Ryo-kei-jutsu-kan-to was used to successfully treat two cases of overtraining syndrome with anemia. The first case was an 18-year-old woman. Several years ago, she was diagnosed with iron deficiency anemia, and she took Fe pills intermittently. After university graduation in 1996, she began to experience lightheadedness and general malaise concurrently with increased training of long-distance running. In September of the same year, her anemia worsened, and she was introduced to our department. Administration of Ryo-kei-jutsu-kan-to improved her symptoms, anemia and maximal oxygen uptake. The second case was a 19-year-old woman. She was an office worker and a member of her company's athletic club. She became easily fatigued, and she came to our clinic in December of 1996. Hochu-ekki-to was administered and her fatigue improved. But in the following year she began to feel depressed and lightheaded, and she became anemic after increased increasing her training of long-distance running. Administration of Ryo-kei-jutsu-kan-to improved her symptoms and anemia.

We present here two cases of relapsing infection of the lower airway caused by the recurrent laryngeal nerve paralysis. Seihai-to offered useful palliation and symptom control in the two cases described below. Case 1 was a 50 year-old-man who received surgery and radiotherapy for a cervical tumor in 1970. Thereafter he suffered from cough reflex at meals and a hoarse voice. He has suffered from airway infection four or five times a year since 1992. In May 1995 he was hospitalized for pneumonia. Two more attacks of pneumonia followed in the next two months. Administration of Seihai-to provided a palliation period of 15 months at first and decreased frequency of recurrence to as few as three times during the follow-up period of 43 months; one was pneumonia and two were bronchitis. Case 2 was a 76-year-old man who received surgery and radiotherapy for lung cancer in the left upper lobe in 1984. Thereafter he suffered from cough, sputum, cough reflex at meals, and hoarse voice. Lower airway infection was exacerbated five or six times a year since 1984. He was hospitalized for pneumonia in May 1997 and March 1998, and came to our hospital asking for Kampo therapy in April 1998. Administration of Seihai-to improved his symptoms and achieved a palliation period of 8.5 months. The original text “Man-byo-kai-shun” mentioned that loss of voice is one of the indications of Seihai-to. We took notice of hoarse voice in the two cases at selection of formulae.

Currently, Keishi-bukuryo-gan is widely used for overcoming blood stagnation, and is most frequently used for adult women with blood stagnation (Oketsu) presenting the cold and hot flush (rush in the bust and cold in the lower half of the body) such as menopausal disorder. This time, we carried out thermographic tests for two groups: the patients with subjective symptoms of the cold and hot flush (group 1:8 adult women) and patients with subjective symptoms of cold sensation only in the lower limbs (group 2:8 adult women).
In the first group the difference between the surface temperature of the skin of the upper abdomen and that of the lower abdomen was more significant as compared with the second group. We also observed both groups for 60 minutes after administration of Keishi-bukuryo-gan. In the second group the surface temperature of the skin of both upper and lower abdomen decreased. In the first group, however, the skin temperature of the upper abdomen decreased but that of the lower abdomen increased in reverse, and the difference of the temperature between the upper abdomen and lower abdomen was reduced. This means Keishi-bukuryo-gan worked for improving “the cold and hot flush, ” i. e., the imbalance of the endocrine system and autonomic nervous system.
The findings suggest that Keishi-bukuryo-gan treatments for hot flush, which is the increase of the skin temperature caused by telangiectasis of the skin of the upper body, may increase the blood flow in the lower abdomen and improve pelvic congestion, which is one of the conditions of blood stagnation, as well as decreasing the skin temperature by contracting peripheral vessels.

Guidelines recommend that clinical laboratories perform phenotypic tests (nitrocefin-based test and penicillin 10-U [P10] or 1-U [P1] zone edge tests) to detect penicillinase in Staphylococcus aureus isolates. This study aimed to assess the prevalence of blaZ encoding penicillinase and perform various phenotypic tests in S. aureus isolates from Japan. We prospectively collected 200 methicillin-susceptible S. aureus isolates from June 2015 to January 2016 and performed six phenotypic tests (nitrocefin-based test, P10 zone edge test/P10 diffusion test, penicillin 2-U [P2] zone edge test/P2 diffusion test, and cloverleaf test) on each sample. We confirmed the presence of blaZ (two blaZ-positive isolates) using PCR. Using blaZ PCR as a standard, we observed a low sensitivity (50%) and positive predictive value (PPV, 50%) of the nitrocefin-based test, low PPV (18.2%) of the P10 zone edge test, low sensitivity (50%) of the P10 diffusion test, low PPV (50% and 22.2%) of the P2 zone edge test and P2 diffusion test, respectively, and low sensitivity (50%) of the cloverleaf test. These data suggest a low performance (sensitivity and PPV) of these six phenotypic tests because of the low prevalence (1%) of blaZ in S. aureus isolates from Japan.
Diffusion ; Japan* ; Penicillinase* ; Penicillins ; Polymerase Chain Reaction ; Prevalence* ; Prospective Studies ; Staphylococcus aureus* ; Staphylococcus*

