Hyperlexia and ambient echolalia are rare conditions, and investigations into their clinical course have not been reported in the literature thus far. Here we report the case of a 69-year-old woman with cerebral infarction of the left anterior cingulate cortex and corpus callosum, on whom we performed an echo induction test for studying her long-term hyperlexia and ambient echolalia. Her clinical features included symptoms of complex disorders such as visual groping, compulsive manipulation of tools and callosal disconnection syndrome. The patient did not have dementia or aphasia. Her most outstanding behavioral traits were the hyperlexia and ambient echolalia. We investigated the induction of her hyperlexia and ambient echolalia by subjecting the patient to 10 verbal questions using a background of visual (bookshelves were placed in front of her) and auditory (imitated hospital announcements) stimuli at periods of 1, 2 and 6 months after the stroke. Hyperlexia was induced at 1 and 2 months after stroke, whereas ambient echolalia was only induced at 1 month after stroke. The disappearance of the hyperlexia and ambient echolalia in this case might be due to a reduction in the disinhibition of response to external stimuli caused by damage sustained in the stroke to the left anterior cingulate cortex and corpus callosum.

Sleep disturbance is often observed among patients with diabetes and poor sleep is associated with higher HbA 1 c levels. Therefore, treatment of sleep disturbance is important. We experienced two cases in which sansoninto was useful in the treatment of insomnia with type 2 diabetes mellitus. A 58-year-old man had been treated with insulin for 10 years and a 79-yerar-old man had been treated oral hypoglycemic agents for 15 years. We administered sansoninto in each patient, after which sleep disturbance disappeared gradually. These results suggest that sansoninto is useful for sleep disturbance in patients with diabetes.

Introduction: The rapid-onset opioid fentanyl is used to treat breakthrough pain in the management of cancer pain. Case Report: A 33-year-old woman started to receive palliative radiation for multiple spinal metastases and pathological fracture of the sacrum following surgery for right breast cancer. Although oxycodone sustained-release tablets and oxycodone powder had been used for the treatment of pain, there had been no alleviation in response to oxycodone powder at times that she experienced breakthrough pain. Therefore, the patient was switched to rapidly acting fentanyl citrate sublingual tablets. An analgesic effect was obtained, but numbness of the lower lip and taste disturbance emerged. Furthermore, pain in the lower jaw emerged and eating became difficult. Therefore, the patient was switched to fentanyl citrate buccal tablets. However, once the agents were dissolved and spread inside the mouth, the same symptoms emerged. Conclusion: Because the same symptoms were observed even after switching agents, fentanyl citrate or the common ingredient contained in both agents appeared to be the cause of this event.

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.

