Introduction
We attempted to get an objective index of pain, giving electro-nocistimulus to the tooth and making a comparison between the stimulus rate and subjective pain. We examined variations of the response to stimulus under this low-frequency electric treatment.
Method
Treated were single healthy upper incisors of 14 medical doctors. Fixing a silver electrode of 4mm² on each tooth and an indifferent electrode on the buccal surface of the same side, stimulation was applied.
Effect
Three categories of pain, i. e. pre-pain, tolerable pain and intolerable pain were established for the purpose of this study. We made use of these categories as an objective index of pain. It was also evident that, under low frequency electric treatment to acupoints of acupuncture anesthesia, there were variations in intolerable pain. We examined variations of this pain.
Conclusion
It was concluded that there were two types of objects, i. e. the effective and the ineffective.
Intolerable level was affected by the low frequency electric treatment and pain was alleviated.

The Japan-Korea Primary Care Exchange Programme, which is an international project held by the Japan Primary Care Association and Korean Academy of Family Medicine, provides young family physicians opportunities to visit annual conferences and training programs each year. This article reports the history and several topics that Japanese delegates in 2018 learned about in Korea regarding family medicine: "Outpatient Department" "Health Information Systems" "Healthcare System for the Rapidly Aging Population," and "The Current Situation and Issues in Long-term Care Insurance."

The pain eliminating effects of electroacupuncture have long been known however the analgesic mechanism involved has yet to be clarified. Recently with the discovery of endogenous analgesic peptids called endorphins much attention has been called to the relationship of these endorphins and the acupuncture analgesic effect. We examined to determine how electroacupuncture influences lumbar CSF endorphins and the so-called pain transmitting substance, Substance P.
In order to establish continuous lumbar anesthesia using tetracaine for 8 patients with gynecological lower abdominal diseases, a Tuohy needle was inserted from the lumbar area and a catheter inserted into the subarachnoidal space. In each case at the time of the insertion of the catheter 5ml. CSF was tapped. As pre-medication 0.01mg/kg. atropine sulfate, 2mg/kg secobarbiturate were administered. To maintain the analgesic effect hyperbaric or hypobaric tetracaine was administered according to individaul needs. For hypotension during the operations a plasma expander and when necessary ephedrine were administered by intramuscular or intravenous injection.
Immediately following the start of surgery acupuncture needles were inserted at right and left LI-4 and electrical stimulation at 3c/s, 1.0mA was administered for 50-120 minutes using the acupuncture therapy apparatus “TOKKI”. when the operation was finished, after 5ml. of CSF was again tapped through the catheter, the catheter was withdrawn as far as the subdural space and 20-40ml. physiological saline injected to combat the headache due to spinal fluid leakage. The test substance was immediately transferred to a siliconized test tube and cooled to a temperature of-80°C.
The RIA methods were used for the measurement of both endorphins and substance P. The crossover reaction between the β-endorphin and the βLPH was 50%. (Using the β-endorphin measuring kit manufactured by NEN).
The results in 7 of 8 examples showed a significant increase in CSF endorphins after electroacupuncture. It also became clear that there was a tendency for substance P levels to decrease due to electroacupuncture.

We conducted a questionnaire survey involving 270 interns in the year 2011 at the pharmaceutical department of Teikyo University, in order to clarify pre- to post-practical training changes in: 1) the degree of pre-clinical training’s usefulness, 2) desired workplace in the future, 3) degree of satisfaction, 4) confidence degree of practical training, etc. The degree of pre-clinical training’s usefulness exceeded 80% in all training periods. Regarding the desired workplace in the future, a large proportion of students answered that they want to become a pharmacist in a pharmacy or hospital, both before and after their practical training in all training periods. Also, it was estimated that students decide their career with reference to their practical training experience. In terms of the degree of satisfaction with practical training, the proportions of those who answered “Satisfied” or “Somewhat satisfied” were: 95.1% in the 1st, 95.6% in the 2nd, and 86.1% in the 3rd periods. The confidence degree significantly increased after practical training in all periods. Because the confidence degree showed a tendency to be higher before the 3rd period of training compared to the other two periods, it was considered that students’ experience of practical training led to increased confidence degree. Regarding communication abilities, the degrees of before-after confidence degree and pre-clinical training’s usefulness were low, and, hence, it was suggested that pre-clinical training needs to be further improved regarding these areas.

Objectives: The first objective of this study was to classify men aged 40-74 yrs with metabolic syndrome (MetS) according to daily rice intake, and the second was to investigate physical measurements, physiological examinations, blood biochemical assays, intake of food other than rice and lifestyle and environmental factors in the study group.
Methods: We analyzed data from 6095 men aged 40-74 yrs who had undergone full medical examinations. The men were classified into 3 age groups: (1) 40-49 yrs, (2) 50-59 yrs, and (3) 60-74 yrs. The men were classified further into 3 groups according to daily rice intake: group 1 (≤300 g), group 2 (300-450 g), and group 3 (≥450 g). The relationship between daily rice intake and the following factors was analyzed in the three age brackets: (1) physical measurements including waist circumference, (2) physiological measurements, (3) serum biochemical indices, (4) whether or not the person was taking medication for hypertension, diabetes mellitus or serum lipid abnormalities, (5) lifestyle, and (6) consumption of foods other than rice.
Results: Daily rice intake was related strongly to the occurrence of MetS in all three age brackets. Multiple logistic regression analysis showed (1) a significant increase in the odds ratio for MetS (1.461 times) for group 3 compared with group 1 in men aged 40-49 yrs and (2) a significant increase in the odds ratio for MetS (1.501 times) for group 3 compared with group 1 in men aged 50-59 yrs. However, there was no significant difference in the odds ratio for MetS among rice intake groups in the 60-74 age bracket.
Conclusion: In men aged 40-59 yrs, daily rice intake strongly influenced the incidence of MetS, whereas in men aged 60-74 yrs, there was no relationship between daily rice intake and MetS.

