We studied the effect of Kampo for the size-limitation of myocardial infarct with morphometrical analysis, utilizing total of 19 male swine. A hand made metal-coil (2×1mm) was inserted in the left anterior descending coronary artery (LAD) of swine with catheterization, in order to induce acute myocardial infarction (AMI). After occurrence of AMI, the swine were divided into two groups, experimental group: Saiko-ka-ryukotsu-borei-to (n=10) and control (n=9). This Kampo formula (0.66/kg/day) was administered via stomach tubes for 4 weeks. The control group received basal rations alone. After serial cross sections of heart, total infarct areas were weighed.
An infarct weight to heart weight of the experimental group (2.9±1.6%, n=10) was significantly decreased than that of the control group (8.2±4.8%, n=9). The infarct weight to left ventricular weight of the experimental group (4.9±2.6%) was significantly decreased than that of the control group (13.4±8.0%). Thus the infarct size of the experimental group was significantly smaller than that of the control. The histological character of the infarct in the control was numerous inflammatory cell infiltration and foci of fresh coagulate necrosis in the border zone, while the infarct of the experimental group was apparent in the border zone with marked fibrosis and few inflammatory cells. Angiogenesis in both the infarct and border zone was marked in the experimental group than in the control. We summarize that this Kampo formula inhibits size development of AMI in animal model.

For simplification of dealings in the central wholesale markets and reduction ofexpenditures in the marketing systems, the standards of shipment are provided for almost all agricultural products as general commodities. In addition to harvesting, the farmers must sort and pack the agricultural products in accordance with the standards of shipment. This has resulted in an increase in the farmers' workloads.
Therefore we investigated the workloads of strawberry-growing farmers during sorting and packing strawberries.
According to the sandard of shipment, strawberries are graded into three categories by quality, six categories by size and three categories by weight, and that combination is very complicated. The farmers spend much time sorting and packing strawberries. Particularly in February and March when strawberries of all sizes are shipped, sorting and packing occupy more than60% of all working hours. The smaller in size the strawberries become, the more time the farmers spend on sorting and packing a pack. We investigated the farmers' work postures, Critical Flicker Fusion Frequency (CFF) and heart rate during work. The results of the investigation showed that sortingand packing strawberries constituted hard physical and mental labour because of the complicated standards. Inquiries regarding awareness of the standards of shipment revealed that 84.3% of the strawberry growing farmers recognized the necessity of the standard of shipment. But 64% of them hoped to make the standards simpler. Simplication of the standards of shipment might reduce farmers' workloads and moreover give consumers benefit.

Sixteen male swine were utilized to study the occurrence of acetylcholine (ACh) induced coronary spasm using catheters. The left anterior descending coronary arteries (LAD) of the swine were denudated by catheterization under anesthesia. The swine were divided into three groups and fed for four weeks. Group A received Tokishakuyaku-san (0.66g/kg/day; Tsumura Co. Ltd.; n=6) in addition to the basal rations; group B received Mokuboi-to (0.25g/kg/day; Tsumura Co. Ltd; n=5) in addition to the basal rations; and the control group were fed for four weeks on the basal rations alone. The Kampo formulas were administered via stomach tubes in groups A and B.
Coronary spasms induced by catheter administration of ACh (100-250μg) were evaluated by elevation of the ST segment as measured by electric cardiography, and vasoconstriction of the LAD as ascertained by cineangiography.
The ACh-induced coronary spasms were found to either be of the diffuse type or LAD segmental type. Coronary spasms were noted to occur at a frequency of 5/13 in group A, 5/12 in group B and 7/13 in the control group, without significant differences among the groups. Groups A and B, however, exhibited a tendency towards a decreased rate of coronary spasm (40%) when compared to the control group (53.8%).
The vasoconstriction rate (VCR) was also calculated, interpreted as a morphological index of spasms as proposed by Takeuchi (1974). The VCR was higher in the spastic segment of the LAD than in the non-spastic LAD. It was suggested that Tokishakuyaku-san and Mokuboi-to have antispasmodic effects and may reduce the occurrence rate of spasms in swine LAD.

The size of myocardial infarct has been proposed as one of the important prognosis factors. In this study, we examined the effect of Kampo for the size limitation of myocardial infarct. Twenty male swine were used. A metal-coil was inserted in the left anterior descending coronary artery (LAD) of swine, in order to induce acute myocardial infarction (AMI). After occurrence of AMI, the swine were divided into four groups: Saiko-ka-ryukotsu-borei-to (TJ-12) group (n=5), Tokishakuyaku-san (TJ-23) group (n=5), Mokuboi to (TJ-36) group (n=5), and control group (n=5). Three kinds of Kampo formula were administrated via stomach tubes for four weeks. The control group received basal rations alone. The infarct size of the TJ-36 group was significantly smaller than that of the control (p<0.05). Each size of the TJ-12 and TJ-23 group had smaller tendency than that of the control, without significant difference. The histological character of the infarct in the control was numerous inflammatory cell infiltration and small foci of fresh coagulative necrosis in the border zone, which was not apparent in any Kampo administration group. We summarize that these Kampo, especially Moku-boi-to, inhibit the infarct size development. This inhibition is probably caused by suppression of harmful free radicals production from inflammatory cells, or by microcirculation improvement. This inhibitory effect by Kampo medicine led to rescue the border zone indicated as “jeopardized zone”.

