The purpose of this study was to investigate changes in muscle strength of the quadriceps femoris after intraarticular acupuncture treatment of the affected joint in subjects with unilateral osteoarthritic knee. Isometric muscle strength was measured by standard dynamometry at 90 degree knee flexion when the subjects contracted the quadriceps muscle slowly and maximally without any pain.
In the preliminary experiment, the repeated measurement yielded a high reliability coefficient (correlation coefficient r=0.95, there is no significant difference between the two means) in the affected knee as well as the normal side for 19 patients with osteoarthritic knee.
Nine subjects, whose muscle strength of the affected side had fallen by more than 20% compared with the normal side, participated in the study. An acupuncture needle was inserted into the point where the tenderness of the affected meniscus was marked. The results revealed a noticeable increase in muscle strength of the quadriceps femoris in the affected side from 14.3±2.2kg before acupuncture to 22.9±3.0kg after intraarticular acupuncture (p<0.001), with no significant change in the normal side from 26.0±2.4kg to 27.1±2.8kg (p>0.05).
A hypothesis was formulated that the dicreased muscle strength of the quadriceps femoris in the osteoarthritic knee results from reflex inhibition from joint receptors and that intro-articular acupuncture has a disinhibition effect on this inhibition of the extensor muscle activity.

Objective: Beginning in October 2014 a drug risk management plan (RMP) will be authorized as a condition for drug approval and for this and other reasons the role the medical representatives (MRs) play regarding drug information will become even greater. We therefore decided to conduct drug information awareness surveys of the MRs who visit our hospital.
Methods: We first conducted a questionnaire survey on RMP, the Pharmaceuticals and Medical Devices Agency (PMDA), and postmarketing surveillance (PMS).　Following the survey we held a seminar for MRs in relation to RMPs, after which we conducted a questionnaire again.
Results: The surveys revealed that most of the MRs were not actively gathering information provided by the PMDA.　They also revealed that after the seminar their knowledge regarding RMPs had increased and their understanding of the relationship between RMPs and PMS had deepened.
Conclusion: Considering that the MRs gained a significantly deeper understanding after the seminar, participation by medical institutions, which are the recipients of the information, in the education of MRs can be said to be meaningful as a means of supporting proper information‐providing activities.

A 60-year-old woman with acute Stanford type A dissecting aneurysm underwent Dacron graft replacement of the total aortic arch combined with the modified elephant trunk technique. Follow-up CT and angiogram demonstrated blood flow into the false lumen from the distal anastomosis. In order to interrupt the blood flow, endovascular stent grafting was undertaken. She recovered uneventfully, and was discharged on the 14th postoperative day. Follow-up CT taken in the third postoperative month demonstrated exclusion of the blood flow into the false lumen of descending thoracic aorta. Aortic arch replacement followed by endovascular stent grafting of the descending thoracic component is a potential therapeutic option in patients with dissecting aneurysm.

Sokeikakketsuto was administered to 33 patients with recurrent cramps of the calf appearing once a week or more and persisting for 2 weeks or more. Treatment response was evaluated 1 month after the start of drug therapy. Patients whose cramps disappeared immediately after starting were regarded as showing a complete response, those with disappearance after 1 month as showing a partial response, those with a reduction to <50% after 1 month as showing a slight response, and those in whom 50% or more of cramps persisted after 1 month as showing no response. A complete response was achieved in 12 patients, a partial response in 11, a slight response in 9, and no response in 1. In 23 (69.6%) of the 33 patients, cramps disappeared within 1 month after the start of drug therapy. In 32 (96.9%), there was a reduction to <50%. In 29 (87.8%) of the 33 patients, cramps disappeared within 3 months, suggesting the efficacy of this drug. Two-package administration in the evening/at bedtime was more effective than 1-package administration for controlling cramps of the calf at night until early in the morning. The intensive pre-attack administration of 2 packages before sleep was the most effective. Sokeikakketsuto may be useful for treating recurrent cramps of the calf.

The effects of bathing with inorganic salts and carbon dioxide (ISCD) on body temperature, systemic circulation, food ingestion and absorption have been studied in healthy volunteers. The peripheral blood flow in the forearm was found to increase in and after immersion of the forearm into a 25l bathing receptacle containing ISCD, as compared with plain water. The peripheral blood flow tended to increase in a dose-dependent manner with ISCD bathing. The skin core temperature, the skin surface temperature and the peripheral blood flow were significantly higher after ISCD bathing than after plain water bathing. The influences of ISCD bathing on food ingestion and absorption were also studied in healthy volunteers. Blood glucose and insulin levels after food ingestion tended to be suppressed by ISCD bathing as compared with plain water bathing. There was no difference between ISCD and plain water bathing in total protein, total cholesterol, triglyceride, HDL cholesterol, and uric acid levels in the blood. These results suggest that ISCD bathing may contribute to the promotion of human health.

The small bowel had long been considered a dark unapproachable tunnel until the invention of capsule endoscopy and doubleballoon enteroscopy in the 21st century, which revolutionized the diagnosis and management of small bowel diseases, including bleeding. Various imaging modalities such as computed tomographic enterography, angiography, capsule endoscopy, and balloonassisted enteroscopy play vital roles in the diagnosis and management of small bowel bleeding. The choice of modality to use and timing of application differ according to the availability of the modalities, patient’s history, and physician’s experience. Small bowel bleeding is managed using different strategies as exemplified by medical treatment, interventional radiology, endoscopic therapy, or surgical intervention. Balloon-assisted enteroscopy enables endoscopic interventions to control small bowel bleeding, including electrocautery, argon plasma coagulation, clip application, and tattooing as a prelude to surgery. In this article, we clarify the recent approaches to the optimal diagnosis and management of patients with small bowel bleeding.

OBJECTIVESAmong the complementary and alternative medical services available in Japan, only judo therapists are covered under the national health-insurance program without a referral from a physician. Many orthopedists claim that judo therapists deprive them of potential patients. If such competition exists, fewer patients would be expected to visit orthopedists in areas where many patients visit judo therapists. Therefore, we examined the correlation between the number of patients visiting judo therapists and those visiting physicians for musculoskeletal diseases.

METHODSIn a cross-sectional study covering each prefecture in Japan (n = 47), we obtained figures for the numbers of judo therapist facilities and elderly patients (over 70 years old) who visited them and the numbers of orthopedists and patients who visited physicians for musculoskeletal diseases. Correlations between the numbers of practitioners per 100,000 population and the numbers of their patients per 100,000 population were examined by prefecture.

RESULTSThere were positive correlations between the numbers of judo therapist facilities and elderly patients who visited them (r = 0.72, P < 0.01, n = 47), and between the numbers of orthopedists and elderly patients who visited physicians for musculoskeletal diseases (r = 0.32, P = 0.03). However, there was no significant correlation between the numbers of elderly patients who visited judo therapist facilities and those who visited physicians (r = 0.06, P = 0.68) for musculoskeletal diseases.

CONCLUSIONSThis study did not find a negative correlation between the numbers of patients visiting judo therapists and patients visiting physicians for musculoskeletal diseases. Thus, these results do not support the orthopedists' claim that the two services compete for patients.

No abstract available.
Bacteremia ; Brachyspira ; Humans ; Intestinal Perforation ; Peritonitis