during retrograde continuous blood cardioplegia (RCBC) was evaluated in 35 patients undergoing elective aortocoronary bypass surgery. The patients were divided into three groups: Group C (n=12) received cold (20°C) RCBC, Group T (n=11) received tepid (30°C) RCBC, and Group W (n=12) received warm (36°C) RCBC. Myocardial oxidative stress was assessed by measuring the release of oxidized glutathione (GSSG), malondialdehyde (MDA), and myeloperoxidase (MPO) in the coronary sinus plasma before aortic clamping, at 1, 5, and 10min after unclamping. Myocardial oxygen uptake and lactate release were assessed at the same times. Both the hemodynamic recovery and the creatine kinase MB (CKMB) activity were measured perioperatively until 24h after unclamping. In Group C, a significant coronary sinus release of GSSG was found in the early reperfusion period in comparison to Groups T and W. However, the peak CK-MB activity was significantly lower in Group T than in Group W. No significant difference in the release of MDA or MPO was noted in the three groups. The recovery of oxygen uptake after unclamping was rapid in Group T. The recovery in the left and right ventricular functions and the myocardial lactate release were similar in the three groups. In conclusion, tepid RCBC is considered to protect the myocardium from ischemia-reperfusion injury better than cold or warm blood cardioplegia under retrograde continuous perfusion.

It is necessary to research constituents of moxa on the studies of moxibution.
As we analyged the essential oil in moxa with gas liquid chromatography, n-nonacosane and n-hentriacontane were detected. Several compound (ex.: tricosanol, hentricontane, arachinakohol, thujone) have been already detected in moxa. But n-nonacosane and n-hentriacontane are newly detected constituents in moxa.

The effects of Qi Gong health maintenance exercises were compared with a control group of walkers considered to have an equivalent amount of exercise, by measuring the changes in the pulse, systolic blood pressure, diastolic blood pressure and peripheral circulation.
Although no significant differences were seen in either the pulse or blood pressure of the control group of walkers when the before and after exercise values were compared, in the Qi Gong group, a decrease in these values was seen over time, with significant decreases from the pre-exercise values indicated in all values 30 minutes after exercise. This is consistent with the findings in a previous report that there was a significant reduction in catecholamine in the Qi Gong group 30 minutes after performing Qi Gong exercises.
When the flow rate of the peripheral circulation was measured using Doppler ultrasound equipment, in comparison with the lack of notable change over time seen in the control group, a significant improvement in the peripheral circulation was suggested for the Qi Gong group when the pre- and post- exercise values were compared. It has also been suggested that Qi Gong health maintenance exercises lower stress hormones and act to improve the peripheral blood circulation; a discussion of which is also included in this paper.

No abstract available.
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We performed tricuspid annuloplasty aggressively in association with mitral and combined mitral and aortic valve disease. Because tricuspid regurgitation (TR) may produce significant morbidity if not corrected. From March 1986 to September 1990, for the purpose of studying the clinicopathology of the biopsied right ventricular myocardium in 54 patients with mitral valvular disease, the diameter of right ventricular myocardial cells and diffuse interstitial fibrosis of biopsied myocardium were measured quantitatively. The degree of diffuse interstitial fibrosis was assessed by the point-counting method, and mean percentage fibrosis (% fibrosis) was noted as 16.1%, % fibrosis was correlated with the severity of TR (r=0.36). Mean diameter of right ventricular myocardial cells was 19.3μm in size. The diameter of right ventricular myocardial cell was correlated with pulmonary arterial pressure (r=0.51). More aggressive narrowing of tricuspid valve ring using DeVega's method was performed on 39 of 54 patients. The evaluation of TR was done by Doppler echo. Postoperative residual TR was observed in four patients of total postoperative patients within mean follow-up period of 41.0 months. In the 4 patients, % fibrosis were in high % fibrosis (>20%). In comparison to the group with low % fibrosis (<15%) (n=27), the group with high % fibrosis (>20%) (n=9) was more serious in severity of TR by Doppler echo (2.4 vs. 1.7), age (58.2 vs. 51.6), NYHA classification (3.2 vs. 2.6) before surgery. In conclusion, open right ventricular myocardial biopsy findings suggest that the degree of myocardial fibrosis is correlated with severity of tricuspid regurgitation. And the patients whose % fibrosis are more than 20% are presumed poor right ventricular function. The diameter of right ventricular myocardial cell is correlated with pulmonary arterial pressure, that is, right ventricular hypertrophy is associated with pulmonary hypertension.

A 45-year-old woman with an 8-year history of systemic lupus erythematosus (SLE) was admitted with complaints of sudden onset of chest and back pain and syncopal attack. Aortography showed DeBakey type I acute aortic dissection. She has been maintained on a small dose of corticosteroids (prednisone 5mg/day). After antihypertensive drug treatment, a replacement of the total aortic arch and arch vessels was successfully performed. The postoperative course was uneventful and she has had no relapse of SLE.

A 45-year-old man was admitted with several histories of cerebral infarction. Transesophageal echocardiography showed a small tumor on the anterior mitral leaflet. Open heart surgery was performed. The tumor was removed including a part of the anterior mitral leaflet and mitral valve plasty was done. The post-operative course was uneventful. Papillary fibroelastoma was diagnosed pathologically. To avoid embolic complication, an early surgical procedure is recommended.