A Case of Panic Disorder Successfully Treated with Keishikyokeikabukuryobyakujutsuto / 日本東洋医学雑誌

We report a case of panic disorder treated with keishikyokeikabukuryobyakujutsuto. The patient was a 42-year-old woman who had one or two episodes of panic attacks every month for 1 year accompanied by dyspnea, fear, rigidity of hands, etc. The episodes were more frequent with physical exertion and menstruation and did not improve with kamishoyosan or kanbakutaisoto. Then, after a car accident, she had a panic attack with a stronger intensity. Blood and imaging examinations revealed no special findings, and we diagnosed her with panic disorder. We considered her complaint as Honton disease and administered ryokeikansoto. After 2 weeks, her mental condition improved, and dyspnea and fear of attacks relieved. After 2 months, office work became more strenuous, and attacks recurred once or twice a week. An abnormal sensation of the posterior cervix occurred as a prodrome of an attack, and simultaneously, she noticed neck stiffness. After switching to keishikyokeikabukuryobyakujutsuto, the cervical sensation disappeared, neck pain and neck stiffness were relieved, and the attacks did not reappear. This case suggested that keishikyokeikabukuryobyakujutsuto was useful for the prevention of panic attacks associated with neck stiffness.

Elongated Odontoid Process of Axis Vertebra.

Introduction: Odontoid process is a bony projection of axis around which the atlas rotates. It measures 1 to 1.25 cms in length and projects upwards from the body of Axis. An elongated odontoid process may narrow the foramen magnum causing compressive neurological symptoms. It can cause cervical stiffness, serious restrictions of neck movement, and even a bone-derived torticollis. Observation: During routine osteology classes, we encountered an Axis vertebra with an elongated odontoid process. The measurements of the elongated odontoid process were taken using digital Vernier slide calipers. Conclusion: Elongated odontoid process can be mistaken for fracture of dens in radiological images; hence the knowledge of elongated odontoid process is useful for the radiologists, neurosurgeons and orthopaedicians for accurate diagnosis and treatment involving cranio-vertebral junctions.

Randomized Controlled Pilot Study of Acupuncture on Neck Stiffness / 全日本鍼灸学会雑誌

To clarify methodological issues in clinical research involving acupuncture, a randomized controlled trial was performed on subjects complaing of neck stiffness. Thirty-two volunteers who gave informed consent were randomly alloca-ted into experimental and control groups by the envelope method. In the experimental group, the acupuncture needle was inserted to a depth of 20 mm and the swallow-pecking technique was repeated 5 times. In the control group, the acupuncture needle penetrated the skin and was removed immediately. Bilateral Tianzhu points (BL 10) were used in both groups. Acupuncture treatment was performed once a week for 3 sessions and the effect was evaluated by the subjective intensity of stiffness using a visual analogue scale. In both groups subjective evaluation was immediately reduced by acupuncture treatment and the effects tended to persist for 7 days.There was significant difference between the two groups. Methodological issues listed below were discussed for further to promote clinical research on acupuncture. 1) acupuncture points and stimulation conditions, 2) adequate control groups, 3) entry criteria, 4) volunteer bias, 5) masking technique, 6) sample numbers