Objectives: To determine the effects of massage therapy on the immune and psychological state, and serum lipids levels.
Design: A non controlled trial with 32 subjects.
Setting: Kyoto Prefectural School for the Blind and Kyoto Prefectural University of Medicine.
Subjects: 32 adults aged from 18 to 56 years (10 males; 22 females).
Interventions: One 25-min whole body massage.
Outcome Measures: Changes in peripheral blood levels of red blood cells (RBC), hematocrit (Ht), white blood cells (WBC), lymphocytes, neutrophils, CD4+ lymphocytes, CD8+ lymphocytes, CD4+/CD8+ ratio, CD16+ lymphocytes, serum interferon-γ (IFN-γ), serum interleukin 6 (IL6), serum total cholesterol (T-CHO), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c); saliva secretory IgA (s-IgA); State-Trait Anxiety Inventory (STAI).
Results: Psychological measures; Both state and trait anxiety scores decreased significantly (p<0.001). Serum lipids; Significant hemodilution and significantly decreased levels of serum T-CHO, LDLc and HDLc (p<0.001) were observed. Immune measures; Significant decreases of neutrophils (p<0.05) and CD16-positive cell counts (p<0.01) were recognized.
Conclusions: It was suggested from our result in the present study that massage therapy is an effective relaxation/stress management technique which could reduce anxiety and modulate immune function.

Cardiac fibromas are rare tumors. A 12-year-old girl who had no cardiac symptoms was evaluated because of her abnormal ECG. Physical examination revealed a grade 1/6 systolic murmur. Routine laboratory examination results and the chest X-ray films were normal. The ECG showed a negative T wave at leads II, III, aVF and V_3-4. Two-dimensional echocardiography demonstrated a tumor in the lower right ventricular free wall. Operation was performed on July 12, 1990. Sharp dissection was used to remove the tumor through right ventriculotomy. She had an uneventful postoperative course and is well 7 years later with no evidence of recurrence. Pathological findings including immunohistochemical studies revealed cardiac fibroma. The 22 reported cases of cardiac fibroma in Japan were reviewed.

Left ventricular myxoma is very rare and only 13 cases have been reported in Japan. A 14-year-old girl was admitted to a local hospital in November, 1983, with a sudden onset of right hemiparalysis. Two-dimensional echocardiograms and left ventricular angiograms revealed two left ventricular tumors. The patient was transferred to our hospital for the operation which was performed one month later. Two tumors originating from the apical interventricular septum were removed with resection of the septum through a left ventriculotomy. The tumors were 2.0×1.7cm in size and 1.9g in weight, 1.9×1.5cm in size and 1.1g in weight, respectively. The pathological diagnosis was myxoma. Her postoperative course was uneventful, and there has been no recurrence for 15 years after surgery. Japanese literature on the subject was reviewed.

Urgent surgical repairs were successfully performed in four patients with blunt traumatic ruptures of the thoracic aorta. All 4 patients were involved in traffic accidents and had ruptures immediately distal to the aortic isthmus. The diagnoses were achieved by IV-DSA in case 1, by IV-DSA and enhanced CT in case 2 and by enhanced helical CT in cases 3 and 4. Intraoperative transesophageal echocardiography was performed in case 4. Operations were accomplished with the aid of temporary shunt in case 1, pulmonary-femoral artery bypass in case 2 and partial left heart bypass in cases 3 and 4. Prosthetic graft interposition was performed in cases 1, 3 and 4 and end-to-end aortic anastomosis was performed in case 2. There was no postoperative paraplegia in any patient. Early diagnosis and urgent surgical repair are important in treating blunt traumatic rupture of the thoracic aorta. Enhanced helical CT and transesophageal echocardiography are useful for the diagnosis of this type of injury.

The case involved a 73-year-old woman who underwent surgical resection for right renal cell carcinoma extending to the inferior vena cava. During surgery the tumor thrombus disappeared from the inferior vena cava. We performed transesophageal echocardiography and detected the tumor thrombus in the right ventricle. Therefore, we immediately tried to remove the thrombus using cardiopulmonary bypass. However, we could not find the tumor thrombus in the right ventricle or in the main pulmonary artery. We used angioscopy of the pulmonary artery and detected the tumor thrombus at the orifice of the inferior pulmonary artery. The tumor thrombus was removed under direct visualization. In the event of an intraoperative pulmonary embolism, simple and safe techniques for exact and rapid diagnosis are needed. Intraoperative angioscopy allows direct visualization of the pulmonary arterial branches and appears to be very useful for detection of tumor thrombi even in emergency cases.