Hochu-ekki-to is one type of medicine that improves a Ki-deficiency. We therefore investigated the effects of Hochu-ekki-to on symptoms indicating a state of Ki-deficiency. In addition, we studied the effects of Hochu-ekki-to on blood pressure or body temperature. We studied 14 adult male patients with symptoms of general fatigue, lack of will power and appetite loss. We orally administered 7.5g of Hochu-ekki-to extract fine granules (EK-41) (Kanebo Pharm. Co, Tokyo, Japan) per day for four weeks. Before the oral administration of EK-41, and again four weeks later, we investigated any improvement of symptoms, and changes in the blood pressure or body temperature. After the oral administration of EK-41 for four weeks the general fatigue or lack of will power improved significantly (p<0.05), and we observed a significant increase in body temperature (p<0.05). The over all rate of “improvement” was 57.1%, and the rate for “slight improvement or more” was 71.4%. The oral administration of Hochu-ekki-to not only improved the symptoms of general fatigue and lack of will power but also raised the body temperature. This leads us to suspect that Hochu-ekki-to increased the metabolic function. We therefore consider the oral administration of Hochu-ekkito to be useful for the treatment of Ki-deficiency state patients with the symptoms of general fatigue and lack of will power.

We have surveyed what physicians in our department think about postgraduate education in bioethics. Although 90% of physicians recognized the importance of bioethics education, 90% of physicians had not taught bioethics to residents and had not read any bioethics books in the last 2 years. Approximately 80% of physicians believed that discussions were needed to confirm residents' awareness of bioethics and life-and-death issues but that residents and physicians do not need to read relevant books and mandatory reports to deepen their awareness of bioethics. Because many physicians in our department have little motivation to improve their view of bioethics, postgraduate education in bioethics is needed for both residents and physicians.

Abnormal Q wave which suggest myocardial necrosis frequently develope after successful reperfusion in acute myocardial infarction(AMI). To investigate patterns of abnormal Q wave development and the significance of the rapid progression of Q wave after reperfusion therapy, sixty patients with first attack of anterior AMI were studied. All patients showed complete occlusion of proximal or mid left anterior desending artery and received intracoronary thrombolysis therapy(ICT) with urokinase. ICT was completed within 6 hours of chest pain. Fourty for patients were reperfused. There were significant correlation between the number of leads with Q waves before ICT(PRE-nQ) and after ICT(POST-nQ) both in patients with reperfused and failed reperfusion(r=0.68, 0.96). Three patterns of abnormal Q wave progression were identified by the first correlationship of PRE-nQ and POST-Nq. Abnormal Q waves were rapidly progressed in 14 patients(Group I : 31.8%), regressed in 10 patients(Group II : 22.7%) and natureally progressed in 20 patients(45.5%). Patients in Group I had greater creatine kinease release(6133+/-2536mIU) and higher QRS score(immidiate ICT : 7.9+/-3.0, 7th day : 8.7+/-3.0) than those of patients in Group II(2135+/-1701mIU, 3.6+/-3.0, 4.6+/-3.3, respectively, P<0.01, all). A significant decreased wall motion of infarcted area was observed in Group I patients(% area change, area 26.1+/-14.0%) compared with Group II patients(46.5+/-10.7%, P<0.05). The followings can be concluded : Three patterns of abnormal Q wave progression were noted after reperfusion therapy in patients with anterior AMI. Rapid progression of abnormal Q wave may indicate accelerated ischemic injury or reperfusion injury rather than salvaging myocardium.
Arteries ; Chest Pain ; Creatine ; Humans ; Infarction* ; Myocardial Infarction ; Myocardium ; Necrosis ; Reperfusion Injury ; Reperfusion* ; Urokinase-Type Plasminogen Activator

Choto-san was administered to 6-week-old spontaneously hypertensive rats (SHR) at the usual dose used for humans and at a 10-times higher dose, and its effects on blood pressure and the autonomic nervous system were examined. Significant blood pressure elevation was noted in the SHRs administered with the 10-fold dose, but no such changes were observed in the SHRs that were administered the usual human dose. Since the urinary levels of adrenaline and noradrenaline and the granulocyte count significantly increased in the 10-fold dose group, the elevation in blood pressure in this group appears to be attributable to stimulation of the sympathetic nervous system. Accelerated sympathetic nervous activity is noted in SHRs during the growing stage, and the excessively high dose of Choto-san probably further stimulated the sympathetic nervous activity.