A Kampo medicine, Dai-kenchu-to, has been used clinically for treatments of various ailments such as vomiting, stomachache, and abnormal intestinal peristalsis caused by abdominal chill. Recently, it is often used to prevent intestinal obstruction after abdominal operations. We searched ancient Chinese and Japanese medical texts for the indications and pharmacological characteristics of Dai-kenchu-to and its constituent herbs (Zanthoxylum fruit, dried Ginger rhizome, Ginseng root, and Malt sugar). We clarified the applications and the cautions of Dai-kenchu-to in this paper. Dai-kenchu-to has rarely been used in China. However, it was often used for the remedy of severe abdominal pain caused by chilling, worm-ileus and hernia in the medieval period of the Edo era in Japan. For these reasons, evidence is considered as described below. i) Japanese people did not have the habit of eating meat in those days. ii) Japanese people used to drink a lot of water. iii) Severe abdominal pain occurred frequently due to wearing traditional Japanese clothing, which does not protect well against cold. iv) Abdominal diagnosis was advanced in Kampo medical methods. We found two precautions in the ancient Japanese medical texts. One is that a purgative should be avoided when used in an applicable case of Dai-kenchu-to. The other is that Dai-kenchu-to should not be given in the case of high fever. It is supposed that the botanical origins and processing of the four herbs used in the medieval period of the Edo era are the same as those of today. Our findings suggest that the pharmacological contribution of the four herbs in Dai-kenchu-to is mainly due to Zanthoxylum fruit and dried Ginger rhizome, and that Ginseng root and Malt sugar harmonize between the condition of patient and the pharmacological action of Zanthoxylum fruit and dried Ginger rhizome.

INTRODUCTION
There have been very few reports on the effects of acupuncture on abnormal eye movements often seen in patients with central vertigo. Recently we had the opportunity to apply acupuncture to a case of Wallenberg's syndrome, which displays a peculiar nystagmus and vertigo. This case is reported because the effectiveness of acupuncture in improving the eye movement was proved by the electronystagmography (ENG) in collaboration with the Nihon University School of Medicine.
CASE REPORT
Patient: A 47 year old man. Diagnosis: Wallenberg's syndrome. Chief Complaint: Vertigo. Present Illness: In Nov. 1980, the patient noticed a loss of pain and temperature sense in his right limb, followed by vertigo. He was admitted to the Nihon Univ. Hospital in Dec. 1980. CT-examination of the whole body, a vertebral arteriogram, etc. indicated a circulatory failure in the left lateral area of the medulla oblongata.
In Mar. 1981, the patient visited our clinic with the chief complaint of vertigo. Present Condition: He complained of rotary vertigo. The orthostatic test was positive with both opened and closed eyes. A decrease in the pain and temperature sense on the right side of the body, except for the head, was observed.
COURSE
Acupuncture was applied to the posterior region of the neck, the back, and the lateral of the lower extremity in order to relax the muscles of these parts. After acupuncture the patient reported a decrease in his vertigo. After the twentieth session of acupuncture the symptoms improved to the extent that he could go out alone. After the twenty-second session, he returned to work. Although his vertigo and nystagmus did not completely disappear, an obvious improvement in these symptoms was seen after each session, and this improved condition remained for two or three days. With the ENG recorded before, shortly after, and 30min. after a session of acupuncture therapy, a decrease in abnormal eye movement after the session was confirmed.
CONCLUSION
Acupuncture therapy was applied to a case of Wallenberg's syndrome.
Result:
1. A short-term decrease in vertigo was observed.
2. A decrease in abnormal eye movement after acupuncture therapy was confirmed by electronystagmography.

