[Objective]In order to provide proper educational guidance to work-study students attending an acupuncture school, learning-related standards were prepared by conducting an exploratory inventory survey, and the relationships among willingness to learn, average test scores, and the number of absences was investigated.
[Methods]Subjects were 234 work-study students majoring in acupuncture at a vocational school. The construct validity of the standards and the verification validity of external variables were investigated using exploratory factor analysis and structural equation modeling.
[Results]The results of exploratory factor analysis revealed the following four factors affecting learning:fatigue, willingness to learn, career matching, and class environment. With verification validity, a model having the number of absences at the center matched the data well (GFI=0.959, AGFI=0.929, RMSEA=0.057, and CFI=0.912).
[Conclusion]For proper educational guidance, the establishment of guidance based on the number of absences-which is affected by willingness to learn and in turn affects average test scores-appears valid.

The purpose of this study was to examine the effects of silver spike point (SSP) therapy on peripheral circulatory function in workers exposed to hand-arm vibration by analyzing the second derivative of photoplethysmogram (SDPTG). Seventy-seven male subjects including public service workers and forestry workers volunteered for the present study. After the SSP therapy on LI4 (Hege) and LI10 (Shousanli) at 1Hz for 10 minutes, the SDPTG-index was significantly increased among the subjects whose SDPTG-index was below the 50th percentile curve of the normal aging curve. The result suggests that the SSP therapy is useful in the improvement of peripheral circulatory function in workers exposed to hand-arm vibration.

To clarify the effects of Silver Spike Point (SSP) therapy on the autonomic nervous function, we evaluated changes in the peripheral circulatory function by second derivative photoplethysmogram (SDPTG) on 22 workers exposed to hand-arm vibration. We also examined the responses of the autonomic nervous function using the coefficient of variation of R-R interval (CV_R-R), total number of white blood cells (WBC), and the ratio of granulocyte (GC) and lymphocyte (LC) as indexes.
As a result, we observed improved peripheral circulation due to the SSP therapy, in which the average pulse rare (PR) tended to decrease, CV_R-R was not significantly changed by the therapy, and WBC and LC were significantly decreased by the therapy.
The 22 subjects were divided into two groups (low-value group, 8 subjects; high-value group, 14 subjects) according to the data of CV_R-R revised using Fujimoto's method. In the low-value group, PR tended to decrease, and SDPTG-index and c/a tended to increase. In the high-value group, on the other hand, CVR-R and LC tended to decrease and WBC significantly increased.
In conclusion, SSP therapy enhanced the parasympathetic nervous function and improved the peripheral circulatory function in the parasympathetic-nervous-function-impaired the group (low-value group). Furthermore, it suppressed the parasympathetic nervous function without affecting the peripheral circulatory function in the parasympathetic-nervous-function-enhanced group (high-value group).

Infrared thermography was performed on 38 forestry workers. The thermograms were analyzed separately for the left and right hands of each subject. Of 75 hands evaluated, vibration-induced white finger was noted in 18 (VWF group), and no symptoms were noted in 57 (non-VWF group). In addition to the above two groups, 42 subjects (84 hands) who had no symptoms of vibration exposure were used as a control group. Based of the thermograms taken after a local warming of the hands for 5min, the temperature distributions of the dorsal aspect of subject's hands were evaluated, and the thermal images of the hand with VWF were categorized into three main patterns. To establish a quantitative evaluation index that incorporates the characteristic thermal image observed in the VWF group, we constructed the representative parameters for each of the three thermogram patterns, and a linear discriminant analysis was performed using the presence or absence of VWF symptoms as the dependent variable and the constructed parameters as the independent variables. A discriminant score derived from this model expression was used as the evaluation index. The accuracy of the index was estimated according to a receiver operating characteristic (ROC) curve, and the area under the curve of 0.942 was obtained (p<0.001). When the cutoff point was set at the maximum point in the Youden index, the sensitivity of the VWF group was 94.4%, and the specificity of the non-VWF group and control group was 84.2% and 89.3%, respectively. These findings suggest that this newly proposed quantitative analysis method, which uses the thermal distributions of the dorsal side of the hand as indicators, may be useful for evaluating peripheral circulatory impairment of HAVS.

