Human skin sections of the Goukoku (LI·4)-corresponding area and its surroudings were collected and they were stained with H. E. dyes. Abundant nerve fibers and blood vessels were observed in the Goukoku (LI·4)-corresponding area, while their numbers were slightly decreased in the non-acupoint area on the meridian. Their numbers in the extra-meridian non-acupoint area were the lowest.
Substance P-containing nerve fibers were examined by histochemistry in the same areas, and many of them were observed in the Goukoku (LI·4)-corresponding area. And further more, they were closely associated with lymphatic vessels. These findings suggest the mechanism that Substance-P secreted by the stimulation of acupoint, is transported to the lymph node via lymphatic vessels, thus leading the stimulation of the lymphatic system.
Lymphatic vessels with abundant smooth muscles were predominantly noted in the Goukoku (LI·4)-corresponding area and scarcely in the non-acupoint area by fluorescent stain. This finding suggests that hypersensitive one may feel the contraction of lymphatic smooth muscle induced by the Substance-P as a phenomenon of propagated sensations along the meridians (PSM).

A study was performed to investigate the validity of the derivative of the ear densitogram for measurement of left ventricular ejection time (LVET) .
Nine male college students performed bicycle exercise at an initial work load of 0 watt (W), subsequently increasing by 60W every 3 min up to 240W. The LVET derived from the derivative of the ear densitogram (LVETe) was compared with that derived from the carotid pulse wave (LVETc) obtained at the same time.
The results were as follows:
1. There was a high correlation coefficient, r=0.987 (P<0.01), between LVETe and LVETc.
2. At rest, LVETe showed a tendency to coincide with LVETc. In contrast, LVETe became longer than LVETc during exercise, and the higher HR became, the larger the difference between the two.
3. In the individual regression equations between LVETe and LVETc, the slopes and the intercepts were nearly identical.
4. The following equation was proposed for the correction of LVETe during exercise. LVET=-0.147⋅HR+ LVETe+ 8.3
From these findings, it was concluded that the validity of the derivative of the ear densitogram for estimation of LVET is sufficiently high. LVETe at rest is valid for the estimation of LVET without correction. During exercise, however, LVETe shows a tendency to be longer than LVETc, and thus it is desirable to correct LVETe using the above equation.

Objective: Owing to the recent advances in genetic analysis technology, its application in drug development is expected to increase, although there are concerns regarding the leakage of personal information.  This study aimed to assess the attitudes of community citizens toward genetic analysis studies associated with clinical trials planned by the pharmaceutical industry.
Methods: A questionnaire survey was conducted after an educational seminar on drug development at a university campus festival.  Answers were obtained from 47 citizens (16 males and 31 females, ages ranging from teens to fifties).
Results: Attitudes toward providing genome samples were assessed using a 100-mm visual analogue scale, and the data revealed significant differences in the conditions of sample use (A, limited to specific genes during the trial, 89±14 mm; B, limited to genes related to the test drug or target disease, 81±23 mm; C, unlimited, 71±33 mm, p<0.01).  Twenty-seven citizens (57%) consistently expressed acceptance toward all three conditions.  The remaining 38% (n=18) expressed denial as the analysis targets widened.  Regarding the acceptable period for sample storage, 17 citizens (36%) allowed “indefinite storage” but 14 citizens (30%) requested “immediate disposal after analysis.”  A feedback on the accidental findings of abnormalities was requested by 43 citizens (91%).
Conclusion: The results demonstrated a wide variety of attitudes toward providing samples.  On the other hand, most citizens requested a feedback on the findings of abnormalities for disease-related genes.  These results suggest that it is necessary to improve the study protocol to reflect these fears and expectations.

For the preservation of health in rural areas, this paper reports on the variation of human serum lipids by intaking lentinus edodes.
Serum lipids levels showed no significant change by intaking lentinus edodes that amounts of 20, 40 and 60g per day each for 5 days. From data of correlationship between serum lipid levels and nutrition intake of experimental diet, it was recognized that high-density-lipoprotein cholesterol level was directly proportional to carbohydrate-fat ratio significantly (p< 0.02), and was inversely proportional to fat intake, fat-protein ratio and carbohydrate-protein ratio significantly (p< 0.05), respectively. Triglycerides level was inversely proportional to protein intake significantly (p< 0.05).
These results concluded that the decrease of serum cholesterol level by intaking of lentinus edodes in healthy young men whose serum cholesterol levels were in normal range was not recognized.

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

Anjo Kosei General Hospital is a large-scale hospital having 692 beds and located in the central part of Aichi. When the hospital moved into the present adress in April 2002, we introduced an electronic chart system that was not common in Japan at that time. Hospital management changed dramatically because until then we were using exclusively papers, and had not possessed even an electronic ordering system. It was also true in the field of medical office work. We hereby report the changes in routines after the introduction of the electronic chart system and its usefulness.The characteristics of our medical work system are as follows.(1)Data refrieval function (Data Ware House)(2)Credit control system(3)Receipt imaging functionWe are evaluating the various effects of the system from seven points of view as follows.(1)Basic data of medical care(2)Staff placement and personnel expenses(3)Work accuracy and efficiency(4)Patients service(5)Storage space reduction(6)Paper reduction(7)In-house questionnaire survey
Work ; Hospitals ; chart ; System ; Reduction (chemical)

