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.

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.

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,

Objective: The mechanism underlying the development of neuropsychiatric symptoms such as unconsciousness, abnormal behavior, delirium, hallucinations, and convulsions in influenza has not been thoroughly investigated. The relationship between drug administration and neuropsychiatric symptoms during influenza is also poorly understood. This study is the first pharmacoepidemiologic study focused on investigating the relationship between drug administration and neuropsychiatric symptoms.
Design: Cohort study
Methods: Study subjects were patients under 18 years old who had influenza during the 2006/07 season. We prepared two kinds of questionnaires for doctor and for patient's family, and carried out the survey between January and March, 2007. Using data from 9,389 patients, we analyzed the relationship between neuropsychiatric symptoms, such as delirium, unconsciousness and convulsion, and drug administration of acetaminophen and oseltamivir.
Results: Analysis of the relationship between delirium and drug administration provided hazard ratios of 1.55(p=0.061)for acetaminophen and 1.51(p=0.084)for oseltamivir. These hazard ratios, which were adjusted for risk factors by multivariate analysis of the proportional hazard model, showed an increasing tendency of delirium after administration of each drug. In patients who received oseltamivir, a high incidence of delirium was observed between 6 and 12 hours after onset of fever. Furthermore, delirium was found to develop in a shorter time following oseltamivir use than it did after acetaminophen use. There was no relationship between unconsciousness and acetaminophen administration, as demonstrated by a hazard ratio of 1.06(p=0.839). The incidence of unconsciousness increased significantly with oseltamivir use with a hazard ratio of 1.79(p=0.0389), and unconsciousness was found to occur in a short time after oseltamivir use.
Conclusion: The results obtained from this study suggest that there are increased risks of delirium and unconsciousness with drug administration. Further pharmacoepidemiologic studies for hypothesis testing are required to study the relationship between abnormal behavior and drug administration.

This study was conducted to assess the appropriateness of preparation fees for dispensing herbal medicines, which were revised in 2006. We investigated the amount of time needed to dispense herbal, and general medicines. For prescriptions of1to 15 days length, the average time needed for herbal prescriptions was 13.4 minutes, which was about 3 times longer than for other prescriptions, which took only 4.4 minutes. For prescriptions of over 30 days length, this was about 7 times longer. Next we comparatively investigated fees charged per minute to prepare herbal medicines, with those for other medicines. Fees for all prescriptions of 1 to 15 days length were nearly equal, while fees for herbal prescriptions of over 15 days length were approximately 1/3 to 1/5l ess. Finally, we investigated the number of prescriptions filled out at one university hospital. In 2003 the number of herbal prescriptions exceeding 30 days length was 2.7% overall, while in 2008 this had increased approximately 14 times, to 42%. We would like to recommend an increase in herbal medicine preparation fees, based on the number of days a prescription is for, as the number of long-term prescriptions is increasing.

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.

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.

An 81-year-old patient, who had a postinfarction left ventricular aneurysm with thrombus underwent left ventricular aneurysmectomy with right coronary artery bypass grafting (CABG). Preoperative examination showed 99% stenosis of the left coronary artery (#7) and 90% stenosis of the right coronary artery (#3). The operation was performed because angina was not improved and formation of thrombus was suspected on the wall of the aneurysm. The operation was performed under cardiopulmonary bypass and by antegrade and continuous retrograde cardioplegia. The aneurysm was resected and a relatively fresh thrombus which was detected on the endocardium of the aneurysm was extracted. The left ventricle was closed by direct linear suture with felt reinforcement. Because the area of resection included part of the left anterior descending artery, only right CABG (#3) with a saphenous vein was done. Weaning from bypass was very easy and the postoperative course was uneventful.