Since 1974 facilities such as so called “Radon Center” have been established one after another and widespreadly used in Japan. But until now no definite scientific data were available concerning their beneficial or injurious effect on health or diseased state. Therefore following surveys were carried out on bathers (female 25 cases, male 25 cases) of so called Radon Centers.
Radon concentration of bath water was about 0.1 Mache u. The water temperature was between 35°C and 41°C. The duration of bath was between 10 and 15 minutes. Including the bathing time, time of stay in the bathroom was about 20 minutes in total. The bathroom was made airtight and the air was circulated. Atmospheric Radon concentration of the bathroom was mostly between 2 and 3 Mache u. (1-4 Mache u. occasionally). Measurement of blood pressure was done before and after bath. Blood count, urinalysis, and blood chemistry examination were carried out before, 2 weeks, 7 weeks, and 8 weeks after serial baths. Laboratory examinations were as follows: Urinalysis (glucose, protein, occult blood, and urobilinogen), blood count (hemoglobin, erythrocyte count, leucocyte count, and hematocrit), chemical analysis of serum (GLT, GPT, LDH, alk. p., total bilirubin, creatinine, urate, urea N, total cholesterol, anorg. P., Ca, total protein). Furthermore CRP, RA test, and erythrocyte sedimentation rate were investigated on the patients of arthritis. Subjective complaints such as backache, joint pain, and neuralgia were improved in 19 cases (38%) out of 50 cases.
There were no definite changes in blood pressure including 5 cases of hypertension. Glucosuria (3 cases) showed no change. Improvement in CRP test was proved in half of the 12 cases. But majority of arthritic patients have been treated by drugs simultaneously. No significant effect was observed on hemotopoietic organs as shown by blood count. From urinalysis and blood chemistry examination, no injurious influence of “Radon bath” on renal function was recognized. Liver function tests with exception of alkaline phosphatase (Al-Pace) showed no definite change. The Al-Pase activity elevated after 2 weeks of serial baths in 28 cases, including a slight increase. But the elevated Al-Pace levels showed rather a recovery after continuing the serial baths through 4 to 8 weeks. To further clarify the cause of elevation in Al-Pase activity, isozyme pattern was investigated in 12 cases with abnormal Al-Pase activity. Al-P5 was proved in 8 cases and Al-P- appeared in 2 cases, which would not be found normally. No control study using plain water bath was carried out in this survey. Further test subjects had variable disorders such as rheumatoid arthritis, senile osteoporosis, osteoarthritis, etc. Therefore no definite relationship between weak Radon bath and Al-Pase elevation was established by this survey and further investigation will be necessary to draw final conclusion.

The present study examined the effects of having bigger amount of protein than usual in competitive season on lean body weight (LBW), cross-sectional area of thigh and abdomen, muscle strengths, blood constituents and urinary urea nitrogen. Seventeen male varsity throwers (javelin, discus, hammer and shot put) ranging from 19 to 22 years of age, were divided into two groups ; Group A (N=9) with a more protein diet (2.1 g·kg^-1·d^-1), and Group B (N=8) with a usual amount diet (1.5 g·kg^-1·d^-1) . The experimental period was 62 days. During this period, they practiced six days a week. Three days were for throwing practice. Other three days were for weight training. All subjects lived in the same dormitory, and their life styles were similar to each other. The averaged daily diet of Group A evaluated by means of a weighing method had 3824 kcal with 175 g of protein (2.0 g·kg^-1·d^-1), 115 g of fat and 552 g of carbohydrate. The averaged daily diet of Group B had 3441 kcal with 130 g of protein (1.5 g·kg^-1·d^-1), 76 g of fat and 559 g of carbohydrate. All the intakes of vitamins (A, B₁, B₂, C) and minerals (calcium and iron) of the diet of each group were higher than the Japanese recommended dietary allowance. After the period, body weight, %fat, fat and LBW of both groups did not change significantly. Muscle strengths and cross-sectional areas in abdomen and thigh of both groups did not change significantly. Urinary urea nitrogen of both groups did not change significantly. Blood constituents (RBC, Hb, Ht, TP, Alb, BUN) of each group were still in normal ranges in spite of significant changes. No significant changes in body composition and muscle strengths were found in each group. These results, therefore, indicated that the more protein diet (2.0 g·kg^-1·d^-1) was not effective for increasing LBW and muscle strength of varsity throwers in competitive season.