Before we moved into the present hospital building in October 2000, we took the opportunity to thoroughly review our medical equipment management system and developed a new centralized management system. With the introduction of the new system, we have made a complete list [an inventory] of medical equipment on hand from small-size instruments to large-scale machinery. We have now become able to grasp the frequency of use of ME, the cause of mechanical trouble, the cost of repairing and so forth. In the future, this system will be further improved so as to enable us to incorporate a labor-saving procedure for equipment lending into the system, share information with other departments, and work out a net working rate and repair rate to make purchasing or disposal plans.Medical care and health services of today cannot be provided without use of modern medical equipment. Under the circumstances, the prevention of accidents and grasp of the optimum amount of machinery and equipment are important. At the same time, the reduction of cost by adequate maintenance work is essential. We think that our centralized equipment management system will work effectively and serve the purpose.
medical equipment ; Equipment used ; Work ; Hospitals ; Management

A number of studies have shown that sleep disordered breathing (SDB) has a strong relation with obesity. The purpose of this study was to examine the effect of a short-term weight-loss program in obese men with SDB. In our 14-week weight-loss program, forty-one obese men (mean±SD, age ; 49.6±10.8 yr, body mass index ; 27.9±2.5 kg/m²) were assigned to 2 subgroups : diet only (DO ; n=19) and diet plus aerobic exercise (DE ; n=22). 2%, 3%, and 4% oxygen desaturation index (ODI) were measured by pulse oximetry before and after the weight-loss program. Weight and %fat significantly (p<0.05) decreased in the total subject pool consisting of DO plus DE (weight ; -8.4±3.5 kg, %fat ; -7.5±3.5%). 2%, 3%, and 4% ODI significantly decreased by -3.46±5.01 event/hour, -2.37±3.57 event/hour, and -1.99±2.84 event/hour, respectively. Significant correlations were found between 2%, 3%, and 4% ODI at baseline and changes of 2%, 3%, and 4% ODI during the weight-loss program (2% ODI ; r=0.48, 3% ODI ; r=0.51, 4% ODI ; r=0.67). Weight loss and %fat loss did not differ significantly between DO and DE (DO : -7.6±3.2 kg, -6.8±3.2%, DE : -9.2±3.7 kg, -8.1±3.7%). The increase in maximal oxygen uptake was slightly larger for DE (4.7±4.6 ml/kg/min) compared to DO (2.5±3.3 ml/kg/min), but there was no significant interaction. Changes of 2%, 3%, and 4% ODI did not differ significantly between groups. These results suggest that for obese men with SDB, the weight-loss program is an effective method, leading to improvement in SDB, although the combination of aerobic exercise to diet may not produce additional effects to SDB, compared with the diet only.

Purpose: Maintenance therapy after oxaliplatin withdrawal is useful in patients with metastatic colorectal cancer (mCRC). This study aimed to investigate the timing of discontinuation or reintroduction of oxaliplatin and the optimal maintenance therapy regimen for survival. Materials and Methods: PubMed and conference abstracts were searched to select phase II and III trials of first-line oxaliplatin-containing therapy with or without bevacizumab using maintenance therapy for mCRC. Correlations of median overall survival (OS) with induction therapy regimens, induction therapy duration, maintenance therapy regimens (fluoropyrimidine plus bevacizumab [FP+Bev], FP/Bev alone, and no treatment), and oxaliplatin reintroduction were investigated using correlation and weighted multivariate regression analyses. Results: Twenty-two treatment arms were analyzed, including 2,581 patients. The maintenance therapy regimen FP+Bev showed the strongest correlation with a prolonged OS (Spearman’s partial correlation coefficient=0.42), and the other three variables correlated weakly with the OS. The maintenance therapy regimen significantly interacted with the induction chemotherapy duration (p=0.019). The predicted OS for FP+Bev crossed the lines of FP/Bev alone at 18 weeks of induction therapy, and of no treatment at 23 weeks. The corresponding OS at 12 and 27 weeks of induction therapies were 28.6 and 24.2 months for FP+Bev, 25.9 and 28.8 months for FP/Bev alone, and 20.5 and 27.5 months for no treatment. Conclusion The optimal maintenance therapy regimen for the OS is a continuous induction therapy as long as possible followed by FP/Bev alone and switching to FP+Bev within approximately 4 months if induction therapy is discontinued.

Purpose: Maintenance therapy after oxaliplatin withdrawal is useful in patients with metastatic colorectal cancer (mCRC). This study aimed to investigate the timing of discontinuation or reintroduction of oxaliplatin and the optimal maintenance therapy regimen for survival. Materials and Methods: PubMed and conference abstracts were searched to select phase II and III trials of first-line oxaliplatin-containing therapy with or without bevacizumab using maintenance therapy for mCRC. Correlations of median overall survival (OS) with induction therapy regimens, induction therapy duration, maintenance therapy regimens (fluoropyrimidine plus bevacizumab [FP+Bev], FP/Bev alone, and no treatment), and oxaliplatin reintroduction were investigated using correlation and weighted multivariate regression analyses. Results: Twenty-two treatment arms were analyzed, including 2,581 patients. The maintenance therapy regimen FP+Bev showed the strongest correlation with a prolonged OS (Spearman’s partial correlation coefficient=0.42), and the other three variables correlated weakly with the OS. The maintenance therapy regimen significantly interacted with the induction chemotherapy duration (p=0.019). The predicted OS for FP+Bev crossed the lines of FP/Bev alone at 18 weeks of induction therapy, and of no treatment at 23 weeks. The corresponding OS at 12 and 27 weeks of induction therapies were 28.6 and 24.2 months for FP+Bev, 25.9 and 28.8 months for FP/Bev alone, and 20.5 and 27.5 months for no treatment. Conclusion The optimal maintenance therapy regimen for the OS is a continuous induction therapy as long as possible followed by FP/Bev alone and switching to FP+Bev within approximately 4 months if induction therapy is discontinued.