Laser-assisted vascular anastomosis (LAVA) of arteries and veins in mongrel dogs was performed using a low-powered carbon dioxide laser. The anastomotic site was irradiated at a point 10mm distal from focus and the beam at this point was 0.8mmφ in diameter. Adequate laser power for anastomosis was 160-200mW for arteries and 120-160mW for veins, and the required duration of radiation was 5-10sec per 1mm anastomotic length for both vessels. In arteries successful anastomosis was achieved by LAVA in 44% of transverse incisions and 65% of longitudinal incisions, compared to 65% and 95% for veins, respectively. LAVA ruptured at a pressure of 102±28mmHg on average in arteries and 77±24mmHg in veins. However, LAVA reinforced with etyl 2-cyanoacrylate were safe at high pressures more than 300mmHg in arteries. Follow up has been achieved in 99 anastomotic sites for 9 months. No stenosis, occlusion, thrombus or infection were found apart from one (1%) pseudoaneurysm formation 4 months after LAVA. Angioscopic views and histological findings of anastomotic tissue welded by mean of LAVA revealed good layer-to-layer continuity of the three-layer structure of arterial wall. LAVA seems to be a useful method for vascular anastomosis.

Objectives : We evaluated the efficacy of tokishakuyakusan and kamishoyosan for patients who complained of feeling cold, and identified key symptoms that would predict positive treatment outcomes for coldness with these medicines.
Design : A retrospective cohort study
Subjects and Methods : The subjects were 188 patients who reported feeling cold. They were treated with tokishakuyakusan or kamishoyosan according to their Sho for more than one month. The relationships between improvement of cold sensation and 62 factors, including other symptoms noted at the first medical examination, were evaluated by means of cross-sectional analysis, followed by logistic regression.
Results : The factors of coldness of the abdomen (odds ratio, 5.0), vertigo (7.7), dimness of sight (16) and blushing (5.6), without anger (0.11) or tinnitus (0.025), were found to be predictors of a positive effect with tokishakuyakusan treatment (p < 0.001). The factors of hot flushes (14), without coldness of the whole body (0.099), and faint feeling (0.21) were significant for kamishoyosan (p < 0.001). This suggests that kamishoyosan can improve subjective coldness of the extremities (AIC -8.64), especially of the legs (-2.23).
Conclusions : Coldness in the abdomen was an important indicator for treatment with tokishakuyakusan, while coldness in the legs, but not in the whole body, was important in the case of kamishoyosan.

Objectives : Persistent coldness is a common complaint for which Kampo, traditional Japanese herbal medicine, is often tried, because there is no definition or objective measure of subjective coldness in Western medicine. The aim of this study was to evaluate the efficacy of a common Kampo agent, tokishigyakukagoshuyushokyoto, and to identify key symptoms that would predict positive treatment outcomes for coldness.
Design : A retrospective cohort study.
Setting : 181 patients who complained of coldness without any organic abnormalities self-surveyed their health using a Kampo questionnaire database system on their first visit. Another 28 patients were assigned to verify the discriminatory predictability of treatment efficacy.
Interventions : Patients were treated with extract product, 7.5 grams a day for a month.
Outcome measures : Treatment efficacy as a binary response.
Results : Frequency and severity scales (0 to 4) for coldness decreased from 3.2 ± 0.7 to 2.1 ± 0.1 (p < 0.01)and from 3.1 ± 0.7 to 2.2 ± 0.9 (p < 0.01), respectively. Improvements in both frequency and severity of coldness were observed in 74.0% of patients. The status of tenderness in the iliac region, without upset stom ach or depression, was obtained as an appropriate model for the prediction of treatment effect, and its discrimi natory predictability was calculated as 84.4%. The predictive accuracy of the model was validated with 82.1% for the 28 new patients.
Conclusions : Coldness susceptible to tokishigyakukagoshuyushokyoto was very frequently accompanied by tenderness in iliac region, without upset stomach or depression.

Exercise-induced changes in body composition are dependent on various external factors. The psychological factor seems to be an important determinant for reducing body mass. However, the effect of changes in mood on weight loss have not been thoroughly investigated. The purpose of this study was to investigate the relationships among mood status, body composition and anthropometric characteristics observed during an exercise training program. Thirty-four obese women, aged 46.5±7.7 years, participated in our 3-month weight loss program. Body mass and % fat significantly decreased from 66.3±7.1 kg to 59.8±6.5kg, and from 31.8±3.1% to 27.9±4.0% (P<0.05), respectively. Aerobic power, as represented by maximal oxygen uptake, significantly increased (from 29.1±5.0 mlin/kg to 34.6±5.2 mlin/kg), and oxygen uptake corresponding to lactate threshold increased as well (from 17.2±2.8mlin/kg to 20.0±3.0mlin/kg) after training (P<0.05) . Accord. ing to the degree of body mass change, the subjects were divided into the following two groups : good-responder group (Group G : -9.2±2.7 kg) and poor-responder group (Group P : -3.8±1.4 kg) . Analyses of variance revealed significant differences (P<0.05) in total mood disturbance between Group G (103.54±16.30) and Group P (115.20±21.17) . These results show the possibility of the effects of mood on the success of weight loss in obese middle-aged women.

