The effects of electrical acupuncture at the patellar tendon and electrical stimulation of the femoral nerve on patellar tendon blood flow were evaluated using laser Doppler flowmetry in anesthetized rats. In most subjects the blood flow in the patellar tendon rapidly decreased for 30 seconds after the start of local electrical acupuncture and then increased above baseline. Changes in blood flow did not necessarily follow changes in arterial blood pressure. Changes in tendon blood flow induced by electrical stimulation of the femoral nerve were similar to those induced by electrical acupuncture at the patellar tendon. Arterial blood pressure and heart rate were not affected by electrical stimulation of the femoral nerve. Phentolamine administration abolished the decreased patellar tendon blood flow seen after initiating electrical acupuncture at the patellar tendon, whereas atropine abolished the increased patellar tendon blood flow seen after terminating electrical acupuncture at the patellar tendon. Furthermore, atropine did not evoke increased blood flow following electrical stimulation of the femoral nerve. These results suggest that the decrease of blood flow seen after initiating electrical acupuncture may be controlled by sympathetic vasoconstrictor nerves and the increase of blood flow following electrical acupuncture may be controlled by cholinergic vasodilator nerves.

We studied the clincal effect of the electrical acupuncture at pudendal nerve in four cases of lumbar spinal canal stenosis. The experimental effect of the direct electrical stimulation to the pudendal nerve on the blood flow of the sciatic nerve evaluated by Laser-Doppler flowmetry in anesthetized rats. Electrical acupuncture at pudendal nerve resulted in the improvement of the gait distance of all four cases. The specific effect of the electrical acupuncture at pudendal nerve was found in one case who did not show any improvement by the acupuncture at the intervertebral joint points. On one hand, the direct electrical stimulation to rats pudendal nerve resulted in the increase of the sciatic nerve blood flow, which were not evoked by administration of atropine. These results suggest that the electrical acupuncture at the pudensal nerve may be effective for the intermittent claudication of the lumbar spinal canal stenosis. The increased blood flow of the sciatic nerve may play one of the important roles in the effect via autonomic nervous system.

Ceftriaxone is one of the easily administrative antibiotics, but little is known about their role in palliative care settings. The aim of this study is to show the effect and the safety of ceftriaxone subcutaneous infusion to infection among advanced cancer patients. Consecutive patients who received ceftriaxone subcutaneous infusion at the Seirei Hospice from January 2013 to January 2014 were enrolled in this retrospective analyses. Primary outcome was the response rate of ceftriaxone, determined by improvement of symptoms within 3 days of ceftriaxone use. Secondary outcomes are inflammatory site reaction, and a comparison of the response rate between ceftriatone and other antibiotics. Among a total of 100 admitted patients, 10 patients used ceftriaxone subcutaneous infusion (4 for urinary tract infection, 4 for pneumonia, 2 for soft tissue infection). The response rate was 70% (95% confidence interval, 39－89). There was no inflammatory symptom at the insertion site observed. For comparisons, 16 patients used other antibiotics with the response rate of 74% (51－88).In conclusion, subcutaneous infusion of ceftriaxone can be useful in the treatment of infections of end－of－life cancer patients, and randomized controlled trial is promising.

We applied electrical acupuncture to the spinal nerve root by inserting needles under x-ray control in two cases with radicular sciatica as a non-pharmacological substitute for the lumbar spinal nerve block. In both cases, symptoms were markedly reduced after electrical acupuncture to the spinal nerve root. The sustained effect was noticeably longer than that of caudal anesthesia previously performed one time on one of the cases. We suggest that descending inhibitory control, inhibitory control at the spinal level, or changes in nerve blood flow may be involved in the mechanism of the effect of electrical acupuncture to the spinal nerve root. These results suggest that electrical acupuncture to the spinal nerve root may be superior to lumbar spinal nerve block or caudal anesthesia when it is applied appropriately in certain cases of radicular sciatica, taking into consideration of patient age, severity of symptoms and duration of the disorder.

We investigated the clinical results of coronary arterial bypass grafting (CABG), using a terminal warm blood cardioplegia (TWBCP) for myocardial preservation. In the past 6 years, 102 cases of CABG have been performed at our institution. These 102 cases were divided into the following two groups; (1) Group T, consisting of 41 cases, in which TWBCP was employed; (2) Group non-T, consisting of 61 cases, in which TWBCP was not employed. We performed a comparative study between the groups on the perioperative cardiac function and so on. Between the two groups, there were no significant differences in age, gender, preoperative ejection fraction (EF), operative time, cardiopulmonary bypass time (CPBT) and the level of CPK-MB. In group T, the number of grafts was significantly more than that in group non-T (p=0.002). Aortic cross-clamp time was significantly longer in group T. However, the duration of assisted circulation after aortic declamp was significantly longer in group non-T than that of group T (p=0.01). The incidence of ventricular fibrillation after release of aortic clamp in group T was 9.8%, while it was 67.2% in group non-T, showing a significant difference. Furthermore, the postoperative cardiac index in group T was significantly higher than that in group non-T. These results suggest that it is important for the myocardium, to recover from its ischemic damage caused by VF after release of aortic cross-clamp. In conclusion, we consider it effective to employ TWBCP in CABG to improve postoperative cardiac function.

