[Objective]Esthesia and algesthia quantitative analyzers (PainVision®) are instruments that enables us to objectively assess the pain intensity. By applying an electrical current we can measure the intensity of pre-existing pain (pain equivalent current) and the minimum electrical stimulation that can be sensed by the patient (minimum perceptible current). In this study, we used PainVision®to evaluate the effectiveness of acupuncture treatment in patients with chronic pain and compared pain-related parameters with the Visual analogue scale (VAS).
[Methods]Twenty-three patients (4 males, 19 females;median age of 68) with chronic pain were studied. Pain degree was evaluated by the following equation;
Pain degree = 100 x (pain equivalent current -minimum perceptible current)/minimum perceptible current.
Pain degree was compared with VAS at pre-and post-acupuncture treatment.
[Results]VAS, pain degree and pain equivalent current by PainVision®decreased significantly after acupuncture treatment (p < 0.0001, p < 0.0001 and p < 0.01, respectively). Minimum perceptible current did not change significantly (p > 0.05). Pain degree and VAS had relatively high correlation coefficients at pre-and post-treatment (r = 0.52, p < 0.05 and 0.47, p < 0.05;respectively). Changes in VAS and pain degree agreed in 87%of the cases.
[Conclusions]PainVision®is a useful tool to assess pain intensity objectively, and parameters derived from it correlated well with VAS. In patients with chronic pain, acupuncture treatment can be evaluated by PainVision®.

Background : There has been no ideal valve prosthesis for children from the point of view of thromboembolism and size mismatch, and the surgical repair of native mitral valve has always been our first priority in children. However, valve replacement becomes the inevitable surgical option if repair is impossible. The purpose of this study was to assess the long-term results of mitral valvuloplasty (MVP) and mitral valve replacement (MVR) for isolated mitral valve diseases in children under 15 years old. Patients and Methods : From 1981 to 2010, 30 patients underwent a total of MVPs (P group) and 26 consecutive patients underwent a total of MVRs (R group). The median age was 4.6 years (4 months to 16 years) in group P and 6.2 years (4 months to 13.7 years) in group R, and the median body weight was 13.4 kg (6 to 35.5 kg) in group P and 16.4 kg (4.8 to 50.7 kg) in group R. The etiology was congenital in 55 (98%) patients, and due to endocarditis in 1 (2%) patient. Isolated mitral regurgitation was present in 41 (73%) patients (group iMR), and isolated mitral stenosis was present in 15 (27%) patients (group iMS). Mechanical valves (bileaflet disc, n=26) were used in all initial MVR patients. Results : Overall hospital mortality was 0%. The median follow-up time was 9.3±7.8 years (4 months to 27.7 years). There were 6 reoperations in P group and 5 explants due to size mismatch in R group with patient growth, and no explant due to structural valve deterioration. Survival rates at 10 years were 100% in the P group and 88.0% in the R group, and there was a significant difference (p=0.043). Freedom from reoperation at 10 years was 77.6% in P group and 77.0% in R group. Freedom rate from cerebral events at 10 years were 100% in both groups, respectively, and there were no significant differences. Survival rates at 10 years were 100% in the iMR group and 53.3% in the iMS group, respectively, and there was a significant difference between the groups (p<0.001). Freedom rates from reoperation at 10 years were 77.1% in the iMR group and 64.3% in the iMS group, respectively, there being no significant difference. Conclusions : The long-term results of pediatric mitral surgery were acceptable. Mitral valvuloplasty for patients with isolated mitral regurgitation were excellent. Mitral valve replacement can be performed with low initial mortality but should be reserved for medical and reconstruction failure because reoperation and late mortality are high, particularly for patients with isolated mitral stenosis.

Background: Complementary medicine and alternative medicine have been included in the curricula of many medical schools and colleges; however, teaching methods have not been standardized. We gave lectures and practical instruction on acupuncture and moxibustion medicine to medical students during their clinical clerkship in anesthesiology. We used a questionnaire to evaluate the usefulness of small-group teaching.
Methods: The subjects were 93 fifth-year medical students doing clinical clerkships in anesthesiology. The clinical clerkship consists of small-group learning with 2 or 3 students per group. After a lecture and practical instruction on acupuncture and moxibustion were given, students were asked to fill out a questionnaire about their interest in and basic knowledge of acupuncture and moxibustion and whether they would like to master the technique.
Results: All 93 students answered the questionnaire （response rate, 100%）. After the small-group teaching, students became more interested in acupuncture and moxibustion and learned that the costs of treatment were covered by health insurance. Most students were interested mastering acupuncture and moxibustion in the future.
Discussion: Our results suggest that lectures and practical instruction during clinical clerkship are useful for getting medical students interested in acupuncture and moxibustion medicine.

Objective: When responding to questions regarding drug-drug interaction by the medical staff of our hospital, pharmacists previously collected information using some drug databases from Japan and the United States.  The aim of this study was to construct a search system for interaction information using drug databases from both Japan and the United States for streamlining questions and answers regarding drug-drug interaction.
Methods: Using the drug databases from Japan and the United States, we collected information on the interaction pertaining to drugs prescribed at Kobe University Hospital.  This information was further assessed for consistency.  Furthermore, we constructed an original search system for interaction information for streamlining questions and answers regarding drug-drug interaction.
Results: The difference between information obtained from the databases from Japan and the United States was apparent.  Thus, we concluded that it was necessary to obtain interaction information via a database search that included information from both the countries.  Therefore, our original interaction search system was reconstructed with interaction information collected using databases from both the countries.  We compared the response to questions regarding the previous and present methods using our original search system for interaction information; the time required to obtain the responses was 5.89 and 3.09 min, respectively, and it took lesser time for providing responses than the previous method.
Conclusion: We evaluated the usefulness of the original search system for interaction information.  We found that the original system provides a more rapid response to questions compared with the previous method.  We are considering a further upgrade and update for the original system by adding information on drugs not prescribed by our hospital.