The purpose of this study was to investigate semitendinosus muscle (ST) behavior during isometric knee flexions. Healthy male subjects were directed to exert ramp isometric knee flexion up to a maximum of eight knee flexion angles (0, 15, 30, 45, 60, 75, 90, 105 degrees). Displacement of the tendinous intersection (TI) in ST was measured using ultrasonographic images. TI moved proximally 15.8±4.9mm by maximum isometric contraction at 0 degrees, and the displacement of TI was significant at over 30% ramp maximum. Maximum knee flexion torque significantly correlated to displacement of TI at every knee angle, and decreased as the flexion angle increased. These results suggested that TI moved proximally in accordance with flexion torque, and demonstrated the unique behavior of ST, that is, the proximal part concentrically contracted, whereas the distal part eccentrically contracted.

Many researchers have pointed out that CO₂ bathing directly effects expanding dermal vessels. To clarify the effect of CO₂ bathing on red blood cell (RBC), the change of RBC viscosity after single bathing(for 10 minutes at 40°C) with artificial CO₂ water made of sodium bicarbonate and citric acid dissolved in plain water was investigated. RBC viscosity was measured at both shear rates of 0.0439 (low) and 94.5 (high) sec^-1 using a viscosimeter (Low Shear 30 made by Contraves). The subjects of this study consisted of three male patients and three female patients with a history of cerebro-vascular disease and ranging from 53 to 80 years old.
The results are presented below.
1) On the twenty-first day of serial CO₂ bathings, a significant decrease in RBC viscosity was found in these patients as compared with that in controls who were subjected to bathing with plain water. However, it was not found on the first day. RBC viscosity of the blood sample that has an elevated PCO₂ due to the CO₂ gas bubbled into it was measured in relation with the PCO₂. RBC viscosity decreased gradually at both shear rates as the PCO₂ was elevated and the MCV increased.
2) MCV increased significantly after single bathing on the twenty-first day of serial CO₂ baths as compared to that of controls who were subjected to bathing with plain water.
3) ATP concentration in RBC decreased significantly after single bathing as compared to that before bathing.
From these results, we can conclude that serial CO₂ baths effectively decrease RBC viscosity due to the increase in MCV, which is attained by CO₂ through “chloride shift.”

Many researchers have pointed out that CO₂ bathing directly effects expanding dermal vessels. The authors have recently reported a decrease in red blood cell after CO₂ bathing. To clarify other effects of CO₂ bathing on RBC, the changes in the hemoglobinoxygen-dissociation curve (P50) were measured after single bathing (for 10 minutes at 40°C) with artificial CO₂ water made of sodium bicarbonate and citric acid dissolved in plain water. P50 was measured with an oxygen-dissociation analyzer (HEMO-O-SCAN^TM made by American Instrument Company) and 2, 3-diphosphoglycerate (2, 3-DPG) in RBC, with enzymatic analysis. The subjects of this study consisted of six male patients and four female patients, ranging from 53 to 80 years old.
The results are presented below.
1) Nine of ten patients showed an increase in P50 after 15 to 30 minutes of CO₂ bathing. The remainder showed a transient increase in P50.
2) No significant increase in 2, 3-DPG concentration in RBC was found in the group subjected to CO₂ bathing as compared to that of the controls who were subjected to plain water bathing. However, seven patients showed an increase in 2, 3-DPG after 15 to 30 minutes of CO₂ bathing, and three patients showed a decrease in 2, 3-DPG.
3) Partial pressures of oxygen (PO₂) and carbon dioxide (PCO₂) in the venous blood were measured. Elevation of PO₂, lowering of PCO₂, and increase in pH were observed in almost all patients after a single CO₂ bath.
From these results, we can conclude that a single CO₂ bath effectively decreases oxygen affinity of hemoglobin, presumably due to a rise in the blood temperature and partially due to an increase in 2, 3-DPG concentration in RBC.

