From old times, Oriental medicine has had a double layer structure comprising therapeutic medicine and constructive medicine, and therapists of Oriental medicine have believed that the best treatment for us is to take care of our health. The problem of the usual therapeutic system used only by acupuncturists is that clinical field is limited to an acupuncture clinic and the number of patients is also limited. In view of the above and with the goal of solving these problems, we devised a new magnetic acupuncture methol which is applicable to our home treatment in the early stages of disease and examined, from both the viewpoints of Oriental medicine and health medicine, whether or not this magnetic acupuncture is a useful means for systematically performing the treatments of therapeutic medicine and of constructive medicine.
(1) Magnetic acupuncture treatment
In this treatment, it is mainly expected that slight clincal symptom (stiffness, pain) will be relieved owing to the synergistic effect of the needle pressure stimulation and the magnetic action exercised by the needle plastered on the reaction acupuncture points of living body's skin. Compared with the intracutaneous needle which acupuncturists use as a rule, it is easier to operate. In addition, it is superior in rapidity and durability of effect to the commercially available magnetic pellet and acupuncture pellet.
(2) Magnetic acupuncture
The magnet is made of isotropic barium ferrite and has a diameter of 5mm and a thickness of 2.3mm. It has a shape of a disc having a small projection located at the center of the disc on the side which comes into contact with skin (N pole side). The magnetism emanating from the projection has a magnetic flux density of about 952 gauss which is approximately 1.8 times as great as the magnetic flux density of the magnetisms emanating from the flat part of the plate other than the projection. There are two kinds of magnetic acupunctures: one is gold magnetic acupuncture for PU (weak stimulation) and the other is silver magnetic acupuncture Xie (strong stimulation).
(3) Clinical application
In Ling-Shu (Rei Su) which is a volume in the earliest known text on acupuncture, the Nei Ching or Classic of Internal Medicine, or Da-Ging (Dai Kei), it is mentioned that the basic therapeutic point lies in the pain. On these grounds, one magnetic acupuncture disc is plastered on the point at which the response was greatest according to the acupuncture point phenomena (pressure pain, stiffness, depression, hypersensit iveness, trigger-point, etc.) and some additional magnetic acupuncture discs are appropriately plastered on the points surrounding the most sensible point, as well as on the main acupuncture points having a relation to the relief of clinical signs.
A clinical test was performed in order to prove the clinical effects of magnetic acupuncture. Thus, 401 subjects who usually complained of stiffness and pain in shoulder without any objective findings were picked out and clinically tested. These subjects were classified into magnetic acupuncture therapy group (120 subjects) and its placebo therapy group (281 subjects), and the clinical test was performed to compare both the groups. Here is reported a part of the test results.

An 84-year-old woman was referred due to an abnormal shadow on her chest X-ray. Computed tomography and coronary angiography revealed a left coronary artery aneurysm associated with a complex coronary-pulmonary artery fistula. We present our surgical strategy used to treat this complicated pathology.

We studied 90 consecutive cases undergoing open heart surgery with preoperative collection of autologous blood and ultrafiltration during extracorporeal circulation. Among the 58 out of 90 patients (64.4%), open heart surgeries were achieved without homologous blood. We evaluated 13 factors (age, height, weight, body surface area, cardiopulmonary bypass time, aortic cross clamping time, dilutional rate, Hct before predonation, lowest Hct during cardiopulmonary bypass, amount of predonated autologous blood, term of autologous blood predonation, amount of bleeding during surgery, amount of bleeding after surgery) in connection with open heart surgery without homologous blood. Among these factors, age, body surface area, cardiopulmonary bypass time, aortic cross clamping time, lowest Hct during cardiopulmonary bypass, amount of predonated autologous blood, amount of bleeding during surgery and amount of bleeding after surgery demonstrated differed significantly between the only autologous blood transfusion group and the homologous blood transfusion group. According to the evaluation by multivariate regression analysis of these factors, the amount of bleeding after surgery was the most contributor to open heart surgery without homologous blood, followed by amount of bleeding during surgery and body surface area. We concluded that open heart surgery without homologous blood may be achieved in more patients by understanding these factors. Autologous blood predonation by the “leapfrog” method, control of the dilution rate by ultrafiltration during extracorporeal circulation and fresh autologous blood transfusion after extracorporeal circulation were effective to achieve open heart surgery without homologous blood.

