In their infant years, physically handicapped children have a tendency to develop infections, otitis media, tonsillitis and acute sinusitis repeatedly because their physical development is retarded and metabolism poor.
A combination of shosaiko-to and Shokenchu-to were prescribed to a 3-year-old boy with Down's syndrome. and a 2-year-old boy with cerebral palsy. They caught fewer colds, stopped contracting infections, and digestive symptoms were ameliorated. When the sho, or Kampo diagnostic procedure, was followed in the administration of the above combination or other Kampo formulas during infection remission, they were effective in improving weak constitutions.
When a combination of Shosaiko-to and Keishikashakuyaku-to were prescribed for a mantally handicapped 14-year-old boy who suffered from frequent colds and acute sinusitis, good results were obtained. Although the patient's physical development was normal, he became weak due to his poor basic physical habits, such as snacking, which arose from his retarded mental development.

Organochlorine insecticides (BHC, DDT, etc) have been used in massive quatities in Japan. But in 1971, the goverment put a ban on their use as insecticides. We continued the residue analyses of organochlorine insecticide in human bodies from 1971 to 1982. This paper deals with the results of our residue analyses from 1980-1982. In paralel, We have also continued to analyze the residue of PCB.
(1) A total of 264 specimens have been analyzed for human mother milk, the adipose tissue, the liver, the kidney and the spleen.
(2) β-BHC and pp'-DDE were detected from all of these specimens.
(3) Over a span 12 years, the decrease of total-DDT was smaller than that of β-BHC.
(4) In the adipose tissue, there were no signs of a decrease in total DDT.
(5) PCB was detected from all specimens of mother milk, the adipose tissue and the liver.
It is conceivable that the pollution of human bodies by BHC, DDT. PCB, and other chemicals will last for a long time.
There is a need to keep constant surveillance over the tendency of these chemicals in the environment and human bodies.

Objective : To get first-hand information on and understand MEDWatch, a newly created program of the US FDA, on safety information reporting and management.
Design and Method : Through a visit to the FDA office by Japanese members of the ICH M1 (Medical Terminology) Expert Working Group (EWG) and other concerned experts, and discussion with relevant FDA staffs.
Results and Conclusion : (1) The MEDWatch program was introduced in June 1993, to accelerate the spontaneous reporting of adverse events (AE) to FDA by developing a single Adverse Event Reporting Form, i.e., FDA 3500, for (1) drugs, (2) biologics (except vaccine), (3) medical devices, (4) food, and (5) veterinary medicines; (2) Five responsible sectors in FDA have been working together to develop a smooth flow of information from health care professionals and industries; (3) The remarkable result from the development of this new program is the increased reporting of serious AE; (4) Much efforts have been exerted by FDA on the education of health professionals through various health societies and through publications; (5) Some of the issues which remain unresolved include database integration of NDA and PMS information; (6) Advocacy of the AE concept and importance of reporting thereof by health care professionals and the use of simple, easy-to-fill-out form is recommended in Japan.

“DOKAKONSAN IN KINKI YORYAKU” in the original is limited to the usage of women whose menses recur twice a month and of men whose genitals are swollen and painful.
Judging from “YAKUSEI and YAKUNO” of four kinds of ingredients, we recognize the herb is effective against the syndrome, “KEISHITOSHO” easily caught by the Japanese, accompanyed with “KETSUNETSU” and “CHINKYU-OKETSU”.
We got remarkably effective results, after we made the chart of the symptoms at a radorgraph from the point of view of “KOHO” (the ancient school), “HOSHO-ITCHI”, on the basis of six factors, “KI”, “KETSU”, “SUI”, “HI-I”, and “KAN and NETSU”, and administered the herb for 50 cases equivalent to the factors by “TANPO” (a single dose), “KAHO”, or “GAPPO”.
The herb is administered to a broad range, that is, both sex from infants to the aged.
The indications are firstly musculus skeleti connective tissue symptoms and each field of symptoms excluding sensorial symptoms and blood dyscrasia.
Observing the process that “KESSHO” is changed into “KANKETSU” through “OKETSU” and the medicine, “KUOKETSU-ZAI”, the removal medicine, “DOKAKONSAN” can be a unique herb to be effective against the begining stage of “KANKETSU” and to be “ZANRYU-OKETSU KAIJYOZAI” after the administration of “KANKETSU CHINKYU OKETSUZAI”.

