During and after the “Toshi” which is the acupuncture of the carotid sinus, systolic and diastolic blood pressure were measured in the basal pharanx of finger arteries by means of indirect sphygmomanometer called the “volume compensation method”. After 15 minutes resting, 2 minutes acupuncture on both sides of the carotid sinus was carried out in 16 hypertensive subjects. Finger arterial pressure showed a significant decrease by about 14mmHg (mean) in systolic pressure and by 9mmHg (mean) in diastolic pressure during and after the acupuncture (p<0.05). The decrease in blood pressure showed a maximum at 15-20 minutes after the withdrawal of needles. Pulse pressure and heart rate did not show a significant change. These results were almost similar to those obtained in normotensive subjects. These data suggests that hypertensive subjects are also responsible to “Toshi” and that this effect may not be caused by the cardiac inhibition refrex but the change in vascular tonus.

We studied the effect of Saiko-ka-ryukotsu-borei-to (crude extract powder for research purposes) on central monoamine-related substances in mice. The formulation was given in a dose of 50mg/kg or 400mg/kg and was administered once or repeatedly (twice a day for seven days). The brain was removed and segmented in the conventional method. The monoamine-related substances were measured by a method using HPLC-ECD. The main results were as follows. The single or repeated administration of 50mg/kg increased DOPAC and HVA contents in the cerebral cortex. In the hypothalamus, the single 50mg/kg treatment decreased NE, and the repeated 50mg/kg treatment decreased NE but increased DOPA. In the corpus striatum, the single 50mg/kg administration increased DA, DOPAC, HVA, and 5-HIAA while the repeated administration increased NE and MHPG as well. In this region, the single 400mg/kg treatment increased NE and 5-HIAA, and the repeated treatment increased NE. In the hyppocampus, the repeated 50mg/kg treatment increased MHPG, and the repeated 400mg/kg treatment decreased HVA. These results indicate that the effect of this formulation on murine brain monoamines is greater at 50mg/kg than at 400mg/kg and that the effect varies among the regions of the brain.

During and after the LI4 and LI10 Acupuncture, the volume elastic modulus Ev in the basal phalanx of finger arteries were measured. Ev values were noninvasively obtained using a new type of plethysmograph called the “electric impedance-cuff” which can detect indirect arterial pressure and volume change in the artery. After 15 minutes of rest, 2 minutes acupuncture on LI4 and LI10 were carried out in 16 healthy subjects, respectively. Volume elastic modulus showed a significant decrease (p<0.01) during and after the LI10 Acupuncture. Its decrease were maintained at least 20 minutes after the withdrawal of the needle. While the Ev values did not show the typical change during and after the LI4 acupuncture. These date suggest that the elasticity of the peripheral wall was lagely affected by the LI10 acupuncture, and the effect was caused not only by peripheral reflex but by other factors.

Iyaku Bungyo means separation of dispensing from medical practice. Under this system, physicians provide outpatients with prescriptions, if need be, after examinations. The patients visit neighborhood drugstores and produce the prescriptions to pharmacists, who are authorized to accept patients covered by health insurance and to make up prescriptions. The prescribed medicines will be given to the patients in exchange for the payment. The pharmacists will also instruct the customers how to take in the prescribed medicines properly. The system has been so designed as to improve the quality of health care services with the physicians and pharmacists performing their respective roles as the specialists. However, the government office is promoting the Iyaku Bungyo system in favor of the pharmacies outside the hospitals in the name of the containment of medical costs, charging that the medical institutions prescribe and dispense so many kinds and quantities of medicines the patients can hardly take in, simply to make large profits from a comfortable margin between the market price for each pharmaceutical and the price at which it is actually purchased. Ministry of Health, Labor and Welfare officials and insurers have trumpeted the system as if it were an ideal scheme to curb health care costs. In reality, however, medical expenses have been boosted up. It can be taken for granted that the expenditure on national health care is increasing year after year with the population of the elderly on the rise and progress in medical technology. Notwithstanding, it is an important task to hold down increases in the cost of health care with the advent of an era of an aging population.
Marital separation ; experience (practice) ; Medical ; Health Care ; Surveys

　　Mature cystic teratoma with malignant transformation is a rare disease with an incidence of about 1% among ovarian tumors. Here, we describe how we were able to diagnose pathological tissue preoperatively using colonoscopy. The patient was a 68-year-old woman (gravida 4). She presented with abdominal pain. Her general condition was poor. On examination, we found perforation of an ovarian tumor into the sigmoid colon. Lower gastrointestinal endoscopy was performed and some tissue was retrieved. Pathological analysis of the tissue revealed a diagnosis of squamous cell carcinoma.