The purpose of this study was to investigate changes in sarcoplasmic reticulum (SR) Ca²⁺-sequestering capacity in rat fast-twitch plantaris (PL) and slow-twitch soleus (SOL) muscles during recovery after high-intensity exercise. The rats were subjected to treadmill runs to exhaustion at the intensity (10% incline at 50 m/min) estimated to require 100% of maximal O₂ consumption. The muscles were excised immediately after exercise, and 15, 30 and 60 min after exercise. Acute high-intensity exercise evoked a 27 % and 38 % depression (P<0.05) in SR Ca²⁺-uptake rate in the PL and SOL, respectively. In the PL, uptake rate remained lower (P<0.05) at 30 min of recovery but recovered 60 min after exercise. These alterations were paralleled by those of SR Ca²⁺-ATPase activity. On the other hand, SR Ca²⁺-uptake rate in the SOL recovered 15 min after exercise. Unlike the PL, discordant time-course changes between SR Ca²⁺-ATPase activity and uptake occurred in the SOL during recovery. SR Ca²⁺-ATPase activities were unaltered with exercise and elevated (P<0.05) by 25, 30 and 30% at 15, 30 and 60 min of recovery, respectively. These results demonstrate that SR Ca²⁺-sequestering ability is restored faster in slow-twitch than in fast-twitch muscle during recovery periods following a single bout of high-intensity exercise and suggest that the rapid restoration of SR Ca²⁺-sequestering ability in slow-twitch muscle could contribute to inhibition of disturbances in contractile and structural properties that are known to occur with raised myoplasmic Ca²⁺ concentrations.

We have recently experienced a case of impending ruptured aneurysm of the common iliac artery associated with a gelatinous substance in the retroperitoneal space. A 69 year-old male had been diagnosed as a left common iliac aneurysm at another hospital by CTscan during the examination of lower abdominal pain. At the midnight of the day he admitted, the severity of pain gradually intensified. But there was no sign of anemia nor hypotension. Next morning CTscan showed low density left retroperitoneal mass. The patient underwent emergency laparotomy. The further inspection revealed about 600cm³ of gelatinous substance in left retroperitoneal space without the sign of aneurysmal rupture. A bifurcated graft replacement was performed. The low density mass was not recognized by CTscan done 42 days postoperatively. Electrolyte study of the gelatinous substance indicated its serous leakage through the impending ruptured aneurysm. Our present report constitutes a completely distinct variety of common iliac aneurysm, associated with a gelatinous substance in retroperitoneal space without a major rent of the aneurysmal wall.

A 72-year-old man suffering from congestive heart failure, swelling of the lower limbs and hematuria was transferred from another hospital with a diagnosis of large aneurysms of the abdominal aorta and the left common iliac artery. Iliac arteriovenous fistula (AVF) was definitively diagnosed preoperatively by contrast-enhanced CT and angiogaphy. At operation, an infrarenal abdominal aortic aneurysm of 8cm and left iliac arterial aneurysm of 12cm were identified. After proximal and distal aortic clamping, the aneurysm was entered and an AVF orifice of 1cm communicating with the left common iliac vein was disclosed at the right posterior wall of the left common iliac artery. Venous blood reflux was controlled by inserting an occlusive balloon catheter to the fistula and intraoperative shed blood was aspirated and returned by an autotransfusion system. The AVF was closed from inside the iliac aneurysm by three interrupted 3-0 monofilament mattress sutures with pledgets. The aneurysms were resected and replaced with a bifurcated Dacron prosthetic graft. The patient had an uncomplicated postoperative recovery; the lower limb edema subsided and heart failure improved rapidly. Preoperative identification of the location of the AVF is mandatory to make surgery safe. Moreover, easy availability or routine use of the devices for controlling undue blood loss such as an autotransfusion system and an occlusive balloon catheter are other important supplementary means to obtain good results of surgical treatment.

Twenty six adult patients who underwent prosthetic heart valve replacement and treated anti-thrombogenic therapy, were divided into 2 groups. One was administered Warfarin alone, another was administered Warfarin plus Aspirin (162mg/day) as antiplatelet therapy. Trapidil (300mg/day) was administered to all of the patients. Platelet aggregation, plasma level of TXB₂ (stable metabolite of thromboxane A₂), and 6-keto-PGF₁ (stable metabolite of PGI₂) were measured before and 1, 3, 6 months after Trapidil therapy. Platelet aggregability suppressed in both 2 groups. Plasma TXB₂ level, and TXB₂/6-keto-PGF₁ ratio showed a tendensy to decrease (p<0.05) 6 months after administration. In the Aspirin plus Trapidil group, platelet aggregability, serum TXB₂ level, and TXB₂/6-keto-PGF₁ ratio are significantly lower than that in the Trapidil only. These results suggest that Trapidil is clinically useful for antiplatelet agent, but the combined Aspirin plus Trapidil therapy is more efficacious than the Aspirin or Trapidil single therapy.

A gelatin-sealed knitted Dacron graft which has zero-porosity at implantation and does not require preclotting preparation has been developed. Gelatin-sealed aortic grafts were implanted into 39 patients and vascular surgery reconstruction was performed for thoracic aortic aneurysm (TAA) in 10, abdominal aortic aneurysm (AAA) in 19, and arteriosclerosis obliterans (ASO) and other conditions in 10. A total of 39 bifurcated or straight grafts were inserted. The Gelseal Dacron graft had superior handling characteristics and biocompatibility in comparison to conventional graft. There was no measurable blood loss from the body of the sealed graft at the time of implantation. The gelatin-sealed Dacron graft (n=10) was compared with an Intervascular Micron^® graft (n=10) implanted into the abdominal aorta. No problems were evident with regard to intraoperative bleeding, allogenic and autologous transfusion volume and blood parameters between the two groups. These results suggested that the Gelseal Dacron graft sealed with gelatin was a safe, zero-porosity implantable prosthesis for clinical use.