Medicine, Kampo ; Metabolic ; Therapeutic procedure ; Syndrome

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.
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.

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.
Five week treatment with Shakuyaku-kanzo-to showed no adverse effects on the myopathy.

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.

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.
Therapeutic procedure ; Graves' Disease ; seconds ; Patients ; Mental disorders

OBJECTIVESIsoliquiritigenin is a chalcone derivative with potential in cancer chemoprevention. Although tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) is a promising anti-cancer agent, some cancer cells are resistant to TRAIL treatment. Current studies have tried to overcome TRAIL-resistant cancer cells. Here, we show for the first time that isoliquiritigenin overcomes TRAIL resistance in colon cancer HT29 cells.

METHODSHT29 cells were treated with isoliquiritigenin and/or TRAIL, and apoptosis induction was detected by flow cytometry and fluorescence microscopy. Protein expression relating to the TRAIL pathway was analyzed by Western blotting.

RESULTSA single treatment with isoliquiritigenin scarcely induced apoptosis in HT29 cells. Combined treatment with suboptimal concentrations of isoliquiritigenin and TRAIL markedly induced apoptosis, however. The effect was blocked by a pan-caspase inhibitor and a caspase-3, 8, 9, or 10 inhibitor, suggesting that the combination facilitates caspase-dependent apoptosis. Furthermore, the apoptosis induced by isoliquiritigenin and TRAIL was blocked by a dominant negative form of the TRAIL receptor. This result indicates that the combined effect is caused by specific interaction between TRAIL and its receptors. Isoliquiritigenin increased the amount of DR5 protein among TRAIL receptors. Isoliquiritigenin did not significantly increase levels of the Bcl-2 family proteins Bcl-2, Bcl-xL, and BAX.

CONCLUSIONSOur results suggest that isoliquiritigenin has the potential to overcome resistance to TRAIL in cancer cells and its chemopreventive effects may depend on TRAIL function.

Background: Gingyo-gedoku-san (GGGS) is an herbal medicine approved for upper respiratory infections in Japan. We conducted an open-label, multi-center, prospective trial, comparing GGGS with oseltamivir in patients with influenza and influenza-like illness (ILI) as a pilot study.
Methods: Subjects were healthy persons aged between 16 and 40, and were enrolled from January 12, 2010 to March 24, 2011. Fifteen patients were enrolled in this trial (8 and 7 for GGGS and oseltamivir, respectively). RT-PCR was positive for pandemic influenza A (H1N1) in 10 patients. The patients were provided with either GGGS or oseltamivir for 5 days. The primary outcome was mortality and/or hospitalization 7 days after the initial diagnosis. Body temperature and other clinical characteristics were also evaluated.
Results: All patients recovered from illness without complication or hospitalization. The mean time to resolve symptoms for the GGGS and oseltamivir groups was 3.9 days and 3.3 days, respectively (p=0.43). The GGGS group appeared to have a smaller symptom score AUC than the oseltamivir group, (p=0.26). Time to recover activity level appeared to be shorter in the GGGS group (p=0.10), with shorter time to recover health status (p=0.02). Sub-group analysis on patients with positive PCR showed similar results between the two groups.
Conclusion: GGGS was associated with symptom improvements resembling oseltamivir for both influenza and ILI. Randomized controlled trials involving larger sample sizes are needed to confirm these results.

Although cardiac rehabilitation (CR) has been shown to improve exercise tolerance and prognosis in patients with cardiovascular diseases, there remains low participation in outpatient CR. This may be attributed to the patients’ busy schedules and difficulty in visiting the hospital due to distance, cost, avoidance of exercise, and severity of coronary disease. To overcome these challenges, many countries are exploring the possibility of remote CR. Specifically, there is increasing attention on the development of remote CR devices, which allow transmission of vital information to the hospital via a remote CR application linked to a wearable device for telemonitoring by dedicated hospital staff. In addition, remote CR programs can support return to work after hospitalization. Previous studies have demonstrated the effects of remote CR on exercise tolerance. However, the preventive effects of remote CR on cardiac events and mortality remain controversial. Thus, safe and effective remote CR requires exercise risk stratification for each patient, telenursing by skilled staff, and multidisciplinary interventions. Therefore, quality assurance of telenursing and multi-disciplinary interventions will be essential for remote CR. Remote CR may become an important part of cardiac management in the future. However, issues such as costeffectiveness and insurance coverage still persist.

[Background] Presenteeism, defined as the practice of sick workers who come to work, and whose work performance effectiveness has been reduced due to various signs and symptoms, causes a significant financial loss to companies. However, comprehensive and effective occupational health countermeasures have not yet been presented. Therefore, we report here the results of an interim analysis to determine whether an allowance for acupuncture treatment is beneficial for workers' presenteeism. [Methods] A four-week randomized intergroup comparative study was conducted on office workers who were aware of their presenteeism. Participants were allocated to either the control group, in which regular recommended presenteeism countermeasures for each workplace were implemented arbitrarily, or to the intervention group in which an allowance of up to 8,000 was given for acupuncture treatment, in addition to the usual arbitrary measures. The primary endpoint was the WHO-HPQ relative presenteeism score: a score lower than 1 indicates lower work performance; and it was analyzed with the "full analysis set" population.[Results] A total of 52 patients were assigned to the intervention group (n = 30) and the control group (n = 22). On average, the intervention group received acupuncture treatments 1.4 times for stiff neck and shoulders (67%), lower back pain (26%), depression (5%), and allergies (2%), and paid a total of 7,219; and 6,556 was paid as an expense allowance. As a result, the relative presenteeism score was 0.95 in the intervention group, compared to 0.91 in the control group, with a between-group difference of 0.04 (ES (r) = 0.22, P = 0.12).[Conclusions] With a total of up to 8,000 offered to office workers who were aware of their presenteeism, an acupuncture treatment allowance for a four-week period was provided 1.4 times on average. The results suggested that the treatment allowance would increase workers' performance efficiency by about 4% (equivalent to 19,691 per person) compared to those without it.