A cross-sectional study was carried out to investigate the effect of physical exercise in daily lives of healthy women on the aging process in terms of maximal aerobic capacity (VO₂max), body fat tissue mass (FTM), lean tissue mass (LTM), bone mineral density (BMD), serum triglyceride (TG), total cholesterol (TC), HDL-C and LDL-C concentrations, and systolic (SBP) and diastolic blood pressure (DBP) . These parameters are considered as risk factors of cerebrovascular disease and/or osteoporosis, which are the main causes of becoming bedridden and demented in middle-aged and older women. One hundred sixty-five healthy female volunteers aged 20 to 76 years participated in the study, 82 of whom were postmenopausal with a mean age at menopause of 49.7±3.1 years. Eighty-two of the subjects had been exercising regularly by jogging, swimming, aerobic dancing, or playing tennis more than twice a week for 2 years (Ex group), whereas 83 individuals had not been engaging in regular exercise (Cont group) . Serum lipid concentrations, SBP and DBP measurements at rest and treadmill VO₂max and HRmax measurements were determined in the morning after an overnight fast. Whole-body BMD (TBMD), head, lumbar, arm and leg BMD, FTM and LTM were measured by dual-energy X-ray absorptiometry one to two hours after a light lunch. The mean and SD of each measurement were calculated for five-year age groups between 40 and 60 years and one group each under 40 and over 60 years.
The results were as follows:
1, VO₂max (r=-0.590) and HRmax (r=-0.632) decreased significantly with age. The VO₂max of the Ex group was significantly higher than that of the Cont group in all each age groups. However, no differences in the aging process in terms of HRmax were found between the two groups.
2, Resting SBP (r=-0.391) and DBP (r=0.315) increased significantly with age. However, no hypertensive individuals (160/95 mmHg-) were found among the 165 subjects.
3. Only serum TC (r=0.346) and LDL-C (r=0.339) among the blood constituents measured changed with age. No changes in serum HDL-C were detected with age. Lower TC (189.2±23.3 mg/dl) and higher HDL-C (72.2±10.9 mg/dl) were observed in eleven runners (49.7±7.7 years) among the subjects who participated frequently in official races than in subjects of the same ages in the Cont group. The highest serum HDL-C (75.8±15.8 mg/dl) and HDLC/TC ratios (0.362) were noticed among the subjects (n=26) who both regularly exercised and consumed alcoholic beverages.
4. A tendency for FTM to increase and LTM to decrease with age were observed in both groups, and a lower %FTM (percentage of FTM to body weight) and higher %LTM were evident in the Ex group. Differences in %FTM and %LTM between the Ex and Cont groups at 40-45 years were significant.
5. Partial and whole BMDs decreased significantly with age (TBMD-Age ; r=- 0.527) . Significantly higher leg BMDs in both the 20-39-year and 40-45-year groups, and spine and TBMD in the 20-39 years in the Ex group, who were premenopausal women, were shown. No significant differences in BMDs between the two groups were observed in postmenopausal women, but the Ex group tended to have higher partial and whole BMDs. The postmenopausal official race runners (n=5.52.6-1.5years) also had higher TBMD and leg BMD values than subjects of the same ages in the Cont group.
6. Investigation of correlations between VO₂max, LTM, FTM, BMDs and serum lipid concentrations, yielded a significantly higher correlation (r=0.669) between LTM (kg) and absolute VO₂max (1/mm) . Although VO₂max per LTM (VO₂max/LTM) decreased with age (r=-0.595), VO₂max/LTM in the Ex group was significantly higher than in the Cont group in each age group. The VO₂max per body weight (ml/kg/min) was negatively correlated with %FTM (r=-0.442) and positively correlated with

The objective of this study was to investigate the edema suppresive effect of single-dose crystalloid cardioplegia against immature myocardium. 50 puppies (3-21-day-old) were separated into 4 groups by the method of myocardial preservation, group A: preservation at 30°C, group B: topical cooling used only, group C: topical cooling with cardioplegia (St. Thomas Hospital solution: 4°C, pH 7.8, 350 mOsm/l), group D: topical cooling with oxygenated cardioplegia, and gravimetric water content of myocardium (%) was measured at control, 5, 30, 60, 90, 120, 150, and 180 min after aortic clamp. All hearts had elevated myocardial water content with linear change pattern, although which in groups A and B was consecutively increased while which in groups C and D was increased immediately after aortic clamp followed by slow increase thereafter. Increase of myocardial water content from 5 min after aortic clamp in group B at 90 min was significantly higher (p<0.01) than those in groups C and D, at 180 min that in group A was higher than that in group C and that in group B was higher than those in groups C and D (p<0.05, p<0.01, p<0.01, respectively). This study has shown that evolution of myocardial edema was suppressed by the administration of cardioplegia, while myocardial water content was seemingly higher because coronary vascular dilatation resulted in increase of intravascular water. We could not find the effect of the topical cooling only or oxygenated cardioplegia.

