Three Cases in which Kampo Therapy was Effective in the Long Term for Menstrual Symptoms in Patients with Mental Illness / 日本東洋医学雑誌

We report three cases of patients with mental illness suffering from symptoms associated with menstruation, which were improved with Kampo treatment. Case1: A 39-year-old female had been in a depressive state after delivery and diagnosed with persistent mood disorder in the Neuropsychiatry Department of Fukushima Medical University (FMU). During treatment for the disorder, she developed premenstrual dysphoric disorder (PMDD) and was immediately hospitalized. After she was introduced to the Obstetrics/Gynecology Department, we treated her with Kampo medicine such as tokakujokito considering the meaning of the pattern (sho), and then she recovered from PMDD. Case2: A 29-year-old female with schizophrenic disorder treated in the Neuropsychiatry Department of FMU was referred to the Obstetrics/Gynecology Department due to PMDD. We administered Kampo medicine such as kamishoyosan, nyosinsan and saikozai when yang pattern was observed, and ninjinto and daikenchuto in yin sho. Then, her condition then gradually improved. Case3: A 37-year-old female diagnosed with borderline personality disorder and attention deficit hyperactivity disorder was hospitalized in the Neuropsychiatry Department of FMU. She was introduced to the Obstetrics/Gynecology department due to dysmenorrhea and PMS. After she was treated with keishibukuryogan and hangekobokuto, her symptoms improved. In conclusion, Kampo treatment appears to be effective for symptoms associated with menstruation in women with mental illness.

Assessment of Patients Treated with Kampo Decoctions Containing Aconite Root Before Processing (uzu) / 日本東洋医学雑誌

We examined 57 patients treated with Kampo decoctions containing uzu for 5 years and 3 months from September 2013. Sekiganryo, which was administered to 32 patients, was the most commonly used decoction. The value of uzu dosage and duration of administration were spread widely and the medians (ranges) are 8.0 (1.0-41.0)g/day and 180 (3-1700) days, respectively. Complete recovery, partial recovery, no recovery, and deterioration in terms of the chief complaint, were observed in 36, 11, 9, and 1 patients, respectively. The number of patients exhibiting complete or partial recovery was higher than that of patients showing no recovery or deterioration when the duration of uzu administration was more than one month and the dosage was higher than 4 g/day (p < 0.05). The patients treated with uzu more than 20 g/day were all sekiganryo administrated ones. Side effects were observed in three patients. Thus, under careful observation, uzu was safely used over a long term and at high doses.uzu: aconite root before processing

A Patient with Diffuse Panbronchiolitis Treated with a Combination of Keishikyoshakuyakukasokyoto and Acupuncture / 日本東洋医学雑誌

We report a case of a 71 year-­old woman treated for diffuse panbronchiolitis (DPB). She received home oxygen therapy and was administered erythromycin ; however, sputum production, cough and respiratory dis­tress worsened. After hospitalization, she was treated with keishikyoshakuyakukasokyoto and acupuncture. After 30 days, respiratory distress, respiratory resistance measured with the pulseoscillation technique and the distance walked in the 6-­minute walk test improved. Thus, combination therapy comprising keishikyo­shakuyakukasokyoto and acupuncture seemed to be a beneficial therapy for an advanced case of DPB.

A Case in Which Byakujutsubushito Responded to Extremity Pain / 日本東洋医学雑誌

The patient was an 84-­year-­old woman living in a nursing home. Her chief complaint was difficulty in mov­ing her body due to extreme pain. She could not lie down especially in a supine position because of severe un­identified somatic pain from left side of lower chest to flank. According to her family, she had been taking 2-­3 L of water daily at her nursing home to avoid dehydration even in the wintertime. Therefore she urinated fre­quently, but she also had constipation for several days. Since NSAIDs had been not effective, byakujutsu­bushito was administered from the first day of her hospitalization. Accordingly, her constipation improved and her pain quickly faded away. We inferred that her pain resulted from “fluid disturbance” caused by massive in­take of water in the wintertime in Aizu region. We believe that byakujutsubushito is a useful Kampo medicine for the treatment of pain resulting from “wind-­dampness” along with keishibushito and kanzobushito.

