Recurrent high-dose intravenous methylprednisolone succinate pulse therapy-induced hepatopathy in a patient with multiple sclerosis

We describe recurrent and reversible hepatopathy in a girl with multiple sclerosis [MS] after glucocorticoid pulse therapy, to point out the possibility that glucocorticoid may harm the liver. An 11-year-old girl with MS, who was treated with high-dose methylprednisolone succinate pulse therapy, developed elevation of liver enzymes. The episodes of hepatopathy occurred 1-5 weeks after the therapy and disappeared within several weeks. The examination for antinuclear antibody and viruses which can cause hepatitis produced negative results. The present case emphasizes the possible effects of high-dose glucocorticoids in the induction of liver enzymes and the importance of follow-up liver tests after pulse therapy

Successful Treatment of Panic Disorder with Ryukotsuto / 日本東洋医学雑誌

We encountered a patient with intractable panic disorder who responded extremely well to Ryukotsuto, a Kampo preparation. Beginning in March 2003, a 55-year-old female began to lose vigor and concentration, while developing palpitations and experiencing a rise in blood pressure (systolic pressure≥190mmHg) accompanied by sudden anxiety. When these symptoms became intense, she was brought to a hospital by ambulance. Although close examination revealed no abnormalities, on clinical diagnosis, however, autonomic imbalance was recognized. Despite treatment with antidepressants and minor tranquilizers, including selective serotonin reuptake inhibitors (SSRI), no improvement was observed. A series of medicinal Kampo preparations, prescribed one after another, also had no effect. For further treatment, she was referred to our hospital on July 22, 2005. At the first consultation, a diagnosis of panic disorder was made, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Hon-Ton disease was suspected based on clinical findings, and Ryokeikansoto was prescribed as a decoction. However, no positive effects were observed after 1 week, while marked incompetence, forgetfulness, and depression were noted. Therefore, based on the results of a self-rating depression scale (SDS), a profile of mood states (POMS), and autonomic function tests, such as pupillary dynamics at the first consultation, panic disorder accompanied by extreme tension with depression was diagnosed. Consequently, her Kampo preparation was changed to Ryukotsuto. As a result, symptoms virtually disappeared and all western drugs were discontinued. Psychological tests, autonomic function tests, and her diagnostic scores for conditions of Ki, Ketsu, and Sui also improved. We conclude that Ryukotsuto may be an effective treatment for panic disorder accompanied by depression.

Kampo Therapy for Graves' Disease Associated with Psychological Disorders / 日本東洋医学雑誌

We report 2 patients with Graves' disease and psychological disorders. In these patients, treatment did not relieve psychological disorders despite normalization of thyroid function, but kampo therapy was effective. Patient 1 was a 24-year-old female. In 2000, she was diagnosed as having Graves' disease. Treatment with an antithyroid drug normalized thyroid function, but did not relieve psychological disorders such as irritation, anxiety, or despair. In February 2005, the patient consulted our hospital. Patient 2 was a 26-year-old female. After graduating from a high school, she developed Graves' disease. Treatment with an antithyroid drug was started. However, thyroid function was unstable ; mild hyperthyroidism and hypothyroidism repeatedly occurred. During this period, irritation, fatigue, malaise, and alopecia deteriorated, and she consulted our hospital in January 2005. In the two patients, keishikanzoryukotsuboreitogohangekobokuto was prescribed (the regimen was changed during follow-up in Patient 1), and their conditions markedly subsided after 16 and 9 weeks of administration, respectively, suggesting the usefulness of kampo therapy in the treatment of Graves' disease associated with psychological disorders.

Effects of Boui-Ougi-To Treatment on Visceral Fat Obesity in Patients with Diabetes Mellitus / 日本東洋医学雑誌

Nineteen non-insulin dependent diabetes mellitus (NIDDM) patients with obesity were divided into two groups, and a group of eight patients who could try exercise was treated with walking over 160 Calories per day, and a group of eleven patients who could not try exercise was treated with Boui-ougi-to, for six months. Although exercise is known as the treatment of visceral fat obesity, no significant improvement was observed in body mass index, visceral fat/ somatic fat (V/S) ratio, blood sugar, serum cholesterol level in the patient group with exercise, whereas in the patient group treated with Boui-ougi-to, serum cholesterol significantly decreased from 197±31mg/dl to 180±19mg/dl (p<0.01), and V/S ratio improved significantly from 0.84±0.56 to 0.64±0.30 (p<0.05). These observations suggest that treatment with Boui-ougi-to is effective for visceral fat obesity and has potential for the prevention of atherosclerosis.

The Effectiveness of Shakuyaku-kanzo-to on Myotonia in a Case of Myotonic Dystrophy / 日本東洋医学雑誌

The effectiveness of Shakuyaku-kanzo-to on myotonia in a 50-year-old female with myotonic dystrophy is reported. Neurological examination showed myogenic distal dominant muscle weakness and myotonia. Treatment with Shakuyaku-kanzo-to improved myotonic time from 12.8 to 6.8 seconds. This effect was equal to phenytoin and mexiletine. The results indicated that Shakuyaku-kanzo-to affected the ion channels of the skeletal muscle membrane. The apaminsensitive K channel was speculated to be the affected site of the ion channel. Glycyrrhizin might play an important role in this mechanism.<br>Five week treatment with Shakuyaku-kanzo-to showed no adverse effects on the myopathy.

A Case of Human T-cell Lymphotropic Virus Type I Associated Myelopathy Treated with Sho-saiko-to / 日本東洋医学雑誌

We introduce the successful treatment of intractable symptoms of 52-year-old female patient with HTLV-I-associated myelopathy (HAM) by Kampo medicine. She showed spastic paraplegia, urinary incontinence, sensory disturbance of extremities and nocturnal myoclonus.<br>Neurological examination proved to be hyperactive deep tendon reflexes and positive pathological reflexes in legs. The viral antibody titer of HTLV-I was elevated both in cerebrospinal fluid and serum. After treatment with Sho-saiko-to, symptoms were improved. The effect is considered to be immunomodulation of Sho-saiko-to.