We report a case of serous gonarthritis with nonproductive cough successfully treated with Eppikajutsuto. A 37-year-old Japanese man developed a right genicular arthrocele with nonproductive cough, in October X. Over 100 ml of serous synovial fluid was drained via an arthrocentesis puncture procedure. Although he was treated with nonsteroidal anti-inflammatory agents by an orthopedist, under a diagnosis of serous gonarthritis, his symptoms did not improve. Laboratory findings suggested inflammatory conditions (serum CRP 3.4 mg/dl, ESR 76 mm/h). At the time of his first visit in January X+1, orthopedic examinations revealed that rheumatoid arthritis was unlikely, based on negative physical and laboratory findings. A contrast MRI knee joint scan did not demonstrate any tumor-like mass of synovium which would indicate pigmented villonodular synovitis. And orthopedists found it difficult to specify the cause of his serous gonarthritis. After a common cold in December X, cough stimulated by cold exposure was superimposed on serous gonarthritis.We utilized Eppikajutsuto under the interpretation that both his genicular arthrocele and nonproductive cough were due to a “sui” disturbance. This Eppikajutsuto therapy reduced his genicular arthrocele and nonproductive cough in1month. His symptoms and inflammatory reactions were completely improved in 3 months, regardless of gradual withdrawal of his medication.
Coughing ; Upper case ecks ; symptoms <1> ; Serous ; Treated with

We report a case with an intractable jugular sense of discomfort, with dryness and nonproductive cough successfully treated with soshikokito. A 62-year-old Japanese man developed jugular sense of discomfort with dryness and nonproductive cough, after odontotherapy in October. Although he was treated with Western drugs by an otolaryngologist, under the diagnosis of xerostomia with no mechanical problems, his symptoms did not disappear. The symptoms followed a protracted course, and he further developed a loss of appetite. At the time of first visit in October, otorhinolaryngological studies showed no structural lesions or problems, with the exception of minimum salivation in the normal range on a gum test. There was no evidence of dry eyes. With the diagnosis of xerostomia, Bakumondoto-go-hangekobokuto was administered for a month but showed no sign of improvement. Making a shift to bukuryoin-go-hangekobokuto regained his appetite, but did not produce any improvement on dryness. We then utilized soshikokito under the interpretation that both dryness and nonproductive cough is ki-gyaku. The soshikokito therapy reduced his dryness in a month's time. Additionally, his nonproductive cough gradually decreased, and within 11 months after, he had no symptoms, regardless of a gradual medication withdrawal.
Coughing ; symptoms <1> ; seconds ; month ; Peripartum discomfort

  Specific activities of the working group include reviewing the assessment score sheet of all falls and the preventive measures by degree of risk, making staff education, training, monitoring the implementation of the safety and preventive recommendations for prevention of falls.
  The data of all inpatient falls which occurred during one year prior to and one year subsequent to the WG intervention were analyzed.
  The incidence of inpatient secondary falls, decreased from 155 to 108 , and reports of level III severe falls, showed a reduction from five cases to three. Statistically, the total percentage of secondary falls incidence decreased from 2.19‰ to 1.54‰.
  We therefore concluded that through the activities of the WG, the strengthening of the in-house system to prevent secondary falls, staff education, training, and heightened staff safety awareness have led to a decrease in the total number of primary and secondary inpatient falls.

The aim of the present study is to clarify the improvement of peripheral muscle oxygen consumption after successful renal transplantation. We investigated change of forearm (brachioradial muscle) muscular oxygen consumption in chronic renal failure children before and after renal transplantation. by using near-infrared spectroscopy.Oxygen consumption of brachioradial muscle was increased significantly after succesful renal transplantation. And half recovery time of brachioradial muscle oxygenation in arterial occlusion and exercise were decreased after renal transplantation.These results suggest that increased muscular blood flow and increased oxidative generation of ATP might contribute to the increased oxygen turn over after renal transplantation.

The system of the Japanese Board of Cardiovascular Surgery is changing. Since the last time, we have deliberated on the medical specialty board for U-40 column articles about the problems faced by young cardiovascular surgeons. This time, we conducted the second survey to U-40 members about the realities of becoming a board-certified cardiovascular surgeon. The results showed the circumstances and details on how to acquire the board certification. Moreover, we discussed about the current problems and future perspectives for the young cardiovascular surgeons.