ABSTRACT
Crowned dens syndrome (CDS) is a pseudogout of the cervical vertebra, which shows calcification around the dens of the axis. We report a case of CDS that was successfully treated with daiobotampito and shimotsuto. An 83-year-old woman visited our clinic because of neck pain. She was diagnosed with CDS and was initially administered daiobotampito and eppikajutsuto. Her neck pain improved slightly, but recurred. She was then administered daiobotampito and shimotsuto, after which her neck pain disappeared. We considered that daiobotampito and shimotsuto were effective for this prolonged illness based on persistent stasis and blood deficiency according to her treatment course and laboratory findings.
ABSTRACT
In daily medical examinations of orthopedic surgery, treatment for chronic pain is sometimes needed. We report a case of chronic pain developed after an open fracture 15 years ago and successfully treated with sokeikakketsuto. A 35-year-old man unfortunately sustained an open fracture in his right lower leg in a traffic accident at his age of 20 years. He underwent 12-13 surgeries for osteosynthesis, post-operative focal infection, and leg extension. Subsequently, he developed periodic pain in his right ankle joint. He consulted our clinic because of the severe pain; although non-steroidal anti-inflammatory drugs were ineffective, sokeikakketsuto was dramatically effective. To treat chronic pain after an old fracture, sokeikakketsuto may be considered as a choice of treatment.
ABSTRACT
Squamous papilloma is a benign mass lesion of the oral mucosa. For papillomas of the tongue, surgery is recommended owing to their malignant potential; however, certain complications may be associated with surgery. A traditional Japanese (Kampo) herbal medicine, Keishibukuryogan-ka-yokuinin (KBGY), has been used to treat viral warts and various skin diseases in Japan. Therefore, the effect of KBGY on papillomas is promising. A 49-year-old Japanese man presented with a wart on his tongue that was about 3 months old. He smoked 5 cigarettes per day. He did not drink alcohol. He had no history of malignant illnesses. He was taking alprazolam for panic disorder. The patient was diagnosed with a suspected papilloma of the tongue at the Department of Otolaryngology and was advised to undergo an excision biopsy to exclude malignancy. However, he refused owing to the fear of an invasive procedure. After informed consent was obtained from the patient, KBGY was prescribed. Three months later, the wart on his tongue spontaneously prolapsed. The histopathological diagnosis was squamous papilloma. There was no indication of malignancy, and the patient discontinued Kampo treatment. He has had no recurrence in the past 3 years. KBGY is a combination of Keishibukuryogan and yokuinin (adlay seeds). Keishibukuryogan may be beneficial for skin or oral mucosal remodeling, and yokuinin may have antiviral properties. The present case report suggests the use of KBGY as an appropriate complementary therapy for squamous papilloma.
ABSTRACT
The meridian system is a popular concept in traditional Chinese medicine. Meridians are channels through which the life energy (qi) flows and are important in herbal medicine as pathways associated with drug entry and distribution. This report describes a patient with chronic eczema successfully treated with Japanese (Kampo) herbal medicine, keigairengyoto (containing the Angelica dahurica root). A woman in her 40 s presented with a 3-year history of eczema on both hands to upper arms that was refractory to treatment. Her eczema was observed to be distributed along the lung meridians of hand-taiyin (the channel for the A. dahurica root), and keigairengyoto therapy was initiated after which her eczema significantly resolved. Knowledge of meridians and the concept of channels of entry of herbal medicines may be useful in diagnostic and therapeutic management of several diseases.
ABSTRACT
<p>Orengedokuto, a Kampo formulation, has traditionally been used to treat various diseases, including hypertension with neuropsychiatric symptoms, gastritis, dermatitis, hematemesis and hemorrhagic stools. We report 8 cases of intractable hemorrhage that could not be controlled by Western medicine, but were successfully treated with orengedokuto. We elaborate on 3 cases, including 1 case treated by enema administration of orengedokuto, which was found to be a useful method. In a representative case, an 80-year-old man with aplastic anemia who was taking anticoagulants due to a history of mitral valve replacement presented with a chief complaint of black stool. Hemorrhagic gastritis was diagnosed. We repeatedly attempted endoscopic hemostatic therapy, but failed to achieve hemostasis. Oral administration of orengedokuto demonstrated hemostatic effects within a few days of starting treatment. In all 8 these cases, moreover, we observed quick clinical responses with no side effects. Although the hemostatic mechanism of orengedokuto remains unclear, we speculate that orengedokuto contains a short-acting component that affects primary hemostasis. As such, conventional orengedokuto may also have potential as a novel hemostatic agent.</p>
ABSTRACT
A 75-year-old man was admitted complaining of sudden bilateral foot coldness and numbness. The patient had undergone endovascular repair for abdominal aortic aneurysm (AAA) 5 years previously. Abdominal X-ray showed a highly kinked endovascular stent-graft, and aortography revealed occlusion of the stent-graft and infrarenal aorta. Emergency axillo-bifemoral bypass was performed to restore the blood flow of the lower extremities, and he recovered uneventfully. Endovascular repair for AAA can be performed with low mortality and morbidity, and is accepted worldwide as a minimally invasive treatment. However, there are several late complications, such as newly developed endoleak, graft migration, graft occlusion, AAA expansion, and AAA rupture. Therefore, great attention should be paid to following patients treated with endovascular procedures for abdominal aortic aneurysm.