A Case of Sarcoidosis Complicated by Knee Pain and Fatigue Successfully Treated with Uzu / 日本東洋医学雑誌

A 48-year-old man presented with knee pain and general fatigue. He had been diagnosed with sarcoidosis 15 years previously. Prednisolone was administered, but the pain and fatigue persisted. Morphine, fentanyl, and a tramadol/acetaminophen combination were then administered, but their effects were not sufficient. Finally, the patient was treated with sekiganryo, uzuto, uzukeishito, and daiuzusen, all of which contained uzu (aconite root without processing). His pain and fatigue improved after administration of these drugs, and he became able to perform various activities of daily living. In this case, uzu alleviated knee pain and general fatigue in a patient with sarcoidosis.

Significance of Individual Support in Technical Aid Support Activities / 日本農村医学会雑誌

We established the Technical Aids Support Office in our hospital to promote the introduction of and technical advice about assistive technology so as to enhance the quality of care and the functioning of patients and ensure staff safety. In this paper, we introduce two complicated cases that needed individual support. Case 1: A patient with amyotrophic lateral sclerosis. The amount of assistance required had gradually increased, but the patient still hoped to use a portable toilet. Because he could barely stand up, the height of the toilet needed adjustment. An elevated seat decreased the amount of assistance required. However, raising the bottom of the portable toilet turned out to be a challenge. Case 2: Multiple limb amputee. The patient and the caregiver experienced pain and distress during transfer between bed and chair. We tried using a lift assist device, but it the hardness of the sling worsened pain at the stump. A cushion with a sliding seat was then placed between the sling and the patient to reduce friction. The shape and hardness of cushion is a future challenge to solve. Timely individual support at each stage in their care for individual patients is indispensable for the provision of technical aid support.

<b>Otsujito Found Effective in Enterocutaneous Fistula after Trying Other Kampo T</b><b>reatments</b> / 日本東洋医学雑誌

<p>Otsujito is a well-known Kampo medicine for treatment of hemorrhoidal diseases. In the current report, we present end results for a case of enterocutaneous fistula treated with Kampo medicine in accordance with traditional “sho” indications.<br>An 81 year-old female developed abdominal wall-intestinal fistula right immediately following partial colectomy due to ischemic sigmoid colic perforation 12 years previously. Two years later, she had a fistulectomy and repair using intraperitoneal mesh for abdominal recruitment. Eight years after repair of the enterocutaneous fistula, she had peritonitis caused by the tardive intraperitoneal mesh infection. Since then, she has had frequent repeated ileus and received conservative treatment for two years. Several local operations and abdominal drainages were performed after transfer to Aizu Medical Center. Kigikenchuto was provided for wound healing for approximately 1 year, and one fistula was finally identified. Otsujito dramatically decreased the leakage of intestinal juice and closed her enterocutaneous fistula.<br>Angelicae Radix as an anti-inflammatory agent, and Cimicifugae Rhizoma as originally indicated, may have played pivotal roles in this case with Otsujito.</p>

<b>Three Cases with Intractable Pain Treated with a Dose of Daiuzusen, and an Analysis of Aconite Concentrations in Prescriptions and Patientsʼ </b><b>Serum</b> / 日本東洋医学雑誌

<p>In 2013, we prescribed daiuzusen for 3 patients with intractable pain; pain from complex regional pain syndrome, colic pain of unknown origin after an abdominal operation, and colic pain from advanced colon cancer and ileus. A dose of daiuzusen (containing uzu 0.5-2 g) quickly relieved their pain in several minutes. Another common symptom was “cold” in their bowel or extremities when they were feeling pain. Aconite levels in drugs and patients' serum after taking daiuzusen were analyzed by liquid chromatography tandem mass spectrometry. Daiuzusen per 1 g of uzu contained aconitine 1.28 μg, mesaconitine 2.31 μg, and hypaconitine 92.89 μg, while jesaconitine was not detected; this was about 5 to 35 times the level of tsumyakushigyakuto per 1 g of uzu. Serum concentrations of hypaconitine peaked in the study at 1.11 ng/mL after about an hour of taking daiuzusen (1 g of uzu). We posit that the immediate effect after taking daiuzusen was due to transmucosal absorption of uzu components. However serum hypaconitine, which we are now able to monitor, is at least one practical way of indicating the use of uzu or bushi containing prescriptions.</p>

<b>Sansoninto (Containing Zizyphi Spinosa Semen) Alleviates Multiple Joint and Muscle Pains More Effectively than Insomnia : a Report on two Cases</b> / 日本東洋医学雑誌

