We examined the clinical effects of the administration of Saiboku-to (TJ-96 7.5g/day) on 14 patients suffering from chronic bronchial asthma. The observation period was from 22 to 52 weeks, and the administration period 26 to 52 weeks. Eight out of 14 cases (57.1%) showed slight improvement or better with respect to asthmatic points and clinical phenomenon. A Steroid-sparing effect was evident in 6 out of 14 cases (42.9%). From urinary excretions following the administration of Saiboku-to, we detected the magnolol component of magnoliae cortex. Effective cases showed increased free magnolol in urine, suggesting the value of combined magnolol as a clinical parameter. We also investigated the function of 11β-hydroxysteroid dehydrogenase (11-HSD) inhibition, one of the mechanisms of the steroid-sparing effect, in healthy subjects using three Saiko-zai. Saiboku-to lowered the activity of 11-HSD and increased the concentration of prednisolone (PSL), while Sairei-to had no influence on the metabolism of PSL. Shosaiko-to, on the other hand, increased the activity of 11-HSD and lowered the concentration of PSL. Thus the three Saiko-zai showed different results.

Mengen is an acute symptom that sometimes occurs after administration of a Kampo formula. It is a shortterm phenomenon and its onset indicates that the patient's clinical course will improve rapidly. It is important to distinguish it from other adverse events, which are not temporary. However, to date, detailed analysis of mengen characteristics such as its frequency, time of onset after Kampo administration, and duration have not been reported. Therefore, we report a precise analysis of mengen characteristics through a literature review of case reports published between 1945 and 2009 in Japan, and retrospective analyses of the cases in our institute.
The literature review revealed that 42% patients developed symptoms of mengen within a day of administration, and 79% developed symptoms within 3 days. In terms of mengen duration, the symptoms persisted for 1 day in 35% cases and 3 days in 63% cases. A diagnosis of mengen proved difficult in 39% cases that presented with atypical symptoms.
Overall, the retrospective analysis of the cases in our institute revealed that 11 patients (7.7%) developed mengen, among 143 patients treated with Kampo between May 2010 and November 2011.

Kakkonkokato is a special formula used for the treatment of rosacea-like dermatitis lesions in the nasal region, but very few cases treated with this formulation have been reported so far. Here, we report three patients with refractory facial eruptions of rosacea-like dermatitis treated successfully with kakkonkokato. Case1was a 39-year-old man who presented with a 15-year history of rosacea-like dermatitis lesions in the nasal region. After 3 weeks' treatment with kakkonkokato, a marked improvement of his lesions was seen, with disappearance of the redness of his face. Case 2 was a 56-year-old woman who presented with a prolonged history of itchy eruptions around her mouth and nasal region. After 8 weeks' treatment with kakkonkokato, an almost complete disappearance of her eruptions was observed. Case 3 was a 26-year-old woman who presented with atopic dermatitis and intractable erythema under her nose, which was refractory to treatment with steroid ointments and antiallergic agents. After 2 months' treatment with kakkonkokato, her erythema completely resolved, along with improvement of the systemic lesions of atopic dermatitis. The observations in these three cases suggest that kakkonkokato may be a useful formula for the treatment of not only rosacea-like dermatitis in the nasal region, but also of refractory facial eruptions of other causes.
therapeutic aspects ; seconds ; Lesion, NOS ; Nasal ; Acne Rosacea

The purpose of this study was to investigate the cross-sectional development characteristics of body composition, lower-leg multi-joint power output and sprint running in non-elite junior and youth soccer players. The leg extension power, counter-movement vertical jump(CMJ), and 30m-sprint time for eighty male soccer players aged 13.8-18.1 yrs were measured. Junior and youth soccer players were compared with sedentary normal identical aged boys. Statistical analysis was used by one-way ANOVA and multiple comparisons of variance were performed on the basis of the Tukey-Kramer HSD test. Statistical significance was accepted at level of p < 0.05. Relative increases from 14 yrs to 18 yrs players were significantly (p < 0.05) indicated; body height (7.7%), leg extension power (87.8%), CMJ (35.3%), 30m-sprint (8.7%). 10m-sprint time was negatively correlated with both leg extension power (r = -0.52) and CMJ (r = -0.60). Comparison of relative values of increase from 14 to 18 yrs in junior and youth soccer players to those in sedentary normal boys were as follows; 2.3 (body height), 2.5 (leg extension power), 3.0 (CMJ), 2.1 (sprint ability). It might be suggested that consistent regular soccer training from junior and youth aged might prompt developmental gains not only largely for lower-leg multi-joint power but also not a little for sprint ability.

The decision of which surgical approach to use for the treatment of a multifocal craniofacial abscess is still a controversial matter. A failure to control disease progress in the craniofacial region can potentially put the patient's life at risk. Therefore, understanding the various ways to approach the craniofacial region helps surgeons to obtain satisfactory results in such cases. In this report, we describe a patient who visited the emergency department with a large swelling in his right cheek. A blood test and computed tomography revealed odontogenic maxillary sinusitis. The patient developed sepsis due to a progressive multifocal abscess. An abscess was seen in the temporal muscle, infratemporal fossa, and interorbital region. To control this multifocal abscess, we used the facial dismasking flap (FDF) approach. After debridement using the FDF approach, we succeeded in obtaining sufficient drainage of the abscess, and the patient recovered from sepsis. The advantages of the FDF approach are that it provides a wide surgical field, extending from the parietal region to the mid-facial region, and that it leaves no aesthetically displeasing scars on the face. The FDF approach may be one of the best options to approach multifocal abscesses in the craniofacial region.
Abscess* ; Cheek ; Cicatrix ; Debridement ; Drainage ; Emergency Service, Hospital ; Facial Bones ; Hematologic Tests ; Humans ; Maxillary Sinus ; Maxillary Sinusitis ; Orbit ; Parietal Lobe ; Sepsis ; Surgeons ; Temporal Muscle

