Objective: The purpose of this study was to compare the performance of the salivary cortisol immunoassay kits that were manufactured by DRG International, Inc., Salimetrics, LLC., and IBL Hamburg, which were widely used in neuroendocrine research. Correlations between plasma and salivary cortisol concentrations and between enzyme-linked immunosorbent assay (ELISA) and luminescence immunoassay (LIA) were investigated.
Methods: Saliva and plasma samples were collected in eight participants who took part in the study of the exercise stress testing. In total, forty salivary cortisol samples were assayed by means of the three salivary cortisol immunoassay kits. Plasma cortisol concentrations were determined by ELISA kit (IBL).
Results: Salivary cortisol concentrations measured by the three immunoassay kits were significantly and highly correlated with plasma cortisol concentrations (r ≥ .863). Scattergrams also indicated that exponential curve well explained the relationship between salivary and plasma cortisol concentrations (r ≥ .925). Salivary cortisol concentrations measured by LIA (IBL) was correlated with salivary cortisol concentrations measured by ELISA (DRG and Salimetrics: r=.943 and .985, respectively). Values of cortisol concentration measured by ELISA (DRG) were higher than those by ELISA (Salimetrics) and LIA (IBL).
Conclusion: Salivary cortisol concentrations that were measured by the three immunoassay kits reflected the variations of plasma cortisol concentration. Differences in immunoassay methods (ELISA and LIA) did not influence the values of cortisol concentration. These findings indicated that it is possible to assess stress by measuring salivary cortisol without the need for blood sampling.

An objective assessment of stress is needed to manage stress and prevent the development of stress-related diseases such as depression and coronary heart disease. In this paper, we discussed the possibility of applying saliva to an assessment of stress. We illustrated the procedures for collecting and analyzing saliva, and reviewed the relationships of acute, chronic, psychological, or physical stress to seven salivary substances: Cortisol, Dehydroepiandrosterone, Testosterone, Chromogranin A, 3-Methoxy-4-hydroxyphenyglycol, α-Amylase, and Secretory Immunoglobulin A. Considering unique characteristics of each salivary substance and purposes of the study or the non-invasive assessment, salivary substances should be selected for the assessment of stress.

It is well known that eccentric exercise induces muscle damage that is characterized by a prolonged decrease in muscle strength and range of motion, development of delayed onset muscle soreness, and swelling. Therefore, the present study aimed to compare the acute effects of hold-relax stretching (HRS) with those of static stretching (SS) on muscle strength and soreness. The participants comprised 28 male volunteers randomly assigned to either the HRS group (N = 14) or the SS group (N = 14). Initially, the participants of both groups performed 60 maximal eccentric contractions of the knee extensors. Two and four days after this exercise, each group performed either HRS or SS for 60 s at a time and repeated them six times for a total of 360 s. Muscle strength and soreness during stretching and contraction were measured before and immediately after HRS and SS. The results showed that the muscle soreness observed after eccentric contraction significantly decreased immediately after both HRS and SS were performed two and four days later. In addition, there were no significant changes in muscle strength immediately after both HRS and SS were performed two and four days later. The rate of change in muscle soreness after HRS was significantly higher than that after SS two days post eccentric contractions. These results suggest that while both HRS and SS can effectively decrease muscle soreness, the effect of HRS on muscle soreness was larger than the effect of SS.

A 15-year-old girl who had undergone a tracheostomy 4 years earlier because of holoprosencephaly and severe mental and physical disabilities had tracheo-innominate artery fistula with sudden-onset bleeding after endotracheal suctioning. Due to respiratory and circulatory instability, VIABAHN® was implanted in the brachiocephalic artery, and the patient was discharged on postoperative day 33. Three months later, rebleeding from the tracheostomy site was observed, and the patient was transported to our hospital. Although the bleeding stopped spontaneously on arrival, the patient experienced multiple bleeding episodes after admission. Therefore, transection of brachiocephalic artery was performed, after which the patient was discharged on postoperative day 20. Tracheo-innominate artery fistula is a rare complication that occurs after tracheostomy, but it is associated with a poor prognosis, and has a mortality rate of 100% if left untreated. Our case suggests that endovascular treatment using VIABAHN® for tracheo-innominate artery fistula is useful for temporary hemostasis.

Resistance training is a treatment for muscle weakness and muscle atrophy. Although previous studies reported that muscle strength increased via changes in neural adaptation after low-intensity resistance training with skin cooling (SC), the effects of the training on both muscle strength and muscle thickness were unclear. Therefore, this study investigated the effect of low-intensity training of the triceps brachii with SC on muscle strength and muscle thickness. Volunteers were 12 healthy men, with one arm randomly assigned to SC and the other to control groups. Elbow extension exercises were performed for 8 weeks, and 1 repetition maximum (RM) and muscle thickness of triceps brachii were measured before and after training. Resistance exercise was performed thrice a week using a dumbbell adjusted to 50％ of 1 RM for both the groups. The SC side used an ice bag secured to the triceps brachii during training. There were no significant interaction effects of 1 RM and muscle thickness of triceps brachii；however, both variables significantly increased after training in both the SC and control groups. Muscle strength and muscle thickness increased after the 8-week training program with SC. No significant differences were observed between the groups.