The primary aim of this study was to estimate the number of cancer patients who wanted home death based on the bereaved family survey.A postal survey performed on 1,137 bereaved family members in 4 regions to clarify the degree what they believed that the patient actually died where s/he had wanted on the Good Death Inventory, and to explore the preferred place of death. We calculated estimated number of patients who had wanted home death as a total of (1) the actual number of home death × the percentages of the family members who agreed that the patient actually died where s/he had wanted, and × the actual number of hospital death × the percentages of the family members who disagreed that the patient actually died where s/he had wanted and home was the preferred place of death. Estimated number of cancer patients who wanted home death was 32.8%［95%C.I., 31.7, 33.9］ in the surveyed regions, and 31.2%［95%C.I., 31.1, 31.4］ for national data.

Purpose and Methods: Infection and neoplastic fever is one of the common complication in patients with advanced cancer. To develop a novel method to differentiate neoplastic fever from infection, we performed a retrospective study of hospitalized terminally ill cancer patients at Seirei Hospice from April 2009 to August 2011. Results: We identified a consecutive sample of 12 patients with neoplastic fever and 12 patients with infection as a control. We extracted demographic data, laboratory data, vital signs and symptoms from medical charts. We found significant differences in difference in C-reacive protein value between afebrile and febrile period (p＜0.001), difference of white blood cell count between afebrile and febrile period (p=0.0017), percentages in neutrophil counts (p=0.023), percentages in lymphocyte counts at base line (p=0.011) and the presence of delirium (p=0.012). Conclusion: These findings suggest that we might differentiate neoplastic fever from infection with common laboratory data and their longitudinal change.

Mouse and vole embryos were allogeneically and xenogeneically transferred into pseudopregnant CD.1 and immunodeficient (seid)female mice,and we investigated the distribution of uterine leucocytes cells in the implantation sites on days 5,6,and 7 of pregnancy. Maerophages were evenly distributed in the endometrium on days 5-7.Neutrophils were rarely seen on days 5-7,but lymphocytes were found throughout the endometrium,often in groups associated with glands or the luminal epithelium.The number of uNK cells increased markedly at the mesometrial uriangle and the outer decidual area in the CD-1 uteri containing vole embryos;by contrast,seid uteri having vole embryos showed almost the same number as those having mouse embryos.Mast cells were present in large numbers at the myometrium,but rarely in the decidua in all types of pregnant uteri.Cells at the myometrium were more numerous in xenogeneic than in allogeneic transfer.Maay mast cells appeared in the inner decidua where xenogeneically transferred vole embryos were dead and aborted.These results suggest the possibility that uterine leucocytes mediate various immunological events in the mouse-vole interspesific pregnancies.

We report a case of an obstinate belch successfully treated with goshuyuto. The patient was a 74-year-old female. She had been hospitalized seven times in the past due to the belch, abdominal distention and anorexia, and had been prescribed various Kampo formulas. But her symptoms fluctuated up and down. The obstinate belch essentially disappeared after administering goshuyuto, and her appetite improved. Many of Kampo formulas that treat belchs are related to Shoyobyo (shao yang bing), but we consider that goshuyuto may be effective for a belch, which is yin-related and accompanied with stiffness and rigidity below the heart, and fullness in the chest and hypochondrium.
Medicine, Kampo ; Treated with ; Case Report ; plastic property - rigidity ; symptoms <1>

We report a case of recurring adhesive ileus that was successfully treated with shojokito (decoction) without inserting a nasogastric tube. The patient was a 75-year-old male who had been treated for abdominal symptoms in our department after a laparotomy. He visited our hospital mainly for complaints of abdominal pain and distention, was diagnosed with adhesive ileus because of a niveau image upon abdominal X-ray, and was hospitalized the same day. We diagnosed him as Yang syndrome and excess syndrome because he had thick yellow fur of the tongue, and administered shojokito. He broke wind at 40 minutes after administration of shojokito, and had bowel movement two hours later. Furthermore, he had mass diarrhea after another administration of this formula, and the niveau image disappeared the next day. It is often considered that an ileus develops with Cold, for which daikenchuto is prescribed frequently. However, in some cases cold purgative formulas such as jokito group may be effective, if such cases are Yang syndrome and excess syndrome, and present with yellow fur of the tongue.
Intestinal Obstruction ; Syndrome ; Treated with ; Yellow color ; Yang