Aim: AS stated in the past reports that approx, 75% of hralthy adulte have experienced it, headache is a symptom often experienced in the crinical peactice of acupuncture.
Effects of acupunctural therapy against headache hace already been reported in many cases, but few reports hace been published so far on the use of acupunctural stimulation for the purpose of diagnosis. In the past 15 years, we used the acupunctural stimulation dor diagnosis of tinnitus and headache and ecaluated the meanings of uts use.
In the present study, we examind the cases whose pains could be reproduced by the acupunctula stimulation in the patients with pain who were introduced to us for diagnosis from the Department of otorhinolaryngology of our hospital.
Ptients and method: Of the patients with pain as the chige complaints whise diagmoses were requested to the Oriental Medicine clinic from the Department of Otorhinolaryngology of Showa University since April 1982 up until October 1990, thise whi complained of facial pain were subjected to our diagnosis, previding that they had no abnormalities in the otorhinolaryngological and ophthalmological checks.
A stainless steel needle (50mm Mo. 20) was usedfor theusting into block points of greater occiptal nerce and the possible relationship between the pain and the sense of reacting sense was examind at the time of thrusting.
Results: 1) It could be reconfirmed that the reacting sensation was produced deep in the inner part and in the epicanthal area of eyes by the neadle thrusting to block points of the greater occipital berce. 2) Ammong the patients who had been teated nefor against trigeminal neuralgia or what were claimed to be pains of eyes of buknown causes, there were cases withe pains coincidental with pathological symptoms such a manner that the reacting sensation by the neadle thrusting (1) resembled the nature of the pain and (2) wads coincidental with that of the affected regions, and (3) the pain could be reproduced by the acupunctural stimulatiom in synchronization with the acupuncturalhandling of the neadle. 3) The efficary of the acupunctueal treatments was higher in those whose pains could be reproducedby the acupunctueal stimulation.
Summaary: The stimulations to the block points of the greater occipital berve caused reacting sessation deep in the inner part of eyes. By utilizing this sensation for diagnostic purposes, sone cases could be properly diagnosed. On the ground of these fundungs it can be claimed that the acupunctueal stimulation according to the method in our present study would be one of the useful methods for cheeck of the pain and also for therapeutic treatment in view of the therapeutic meanings of the findings described in the subparagraphe of (1) through (3) in the paragraph 2) and in the paragraph 3) of the above-mentioned “Results”.

An 88-year-old woman presented at a local hospital with a left femoral pulsatile mass. CT revealed saccular aneurysms with irregular intima in the descending thoracic aorta, the right common femoral artery and the left superficial femoral artery. They were 60 mm, 30 mm, and 25 mm in diameter, respectively. After referral to our hospital, multiple inflammatory aneurysms were strongly suspected by detailed examinations. Endovascular treatment including thoracic endovascular aortic repair and surgical replacement were performed by two-stage operations. After steroid therapy was started postoperatively, her c-reactive protein (CRP) value decreased. Nevertheless, the thoracic aortic aneurysm enlarged and she died due to hemorrhage. Multiple inflammatory aneurysms are extremely rare. We consider that appropriate steroid therapy and close follow-up are most important.

An 80-year-old man presented with a history of retrosternal gastric tube reconstruction for esophageal cancer. He experienced sudden chest pain, and temporarily lost consciousness, before being transferred to our hospital. Contrast-enhanced computed tomography revealed acute Stanford type A aortic dissection and a retrosternal gastric tube. We performed emergency operation using a median sternotomy approach. Before median sternotomy, we detected the gastric tube in the subxiphoid and suprasternal spaces. The anterior and right sides of the gastric tube were dissected bluntly from the posterior surface of the sternum and median sternotomy was performed. The gastric tube was mobilized to the left side and we were able to obtain the usual operative view for ascending aorta graft replacement. Intraoperatively, the gastric tube remained intact and uninjured. The patient was transferred to another hospital for rehabilitation on postoperative day 34.

A 60-year-old male was diagnosed as having sarcoidosis four months previously because of bilateral hilar lymphadenopathy seen on a chest X-ray, uveitis, and elevation of serum angiotensin converting enzyme. In summer, the patient suffered from hypercalcemia, hypercalciuria, and renal dysfunction. Renal biopsy showed interstitial nephritis with gallium scintigraphy demonstrating high uptake in the bilateral hilum, eyes, and kidneys. Corticosteroid treatment was effective in remarkably improving the renal disorder and radiographic abnormalities.
The calcium metabolic abnormalities and the granulomatous interstitial nephritis showed a marked response to corticosteroid therapy, so that immediate administration of corticosteroid may be justified even in cases without histological evidences. Gallium scintigraphy is suggested to be useful in noninvasive examination in acute stage of sarcoidosis.

　　In this study, to establish a system unique to our hospital, an awareness survey of physical therapists was conducted using a newly developed form to investigate the degree of anxiety about, and participation in supporting, pediatric patients with a developmental disorder, managing patients’ families, and interdisciplinary cooperative activities. The level of anxiety and the degree of participation were evaluated using a visual analog scale. The Mann-Whitney U test was used to compare cooperative activities with different professionals. The results showed that 20 (90.9%) of the physical therapists were anxious about supporting and handling pediatric patients with a developmental disorder and their families. No significant difference in the degree of anxiety was observed among different professionals, but the highest anxiety was observed when working in cooperation with physicians (Dr), followed by clinical psychotherapists (CP), nurses (Ns), medical social workers (MSW), occupational therapists (OT), and then speech therapists (ST). Physical therapists cooperated most frequently with Dr, followed by Ns, OT, MSW, ST, and then CP, with a significant difference between Dr and CP. The findings of this study, showing current awareness and challenges related to pediatric patients with a developmental disorder, provide information that is fundamental for the establishment of a system unique to our hospital.