The peak (dPower/dt), the maximum value of dPower/dt calculated by differentiation of ventricular power with respect to time, is verified from the physiological studies to be quite useful index indicating the ventricular contractility independent of the pre- and afterloads. However, the index has the disadvantage in the clinical application that it can not be measured by a non-invasive method. In the present study, peak (dPower/dt) could successfully be determined in a non-invasive manner as the product of aortic flow as measured with an ultrasonic pulsed Doppler flowmeter and brachial blood pressure as measured with cuff in the new apparatus. Involved in this study were 21 children, 52 adults with normal cardiac performance and 11 adult patients with coronary artery disease. The measurement of the index was successfully carried out in 28 of 61 adults and especially 16 of 21 children. The results of the study are summarized as follows:
1. Power waveform is similar to blood flow waveform and is little influenced by blood pressure waveform.
2, Peak (dPower/dt) can be determined as product of peak rate of change of aortic flow (peak (dF/dt) ) and mean brachial blood pressure without resorting to measurement of blood pressure waveform.
3. Peak (dPower/dt) was found significantly lower in cases having an ejection fraction less than 50% (93.5 J/sec²) than in those showing an ejection fraction of above 50% (145.3 J/sec²) (p<0.001) .
4. Peak (dPower/dt) normalized with body surface area was not significantly different from 8 years old children (80.2 J/sec²/m²) and 21-34 years old adults (88.0 J/sec²/m²) . According to this index, the cardiac contractility of 8 yearus old children seemed to reach the adult level.
From these findings it is concluded that the non-invasive method of determining a cardiologic parameter, peak (dPower/dt), as an index of cardiac contractility provides a means of salient clinical value.

The purpose of the present review is to evaluate the effects of common risk factors for suicide by meta-analyses using data extracted from studies based on the psychological autopsy method. We focused on five common risk factors of suicide: substance-related disorders, mood disorders, adverse marital status, adverse employment status, and self-harm behaviors. A total of 24 articles were identified from MEDLINE in which the crude odds ratio (OR) could be calculated for the above five risk factors through 30 April 2007, using such search keywords as "suicide," "psychological autopsy," and "case-control study." Overall, both substance-related disorders [OR = 5.24; 95% confidence interval (CI) = 3.30-8.31] and mood disorders [OR = 13.42; 95% CI = 8.05-22.37] were strongly associated with suicidal risk. Suicidal attempt and deliberate self-harm, which can directly lead to completed suicide, have been shown to be very strongly associated with suicidal risk [OR = 16.33; 95% CI = 7.51-35.52]. Effects of social factors such as adverse marital and employment status were relatively small. As substance-related disorders and mood disorders were strongly associated with an increased risk of completed suicide, the comorbidity of these two disorders should be paid a maximum attention. The effective prevention of suicide depends on whether we can successfully incorporate these personal factors as well as social factors into an adequate multi-factorial model.

STUDY DESIGN: Retrospective case-control study. PURPOSE: To determine whether kissing spine is a risk factor for recurrence of sciatica after lumbar posterior decompression using a spinous process floating approach. OVERVIEW OF LITERATURE: Kissing spine is defined by apposition and sclerotic change of the facing spinous processes as shown in X-ray images, and is often accompanied by marked disc degeneration and decrement of disc height. If kissing spine significantly contributes to weight bearing and the stability of the lumbar spine, trauma to the spinous process might induce a breakdown of lumbar spine stability after posterior decompression surgery in cases of kissing spine. METHODS: The present study included 161 patients who had undergone posterior decompression surgery for lumbar canal stenosis using a spinous process floating approaches. We defined recurrence of sciatica as that resolved after initial surgery and then recurred. Kissing spine was defined as sclerotic change and the apposition of the spinous process in a plain radiogram. Preoperative foraminal stenosis was determined by the decrease of perineural fat intensity detected by parasagittal T1-weighted magnetic resonance imaging. Preoperative percentage slip, segmental range of motion, and segmental scoliosis were analyzed in preoperative radiographs. Univariate analysis followed by stepwise logistic regression analysis determined factors independently associated with recurrence of sciatica. RESULTS: Stepwise logistic regression revealed kissing spine (p=0.024; odds ratio, 3.80) and foraminal stenosis (p<0.01; odds ratio, 17.89) as independent risk factors for the recurrence of sciatica after posterior lumbar spinal decompression with spinous process floating procedures for lumbar spinal canal stenosis. CONCLUSIONS: When a patient shows kissing spine and concomitant subclinical foraminal stenosis at the affected level, we should sufficiently discuss the selection of an appropriate surgical procedure.
Case-Control Studies ; Constriction, Pathologic ; Decompression ; Humans ; Intervertebral Disc Degeneration ; Logistic Models ; Magnetic Resonance Imaging ; Odds Ratio ; Postoperative Complications ; Range of Motion, Articular ; Recurrence ; Retrospective Studies ; Risk Factors ; Sciatica* ; Scoliosis ; Spinal Canal ; Spine ; Weight-Bearing