Only a few years have passed by since the national health insurance began to be applied to the KANPO treatments. In order to grasp the patients profile of KANPO treatments, 3, 156 patients who consulted Shibuya Clinic from the lst of December in 1981 through the 30th of November in 1982, were analyzed. As the result; (1) in the respect of sex-age distribution in number, middle-aged female were most frequent. (2) the classification of chief complaints associated with the sex-age distribution seemed to suggest that the symptoms might change by aging from those of the upper respiratory tract or the skin lesion to arthralgia or lumbago, from the surface to the deep, or from the upper to the lower part of the body. we also tried to compare the result with this kind of reports of the others.

In this paper we introduce recent developments in the studies of brain activation during somatosensory stimulationexploiting new technologies. Somatosensory stimulation such as acupuncture, inauces tocai activation in tne central nervous system. The electroencephalogram is a popular method to investigate this activation, however, it is difficult to identify the exact location of the activation site. Recent new technologies may provide more accurate localization. Besides magnetoencephalography (MEG), which recognizes the activated brain areas by an evoked magnetic field with induced current, two other methodologies, which take advantage of physiological phenomena occurring during brain activation, were used in this functional study. Following excitation of neurons, brain tissue is supplied with oxygen from oxyhemoglobin causing oxyhemoglobin to turn into deoxyhemoglobin. As a consequence deoxyhemoglobin increases in the brain tissue. In the near-infrared spectrum, the deoxyhemoglobin absorption peak shows higher signal intensity than that of oxyhemoglobin, for which reason activated brain areas can be identified by absorption maps. In functional magnetic resonance imaging (fMRI) activated area can be revealed with high spatial resolution due to the change in magnetic susceptibility of deoxygeneated blood. This paper describes fMRI studies employing these three methods for the evaluation of experiments using acupuncture for focal brain activation.

Silicate compounds are added as extenders to dusts, flow dusts (FDs) and wettable powders, meaning that it can be predicted to contain free silica, which in turn affects the incidence of pneumoconiosis. The percentage of free silica content was measured by X-ray diffraction in 18 pesticides consisting of 3 types of dusts, 4 types of FDs and 11 types of wettable powders. As a results, free silica was identified in 14 of pesticides as follows: 22-34% in dusts, 3-11% in FDs and less than 1% to 20% in wettable powders. The percentages contained in the FDs were lower than in the dusts, probably because crystal structures became amorphous during the processing of FDs into super fine gradules with a mean particule size of 2μm.
The levels of dust exposure during spraying were measured with respect to Sumithion dust, Morestan FD and TPN FD by classifying them into respirable dust of less than 7.07μm in aerodynamic diameter (which is liable to be deposited in the lung) and total dust. When the concentration of a dust to which sprayers were exposed was compared with the TLV established taking into free silica content based on recommendation of the Japan Association of Industrial Health, the dust spray levels were 75-fold in the case of respirable dust and 53-fold for total dust, those for the spraying of FDs were 7-fold for respirable dust and 3-fold for total dust.
These results suggest the necessity of using pesticides with low free silica content. It is also considered necessary for sprayers to wear dust respirators.

A 26-year-old man with Marfan's syndrome suffered aortic dissection repeatedly during hospitalization. He was admitted with a diagnosis of annuloaortic ectasia with severe aortic regurgitation. A type A aortic dissection occurred after diagnostic angiography. Three weeks after the onset of the dissection, an aortic root replacement in combination with a total arch replacement was performed. Eight months later, residual dissection in the descending thoracic aorta was replaced with distal perfusion by a temporary bypass from the left subclavian artery to the descending thoracic aorta. At the termination of the operation, abdominal aortic dissection occurred with acute bilateral limb ischemia, which was treated with abdominal aortic intimal fenestration. He recovered uneventfully and was discharged 3 weeks after operation. In light of our experience, because of vascular fragility, great care should be taken in treating patients with Marfan's syndrome to avoid iatrogenic aortic dissection.

We report a case of coronary artery bypass grafting (CABG) in a patient with systemic lupus erythematosus (SLE). A 24-year-old woman with SLE had been treated with steroids and immunosuppressive agents for 7 years. The patient was admitted to Kumamoto University Hospital for the management of unstable angina. CABG was successfully performed using bilateral internal thoracic arteries and postoperative 3D-CT demonstrated good patency of both arterial grafts. The patient experienced no significant postoperative complications, and has remained well to date (8 months postdischarge).

A 69-year-old woman was admitted with severe hypertension and intermittent claudication. The results of further examination, showed that the hypertension and intermittent claudication were due to stenosis of the descending aorta and we diagnosed atypical aortic coarctation. We performed median sternotomy and ventrotomy with side-to-end anastomosis a woven Dacron graft and the ascending aorta. The graft was passed through the lesser omentum, and mesocolon and to abdominal aorta. The postoperative state was stable, and the hypertension and intermittent claudication were remarkably ameliorated. Many cases of extra-anatomical bypass were reported, and the ascending aorta-abdominal aorta bypass was useful method and, very successful with no complications in this case.

At the Niigata University School of Medicine, objective structured clinical examinations (OSCEs) were performed for the first time in 2001 for 92 fourth-year medical students. The average evaluation scores students received from instructors were summarized, and the differences between scores given by different instructors were examined. We found that practice methods for the medical interview and physical examination before OSCE and the question topics and evaluation methods of OSCE were appropriate, but scores on some items were extremely low. The standardization and objectivity of the evaluation were satisfactory, perhaps because one explanatory conference and two training conferences were held for instructors before OSCE. However, some questions tended to produce differences between instructors, as did some topics, especially in the medical interview. The scores with standardized patients and those by teachers were strongly correlated, but those with the former were lower than those by the latter.

The purpose of this study is to evaluate MRI findings for the shoulder pain in hemiplegic stroke patients in relation to clinical characteristics. We studied 18 hemiplegic patients with first-ever stroke presenting with shoulder pain in the affected side (mean age±SD=67.6±10.1years ; 8 men and 10 women ; 12 right and 6 left hemiplegia). All patients had shoulder pain during passive movements and 4 also had pain at rest. The mean duration from stroke onset to MRI was 67±42 days. MRI revealed abnormal findings in all patients. Tendinosis of the long head of the biceps and supraspinatus tendon injuries were most frequently found. The tendinosis of the long head of the biceps was related to hemihypesthesia and a reduced range of motion for external rotation of the shoulder. The supraspinatus tendon injuries were related to older age and lower Fugl-Meyer (FM) and Functional Independence Measure (FIM) scores. The mean number of abnormal findings per patient was 3.2±1.4. The patients with more than 3 abnormal findings were significantly older, had shorter duration from stroke onset and lower FM and FIM scores than those with less findings. It was suggested that those patients with more severe paresis might have more abnormal findings on their MRIs for shoulder pain.