The effectiveness of the Kampo medicine shakuyakukanzoto extract for patients with muscle cramp is well known, but recently side effects related to pseudoaldosteronism have also been reported. To avoid this issue, Kampo medicines without Glycyrrhizae Radix are needed for treatment of muscle cramp. We investigated the therapeutic effect of shimotsuto extract, which has traditionally been used to treat anemia, in 26 patients (mean age : 70.7 ± 12.1 years) with muscle cramp. Improvement of the symptom was noted in 18 patients (69%), with no change in 8 patients (31%). The abdominal muscle tension of the former patients was significantly lower than the latter. Here, the cases of four representative patients in whom muscle cramp was improved by shimotsuto are described. The response rate to shimotsuto was similar to that of shakuyakukanzoto. Our results suggest that shimotsuto extract is a suitable alternative to shakuyakukanzoto for treatment of muscle cramp in older non-robust type patients not in need of emergency care.

OBJECTIVE: Autistic spectrum traits are postulated to lie on a continuum that extends between individuals with autism and individuals with typical development. The present study was carried out to investigate functional and network abnormalities associated with autistic spectrum trait in healthy male subjects. METHODS: Subjects were 41 healthy male subjects who underwent the social responsiveness scale-adult (SRS-A) and magnetic resonance imaging. RESULTS: There was significant positive correlation between the total score of SRS-A and the regional cerebral blood flow (CBF) in posterior cingulate cortex (PCC). Also, there were changes in functional network such as in cingulate corti, insula and fusiform cortex. Further, we also found the significant difference of functional networks between the healthy male subjects with high or low autistic spectrum trait, and these points were congruent with the previous perceptions derived from autistic-spectrum disorders. CONCLUSION: These findings suggest a biological basis for the autistic spectrum trait and may be useful for the imaging marker of autism symptomatology.
Autism Spectrum Disorder ; Autistic Disorder ; Cerebrovascular Circulation* ; Gyrus Cinguli ; Humans ; Magnetic Resonance Imaging ; Male* ; SRS-A

Introduction: There has been no case report in which hyperpigmentation developed on the skin area where a transdermal fentanyl patch was applied in a patient. Case report: A 43-year-old man with recurrence of postoperative rectal cancer was treated by cetuximab plus irinotecan and panitumumab plus FOLFIRI. For cancer pain, transdermal fentanyl patch (Fentos®) was administered, and radiation from behind was performed. Hyperpigmentation then appeared on the chest and the abdominal skin sites where the patches were applied. The hyperpigmentation nearly disappeared four months after the fentanyl patch was discontinued. Discussion: The cause of the pigmentation was possibly due to post inflammatory hyperpigmentation secondary to contact dermatitis. It was desirable to conduct patch test and skin biopsy for making an accurate diagnosis. Conclusion: We should pay a careful attention to hyperpigmentation of the skin where a transdermal fentanyl patch is applied.

We herein report a patient who complained persistent exudate at navel in spite of adequate antibiotics therapy after laparoscopic cholecystectomy was successfully treated with Kampo therapy. The pharmacological effect of this Kampo formulation i.e. senkinnaitakusan is still unknown, but this formulation has been used for persistent infectious diseases. According to the description in the classic textbook, this formulation is suggested to encourage metabolic function and exhibit anti-inflammatory function. There have been no reports of Kampo therapy for the superficial incisional site infection associated with laparoscopic surgery. The authors propose that Kampo medicine is another promising option in the management of surgical site infection (SSI).

We herein report three patients who complained atypical febrile diseases associated with painful whole body (Case 1), general fatigue (Case 2), and a sense of general discomfort (Case 3). All cases were not accompanied by dizziness and a shaky feeling which are commonly associated in shimbuto-sho i.e. indication of shimbuto, but presented severe tenderness at the left paraumbilical region which was suggested as indicative point of shimbuto by Yoshiko Takagi. We made a diagnosis in these three cases as shimbuto-sho based on the Takagi's tender point. Through these clinical experiences we propose that a new type of shimbuto-sho, which are completely different from the fixed idea of inherited knowledge. This new type of shimbuto-sho consists of following signs ; fever with chill, floating and feeble pulse, no sweating, general fatigue or body pain, and severe pain at Takagi's tender point.