Twelve patients with chronic renal diseases who underwent hemodialysis in the Oriental Medicine Outpatient Clinic of a general hospital were analyzed. The ratio of female to male patients was high, and patients' ages ranged from 31 to 71 years, with a mean age of 53.3 years. Many patients had been receiving hemodialysis for a relatively long time at a frequency of three times a week in most cases. They thus had to maintain a fixed posture for 4-5h per day several times a week. Underlying diseases were chronic glomerulonephritis, diabetic nephropathy, polycystic kidney and nephrosclerosis. Blood biochemical examination revealed high levels of BUN, CRE and UA, while K, Na, Ca and Pi electrolytes were almost normal. The drug therapy consisted mainly of urate biosynthesis inhibitors and electrolyte metabolism amelioraters. Symptoms resulting from long-term maintenance of a fixed posture and abnormalities in K, Na, Ca and Pi electrolytes included headache, stiffness in the neck and shoulder, pain in the arms, low back pain, pain in the legs and pain in the knee joint. Acupuncture was slightly effective or better in 73.1% of the patients, and none of them showed aggravation.

We conducted a survey concerning the sex lives of those women who had undergone hysterectomy. A total of 128 women responded to the questionnaire. The following is a summary of the findings:
(1) After the women had their cases diagnosed as myoma of the uterus, 46.1% of them suffered changes in their sex lives. Postoperatively, however, 73.5% had the same pattern as before.
(2) The largest 44.5% had sex 31-60 days after surgery ; 27.3%, more than 60 days after surgery; and 22.7%, in 30 days.
(3) During the first after-surgery coitus, 9.4% had pains ; 5.5%bled ; and 19.5% suffered inadequate secretion. 29.7% complained about loss of sexual desire.
(4) The majority of the respondents (57.8%) said that they are doing well, but some registered complaints of headache, fatigue and lowering of physical strength.
(5) In order to solve all the sex problems, some need herb medicine or acupuncture. Depending on the cases, psychosomatic counseling would be helpful.

Objective: This study aimed to confirm whether the methods for assessing the reported causal relationship between dietary supplement intake and adverse events are reliable in the clinical setting.
Design: The relationships between supplement intake and adverse events were assessed using two algorithms proposed in our previous report, and causal relationships were evaluated.
Methods: Twelve raters with a high probability of handling adverse event information examined 200 records of dialogues with supplement users.  Each rater independently assessed the causal relationship using the two algorithms.  The relationships between supplement intake and adverse events were assessed for all 200 cases.  Variability in the evaluation among raters was analyzed for each occupation and the whole group of raters.  The distributions of evaluation were analyzed, and inter-rater reliability was evaluated using the intraclass correlation coefficient (ICC) and Fleiss’ kappa coefficient.
Results: All events of 200 cases seemed to be slight and within the range of variation in daily life.  Almost all cases were classified into two categories as “Possible” and “Lack of Information” by each rater.  The ICC values for all raters, pharmacists, dieticians, and health care workers were 0.644, 0.573, 0.678, and 0.694, respectively, and the kappa coefficients using the two algorithms were 0.466, 0.426, 0.468, and 0.519 and 0.481, 0.478, 0.465, and 0.517, respectively.  There were moderate levels of agreement based on the kappa coefficients and ICC values.
Conclusion: The two algorithms proposed in our previous report may be reliable in the clinical setting.  Their reliability could be enhanced by establishing a unified method of accumulation and recording adverse events for supplement intake, which should be evaluated by more raters using more cases of adverse events.