To assess the changes in attitudes toward smoking after the smoking-prevention classes presented by Kumamoto Tobacco-Free Forum, this study administered a questionnaire survey to first-year junior high school students before and after a smoking-prevention class at a junior high school. The questionnaire that was used to pre and post comparison comprised thirteen items, ten from the Kano Test for Social Nicotine Dependence (KTSND-Youth) and three as follows: “I think I will be a smoker in the future,” “I think I will smoke about once,” and “What do you think of people around you who smoke tobacco?” The results of this pre- and post-class questionnaire indicate that attitudes toward seven items improved in a statistically significant way. These included four from KTSND-Youth: “Smokers cannot stop even if they want to,” “Smoking is adult-like and cool,” “Smoking is enjoys taste and a fragrance,” and “If it’s a place with an ashtray, it’s okay to smoke.” The smoking-prevention classes significantly decreased total KTSND-Youth scores. Furthermore, the analysis has clarified that the KTSND-Youth items: “Smoking is adult-like and cool” and “Doctor and school teachers say, ‘Tobacco is no good too much”, as well as the item “What do you think of people around you who smoke tobacco?” are significantly influencing factors for the item “I will be a smoker in the future.” These results indicate that the smoking-prevention classes presented by Kumamoto Tobacco-Free Forum were effective for decline in social nicotine dependence of the first-year students in junior high school.

The therapeutic efficacy of Hachimi jio-gan on pain, weakness, numbness and coldness of the limbs and lower back was investigated in 37 aged patients. After administration for 4 weeks, improvement in the global improvement rating was 55.9%, and improvement in pain, weakness, numbness and coldness were 44.8%, 39.3%, 59.1% and 31.8%, respectively. For the improvement of numbness, more significant improvement was seen in patients 60 years old or greater than in those 59 or less. Such symptoms as hair thinning or hair loss, dimming of the eyes, constipation, pain in the upper limbs, numbness in the lower limbs, coldness of the upper limbs and coldness of the lower limbs showed significant improvement. These results suggest that Hachimi jio-gan is effective in the treatment of pain, weakness, numbness and coldness in aged patients.

Chronic hepatitis C has a high incidence of proceeding to liver cirrhosis, and a natural healing from chronic hepatitis C is extremely rare. We observed a case of chronic hepatitis type C, in which the virus was eliminated after Kampo treatment. The patient was a 37-year-old female who underwent a blood transfusion following delivery of her first child in 1982. In January 1983, she became aware of general malaise, and was diagnosed as having chronic hepatitis. She was treated with Stronger Neo Minophagen C, but her symptoms and laboratory data were unchanged. A liver biopsy disclosed chronic active hepatitis in 1988, and she was transferred to our hospital for Kampo treatment in May. Although the symptoms rapidly disappeared after treatment with the Kampo formulas, Hochu-ekki-to and Keishi-bukuryo-gan, her transamilase values did not change. Her transamilase level decreased gradually after the prescription was changed to Saiko-keishi-to-go-Toki-shakuyaku-san-ryo, and returned to normal after her prescription was changed to Kami-shoyo-san-ryo in May 1996.
Concerning HCV-RNA in the serum, in March 1995, when Saiko-keishi-to-go-Toki-shakuyaku-san was administered, the amount of HCV-RNA in the serum was 10⁴ Kcopies/ml. But that was less than the detectable sensitivity in April 1998. We believe this to be a case in which elimination of HCV was achieved by Kampo treatment alone.

As many natural medicines absorb water at boiling, yields of the decoctions are affected by absorbed water. Therefore, we examined the quantity of imbibition of each crude drug at boiling. We used 75 kinds of crude drugs. After boiling 600ml of water, each natural medicine was boiled for 70 minutes. The medicine was left for 60 minutes, and then boiled again for 20 minutes. The quantity of imbibition of each natural medicine was measured at 10, 20, 30, 40, 60, 130, and 150 minutes. The maximum data among the quantity of imbibition at each point was labeled “maximum quantity of imbibition.” With regard to the maximum quantity of imbibition in natural medicines of plant origin, the range was from a maximum of 69.10g in Chrisanthemi Flos to a minimum of 3.26g in Persicae Semen. The average maximum quantity of imbibition was 22.51±13.00g, and there were large differences among each of the natural medicines. The quantity of imbibition at 10 minutes or 20 minutes was above 80% of each maximum quantity of imbibition on many crude drugs, but that gradually increased over the time course for some crude drugs.

A 59-year-old man was admitted to our hospital with severe mitral incompetence. Mitral valve repair, tricuspid annuloplasty and the Maze procedure were performed. After weaning from cardiopulmonary bypass, his systolic blood pressure (SBP) dropped to 40 mmHg. Immediate administration of catecholamines markedly increased SBP but his continuing low blood pressure required additional treatment with vasopressin and hydrocortisone. On postoperative day 12 in the general ward, he suddenly lapsed into an intractable hypoglycemic coma. Endocrine function tests revealed adrenocorticotropic hormone deficiency. Since the time of writing has been doing well with 20 mg of hydrocortisone.