Introduction:
The mechanism of moxa-needle therapy is unknown to us in spite of its significant effect. We observed variations in the temperature of the moxa-needle and that of the microwave-applied needle.
Method:
Chinese needles of the said two types were inserted into meat specimens (3×3×2cm) nd a house rabbit to the depth of 1.0cm and 1.5cm, respectively, and temperature was taken by a thermister around the needles at the depth of 15, 10, 5, and 1.0mm, respectively.
Effect:
1. In the moxa-needle, the temperature went up mainly at the top surface of the specimen or the surface of rabbit skin.
2. In the microwave-applied needle, from the beginning the temperature increased and as it plateaued, the heat was transmitted to the needle tip.
3. Typical temperature curve of the rabbit was found rather flat as compared with the same of meat specimen.
Conclusion:
1. In the moxa-needle, a rise in the temperature was limited under the subcutaneous area, it was not transmitted to the acupoint.
2. In the microwave-applied needle, it elevated the temperature around the needel; therefore, we believe that it stimulated the acupoint greatly.
3. In the light of the foregoing observations, it may be concluded that the microwave-assisted acupuncture would be significantly useful.

The purpose of this study was to determine sway characteristics of a supported leg during a lateral stepping over obstacle task with different obstacle height and movement patterns, using a small triaxial accelerometer. We examined 20 healthy young adults to assess their trochanter malleolar distance traveled during a lateral stepping over obstacle task with obstacle heights of 30%, 50%, and 70%. The lateral stepping over tasks revealed flexion and extension patterns. We directed the subjects to grasp a forward handrail, perform the lateral step, and subsequently step over to the side. We calculated synthetic acceleration (SA) from acceleration data measured using two small triaxial accelerometers and two web cameras. We calculated supporting leg sway; RMS phases of X-, Y-, and Z-axes; and SA data. The subjects showed increased RMS of Y-axis and SA according to the obstacle height for the flexion pattern; however, they did not show change in RMS of Y-axis and SA according to the obstacle height for the extension pattern. During lateral stepping over, the RMS of Y-axis and SA for the flexion pattern were higher than for the extension pattern. The findings for the flexion pattern suggest that the center of gravity shifts higher according to increased obstacle height; consequently, the supporting leg becomes unstable. The findings for the extension pattern suggest that the “screw-home” rotation effect of the supporting leg during movement can support lateral stepping over better than the flexion pattern.

We describe three cases of calf cramps successfully treated with shimbuto. Case 1 was a 74-year-old female who suffered from calf cramps and knee pain caused by gonarthrosis. She was treated with boiohito, but did not respond. When she complained of diarrhea, shimbuto was substituted for boiohito. After taking shimbuto, her knee pain improved, and her cramps disappeared. Case 2 was a 77-year-old female who suffered from leg edema and calf cramps. Tokishakuyakusan was prescribed, but she complained of an upset stomach. Tokishakuyakusan was replaced with shimbuto, and her cramps improved together with a decrease in the coldness and edema in her legs. Case 3 was a 79-year-old female who took kososan for uneasiness and restlessness after the death of her husband. She had edema and coldness in her legs, and suffered from calf cramps during the daytime and early in the morning. Shimbuto was added to kososan, and her coldness improved ; subsequently the leg edema diminished, and finally her cramps disappeared.
These cases suggest that shimbuto is indicated for patients with calf cramps, who report internal coldness caused by kidney deficiency with gastrointestinal dysfunction.

