1.Surgical Diseases and Their Sequelea
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 1967;31(1-2):63-72
1) Of 3887 patients hospitalized in our surgical clinic during about 20 years from 1946 to 1966, 43% were patients with abdominal surgery, 20% with neuralgia or rheumatoid arthritis, 9.8% with injuries of four extremities, 9.6% with malignant diseases, and 5.8% with postoperative disturbances.
2) It was concluded by our clinical investigations and laboratory findings that postoperative early ambulation (walk from 3rd. postoperative day) with early thermal bathing (40-42°C, 5 minutes bath from 7th postoperative day) in about 520 patients with gastrectomy or cholecystectomy promoted their postoperative recovery. But it was noted that postoperative recovery with malignant was not always promoted by early ambulation with early bathing and so care must be taken of such postoperative patient.
3) Recently patients with postoperative disturbances have been gradually increasing in our clinic. Of 99 patients with postlaparotomy disorders, 78 of them were postoperative intestinal adhesion. 38 of which were not re-operated and were treated by hydrotherapy that diminished their complaints from 100% to 37.7% after average 48 day therapy.
4) 328 patients with lumbago and sciatica were treated combined with balneotherapy. Of 28 patients with lumbal disc hernia, 53.6%, healed, 46.4% were markedly improved after two month therapy. But, of 21 patients with postlaminectomy or postmyelogram disturbances, only 23.8% healed, 57.1% were improved and 19% were unchanged after two month therapy.
5) 380 patients with rheumatoid arthritis were treated by balneotherapy combined with intraarticular corticosteroid injection. When local improvement by these treatments was little, these patients were treated by means of such procedures as intraarticular pumping and washing, curettage of synovial membrane and fenesteration or partial synovectomy. Balneotherapy markedly improved operated joint function. R. A. patients were permitted to take thermal bathing 6-12 hours after intraarticular corticosteroid injection and there were no articular infection by bathing.
4.Revision of Medical Care System as I See It
Journal of the Japanese Association of Rural Medicine 2004;53(4):631-640
It is said that medical care is a social application of medicine to the benefit of community or individual. In step with progress in medicine, medical care has been made all the more complicated. Moreover, the system supporting medical care has fallen behind the times when its surroundings have been changing drastically. This situation could be ascribed to the institutional fatigue that the system itself is suffering from after a long period of existence. It also can be pointed out that there have been revolutionary changes in traditional Japanese cultural values together with the awareness of people concering health. However, the primary factor that lies behind need of reform is financial difficulties. At present, in connection with deregulation of medical care, the introduction of mixed medical care and the entry of joint-stock corporations are taken up for discussion as topics of the day. In the meantime heated debates are being held over the subjects of institutional reform including the setting up of medical care for the aged as part of the fee-for-service system and reconstruction of the network of providers of health care and services. Moreover, the institutions that are engaged in the practice of medicine are expected to tackle a broad range of tasks- -catching up with ever-progressing information technology, disclosure of information, and strengthening of safety measures against medical accients, among many others. However, these are not the issues which have cropped up in recent years. Many have been brought up and discussed from an angle a little different from what it is today. It is now high time for us to discuss these issues through and through in light of actual situations while looking back on the history of medical care and its system. In this paper the author shall dwell on the development of the nation's medical system and point out some problems confronting us today with the use of some materials thus far presented by the Japan Medical Association. His view is based on his personal experience in hospital management and with the Japan Medical Association.
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8.Anterior correction of idiopathic scoliosis using the KASS-Dual rod system
Kiyoshi KANEDA ; Yasuhiro SHONO
Orthopedic Journal of China 2006;14(21):1622-1627
[ Objective] To analyze the clinical results of scoliosis patients treated by anterior correction surgery using the KASS (Kaneda Anterior Scoliosis System: the dual rod system). [ Method] Total 123 idiopathic scoliosis patients were treated. The patients' curve patterns by King classification were as follows:Thoracic scoliosis [ type Ⅱ (n = 13), Ⅲ (n = 18 ) , and Ⅳ (n = 16) ,total (n =47) and thoracolumbar or lumbar (TL/L) curve (n = 76)]. In all patients, anterior correction surgery within the range of the major curve was performed. The average follow-up period was 7 years 7 months (2 ~ 13 years 6 months).[ Result] Fusion was attained in all patients. Correction rates of the major curve scoliosis were 68% in thoracic scoliosis and 81%in TL/L scoliosis. In sagittal alignment, all patients restored nearly physiologic thoracic kyphosis and lumbar lordosis. Correction rates of horizontal tilt of the lowermost end vertebra were 78% in thoracic scoliosis and 83% in TL/L scoliosis. Correction rates of the apical vertebral rotation were 59% in thoracic scoliosis and 70% in TL/L scoliosis. No neurovascular and implant related complications were observed. [ Conclusion ] KASS allows excellent 3-D correction of the scoliosis and rigid enough stability to maintain the correction with a shorter fusion.
10.The History of Sho-saiko-to.
Shinyu NUNOME ; Yasuhiro KOMATSU
Kampo Medicine 1997;48(3):301-318
Sho-saiko-to, a prescription composed of seven crude drugs, is one of the most popular Kampo formulas in clinical use. Recently, the side effects of Sho-saiko-to have become an issue. To gain perspective on this problem, the authors searched the indications and pharmacological characteristics of the Sho-saiko-to as noted in ancient Chinese and Japanese medical texts.
Sho-saiko-to was first described in the ‘Shokanron’ (_??__??__??_); ‘Shang Han Lun’; ‘Treatise on Damaging Cold’), which contains are over ten references to this formula. It is recommended for a variety of conditions, but its most fundamental usage was for exogenous febrile diseases. The meaning of some of the indications are still somewhat vague.
In China, the crude drug composition and clinical use of Sho-saiko-to gradually changed over the years. In Japan, Sho-saiko-to has been in use since the Kamakura era. In the Edo era, it was mainly used for complaints of alternative spells of fever and chills, a feeling of fullness and discomfort in the chest and hypochondrium, lack of appetite and vomiting.
Sho-saiko-to has been in use for centuries and is still a very useful prescription. However, the classical medical texts also indicate that adverse reactions will result if this formula is not prescribed properly following accurate Kampo diagnosis.