[Purpose]Ginger-partitioned moxibustion is indirect moxibustion of putting sliced ginger between the skin and the moxa. It can give mild stimulation with damp heat. The characteristic of the temperature by the thickness of the ginger was investigated with a temperature sensor without changing the weight of the moxa. Moreover, the relation between the result of a questionnaire on thermal sense and maximum temperature was investigated by applying different thicknesses of ginger-partitioned moxibustion to participants.
[Method]A thermometer was fixed on a wood board 3mm thick. Ginger was cut in a 2 cm square, in three kinds of thickness; 3mm, 5mm, and 7 mm. The temperature change was measured every 30 seconds when the cone-shaped moxa (weight: 200 mg, diameter: 2cm, height: 2cm) was burnt on the ginger for each thickness. Next, the thermal sense of the human body was investigated for ginger-partitioned moxibustion. The maximum temperature of ginger-partitioned moxibustion to the forearm of participants was measured by the thermometer set between the sliced ginger and skin. After moxibustion, we did a questionnaire survey about thermal sense and comfort sense.
[Result]As a result of measuring the temperature on the wood board, the maximum temperature decreased and the time to reach the maximum temperature took a long time according to ginger thickness. Ginger-partitioned moxibustion applied to the human body resulted in a correlation between thermal sense and the maximum temperature. The thinner sliced ginger had the stronger thermal sense. Participants who answered little comfort, comfortable or very comfortable were 5/10 people in the 3mm thickness sliced ginger, 9/12 people in the 5 mm ginger group, and 5/9 persons in the7 mm ginger group.
[Discussion and Conclusion]The thickness of ginger can be an important factor that influences the quantity of stimulus of ginger-partitioned moxibustion. In investigating the comfort sense, the stimulation of ginger-partitioned moxibustion was expected to give the comfort. But four of ten participants who received ginger-partitioned moxibustion with a 3mm thickness felt uncomfortable. If we apply ginger-partitioned moxibustion of 200 mg to patients without discomfort, it is undesirable that the ginger thickness be 5 mm or less.

[Purpose] People have various mental images of moxibustion treatment. The purpose of this study was to investigate relationships between weight of moxa and perceptions of moxibustion treatment.
[Methods] We administered a questionnaire survey on moxibustion to 75 new students and visitors to this college. Furthermore, we instructed subjects to make a moxa as they imagined it would be used in moxibustion treatment, then measured these moxa.
[Result] The questionnaire survey had many replies indicating that moxibustion is associated with images of “hot”, “scar remains”, and “effective”.
Comparing the weights of moxa made by people with moxibustion experience to those made by people with no moxibustion experience, moxa was lighter for the experienced group than for the inexperienced group.
Furthermore, when weight of moxa was compared based on images of moxibustion, only moxa of the group with positive images of moxibustion tended to be light.
[Conclusion] Image size of the moxa appears to be connected with impressions and experiences of moxibustion treatment.

Senile patients with heart disease were evaluated in order to study the correlation between their mental and physical activities in daily life. Mental activity was classified using Hasegawa's dementia scale, and physical activity was measured by the number of steps per day recorded with a passimeter. It was found that;
1) Hasegawa's dementia score was positively related to the number of steps.
2) Hasegawa's dementia score was significantly increased after walking training for 1 year.
Thus it is suggested that appropriate physical exercise is necessary for maintaining or increasing mental activity in aged patients with circulatory disease.

[Objective]To evaluate the effectiveness of moxibustion treatment for patients with nocturia in a randomized controlled trial.
[Methods]Subjects were 36 patients with refractory nocturia, randomly allocated to a moxibustion group (n = 20) and a sham moxibustion group (n = 16). Moxibustion treatment to Chung-Chi (CV3) was performed three times/day for one week by the patients themselves. The average number of nocturia in the week before and the week during moxibustion treatment were compared between groups.
[Results]The average number of nocturia during moxibustion was significantly decreased in the moxibustion group compared to that before treatment. No significant change was seen in the sham moxibustion group.
[Conclusion]Moxibustion treatment appears to reduce the average number of nocturia. Moxibustion to Chung-Chi seems to represent an effective therapeutic option for nocturia.

