A total of 20 chronic headache cases in which other Kampo medicines were ineffective or hardly effective were treated with Kumi-binro-to extract, and the effect of this medicine was investigated.
At the start of administration, we investigated the following items: any deficiency or excess, presence or absence of stagnation of vital energy (facial erythema, ophthalmologic injection, bitter taste in the mouth, etc.) and disease caused by contaminated water (tendency of edema, sound of fluctuating liquid in the region of the stomach, decreased urine volume) as well as the presence or absence of grasping pain (pressure pain) in the gastrocnemius muscle which is a characteristic symptom as a target of this drug. The efficacy of Kumi-binro-to was assessed by a pain score after weeks from the start of administration.
Kumi-binro-to was markedly effective in 5 cases, effective in 11 cases and ineffective in 4 cases, indicating that the ratio of markedly effective and effective cases accounted for 80% of the patients treated. There was no adverse reaction. When the characteristics of 16 cases assessed as markedly effective or effective were investigated, disease caused by contaminated water and stagnation of vital energy was observed in 13 and 14 of the 16 cases respectively. The grasping pain in the gastrocnemius muscle that is a characteristic target of this drug was noted in only one case.
The above result suggests that Kumi-binro-to promotes diuresis to eliminate wetness-evil and regulates vital energy, and is effective against chronic headache, especially when the disease caused by contaminated water is accompanied with stagnation of vital energy.

The prevention of dementia is an important issue that should be addressed in Japan. To prevent dementia, it is important to implement interventions (e.g., exercise or cognitive training) for the healthy community-dwelling elderly. However, such interventions are not always evidence-based. In this review, we evaluated exercise and cognitive training intervention protocols for the prevention of dementia based on recent findings. In addition, we proposed specific methods for implementing such interventions in the community.

Small bowel ileus due to the parasitic infection caused by omophagia of freshwater fish is relatively rare. We present a case of small bowel ileus possibly caused by inflammatory change associated with Gnathostoma doloresi infection. A 62-year-old man underwent partial resection of the small bowel under a diagnosis of ileus due to complete obstruction of the small bowel. He had eaten a few slices of raw freshwater fish four weeks before abdominal pain appeared, and he contracted creeping disease with several welts on the abdominal wall. Chronic inflammatory change suggestive of parasite infection was observed in the resected specimen. An immunoserodiagnostic study using microenzyme-linked immunosorbent assay led to a diagnosis of Gnathostoma doloresi infection. The postoperative course was favorable, and the patient was discharged 12 days after surgery. Only two cases of ileus due to Gnathostoma doloresi infection have ever been reported.

A 66-year-old man with an abdominal aortic aneurysm and coexisting horseshoe kidney is reported. The aneurysm was successfully replaced by a prosthetic graft without resection of the renal isthmus. Because of renal blood supply and location of renal isthmus, aortic reconstruction presents a significant technical problem. Preservation of multiple renal arteries may be facilitated by preoperative aortography, and retraction of the renal isthmus offers good operative exposure.