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The purpose of this study was to investigate the influence of a shoulder injury on rotator cuff muscle thickness and shoulder muscle strength in baseball players. Based on orthopedic medical checks performed by a doctor for 57 male collegiate baseball players, two groups, the pain-free normal group (NOR group, n=19) and the impingement test positive group (IMP group, n=17) volunteered to participate in the study. Muscle thickness of the supraspinatus, infraspinatus and posterior deltoid muscles was measured bilaterally using a B-mode ultrasound apparatus (SSD-500, Aloka) with a 5-MHz transducer. Isometric shoulder abduction strength was measured bilaterally with a hand-held dynamometer in the sitting position with the arm at 45 degrees abduction, and shoulder external and internal rotation strength were measured bilaterally with an isokinetic dynamometer in the sitting position with the upper arm at 90 degrees abduction.
When the two groups were compared, the NOR group showed significantly greater values on the dominant side than on the non-dominant side for muscle thickness of the posterior deltoid. However, the IMP group showed significantly greater values on the non-dominant side than on the dominant side of muscle thickness of the supraspinatus, the muscle strength with the abduction and external rotation (300 deg/sec) and external internal rotation strength ratio (180 deg/sec) .
Also, the IMP group had a significantly weaker dominant/non-dominant ratio of supraspinatus muscle thickness (p<0.05) and abduction strength than the NOR group (p<0.01) .
These results suggest that baseball players with positive impingement show both a morphological and functional decline in the supraspinatus muscle. The dominant side supraspinatus weakness observed in the IMP group of this study may reflect muscle atrophy and chronic fatigue.

An 84-year-old man with a thoracic aortic aneurysm underwent total arch replacement with selective antegrade cerebral perfusion. Immediately after the operation, respiratory distress and hypotension developed and Chest X-ray films and computed tomography showed bilateral lung edema. Echocardiography showed a small, underfilled left ventricle, but with preserved systolic function. We suspected transfusion-related acute lung injury (TRALI), and started sivelestat and steroid pulse therapy. His respiratory condition gradually improved, and he was discharged on postoperative day 78. The diagnosis of TRALI was confirmed by positive test results of an HLA class I antibody in the transfused fresh frozen plasma and T- and B-cells of the patient. TRALI should be considered as a cause of acute lung injury after surgery with blood transfusion.

Objective To observe the therapeutic effect of the new plan of concurrent capecitabine (CAP) and radiation therapy for hu-man cervical adenocarcinoma in nude mice. Methods The nude mice were injected with CAC-1 cells for the modelization of cervical ade-nocarcinoma. Before treatment,all mice with tumors were randomly divided into control group,CAP group,5-FU group,radiation group,CAP+ radiation group,5-FU+radiation group. According to the tumor size,mice were furtherly divided into large-size and small-size groups in the control group,CAP group,radiation group, CAP+radiation group. The change of tumor size,tumor growth percentage and the delay time of tu-mor growth were evaluated. Results The therapeutic effect of combining 2/3MTD CAP with 6 Gy radiation or fractionation 2 Gy × 8 times radiation was better than that of the control group,chemotherapy group and the radiation group. The difference was significant (P < 0.05). The restraint effect of the combining 2/3MTD CAP with 6 Gy radiotherapy was better than that of the combining 2/3MTD 5-FU with 6 Gy radiotherapy. Combining 2/3MTD CAP with fractionation 2 Gyx8 times radiation therapy was more efficient than Combining 2/3MTD CAP with fractionation 6 Gy radiation therapy. In combining therapy groups,the response of large-size tumors was more significant than that of the small-size tumors (P < 0.05),which had almost no obvious response. Conclusion Concurrent CAP and radiation therapy has obvious restraint effect on CAC-1 cervix adenocarcinoma in nude mice. The CAP and radiation therapy can promote the therapeutic effect to each oth-er. The therapeautic effect of the concurrent CAP and radiation therapy is affected by the radiation dose, radiation method and the tumor size.

