There have been few studies of the relationship between respiratory function, chest x-rays, electrocardiograms, and the abdominal palpation signs of Kampo medicine. This investigation was designed to elucidate the above points with 489 subjects who had undergone a full physical examination. As a result of this study, we make clear the following features:
1. Abdominal tension (traditionally referred to as “fukuryoku”) was related to vital capacity, lateral distance of the thorax, CTR, counter-clockwised axis deviation of QRS, and negatively related to the intra-vertical thoracic distance.
2. Sound of gurgling fluid in the abdomen (“Shinsuion”) was related to intravertical distance of the thorax, clockwise axis deviation of QRS, negatively related to the lateral distance of the thorax, width of the heart and CTR.
3. Tonus of the rectus abdominis muscles was related to vital capacity and intravertical distance of the thorax and negatively related to the lateral distance of the thorax.
4. Palpitation of the abdominal aorta (traditionally called “Shinkaki”, “seijouki”, and “saikaki”) revealed nega tive correlation to the lateral distance of the thorax and width of the heart.
5. Resistance or tenderness upon pressure in the epigastric resion (“shinkahiko”) was negatively related to the intrathoracic distance.
6. Resistance resembling a string of pearls in the midline of the lower abdomen (“seichushin”) was related to intravertical distance of the thorax, clockwise axis deviation of QRS, and negatively related to SV 1 electro cardiogram voltage.

There have been few studies on the relationship between the body mass index (BMI), complete blood cell count, blood chemistry, fatty liver evidence and Kampo abdominal palpation signs. This study was designed to clarify the above points. It involved 484 subjects who had undergone full physical examinations. The results of this study, can be summarized as follows:
1. Abdominal tension (traditionally referred to as “fukuryoku”) was related to BMI (males and females), TG, TCh/HDL, GPT, RBC, Hb and evidence of fatty liver (males) and corresponded negatively with HDL (males).
2. Tonus of the rectus abdominis muscle (“fukuhikokyu”) was negatively related to BMI (males).
3. The sound of gurgling liquid in the stomach (“shinsuion”) was negatively related to BMI (males and females).
4. Palpitations of the abdominal aorta in the upper abdomen (“shinkaki”) was related toHDL (males) and negatively related to BMI (males and females).
5. Palpitation of the abdominal aorta below the navel (“saikaki”) was negatively related to BMI (males).

Four intractable decubitus ulcer patients who had not responded to any Western medicine were treated effectively with Kigi-kenchu-to-ka-bushi. Case 1 was a 82-year-old female patient who had been admitted due to multiple-cerebral infarction. She had been bedridden and suffered repeatedly from pressure ulcers. Her bed sores were controlled successfully with Kigi-kenchu-to-ka-bushi. After treatment by Kigi-kenchu to-ka-bushi, any decubitus ulcer was not recurrence. Case 2 was a 85-year-old female patient. The pressure ulcer was 2cm in diameter and extent of soft tissue fissure underlying it was about 10cm in diameter. Skin color around pressure sore changed to purple. After administration of Kigi-kenchu-to-ka-bushi, skin color returned to normal and decubitus ulcer recovered. Case 3 was a 59-year-old male patient who had undergone operation on an intractable decubitus ulcer with fistula, but he did not get well. Two weeks later, after treatment with Kigi-kenchu-to-ka-bushi, he felt pain when we sterilized his ulcer. It was thought to be a sign of improvement of the wound. Physical status became better as the ulcer healed. Case 4 was a 64-year-old female patient with brain death because of acute myocardial infarction. Her pressure ulcer was treated effectively with Kigi-kenchu-to-ka-bushi, too.

We report three cases with somatoform disorder which were considered as “Hontonki” disease, successfully treated with keishikakeito. Case1 was a 34-year old male who was suffering from headache and palpitation. He said ‘Something pierces and it goes up from the chest to the head.' We considered his complaint as Hontonki disease and administered keishikakeito. After one week, the headache disappeared and four weeks later, palpitation and tinnitus were definitely improved. Case2 was a 22-year old male. His complaints were excessive strain and general fatigue. Because he had coldness of lower extremities and spasmodic headache, we interpreted these symptoms Hontonki disease and administered keishikakeito. After that these symptoms and his psychological test scores improved markedly. Case 3 was a 75-year old female. Severe headache and palpitations presented after remodeling her home. Three weeks later taking keishikakeito, her symptoms had disappeared dramatically. Recently, Hontonki disease are often compared with panic disorder, and it is possible that some somatoform disorder cases include Hontonki disease. It is important to consider the possibility of Hontonki disease behind the physical complaints such as headache and palpitation, when we use keishikakeito.

