More Preferable Managements on Hemodialysis after giving Oren-gedoku-to for an Intellectual Handicapped Person both with Chronic Renal Failure and Aggressive Disruptive Behavior / 日本東洋医学雑誌

A 22-year old man was referred for mental retardation, refractory epilepsy, and chronic renal failure due to congenital anomalies of the kidney and urinary tract since he was an infant. Although hemodialysis was introduced both 3 years and 8 months ago, neither its appropriate safe management nor good quality of life were obtained, because of polyhydruria, psychogenic polydipsia, and his aggressive disruptive behavior in refusing any proper direction. After the fourth making of a shunt vessel with an artificial material, we gave him Orengedokuto to reduce his insomnia, itching, and other indefinite complaints.<br>As a result, his complaints and behaviors improved and he stopped taking too much water on the days before hemodialysis; which then began to work preferably with the proper amount of water exclusion. Moreover, we could reduce the amount of carbamazepine and methylphenidate hydrochloride he required. This case demonstrates that Orengedokuto may have an effect on the central nervous system to improve behavioral problems stemming from developmental disorders in children, or adolescents.

Orthostatic cardiovascular regulation in persons with both severe mental retardation and severe physical disabilities / 体力科学

Eighteen persons with both severe mental retardation and severe physical disabilities and ten normal persons participated to investigate cardiovascular response to hydrostatic pressure stress using supine and sitting positions. All of the handicapped subjects lay down on the bed during the entire day. They were classified into three groups. That is, the first group (LD) had not opportunity of sitting passively in daily living at all. Another two groups were given opportunity of sitting. In addition, the second group (ST 1) was unable to sit and stand independently in the past but the third group (ST 2) was able. The LD showed unchanged heart rate and decreased blood pressure with reduced peripheral blood flow in the sitting position. This suggested that serious lower function or dysfunction in both central and peripheral circulatory system. The cardiovascular function of the ST 1 was characterized by elevated heart rate and lowered blood pressure. This seemed to indicate lower baroreflex control to the peripheral vascular system. The ST 2 demonstrated similar function to the normal persons. The cardiovascular regulation in the severely handicapped persons may depend on opportu-unity of taking orthostatic posture in daily living in addition to motor adility in the past.