Sato Susumu (1845-1921), the third president of Juntendo, was one of the most famous physicians in the Meiji era. He went to Germany with the first Japanese passport issued by the Foreign Ministry. He was the first medical doctor in Asia to graduate from the Department of Medicine, Berlin University, in 1874. This paper describes his life in Berlin through his autographs and the letters he exchanged with his family.
When Juntendô University and Charité-Universitätsmedizin Berlin signed a contract of cooperation in 2011, this was one further step in the history of medical relations between Germany and Japan, which go back more than 300 years. Satô Susumu, the first Japanese who took an official degree of Doctor of Medicine in Germany, played an important role in the history of these medical relations.
What kind of city did he encounter, when he arrived in Berlin in October 1869 shortly before the outbreak of the Franco-Prussian War? Who were his fellow students and what were the requirements for a formal full 4-year medical study at the University of Berlin? Who were his eminent teachers and what were their special skills and their personal characters?
In contrast to Mori ôgai, who left a detailed “German diary” in which he recorded his days in Germany more than one decade later (1884-88), there is little evidence of Satô Susumu's study in Berlin. Apart from Sato's certificates, which are kept securely in the archives of Humboldt University, there is a skull of a Japanese from Yeddo (Edo) in the skull collection in the Museum of Prehistory in Berlin. This might be the one that Satô ordered for his teacher, the anatomist Bogislaus Reichert, and which was presented by Okubo Toshimichi, a member of the Iwakura mission, in 1873. Until recently, it was not known exactly on what day Satô Susumu sat his examination for his doctor's degree and how the graduation ceremony was held, but the author has found a newspaper cutting that reports on this historical event on 10th August, 1874, and shows that the ceremony followed the conventions of the University of Berlin at that time.
Beate Wonde, the author of this article, has given several lectures on German-Japanese medical history at symposia by Juntendô and Charité. That she also, as Curator of the Mori ôgai Memorial in Berlin, shines a light on the various associations between Satô and ôgai and on the footprints they left behind in Berlin, is not surprising.
Locomotive syndrome refers to conditions under which the elderly receive care services, or have high-risk conditions under which they may soon require care services, due to locomotive organ disorders. Knee osteoarthritis (OA) is one of the representative diseases strongly associated with locomotive syndrome. While OA is a disease that primarily results in the degeneration and destruction of articular cartilage, other joint structures, such as the meniscus, subchondral bone, and synovium, are also affected, which results in disability in the activities of daily living. Although the gold standard for assessing joint damage is still plain radiography, biomarkers and magnetic resonance imaging (MRI) are candidates that can detect and monitor joint structures precisely. Given the lack of disease-modifying drugs (DMORDs) for the treatment of knee OA, there is a strong need for treatments of knee pain. Recently, opioids have become available for the treatment of knee OA. For surgical treatment, while endoscopic surgery should be performed for limited cases with meniscal catching or rocking, joint replacement surgeries (TAK or UKA) are associated with excellent long-term outcomes. In addition, high tibial osteotomy (HTO) is also recommended because of the development of a fixation device with stable mid-term outcomes. Therefore, surgical treatment should be considered positively for patients with end-stage knee OA. Owing to the lack of systematic treatment guidelines for knee OA, evidence-based systematic treatment guidelines for knee OA are required.
Glucosamine, a naturally occurring amino monosaccharide, is present in the connective and cartilage tissues as a component of glycosaminoglycans, and contributes to maintaining the strength, flexibility, and elasticity of these tissues. Thus, glucosamine has been widely used to treat osteoarthritis (OA) in humans for more than two decades. In fact, several short- and long-term clinical trials on OA have shown the significant symptom-modifying effect of glucosamine. Recently, we have revealed that glucosamine exhibits anti-inflammatory and chondroprotective actions on OA, on the basis of the findings that glucosamine suppresses synovitis and type II collagen degradation, whereas it enhances type II collagen synthesis in articular cartilage, as evidenced by using several biomarkers including hyaluronic acid, CTX-II, C2C, and CPII.
Osteoarthritis (OA) of the knee is a prevalent musculoskeletal disorder of elderly people in developed countries. Exercise is an effective therapy and now recognized as the first-choice method of treatment for knee OA. The basic mechanism by which therapeutic exercise reduces pain caused by OA remained unknown. However, in the early 21st century, many studies using cultured chondrocytes revealed that inflamed chondrocytes produced less proinflammatory or even produced anti-inflammatory cytokines when exposed to tensile strain of 5-10% than those with no strain. This anti-inflammatory action of mild strain on inflamed cells of joints is now thought to be the underlying mechanism by which therapeutic exercise reduces inflammation and pain caused by knee OA.
