Lower abdominal cramps, or shofukukyuketsu in Japanese, are thought to be one indication to use tokakujokito for the abdominal symptom of oketsu. To clarify the condition, anatomical analysis was performed using 3 D imaging. There were 20 women and11men entered in this study who consulted our hospital for lower abdominal pain or a sense of discomfort. Width and the thickness of the rectus muscle of the abdomen were analyzed. Moreover, gas images and feces in the intestinal tract under the abdominal wall were also observed. In addition, the presence of rectus abdominal muscle separation, or shofukufujin in Japanese, was evaluated. In the women, where lower abdominal cramps were a complaint, young age (53.1 ± 18.3 vs. 30.4 ± 9.8, p < 0.05), low parity (1.5 ± 1.0 vs. 0.25 ± 0.5, p < 0.05), and thickness of the abdominal rectus muscle (8.14 ± 2.5 mm vs. 12.4 ± 1.6 mm, p < 0.05) were confirmed. Also in several cases of lower abdominal cramps, feces were seen at the sigmoid colon. A significant difference was seen in the male group. Cases with lower abdominal cramps suggest involvement of local muscle spasms at the bottom of abdominal rectus muscle, which may contribute to the seemed symptom of abdominal formation. On the other hand, a mechanism different from that in women was considered in the men. This suggests that it is necessary to consider gender differences when making a Kampo diagnosis.

Lower abdominal cramps, or shofukukyuketsu in Japanese, are thought to be one indication to use tokakujokito for the abdominal symptom of oketsu. To clarify the condition, anatomical analysis was performed using 3 D imaging.There were 20 women and11men entered in this study who consulted our hospital for lower abdominal pain or a sense of discomfort. Width and the thickness of the rectus muscle of the abdomen were analyzed. Moreover, gas images and feces in the intestinal tract under the abdominal wall were also observed. In addition, the presence of rectus abdominal muscle separation, or shofukufujin in Japanese, was evaluated. In the women, where lower abdominal cramps were a complaint, young age (53.1 ± 18.3 vs. 30.4 ± 9.8, p < 0.05), low parity (1.5 ± 1.0 vs. 0.25 ± 0.5, p < 0.05), and thickness of the abdominal rectus muscle (8.14 ± 2.5 mm vs. 12.4 ± 1.6 mm, p < 0.05) were confirmed. Also in several cases of lower abdominal cramps, feces were seen at the sigmoid colon. A significant difference was seen in the male group. Cases with lower abdominal cramps suggest involvement of local muscle spasms at the bottom of abdominal rectus muscle, which may contribute to the seemed symptom of abdominal formation. On the other hand, a mechanism different from that in women was considered in the men. This suggests that it is necessary to consider gender differences when making a Kampo diagnosis.

Most obstetricians rarely encounter a case of placenta accrete, where the placenta does not detach after childbirth. If placenta accrete attachment is deep, it is likely to lead to poor prognoses such as massive bleeding and shock. With western medicine, it is currently accepted that the only medical intervention is doing a simple total hysterectomy. Our patient was a 27 year old, primiparous Japanese woman. Signs of placental separation were not seen after birth, and conservative medical management for also ended up failing. This was then diagnosed as placenta accrete via sonography and an MRI, and simple total hysterectomy was recommended. She hoped to keep her uterus, however, and she was prescribed tokakujokito Kampo therapy. Her postpartum period passed without abnormality, and the placenta, which had remained intact to the 50 th day after birth, was removed. There is not literature on Kampo therapy as it applies to placenta accrete, and we believe this case to be the first valuable report.

It is thought that meirouin was created by Toukaku Wada, originally. Although prescriptions were applied for ophthalmologic disease at first, such case reports have decreased recently. Here, we report that meirouinkakikuka was successful for serous retinal detachment complicated with an abnormal visual field during postpartum.
We present the case of a 34 year old Japanese woman. Tinnitus had appeared from 35 weeks of pregnancy. Blood pressure rose to 140/100 mmHg at 36 weeks of pregnancy, the patient was diagnosed with preeclampsia,and hospitalized. After hospitalization, blood pressure was rose further to 190/120 mmHg, and an emergency cesarean section was performed. On the 2 nd postpartum (post operation) day her field of view became yellowed and eyesight failure arose. She was diagnosed as hypertensive retinopathy and serous retinal detachment by an ophthalmologist. She stopped applying her eyewash treatment herself because she was feeling unwell. One week afterward, she desired Kampo treatments. Meirouinkakikuka was prescribed, the tinnitus disappeared in 2 weeks, furthermore, her retinal detachment was recovered from 4 weeks later. Thus we believe that Kampo treatments can be a viable alternative, as suggested by this case where application of an eyewash treatment was difficult.

