We encountered a 24-year-old female patient with anorexia nervosa and a 25-year-old male patient with depressive neurosis, both of whom failed to respond to an antidepressant or an antianxiety drug but improved significantly with Rikkunshi-to (Tsumura's extract granules) given three times a day between meals in a daily dose of 7.5g.
In order to determine the effect of this Kampo formulation, we evaluated their mental condition weekly using the HDRS, BDI, and MAS scales. Although the MAS, which assesses anxiety, did not change very much, the HDRS and BDI, which assess depression, improved significantly. The evaluation was indicative of problems in personality formation originating from the patients' complicated life history. We had the impression that while in both cases Rikkunshi-to was ineffective in relieving anxiety related to personality factors, it was effective with depressive symptoms (anorexia, fatigue, malaise, insomnia etc.) occurring secondarily to anxiety.

We encountered three patients with schizophrenia diagnosed by DSM-III-R and/or ICD-9, all of whom improved significantly with Daisaiko-to. Psychiatric presentations evident were irritability, face-to-face tension and agitation, and constipation was present a somatic disturbance.
The psychiatric symptoms were associated with anger, the specific emotion corresponding to the orbis hepaticus, based on the Five Evolutive Phases (wu-hsing). Therefore, these symptoms were thought to be caused by dysfunction of Liver Ki (Qi) (energetic configuration). Daisaiko-to was prescribed in order to improve the function of Liver Ki based on the concept that the disorder was related to Kankao (a flaming up of Liver Fire). The effectiveness of this formula suggested that both Bupleuri Radix and Raeoniae Radix, which are components of Daisaiko-to, were important herbal drugs to alleviate “flaming up of the Liver Fire, ” in the treatment of schizophrenia.

The series of ECG examination were performed to study the influence of different kinds of exercise on heart of two untrained middle aged healthy male volunteers.
One of them was assigned to run 10 kilometers or so, as fast as he could, once a day for 17 days. The other was assigned to run on a treadmill of three degree gradient for 20 minutes with a speed of 150 meters per minute once a day for 10 years. This volume of exercise was designed at a workload requiring 2/3 of his VO₂max value.
In the former case, frequent supraventricular premature beats with ventricular aberrant conduction occurred on the 21 st day from the beginning of the study. These changes on ECG were complicated with sinus arrhythmia and complete AV block on the 23 rd day. Sinus bradycardia and supraventricular bigeminy with ventricular aberrant conduction were noted on the 44 th day. Supraventricular bigeminies still persisted on the 213 th day, however they disappeared after that.
The latter developed interpolated ventricular premature beats at rest for the first time in the 5 th year from the beginning of the study. These premature beats disappeared during exercise and recurred at rest. In the 8 th year ventricular premature beats became to show bigeminies.
These results suggest that the severe exercise could cause various types of arrhythmia for a long period of time after the cessation of exercise even if the term of exercise would be short. On the other hand, the moderate load of exercise could not cause clinically significant arrhythmias inspite of continuous performance for a long term.

To monitor the quality of life （QOL）of cancer patients through the Patient Behavior Survey, a large population-based survey, we developed a short QOL and quality of care （QOC）questionnaire. In order to help evaluate QOL in cancer patients, we also conducted a web–based survey designed to evaluate the content validity and interpretability of the questionnaire. In total, 630 cancer patients completed the survey. For each item, the result that more than 90% responses determined the item was of importance indicated that the item was important for living with cancer. Regarding items related to QOC, satisfaction with care, we consolidated responses; for example, the answer of “neutral” could also be interpreted as “almost satisfied” and patients who answered “other” may also mean that the item does not apply to them. We found that this questionnaire accurately evaluated the QOL of cancer patients and the responses were interpretable and presentable.

The effect of octylphthalide (OP) bathing was compared with placebo bathing on patients with rheumatoid arthritis (RA).
A liquid containing octylphthalide was dissolved in water of 40°C at a concentration of 10ppm. A liquid which has quite similar appearance and perfume to the above was used as a placebo. Double blind controlled study tests were performed.
Twenty patients (10 for OP bathing and 10 for placebo bathing) were tested by single bathing, 33 other patients (16 patients for OP bathing and 17 for placebo bathing), by serial bathing for 30 days (once a day).
After a single bathing, while grip strengths, tender joints scores, and 20m walking time improved significantly in the OP bathing group, only tender joint scores and 20m walking time improved significantly in the placebo bathing group.
After serial bathing for 30 days, tender joint scores improved significantly in the OP bathing group, but no improvement was observed in the placebo bathing group. The above results suggest that OP bathing may be beneficial for RA patients, but further study may be needed.

　　Epidermal growth factor receptor (EGFR) gene mutation examination is now performed in most medical institutions in order to select the molecular targeted medicine for lung cancer. It became clear that the positive rate of the biopsy material was lower than that of the surgical sample in this hospital. The cause was attributed to false negatives due to low tumor cell content in biopsy specimens. We investigated the presence of the mutation using surgical samples and preoperative biopsy specimens from the same patients in 13 cases. Furthermore, we investigated the tumor cell content of the biopsy specimens by cell counting. Results showed that 3 of 6 biopsy specimens that were associated with positive surgical samples were judged to be negative. The tumor cell content was less than 5% in all negative cases. Regarding EGFR gene mutation examination, we should carefully determine tumor cell content when using biopsy specimens.