In osteoarthritis (OA) of the knee, non-operative treatment should initially be performed. Surgical treatment is considered when conservative therapies are not effective. There are various methods of its operative treatment, including arthroscopy, osteotomy, and knee arthroplasty. The surgical choice of treatment is based on age, XP findings, activity, and other factors. Arthroscopic debridement is a minimally invasive surgery, but the effect is controversial. Carefully selected patients can be considered for arthroscopy. High tibial osteotomy (HTO) is performed for unilateral compartmental OA. Although HTO can preserve the knee joint, it requires a long period of rehabilitation. In recent years, however, an early rehabilitation program was established by open wedge osteotomy using TomoFix. Total knee arthroplasty (TKA) is one of the most successful interventions for end-stage OA of the knee. However, it requires careful perioperative management because of a high risk of complications such as infection and venous thromboembolism. Each surgery has both advantages and disadvantages, and there are no curative therapies for OA of the knee. It is essential to determine the limitations of surgical treatments. Besides, informed consent before the surgery is very important.
Objective : It is generally believed that the sweat glands of the palm do not respond to thermal stimulus and only show emotional sweating. However, we often experience the presence of sweat on the palm when we clasp another's hand in a hot environment, but not under cool conditions. Therefore, we examined the influence of thermal stimulus on emotional sweating.
Measurements : Sweating responses of 7 healthy college students were examined. In an air-conditioned room, emotional sweating from the palm and thermal sweating from the cubital fossa were measured under hot (28°C) and cool (16°C) conditions.
Results and Discussion : Thermal sweating was little detected under cool conditions, while it increased in a hot environment;it did not respond to various tasks (mental calculation, puzzle, and hand clasping, etc.). Sweating from the palm was not affected by environmental temperature under rest conditions. However, emotional sweating caused by tasks significantly increased under hot conditions.
Conclusions : These results indicate that emotional sweating induced by mental and physical stimulus can be influenced by thermal stimulus.
Objective : The purpose of this study was to elucidate the effectiveness of back care with aromatic plant oils on the respiratory function and subjective symptoms of healthy middle-aged and elderly subjects.
Participants : The subjects were 16 men and women in the 5th to 7th decades of life who had no past medical history or present conditions that would affect respiratory function, had no experience of skin trouble as a result of using aromatic plant oils, had no regular exercise habit, and who gave their informed consent to participate in this study. Methods : We performed interventions A, B, and C, as explained below, on all of the subjects. Before and after each intervention, we measured their respiratory function with a spirometer, chest expansion, and subjective symptoms on a 5-item visual analog scale (VAS). In intervention method C, we used Lavender super and Eucalyptus radiate diluted to 3% in jojoba oil.
A : Control (rest for 15 min);B : a total of 15 min consisting of a back massage with plant oil (jojoba oil) for 8 min+wiping the back with a hot towel+rest;C : a total of 15 min consisting of a back massage with aromatic plant oil for 8 min+wiping the back with a hot towel+rest.
Results : The subjects were 8 men and 8 women. Their mean age was 54.1±7.4 years, and their mean body height was 163.8±6.5 cm. The data in the group that received back care showed improvements in comparison with the control group in regard to chest expansion (F=8.898, p<0.01), tidal volume (TV) (F=3.919, p<0.05), and two VAS items, namely, “I am satisfied with my overall physical condition” (F=4.34, p<0.05) and “I do not have any discomfort in my shoulders and neck” (F=6.870, p<0.01). No differences were observed according to age or the order in which interventions B and C were performed, but an interaction according to sex was observed in the item “I can breathe easily” (F=4.28, p<0.05).
Conclusions : The results showed an increase in thoracic flexibility, alleviation of subjective symptoms, and associated improvement of respiratory function in response to brief back massage care using aromatic plant oils. The back care adopted in this study is a method that can be performed by anyone in a short time, and its incorporation into daily care conducted in a clinical setting or at home is recommended.
We perform laparoscopic inguinal hernioplasty with the TANKO-Totally extraperitoneal repair (TEP) technique. There are misunderstandings that the prevesical space (Retzius space), the route of penetration in the surgery, is the pre-peritoneal space (Bogros space) between the superficial and deep layers of the pre-peritoneal fascia, and also that the bladder is not covered with the deep layer of pre-peritoneal fascia because it is derived from endoderm. The Retzius space is a sparse cavity lying between transversalis fascia and the superficial layer. This is different from the pre-peritoneal space owing to the boundary surface of the superficial layer and lack of communication between them. Bladder epithelium is derived from endoderm, and bladder (''space'') is embedded in vesical fascia as the pre-peritoneal fascia continues from mesodermally derived renal fascia.
Wernicke encephalopathy (WE) is an acute neuropsychiatric syndrome resulting from thiamine (vitamin B1) deficiency. Here, we report two elderly patients who developed WE long after gastric surgery. Patient 1 was an 85-year-old man, who developed ophthalmoparesis, gait ataxia, and areflexia 43 years after distal gastrectomy (Billroth's operation I) for gastric ulcer. Patient 2 was a 78-year-old man presenting with drowsiness, ophthalmoplegia, and ataxia, 7 years after proximal gastrectomy and jejunal interposition for gastric cancer. After intravenous infusion of thiamine, patient 1 completely recovered and patient 2 partially improved. Physicians should recognize that gastric surgery is a risk factor for developing WE, and that early diagnosis and treatment are necessary.