For many patients with trigeminal neuralgia, oral administration of carbamazepine is highly effective. Micro decompression surgery (Jannetta's operation) is also considered a fundamental treatment. However, there are patients who do not respond to carbamazepine and who hesitate to have surgery. Here, we report 14 cases whose pain was relieved solely by Kampo (7 cases) or by a combination of Kampo and carbamazepine (7 cases). The Kampo formulations used were Goshuyu-to (2 cases), Gorei-san (9 cases), Saiko-keishi-to (1 case), Toki-shigyaku-ka-goshuyu-shokyo-to (1 case) or Mao-bushi-saishin-to (1 case), depending on the “Zheng” of each patient. In trigeminal neuralgia, the nerve root is compressed or adhered to surrounding vessels, such as the superior cerebellar artery. It is highly possible that localized edema at the point of compression is responsible for the pain. The diuretic action of the Kampo may diminish the localized edema around the trigeminal nerve root.

Studies on the effects of heating as well as the mineral components of hot spring water have been conducted to investigate the effects of balneotherapy. However, few studies have been conducted on the effects of hydrostatic pressure and buoyancy during water immersion. Therefore, we investigated the effect of water immersion up to the neck at thermoneutral temperature on hemostatic activity.
Nine healthy men aged 22 to 34 were immersed up to the neck in the standing position in thermoneutral water (34.0±0.5°C) for two hours. The heart rate decreased immediately after starting water immersion and remained low during the immersion. Hematocrit values (Ht) of the blood samples taken from the ante-cubital vein decreased by 3.4% in average. The decrease in Ht was more prominent in the blood samples taken from the earlobe (4.0%), suggesting that hemodilution due to fluid shift was stronger in the upper part of the body. The time until euglobulin clot lysis shortened immediately after starting the immersion. Although fibrinolytic activity was enhanced, the concentration of tissue plasminogen activator (t-PA) antigen in the blood decreased gradually during the immersion and tended to return to the original level 30 minutes after immersion. A larger decrease in the concentration of plasminogen activator inhibitor-1 (PAI-1) antigen in the blood was observed immediately after starting the immersion, and it remained low for 30 minutes after immersion. An increase in fibrinolytic activity due to the decrease in PAI-1, not in t-PA, was observed during water immersion at thermoneutral temperature and the activation of fibrinolytic system without activation of the coaguration system was also observed.

The relationship between bone strength and bone quality in rats fed with a low-magnesium (low-Mg) diet was examined. Twenty four-week-old male Wistar rats were divided into a control group (n = 10) and a low-Mg group (n = 10). Each group was fed with a conventional diet or a low-Mg diet (Mg, 6 mg/100 g diet) for 8 weeks, respectively. After the rats were sacrificed, bone strength, bone mineral content (BMC) and three-dimensional (3D) trabecular structure of the lumbar vertebra were measured, respectively. The results showed that the values of the BMC were almost the same between the control and the low-Mg diet groups. On the other hand, the bone strength of the low-Mg diet group was significantly lower than that of the control group (p < 0.01). 3D trabecular structure analysis showed a significant decrease (p < 0.05 or 0.01) in the trabecular structure of the low-Mg diet group as compared to the control group. These findings suggest that the bone strength in this model is not affected by the BMC but is strongly affected by the trabecular structure. The low-Mg diet model is considered to be an excellent model for examining bone quality.

We have recently seen an increasing number of patients with osteoporosis of the type that occurs as a chronic illness in the elderly, and particularly in elderly female patients. It is important not only to treat pain but to follow-up with treatments to prevent further bone mass loss. To measure bone mass in patients with osteoporosis, we employed Digital Imaging Processing (DIP). In this study, the authors examined changes in the bone mass of patients in long-term therapy with Keishi-ka-Jutsubu-to and Gosha-Jinki-Gan. As a comparative-control group, or non-treatment group, we selected 11 patients who had been diagnosed as having osteporosis in an outpatient clinic, and whose bone mass had been measured with DIP. These patients discontinued treatment, but returned to the outpatient clinic six months to one year later. The average duration of non-treatment in the control group was 9.8 months. Metacarpal index (MCI) and metacarpal bone mineral density (m-BMD) at the first visit were 0.40±0.07 and 2.22±0.38, but 10 months later they were 0.36±0.05 and 1.97±0.38, which represents a significant decrease.
In 20 cases given Keishi-ka-Jutsubu-to, the initial bone mass data were: MCI, 0.39±0.08; m-BMD, 2.07±0.32. Measurements performed after three, six, and nine months of treatment showed no difference or increase from the initial values.
In 12 cases given Gosha-Jinki-Gan, the initial data were: MCI, 0.40±0.07; m-BMD, 2.06±0.27. Measurements performed after three, six and nine months of treatment showed no difference from the initial values.
The severity of pain was equally reduced by treatment with Kampo formulation or NSAIDs (non-steroidal anti-inflammatory drugs) by four weeks, but after eight weeks low back pain in patients treated with the Kampo formulation was significantly reduced compared with low back pain in the group treated with NSAIDs.

　　In this study, to establish a system unique to our hospital, an awareness survey of physical therapists was conducted using a newly developed form to investigate the degree of anxiety about, and participation in supporting, pediatric patients with a developmental disorder, managing patients’ families, and interdisciplinary cooperative activities. The level of anxiety and the degree of participation were evaluated using a visual analog scale. The Mann-Whitney U test was used to compare cooperative activities with different professionals. The results showed that 20 (90.9%) of the physical therapists were anxious about supporting and handling pediatric patients with a developmental disorder and their families. No significant difference in the degree of anxiety was observed among different professionals, but the highest anxiety was observed when working in cooperation with physicians (Dr), followed by clinical psychotherapists (CP), nurses (Ns), medical social workers (MSW), occupational therapists (OT), and then speech therapists (ST). Physical therapists cooperated most frequently with Dr, followed by Ns, OT, MSW, ST, and then CP, with a significant difference between Dr and CP. The findings of this study, showing current awareness and challenges related to pediatric patients with a developmental disorder, provide information that is fundamental for the establishment of a system unique to our hospital.

Effects of 38°C 30-minute bathing on hemostatic function and autonomic nervous function were studied in 15 48-to-72-year-old patients with cerebral infarction. Blood samples were collected three times: immediately before the bathing, at the end of 30 minutes of bathing, and 30 minutes after the bathing. Hematocrit values and fibrinogen concentrations decreased during bathing and returned to the pre-bathing levels 30 minutes after bathing. This indicates that bathing caused hemodilution due to the fluid shift. During bathing, noradrenaline decreased at a rate significantly higher than that of hemodilution while the sympathetic nervous function, which was evaluated by spectral analysis of sequential variation in arterial blood pressure, was not suppressed. The autonomic nervous system seemed to be inactive in these patients. Coagulation time (PT and APTT) and platelet factor (β-TG and PF4) showed few changes. In the fibrinolytic system, however, tissue plasminogen activator (t-PA) antigen levels increased and plasminogen activator inhibitor type-1 (PAI-1) levels decreased after 30 minutes of bathing. This suggests that fibrinolytic activity was enhanced by 38°C bathing for 30 minutes. Thus, subthermal bathing with comfort may be useful in preventing cerebral infarction.