Objective To explore the effect of the simple flexible ankle-foot orthosis on the hemiplegic patient's gait.Methods There are 22 hemiplegic patients (observation group) and 21 healthy individuals (control group) involved in the study. The parameters of gait are collected and analyzed.Results With the simple AFO, the walking time and knee flexion degree of the patients at Brunnstrom stage Ⅳ and stageⅤ are close to that of healthy individuals. When the patients at Brunnstrom stage Ⅲ walk with plastic AFO and then with the simple flexible AFO, there is a obvious difference in knee flexion degree at the initial stage of standing between the two situations.Conclusion The simple flexible AFO can improve the walking ability of hemiplegic patient with light tip foot.

Objective To test the practicability of hand-made type of simple-flexible-orthosis.Methods The correction force of simple-flexible-orthosis made by different materials, and 10 min walking speed and step frequency after wearing orthosis or without orthosis were tested, and a questionnaire was also used to collect the information that the patients using this orthosis during daily living.Results The orthosis made by different materials had different correction force, and the walking speed and step frequency when wearing orthosis were significantly different from that when not wearing orthosis ( P＜0.01).Conclusion After the simple-flexible-orthosis made by different materials is improved, the correction force, walking speed, step frequency have increased, and this orthosis is suitable for mild drop foot in patients with hemiplegia during their daily living.

Objective: The aim of this study was to review cautionary statements regarding hypersensitivity to drugs with a moiety similar to sulfonamide on Japanese package inserts.
Methods: From approved drugs listed as of March 2015, we selected those with a moiety similar to sulfonamide and examined their therapeutic categories, together with the presence or absence, location, and wording of cautionary statements regarding usage, and matters pertaining to a history of drug hypersensitivity that was not limited to sulfonamide, on the package inserts.
Results: We extracted 73 drugs (65 components) that included a moiety similar to sulfonamide.  Their therapeutic categories were diverse, and 39 (53.4%) had cautionary statements about hypersensitivity caused by a moiety similar to sulfonamide.  Among these 39 drugs, the cautionary statements were located in different sections (Contraindication 31, Careful Administration 4, and Important Precautions 4).  The cautionary statements showed differences in wording according to the individual drugs or positions.  For 10 of the drugs, information pertaining to a history of drug hypersensitivity not limited to sulfonamide was provided.
Conclusion: Medical staff should recognize that package inserts are not standardized with regard to cautionary statements about hypersensitivity caused by moieties similar to sulfonamide, and that it is necessary to predict or judge the likelihood of cross-hypersensitivity reaction to such moieties on the basis of their chemical structure.  In addition, it is necessary to carefully observe the clinical condition of individual patients who are receiving drugs that have a moiety similar to sulfonamide.

We assessed the effectiveness of practical instruction in parasitology for undergraduates at Jichi Medical School by examining grades on a practical examination. Two hundred six second-year medical students in 1997 and 1998 (103 students in each year) were enrolled in this study. The students took written and practical examinations at the end of the program. We found that grades on the practical examination were correlated with grades on the written examination (r=0.5664; p<0.001). The discrimination index ranged from 0.23 to 0.78. The percentage of correctly identified species was significantly higher when students studied live specimens than when they used other methods (p<0.0001 in both 1997 and 1998). The highest rates of correct identification (more than 90%) were for Anisakis species larvae and Enterobius vermicularis eggs in 1997 and for Anisakis species larvae, E. vermicularis eggs, and Anopheles mosquitoes in 1998. Results of neither written nor practical examinations differed significantly between students who chose biology at the entrance examination and those who did not. Our results suggest that undergraduates would gain a better understanding of parasitology by studying live specimens.

Attention has been focussed more in recent years on health control for the middle/advance-aged, in the midst of so-called aged society or complicated society. As one of the measures, sports with the purpose of health promotion/stress removal have been more vigorously made, contrary to which, sporting disturbances, accompanied by abrupt sports, are on the increase. Many cases, however, with muscular pain and light joint sprain etc. are treated personally with poultices/adhesives of a chilling type, while various warming adhesives with its warming therapy happen to demonstrate an effect or another against chronic stiff shoulder and lumbago, due to long-lasting stress. Nowadays, adhesives of both such chilling and warming types are available on market; muscular pains and stiffness being practically treated casually with warming therapy (warming sensation).
The warming effect of PCP-S was investigated by using thermography, the result of which runs as follows.
1. Application of PCP-S adhesives caused a clear dermal temperature increase, with a significant difference from the un-treated control and the side opposite to the applied.
2. The comparison between PCP-S and O-S, removed of its active extract, proved a skin temperature increase due to capsicum extract and not due to a change in dressing the dermal surface of the skin.
3. Result of the comparison in temperature increase between the application for 60 minutes and 120 minutes recognized the peak to occur at 60-70 minutes.
4. A more significant dermal warming effect was seen on main body than on upper limbs.
5. Sensation of warming, prickling and light pain sensation occurd in that order, with no suspension of its application due to pain.