Generally, as for the Bell paralysis in facial nerve paralysis, about 70% are cured spontaneously, and, as for the remainder, steroid and antiviral agent (aciclovir) medical treatment are taken, but treatment of the Western medicine is invalid in the serious case. As a result, the paralysis remains and the aftereffects of the morbid synkinesis is caused. Finally, it becomes the result of greatly damaging QOL because of features of a peculiar face for the patient.The case is 29-year-old pregnant woman and primipara. Abnormality was not especially found in the previous history without what had to be mentioned specially while getting pregnant. A right paralysis of facial nerve developed suddenly cold early morning of 35 gestational weeks (paralysis score 0/40). She gave birth naturally without the effect though the steroid was treated by otorhinolaryngologist. After birth, Kampo treatments were begun with Kakkonto and Saireito for two months. Place where those medicines changed to Daisangoshichisanryo and Kososan because of invalidity, an eye closure and open eyes would become smooth in two weeks, and it recovered in almost one month. Here is a first reported case that concurrent Kampo therapy with Daisangoshichisanryo and Kososan were effective for patient with paralysis of facial nerve that developed during pregnancy.

Between September 1972 and December 1987, 808 gastric cancer patients were treated at our hospital. The male/female ratio was 1.7. Gastric resection was performed on 88% of the patients, while curative resection was performed on 59.2%. The operative mortarity rate was 1.8%.
In patients undergoing surgery, the cumulative 5-year survival rates according to stage were 96.4% for stage 1, 68.6% for stage 2, 48.7% for stage 3 and 4.5% for stage 4.
With the spread of a mass screening, many cases of early gastric cancer have been detected recently. However, the incidence of advance cancer increased with age. This suggests the necessity of encouraging the aged to participate in the mass screening. Though gastrectomy is safety procedure of encouraging the aged to participate in the mass screening. Though gastrectomy is safety procedure in old patients over 75 years of age, its indications should be evaluated taking into consideration the quality of the patient's life.

We reviewed 338 cases of colorectal cancer treated in our clinic since 1973. On these patients, 62% were aged 60 years or older.
By location, the malignant tumor was found most frequenty in the rectum, followed by the sigmoid colon.
Resection was perforoed in 94.3%, of the patients with curative resection accounted for 68.3%. In the curative resection group the cumulative 5-year and 10-year survival rates were 77% and 65, 9%, respectively.
Early colorectal cancer was detected in only 26 patients. Mass screening for colorectal cancer using occult blood tests of feces had just recently started in our communities. Thus, further efforts to detect early colorectal cancer are needed.

Introduction: Tramadol (TRM) has been included as a weak opioid at the second step of the WHO analgesic ladder and has been widely used in palliative medicine. Here we report a case of amelioration of cancer pain by TRM therapy in a female patient with myasthenia gravis (MG). Case:The patient was a 70’s woman who was diagnosed with advanced endometrial carcinoma and suffered from chest pain caused by chest metastasis. 25 mg of a TRM capsule was orally administered three times a day. The dose was increased to 50 mg twice a day. It was resulted in sound pain relief with transient muscle weakness but without a myasthenic crisis.

Aim of the present study was to statistically evaluate the examination rule with use of a questionnaire obtained from physicians regarding treatment for chillness of the limbs, and to prove the clinical usefulness of the database. The database showed that tokishigyakukagoshuyushokyoto was the most frequently used to treat chillness of the limbs, and subsequently keishikajutsubuto, hachimijiogan, and tokishakuyakusan were ranked as drugs with wide use. When physicians determined a kampo formulation suitable for each patient, they used findings specific for the kampo formulation, but not uniform findings obtained from the four traditional examination methods (i.e., inspection, listening and smelling, interviewing, palpitation). There was a statistical difference in the selection mode of drugs among physicians. In a simulation obtained from a questionnaire, there was a positive association between time (time X) to the start of becoming physically warm in the limbs, and time (time Y) to remission (R² = 0.971, P = 0.014). The formula (Y = 4.379 X−0.519), which could predict time Y on the basis of information on time X, was able to accurately monitor the clinical courses of 7 responders to treatment for chillness of the limbs. Taken together, these results strongly suggest that the database constructed in the present study may be useful for evaluation of traditional Kampo medicine, and might allow us to perform more fittingly personalized Kampo medicine in the near future.

Introduction：Respiratory failures are categorized into types I and II. To our knowledge, we report the first case of pulmonary rehabilitation in a patient with systemic sclerosis/polymyositis overlap syndrome who developed type II respiratory failure.Methods：The patient was a 77-year-old woman who had received treatment for systemic sclerosis and polymyositis at another hospital. When she visited our hospital to obtain a second opinion, she suddenly lost consciousness and underwent trachea intubation because of typeⅡrespiratory failure. She received physical therapy on the third day of hospitalization and underwent a tracheotomy on the 16th day. As her thoracic movement was markedly restricted, we started physical training. After she was weaned off from the ventilator on the 43rd day, we performed muscular strength training and aerobic exercise. No exacerbation of CO2 storage was observed even if chest motion training was performed. She was discharged on the 72nd day and advised to wear retina®．Administration of therapeutic drugs such as steroids was maintained at the same dose.Conclusion：Physical therapy, such as chest mobilization, was effective for marked restriction of chest movement in a patient who had both polymyositis and systemic sclerosis.