In an attempt to study the effect of a moderate work load on the concentration of serum erythropoietin and hemoglobin in young women, 8 female university students with a high hemoglobin content (group H), 7 female university students with a low hemoglobin content (group L) and 7 female university students with a tendency to be anemic (group A) were subjected to moderate work for 7 successive days in summer.
Each subject pedalled at a constant work load of 1.25kp at a cycling rate of 50rpm for 60min every day. Blood samples were drawn from the cubital vein under basal conditions on the day before training, the fourth day of training and the day after the training period. The results obtained were as follows; Group H showed a significantly higher erythropoietin concentration before training than groups L and A. The concentration of erythropoietin in group H decreased slightly during the training period, whereas those in groups L and A increased, although the differences were not statistically significant.
The concentration of serum iron in group H was significantly higher than that in group L before training. The former decreased significantly during the training period, whereas the latter was maintained at a lower level. The differences in blood constituents found among the three groups before training lessened after one week's moderate exercise.
The increase in Hb concentration in the subjects in groups L and A after training might have been induced by the augmented secretion of erythropoietin due to training for 7 successive days.

Patients often complaint about their health, even if nothing is wrong with them upon concise objective examination. The complaints often imply the symptoms reflect more than one organ. Kampo treatment has the advantage of curing several symptoms at the same time, with only one or a few medicines. Kampo medicines comprise Chinese herbal formulations individually tailored to the patient. Therefore, symptom reduction is one of the most essential outcome parameters in Kampo treatment. However, how these subjective symptoms should be quantified, is controversial. The purpose of the current paper is to introduce an evaluation system for subjective symptoms. The system is referred to as Tokyo Women's Medical University Oriental Medicine Research Active Support System (TOMRASS). Apart from subjective symptoms, this database contains physical examination, laboratory data, clinical diagnosis and prescribed medicines, etc. In this study, 2 cases are shown as examples of practical use with TOMRASS use. One is a case with many complaints, which is effective with one medicine, Toki-shigyaku-ka-goshuyu-shokyo-to. The other is a case, which reveals unexpected outcomes with Sho-seiryu-to.
The new approach enables us not only to give more consideration to the patient's perspective, but also to differentiate therapeutic implications. The investigation between the subjective quality of life and therapeutic relationship may contribute to further understanding of Kampo treatment.

Daily energy expenditure has been measured by the physical activity recording and/or the questionnaire method. Recently, the accelerometer or pedometer is used to measure daily energy expenditure. The purpose of this study was to examine validity of the pedometer with accelerometer and to compare the daily physical activity between young and older Japanese. To examine validity of the pedometer, 10 young subjects worn the pedometer (Lifecorder) on the waist and then performed the walking test. Energy expenditure was measured by the expired gas analysis during the test. Fourtythree young and 54 older subjects worn the Lifecorder on the waist during free-living condition for 14 days. The intensity of Lifecorder had a high correlation with the physical activity intensity (METs) (r=0.958, P<0.001) . In the free-living condition, daily energy expenditure was 2171±305 kcal in young and 1617±196kcal in older (P<0.001) . Total step in young was significantly higher than older (young: 9490±2359 steps ; older: 6071±2804 steps, P<0.001) . There was no significant difference in the duration of physical activities at the Lifecorder intensity 1 such as desk working, watching TV sitting on a sofa and driving a car. However, the duration more than the intensity 2 corresponding to 2.2 METs in young subjects was longer than that in older (P<0.001) . We concluded that in older subjects, not only amounts of daily energy expenditure but also intensities of daily living were lower compared to the young subjects.

A total of 147 subjects presenting with common colds were discussed in the context of traditional Japanese medicine. Using diagnoses and treatment based on traditional Japanese medicine, the subjects were divided into three groups, including wind-cold and wind-heat, and were prescribed herbal medicines. The subjects were compared in terms of time-of-onset, complaints, subjective and objective symptoms, and constitution.1) Wind-cold was observed in 42.9% of their cases, mostly treated with kakkonto/keishito. This type of common cold occurred frequently during winter but was less common in summer. Many patients were found to have a weak stomach and/or an excessive sensitivity to cold. Typical symptoms were chills (often the chief complaint) and cold sensations in the limbs, both of which are external cold symptoms. There were no objective symptoms other than a floating pulse. 2) The percentage of wind-heat colds was 46.3%. Gingyosan was frequently used. This type of common cold occurred more frequently in spring, but was also seen in autumn. Slightly more subjects were sensitive to heat and/or had a healthy constitution. Symptoms were extensive, including external/internal heat symptoms, such as pharyngeal pain (often the chief complaint), redness of the pharynx, hot sensation, feverishness, dry mouth favoring cold water, and dryness symptoms and, less often, cold state symptoms. 3) The remaining subjects, accounting for 10.9%, were regarded as a complex of cold and heat states, and were treated with kufugedokuto.