Placebo is commonly used in clinical trials but it is also used in clinical practice. However, it is difficult to get informed consent for the placebo use from patients in clinical practice. Thus, placebo use in such occasion can lead to an ethical problem. We have previously reported the current use of placebo and the psychological conflict of doctors and nurses about the use of placebo treatments in the actual medical settings. However, to date, no study has reported the perception of pharmacists, some of whom prepare and explain the use of placebo medicines to patients, as their medication. We conducted a survey of the current use of placebo in clinical practice and the perception of pharmacists regarding its use in 3 hospitals based on anonymous self-report questionnaire as a pilot study prior to a nationwide survey. We administered the questionnaire to 92 pharmacists belonging to 3 hospital pharmacies between July 2 and 24, 2012. Of the 92 pharmacists, 84 (91.3%) returned the questionnaire, then we analyzed the data by descriptive statistics and a contingency table. Our results showed that 54.8% of the pharmacists had experience of placebo use in medical settings, and 9.9% of them had instructed on the use of placebo ; while 43.2% of them (answered that they feel uncomfortable with the use of placebos in clinical settings) tended to feel antipathy toward the use of placebos in clinical practice. While the use of placebos in medical setting may have a potential ethical issue, 66.7% of the pharmacists considered that placebo use in clinical settings is not necessarily unethical. Pharmacists who had previously discussed this issue with other staff thought that placebo use in clinical practice is unethical (p＝0.009).

The outstanding feature of the drift of population observed in our country of late is understood in terms of the population exodus from rural areas into urban or industrial areas, which brings about. a conspicuous decrease in rural population especially in that of the younger working age bracket. with a view to clarifying an aspect of such wide-ranging migration of population, a study was made in the three remote mountain villages in the Chilbu District, where people are living on an extremely low economic level Investigation conducted for eacch respective economic level revealed an even. abnormally advanced decrease in the population of such younger generation, far advanced than in average rural areas. Thus the unfavorable topogra-phical conditions, lack of cultivating lands, low income, etc.were considered to be responsible for the acceleration of such population exodus. Attention was also drawn to the fact that not only the surplus labor power but even many of the eldest sons. who are the successors to their fathers' occupations are turning to urban areas for employ-ment, threatening the possibility of the replenishment of agricultural labor power and the development of agricultural economics, as well as the future reproduction of population in rural areas.

Evaluation of the physical fitness level of children and adolescents must include consideration of individual growth rates. This study evaluates the relationship between height and physical fitness in a large sample of 6-17 yr students. Physical fitness test scores were calculated for every 1 cm height group and used to generate quadratic regression equations. Physical fitness data reported by the Ministry of Education, Culture, Sports, Science and Technology in Japan (MEXT) were compared with estimated values obtained using our regression equations. The differences between the values reported by MEXT and our estimated values were very small. Comparison of physical fitness T-scores calculated based on school grade averages with T-scores based on means calculated using our regression equations indicated that shorter height students had lower T-scores if school grade averages were used for the calculation. In conclusion, in elementary and junior high school students, it is important to evaluate physical fitness level relative to individual physical growth.

Recent studies indicate that exercise with a low muscle glycogen state enhances exercise-induced metabolic adaptation. However, it is unclear whether metabolic adaptation is involved with muscle glycogen depletion level. In this study, we investigated the effects of prior muscle glycogen depletion level on metabolic response during acute continuous exercise. Seven men completed two experimental trials consisting of two exercise sessions per day. During the first session, participants performed either intermittent exercise (IE) at VO₂max (the IE-CE trial) or continuous exercise (CE) at lactate threshold (the CE-CE trial). During the second session, participants performed 60 minutes of CE at lactate threshold. During this second session, fatty acid oxidation (FAO) was calculated. To determine muscle glycogen content and PGC-1α and PDK-4 mRNA abundance, muscle biopsies were taken at rest after the first session and 2 hours after the second session. After the first session, muscle glycogen content was significantly lower in the IE-CE trial (38.1±5.0 mmol/kg w.w.) than in the CE-CE trial (56.7±10.2 mmol/kg w.w.), P<0.05. FAO was higher in the IE-CE trial than the CE-CE trial at baseline and 15 minutes after the second session (both P<0.05). PGC-1α mRNA abundance increased after exercise (IE-CE, 5.9±2.5; CE-CE, 2.6±1.3-fold; P<0.1). PDK-4 mRNA abundance increased significantly after exercise (IE-CE, 22.2±8.8; CE-CE, 31.5±10.6-fold; P<0.05). PGC-1α and PDK-4 mRNA were not significantly different between the trials. In conclusion, continuous exercise with a slightly muscle glycogen-depleted state induced similar level of PGC-1α and PDK-4 mRNA expression, but attenuated FAO, compared to exercise with a moderate muscle glycogen-depleted state.

Recent health guidelines suggest that children should accumulate 60 minutes of physical activity (PA) of moderate to vigorous intensity every day. The purpose of this study was to assess PA on weekdays, in addition to physical fitness, in elementary school children during short-term extracurricular activities (EA). Children from an elementary school (n=160) who carried out EA were assigned to the EA group, and children from the neighboring elementary school (n=210) comprised the non-EA group. A physical fitness test was applied to evaluate physical fitness in pupils. Moreover, 48 children (EA, n=24; non-EA, n=24) wore a pedometer with a uniaxial accelerometer to determine the amount of PA and time spent in moderate- to vigorous-intensity PA. The PA of EA was evaluated with the exception of the short program (10 min). Jogging distance of the EA was 1357 ± 333 m, average speed was 170 ± 42 m/min. The estimated energy consumption of jogging was 55 ± 19 kcal. Multiple items of the physical fitness test scored significantly higher in the EA group than in non-EA subjects. Total step counts were 15485 ± 1915 steps/day for the EA group and 12363 ± 2464 steps/day for the non-EA group on weekdays (p<0.001). Time spent in moderate- to vigorous-intensity PA on weekdays was 61.6 ± 10.0 min/day for EA children and 46.5 ± 12.9 min/day for non-EA children (p<0.001). In addition, the extent of PA in the EA group was higher than the amount recommended for children in general. This study suggested that short-term EA are related to both the fitness and PA levels of elementary school children.