Introduction : We examined the characteristics of paralytic scoliosis using plain radiography.Subjects and methods : We recruited fourteen patients aged ≥ 15 years old with no history of bone surgery at the time of their final observation. Participants included those who had cerebral palsy or those who had a history of encephalitis and underwent spinal frontal plain radiography in the supine position at different time points. We evaluated gross motor function, position and direction of the curve, Cobb angle, rate of variability, and degree of progression at 5-year intervals. We measured the percentage of migration using hip frontal plain radiography to assess hip dislocation.Results : The final Cobb angles were 82.0°, 118.4°, and 92.3°for the thoracic, thoracolumbar (TL), and lumbar curvatures, respectively. TL curvatures showed the greatest progression, although this was not statistically significant. The progression was greatest in the 10-15-year age group (12.5°annually). The final Cobb angles in the hip dislocation, subluxation, and no dislocation groups were 102.8°, 108.8°, and 87.5°, respectively；the difference was not statistically significant. No relationship was observed between the location or progression of curvature and the state of the hip location.Discussion : Paralytic scoliosis progressed most rapidly in 10-15-year-old patients, especially in those with TL lesions. We did not detect any relationships between hip dislocation and Cobb angle, but these parameters progressed at different rates in different patients.

We described a patient with free wall rupture followed by papillary muscle rupture due to acute myocardial infarction. A 69-year-old man was transferred complaining of transient unconsciousness. His clinical history, electrocardiogram, and chest CT showed myocardial infarction with free wall rupture indicated that several days had passed since the onset. Coronary angiography showed occlusion of the right coronary artery and severe stenosis of the left anterior descending artery. Since cardiac rupture was at inferior wall and hemorrhage wasn't active, repair of the rupture using fibrin glue and fibrin sheet and coronary artery bypass grafting to the left anterior descending artery was performed without cardiopulmonary bypass. On the 10th postoperative day, his arterial oxygen saturation suddenly deteriorated. Transesophageal echocardiography revealed papillary muscle rupture and severe mitral regurgitation. Emergency mitral valve replacement was performed. After two emergency operations, he gradually recovered and were discharged to home. In three months after discharge, he was admitted again due to congestive heart failure with left ventricular aneurysm at inferior wall and recovered in response of conservative treatment. Surgical experience of double rupture is rare. Based on this case, it may be necessary to perform reperfusion therapy toward even this case of recent myocardial infarction, to prevent papillary muscle rupture. It also may be better to use a patch on free wall rupture to prevent cardiac aneurysm.

The effect of moxibustion on duodenal motility was examined. Duodenal motility was measured by the balloon method in anesthetized, artificially ventilated rats. The stimulation temperature and duration of moxibustion varied. Treatments were applied to the hind paw and abdomen.
The duodenal motility exhibited an excited response by pinch stimulation of hind paw, and inhibitory response by abdominal pinch stimulation. Duodenal motility did not show any response to indirect moxibustion stimulation of the hind paw and abdomen. Duodenal motility exhibited an excited response by direct application of moxibustion to the hind paw and an inhibitory response by direct application of moxibustion to the abdomen.

The reflex mechanisms of the responses in heart rate elicited by acupuncture stimulation in anesthetized rats were examined. An acupuncture needle measuring 160μmin diameter was inserted into skin and the underlying muscles to the hindlimb to a depth of about 5mm and was twisted once every second for 1min. A decrease in the heart rate was observed in 55% of 22 trials and in 70% of 20 trials when muscles separated from the overlying skin were stimulated. The response was abolished completely by cutting the femoral and sciatic nerves. The response was not influenced by transecting of the bilateral vagi but was totally abolished by transecting of the cardiac sympathetic nerves. Therefore, we conclude that the decrease in heart rate elicited by acupuncture stimulation of a hindlimb is based on a somato-autonomic reflex, in which the afferent pathway is composed of hindlimb muscle afferents and the efferent pathway is composed of cardiac sympathetic nerves.

We evaluated bedside learning in the department of pediatric surgery by conducting a questionnaire survey of senior medical students at Chiba University School of Medicine. We obtained responses from 70 of 95 students (74%). Although 84% of students responded by making lists of patients' problems. Many students indicated insufficient knowledge about diseases and insufficient technical skills for medical treatment as the reasons they could not solve these problems. This finding indicates that students do not have sufficient basic knowledge and clinical skills for bedside learning. These skills must be acquired and evaluated before bedside learning can be started.

In this study, we demonstrated that immobilized fibronectin (FN) enhanced LAK activity, and that the enhanced LAK activity was completely abrogated by an anti-VLA-5 monoclonal antibody and RGD peptide. Fresh -spleen cells expressed VLA-4, VLA-6 and vitronectin receptor, whereas VLA-5 was expressed only on the spleen cells activated with IL-2. LAK cells showed increased adhesion to immobilized FN compared with that to control BSA, and the increased adhesion of LAK cells to immobilized FN was inhibited by anti-VLA-5 monoclonal antibody. Conjugate-formation assay showed that the LAK cells cultured on immobilized FN bound to target cells more efficiently than the control LAK cells, and that anti-LFA-1 monoclonal antibody inhibited the LAK-target cell binding. Immobilized type IV collagen and laminin, as well as FN, enhanced LAK activity. All these results suggest that the interaction of inte-grins expressed on LAK cells with extracellular matrix proteins act as co-stimulator for the enhancement of LAK activity , and that anchorage is necessary for full activation of LAK cells.

Twenty six adult patients who underwent prosthetic heart valve replacement and treated anti-thrombogenic therapy, were divided into 2 groups. One was administered Warfarin alone, another was administered Warfarin plus Aspirin (162mg/day) as antiplatelet therapy. Trapidil (300mg/day) was administered to all of the patients. Platelet aggregation, plasma level of TXB₂ (stable metabolite of thromboxane A₂), and 6-keto-PGF₁ (stable metabolite of PGI₂) were measured before and 1, 3, 6 months after Trapidil therapy. Platelet aggregability suppressed in both 2 groups. Plasma TXB₂ level, and TXB₂/6-keto-PGF₁ ratio showed a tendensy to decrease (p<0.05) 6 months after administration. In the Aspirin plus Trapidil group, platelet aggregability, serum TXB₂ level, and TXB₂/6-keto-PGF₁ ratio are significantly lower than that in the Trapidil only. These results suggest that Trapidil is clinically useful for antiplatelet agent, but the combined Aspirin plus Trapidil therapy is more efficacious than the Aspirin or Trapidil single therapy.

A check of the health of residents in their twenties and thirties in Nagano Prefecture's rural communities indicates that the rate of hypertensives and the incidence of cholesterolemia were low in those age groups. There were signs that the prevalence of obesity is somewhat high among males but low among females. Virtually no incidence of anemia was observed among men but the incidence was fairly high among women. The number of persons with hepatic dysfunction was relatively large among men. In terms of the intake of nutrients, there were not a few men for whom the meals were imbalanced, and the intake of alcoholic beverages was high.
It is necessary that women should refrain from taking in confectionary and taken in fishmeat, meat, milk, egg, soybeans and other proteins. In Nagano Prefecture's rural communities, there remain signs that the intake of salt is high even in young generation, so that it is important to take measures for the prevention of hypertension.