Objective: To study the hypoglycemic effects of soybean isoflavones (SI) and soyasaponins (SS) in diabetes, and their inhibitory activities on alpha-glucosidase (EC 3.2.1.20) and alpha-amylase (EC 3.2.1.1). Methods: GK/Jcl type 2 diabetic rats were given diet containing 20 g/kg of soybean hypocotyl extracts (SHE) for 20 weeks, then the blood glucose and oral glucose tolerance test were observed. SI and SS were isolated by ODS column chromatography and high-performance liquid chromatography (HPLC) from SHE. The inhibitory activities of each component of SI and SS against alpha-glucosidase and alpha-amylase were tested by colorimetric method. Results: SHE decreased blood glucose significantly in type 2 diabetic rats and improved glucose tolerance in both normal and diabetic rats. In alpha-glucosidase inhibitory assay, Group B, Group E and DDMP (2,3-dihydro-2,5-dihydroxy-6-methyl-4H-pyran-4-one) saponins showed potent inhibitory activities with IC50 values of 10-40 靘ol/L. Isoflavone aglycones also showed potent inhibitory activities against alpha-glucosidase with IC50 values of 20-150 mol/L, while isoflavone glycosides showed a little lower potencies. Inhibition of SI and SS on alpha-amylase was low, and their inhibitory activities were about 10%~20% at the concentration of 1g/L. Conclusion: SI and SS may decrease blood glucose and improve oral glucose tolerance in diabetic rats, probably via the inhibitory effects on alpha-glucosidase and alpha-amylase.

A 72-year-old man suffering from congestive heart failure, swelling of the lower limbs and hematuria was transferred from another hospital with a diagnosis of large aneurysms of the abdominal aorta and the left common iliac artery. Iliac arteriovenous fistula (AVF) was definitively diagnosed preoperatively by contrast-enhanced CT and angiogaphy. At operation, an infrarenal abdominal aortic aneurysm of 8cm and left iliac arterial aneurysm of 12cm were identified. After proximal and distal aortic clamping, the aneurysm was entered and an AVF orifice of 1cm communicating with the left common iliac vein was disclosed at the right posterior wall of the left common iliac artery. Venous blood reflux was controlled by inserting an occlusive balloon catheter to the fistula and intraoperative shed blood was aspirated and returned by an autotransfusion system. The AVF was closed from inside the iliac aneurysm by three interrupted 3-0 monofilament mattress sutures with pledgets. The aneurysms were resected and replaced with a bifurcated Dacron prosthetic graft. The patient had an uncomplicated postoperative recovery; the lower limb edema subsided and heart failure improved rapidly. Preoperative identification of the location of the AVF is mandatory to make surgery safe. Moreover, easy availability or routine use of the devices for controlling undue blood loss such as an autotransfusion system and an occlusive balloon catheter are other important supplementary means to obtain good results of surgical treatment.

Aim:To examine any relations of workload and outcomes of pharmacists’ home visiting service for medication management and guidance. Survey Target:Managing pharmacists and home-visiting pharmacists from community pharmacies of the Osaka Pharmaceutical Association’s Yao and Toyonaka branches as of March, 2012. Methods:Survey forms regarding drug management and guidance at patients’ homes were mailed, requesting mail or online response. Workload indexes were visit frequency and work time on site. The relation of workload and its outcomes was examined using univariate analysis regarding three items:change in unused medication amount;detection of side effects during visits;change in prescription. SPSS ver. 20 for Windows was used for statistical analysis. Results:90 of 201 pharmacies responded (collection rate 44.8%), and 110 home patients’ data were analyzed. 5-to-15-minute actual work time scored highest (57.4%), followed by less than 5 minutes and 15 to 30 minutes, both at 21.3%. Visit frequency of twice a month scored highest (70.4%), followed by once a week (19.4%), once a month (7.4%), and once in more than one month (2.8%). 5-minute or longer patient visits had a tendency of higher percentage of patients whose unused medication decreased after visits started than less-than-5-minute visits (P=0.072). “Once a week” visits had a tendency of higher percentage of pharmacists detecting side effects than less frequent visits (P=0.061) and changing in prescription (P=0.085). Conclusion:The results above implied the relationship between workload and outcomes incurred by pharmacists’ home visits for medication safety management and guidance.

A gelatin-sealed knitted Dacron graft which has zero-porosity at implantation and does not require preclotting preparation has been developed. Gelatin-sealed aortic grafts were implanted into 39 patients and vascular surgery reconstruction was performed for thoracic aortic aneurysm (TAA) in 10, abdominal aortic aneurysm (AAA) in 19, and arteriosclerosis obliterans (ASO) and other conditions in 10. A total of 39 bifurcated or straight grafts were inserted. The Gelseal Dacron graft had superior handling characteristics and biocompatibility in comparison to conventional graft. There was no measurable blood loss from the body of the sealed graft at the time of implantation. The gelatin-sealed Dacron graft (n=10) was compared with an Intervascular Micron^® graft (n=10) implanted into the abdominal aorta. No problems were evident with regard to intraoperative bleeding, allogenic and autologous transfusion volume and blood parameters between the two groups. These results suggested that the Gelseal Dacron graft sealed with gelatin was a safe, zero-porosity implantable prosthesis for clinical use.