We examined three cases where Kampo medicine had effects on palindromic rheumatism. All the patients are men with arthralgia accompanied by redness, fever, and swelling. All cases are RF negative. Cases 2 and 3 are brothers. Case 1: A 58-year-old patient with recurrent arthralgia on shoulders, hands, and legs for 30 years. Eppi-ka-jutsu-to was administrated for arthralgia. When discomfort of the hypochondrium (Kyokyokuman) was noted, the administration of Sho-Saiko-to reduced the symptom.
Case 2: A 40-year-old patient with recurrent arthralgia on shoulders, hands and legs for nine years. Eppi-ka-jutsu-to was administrated for arthralgia. When discomfort of the hypochondrium (Kyokyokuman) and contraction of the abdominal muscles (Fukuhikokyu) was noted, the administration of Eppi-ka-jutsu-to-go-Shigyaku-san-ryo was replaced, which reduced the symptoms.
Case 3: A 46-year-old patient with recurrent arthralgia on knees and fingers, and pain in hip joints. Eppi-ka-jutsu-to was administrated for arthralgia. When discomfort of the hypochondrium (Kyokyokuman) and contraction of the abdominal muscles (Fukuhikokyu) were noted, the administration of Shigyaku-san reduced the symptoms.
All cases were typical palindromic rheumatism, and Eppi-ka-jutsu-to was effective to a certain degree. Kampo diagnosis of Saiko (Saiko-sho) was made and additional Saiko-drugs (Saiko-zai) reduced the frequency, the degree, and the length of the period of symptoms.

Aortic dissection with multiple familial members is rare. It is commonly associated with Marfan syndrome. Several authors have reported familial aortic dissection without Marfan syndrome. We encountered 4 cases of aortic dissection in a family. The aortic dissection occurred in the mother and all of her children. No case had clinical manifestations of Marfan syndrome or other connective tissue disease. Histopathological examination of the aorta did not show cystic medial necrosis in 2 operated cases. Many members in the family had systemic arterial hypertension. The presence of multiple incidence of aortic dissection in one family suggests underlying connective tissue disease, irrespective of the absence of typical features of Marfan syndrome. Therefore we propose that other close relatives as well as the members with aortic dissection should be followed-up in the same way used for families with typical connective tissue disease like Marfan syndrome.

Purpose
  The purpose of this study is to clarify the impressions that elderly people requiring care have when exposed to a “rooftop forest-like field.”
Methods
Experimental sites : (1) The rooftop forest-like area: It covers an area of 122 m² on the 3rd story rooftop of a health service facility. It has 140 cm undulations, and a murmuring stream 7 m long and 58 cm deep flowing through the center. Fifty-one species of trees and 33 species of weeds, herbs, and grasses have been planted. Nearby is a mountain from which some birds come to the area. This mountain formed the background to this landscape. (2) The outdoor parking area: Control area was an area of 170 m² next to the same facility. Cars were prevented from entering during the study.
Subjects:The subjects were 30 females aged from 71 to 95 (mean ± SD: 81.7 ± 5.6). They were residents of the facility or attended to the facility for day care. They were divided into two groups, A and B, consisting of 15 females each. The groups were matched for age and cerebral vascular disorders (CVD). No patients with dementia were included. Experimental design : On the first day of The experiment, group A was sent to the rooftop forest-like area, and group B was sent to the open-air parking area. On the second day, each group went to the other area to eliminate the order effect. The subjective impression was measured using the semantic differential (SD) method. Patients sat still in a wheelchair and watched the scenery for 7 minutes and then answered the questionnaire.
Results and Discussion
  The rooftop forest-like field was perceived as a “beautiful,” “refreshing,” “orderly,” “enjoyable,” “comfortable” “secure,” “healthy,” “calm,” “soothing,” “friendly,” “quiet,” and a “holy” area. It was similar to the impression made by natural coniferous forests or natural rice fields. More than 80% of subjects expressed subjective relaxed state, as “most enjoyable,” “most comfortable,” and “most secure” as their impressions of the rooftop forest-like area. The impression of rooftop forest like area was characterized by high scores for both space and sensory factors using the SD method. Compared with previous reports, this forest-like area may have a relaxing effect on elderly people requiring care which is subjectively perceived.
Conclusion
  It was demonstrated that the rooftop forest-like field was perceived as a “comfortable”, “healthy”, and “relaxing” space by elderly people requiring care.