Japanese Physiotherapy (JPT) is a kind of therapy that is based upon the Oriental medical art —as we know as acupuncture, moxibustion and anma— and is combined with the physical therapy of the western medical art as an organic whole. JPT has been studied and developed chiefly in the JPT course in schools for the blind.
In order to make clear the popularity of JPT and its movement of the demand, I made a questionnaire about JPT and its fundamental therapy —acupuncture, moxibustion and anma— bounding the occupation and area of the object. See the following list;
a. the appriciation of the effect of JPT.
b. the rate at which the adaptation disease arises and its cause.
c. the existence of the experience of having the therapy and the demand of having the therapy once more.
d. the better place of having the therapy.
e. the desirable rate at which you have to pay for the care.
f. the problems when you have the therapy.
This is the main points of the investigation.
1. Method:
1) Object; teachers and bus drivers in Shizuoka prefecture.
2) Way; doring out questionnaire papers and gathering them.
2. Results
1) We handed out 2119 papers and gathered 1827 answers.
(Its effective rate is 86%.)
2) The 70-80% of the answerer admitted the effect of the therapy.
3) The adaptation disease of JPT is firmly connected with the occupations of the patients.
4) In comparison with the rate of the patients who have experienced the therapy, the rate of the patients who want to have the therapy for their health is not so high. But many of the patients say that they want to have the therapy once or more times.
5) The most offensive problem, when the patients are to have the therapy, is the high rate of the patients' contribution paid for the care. The second problem is that the patients have anxiety about the contents and methods of the therapy.
3. Problems from now on
1) The early realization of cutting down the rate of the patients' contribution paid for the care.
2) Making public relations that JPT is good for the early recovery from fatigure and the promotion of health and the prevention of disease.
3) The establishment of JPT as Industrial Medicine.

A 51-year-old man was referred to us because of upper extremity hypertension and vascular claudication of the lower extremities. He underwent extraanatomic ascending aorta-abdominal aorta bypass with vascular graft under a median sternotomy and a midline laparotomy incision without cardiopulmonary bypass. The postoperative course was uneventful. Upper extremity hypertension and vascular claudication were completely resolved. Although the patient has done well in the three years since his operation, we continue to observe him closely. The etiology of atypical coarctation may be related to Takayasu arteritis because of the angiographic findings and positive specific alleles such as HLA-B5201 and DRB1 1502.

Tricuspid valve myxoma is extremely rare. A 33-year-old woman who had undergone clipping of a cerebral aneurysm, had a cardiac tumor pointed out incidentally while undergoing echocardiography. Echocardiography showed a mobile and solid round mass (14×12 mm) attached by a short stalk. We suspected a right ventricular tumor. Once the diagnosis of cardiac tumor has been established, prompt excision is essential to prevent complications, as well as syncope or collapse due to the transient occlusion of the tricuspid or pulmonary valves with embolization by the thrombus or fragments of the tumor tissue. Surgery was performed under cardiopulmonary bypass. The tumor was attached to the anterior papillary muscle and chordae of the tricuspid valve. The tumor was extirpated along with a piece of the papillary muscle and chordae. We performed tricuspid chordoplasty with artificial chordae. The histopathologic diagnosis was myxoma. The postoperative course was uneventful and the patient was discharged on the 15th day after the operation. While the patient has done well with no recurrence of the tumor during the five years that have passed since her operation, we will continue to observe her closely in the future because there have been some reports of recurrence after complete excision of cardiac myxoma and there are no long-term follow-up results of artificial chordae in the tricuspid position.

Twelve normal female adults were studied using a new model of infrared thermography on the thermographic patterns, the average and the maximum skin temperature of the selected areas, the change of the skin temperature in menstrual cycle and the change of the skin temperature after immersion of the right hand in ice water. The new thermoviewer (JTG-500M) has a computer and can calculate the average and maximum temperature in any rectangular area we draw. It made us possible to detect slight change of the skin temperature precisely. The results were as follows:
1) The average temperature of the trunk was higher than those of the lower extremities and the dorsal surface of the hand.
2) Among the maximum temperatures of the selected areas, the highest was of the trunk, the second was of the dorsal surface of the hand and the last was of the lower extremities.
3) Of the change in menstrual cycle, a significant positive correlation between the basal body temperature and the skin temperature was found. The skin temperature in the progestational phase was significantly higher, by 0.5°C to 0.7°C, than that in the estrogenic phase.
4) The change of the skin temperature after immertion of the right hand in ice water for one minute was surveied at the chest, the abdomen, the back, the dorsal surface of the left hand and the left lower extremity during five minutes. While the skin temperature at the chest and the back dropped, the dorsal surface of the left hand got higher clearly. No change was found at the abdomen and the lower extremity.

