Neonatal seizures are only a manifestation of a variety of organic, metabolic or functional disorders of the neonatal brain. Most are caused by acute brain insults such as perinatal hypoxic-ischemic encephalopathy, intracranial hemorrhage or CNS infections. Recent years have witnessed a remarkable reduction of simple hypocalcemia, resulting in a relative increase of hypoxic-ischemic encephalopathy. These acute symptomatic seizures are different from epilepsy, a chronic seizure disorder. Most previous studies concerning seizure manifestations of the newborn have dealt with all types of neonatal seizures together, regardless of etiology. It is true that seizures in the neonate pose unique diagnostic and therapeutic problems because of the immaturity of the neonatal brain, but it is not appropriate to study seizure types in the newborn on the basis of acute symptomatic seizures such as those occurring in hypoxic-ischemic encephalopathy in which acute brain swelling or neuronal necrosis may obscure the unique developmental state of the neonatal brain. No one would attempt to classify the seizure types in older children with acute encephalitis and epilepsy together. Such acute symptomatic neonatal seizures should be excluded from the classification of epileptic seizures and syndromes, although they may evolve into symptomatic epilepsy later as a sequel. The current International Classification of Epilepsies and Epileptic Syndromes lists five epileptic syndromes in which neonatal seizures are a major manifestation; benign familial neonatal convulsions(BFNC), benign neonatal convulsion(BNC), early infantile epileptic encephalopathy with suppression-burst(EIEE), early myoclonic enecphalopathy(EME), and neonatal seizures. BFNC and BNC are categorized in idiopathic generalized epilepsies according to the International Classification. BFNC are described as being associated with clonic or apneic seizures, although the ictal EEGs of these seizures have been well documented in only a small number of cases. Seizure types reported to date were partial or generalized. Three of four patients in whom we were able to record ictal EEGs displayed definite partial seizures. One diagnosed as haying generalized seizures did not show typical electroclinical features of generalized tonic-clonic convulsions.
Brain ; Brain Edema ; Child ; Classification ; Electroencephalography ; Encephalitis ; Epilepsy ; Epilepsy, Generalized ; Humans ; Hypocalcemia ; Hypoxia-Ischemia, Brain ; Infant, Newborn ; Intracranial Hemorrhages ; Necrosis ; Neurons ; Seizures*

With recent changes in the structure of society, the pathology of diseases is also changing, which includes an increase in Kampo diagnosis of Tokaku-joki-to. This formulation is now frequently used in my clinic too. I studied the clinical effect of the extract of this formulation in 125 evaluable patients (12 males and 113 females) out of 183 patients who received the extract of this formulation from January to October 1992 on an outpatient basis.
The success rates, when shown in the order of the number of patients, were 82% in dysmenorrhea, 74% in hypermenorrhea, 69% in signs and symptoms associated with hypertension, 72% in climacteric disorder, 59% in lumbago, 55% in hot flash with cold feeling of foot, 55% in irregular menstruation, 38% in chloasma, 60% in acne, 57% in hemorrhoid, and 60% in atopic dermatitis. Other disorders included vulvular contusion, prostatic hypertrophy, and sequela of cerebral thrombosis.
According to the instructions and the herb components described in the classics (Toueki, this formulation is considered to be effective for Kigyaku (rush of blood to the head) such as anxiety and feelings of heat on the upper body and cold on the lower body. I believe this formulation can be widely applied to disorders caused by problems in modern society, such as a stressful life-style, palatable food, lack of exercise and constipation.

Complementary and alternative medicine (CAM) is making waves all over the world nowadays. The National Institute of Health started an office of alternative medicine in 1992 and established the National Center for CAM (NCCAM) in 1998. The annual budget has increased to 113.3 million dollars. The NCCAM has founded the Office of International Alternative Medicine (OIHR), to support collaborative work with countries other than USA. In 2003, 10 international planning grants were awarded which included a collaboration with Keio University in Japan.
In most of Asian countries except for Japan, the government supports promotion of its own traditional medicines. When European medicine came from Holland to Japan, in the Edo period, Japanese doctors quickly adopted European ways and mixed them with traditional Kampo medicine. For example, Seishu Hanaoka combined surgery with Kampo, for the benefit of his patients.
Taro Takemi pointed out Kampo drugs should be used in Kampo ways, and not in western medical ways. To globalize Kampo, first of all, Kampo should be more visible both in Japan and in the world. Secondly, the government's support is essential. Thirdly, public enlightenment concerning Kampo is necessary. Many people actually confuse Kampo, with dietary supplements. Fourthly, we need faculty members in universities, who can introduce Kampo as a part of Japan's medical culture. Lastly, Japan should contribute more to the development of traditional medicine in Asia.
Kampo is a definitive model of integrative medicine in our world. We must introduce this traditional heritage and treasure, globally.

Each medical specialist certification system in internal medicine and its subspecialities was founded and controled byeach medical society, but not by the public. Thus, each system had not been harmonized each other, and not recognizedas the public system until the the Ministry of Health, Labour and Welfare (MHLW)'s declaration of permission for publicnotification of each certificated medical speciality when approved according to their criterion. Based on the longstandingdiscussion and negotiation in the special committee on internal medicine of the Japanese Board of MedicalSpecialist, on the other hand, the Japanese Society of Internal Medicine (JSIM) and the societies of subspecialities in theinternal medical fields agreed to build up the so-called 2 stair-system as the framework of medical specialist certificationsystem, where the Certified Member of the JSIM is inevitable for application or renewal of the Fellow of the JSIM andother certifications of medical specialist of the internal medical subspecialities. In face to the new compulsory postgraduateclinical training system with super-rotation for 2 years starting from 2004 fisical year, JSIM decided that 2 yearpostgraduate clinical training is included to the 3 year training period necessary for the application of the Board CertifiedMember of JSIM, because clinical training with super-rotaion system aimed to master the capability of primary medicalcare is recognized to be also an essential part of the training program for internists. For the better medical specialist certificationsystem in the future, the Japanese Board of Medical Specialist should be approved to be the public and independentorganization for quality control of Japanese medical specialist certification system as a whole to improve medicaland welfare quality which fit for the requirement of Japanese people in the 21th century.