No abstract available.
Adult ; Choledochostomy/*adverse effects/instrumentation/methods ; Duodenum/*injuries ; Endosonography/*adverse effects/instrumentation/methods ; Female ; Humans ; Jaundice, Obstructive/diagnostic imaging/etiology/surgery ; Self Expandable Metallic Stents/adverse effects

The purpose of this study was to examine effects of moderate-intensity endurance exercise on reactive oxygen species production and leukocyte activation markers in young and middle-aged persons. Blood samples were collected before and after the jogging of 10 km. Although cytokines recruiting and priming neutrophils and monocytes were released into the circulation and functional after the jogging of 10 km, reactive oxygen metabolites-derived compounds (d-ROMs) were not significantly increased. It was indicated that chemokines and leukocyte activation markers at rest were increased with aging, and that might be accompanied by the higher level of d-ROMs in the elderly.

This study clarified practices in end-of-life care for non-malignant chronic illness patients by expert nurses in general hospitals. Interviews with 7 chronic illness specialist nurses on practice cases were conducted, and final labels were elicited using a qualitative synthesis method（KJ method）. As patients’ conditions deteriorated, nurses defined the necessary interactions to support patients’ decision-making for living their own way of life and accompany patients and families based on their experience, and using patients’ restoration of self-esteem, sense of satisfaction, and acceptance as indices. In general hospitals, measures to cope with pain for patients not receiving life-prolonging treatment were insufficient;and while it was difficult to agree on care between medical professionals and to maintain care in other facilities, expert nurses grasped patients’ wishes on a daily basis and made arrangements for them to permeate through family and community care systems. In end-of-life care in treatment settings, it is necessary to be supportive so that the family and medical professionals can continue the patient’s care. Medical professionals who have been involved from the initial diagnosis stage need to improve their awareness and support skills as medical professionals to be involved purposefully from an early stage to the final stage.

We often meet the patient suffer from skin pruritus caused by jaundice. Those patients are treated with various methods and care, but there therapy are often ineffective. Japanese herbal medicine Gosha‒Jinki‒Gan has been successfully used to reduce skin pruritus in two patients caused by jaundice associated with advanced cancer. Case 1： A 68‒yearold man had suffered from pruritus caused by obstructive jaundice associated with cholangioma. He had treated with endoscopic nasobiliary drainage (ENBD) and other methods, but pruritus was not reduced. Gosha‒Jinki‒Gan (7.5g/day) imploved sleep disturbance. Case 2： A 81‒year‒old man had suffered from pruritus caused by jaundice associated with liver cirrhosis and hepatoma. He had treated with various methods, but pruritus was not reduced. Gosha‒Jinki‒Gan (5.0g/day) reduced his Numeric Rating Scale (NRS) of pruritus (10→3). Gosha‒Jinki‒Gan is recommended for skin pruritus due to jaundice.

[Objective]Although warm-tube moxibustion is easy-to-use in acupuncture therapy, the timing of moxa removal varies among practitioners. In the present study, we used near infrared spectroscopy (NIRS) to compare effects of different durations of moxibustion stimulation on improvement in local circulation as measured by changes in blood oxygenation dynamics in muscle tissue.
[Methods]Twelve healthy adults underwent warm-tube moxibustion with a single cone applied to the upper right shoulder region;measurements of tissue blood oxygenation dynamics (ΔOxy-Hb, ΔTotal-Hb) were obtained at intervals of 0.5 s. Control measurements were first taken for 15 min without intervention (Control);then, subjects received moxibustion 2 min after the start of measurement and had the moxa removed at the following time points: 30 s after patients experienced heat pain (Removal 30, moxibustion group); 45 s after heat pain (Removal 45, moxibustion group);or did not have the moxa removed (Continuous moxibustion group). These 4 different conditions were compared. Additionally, we determined the burning temperature of moxa and the skin temperature and intensity of heat pain sensation at the site of moxibustion.
[Results]Compared with the Control, the Removal 30, Removal 45, and Continuous moxibustion groups had significant increases in ΔOxy-Hb, ΔTotal-Hb, and skin temperature, with no significant differences among the moxibustion groups. No significant difference in the intensity of heat pain sensation was observed among the moxibustion groups. All moxibustion groups began to show rapid increases in both ΔTotal-Hb and ΔOxy-Hb around the time when subjects began to feel heat pain, suggesting that the axon reflex evoked by noxious stimuli of heat pain increased blood volume and arterial blood flow.
[Conclusion]Hemodynamic improvement in muscle tissue through the use of continuous warm-tube moxibustion for 30 s or longer after the occurrence of heat pain was confirmed.

