ABSTRACT
Alkaptonuria is a rare genetic disease, in which amino acids and tyrosine cannot be processed. A 72-year-old man with a history of aortic valve stenosis presented with coronary 3-vessel disease. Intraoperative findings included ochronosis, which is pigmentation caused by the accumulation of homogentistic acids in connective tissues, or on the severely calcified aortic valve, the intima of the aorta, and the coronary arteries. The pigmented region of the coronary arteries had significant stenosis. Aortic valve replacement and coronary artery bypass were performed. From these findings and his past history of arthritis, we diagnosed alkaptonuria. The patient had an uneventful recovery.
ABSTRACT
In the United States, gender-specific medicine has advanced since 1980, and medical centers dealing with women's disease have been established. In Japan, number of the outpatient care units which address women's disease exclusively, have been established over the past two to three years. We believe that this is because the following kinds of medical care are being sought:<br>1) The gender-specific medical care<br>2) Medical treatments that are tailored individually, based on specific female body structures and psychology<br>3) All-round medical care, based on mind-body correlations<br>4) Care which improves the patients' quality of life<br>The goal of Kampo medicine is not only all-round medical care, but also therapy tailored to the individual. In the climacteric period of a woman's life, ovary activity declines against increased secretion of gonadotropin in the sexual center. In other words, endocrine disorders such as a rapid decline of estrogen secretion, affect the autonomic nervous system via catecholamine in the hypothalamus, patients consequently present with various indefinite complaints. This phenomenon is called climacteric disorder. In addition, this decrease of estrogen increases the frequency of the bone mass loss, lipid metabolism abnormalities, urinary disease, and vaginal wall atrophies seen. Not to mention the increased frequency of life-style related diseases (diabetes mellitus, obesity, malignant tumor, liver cirrhosis, etc.) that will arise.<br>Although climacteric disorder is triggered by endocrine disturbance, it takes on the symptoms of autonomic instability as time passes, and therefore cannot necessarily be called an estrogen deficiency syndrome. Kampo drugs are very effective in the treatment of such functional diseases. However, Kampo therapy must be carried out in accordance with oriental medical concepts, and their diagnostic techniques. It is useful to introduce the concept of “ki-ketsu-sui”, when treating climacteric symptoms. From a Kampo standpoint, many climacteric symptoms are pathological conditions, with “oketsu” at their core, which can be modified by “ki” and “sui”.<br>Here we show prescriptions which are frequently used in clinical practice. In addition, we review the effectiveness and limitations of Kampo therapy, for the treatment of climacteric diseases other than climacteric disorder. Finally, we refer to future issues, concerning outpatient care exclusively for women.