[Objective] To clarify the prevalence and aim of acupuncture and moxibustion treatment as well as reasons for choosing this remedy in Japan.
[Methods] We conducted direct interviews with 2, 000 adults (aged 20 years or older) in a stratified two stage sampling in March, 2003.
[Results] Of those interviewd, 71% (1, 420 / 2, 000) responded to the survey of demographics, experience, aim and reasons for choosing acupuncture and/or moxibustion. A total of 7.5% of the population had used Acupuncture and/or Moxibustion during the past 12 months and a total of 26.4% had experienced at least one of these treatment during their lifetime. The most frequent symptoms being treated involved musculoskeletal prob-lems (81.6%), and the most frequent reason for choosing the treatment was the recommendation of family or friends (58.7%).
[Conclusion and Discussion] The prevalence of choosing acupuncture and moxibustion in Japan was higher than that in the U. S. or Europe, which might reflect the history of these methods as popular folk remedies in Japan. The most frequent reason for choosing these remedy might be related to the treatment methods requiring direct contact and stimulation of the body.

We have several choices against bleeding and obstruction in advanced gastric cancer patients such as surgical or endoscopic therapy. But we have few reports about palliative radiation. We conduct this study that we perform palliative radiation for unresectable advanced gastric cancer patients between April 2006 and March 2014 in single center. In the aim of the therapy, to stop gastric bleeding were 8, and to improve obstruction depend on gastric cancer were 4. Response rate of stop bleeding was 63％, and improve obstruction was 50％. Median duration of stop bleeding was 103 day, and improve obstruction was 52 day. Overall survival time was 567 day, survival time after the start of radiotherapy was 105days. Radiotherapy was limited in cases because onset time of response needed in comparison with surgical or endoscopic therapy. However, given minimally invasive therapy and a certain response, we can choice it so much more.

Objective : To research reports of economic analysis of acupuncture therapy.
Method : Searches were performed in Medline for reports of cost description, economic, randomized controlled trial, cost effectiveness, or cost benefit. Studies were included if they reported original data from any form of standard economic analysis.
Results : A total of 15 papers was found. These studies were investigated as follows : angina pectoris, carpal tunnel syndrome, stroke, knee osteoarthrosis, low back pain, musculoskeletal disease, migraine, acupuncture analgesia. On the other hand, only one paper was found in Japan.
Conclusion : Almost studies were noncntrolled trial, non-rigorous and retrospective studies. In future there is a need for high quality and rigorous studies of the cost and benefits of acupuncture.

Nobody studies economic evaluation of acupuncture and moxibustion in Japan. To establish a method of economic evaluation of acupuncture and moxibustion, we introduced case study of economic evaluation of acupuncture and moxibustion at work. In addition, we examined a course of study that annex economic evaluation to a study of acupuncture and moxibustion. This manuscript introduces two case studies of economic evaluation and essential points of economic evaluation.

In a consecutive series of 160 surgically treated abdominal aortic aneurysm, four patients with acute aortic thrombotic occlusion of an abdominal aortic or iliac aneurysm were encountered. Three of four aneurysms were 7cm in diameter or smaller. Also, 3 of 4 patients had chronic occlusive disease of legs. Our mortality rate was 75%. The recommendation is made that all abdominal aortic aneurysms be resected if there is substantial associated distal occlusive disease.

A 44-year-old woman with over 20 years history of rheumatic heart disease developed progressive heart failure from aortic stenosis and mitral restenosis after open mitral commissurotomy. In December, 1986, she underwent aortic and mitral valve replacements with Medtronic Hall prosthesis (aortic: 21mm, mitral: 27mm). Following an eventful recovery, she was discharged from the hospital and continued on a regimen of Coumadin. In February, 1991, the patient developed chest and back pain, which necessitated her emergency admission to our clinic. During the coronary examination, the aortic prosthetic occluder was not moving, fixed in the opening position, lasting from one to several minutes. She underwent emergency operation for replacement of the defective valve. At operation, we noted the pannus formation into the valve orifice on the inflow side of aortic prosthesis. She made a satisfactory recovery and has enjoyed good health since that time.

This is a case report of a rare combination of a single coronary artery and a coronary artery fistula. An 8-year-old girl was asymptomatic with a grade II continuous murmur in the third left intercostal space. Selective coronary angio-graphy revealed that a single coronary artery arising from the left aortic sinus was dilated and ended as a fistula to the outflow tract of the right ventricle. At operation, the fistula could not be exposed on the surface of the heart. On cardiopulmonary bypass, the aorta was clamped, and the fistula was closed by direct suture in the right ventricle. The postoperative course was uneventful with no complications.