In Kampo, respiratory symptoms are treated with prescriptions related not only to “lung”, but also other parenchymatous viscera. We report 2 patients whose stress-induced chronic cough was ameliorated by hachimijiogan. Case 1 was a 25-year-old female who was working under stressful circumstances at her company and reported an oppressive feeling in the chest. She was initially prescribed hangekobokuto because of a feeling that something was stuck in the pit of her stomach on abdominal examination, but her cough did not get better. As she also noted a dull feeling in her back ; she was switched to hachimigan, and her cough disappeared. Case 2 was 42-year-old female who suffered from depression, sore throat and an obstructive feeling in the throat ; she had been receiving infertility treatment for several years. Hangekobokuto and bakumondoto showed insufficient effect on her persistent cough. Her coughing stopped when she was prescribed hachimigan for back pain. Neither of these patients showed lack of resistance of the lower abdomen on abdominal examination.
Chronic ki (qi) stagnation under stressful conditions may cause ki deficiency, especially kidney deficiency. The symptom of stress-induced cough in our cases was considered to be due to kidney deficiency, and therefore hachimijiogan, but not hangekobokuto, was effective. The short duration of the complaints and relatively young age (20-40's) of the patients may account for the absence of the typical abdominal sign of kidney deficiency. Back stiffness and pain may also be important signs for cough due to kidney deficiency.

We performed cardiac resynchronization therapy (CRT) in addition to coronary artery bypass grafting (CABG), mitral valve replacement (MVR) and tricuspid valve annuloplasty (TAP) in a 72-year-old patient with poor cardiac function (New York Heart Association functional class III, ejection fraction 38%), triple coronary vessel disease, and mitral and tricuspid valve insufficiency after three-area old myocardial infarction. Electrocardiography showed no change in the QRS interval after CRT. However, tissue Doppler echocardiography showed synchronicity of the septum and posterior segments in the left ventricle, and that contraction of the septum was in the systolic phase of the cardiac cycle after CRT. New York Heart Association functional class improved from III to I after the operation. CRT of the dyssynchronized myocardium in which ischemia and volume overload were improved by CABG, MVR and TAP may improve regional cardiac function and synchronicity.

In Japan problems of the pediatric emergency-care system have recently increased the needs of consultation to deal with the growing anxiety of parents about how to raise their children and have decreased the number of pediatricians. We believe that one solution is to make pediatric primary care a required part of postgraduate clinical training and thereby increase the ability of nonpediatricians to provide pediatric primary care and to support the care of children. We hope that postgraduate clinical training programs will be reformed so that physicians of all departments can contribute to improving pediatric primary care.

We investigated the relationship between the electrical and the mechanical responses of the frog sartorius in situ in isometric reflex contraction. All the thigh muscles other than the sartorius were dennervated. Mechanical stimulations were applied mainly on the dorsal skin of the ipsilateral foot. The electrical response led from the surface electrode was integrated by means of the Miller integrator. The mechanical response was recorded by the mechano-electric transducer, and its impulse was measured by the planimeter.
A very high positive correlation was found between the integrated value of the EMG and the mechanical impulse. It was found that the quantitative measurement of the electrical response of the muscle could be made in more accurate and efficient way by the Miller integrator than the other methods discussed in this paper.

This report deals with the response of heart rate, blood pressure and respiratory rate when the subjects of different ages and sexes worked on a bicycle ergometer. The subjects were 126 healthy persons of both sexes. They consisted of 8 groups : prepuberty male (N=15) and female (N=16), puberty male (N=20) and female (N=18), young adult male (N=15) and female (N=16), middle aged male (N=17) and female (N=9) . All subjects tried pedalling exercise with 3 kinds of loads, i.e., 5kgm/kg/min, 10kgm/kg/min and 12.5 kgm/kg/min for 6 minutes.
Heart rate was calculated from chest lead ECG and respiratory rate was measured by the thermistor method continuously recorded before, during and after exercise. Blood pressure was measured by Riva Rocci sphygmomanometer before exercise, at the early stage of recovery and in 10 minutes after exercise.
The results of this study are summarized as follows
1) In both sexes the heart rate decreased with age in resting status and exponentially increased during moderate and heavier exercise. A linear relationship was found between the work load and the exercise heart rate.
In males the heart rate during light exercise was high in the prepuberty and the puberty, low in the young adult and the middle aged. But the heart rate during heavy exercise in the middle aged was extremely high. The heart rate in females was higher than that in males when the same work load was given in both sexes. The rising phase of heart rate in prepuberty was the earliest of 4 age groups.
2) The systolic blood pressure and the pulse pressure in resting status increased with age. As for the blood pressure during exercise, it was low in the youth and high in the middle aged. The blood pressure after exercise in the middle aged males was the highest of 4 groups. Generally in all females the systolic blood pressure and the pulse pressure increased with work load, but the former levelled off during heavy exercise.
3) The respiratory rate during exercise increased rapidly, but when the exercise was stopped, the increased respiratory rate returned rapidly to the resting level. As for the respiratory rate, in both sexes it decreased with age from the prepuberty to the middle aged in resting status and during exercise. The sex difference of the respiratory rate during heavy exercise was large.
4) In the youth the correlation coefficient between the heart rate and the blood pressure was high. Therefore, it was suggested that the heart rate was important in adaptation to exercise.

