We report the case of a 51-year-old woman whose body weight was increased after bariatric surgery. She has been obese from a young age. When she was 30 years old, she developed type 2 diabetes mellitus. She was hospitalized for diabetic ketoacidosis at 45 years of age. She was diagnosed bulimic at 48 years of age, and body weight reduction with diet and exercise therapy became difficult because she was bulimic. Then, she underwent bariatric surgery and her body weight had reduced by 11 kg, 6 months after the surgery. However, her body weight began to increase again 7 months post surgery. At this time, her mental status had become unstable and she ate constantly in the afternoons. We administered yokukansan 5 g/day to treat her unstable mental status. Her body weight then decreased in accord with decreasing energy intake after the administration of yokukansan. She also became aware that her mental status was improving. Furthermore, her HbA1c (JDS) decreased from 8.7% to 7.1% after yokukansan treatment. In this case, it is possible that yokukansan suppressed the overeating by stabilizing her mental status, with the parallel decreases in body weight and HbA1c.

To investigate the effect of intense exercise on immunological factors in saliva, we measured secretory immunoglobulin A (sIgA), lactoferrin and fibronectin. We used a reliable saliva collection method that has already been reported. Timed saliva samples were obtained from 16 healthy young males. Samples were collected before, immediately after, 1 day after and 5 days after endurance running (42.195 km) . The concentrations (μg/ml) of sIgA, lactoferrin and fibronectin were measured by ELISA, and the secretion rates (μg/min) of each were calculated. Immediately after the exercise, the concentration of total protein in saliva increased significantly, but the sIgA secretion rate decreased to 53%. The secretion rates of both lactoferrin and fibronectin did not change significantly. The local immune system plays an important role in mucosal surface defense against upper respiratory tract infection. The sIgA level in the oral cavity was temporarily decreased after intense exercise. A decreased sIgA secretion rate might partly explain the increased susceptibility to upper respiratory tract infection after endurance exercise.

It is generally accepted that visually impaired individuals generally have a low aerobic capacity, which may be partly attributed to a lack of physical activity, and have hypothesized that their response to exercise may differ from that of normal-sighted people. In this study, we investigated the effect of exercise on local immunity in the oral cavity in 24 visually impaired males (n=8 ; totally blind group, n=16 ; partially sighted group) and 8 normal-sighted males. The subjects performed submaximal graded bicycle ergometer exercise to an intensity of 75% heart rate max for 12 min. Before and immediately after exercise, we collected timed saliva samples and measured secretory immunoglobulin A (sIgA) .
The totally blind group had lower levels of aerobic capacity and a lower sIgA secretion rate compared to the partially sighted and sighted groups. Immediately after exercise, the sIgA secretion rate tended to increase in the totally blind group.
It is suggested that the exercise-induced response of local immunity in the totally blind group differed from that in the other groups.

It is generally accepted that secretory immunoglobulin A (sIgA) is a major effector of local immunity in the oral cavity. The salivary sIgA level is known to be temporarily decreased after an acute single bout of intense exercise. On the other hand, the effect of continuous exercise training on salivary sIgA has been controversial. In the present study, we collected timed saliva samples from collegiate kendoists using the reliable saliva collection method that has already been reported. The collection was performed before, during and after a traditional high-intensity 10-day training camp during the coldest part of the winter. We investigated the effect of repetitious intense exercise training on resting sIgA levels in saliva.
The subjects were 19 males and 8 females (age: 19.9±0.5 years) who took part in the camp. We obtained saliva samples before the camp, on the first and the 10th days of the camp, and 4 and 10 days after the camp at 5 p. m. The concentration of sIgA was measured by ELISA, and the sIgA secretion rate was calculated.
The resting sIgA secretion rate decreased significantly during the camp. It remained at a lower level 4 and 10 days after the camp compared to the initial level, although it tended to recover gradually. Prolonged suppression of the resting sIgA secretion rate during a traditional winter kendo training camp might be induced by repetition of high-intensity training.

We previously reported that a case of yokukansan efficaciousness for weight gain due to overeating behavior following bariatric surgery. The reason is considered that yokukansan stabilized the patient's mental state. So, we proposed that administration of oriental medicines for mental state might be a new way of treating obesity. We investigated the efficacy of mazindol, bofutsushosan or yokukansan for obese patients. We retrospectively reviewed clinical data to identify patients administered mazindol, bofutsushosan or yokukansan for treatment of obesity. The inclusion criteria were patients tolerant to medicine for 3 months, and who could be administered yokukansan for anger. A total of 107 patients met these selection criteria. After 3 months of drug administration, significantly body weight reduction was observed in either the mazindol group or yokukansan group. We also selected and analyzed patients with diabetes mellitus to clarify the efficacy of these drugs for glucose metabolism. Reduction in HbA1c was not significant in the groups. These results suggest that mental health problems are very important for the treatment of obesity. And we suggest that oriental medicine is an effective treatment for mental health in obesity patients.

We report the case of a 60-years-old man who complained fever and left knee pain. Fever and arthralgia appear once a month, and these symptoms disappear spontaneously in 3 days. The patient came to our hospital to receive Kampo treatment, because the patient experienced improving these symptoms by Kampo medicine about 20 years ago. I judged the arthralgia as kanshippi, because the arthralgia improved when the patient warmed the joint. We prescribed keishikajutsubuto 7.5 g/day. Arthralgia improved after administration of keishikajutsubuto, but the attack appeared every month. We prescribed maobushisaishinto 5 g/day in addition to keishikajutsubuto 5 g/day for further improvement of arthralgia. The frequency of fever and arthralgia attack was dramatically decreased after we prescribed keishikajutsubuto 5 g/day and maobushisaishinto 5 g/day. We considered the possibility of palindromic rheumatism based on clinical symptoms, X-ray in other clinic and blood test results in our hospital. We report an effective case of keishikajutsubuto and maobushisaishinto on arthritis attacks with fever that resolved spontaneously in a short time.