We have limited evidence as to the clinical indications for Kampo medicines, especially as they relate to gastrointestinal function. Thus, we investigated the efficacy of the Kampo medicine hangekobokuto (HKT) on patients with functional dyspepsia (FD), with special reference to its clinical indications for gastrointestinal function, including gastric emptying and bowel gas volume.Gastric emptying rate (GER) in FD patients was significantly facilitated by HKT. HKT also improved the gastrointestinal symptoms of the patients. Among these, patients who had inchuusharen, or a symptom of globus sensation, and a representative indication for HKT, showed significant improvement of both their GER and gastrointestinal symptoms compared with patients who did not have inchuusharen. As for bowel gas, the bowel gas volume calculated from a plain abdominal radiogram (gas volume score, GVS) in FD patients decreased significantly, after administration of HKT. Patients who had fukuman, or a feeling that one's stomach is full or bloated, and another representative indication for HKT, showed significant decrease of their GVS to normal levels, compared with patients who did not present with fukuman.These results suggest that the presence of clinical indications, such as inchuusharen or fukuman, are strongly related to HKT efficacy in patients with FD, and that these are useful, scientifically validated markers for the efficient use of HKT.
Clinical ; Final diagnosis (discharge) ; Gases ; seconds ; Volume

Standardizing Kampo medical findings is a significant challenge in Kampo medical circles. These findings are fundamental to Kampo diagnosis. This paper introduces our attempt to standardize these findings in a specialized Kampo medical service facility.
We started our project with verbal standardization. Nine medical doctors, all of whom were Kampo advisors or Kampo specialists, discussed issues such as subjective and objective findings, including those of the tongue, pulse, and abdomen, as well as the selection of target items, criteria for judgments on each item, and associated issues. When discussing the above issues, descriptions in prominent traditional Kampo texts were given most importance, and the wisdom of famous Kampo doctors since the Showa period was also given weight. In addition, we focused attention on clarifying the criteria for making judgments.
One hundred and twenty items were selected as subjective Kampo findings. We selected 12, 6 and 10 items as objective Kampo findings in the tongue, pulse, and abdomen, respectively, and provided criteria for judgments with each.
Our next challenge is to spread these standardizations in Kampo medical circles.

Background/Aims: Dual red imaging (DRI) is a new, image-enhanced endoscopy technique. There are few reports about the usefulness of DRI during gastric endoscopic submucosal dissection (ESD). We aimed to examine the usefulness of DRI in endoscopic hemostasis during gastric ESD. Methods: We enrolled a total of 20 consecutive patients who underwent gastric ESD. Five endoscopists compared DRI with white light imaging (WLI) for the visibility of blood vessels and bleeding points while performing endoscopic hemostasis. Results: The visibility of blood vessels was increased in 56% (19/34) of the cases, and the visibility of bleeding points was improved in 55% (11/20) of the cases with the use of DRI compared with the use of WLI. Conclusions DRI improved the visibility of blood vessels and bleeding points in cases with oozing bleeding, blood pooling around the bleeding points, and multiple bleeding points.

PURPOSE: The pathological mechanism of lumbar spinal stenosis is reduced blood flow in nerve roots and degeneration of nerve roots. Exercise and prostaglandin E1 is used for patients with peripheral arterial disease to increase capillary flow around the main artery and improve symptoms; however, the ankle-brachial index (ABI), an estimation of blood flow in the main artery in the leg, does not change after treatment. Lumbar spinal nerve roots contain somatosensory, somatomotor, and unmyelinated autonomic nerves. Improved blood flow by medication with prostaglandin E1 and decompression surgery in these spinal nerve roots may improve the function of nerve fibers innervating muscle, capillary, and main vessels in the lower leg, resulting in an increased ABI. The purpose of the study was to examine whether these treatments can improve ABI. MATERIALS AND METHODS: One hundred and seven patients who received conservative treatment such as exercise and medication (n=56) or surgical treatment (n=51) were included. Low back pain and leg pain scores, walking distance, and ABI were measured before treatment and after 3 months of conservative treatment alone or surgical treatment followed by conservative treatment. RESULTS: Low back pain, leg pain, and walking distance significantly improved after both treatments (p<0.05). ABI significantly increased in each group (p<0.05). CONCLUSION: This is the first investigation of changes in ABI after treatment in patients with lumbar spinal stenosis. Improvement of the spinal nerve roots by medication and decompression surgery may improve the supply of blood flow to the lower leg in patients with lumbar spinal stenosis.
Adult ; Aged ; Aged, 80 and over ; Alprostadil/therapeutic use ; *Ankle Brachial Index ; Decompression, Surgical/methods ; Female ; Humans ; Low Back Pain/drug therapy/physiopathology/surgery/*therapy ; Lumbar Vertebrae/physiopathology/*surgery ; Male ; Middle Aged ; Pain/surgery ; Spinal Nerve Roots/physiopathology ; Spinal Stenosis/physiopathology/*surgery/*therapy ; Treatment Outcome