Here we report a case with fever, abdominal pain, frequent urination and urinary incontinence after vesicolysis, for bladder hematoma after transvaginal ultrasound-guided oocyte retrieval, that was successfully treated with Kampo medicine based on daily changing sho for acute disease.
A 44 year-old woman underwent transvaginal ultrasound-guided oocyte retrieval under venous anesthesia in the morning, in order to perform in vitro fertilization, and got home around noon. She had right lower quadrant abdominal pain, frequent urination, hemoptysis, urinary incontinence, fever and chill in that evening. Emergency room ultrasonography revealed a 45 mm size bladder hematoma. She was admitted and the vesicolysis was performed. Antibiotics and hemostatics were administered, and were followed by self-sustaining flow back into the bladder. Although she became afebrile on day 3, her right lower quadrant abdominal pain remained and fever returned on day 5. Daiobotanpito was prescribed because of the right lower quadrant abdominal pain, frequent urination, urinary incontinence, constipation and a floating pulse. Additionally, goreisan was prescribed because of her tooth mark and leg edema. On day 6, her abdominal pain had largely disappeared, and her frequent urination and urinary incontinence were also improved. However, perspiration with fever and soft stools then appeared. Keishito was prescribed because of the perspiration, a weak pulse and weak abdominal strength. Additionally choreito was prescribed for the frequent urination and urinary incontinence. She started sweating continuously with no fever. The frequent urination and urinary incontinence then also disappeared, and she was discharged on day 7.

Introduction: Although fentanyl patch (FP) are often used to treat cancer pain because of the low incidence of adverse effects of this formulation, there are cases in which it is impossible to eliminate the pain despite increasing the doses. We report a patient of advanced gastric cancer with abdominal pain, in whom successful pain control was achieved by opioid rotation from FP to continuous intravenous infusion of morphine hydrochloride. Case Report: The patient was a male in his 60's who had been diagnosed as having primary gastric cancer and complained of abdominal pain, thought to be visceral pain caused by obstruction of the digestive tract. Oral intake became more difficult as the disease progressed. Despite a switch to FP from oxycodone used to treat the abdominal pain and an increase in the dose, pain relief was not achieved. Then, we undertook a partial opioid rotation to continuous intravenous infusion of morphine hydrochloride, which provided adequate pain control. Discussion: One possible reason for the pain relief in this patient is suppression of the gastrointestinal motility by morphine. When adequate pain relief cannot be achieved with one opioid, opioid rotation should be considered. We concluded that the opioid rotation should, however, be performed in a stepwise manner. Palliat Care Res 2009; 4(1): 307-311

Herb supplies can become unstable because of climate change and the economic development of herb exporters. In this paper, in order to increase the self-sufficiency of herbal resources we examined the possibil ity of changing to herb crop production from tobacco, for which demand is declining. Firstly, we considered demand, quality and the price of raw herb materials to make recommendations for corrections, and selected Angelica (A. ) acutiloba and Bupleurum (B. ) falcatum Linne. Next, we compared the profitability of tobacco and the herbs. Profit margins for A. acutiloba were less than for tobacco. It was thought that the profitability of A. acutiloba could become equivalent to tobacco if an adjustment subsidy were provided. The self-sufficiency rate for A. acutiloba would be one hundred percent with 35 million yen in every year. Although the profitabil ity of B. falcatum has exceeded tobacco, its selling price was about 3 times that of imports, while the price of medical B. falcatum was lower than its selling price. It was thought that the price competitiveness problem of B. falcatum can be covered if a production subsidy is provided, and to reach a 50 percent B. falcatum self sufficiency rate with 660 million yen per year.

In order to avoid the risk of COVID-19 among our clinic staffs, remote medical care using tablet-type devices was conducted in our fever outpatient clinic. In about 5 months, there were 87 patients with COVID-19 diagnosed by PCR test. Among them, 24 patients (15 men and 9 women, average age 36.2 years) were treated with Kampo medicine. Four of 24 patients required hospitalization. All patients, including those hospitalized cases, improved their symptoms during the observation period. We believe that Kampo medicine is effective in the early treatment of COVID-19. In addition, we consider that remote medical care using tablet-type devices is one of the useful methods in the treatment of highly contagious infectious diseases.

Human cytomegalovirus (HCMV) is a member of the herpesvirus family. HCMV infection persists throughout the host lifespan in a latent state following primary infection. The ability of HCMV to escape control by the host immune system and its resulting reactivation suggests the importance of ongoing immune surveillance in the prevention of HCMV reactivation. HCMV is a common cause of opportunistic infection that causes severe and fatal disease in immune-compromised individuals. In inflammatory bowel disease patients, particularly those with ulcerative colitis (UC), HCMV is often reactivated because these patients are frequently treated with immunosuppressive agents. This reactivation exacerbates colitis. Additionally, HCMV infection can induce severe colitis, even in patients with UC who have never been treated with immunosuppressive agents. However, the role of HCMV in colonic inflammation in patients with UC remains unclear. Here, we present previous and current clinical data on the diagnosis and treatment of HCMV infection in UC. Additionally, our experimental data from a newly established mouse model mimicking UC with concomitant CMV infection clearly demonstrate that inflammation could result in the exacerbation of UC disease activity with induction of HCMV reactivation. In summary, optimal control of colonic inflammation should be achieved in UC patients who are refractory to conventional immunosuppressive therapies and are positive for HCMV.
Animals ; Colitis ; Colitis, Ulcerative* ; Colon ; Cytomegalovirus Infections* ; Cytomegalovirus* ; Diagnosis* ; Humans ; Immune System ; Immunosuppressive Agents ; Inflammation* ; Inflammatory Bowel Diseases ; Mice ; Opportunistic Infections ; Tumor Necrosis Factor-alpha ; Ulcer* ; United Nations