We present here an interesting case of anorexia nervosa that was well controlled by Ancyu-san, a traditional Japanese herbal medicine. A 17-year-old student was re-admitted to our department in December of 1990, because of anorexia and eating disorders. She had lost approximately 12kg body weight during 3 months. She was 154cm tall and weighed 26kg. Her blood pressure was 75/40mmHg, her pulse rate was 30beats/min, and her body temparature was 34.4°C. She was extremely emaciated and hyperactive. On oriental examination, a shallow complexion, a cold feeling in the limbs, postprandial headaches, and a feeling of obstruction of the external ear. Her pulse was slow and feeble. Abdominal examination revealed that the abdominal strength was reduced to 2/5 with Inai-teisui (abdominal water and gas retention). Based on these findings, this case was diagnosed as Deficient Spleen and Stomach due to Deficient Ki and Blood combined with Stagnated Ki, and therefore a candidate for the Kampo formula Ancyu-san. The patient began medication in January 1991. Her appetite improved gradually and her body weight increased from 26kg to 47kg in two months.

Silicate compounds are added as extenders to dusts, flow dusts (FDs) and wettable powders, meaning that it can be predicted to contain free silica, which in turn affects the incidence of pneumoconiosis. The percentage of free silica content was measured by X-ray diffraction in 18 pesticides consisting of 3 types of dusts, 4 types of FDs and 11 types of wettable powders. As a results, free silica was identified in 14 of pesticides as follows: 22-34% in dusts, 3-11% in FDs and less than 1% to 20% in wettable powders. The percentages contained in the FDs were lower than in the dusts, probably because crystal structures became amorphous during the processing of FDs into super fine gradules with a mean particule size of 2μm.
The levels of dust exposure during spraying were measured with respect to Sumithion dust, Morestan FD and TPN FD by classifying them into respirable dust of less than 7.07μm in aerodynamic diameter (which is liable to be deposited in the lung) and total dust. When the concentration of a dust to which sprayers were exposed was compared with the TLV established taking into free silica content based on recommendation of the Japan Association of Industrial Health, the dust spray levels were 75-fold in the case of respirable dust and 53-fold for total dust, those for the spraying of FDs were 7-fold for respirable dust and 3-fold for total dust.
These results suggest the necessity of using pesticides with low free silica content. It is also considered necessary for sprayers to wear dust respirators.

Evaluation of the physical fitness level of children and adolescents must include consideration of individual growth rates. This study evaluates the relationship between height and physical fitness in a large sample of 6-17 yr students. Physical fitness test scores were calculated for every 1 cm height group and used to generate quadratic regression equations. Physical fitness data reported by the Ministry of Education, Culture, Sports, Science and Technology in Japan (MEXT) were compared with estimated values obtained using our regression equations. The differences between the values reported by MEXT and our estimated values were very small. Comparison of physical fitness T-scores calculated based on school grade averages with T-scores based on means calculated using our regression equations indicated that shorter height students had lower T-scores if school grade averages were used for the calculation. In conclusion, in elementary and junior high school students, it is important to evaluate physical fitness level relative to individual physical growth.

Horseshoe kidney is an unusual abnormality occurring in 0.25% of the population. In surgery for AAA with horseshoe kidney, reconstruction of aberrant renal and preservation of renal isthmus is important. We report 3 cases of AAA with horseshoe kidney treated successfully without division of the isthmus.

Background: Rotavirus vaccines were introduced in Japan in November 2011. We evaluated the subsequent reduction of the health-care burden of rotavirus gastroenteritis. Methods: We conducted active surveillance for rotavirus gastroenteritis among children under 5 years old before and after the vaccine introduction. We surveyed hospitalization rates for rotavirus gastroenteritis in children in Tsu City, Mie Prefecture, Japan, from 2007 to 2015 and surveyed the number of outpatient visits at a Tsu City clinic from 2010 to 2015. Stool samples were obtained for rotavirus testing and genotype investigation. We assessed rotavirus vaccine coverage for infants living in Tsu City. Results: In the pre-vaccine years (2007-2011), hospitalization rates for rotavirus gastroenteritis in children under 5 years old were 5.5, 4.3, 3.1 and 3.9 cases per 1000 person-years, respectively. In the post-vaccine years (2011-2015), the rates were 3.0, 3.5, 0.8 and 0.6 cases per 1000 person-years, respectively. The hospitalization rate decreased significantly in the 2013-2014 and 2014-2015 seasons compared to the average of the seasons before vaccine introduction (p < 0.0001). In one pre-vaccine year (2010-2011), the number of outpatient visits due to the rotavirus infection was 66. In the post-vaccine years (2011-2015), the numbers for each season was 23, 23, 7 and 5, respectively. The most dominant rotavirus genotype shifted from G3P[8] to G1P[8] and to G2P[4]. The coverage of one dose of rotavirus vaccine in Tsu City was 56.5% in 2014. Conclusion: After the vaccine introduction, the hospitalization rates and outpatient visits for rotavirus gastroenteritis greatly decreased.

Measurement of bone mass (BM), especially in the lumbar vertebrae, is very important for diagnosis of osteoporosis. In this study, we compared BM values measured by computed X-ray densitometry (CXD) with those by quantitative computed tomography (QCT), and discussed differences between the two methods.
The subjects were 90 women and 3 men, aged 42-86 years, who visited our outpatient department of osteoporosis. Metacarpal bone density (ΣGS/D) and metacarpal index (MCI) in the second metacarpal bone were measured by CXD. QCT was uesd for measurement of bone mineral density (BMD) in the lumbar trabecular bone, where pronounced osteoporotic changes occur early. The mineral values of L3 were expressed as mineral equivalent of CaCO³ in mg/ cm³, and≤75 mg/cm³ of L3 values were judged to be loss of lumbar BMD.
There were negative correlations between age and ΣGS/D, MCI or L3 value, and positive correlations were found between ΣGS/D or MCI and L3 value. Based on the above criterion of lumbar BMD loss, sensitivity and specificity of ΣGS/D for lumbar bone loss were examined. If ΣGS /D of 2.30 (T score -2.7) was used as the cut-off point, the sensitivity was 69.8% and the specificity was 75.0%, and if ΣGS/D of 2.37 (T score -2.3) and 2.40 (T score -2.1) were employed, the sensitivity was 79.1% and 79.1%, while the specificity was 64.5% and 62.5%, respectively. We concluded that BM values of cortical bone and trabecular bone decrease with age, and that sensitivity and specificity of GS/D for diagnosis of lumbar BMD loss are not very high.

With the aim of investigating the effect of drop in blood pressure of the Zusanli (ST36), a multi-center randomized controlled trial was conducted with the envelope method. Patients showing the high blood pressure condition were divided into 2 of the group treated with use of the Zusanli point and the group with non-use of Zusanli point.Changes in blood pressure were then measured.The present results show no significant difference was seen between the 2 groups, thus did not find the Zusanli point to be effective.