We report a case of tricuspid infective endocarditis with peripheral pulmonary artery aneurysm. A 31-year-old man with a history of intravenous drug abuse was admitted to our institution. Echocardiography showed severe tricuspid valve insufficiency and large vegetation (10 mm) attached to the tricuspid valve. Computed tomography (CT) revealed a right peripheral pulmonary artery aneurysm. We operated because of the large amount of vegetation. Before the operation, we performed coil embolization for peripheral pulmonary aneurysm. During the operation, we removed the posterior leaflet with vegetation, and performed tricuspid valve repair. The postoperative course was uneventful. Postoperative echocardiography did not show any tricuspid valve insufficiency or vegetation.

Microvascular free flap transfers have become a preferred reconstructive technique; however, rare complications may still prove devastating. This study reviewed 213 consecutive free-tissue transfers in order to assess the incidence and causes of complications in patients undergoing microvascular free flap reconstruction in the oral and maxillofacial region. In most cases, reconstruction was undertaken after resection of a malignant tumor. The flap donor sites were the radial forearm (n=111), rectus abdominis (n=88), scapula (n=13), and latissimus dorsi (n=1). The superior thyroid artery and the external jugular vein were commonly used as recipient vessels for anastomosis. The overall flap success rate was 99%. There were 7 cases of postoperative vascular thrombosis (6 venous and 1 arterial), constituting 3.3% of the entire series. Five flaps were salvaged, representing a 71.4% successful salvage rate in cases of vascular complications. Most of the successful salvage attempts were made within 24 hours of the end of the initial operation, and the successful salvage rate for re-exploration was 100%. Finally, the total flap loss rate was 0.9% and the partial flap loss rate was 2.3%. We conclude that early re-exploration should be the first choice for management of vascular compromised flaps. Complications at the donor site occurred in 17 cases (8.0%), the most common complication of which was partial skin graft loss after harvesting a radial forearm flap (n=10; 9.0%). Recipient and donor site morbidity was limited and considered acceptable.

Background: We retrospectively compared endscopic gastroduodenal stenting with gastrojejunostomy as a means of palliating malignant gastric and duodenal obstruction. Methods: This retrospective study investigated patients treated for malignant gastric and duodenal obstruction from April 2011 to April 2015 at Shikoku Cancer Center. Results: Of the 40 patients in this study, 25 underwent gastroduodenal stenting and 15 had operative gastrojejunostomy. Comparing the stenting and operative patients, technical success rate was 100% in both group, clinical success rate was 84% in stenting patients and 93% in operative patients. The median time to fluid intake was significantly shorter in stenting patients than operative patients(0 day vs 2 days, p=0.0003), and the median time to intake of solids was also significantly shorter in stenting patients(1day vs 3 days, p<0.0001).The median hospital stay was significantly shorter in stenting patients(9 days vs 23 days, p=0.0116). Median cost of hospitalization is more expensive in operative patients than stenting patients(¥1,106,170 vs ¥752,290, p=0.0052). Conclusion: Our study suggested that gastoroduodenal stent was less length of time to fluid/solid intake, and less costly than gastrojejunostomy.

It has been experienced that Kampo, with its philosophy that every disease is psychosomatic in origin and that herbs affect both the psyche and the soma, sometimes has a dramatic effect on somatoform disorders, though there has been no study examining the effects of Kampo on somatoform disorders. In this preliminary study, the morbidity of somatoform disorders among patients who visited the Keio Kampo Clinic and the patients' psychological well-being were examined.
One hundred patients (17 males and 83 females; mean age [±SD], 39±16) who sought Kampo treatment for the first time at Keio University Hospital participated in this study. A Japanese checklist derived from the somatoform disorders schedule (version 1.1) was used to check the somatoform symptoms. To assess psychological well-being, the subjective well-being inventory (SUBI) was performed. The subjects' clinical records were examined afterwards to rule out symptoms which could be medically explained.
Somatoform patients and medically ill (non-somatoform) patients were 65% and 26% of the total respectively. The somatoform patients showed significantly lower SUBI positive scores than the non-somatoform patients (p=0.042), while SUBI negative scores were significantly higher (p=0.001). Among the somatoform patients, there was a negative correlation between numbers of somatoform symptoms and SUBI positive scores (r=0.267; p=0.032), and a positive correlation between numbers of somatoform symptoms and SUBI negative scores (r=0.337; p=0.006).
Following the SUBI scores through treatment courses may lead to a better understanding of the pathology of somatoform disorders and to more effective use of Kampo.