An in vitro infection system of Trypanosoma cruzi and HeLa cells was used to measure the anti-T. cruzi activities of various calcium antagonists classified into dihydropyridines, diphenylalkylamines, and benzothiazepines and of allopurinol and benznidazole as medium and highly effective reference compounds, respectively. Six dihydropyridines (10 μM each), i. e. nifedipine, nicardipine, nimodipine, nisoldipine, nitrendipine, and amlodipine, decreased the rates of infection of HeLa cells from 11.7% (control) to 5.8, 0.9, 1.2, 3.6, 5.9, and 1.7%, respectively. Nicardipine and amlodipine were highly toxic to HeLa cells, causing detachment of cells from coverslips. Nimodipine was thus the most effective inhibitor tested against T. cruzi infection in HeLa cells. Verapamil and gallopamil (diphenylalkylamines), diltiazem and midazolam (benzothiazepines), and allopurinol (positive control) were less effective than nimodipine. IC₅₀ values, the concentrations of compounds that elicited a 50% reduction in the infection rates of HeLa cells, were 2.5, 2.6, 1.3, 2.1, and 1.7 μM for nicardipine, nimodipine, amlodipine, verapamil, and benznidazole, respectively, while the values for nifedipine, diltiazem, and allopurinol were much higher. Nicardipine, amlodipine, and verapamil again showed significant cytotoxicities to HeLa cells. When Swiss 3T3 fibroblasts replaced HeLa cells, nimodipine markedly lowered the host-cell-infection rate, with an IC₅₀ value of 8.3 nM. Thus, nimodipine is expected to be a highly effective anti-T. cruzi lead compound, with low cytotoxicity to mammalian cells. Structural formulas of nimodipine and nicardipine in relation to their low and high cytotoxicities, respectively, against HeLa cells are discussed.

We investigated the system of emergency medical service in the Chuno area in Gifu prefecture.It was found that about 20,000 emergency cases were carried into the Emergency Medical Center (EMC) in Chuno Kosei Hospital annually. About 90% were patitents with mild disease or injury. During the past four years an increasing number of severely ill patients such as those acute myocardial infarction and cerebral apoplexy were transfered to our EMC from other hospitals in the Chuno area.We found that many emergency patients came to our EMC, which was not staffed with so many emergency care specialists nor equiped with so many beds for emergency patients. Therefore, we requested residents, family doctors, primary care clinics, common hospitals and administrators in the Chuno area, to contribute their share to emergency medical care together with EMC.In conclusion, we thought it necessary to build a better system of emergency medical care in this area promptly.
Area ; Medical ; Central ; Bale out ; medical care

To evaluate the efficacy of the retroperitoneal approach (RP) when compared with the transperitoneal approach (TP) in elective aortoiliac reconstruction, 41 cases were reviewed. From February 1987 through October 1991, 16 patients underwent aortoiliac reconstruction through the TP approach and 25 patients underwent operation through the RP approach for abdominal aortic aneurysms (AAA). The TP approach was associated with larger intraoperative blood loss (648.6±416.5ml) when compared with the RP approach (357.7±208.9ml) (p<0.01). The TP approach was associated with greater intraoperative blood transfusion (2093.8±1179.0ml) when compared with the RP approach (1010.4±905.3ml) (p<0.01). Both groups had similar operative times. Postoperative initiation of oral water intake was prolonged in the TP group (50.2±27.4hr) when compared with the RP group (22.3±8.9hr) (p<0.01). Postoperative initiation of walking training was prolonged in the TP group (88.7±37.1hr) when compared with the RP group (60.1±23.2) (p<0.01). This experience demonstrates that the RP approach is a preferable alternative to the TP approach in elective aortoiliac reconstruction.

Literature on Bukuryo-shigyaku-to describes it as “those who perspire, have diarrhea, do not recover from disease and are afflicted by restlessness.” In this study we examined 4 cases where the administration of Bukuryo-shigyaku-to had an effect, where complaints which accompanied autonomic disorder and psychoneurosis brought about by automobile accidents were diagnosed as restlessness. With the experience of these cases and consideration of the literature, we consider the following to be appropriate states of illness for the administration of Bukuryo-shigyaku-to in psychoneural sicknesses.
1) states of illness where conditions of psychological introversion caused by such things as fear, heart palpitations, and depression exist, and it is necessary to lift spirits.
2) states of illness where such Ki-depressions as whole body weariness and lack of appetite exist.3) states of illness where such stasis of body fluids as dull headache and dizziness exist.
4) where epigastric region tenderness and abdominal palpitations exist.

To clarify the correlation between pulse, appearance of the tongue and abdominal palpation signs as measured by Kampo medicine diagnostic techniques, we investigated 488 cases who received health screening. In addition we investigated the effects of smoking and drinking alcohol on pulse, tongue and abdominal palpation signs, and also the correlation between the findings of blood biochemical tests, and the pulse and appearance of the tongue, and obtained the following results.
1) In normal pulse the abdominal power and the tension of lower abdominal wall elevate, and the subjective palpitations of the upper umbilicus and the fluid sound in the stomach upon palpation were faint.
2) In elevated pulse abdominal power increased and the subjective palpitations of the lower umbilicus were faint.
3) As the oppressive pain on bilateral area near the umbilicus increased, the petechia often occurred.
4) The epigastric throbbing pulsation over epigastric region showed the positive correlation with transverse dehiscence.
5) Positive correlation was shown between the oppressive pain on the left area near the umbilicus and the purple tongue coating.
6) Smokers are apt to have red or purple tongue and tend to show yellow, thick, or ? residue-like (_??__??_) tongue coating. During abdominal palpation the positive correlation was shown between the frequency of smoking and the tonus of the left rectus abdominis muscle.
7) The amount of drinking alcohol and the abdominal power show positive correlation, and negative correlation with the subjective palpitations of the upper umbilicus.
8) The value of hemoglobin and hematocrit were often increased when a red tongue coating, purple tongue coating, petechia or a thick tongue coating were shown, and were decreased in ? emaciation (_??__??_).
9) The value of amylase showed a negative correlation with the red, thick, ??_??__??_, ? residue-like (_??__??_) tongue coating.