Computed Tomography(CT) has been of great value in planning treatment for patients with hypertensive intracerebral hemorrhage. The patient with a moderate-sized extracapsular hematoma is usually mild. Such a patient, as a rule, should be treated conservatively. However if the patients shows progressive deterioration or mass signs on the CT, he will be subjected to surgery. The patient with putaminal hemorrhage involving the internal capsule is also indicated for surgery. The patient with a large hematoma extending to the thalamus and the hypothalamus extending to the thalamus and the hypothalamus shows poor prognosis and never indicated for surgery. From the viewpoint of hematoma volume, more than 25ml in size, indicates surgical removal. The acute hydrocephalus following intracerebral hemorrhage confirmed by CT, requires a ventricular drainage, especially if the case of ventricular component is present, in the third and/or fourth ventricles. In the management of hypertensive intracerebral hemorrhage, the choice of treatment, surgical or conservative, is a very important decision. In spite of the fact that surgical treatment of the disease has been actively carried out for the last decade in various facilities in Japan, the indication for surgery is still in controversy in the field of neurosurgery. Today, it is noted that preoperative conditions of the patient such as age, state of consciousness, location of hematoma and timing of operation are closely related to operative results3). As it is well known, computed tomography(CT) will be of great help in the choice of treatment for hypertensive intracerebral hemorrhage. CT gives us not only definite diagnosis of intracerebral hemorrhage but also shows us variable intracranial pathology. Information relating to the exact location of hematoma, estimated hematoma-volume, presence or absence of ventricular component, size of the ventricles and mass effect from displacement of midline structures on CT, will be of extremely valuable in planning further treatment.
Cerebral Hemorrhage ; Consciousness ; Diagnosis ; Drainage ; Fourth Ventricle ; Hematoma ; Hemorrhage* ; Humans ; Hydrocephalus ; Hypothalamus ; Internal Capsule ; Intracranial Hemorrhage, Hypertensive ; Japan ; Neurosurgery ; Pathology ; Prognosis ; Putaminal Hemorrhage ; Thalamus

We report a patient with candidemia, and remote organ infection, who underwent surgical treatment of aortic valvular stenosis. The patient was a 77-year-old man. Candida glabrata was detected in a blood culture during pharmacological treatment for pyelonephritis associated with vesicoureteral transition stenosis. A ureteral stent had been placed to preserve urine outflow, and vesicoureteral surgery had been scheduled. However, the urological surgery had to be performed first because of severe aortic valvular stenosis. After long-term (5 months) of antifungal treatment, Candida was no longer detected in the urine or blood cultures, but the serum β-D-glucan level did not fall below the reference value (21.6 pg/ml at the last measurement). It was difficult to control the infection further, and we decided to perform aortic valve replacement. There was no evidence of endocarditis at surgery, but pathological examination revealed traces of the fungus in the tissue of the aortic valve. The post-operative course was uneventful, and urological surgery was carried out 45 days later. Infection recurred when the antifungal medication was temporarily discontinued. The infection was then controlled by resumption of the antifungal medication. The patient has been free of recurrence for the past year since the aortic valve replacement. In the present case, in which a mycosis from a remote source was not readily eradicated prior to valve replacement, we were able to obtain good results by first administering long-term antifungal medication to quell the inflammation as much as possible.

We herein report a 79-year-old man who developed anaphylactoid purpura after thoracic endovascular aortic repair, which he underwent for a distal aortic arch aneurysm of saccular type. On the third postoperative day he had purpura over his lower legs and abdomen accompanied by intermittent fever. His serum C-reactive protein concentration reached a maximum of 12 mg/dl, and remained at around 4 mg/dl thereafter. A dermatologist diagnosed anaphylactoid purpura ; this gradually improved with topical steroid and the nature and dosage of the oral medication. We suspected the presence of malignancy ; however, appropriate investigations failed to identify a cause for the purpura. During 6 months of outpatient follow up he has been free of recurrence. Anaphylactoid purpura occurs most frequently in childhood, often after an upper respiratory tract infection, whereas this condition is rare in adults. Triggers for anaphylactoid purpura include surgery, infection, certain medications, chronic lung, liver, or renal failure, and malignancy. We believe that the stress of undergoing thoracic endovascular aortic repair was the trigger in this case. Anaphylactoid purpura may be complicated by arthritis, gastrointestinal involvement and renal manifestations. There were no such complications in this case.