<p>Case 1 : A 56-year-old woman had been suffering from insomnia for 10 years, and multiple joint pains on her shoulders, wrists and fingers for 2 years. She complained of headache, dizziness, heart palpitations, and irritable bowel syndromes. Case 2 : A 72-year-old woman presented with cold and painful feeling in her legs that she had had for 10 years, as well as insomnia, excessive sweating, alopecia and pollakiuria that she had had for two years. In both cases, organic diseases of the joints or muscles were ruled out by several doctors, and the patients had been suffering from malaise and insomnia for which they had been taking brotizolam for several years. Consequently, the patients consulted our department of traditional Japanese medicine (Kampo). Medical interviews revealed that they had been under a lot of stress for a long time because of family problems. Sansoninto (roasted Zizyphi spinosa semen 15 g, Poria 3 g, Cnidii Rhizoma 3 g, Anemarrhenae Rhizoma 3 g,Glycyrrhizae Radix 1.5 g) was prescribed, which reduced the pain in their joints and muscles, and their other complaints, in several weeks. Sansoninto seemed not to alleviate insomnia as effectively as it did the pain and other multi complaints, because the patients were not able to discontinue brotizolam. Patients with multiple complaints including insomnia with fatigue induced by long-term stressful lifestyle may sometimes possibly express non-organic joint or muscle pain. Sansoninto may be an effective prescription for non-organic joint and muscle pain.</p>

<b>A Case of Fibromyalgia Complicated by Chronic Fatigue Syndrome and Complex Regional Pain Syndrome Successfully Treated with a Combination of Kampo Treatments Including Uzu and Acupuncture </b> / 日本東洋医学雑誌

A 45-year-old woman had been suffering from fibromyalgia, chronic fatigue syndrome, and complex regional pain syndrome (CRPS) for 2 years before admission. Non-steroidal anti-inflammatory agents, selective serotonin reuptake inhibitors and pregabalin did not affect the various symptoms. A severe feeling of Coldness, the widespread systemic pain and the severe fatigue were decreased by tsumyakushigyakuto (glycyrrihza 4 g, processed ginger 9 g, aconite root 6 g). Attacks of CRPS were relieved by a dose of daiuzusen (aconite root 1 g, honey 10 g). The CRPS attacks presented mainly on the left heart meridian and the small intestine meridian where we treated them with electroacupuncture with reference to the <i>Shigoryuchu </i>(子午流注) methods. Acupuncture and electroacupuncture decreased the frequency of pain attacks, and alleviated the muscles stiffness caused by the CRPS. Thus, the combination of Kampo medicine and acupuncture were effective for the severe pain and other symptoms associated with fibromyalgia, chronic pain syndrome and CRPS.

Comparison of a small volume of hypertonic saline solution and dextran 40 on hemodynamic alternations in conscious calves

The hemodynamic effects of rapid intravenous (IV) administration of 10% dextran 40 in saline solution (D40) and 7.2% hypertonic saline solution (HSS) in calves were compared. Calves received isotonic saline solution (ISS), HSS or D40 (3 calves/group) and were monitored of blood pressure, and cardiac output (CO) for 180 min. HSS and D40 infusions induced a significant increase in relative plasma volume reaching 134.9 +/- 2.8 and 125.0 +/- 1.9%, respectively at the end of fluid infusion. In the HSS group, CO, cardiac index (CI) and stroke volume (SV) remained constant at low levels after 90 minutes despite the maximal values of CO, CI and SV at the end of infusion, reaching 21.0 +/- 6.3 l/min (p<0.05), 177.8 +/- 14.2 ml/min/kg (p < 0.001) and 0.20 +/- 0.03 l/beat (at t = 10 min, p < 0.001), respectively. In contrast, CI and SV in the D40 group showed significant increases to 14.7 +/- 2.9 l/min and 153.5 +/- 17.2 ml/min/kg, respectively, at the end of fluid infusion. And those values remained constant at higher levels than those of the before infusions values throughout the experimental periods. Positive effects for hemodynamic alternations of D40 in calf practice were milder and longer than those of HSS. Therefore, the D40 infusion should be explored as a possible treatment for dehydrated calves, since rapid infusion of D40 may be safe and more beneficial for rehydrating more than HSS treatment.