Background: Complementary medicine and alternative medicine have been included in the curricula of many medical schools and colleges; however, teaching methods have not been standardized. We gave lectures and practical instruction on acupuncture and moxibustion medicine to medical students during their clinical clerkship in anesthesiology. We used a questionnaire to evaluate the usefulness of small-group teaching.
Methods: The subjects were 93 fifth-year medical students doing clinical clerkships in anesthesiology. The clinical clerkship consists of small-group learning with 2 or 3 students per group. After a lecture and practical instruction on acupuncture and moxibustion were given, students were asked to fill out a questionnaire about their interest in and basic knowledge of acupuncture and moxibustion and whether they would like to master the technique.
Results: All 93 students answered the questionnaire （response rate, 100%）. After the small-group teaching, students became more interested in acupuncture and moxibustion and learned that the costs of treatment were covered by health insurance. Most students were interested mastering acupuncture and moxibustion in the future.
Discussion: Our results suggest that lectures and practical instruction during clinical clerkship are useful for getting medical students interested in acupuncture and moxibustion medicine.

IABP is in wide clinical use as an effective adjunctive means for the management of seriously impaired cardiac function. Unfortunately, however, it is an undeniable fact that this specialized circulatory support technic has so far been used in severe heart disease cases in a desultory way, with no established criteria being available for indication of elective IABP for prophylactic purposes. Under such circumstances, it was felt worthwhile to analyze data on preoperative left ventricular function from a series of open heart surgery cases (25 treated with and 94 without IABP) encountered in our hospital since 1983 (when procedure for myocardial protection was virtually standardized) in an effort to formulate acceptable criteria for indication of elective IABP. Hemodynamic parameters studied were LVESVI, LVEF and LVEDP. The results led us to conclude that scheduled IABP can be regarded as indicated for use in each of the following valvular heart diseases if at least one of the respective criteria specified below is fulfilled: MR: LVESVI≥120ml/m², LVEF≤0.4, LVEDP≥21mmHg; AR: LVESVI≥135ml/m², LVEF≤0.4, LVEDP≥18mmHg; MS: LVESVI≥70ml/m², LVEF≤0.35, LVEDP≥23mmHg.

Adult ; Aged ; Audiometry, Evoked Response ; Hearing Loss, Sensorineural ; physiopathology ; Humans ; Middle Aged ; Recurrence

A-kinase anchoring protein (AKAP) 12 is a scaffolding protein that anchors various signaling proteins to the plasma membrane. These signaling proteins include protein kinase A, protein kinase C, protein phosphatase 2B, Src-family kinases, cyclins, and calmodulin, which regulate their respective signaling pathways. AKAP12 expression is observed in the neurons, astrocytes, endothelial cells, pericytes, and oligodendrocytes of the central nervous system (CNS).Its physiological roles include promoting the development of the blood–brain barrier, maintaining white-matter homeostasis, and even regulating complex cognitive functions such as long-term memory formation. Under pathological conditions, dysregulation of AKAP12 expression levels may be involved in the pathology of neurological diseases such as ischemic brain injury and Alzheimer’s disease. This minireview aimed to summarize the current literature on the role of AKAP12 in the CNS.

We previously described a rare case of anaphylaxis presumably induced by carminic acid in cochineal dye used as a food additive. In this study, highly pure carminic acid was added to an albumin-containing buffer at various concentrations, followed by serial dilution. Varying the mixing ratio of carminic acid and albumin affected the extent of histamine release from passively sensitized basophils. Similar basophil histamine release occurred with carminic acid-globulin solutions. These results provide experimental evidence indicating that basophil activation is dependent on hapten (carminic acid) and carrier (protein) interaction.
Anaphylaxis ; Basophils ; Carmine ; Food Additives ; Histamine Release ; Hypersensitivity ; In Vitro Techniques

Background/Aims: Empiric antibiotics are given in combina-tion with biliary drainage for acute cholangitis but sometimes turn out to be insensitive to microorganisms in blood and bile. Clinical outcomes were compared according to sensitiv-ity to microorganisms detected in blood and bile culture to evaluate the impact of sensitivity to empiric antibiotics in cholangitis. Methods: Consecutive patients who underwent biliary drainage for acute cholangitis were retrospectively studied. Clinical outcomes such as 30-day mortality, length of hospital stay and high care unit stay, organ dysfunction and duration of fever were compared in three groups: group A (sensitive to both blood and bile culture), group B (sensitive to blood culture alone) and group C (insensitive to both blood and bile culture). Results: Eighty episodes of cholangitis were classified according to sensitivity results: 42, 32 and six in groups A, B and C. Escherichia coli and Klebsiella were two major pathogens. There were no significant differences in 30-day mortality rate (7%, 0%, and 0%, p=0.244), length of hospital stay (28.5, 21.0, and 20.5 days, p=0.369), organ dysfunc­tion rate (14%, 25%, and 17%, p=0.500), duration of fever (4.3, 3.2, and 3.5 days, p=0.921) and length of high care unit stay (1.4, 1.2, and 1.7 days, p=0.070) in groups A, B and C. Empiric antibiotics were changed in 11 episodes but clinical outcomes appeared to be non-inferior even in 31episodes of cholangitis who were on inadequate antibiotics throughout the course. Conclusions Sensitivity of empiric antibiotics was not associated with clinical outcomes in acute cholangitis.

BACKGROUND: Preventing the need for long-term care (LTC) by identifying physical function risk factors are important to decrease the LTC burden. The objective of this study was to investigate whether grip strength and/or walking speed, which are components of the frailty definition, are associated with LTC in community-dwelling older and oldest people. METHODS: The participants were 1098 community-dwelling older and oldest people who had not received LTC at the baseline. The endpoint was receiving LTC after the baseline survey. The independent variables were grip strength and walking speed, and participants were divided into two groups based on these variables. The confounding factors were age, sex, the Japanese version of the Montreal Cognitive Assessment (MoCA-J), hypertension, diabetes mellitus, stroke, joint diseases, living alone, body mass index, and serum albumin. We calculated the hazard ratio of receiving LTC using the Cox proportional hazard model. RESULTS: Among the 1098 participants, 107 (9.7%) newly received LTC during the follow-up. Regarding the physical function, only slow walking speed was significantly correlated with LTC after adjusting for all confounding factors except the MoCA-J score (HR = 1.74, 95% CI = 1.10-2.75, P = .018). However, slow walking speed was still a risk factor for LTC after adjusting for the MoCA-J score and other confounding factors (HR = 1.64, 95% CI = 1.03-2.60, P = .037). CONCLUSIONS The findings from this study may contribute to a better understanding of slow walking speed as a factor related to LTC, which might be a criterion for disability prevention and could serve as an outcome measure for physical function in older people.
Aged ; Aged, 80 and over ; Exercise ; Female ; Humans ; Independent Living ; statistics & numerical data ; Japan ; Long-Term Care ; statistics & numerical data ; Male ; Proportional Hazards Models