[Objectives]We investigated the behaviour factors in Hiesho (excessive sensitivity to cold symptoms), a summary score of Health-related QOL (SF-8) and Body Mass Index (BMI) in subjects who feel Hiesho (hereinafter referred to as Hiesho Subjects), in relation to sex, and showed the future direction of acupuncture therapy on Hiesho.
[Methods]After approval by the Ethics Committee, we obtained written informed consent from the participants in this study. Participants were 753students in a vocational college. The study was performed with questionnaires, which were delivered by hand to the participants in September, 2008. We analyzed 629 subjects (538 males and 91 females, mean age of 27.4 ± 6.8) whose responses were valid. The questionnaire consisted of age, sex, height, weight, subjective Hiesho, 24 behaviour patterns of Hiesho according to a previous study, and Health-related QOL (SF-8, Japanese version). We used two summaries -physical component summary (PCS) and mental component summary (MCS) -which are derived from standard values (scores) in the nation on eight scales of SF-8 calculated using the special scoring software. Total scores of behaviour patterns of Hiesho subjects (HIE Scores) and summary scores and BMI in male and female subjects were statistically analyzed using covariance structure analysis technique in multiple populations (Amos Ver. 7).
[Results]In our model, the Comparative Fit Index (CFI), Akaike's Information Criterion (AIC) and Root Mean Squares Error of Approximation were 1.00, 75.886 and 0.00, respectively, which showed a high degree of compatibility. We found the relations from Hiesho Scores to PCS (β=-0.175, p < 0.01) and MCS (β=-0.179, p < 0.001) and from PCS to MCS (β=-0.089, p=0.038) in male Hiesho subjects. In contrast, in female Hiesho subjects, there were relations from Hiesho scores to MCS (β=-0.601, p < 0.001) and from PCS to MCS (β=-0.244, p < 0.05).
[Discussion]From the results of our investigation, Hiesho was considered not to be associated with Health-related QOL in male Hiesho subjects but to be associated with mental factors in female Hiesho subjects.
[Conclusions]It was shown that we should consider the patient's sex in acupuncture therapy on Hiesho.

Controlled Freezing-point Storage (CF Storage) is a new method of preserving foods in minus non-frozen temperature range. So, we tried to apply this method to entrails preservation and investigated the effect of controlled freezing-point storage of hearts on ventricular function in isolated perfused rat heart (male, Sprague dawley strain, in body about 300g weight). The hearts were perfused by working heart mode for 10min, and received infusion of cardioplegic solution which was followed by 4 hours of cardiac arrest at a myocardial temperature 4°C (4°C group) or minus non-frozen temperature (CF storage group). Then, the aerobic reperfusion by working heart mode was continued for an additional 30min. The recovery rate of cardiac output was 33.5% and 62.5% respectively of the preischemic value in 4°C group and CF storage group, which was statistically significant (p<0.01). ATP activity after 4 hours of cardiac arrest in 4°C group was significantly lower than that in CF storage group (p<0.05). These data suggest that CF storage of hearts might have a protective effect against an ischemic insult upon myocardial cell during hypothermic cardiac arrest.

It is well known that patients with abdominal aortic aneurysms (AAA) have a high incidence of coronary artery disease (CAD), and that the major cause of death in patients undergoing aneurysmectomy is acute myocardial infarction. A total of 53 patients (mean age, 71 years) underwent elective repair of AAA between January 1991 and November 1999. In an attempt to reduce early and late mortality caused by myocardial infarction, coronary angiography (CAG) was performed in all cases. Significant CAD was found in 23 patients (43%), with triple vessel disease in 1 patient (2%), double vessel disease in 5 patients (9%), single vessel disease in 16 patients (30%) and left main in 1 patient (2%). Ten patients (19%) in whom CAD was detected by CAG had no history of CAD and displayed no ischemic findings on ECG. In 4 patients (8%), AAA repair was performed 2 (mean) months after coronary artery bypass grafting (CABG). Percutaneous transluminal coronary angioplasty (PTCA) was performed in 8 patients (23%) 19 days (mean) prior to AAA surgery. No patient had a perioperative myocardial infarction either following coronary revascularization (CABG and PTCA) or AAA resection. Moreover, there was only one operative death after abdominal aneurysmectomy (2%), in a patient who was 70 years old with chronic hemodialysis and who died due to multiple organ failure caused by uncontrollable adhesional ileus. The results of this study emphasize the importance of preoperative routine coronary angiography following coronary artery revascularization to enhance the operative outcome of AAA repair.