Previous studies have shown that the process of recovery after disuse muscle atrophy varies in different experimental models. We investigated the process of recovery of M, soleus atrophy after immobilization, with special reference to changes in structural and soluble proteins by means of electrophoresis and histochemical changes using myosin-ATPase staining. After rabbits had been subjected to 3 weeks of hindlimb immobilization, the changes were investigated immediately after the termination of immobilization, and at 1, 2, 3, 4 and 6 weeks of recovery. Just after the termination of immobilization, the wet weight of the M. soleus was 32.7±14.0% that of the opposite limb. The wet weight recovered rapidly and returned to the same level as that of the opposite side by 4 weeks. The amount of structural proteins decreased after immobilization, but did not return to the control level at 6 weeks after recovery. No new bands appeared in the electrophoretic patterns of the structural and soluble proteins at any of the stages of recovery. Furthermore, the special features of the bands of myosin light chains (MLCs-1, MLCs-2) also showed no change. ATPase staining showed that the area of type 2 fibers increased, and occupied 45.2±12.6% of the total area at 3 weeks after recovery, whereas that of muscle from controls occupied 17.3±5.7%. The area did not return too the control level by 6 weeks of recovery. The discrepancy between the histochemical changes and the changes in structural or soluble proteins during the recovery process appeared to be due to differences in the turnover ratio of each protein. It appears that the process of recovery of disuse muscle atrophy after immobilization is variable and compley, and differs according to the method of observation.

A six-month follow-up study of athletic injury and physical fitness was conducted on ten players in a nationally ranked boys' high school water polo team. The first medical check-up was conducted on May 28th, 1995, and the second just 4 days before the national athletic meet on September 2 nd. The final check-up was done on November 18 th. A thorough examination in addition to X-ray evaluation by an orthopedist was done on June 26th after the first medical check-up.
In our check-ups, athletic injuries were defined as injuries due to water polo or disorders which prevented individuals from playing. In the thorough examination, athletic injuries included any physical conditions that required further investigations or treatment by the doctor.
Six players had taken part in swimming before taking up water polo, and seven had played water polo since junior high school. Of the athletic injuries sustained, 55% occurred at the age of 13-14 yr. Injuries due to carelessness and over-enthusiasm amounted to six. Motion pain in the pes anserius, iliotibial tract, and hip joints without traumatic episodes were thought to originate from the characteristic leg action under the water.
Although body weight and height varied among the players, the differences in the values of body fat percentage, body mass index, and lean body mass were slight.
Since the players had few complaints, athletic injuries were difficult to find. However, with periodic medical check-ups and a thorough examination, we are able to prevent some problems such as pain in the pes anserius or iliotibialtract.

In order to observe the development of physical fitness of rural boys and girls, a series of examinations with respect to physique, various physical-strength-tests, maximum O₂ intake and vital capacity were investigated with 541 boys and 436 girls in middle-and high-school in Nakatsugawa district in Gifu prefecture in autumn, 1966. And their result was compared with the value of average Japaness children of the same age. The result obtained was summarized as follows
1) The development of physique, such as body height, body weight, girth of chest and sitting height, did not differ from the average Japanese level.
2) The running ability of rural children was slightly inferior to that of the average Japanese children for the short-distance-running (50m), in which one must give the maximum power within short period of time. On the other hand, it was rather superior to the average Japanese children for the long-distance-running (1500m for boys and 1000 m for girls), in which one must display a full effort for the endurance work for relatively long period of time.
3) The result of neuromuscular test, which was revealed by broad jumping, side step and back strength, indicated that the value of rural girls was lower than the average Japanese, whereas that of rural boys did not show such a difference. An index of respiratory and circulatory system as in the step-test for girls was slightly lower than the average Japanese girls, but no difference was obtained in rural boys.
4) The vital capacity and maximum O₂ intake of rural children were, in general, nearly the same as the average Japanese value. However, among children of middle school who were not able to go on to high school on account of poverty, there were several boys and girls having a lesser pulmonary function.
5) The comparison of these items with those of foreign children indicated that no difference was recognized among them, for example, the indication of physical capacity for long endurance work, the maximum O₂ intake of rural Japanese children was not different from that of the Swedish children reported by P.O. Åstrand,

It is difficult to treat vulvar pain of an unknown cause. We report a case of vulvodynia with dysuria treated effectively with goshajinkigan. The case was 92 years-old female who could not sleep well because of vulvar pain. She did not have inflammation of the vulva or vagina. Moreover, she was sometimes treated with urethral catheterization for urinary retention. Goshajinkigan was prescribed, and her pain was decreased so much, that she could sleep well. Furthermore, she was relieved of her urinary retention.

The aim of the current nationwide survey was to investigate the Kampo medicine experiences of Japanese physicians working at hospitals designated as core cancer centers by the Ministry of Health, Labour and Welfare. Among the 900 physicians surveyed, 92.4% reported having prescribed Kampo medications, of whom 73.5% reported having prescribed them for cancer patients. Despite this high percentage, only 28.7% of the physicians had studied Kampo medicine.
This survey found that over 40% of physicians in each generation had no intention of learning Kampo medicine. When asked to categorize their expectation of Kampo efficacy, about 30% said they had an ‘expectation’, a ‘no and yes expectation’, and ‘no expectation’ respectively.
However, physicians who had experience learning Kampo medicine had more expectation than physicians who had not. And the same expectation tendency for prophylaxis treatment was shown in physicians with that experience and those without. This difference is disadvantageous to patients. We therefore believe it necessary to create an environment in which physicians can learn Kampo medicine and methodology, which engenders cooperation between Kampo specialists and Japanese physicians in the treatment of cancer.