This time the statistics for injuries and disorders due to sports in the five-year period up to 1985 were taken, evaluated and compared with those of the last five-year period. The following results were obtained :
1. There were 1, 300 cases of injuries and disorders due to sports in the five-year period up to 1985, which was 4.4% of the total number of outpatients in the department of orthopaedics.
2. Sex : There were more male patients, but the rate of female patients has been increasing lately.
3. Age : Patients in their teens or twenties accounted for about 70%.
4. Body Side : There was no significant difference between incidence of injury on the right side of body or the left, but cases of injuries on both sides have been increasing recently.
5. Kind of Sport : The largest number of trauma were due to skiing, although the number of trauma resulting from playing tennis has been high in the past five-years of investigation.
6. Time of Injury ; Most patients were injured during practice, followed by recreation and game.
7. Position of Truma : Most cases were injuries to their knee joints from skiing.

This time the statistics for injuries and disorders due to sports in the five-year period up to 1985 were taken, evaluated and compared with those of the last five-year period. The following results were obtained :
1. There were 1, 300 cases of injuries and disorders due to sports in the five-year period up to 1985, which was 4.4% of the total number of outpatients in the department of orthopaedics.
2. Sex : There were more male patients, but the rate of female patients has been increasing lately.
3. Age : Patients in their teens or twenties accounted for about 70%.
4. Body Side : There was no significant difference between incidence of injury on the right side of body or the left, but cases of injuries on both sides have been increasing recently.
5. Kind of Sport : The largest number of trauma were due to skiing, although the number of trauma resulting from playing tennis has been high in the past five-years of investigation.
6. Time of Injury ; Most patients were injured during practice, followed by recreation and game.
7. Position of Truma : Most cases were injuries to their knee joints from skiing.

A 72-year-old man with jaundice by ampullary adenocarcinoma was treated at our hospital. For biliary decompression, a transpapillary, fully covered, self-expandable metal stent (FCSEMS) was deployed. Four days later, the patient developed acute cholangitis. Endoscopic carbon dioxide cholangiography revealed kinking of the common bile duct above the proximal end of the FCSEMS. A 7-F double-pigtail plastic stent was therefore placed through the FCSEMS to correct the kink, straightening the common bile duct (CBD) and improving cholangitis. This is the first report of a unique use of a double-pigtail plastic stent to correct CBD kinking. The placement of a double-pigtail plastic stent can correct CBD kinking, without requiring replacement or addition of a FCSEMS, and can lead to cost savings.
Aged ; Common Bile Duct/*injuries ; Constriction, Pathologic/surgery ; Decompression, Surgical/instrumentation/methods ; Humans ; Male ; Self Expandable Metallic Stents/adverse effects ; *Stents ; Torsion Abnormality/*surgery

A 69-year-old woman with jaundice was referred to our hospital. After a final diagnosis of pancreatic cancer with liver metastasis, we performed transpapillary biliary drainage with a covered self-expandable metal stent (SEMS). Three months later, we also placed an uncovered duodenal stent for duodenal stricture in a side-to-end fashion. Another month later, for biliary SEMS obstruction, we attempted a transpapillary approach. A duodenoscope was advanced and a guidewire was passed through the mesh of the duodenal stent into the bile duct with a flexible tip catheter, but the catheter was not. Thus, we exchanged the duodenoscope for a forward-viewing two-channel endoscope and used the left working channel with a flexible tip catheter. By adjusting the axis, we finally succeeded biliary cannulation and accomplished balloon cleaning for recanalization of the SEMS. This is the first case with successful biliary cannulation by combined use of a two-channel endoscope and a flexible tip catheter.
Aged ; Bile Ducts ; Catheterization ; Catheters ; Cholestasis ; Constriction, Pathologic ; Diagnosis ; Drainage ; Duodenoscopes ; Endoscopes ; Female ; Humans ; Jaundice ; Liver ; Neoplasm Metastasis ; Pancreatic Neoplasms ; Stents