In repair of the tricuspid valve (TV) due to Ebstein's anomaly, mobilization of the anterior leaflet associated with longitudinal right ventricle placation (Carpentier's procedure) has provided good results in both short- and long-term follow-up. However, if the anterior leaflet is small or severely deformed, such repair may be ineffective. We report two cases of Ebstein's anomaly (63 and 53 years old) with deformed anterior leaflets of the TV in whom Carpentier's procedure was not feasible. In one patient, the anterior leaflets were broadly plastered on the right ventricle and Carpentier's procedure was tried. However, the repair was converted to valve replacement because of significant residual regurgitation. The other patient had a cleft in the anterior leaflet, therefore Carpentier's procedure was not suitable. The repair restructured the valve mechanism below the true annulus by using the most mobile leaflets for valve closure (modified Hetzer's procedure). This method of repair could be an alternative method to repair of the TV in Ebstein's anomaly, particularly when the anterior leaflet is deformed.

Objective: This study aimed to elucidate the electro-clinical characteristics of epilepsy and immunological markers in patients with epilepsy after infl uenza-associated encephalopathy/encephalitis (IAE). Methods: Eighteen patients with epilepsy after IAE (8 males, 10 females; mean age of onset 6.4±6.4 years) were studied. Antibodies to glutamate receptor (GluR) ε2 (NR2B) were examined by immunoblot and ELISA. Cytokines were measured by BioPlex. Results: Mean interval between IAE and epilepsy onset was 63.2 ± 95.0 days (mean ± SD). In 16 of 18 patients, complex partial seizures were observed. Most complex partial seizures were of short durations and showed few lateralizing signs. Interictal discharges were seen in the frontal area in 7 of 14 patients. Ictal EEG showed rapid propagation to bilateral hemispheres. Patients with higher cerebrospinal fl uid levels of anti-GluRε2 antibodies, higher cerebrospinal fl uid levels of IL-1β, soluble tumor necrosis factor receptor 1 and IFN-γ during chronic stage, had higher frequency of epileptic seizures. Conclusion: This study indicates that the frontal lobes are susceptible to rapid epileptogenesis after IAE, and that epileptic partial seizures after IAE had characteristics resembling generalized seizures. Presence of anti-GluRε2 antibodies and elevated IL-1β, TNFα, and IFN-γ in cerebrospinal fl uid may be associated with intractability of epileptic seizures.

We administered a Kampo decoction containing bushi (prepared aconiti tuber) or uzu (un-prepared aconiti tuber) to two children in Aso Iizuka hospital. Case 1 was a thirteen year-old girl with atopic dermatitis that worsened after her topical steroid was stopped. When her itching sensation was reduced following a bath, we considered that she was suffering from coldness. Therefore we administered a half dose of bukuryoshigyakuto.The next morning her old skin flaked off and her skin appeared healthy. We administered bukuryoshigyakuto before every meal and there was rapid improvement in her dermatitis. Case 2 was a twelve year-old girl with orthostatic dysregulation who was unable to attend school. She had become aware of coldness the previous autumn and had not been able to go to school, nor even sit up, since the previous winter because of severe fatigue. We diagnosed her with severe coldness and so started sekiganryo administration, and included 2 g of uzu. We gradually increased the uzu. At a result, her severe fatigue improved to the extent that she could eat breakfast and go to school inside the hospital. Children may have severe coldness if they suffer from a long-term illness. Moreover, particular attention should be given to toxicity caused by aconiti tuber.

