Hié or cold hypersensitivity is a form of thermal hyperalgia that is predominantly localized to hands and feet. It is a subjective symptom that has no clear conception in Western medicine. The pathological process underlying cold hypersensitivity includes various factors such as impaired peripheral circulation in response to cold exposure, decrease in thermogenesis due to age, lifestyle habits such as nutritional deficiency anemia, lack of exercise, and chronic stress, and other organic causes. Modern times have witnessed an increase in cold hypersensitivity among young females. In traditional Oriental medicine, this condition is defined as mibyo or pre-disease state that is classified into five types on the basis of Kampo treatment. Clinically, cold hypersensitivity and painful states are intimately correlated such that cold hypersensitivity is often considered to exacerbate pain. Representative Kampo medicine for the treatment of cold hypersensitivity and pain include tokishigyakukagoshuyushokyoto and bushi.

Kampo is being reappraised as complementary alternative medicine due to emerging clinical evidence from randomized controlled studies and partial elucidation of the mechanism of actions from basic studies. In this paper we introduce our clinical experience and some clinical reports to describe the effectiveness of two widely prescribed Kampo extract in neurosurgery: goreisan for the treatment of chronic subdural hematoma, and yokukansan for dementia.

Kampo is herbal medicine which is constituted mainly of many dried plants and vegetables. Chinese herbal medicine has a long history, more than 5000 years. What is characteristic of Chinese herbal medicine is that it is basically personalized medicine. Prescription has been done not based on the diagnosis of disease, but based on the patients’ general conditions, body built, energy level, and symptoms. In Japan, introduced Chinese herbal medicine is now organized as individual unique formula, which is over 100. In this article, the usage of Kampo in the treatment of urological diseases is discussed.

Objective: This study aims to elucidate the characteristics of bone metabolism in middle-aged and older mountaineers and compare them with those who walk regularly and those who do not exercise regularly.

Materials: We enrolled 17 middle-aged and older mountaineers [Mountaineer Group; 8 males (age: 65.9±4.5 years) and 9 females (age: 60.4±5.5 years)], 20 people who walked regularly [Walker Group; 10 males (age: 67.5±5.2 years) and 10 females (age: 63.2±5.7 years)], and 17 people with sedentary lifestyle [Control Group; 9 males (age: 67.3±5.2 years) and 8 females (age: 62.7±4.9 years)] in this study.

Methods: All assessments in this study were based on the osteo sono-assessment index (OSI) and bone metabolism markers. We used bone alkaline phosphatase (BAP) and procollagen type 1 aminoterminal propeptide (P1NP) as bone formation markers. In addition, we used tartrate-resistant acid phosphatase 5b (TRACP 5b) and type I collagen cross-linked N-telopeptide in serum (sNTX) as bone resorption markers.

Results: There was no significant difference in OSI among the three groups in males and females. In addition, there was no significant difference between BAP and P1NP in males. The TRACP-5b level was significantly higher in the Mountaineer Group (459.5 mU/dl) than in the Control Group (333.0 mU/dl; p<0.05) in males. In addition, there was no significant difference in the bone formation/resorption ratio among the three groups in males. In females, there was no significant difference in each bone metabolism marker among the three groups.

Conclusions: Middle-aged and older males who mountaineer regularly had higher resorption than those who do not exercise regularly, but there was no difference in coupling. Furthermore, there were no prominent traits in the bone metabolism of middle-aged and older females who mountaineer regularly.

Objective: Reduced physical activity (PA) is associated with poor prognosis in patients with chronic obstructive pulmonary disease (COPD). The HT-PB3 is a triaxial accelerometer with long-term recording and tapestry-display output capabilities corresponding to activity levels and exercise frequency, and we investigated its utility for evaluating PA in COPD patients.

Materials: Study subjects were 10 COPD patients and four age-matched individuals without COPD.

Methods: Study subjects wore the HT-PB3 on the wrist, and the device continuously recorded PA. They also made a record of their actual daily physical activity during the measurement period. The COPD patients completed Saint George’s Respiratory Questionnaire (SGRQ) and COPD assessment test (CAT) questionnaires, and their respiratory function was examined. HT-PB3-generated tapestry displays were compared with actual self-report records of physical activity, to ascertain whether differences in PA level were visually detectable. We also investigated associations between motion sensor-derived parameters (step count and time distribution by activity level) with respiratory functions and the scores of quality of life questionnaires.

Results: We confirmed that changes in PA are discernible in the tapestry display by comparing HT-PB3 output with actually recorded activity. The total step count significantly correlated with the total SGRQ scores and CAT scores (p=0.002, rs=0.88, and p=0.026, rs=0.69, respectively). Besides, duration of exercise time distributed to 3.0 to 6.0 METs was also correlated with the total SGRQ score and CAT scores (p=0.003, rs=0.86, and p=0.040, rs=0.66, respectively).

Conclusions: The HT-PB3 could be useful for PA evaluation in patients with COPD.

The Philippine Emergency Medical Services (EMS) has evolved greatly from the time of its establishment. One of the recent changes in the EMS is the establishment of a nationwide emergency hotline. However, the Philippine EMS continue to face different problems such as overcrowded hospital, lack of sufficient facilities, referral system and regulated ambulance system and paramedic profession. Strategies that can help resolve these issues include updating local EMS data through research, unifying national and local EMS program through standardization and patient education.