Chronic obstructive pulmonary disease (COPD) causes severe respiratory dysfunction and severely limits patients' daily activities. We report a case of the patient with COPD whose respiratory symptoms were successfully improved by acupuncture. A 70-year-old man visited Meiji University of Oriental Medicine Hospital complaining of dyspnea during exercise on _??_. Despite strictly controlled medication and a regimen of home oxygen therapy (HOT), his general condition continued to worsen. Then a series of acupuncture treatment was started on _??_. The severity of dyspnea of the patient before acupuncture treatment was determined as level V according to Hugh-Jones classification, and spirometry showed severely disturbed respiratory functions (%VC: 63.5%, FEV₁%: 29.4%, PEFR: 84.8 1/min in the morning and 93.5 1/min at night). The basic combination of meridian points for the treatment of the case was LU1 (Zhongfu), CV12 (Zhongwan), CV4 (Guanyuan), LU5 (Chize), and BL13 (Feishu). The acupuncture needles were retained for ten minutes in each session. The single-subject research design (A-B-A method) was applied to detect the specific effect of the acupuncture treatment on the respiratory functions or the symptoms of the subject. “A” and “B” mean “treatment period” and “no treatment period” respectively. After 60 acupuncture treatments during a 14-month period, both the respiratory symptoms and the VAS for dyspnea showed improvement, which were specifically observed during the intervention period. Improvement was also reflected in the level of the Hugh-Jones classification and respiratory function test. It was suggested that acupuncture treatment might be effective for advanced cases of COPD.

[Aim] Acupuncture has traditionally been used in Japan in the treatment of bronchial asthma and is being increasingly applied. However, although there are many published studies on acupuncture and asthma, few meet the scientific criteria necessary to prove the effectiveness of acupuncture. Therefore, this study presents the clinical results of acupuncture treatment for adult bronchial asthma.
[Design] Single-subject research design (N-of-1 method).
[Setting] Department of Internal Medicine, Acupuncture and Moxibustion Center, Meiji University of Oriental Medicine, Japan.
[Participants] Six patients of both genders (mean age, 49.0 years old) with moderate-to-severe persistent bronchial asthma.
[Intervention] Six patients received 10 sessions of acupuncture treatment (once per week) for 10 weeks. The basic combination of meridian points for the treatment of the patients were LU 1 (Zhongfu), LU 5 (Chize), LU 9 (Taiyan), CV4 (Guanyuan), CV 12 (Zhongwan), BL 13 (Feishu), BL20 (Pishu) and BL23 (Shenshu).
[Measurements] Primary outcome was the symptom of asthma at the end of the 10 treatment sessions. Secondary outcomes were the Dyspnea Visual Analogue Scale (DVAS), respiratory function, Peak Expiratory Flow Rate (PEFR), blood, the use of asthma drugs. The effect of the intervention on eosinophils in blood was assessed.
[Main results] Late effects of asthma patients showed significantly better results compared with the base line on outcome measures after the 10 weeks. In this study, symptoms of asthma and dyspnea VAS in patients with asthma were significantly improved by acupuncture.
[Conclusion] This study indicated that acupuncture was effective in asthma symptoms and respiratory functions.

Purpose: To clarify factors associated with the Japanese perception of whether they can live at home until death with the inclusion of knowledge and beliefs about end-of-life. Methods: A questionnaire survey was conducted on the Japanese general population who participated in a lecture meeting about palliative home care (N=61, effective response rate, 100%). Results: Ten (16%) responded they could live at home until death. Barriers to end-of-life home care were "Home care would burden my family (80%)," " Family and I are anxious about emergency care when I get worse (59%)" and "Family and I are anxious about whether I can enter a hospital emergently when I get worse (52%)" in that order. From the multivariate logistic regression model, respondents who expressed "Opioids cause addiction (OR, 95% confidential interval (CI):0.29, 0.09-0.99)" and "Artificial hydration and nutrition should be continued as the minimum standard until death (OR, 95%CI:0.39, 0.16-0.95)" were more likely to perceive that they could live at home until death. Conclusion: The empowerment activity for the general population regarding correct knowledge about palliative care, benefit and disadvantage of life-sustaining treatment, and correct knowledge about home care is important for the end-of-life patients who want to live at home until death to achieve their wish.

BACKGROUND: In recent years, various studies have analyzed the concepts of “good death” and “quality of dying and death” in the world. The objective of this study was to compare community residents and physicians regarding their perceptions of “good death” in a terminal cancer setting in Fukushima, Japan.
METHODS: One thousand residents of Fukushima City (40 years or older) were randomly selected for comparison to the 483 physicians working in the same city. A self-administered questionnaire was used to query residents and physicians on 52 items about “good death.”
RESULTS: The response rate was 73.6% for the residents and 53.0% for the physicians. The concept of “good death” was composed of 14 factors for both groups. We elucidated the structure of the concept of “good death” in the general population and physicians in Japan, and only the third factor, “religion and spiritual beliefs, ” was the same between the general population and physician.
CONCLUSION: The data offers useful information pertaining to palliative care education for medical providers. Specifically, physicians should understand the differences between concepts held by the general population and physicians. For example, some same items were included in factor X (continuance of one's lifestyle) for citizen and factor II for physician. But contribution ratios of factor X for citizen and factor II for physician were different. This should lead to the better palliative care provision.