ABSTRACT
A case of aortic valve replacement in a 92-year-old woman is reported. Severe aortic valve stenosis was pointed out when she suffered from congestive heart failure (CHF). After medical treatment for CHF, she complained of leg edema even with only mild exercise. Aortic valve replacement was performed, because her general condition and her left ventricular contraction on UCG were good. Her postoperative course was good except for a transient rapid atrial fibrillation. We think that surgery should not be withheld on the basis of age alone.
ABSTRACT
A 72-year-old man consulted a local physician due to an episode of loss of consciousness. When chest CT was performed after amelioration of symptoms, aneurysmal dilation was detected at the distal aortic arch. On CT, a distal aortic arch aneurysm appeared to be a sacciform aneurysm measuring 55mm in maximum diameter. In addition, coronary arteriography demonstrated complete obstruction of left anterior descending branch #6, while left ventriculography demonstrated left ventricular aneurysm due to old myocardial infarction. The left ventricular end-diastolic volume was increased to 285ml, and the end-systolic volume was increased to 224ml. Moreover, the left ventricular ejection fraction was markedly decreased to 21%. The distal aortic arch aneurysm was treated by total aortic arch replacement. Considering the postoperative development of cardiac failure, the left ventricular aneurysm was simultaneously treated by endoventricular patch plasty, the so-called Dor operation. The postoperative course of this patient was satisfactory, because the end-diastolic volume was decreased to 241ml, and the end-systolic volume was also decreased to 147ml. Furthermore, the left ventricular ejection fraction was increased to 39%, demonstrating an improvement in left ventricular function. In Japan, there have not been any reports describing simultaneous surgery for thoracic aortic aneurysm complicated by left ventricular aneurysm. Therefore, the present study reports the course of this patient, including the indications of endoventricular patch plasty.
ABSTRACT
Mitral regurgitation caused by papillary muscle rupture has a poor prognosis and should be operated on soon after onset. We recently encountered a patient who was operated on 8 months after the onset of mitral regurgitation caused by rupture of the posterior papillary muscle. The patient was a 72-year-old man who was admitted as an emergency case for acute left heart failure due to severe mitral regurgitation. As medical treatment was effective, he refused to have mitral valve surgery. Six months later, he was admitted to our hospital complaining of nocturnal orthopnea and underwent surgical treatment. Severe mitral regurgitation with postero-medial papillary muscle rupture was revealed by transesophageal echocardiography. Coronary angiography showed 90% stenosis of the proximal left circumflex artery. At 8 months after the onset of mitral regurgitation, the patient underwent successful scheduled mitral valve replacement together with coronary artery bypass grafting. There are few reports of mitral valve surgery being performed successfully for papillary muscle rupture due to coronary artery disease in the chronic stage.
ABSTRACT
We report a 69-year-old woman with transient mitral valve regurgitation and hemolysis following mitral valve replacement with a Carpentier-Edwards pericardial bioprosthesis. She had a history of congestive heart failure caused by mitral valve regurgitation so we performed mitral valve replacement with a Carpentier-Edwards pericardial bioprosthesis (Model 6900). Three days after surgery, a systolic murmur became clearly audible and the serum LDH level reached a maximum of 2, 018IU/<i>l</i> on postoperative day 10. Echocardiography showed regurgitant flow through the center of the bioprosthetic valve. It was thought that stent distortion of the implanted pericardial bioprosthesis had occurred and re-operation would be necessary, but the regurgitant flow disappeared suddenly on postoperative day 12. If mitral valve regurgitation occurs following mitral valve replacement with a pericardial bioprosthesis, stent distortion should be taken into consideration.