In this seminar, the effects of acupuncture and moxibustion on muscle diseases and muscular functions/metabolism were reported, and the status of these techniques were summarized.
In the clinical study section, it was reported that the effects of treatment on muscle diseases and muscular functions were evaluated using objective criteria, such as electromyograms. In the review of the methods for the evaluation of muscular functions using surface electromyograms, the static electromyograms, dynamic electromyograms, and power-spectrum analysis were presented, and the effects of acupuncture and manual treatment on diseases mainly in locomotor organs and their problems were discussed. For example, 72.9% of the 48 patients with cervical dystonia were found to show improvement by 10 courses of acupuncture treatment, and effects were observed in all patients by electromyography. Similar effects were obtained with patients with drug-induced dystonia. In many of the patients with writer's cramp who underwent 10 courses of acupuncture treatment, improvement in writing tests, subjective evaluation, and the strength of pen stokes were observed.
In the review of the basic studies, the effects of acupuncture, electroacupuncture, and transcutaneous electrical nerve stimulation (TENS) on muscular tension, muscular metabolism (energy metabolism, intracellular pH, lactate metabolism), muscular circulation, and noxious and non-noxious motor reflex were surveyed, and their mechanisms and problems were discussed.

A 72-year-old man was referred to our hospital because of lumbago and an abdominal aortic aneurysm (AAA). Computed tomography revealed the AAA to be 5cm in diameter with a retroperitoneal hematoma. A diagnosis of chronic contained rupture of an AAA was made, and an operation was performed. At laparotomy, a punched-out defect (10×20mm) that was thought to connect the thrombosed aneurysm to an organized retroperitoneal hematoma was discovered on the right side of the aorta. The aneurysm was replaced with a Y-shaped prosthetic graft. The patient's postoperative course was uneventful. This case of chronic contained rupture of an AAA was distinctly different from cases of acute rupture. Although patients with chronic contained rupture of an AAA are hemodynamically stable, such cases should be assessed and treated as quickly as possible because of the risk of re-rupture.

The IPCD (Immersing Powdered Crude Drugs) method, inspired by the “zhu san fa” which was widely used in the Song period of China, has been developed to prepare Kampo decoctions quickly and easily, with highyield extract from crude drugs. One trouble with the IPCD method occurs when separating the decoction from the muddy residue of the crude drug powder. When powdered ephedra herb is packed in a nonwoven fabric bag and immersed in hot water, yield of the marker compounds is much lower than that obtained when ephedra herb powder is dispersed freely in hot water without a nonwoven fabric bag. Thus the use of a nonwoven fabric bag was shown to be unsuitable with the IPCD method. In investigating an easy and more efficient separation method, we tried decanting with a commercially available wine carafe to separate the decoction and residue. With IPCD followed by decantation using the wine carafe, yields of about 80% decoction volume were obtained as compared with those when cut crude drugs are decocted and filtered using a tea strainer, in 6 of the 7 formulas tried. We find that decantation using a wine carafe is a more practical way of separation in the IPCD method.

This study examined relationships between physical activity and sleep relative to leisure-time, household, and occupational physical activity in community-dwelling, older adults. From 3,000 randomly chosen community-dwelling, adults, aged 65-85 years, we recruited 509 eligible subjects (mean age 73.2 ± 5.1 years). We assessed nocturnal sleep duration, sleep onset latency and subjective sleep quality over the previous month through a questionnaire. Physical Activity Scale for the Elderly was used to assess leisure-time, household, and occupational physical activity. Items pertaining to sleep were expressed as dichotomous variables (good/poor), and each physical activity score was divided into two categories based on activity level. To investigate the relationship between sleep (dependent variable) and physical activity (independent variable), we used a logistic regression analysis, controlling for age, gender, living arrangement, depressive symptoms, and cognitive function. Prolonged sleep latency was significantly related to no participation in low intensity exercise (OR 2.14; 95% CI 1.42-3.21) and muscle strength exercise (OR 1.99; 95% CI 1.06-3.74). Our data suggest that not participating in low intensity exercise or muscle strength exercise may be associated with difficulty initiating sleep in older adults.

Fifty-three patients who had received aortic valve replacement (AVR) using tilting disc valve prostheses (Lillehei-Kaster valve, Omniscience valve, Omnicarbon valve), underwent replacement of their aortic valve prostheses over the past 13 years. The indications for reoperation were non-structural opening failure in 35 patients, thrombosed valves, including 2 stuck valves in 8, prosthetic valve endocarditis (PVE) in 7 and perivalvular leakage (PVL) in 3. The interval periods until reoperation for opening failure and thrombosed valve were 112 and 118 months respectively, and for PVE and PVL were 21 and 25 months. There were 7 hospital deaths (13.2%). Surgical results in cases of active PVE with root abscess and stuck valve required emergency operation were significantly worse than these for nonstructural opening failure. Opening failures, which accounted for two-thirds of the indications for reoperation was found to be due to subvalvular pannus formation on minor orifices which hindered the disc from opening properly. It was suggested that reoperation for these types of prosthetic valve should be done before they develop into emergency cases, taking account of these valve-related complications.