Resistance training is a treatment for muscle weakness and muscle atrophy. Although previous studies reported that muscle strength increased via changes in neural adaptation after low-intensity resistance training with skin cooling (SC), the effects of the training on both muscle strength and muscle thickness were unclear. Therefore, this study investigated the effect of low-intensity training of the triceps brachii with SC on muscle strength and muscle thickness. Volunteers were 12 healthy men, with one arm randomly assigned to SC and the other to control groups. Elbow extension exercises were performed for 8 weeks, and 1 repetition maximum (RM) and muscle thickness of triceps brachii were measured before and after training. Resistance exercise was performed thrice a week using a dumbbell adjusted to 50％ of 1 RM for both the groups. The SC side used an ice bag secured to the triceps brachii during training. There were no significant interaction effects of 1 RM and muscle thickness of triceps brachii；however, both variables significantly increased after training in both the SC and control groups. Muscle strength and muscle thickness increased after the 8-week training program with SC. No significant differences were observed between the groups.

The purpose of this study is to clarify factors related to the effect of daikenchuto on constipation during pregnancy. The subjects were 21 patients who had constipation during pregnancy and received 15 g/day of daikenchuto. Based on the constipation score that was created independently, the score values before administration, 2 weeks and 4 weeks after administration were retrospectively investigated. Furthermore, from the outcome of the oral status at 4 weeks, we divided the patients into 2 groups (12 in the improvement group and 11 in the non-improvement group), and attempted to extract factors that were considered to be related to efficacy. The total constipation score decreased significantly before and after administration of daikenchuto, and the concomitant symptoms of constipation scores were low, especially such as abdominal distension and abdominal pain. A comparison of the backgrounds of the improved group and the non-improved group revealed that the proportion of the patients with a history of surgery (laparotomy or laparoscopic surgery) was significantly higher in the improvement group. In addition, there were no particular problems with the pregnancy and delivery course of the 23 patients. Daikenchuto was considered to be highly effective against constipation during pregnancy, especially in pregnant women with a history of surgery.

A 70-year-old female with a pulmonary embolism was admitted to a local hospital. On admission, transthoracic echocardiography detected a mobile cardiac tumor on the aortic valve. After medical treatment for a pulmonary embolism, she was slated for a resection of the tumor in our hospital. Although preoperative examinations showed an isolated tumor attached to the non-coronary cusp without valve dysfunction, meticulous intraoperative inspection revealed multiple fine villous tumors located in the left coronary cusp of the aortic valve. Being immersed in saline solution, these tumors had resembled a distinctive sea anemone-like appearance. These fine tumors could not be detected with intraoperative transesophageal echocardiography even in a retrospective manner. We eventually performed aortic valve replacement. The tumors of the two cusps were pathologically diagnosed as papillary fibroelastoma. Of note, a macroscopically undetected tumor was identified in the right coronary cusp by histopathological evaluation. Careful intraoperative observation is essential for surgical decision and patient’s prognosis. It is also considered that latent tumor might be concealed even in seemingly normal adjacent cusps in a case with multiple papillary fibroelastomas.

We aimed to clarify the significance of using Kampo therapy centered on kamishoyosan and tokishakuyakusan together with general infertility treatment. The subjects were 41 women who visited a Kampo outpatient clinic for infertility and received general infertility treatment with Kampo therapy (Kampo group). The control group was 781 women who received only general infertility treatment at the same time (non-Kampo group). In comparing both groups, we conducted a retrospective survey on the pregnancy rate by cycle and the pregnancy rate by prescription. The pregnancy rate in the first cycle was 24.4% in the Kampo group and 8.5% in the non-Kampo group, and the pregnancy rate was higher in the Kampo group (P = 0.003). There was no difference in pregnancy rates after the second cycle. The pregnancy rate by prescription was 26.7% for kamishoyosan, 22.2% for tokishakuyakusan, and 8.5% for the non-Kampo group. In the comparison between the first cycle pregnant group and the non-pregnant group, the qi counter flow score was clearly higher in the first cycle pregnant group (P = 0.012). It is suggested that combined use of Kampo therapy including kamishoyosan and tokishakuyakusan may be effective from an early stage. Meanwhile, if pregnancy does not occur even after the combined use of Kamp therapy, it would be an opportunity to consider stepping up as Western medical therapy.