Objective: We aimed to characterize patterns of use of complementary and alternative (CAM) therapies on patients with intractable neurodegenerative diseases and their caregivers.
Methods: We sent questionnaires to 1,406 patients with subacute myelo-optico-neuropathy (SMON), amyotorophic lateral sclerosis (ALS), Parkinson’s disease (PD), Parkinson related disease, or spino-cerebellar degeneration (SCD). We also send questionnaires to the 1,406 caregivers of these patients. The participants were asked to answer questions about current use of Annma/Massage/Shiatu, acupuncture, Zyudoseifuku, Chinese medicine or Supplementary food. Other questions including reasons for the use, subjective effectiveness of the CAM and subjective wellness were also asked.
Results: 33.7% of patients and 30% of caregivers responded to the questionnaires. Anna/Massage/Shiatu and Chinese medicine were most frequently used by patients (60.8%), and 51.3% of them answered that these therapies were effective. The caregiver’s response showed supplementary food and Anna/Massage/Shiatu were most frequently used (42.5%), and 35.9% of them answered that these were effective.
Conclusion: The present study showed that use of CAM was 20.5% in patients with intractable neurodegenerative diseases and 9.8% among caregivers when calculated using collection rates. Annma/Massage/Shiatu was most frequently used and was regarded effective on subjective wellness both in the patients and caregivers.

Re-do open cardiac surgery may sometimes require complete ablation around the pericardium for the 2 major reasons of attaining better myocardial protection and obtaining effective DC cardioversion. However, this ablation may increase postoperative hemorrhage which may require blood transfusion. Hypothermia is based on the concept of myocardial protection during open heart surgery by suppressing myocardial metabolism, but recently the approach has been changed to maintaining myocardial metabolism with aerobic or anaerobic energy production. We have already reported that histidine-buffered cardioplegia which promote anaerobic glycolysis, provided an excellent functional recovery of myocardium post-ischemia with lower inotropic requirements in a range from 10°C to 37°C of myocardial temperature. Based on our theoretical background and clinical data, we tested the efficacy of this type of cardioplegia in patients receiving multiple surgical procedures with minimum ablation after sternotomy. First case, who had undergone a Bentall procedure for annulo-aortic ectasia 14 years previously had a thrombotic valve and mitral regurgitation. Aortic valve plasty and mitral valve replacement (MVR) was performed. The second case who had undergone MVR 15 years previously had malfunction of the prosthetic valve and underwent re-MVR. The third and fourth cases had ventricular septal defect (VSD) which were closed using Teflon patches. The third case had patch closure during second operation for residual shunt. The fourth case received tricuspid valve replacement (TVR) for tricuspid regurgitation due to a pacemaker lead implanted into the right ventricle through the left subclavian vein. The fifth case received coronary artery bypass surgery in a second operation for restenosis of the graft and progressing atherosclerosis. All hearts started beating spontaneously without DC cardioversion after the aortic unclamp. Ventricular fibrillation occurred in the first case while the patient was weaned from cardiopulmonary bypass and treatment was performed by aortic cross clamp, infusion of the cardioplegia followed by aortic unclamp to start own beat again. Two of 3 patients who were able to donate their own blood preoperatively did not require homologous blood transfusion. Due to advantages such as excellent myocardial protection under hypothermic or normothermic condition, ease of use and relatively lower potassium concentration, histidine-buffered cardioplegia can be an excellent candidate for myocardial protection in re-do cases with less ablation technique.