Purpose: The impact of postoperative nutritional status on clinical outcomes and biomechanics following total knee arthroplasty remains largely unknown. This study aimed to assess this question using the prognostic nutritional index to evaluate the nutritional status of orthopedic participants. Methods: Patients with knee osteoarthritis who underwent total knee arthroplasty (n=49) in Japan were divided into two groups based on their 1-week postoperative prognostic nutritional index. Group L patients had a prognostic nutritional index <40, whereas Group H comprised patients with a prognostic nutritional index ≥40. Postoperative improvements in Knee Injury and Osteoarthritis Outcome Score were evaluated. The patients performed squats under single-fluoroscopic surveillance in the sagittal plane for biomechanical evaluation. A two-dimensional/three-dimensional registration technique was employed to measure the tibiofemoral kinematics. The axial rotation of the femoral component relative to the tibial component and the anteroposterior translation of the medial and lateral femorotibial contact points were measured. Results: Group H showed significantly higher pain scores than Group L at 12 and 36 months postoperatively and a significantly higher symptom score at 36 months postoperatively. The kinematic comparison revealed that the axial external rotation in Group L was larger than that in Group H from 70° to 80° with flexion. Moreover, in the medial anteroposterior translation, Group L was more anteriorly located than Group H, with flexion beyond 30°. Conclusion The results suggest that a high postoperative nutritional status significantly improved pain and other symptoms and was associated with better knee biomechanics following total knee arthroplasty.

Purpose: The impact of postoperative nutritional status on clinical outcomes and biomechanics following total knee arthroplasty remains largely unknown. This study aimed to assess this question using the prognostic nutritional index to evaluate the nutritional status of orthopedic participants. Methods: Patients with knee osteoarthritis who underwent total knee arthroplasty (n=49) in Japan were divided into two groups based on their 1-week postoperative prognostic nutritional index. Group L patients had a prognostic nutritional index <40, whereas Group H comprised patients with a prognostic nutritional index ≥40. Postoperative improvements in Knee Injury and Osteoarthritis Outcome Score were evaluated. The patients performed squats under single-fluoroscopic surveillance in the sagittal plane for biomechanical evaluation. A two-dimensional/three-dimensional registration technique was employed to measure the tibiofemoral kinematics. The axial rotation of the femoral component relative to the tibial component and the anteroposterior translation of the medial and lateral femorotibial contact points were measured. Results: Group H showed significantly higher pain scores than Group L at 12 and 36 months postoperatively and a significantly higher symptom score at 36 months postoperatively. The kinematic comparison revealed that the axial external rotation in Group L was larger than that in Group H from 70° to 80° with flexion. Moreover, in the medial anteroposterior translation, Group L was more anteriorly located than Group H, with flexion beyond 30°. Conclusion The results suggest that a high postoperative nutritional status significantly improved pain and other symptoms and was associated with better knee biomechanics following total knee arthroplasty.

Purpose: The impact of postoperative nutritional status on clinical outcomes and biomechanics following total knee arthroplasty remains largely unknown. This study aimed to assess this question using the prognostic nutritional index to evaluate the nutritional status of orthopedic participants. Methods: Patients with knee osteoarthritis who underwent total knee arthroplasty (n=49) in Japan were divided into two groups based on their 1-week postoperative prognostic nutritional index. Group L patients had a prognostic nutritional index <40, whereas Group H comprised patients with a prognostic nutritional index ≥40. Postoperative improvements in Knee Injury and Osteoarthritis Outcome Score were evaluated. The patients performed squats under single-fluoroscopic surveillance in the sagittal plane for biomechanical evaluation. A two-dimensional/three-dimensional registration technique was employed to measure the tibiofemoral kinematics. The axial rotation of the femoral component relative to the tibial component and the anteroposterior translation of the medial and lateral femorotibial contact points were measured. Results: Group H showed significantly higher pain scores than Group L at 12 and 36 months postoperatively and a significantly higher symptom score at 36 months postoperatively. The kinematic comparison revealed that the axial external rotation in Group L was larger than that in Group H from 70° to 80° with flexion. Moreover, in the medial anteroposterior translation, Group L was more anteriorly located than Group H, with flexion beyond 30°. Conclusion The results suggest that a high postoperative nutritional status significantly improved pain and other symptoms and was associated with better knee biomechanics following total knee arthroplasty.