A 51-year-old male with cyclic neutropenia, on whom we previously reported, was admitted to our hospital with severe abdominal pain and diarrhea four years and seven months after his last hospitalization. Since then, he has received Kampo treatment at our hospital every three weeks, with good clinical results. This time, he was at first treated with Kampo daikenchuto combined with bushikobeito, which had been effective during his last hospitalization, although this time the remedy had no effect. From the viewpoint of Japanese traditional (Kampo) medicine, it was considered that the patient had severe cold syndrome. He was given uzukeishito three times a day (at 10.00, 15.00 and 20.00 hours). The dose of uzu in uzukeishito was gradually increased. Daiuzusen, in which the dose of uzu (an aconite) was 1g or 2g, was also administered five times a day due to the patient's very severe abdominal pain. On the fourth day of uzukeishito administration, the patient felt very hot and still had severe abdominal pain, although this pain was different from the previous pain, thirty minutes after daiuzusen (with 2g dose of uzu) was administered. This reaction can better be explained as mengen rather than uzu poisoning. Very soon he had a good appetite, his abdominal pain was reduced and the cycle of neutropenia was normalized. The case suggests that in cases of very severe cold syndrome, frequent and high-dose administration of aconite component medicine can be effective.

STUDY DESIGN: Retrospective study. PURPOSE: We conducted a study to investigate the time course changes in bone metabolic markers after the administration of the anti-receptor activator of nuclear factor-kappa B ligand (RANKL) antibody and to assess drug compliance among osteoporotic patients. OVERVIEW OF LITERATURE: The anti-RANKL antibody is expected to provide an improvement in those with a bone metabolism disorder. However there are only a few clinical reports available on the effect of treatment. METHODS: We included 40 post-menopausal osteoporotic patients who received the anti-RANKL antibody. To determine the time course changes in the bone metabolic markers, we measured the serum tartrate-resistant acid phosphatase 5b (TRACP 5b; a bone resorption marker) and the serum N-terminal propeptide of type 1 collagen (P1NP; a bone formation marker) levels prior to and 1 month after administrating the anti-RANKL antibody. To evaluable drug compliance, we assessed the dropout rate during treatment and at 6 months after treatment. RESULTS: The average TRACP 5b level significantly decreased from 574.8 mU/dL before treatment to 153.2 mU/dL 1 month after treatment (p<0.05). There was no significant difference in the average P1NP level, which was 56.9 microG/L and 35.1 microG/L before and 1 month after treatment, respectively (p>0.05). As for drug compliance, we did not have any dropouts during the treatment or after 6 months (dropout rate: 0%). CONCLUSIONS: Our study suggests that anti-RANKL antibody treatment suppresses bone resorption and maintains bone formation.
Acid Phosphatase ; Bone Resorption ; Collagen Type I ; Compliance* ; Humans ; Metabolism ; Osteogenesis ; Osteoporosis* ; Patient Dropouts ; RANK Ligand ; Retrospective Studies

There were some mistakes in the numerical values of the graphs.

  We reviewed the clinical features and treatment outcome of 110 children with leukemia. Treatment was performed between 1980 and 2009 at our hospital. The mean age at onest was 5 years 6 months, the ratio of males to females was 1:0.72, and mean leukocyte count was 4.91×10⁴/μl. Subtypes of leukemia were acute lymphoblastic leukemia (ALL) in 79.1% of the patients, acute myeloid leukemia (AML) in 17.2%, and chronic leukemia in 3.6%. In all patients, the overall 30-year survival rate estimated by the Kaplan-Meier method was 67.4%. In the three decades from the 1980s, the overall 10-year survival rate has been improved significantly from 46.4% in the 1980s, 69.2% in the 1990s to 87.2% in the 2000s (P<0.01). The overall 10-year survival rate was 70.7% in all children with ALL, and 70.6% in all children with AML. But in the last decade, the 10-year survival rate was improved to 87.0% in children with ALL and 87.3% in children with AML. Twenty-four patients received hematopoietic stem-cell transplantation, and the 10-year survival rate was 58.6% after transplant. Second malignancies were detected in three patients, and six patients have long-term sequelae. In conclusionn, the treatment result of childhood leukemia has improved considerably, so that more intensive treatment for patients with poor prognosis and less toxic treatment for patients with good prognosis will be necessary in future.