Recently we treated two patients with Toki-shigyaku-ka-goshuyu-shokyo-to-ka-uzu decocted with 400ml of water and 400ml of rice wine SAKE for 60 minutes.
Case 1 was a 46-year-old female patient. Feelings of coldness prevented her from sleeping, and she could not get to sleep without warming up the room and heating her arms with a dryer. After boiling Toki-shigyaku-ka-goshuyu-shokyo-to-ka-uzu with sake, she was able to sleep well.
Case 2 was a 65-year-old male patient who had been suffering from polyarthralgia, low back pain and feelings of coldness. After taking Toki-shigyaku-ka-goshuyu-shokyo-to-ka-uzu boiled with sake, he felt numbness around the lips and limbs, although the amount of aconiti tuber was not changed.
It is believed that SAKE heats and enhances Yang-Ki in Kampo formulas. These characteristics are the same as those produced by aconiti tuber. At first, we suspected that aconiti tuber and alcohol combined synergistically and could therefore give rise to occurrences of aconiti poisoning. But ethanol, in amounts comparable to the alcohol content in sake, did not create this effect. The effect was dependent on the sake itself rather than the alcohol.

Undergraduate medical students in their 5th year were given integrated lectures on two topics, “ The cerebellum ” and “Patient -centered medical care”. The results of a questionaire survey indicated that students had hoped for continuation and expansion of the lectures to include many other topics. A series of discussions among faculty however, disclosed two problems with regard to continuation and expansion, i. e., a lack of experts for integration and lack of adequate means to assess educational impact. Teaching personnel in integrated lectures need not necessarily be experts or professors, but persons who can be in close contact with one another for the purpose of integration. Setting aside rigid discussions on validity, small achievement tests may be useful in assessing the degree of student comprehension.

A 76-year-old man who suffered from consistent back pain was admitted for anti-hypertensive therapy to strictly manage the early thrombosed acute type A aortic dissection (AAAD). On admission, his blood pressure could not be controlled well ; soon he complained of recurrent severe back pain. The second thoracoabdominal enhanced computed tomography revealed the progression of AAAD from DeBakey type II to type I with thrombosed pseudolumen at the descending thoracic aorta ; therefore, emergent surgical intervention by primary central repair was conducted. Paraplegia was diagnosed eight hours after surgery, then cerebrospinal fluid drainage and intravenous administration of Naloxone were started immediately followed by keeping the systemic blood pressure more than 120 mmHg. However, paraplegia had never improved and been persistent with neurological deficit of the lower extremities. We herein report a complicated surgical case of an AAAD patient with paraplegia and review the complex clinical settings.

No abstract available.
Centrifugation ; Weightlessness

A nationwide survey of Japanese teachers belonging to departments of medicine was conducted to investigate their opinions about: 1) expanding medical departments into medical schools and, 2) the required subjects and selection criteria for admitting students to the faculty of medicine. We found that responses to both questions depended largely on the specialty of the teachers. With regard to the medical school design, which will cause a dramatic change in medical education in Japan, 60% of the teachers were in favor of expanding departments into medical schools.

BACKGROUND: The number of adults aged over 65 years is rapidly increasing in several Southeast Asian countries. Muscle mass decreases with age, leading to sarcopenia. The primary objective of this study was to determine whether differences exist in the body composition and physical strength, according to ethnicity, among community-dwelling Japanese and Thai older adults living in Chiang Mai Province, Thailand. METHODS: A survey was conducted in February and March 2019. Japanese and Thai adults aged ≥ 60 years living in Chiang Mai Province were recruited through community clubs. Participants completed a self-administered questionnaire that enabled collection of data on age, sex, educational background, marital status, annual income, current medical conditions, smoking and alcohol consumption, and exercise habits. Measurements were collected on height, weight, body composition, blood pressure, hand grip, and walking speed for 6 m. Body composition was measured using a standing-posture 8-electrode multifrequency bioimpedance analysis analyzer. Hand grip of each hand was measured with the patient in the standing position using a digital grip dynamometer. Multivariable logistic regression was used to determine factors associated with skeletal muscle mass index (SMI). RESULTS: Of the total 119 participants, 47 were Japanese (26 men, 21 women) and 72 were Thai (16 men, 56 women). The prevalence of a low SMI was 3/26 (12%), 1/21 (5%), 6/16 (38%), and 5/56 (9%) among Japanese men, Japanese women, Thai men, and Thai women, respectively. The prevalence of low muscle strength was 2/26 (8%), 2/21 (10%), 3/16 (19%), and 13/56 (23%) among Japanese men, Japanese women, Thai men, and Thai women, respectively. There were significant differences between ethnic groups in body mass index for both sexes, percentage body fat in women, SMI in men, and average grip strength in men. Ethnic group, sex, age, and body mass index were independent predictors of SMI. CONCLUSIONS Ethnicity had a clinically important effect on body composition and physical strength among older Japanese and Thai adults living in a similar environment.
Aged ; Aging/physiology* ; Asians/ethnology* ; Body Composition ; Body Mass Index ; Cross-Sectional Studies ; Electric Impedance ; Ethnicity ; Female ; Hand Strength ; Humans ; Independent Living ; Male ; Middle Aged ; Muscle Strength ; Thailand/ethnology* ; Walking Speed