Leg cramps are frequently seen in patients who are undergoing hemodialysis. Syakuyaku-kanzo-to is usually effective against leg cramps, but not for all patients. On the other hand, Yokuinin, coix seed, has been known to restrain spasms of the frame muscle. This paper reports on the effectiveness of Yokuinin in controlling leg cramps during hemodialysis-especially when Shakuyaku-kanzo-to is not effective. Tests were performed on nine patients who have had maintenance hemodialysis in our hospital, and whose leg cramps were not responsive to Syakuyaku-kanzo-to. The patients were provided with three to six tablets of Yokuinin (Yokuinin extract tablet “Kotaro”) a day, and the effect on their leg cramps was measured after three weeks. Yokuinin was effective on five patients, whose leg cramps disappeared (an efficacy rate of 55.6%). Side effects were not observed. These results suggest that Yokuinin is a useful medicine (as part of a treatment regimen of traditional medicine) for leg cramps that result from hemodialysis-especially with patients for whom Shakuyaku-kanzo-to is not effective.

Yokuinin, coix seed extract, has been used to regulate gastric functions and to reduce pathological water retention. This paper reports the effect of Yokuinin on controlling hydrarthrosis for patients with arthralgia. Seventeen patients who have had maintenance hemodialisis for an average of 12.7 years and who have suffered hydrarthrosis with arthralgia have been tested. There are 7 male and 10 female patients, with an average of age of 63.4. The hydrarthrosis of the patients resulted from dialysis arthropathy and gonarthrosis. The patients were provided with 3 to 6 tablets of Yokuinin (Yokuinin extract tablet “Kotaro”) a day, and the effect on hydrarthrosis was measured after 3 weeks. The dosage of Yokuinin was 0.33g in 3 tablets. Yokuinin was effective on 14 patients (hydrarthrosis was reduced), relatively effective on 2 patients, and not effective on one patient. This shows an efficacy rate of 82.8%. Arthralgia was reduced for 12 patients, and analgesia was seen in 3 patients. Effective reduction of hydrarthrosis by this medicine was observed: 5 cases out of 6 for patients with dialysis arthropathy (83.3%); 6 cases out of 7 for gonarthrosis (85.7%); and 3 cases of 4 for other diseases (75.0%)—a total of 82.8%. The patient for whom the drug was not effective was suffering from acute hydrarthrosis. Side effects were not observed except for indigestion and cramps. These results suggest that Yokuinin is an effective medicine to control hydrarthrosis with arthralgia for patients under hemodialysis.

Four patients, 13 to 53 years old, with congenital venous malformation including Klippel-Trenaunay syndrome underwent surgical treatment followed by sclerotherapy. They developed marked dilatation of varicose veins with spots, and complained of pain, dullness, and bleeding. Two patients also had hypertrophy of the diseased leg. Phlebography and color Doppler ultrasonography were performed in all patients to precisely determine the abnormal vein and incompetent communicating veins which were then resected and/or ligated with minimal skin incision. In two patients, additional ligation of incompetent communicating veins was necessary. One to two weeks after surgical therapy, sclerotherapy was performed with 1-2% polidocanol. Symptoms improved after treatment, even in a patient with claudication before operation. Surgical therapy for congenital venous malformation was feasible and satisfactory, with the aid of meticulous identification of abnormal veins and communicating veins by not only phlebography but color Doppler ultrasonography.

BACKGROUND/AIMS: There have been several reports of thermal injury induced by argon plasma coagulation (APC) in animal models, but no follow-up studies have revealed the actual thermal injury. METHODS: APC was performed on the stomachs of two living minipigs with and without prior submucosal injection of normal saline. The power and argon gas flow were set to 60 watts and 2 L/min, respectively, and pulse durations of 5, 10, and 20 seconds were used. One of the minipigs was killed immediately thereafter and the other was killed 1 week later. RESULTS: The minipig killed immediately showed only subtle differences between noninjected and injected injuries under all the conditions, and the usefulness of prior submucosal injection was not obvious. However, the minipig killed 1 week later had a deep ulcer extending to the deeper muscle layer at the noninjected site where APC had been applied for 20 seconds, whereas tissue injury of the injected site was limited to the submucosal layer. CONCLUSIONS: Unexpected tissue damage can occur even using a short-duration APC. Prior submucosal injection for APC might be a safer alternative technique, especially in a thinner and narrower gut wall.
Argon ; Argon Plasma Coagulation ; Models, Animal ; Muscles ; Stomach ; Swine, Miniature ; Ulcer

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