The therapeutic effects of long-term treatment with Sho-saiko-to, a traditional Chinese medicine, was evaluated in patients with idiopathic interstitial pneumonia (IIP). Twenty-nine patients with IIP without steroid therapy were divided into two groups: one for administration of Sho-saiko-to (n=9) and another for control (n=20). Clinical symptoms and results of respiratory tests over periods of 11 to 43 months were recorded. No adverse effects of Sho-saiko-to were odserved.
One patient of the Sho-saiko-to administered group improved markedly, three improved slightly and five showed no changes, though no patients in the control group improved. The two patients of improving slightly had “Sho” of “Kyokyo-Kuman” (discomfort of the hypochondrium) which is applied for Sho-saiko-to. The results suggested that Sho-saiko-to might be a useful medicine to suppress the inflammatory procees in patients with IIP.

We report a case of refractory cancer pain that was successfully treated with opioid switching by adding methadone to the preceding opioid. A 38-year-old man had severe epigastric pain and back pain because of paraaortic lymph node metastasis of a gastroesophageal junctional carcinoma. His pain was treated with continuous intravenous morphine administration and the frequent use of a rescue dose. When the morphine dose was increased, respiratory depression developed; thus, his pain was considered refractory to the morphine, and methadone was added on. The pain was relieved after initiating methadone, and the frequency of the rescue dose was markedly decreased. The methadone dose was gradually increased in parallel, and the morphine dose was reduced and finally discontinued. No methadone-induced side effects were noted, and the patient was discharged with good analgesia. In our case, adding methadone without decreasing the preceding opioid dose under strict monitoring made it possible to stably switch the opioid without increasing pain.

We investigated the impact of Bazett (B) and Fridericia (F) correction formulas on the evaluation of QT prolongation in patients during methadone administration and to explore the relationship between heart rate and corrected QT interval (QTc) according to both correction formulas. This study was conducted as a single-center, retrospective observational study. Subjects were cancer patients who underwent electrocardiographic evaluation for methadone therapy at our institute from April 1, 2013, to August 31, 2023. The study assessed the incidence of QT prolongation and analyzed the correlation between heart rate and QTc derived from the B and F formulas. The mean QTc of 430.3±25.8 msec for the B formula and 409.2±20.8 msec for the F formula. The incidence of QT prolongation was significantly lower with the F formula (8.4%) compared to the B formula (27.7%), indicating a 19.3% reduction in QT prolongation cases (p<0.001). Additionally, the difference in QTc between the two formulas increased with an increase in heart rate (p<0.001). These results suggest that the F formula for QT interval correction in methadone therapy potentially expands the eligible patients for this therapy.