With an increasing number of patients suffering from chronic renal failure, the question of how to prolong the period before starting hemodialysis therapy has been attracting great attention. Kremezin^® and Daio-Kanzo-To, which have been reported to produce good clinical results, were administered to two patients with chronic renal failure in the preservation phase. When the treatment started, renal function tended to deteriorate, and hemodialysis had to be introduced in both patients. We investigated possible causes of this deterioration, and the effect of the combined use of Kremezin^® and Daio-kanzo-To the renal function could not be denied. This combination therapy needs to be studied very carefully.

A 71-year-old man who had been on peritoneal dialysis for 6 years was referred to our hospital for renal transplantation from a living donor. Preoperative echocardiography revealed diffuse severe hypokinesis, a left ventricular ejection fraction (LVEF) of 25%, and a pedicled floating mass in the right atrium. He had not exhibited positive symptoms of active endocarditis or metastatic malignant tumor, and the causes of cardiomyopathy seemed to be uremic and/or ischemic factors. Renal transplantation was postponed, and the extirpation of the mass in the right atrium was scheduled. LVEF improved to 48% 2 months following the induction of hemodialysis before the cardiac operation. Pathohistological findings of the extirpated intra-atrial mass showed sphachelus and fibrotic thrombus, which meant asymptomatic healed infective endocarditis. He recovered uneventfully, and underwent a living renal transplantation from living donor 5 months after the cardiac operation. LVEF further improved better to 56%, and his performance status was remarkably improved. These results imply that renal transplantation and hemodialysis in peritoneal dialysis patients with uremic cardiomyopathy can achive improvement of cardiac function and enable a safe cardiac operation.

Destructive aortic valve endocarditis or poor controlled aortitis cause the development of left ventricular-aortic discontinuity. We reported our experience with aortic root replacement for cases of severe aortic annular destruction. Between 1999 and 2006, 9 patients with severe aortic annular destruction underwent aortic root replacement at our institute. There were 8 men and one women with a mean age of 55 years. Seven patients were in New York Heart Association functional class III. Four of 9 patients had native valve endocarditis, 4 had prosthetic valve endocarditis (previous aortic valve replacements in 2, aortic root replacements in 2) and one had active aortitis with a detached mechanical valve. Radical debridement of the infected cavity and necrotic tissue was performed in all cases, followed by reconstruction of the aortic annulus using autologous or xenogenic pericardium in 3 cases. Antibiotic-saturated fibrin glue was applied to the cavity. Aortic root replacement was achieved with a pulmonary autograft (Ross procedure) in 4 and stentless aortic root xenograft in 4. One patient who had advanced liver cirrhosis underwent aortic valve replacement with a stentless xenograft by subcoronary implantation method. No mortality was observed during hospitalization and follow-up. Reoperation within 5 years was not necessary in 66.7% of the patients. Excellent outcome can be achieved by radical exclusion of the abscess cavity and viable pulmonary autograft or stentless aortic root xenograft in patients with severe aortic annular destruction.

A 24-year-old woman underwent successful repair of a traumatic pseudoaneurysm of the aortic isthmus concomitant with right diaphragmatic hernia which developed after a traffic accident, and the steering wheel of the crashed car was considered responsible for both lesions. Due to the right diaphragmatic hernia, she could breathe mainly with the left lung only. The aortic isthmus aneurysm was considered to be a pseudoaneurysm, and because of the potential risk of rupture, we performed urgent aortic surgery. Prior to a left thoracotomy, we anastomosed an 8-mm prosthetic graft to the right axillary artery. When the left lung was collapsed in order to perform a femoro-femoral bypass, the SpO₂ level of her right index finger and her cerebral rSO₂ markedly decreased. Therefore, we administered additional perfusion via the right axillary artery, which provided sufficient oxygen to the upper body and brain. The patient underwent Marlex mesh reinforcement of the right diaphragmatic hernia 30 days after grafting, and is doing well 1 year postoperatively.