Traditional East Asian medicines, Kampo included, are to be incorporated into International Classification of Diseases11 (ICD-11) which will be released in2015.To understand the significance of this plan, ICD itself needs to be understood. In this article, we describe ICD history, its significance and problems, and why the WHO became interested in traditional medicine. In the beginning, the ICD was only for classifying causes of mortality, and has since expanded to cover disease information according to the diverse needs of a changing society. And in Japan today, it is widely used not only for death certificate and disease information, but also for research purposes. There are many problems with the ICD, however:e.g. it is not clinically convenient, and it lacks certain terminology. Revision from IDC-10 to ICD-11 is now ongoing. It will be expanded and electronic. At the same time, plans are to have it broadly implemented in Asia by including traditional East Asian medicine.

Masked obesity is the presence of obesity based on percent body fat (%BF) when the body mass index (BMI) shows an absence of obesity. To examine the relationship between masked obesity and arteriosclerosis risk factors, we compared both serum lipid levels and the prevalence of hyperlipidemia in male and female high school freshmen with and without masked obesity. Subjects consisted of 403 male and 326 female high school students aged 15∼16 years. Of these, 34(8.4%) males and 36(11.0%) females had masked obesity, defined as 17≤BMI<23.60 and %BF≥25% in males, and 17≤BMI<24.17 and %BF≥30% in females, while the remaining 300 males and 246 females were not obese, having 17≤BMI<23.60 and %BF<25% and 17≤BMI<24.17 and %BF<30%, respectively. For both sexes, serum total-cholesterol (TC), low-density lipoprotein cholesterol (LDLC), triglycerides and the arteriosclerotic index (AI) were significantly higher (p<0.05∼0.01) in those with masked obesity. And many of the subjects with masked obesity had abnormal levels of TC, LDLC and AI, compared with those who were not obese (p<0.05∼0.01). Additionally, we compared both serum lipid levels and the prevalence of hyperlipidemia between subjects with masked obesity and control groups with the same BMI values. As a result, subjects with masked obesity had high serum lipid levels and a prevalence of hyperlipidemia. These results support the existence of masked obesity and suggest that masked obesity is associated with increased serum lipid levels, and thus could be a risk factor for arteriosclerosis in male and female high school freshmen.

Pouchitis is the most common complication following ileal pouch-anal anastomosis in patients with ulcerative colitis and is strongly correlated with the risk of pouch failure and malignant mucosal transformation in the pouch. Here we report a case treated successfully with the Kampo decoction, daitokato. A 41-year-old male treated with ileal pouch-anal anastomosis due to severe ulcerative colitis suffered from repeated pouchitis and stenosis of the ileal pouch post-operatively. He complained of general fatigue, chills, continuous lower abdominal pain and discomfort, and severe pain with evacuation. Initial treatment with antibiotics and painkillers was ineffective, so the patient came to our hospital's Kampo clinic, where he was initially prescribed the decoction, shokenchuto. This proved ineffective at resolving his fatigue. Subsequent treatment with ogikenchuto improved physical strength but was ineffective for pouchitis. Antibiotic resistant pouchitis occurred afterwards and we attempted treatment with saikokeishito decoction and the extracts, hochuekkito and juzentaihoto, which similarly improved fatigue but not pouchitis. Following administration of daitokato, instances of pouchitis were reduced with no recurrence 6 months post-treatment. This case illustrates the therapeutic efficacy of daitokato in improving ileal pouch disorders resistant to treatment with Western medicine.

Traditional medicine educational systems in Japan and China were compared.
In Japan, Kampo medicine has been integrated into the core curriculum of undergraduate education in all medical colleges since 2001. Japanese university medical schools give 6,000 hours of western medical educa tion, and only 30 hours of Kampo education. In China at Traditional Chinese Medicine (TCM) universities, nearly half of teaching hours are devoted to TCM, and half to Western medicine. And even at medical univer sities that specialize in Western medicine, students will usually have 80 hours in TCM courses. Usually it takes five years to graduate. In Japan, Kampo education puts a special focus on the Shang-han-lun and Jin-kui-yao lue texts, which still influence daily practice. In China, on the other hand, TCM doctors rely on traditional theories of Chinese medicine such as the Yin-Yang theory, the Five Elements theory or relationships between meridians and organs. Kampo specialists have been increasing in recent years, although in China, the number of TCM doctors has been decreasing. However, better traditional medicine education would play a role in in creasing our inheritance of both in Japan and in China.

The effectiveness of recombinant human erythropoietin (rHuEPO) was evaluated in elderly patients who underwent coronary artery bypass grafting. A total of 133 patients were divided into three groups: those who were 70 years of age or older and received rHuEPO (group I; n=32), those who were also 70 years of age or older but did not receive rHuEPO (group II; n=35), and those who were 60 years or younger and received rHuEPO (group III; n=66). In 87.5% of group I, 42.9% of group II, and 98.5% of group III, homologous blood transfusion could be avoided. The percentage of patients without homologous blood transfusion was significantly higher in group I than in group II (p<0.001). The rate of homologous blood transfusion was significantly higher in group I than in group III (p<0.05), but rHuEPO had equal effects in terms of increase in hemoglobin level in the two groups. Furthermore, in patients without anemia, the rate of homologous blood transfusion was almost the same in the two groups. In conclusion, the administration of rHuEPO enables even elderly patients to undergo coronary artery bypass grafting without homologous blood transfusion.