OBJECTIVES: Glucocorticoid (GC) treatment inhibits activation of runt-related transcription factor 2 (Runx2), which is essential for osteoblast differentiation from stem cells. As a result, GC treatment results in bone loss, GC-induced osteoporosis (GIO), elevated fracture risk, and delayed bone healing. Bisphosphonates such as alendronate (ALN) are recommended for treating or preventing GIO, and lowintensity pulsed ultrasound (LIPUS) facilitates fracture healing and maturation of regenerated bone. Combined therapy with ALN and LIPUS may stimulate cancellous bone healing in GIO rats. Here, we examined the effect of ALN and LIPUS on cancellous bone osteotomy repair in the proximal tibia of GIO rats. METHODS: Prednisolone (10 mg/kg body weight/day) was administered for 4 weeks to induce GIO in 6-month-old female Sprague-Dawley rats. Tibial osteotomy was then performed and daily subcutaneous injection of ALN (1-µg/kg body weight) was subsequently administered alone or in combination with LIPUS (20 min/day) for 2 or 4 weeks. RESULTS: ALN significantly increased bone mineral density (BMD) at 2 and 4 weeks, and ALN + LIPUS significantly increased BMD at 4 weeks. Bone union rates were significantly increased after 2 and 4 weeks ALN and ALN + LIPUS treatment. Lastly, ALN and ALN + LIPUS significantly increased the proportion of Runx2 positive cells at 4 weeks. CONCLUSIONS: ALN monotherapy and combined ALN and LUPUS treatment augmented BMD and stimulated cancellous bone repair with increased Runx2 expression at the osteotomy site in GIO rats. However, the combined treatment had no additional effect on cancellous bone healing compared to ALN monotherapy.
Alendronate* ; Animals ; Bone Density ; Bone Diseases, Metabolic* ; Diphosphonates ; Female ; Fracture Healing ; Humans ; Infant ; Injections, Subcutaneous ; Osteoblasts ; Osteoporosis ; Osteotomy* ; Prednisolone ; Rats* ; Rats, Sprague-Dawley ; Stem Cells ; Tibia* ; Transcription Factors ; Ultrasonic Waves*

Methods: Nineteen volunteers (16 men, three women) lifted a 60-kg doll from a seated position to a standing position. The first transfer was performed without the HAL for Care Support, and the second was performed with the HAL for Care Support assistive robot. We evaluated transfer performance, the visual analog scale (VAS) score for lumbar fatigue, and electromyogram analyses of the trunk and hip. Results: Four participants (two men, two women) succeeded with the HAL for Care Support even though they were unable to perform the task without it. The mean lumbar fatigue VAS score for all participants without the HAL for Care Support was 62 mm, while that with it was 43 mm. With lumbar assistance from the HAL for Care Support, subjective lumbar fatigue during the transfer decreased significantly. A power analysis indicated adequate statistical power to detect a difference in the VAS score for lumbar fatigue (0.99). The activity of the left gluteus maximus alone increased significantly during transfers with the HAL for Care Support. No adverse events occurred during use of the HAL for Care Support for transfers. Conclusions The HAL for Care Support was able to reduce lumbar load in a simulated patient transfer.

OBJECTIVES: The purpose of this study is to evaluate the effects of teriparatide (TPTD) on bone mineral density (BMD), bone strength, and bone quality in Akita mouse models of diabetes mellitus. METHODS: Twelve-week-old female Akita mice and control mice (C57/BL/6NCrSlc) were divided into 4 groups: control mice treated with vehicle (n = 7) or TPTD (n = 6); and Akita mice treated with vehicle (n = 6) or TPTD (n = 7). TPTD or vehicle was administered subcutaneously 3 times a week for 8 weeks. Blood glucose, serum sclerostin, total tibial BMD, femoral shaft bone strength, and bone quality using Fourier-transform infrared spectroscopy imaging were evaluated. RESULTS: No significant differences in serum sclerostin levels were evident among these groups after 8 weeks of treatment. TPTD significantly increased BMD in control mice (+12.7%, P = 0.02) and Akita mice (+29.2%, P = 0.001) compared with vehicle. Maximum load and stiffness were significantly higher in Akita mice treated with TPTD than in Akita mice treated with vehicle (+56.6%, P = 0.03 and + 90.5%, P = 0.02, respectively). On Fourier-transform infrared spectroscopy imaging, the mineral/matrix ratio was significantly lower in Akita mice treated with vehicle than in control mice (−12.2%, P = 0.02), and TPTD treatment significantly increased the mineral/matrix ratio (P = 0.003). CONCLUSIONS TPTD thus improved BMD and bone strength in both control mice and Akita mice, with improvements in the mineral/matrix ratio among Akita mice.