Objective: In Japan, beta 2 agonist (BA) has an indication for acute bronchitis with airway obstruction. To investigate BA prescribing practices for children whose diagnosis were acute bronchitis without asthma in Japan, a database study and interviews with pediatricians were conducted.
Design: Database study
Methods: We conducted a database study. Using the Japan Medical Data Center database, medical receipts of about 100,000 children younger than 18 years old were obtained between 2005 and 2008. First we identified all the new incidences (362,287 cases) of upper respiratory tract infection, influenza, or acute bronchitis. Outcome measure was prescription of BA within 21 days of the incidence. We calculated the prescription proportions of BA for the asthma group (41,064 cases) and the non-asthma group (321,223 cases). We then interviewed 10 pediatricians to elucidate the reason why they prescribe BA for patients.
Results: The proportion of children prescribed BA at least once a year in 3-5 years old was 49.9 %. Among 3-5 year olds with acute bronchitis, the BA prescription proportions in the asthma group (58.6%) was nearly as high as that in the non-asthma group (56.6%). Although BA prescription proportions in the asthma group decreased annually with the exception of 0-2 years old, those in the non-asthma group remain unchanged. Based on the interview study, we found interpretations of airway obstruction for acute bronchitis without asthma were broadly-divided into 2 types: the effect of inducing bronchospasm and the effect of producing large amounts of secretions in the airways.
Conclusion: In this study, it was revealed that pediatric patients with acute bronchitis were commonly prescribed BA in Japan. To promote an appropriate use of BA, prescriptions of BA to non-asthma pediatric patients should be carefully watched. (Jpn J Pharmacoepidemiol 2012; 17(1): 1-12)

A 70-year-old man with dextrocardia with situs inversus, presented to our hospital complaining of chest pain. ECG showed ST elevations in leads II, III and _aV_f , and ST depressions in leads V3 through V6. Blood tests showed creatinine kinase elevation. He underwent coronary angiography, which revealed obstruction of the anatomical right coronary artery and we diagnosed acute inferior myocardial infarction. However, the anatomical left coronary artery was not clearly identifiable because of its anomalous origin. He was transferred to our intensive care unit and intra-aortic balloon pumping was initiated. Coronary 3D-CT was then performed to obtain an anatomical overview of the coronary artery system. This enabled a second coronary angiography which showed obstruction of the left anterior descending artery and stenosis of the left main trunk in the first diagonal branch and the ramus intermedius branch. Coronary artery bypass grafting surgery (CABG) was indicated. He underwent conventional quintuple CABG using the right internal thoracic artery and saphenous vein grafts. Preoperatively we made digital mirror images of the original coronary angiographic images to clarify his coronary artery anatomy. During surgery, the main surgeon continuously stood on the patient's left side except when opening and closing the chest, which enabled us to perform CABG. The postoperative course was uneventful. CABG in a patient with situs inversus totalis is very rare. We present this case with a review of the relevant literature.