Background: Rotavirus vaccines were introduced in Japan in November 2011. We evaluated the subsequent reduction of the health-care burden of rotavirus gastroenteritis. Methods: We conducted active surveillance for rotavirus gastroenteritis among children under 5 years old before and after the vaccine introduction. We surveyed hospitalization rates for rotavirus gastroenteritis in children in Tsu City, Mie Prefecture, Japan, from 2007 to 2015 and surveyed the number of outpatient visits at a Tsu City clinic from 2010 to 2015. Stool samples were obtained for rotavirus testing and genotype investigation. We assessed rotavirus vaccine coverage for infants living in Tsu City. Results: In the pre-vaccine years (2007-2011), hospitalization rates for rotavirus gastroenteritis in children under 5 years old were 5.5, 4.3, 3.1 and 3.9 cases per 1000 person-years, respectively. In the post-vaccine years (2011-2015), the rates were 3.0, 3.5, 0.8 and 0.6 cases per 1000 person-years, respectively. The hospitalization rate decreased significantly in the 2013-2014 and 2014-2015 seasons compared to the average of the seasons before vaccine introduction (p < 0.0001). In one pre-vaccine year (2010-2011), the number of outpatient visits due to the rotavirus infection was 66. In the post-vaccine years (2011-2015), the numbers for each season was 23, 23, 7 and 5, respectively. The most dominant rotavirus genotype shifted from G3P[8] to G1P[8] and to G2P[4]. The coverage of one dose of rotavirus vaccine in Tsu City was 56.5% in 2014. Conclusion: After the vaccine introduction, the hospitalization rates and outpatient visits for rotavirus gastroenteritis greatly decreased.

Methods: We enrolled patients who underwent microscopic FMD with outer dural layer resection for CMI. The distance from the tip of the cerebellar tonsil to the C2 vertebral endplate on sagittal magnetic resonance imaging (MRI) was defined as the tonsillar distance (TD). Patients who showed a >20% syrinx diameter reduction on the 1-year follow-up MRI were defined as the syrinx reduction group while the others were categorized in the syrinx nonreduction group. Patients with syringomyelia were categorized into the clinically improved and unimproved groups using the Chicago Chiari Outcome Scale. The imaging and clinical parameters were evaluated pre- and postoperatively. Results: This study included 25 patients of whom 19 (76.0%) had syringomyelia. At the 1-year follow-up, the syrinx diameter had decreased in 11 patients (57.8%). The increased TD significantly differed between the syrinx reduction and nonreduction groups. At the 1-year follow-up, 12 and seven patients with syringomyelia were categorized into the clinically improved and unimproved groups, respectively. The clinically improved and unimproved groups showed significant differences in the mean age and increased TD. Conclusions Postoperative syrinx reduction was significantly correlated with the upward shifting of the cerebellar tonsil in patients with CMI. Our quantitative evaluation of the alterations in hindbrain position after FMD was easily performed and reflects the clinical outcomes.

OBJECTIVE: To investigate the effectiveness of incentive spirometry on respiratory motion in healthy subjects using cine breathing magnetic resonance imaging (MRI). METHODS: Ten non-smoking healthy subjects without any history of respiratory disease were studied. Subjects were asked to perform pulmonary training using incentive spirometry every day for two weeks. To assess the effectiveness of this training, pulmonary function tests and cine breathing MRI were performed before starting pulmonary training and two weeks after its completion. RESULTS: After training, there were significant improvements in vital capacity (VC) from 3.58+/-0.8 L to 3.74+/-0.8 L and in %VC from 107.4+/-10.8 to 112.1+/-8.2. Significant changes were observed in the right diaphragm motion, right chest wall motion, and left chest wall motion, which were increased from 55.7+/-9.6 mm to 63.4+/-10.2 mm, from 15.6+/-6.1 mm to 23.4+/-10.4 mm, and from 16.3+/-7.6 mm to 22.0+/-9.8 mm, respectively. CONCLUSION: Two weeks of training using incentive spirometry provided improvements in pulmonary function and respiratory motion, which suggested that incentive spirometry may be a useful preoperative modality for improving pulmonary function during the perioperative period.
Diaphragm ; Magnetic Resonance Imaging* ; Motivation* ; Perioperative Period ; Respiration* ; Respiratory Function Tests ; Spirometry* ; Thoracic Wall ; Vital Capacity

For the purpose of investigating weights in the era when the Shan Han Lun was set forth, the weight and measures described in the Ben Cao Jing Ji Zhu, written in the period slightly after the Shan Han Lun, were studied. Some descriptions of the metrological standards are confusing in the Ben Cao Jing Ji Zhu. We focused on the measuring container, whose volume is equal to that of the one cun square spoon (fang cun bi), shown in the dun huang version of the Ben Cao Jing Ji Zhu. The volume of this measuring container was calculated on the assumption that the measures in this text follow those of the Han Shu Li Li Shi, and a result of 5.07 cm³ was obtained. The result was confirmed by using the actual measured values of the crude drugs. The result was also considered to support measurements of the volume in the Ben Cao Jing Ji Zhu as following the Han Shu Li Li Shi. With those results, descriptions of the density of honey and lard were examined, and the weight in the Ben Cao Jing Ji Zhu was clarified to follow that in the Han Shu Li Li Shi.