Twister orthoses are used to correct in-toeing and out-toeing, and consist of a pelvic band, a twister cable, and an ankle-foot orthosis (AFO). The twister cable is made of spiral coiled springs and connects the pelvic band with the AFO. Twister orthoses are used for children with lower limb paralysis who in many cases present with a rotation deformity of the hip joint ; however, their use in adults has not yet been reported. We report our experience treating two cases of adult poststroke hemiplegic patients whose gate ability was improved by using twister orthoses.

A 47-year-old man underwent a double-valve replacement involving aortic valve replacement (AVR) and mitral valve replacement (MVR) and Re-Re-DVR 6 and 8 months, respectively, after an initial DVR because of suspected prosthetic valve endocarditis. Detachment of the prosthetic mitral valve occurred during the early postoperative period, for which the patient again underwent treatment 15 and 21 months after the initial surgery. The operative findings showed that the detachment was caused by a wide cleavage of the aortic-mitral continuity. There were bacteria detected on a blood culture, and his C-reactive protein (CRP) level did not reduce at any time. On the basis of these findings, we suspected nonrheumatic inflammatory disease and started steroid therapy. His CRP level became negative, and further prosthetic mitral valve detachment did not recur.

The purpose of this study was to verify the concept of Kampo medicine epidemiologically and demonstrate the objective bases of the Kampo treatment. For this purpose, a population based survey of subjective symptoms based on Kampo medicine was conducted among 1,486 residents of Hase village, Nagano prefecture, ages 20 and older. The completion rate was 80.7% and 1,199 residents provided favorable responses. An investigation of gender differences showed a higher rate of blood deficiency among female residents, while spleen and qi deficiency were more common in males. Considering age differences, symptoms related to blood deficiency and water-dampness affected younger females, symptoms related to qi deficiency primarily affected younger males, and symptoms of liver afflictions were common in younger both genders. Among the elderly residents, symptoms of kidney deficiency were overwhelmingly predominant in both genders. Though younger people with subjective sense of health had few diseases in western medicine, most of the elderly with perceived health actually had some kind of diseases for medical treatment. Physical symptoms in the chest area such as shortness of breath correlated positively with the perception not to be healthy, and these may be regarded as both the manifestation and factors contributing to ill health. Approximately 1 out of 12 residents reported currently receiving the treatment of oriental medicine or demonstrated the potential to benefit from such intervention. These results may clinically be useful as the objective bases to perform the Kampo treatment.