We report on a case of Hailey-Hailey disease successfully treated with Sokeikakketsuto. This case was a 70-year-old woman. Her mother, grandmother and elder sister had the same symptoms. From 2004 August, she noticed erythematous exudative lesions with itching on both sides of her inguinal area. By September, she was diagnosed with Hailey-Hailey disease histologically. We treated using a topical corticosteroid at first. This had little effect, so we considered treatment using Kampo medicines. We diagnosed a kidney Yin-deficiency from a fissure of her tongue, thirstiness, numbness in the region below the umbilicus and night sweat, thus and selected Rokumigan. We then diagnosed deficiency of Qi from her general malaise, so chose Hochuekkito. The pathology of Hailey-Hailey disease exists mainly in the epidermis which covers most of the body's surface area. And this indicates the presence of pathogenic wind factor. We considered the presence of dampness as a disease-inducing factor because of her exudation, and the presence of the heat from her erythema. So we also selected Eppikajutsuto as an anti wind-wetness-heat drug. Her general condition was very much improved with these administrations, but her skin lesions improved very little. So we stopped Eppikajutsuto, and Sokeikakketsuto administration was started instead. After this change of drug, her skin lesions were improved remarkably.

A 71-year-old man had sudden onset of left lower limb swelling and consulted an orthopedic surgeon 14 days later. Venous echography demonstrated compression of the left iliac vein and the thrombus of the common iliac vein. After emergency admission, conservative therapy was given for 7 days, but the symptoms did not sufficiently diminish and a thrombus was also present. We therefore performed femoro-iliac cross-over vein bypass using a 10mm ringed ePTFE graft. Symptoms were completely improved and the graft was shown to be patent by echography after 3 months.

Alpha-fetoprotein-Producing gastric cancer is associated with poor prognosis because of frequent liver and lymph node metastasis. We present a case with synchronous liver metastasis who survived for 5 years. A 69-year-old man with upper abdominal pain was referred to our hospital. Gastrointestinal endoscopy revealed a Borrmann II-like tumor in the lower part of the stomach. Computed tomography revealed a tumor in the left lobe of the liver. Serum alpha-fetoprotein levels were markedly increased. We performed distal gastrectomy after administering oral tegafur/gimeracil/oteracil potassium and administered hepatic intra-arterial cisplatin injection. Liver metastasis showed partial response on computed tomography. Despite left hepatic lobectomy, further metastases to the liver and mediastinal lymph nodes became difficult to control. After sorafenib tosylate administration, stabilization of the disease was observed for 4 months. We conclude that hepatic intra-arterial chemotherapy and oral administration of sorafenib tosylate may potentially improve the prognosis in such cases.
Abdominal Pain ; Administration, Oral ; alpha-Fetoproteins ; Cisplatin ; Endoscopy, Gastrointestinal ; Gastrectomy ; Liver ; Lymph Nodes ; Neoplasm Metastasis ; Niacinamide ; Phenylurea Compounds ; Potassium ; Prognosis ; Stomach ; Stomach Neoplasms