Continuous suppressive antiviral medication for the treatment of repeated genital herpes is often carried out, but few treatments with Kampo have been reported. Here, we report experience with a case in which the repeated recurrence of genital herpes was treated successfully with hochuekkito.
A 34-year-old woman had experienced pregnancy twice and delivered twice. She had also had repeated recurrences of genital herpes from several years earlier, and been treated at a nearby doctor. Her recurring herpes did not resolve, however, and she visited our department. In addition to these recurrences, general fatigue and appetite loss were observed, which were regarded as Qi deficiency, and she was started on hochuekkito 7.5 g/day. The general fatigue disappeared two weeks after the treatment. Herpes recurrences also decreased gradually, and symptoms were no longer observed after medication was stopped less than a year later.
In this case, genital herpes recurrences were decreased, while symptoms such as general fatigue and appetite loss were also improved. Here, genital herpes recurrence was regarded as Qi deficiency, which was possible to treat with hochuekkito.

A 45-year-old man was hospitalized with sudden-onset chest pain. He was in cardiogenic shock with a systolic pressure of 68 mmHg. His electrocardiogram (ECG) showed ST segment elevation in leads I, aVL, and V2-5. An emergency coronary angiogram (CAG) showed that the true lumens of bilateral coronary arteries were compressed, showing acute Stanford type A aortic dissection involving bilateral coronary artery. A bare metal stent was promptly implanted in the left main trunk (LMT) to restore coronary blood flow because of his hemodynamic instability. Soon afterwards, the ischemic changes on ECG disappeared and he was transferred to the operating room in a stable hemodynamic condition. We performed emergency graft replacement of the ascending aorta and coronary artery bypass grafting. The postoperative CAG showed patent bypass grafts. Implantation of LMT stent, as a bridge to surgery, should be the treatment of choice for acute type A dissection involving LMT.

We report a case of type A acute aortic dissection in a patient with situs inversus totalis. A 51-year-old man was hospitalized with sudden-onset back pain. Contrast-enhanced computed tomography revealed Stanford type A acute aortic dissection and situs inversus totalis. Total arch replacement using selective cerebral perfusion and mild hypothermic circulatory arrest was successfully performed. He was discharged home 23 days after the operation.

Introduction: The regional palliative care support center (PCSC) has set the following palliative care goals for correction of misunderstanding and prejudice of the general community against palliative care, home care and home death of cancer patients: practice palliative care early after diagnosis, educate the community to understand palliative care and build a regional palliative care cooperation system. Method: This study reviewed four years (2009-2012) of data from the PCSC. Outcome data of the patients were collected during outpatient care, inpatient care, and in-home care that were supported by the PCSC. The PCSC managed palliative care based on patient conditions and symptoms in the early stage after diagnosis. The PCSC worked to spread the idea and importance of palliative care to the general community and health care professionals of the region, and also worked to promote the regional palliative care cooperation. Result: These efforts led to an increase in the number of first center visit of patients, especially introduction patients, and an extension of the period of treatments of both tumor department and palliative care department. These outcomes resulted in an increase in the rate of in-home care transitions, the length of in-home care and the number of deaths at home. These results suggest that the place of appropriate medical and caregiving treatments and the place of death are converting into home gradually from hospital.

No abstract available.
Lymphoma, T-Cell* ; T-Lymphocytes*