Spinal cord injury is a dreaded and serious complication of operative procedures on the descending aorta. To avoid this serious complication, 53 patients underwent somatosensory evoked potential (SEP) monitoring during operations on the aorta which required cross-clamping of the descending aorta. 38 patients whose SEPs were kept normal during and after operations did not develop spinal cord injury. Among the 14 patients who developed both abnormal decrease in amplitude and elongation of peak latency, 13 lost their SEPs during aortic cross-clamping. Peripheral nerve ischemia seemed to be the cause of those abnormalities in 8 to whom cross-clamping was given to the abdominal aorta. Inadequate perfusion of the distal aorta was suspected in 6 to whom cross-clamping was given to the descending thoracic aorta. In these cases, however, SEP monitoring was not specific in differentiating spinal cord ischemia from peripheral nerve ischemia. Spinal cord injury was noted in only one of the 6 patients. The remaining one patient developed complete loss of SEP and spinal cord injury on the first postoperative day despite the well preserved SEP during the operation. Since this patient underwent flow reversal and thromboexclusion method for the dissecting aneurysm, gradual thrombotic occlusion of the important radicular arteries draining to spinal cord might have resulted delayed appearance of the spinal cord injury. In conclusion, SEP monitoring is the reliable method to detect the spinal cord ischemia which might be developed during cross-clamping of the descending aorta. However, this method bears limitation in its clinical application due to the following reasons. First, intraoperative SEP monitoring cannot predict delayed occurence of spinal cord injury. Secondly, this method cannot detect the qualitative extent of ischemia of spinal cord and the safe range of the cross-clamp time.

[Aim] Diffuse pan-bronchiolitis (DPB) causes severe respiratory dysfunction and severely limits a patient's daily activities. Case: This paper reports a case of a DPB patient whose respiratory symptoms were successfully improved by acupuncture. In a case report in January 2002, a 62-year-old male visited the Department of Respiratory Internal Medicine at Gifu University Hospital, complaining of cough, pumlent sputum and dyspnea on exercise. His general condition had worsened despite ordinary medical treatment. Thus acupuncture was added to the treatment in August, 2001. Intervention: The patient received acupuncture treatments once a week for 50 weeks. The acupuncture treatment was based on the Chinese medicine theory. Measurements: Outcome measures were respiratory symptoms using the Fletcher-Hugh-Jones (F-H-J) classification, 6-minute walking distance (6 MWD), blood test, arterial blood gas and pulmonary function tests. Computed tomography (CT) was assessed. Each evaluation was done after 15 weeks and 50 weeks later.
[Results] After 15 weeks of acupuncture treatment, cough, pumlent sputum, walking distance, the Borg scale and respiratory function were significantly improved compared with the baseline. Moreover, the effect of the acupuncture treatment continued for 50 weeks.
[Conclusion] This suggests that acupuncture treatment was effective in treating the advanced case of DPB.

Coronary artery bypass grafting (CABG) was performed in 16 patients with impaired left ventricular function due to ischemic heart disease (IHD) and the surgical procedures and cardiac functions before and after operation were studied. Preoperative angiogram showed three vessel disease in all patients. The ejection fraction was less than 40% in all and the mean cardiac index (CI) was 1.97l/min/m². At operation arterial graft was used in 10 patients (Group-AG) and no arterial graft but saphenous vein graft was used in 6 patients (Group-SVG). The average total cardiopulmonary bypass time, aortic cross clamping time and the number of revascularized vessels in both groups showed no significant differences. However, intraaortic balloon pumping was necessitated in one of Group-SVG and the requirement of postoperative catecholamine was in higher ratio in Group-SVG than in Group-AG. Postoperative CI improved to 3.1±0.4l/min/m² and 3.3±0.3 l/min/m² in Group-AG and Group-SVG, respectively. The postoperative New York Heart Association Functional Class improved to Class I or II in all patients and there were no significant differences of the improvement between the groups. Conclusively, it seems that the arterial grafts can be used safely and extensively in CABG for impaired left ventricular function due to IHD.