We introduce the successful treatment of intractable symptoms of 52-year-old female patient with HTLV-I-associated myelopathy (HAM) by Kampo medicine. She showed spastic paraplegia, urinary incontinence, sensory disturbance of extremities and nocturnal myoclonus.
Neurological examination proved to be hyperactive deep tendon reflexes and positive pathological reflexes in legs. The viral antibody titer of HTLV-I was elevated both in cerebrospinal fluid and serum. After treatment with Sho-saiko-to, symptoms were improved. The effect is considered to be immunomodulation of Sho-saiko-to.

The effectiveness of Shakuyaku-kanzo-to on myotonia in a 50-year-old female with myotonic dystrophy is reported. Neurological examination showed myogenic distal dominant muscle weakness and myotonia. Treatment with Shakuyaku-kanzo-to improved myotonic time from 12.8 to 6.8 seconds. This effect was equal to phenytoin and mexiletine. The results indicated that Shakuyaku-kanzo-to affected the ion channels of the skeletal muscle membrane. The apaminsensitive K channel was speculated to be the affected site of the ion channel. Glycyrrhizin might play an important role in this mechanism.
Five week treatment with Shakuyaku-kanzo-to showed no adverse effects on the myopathy.

Nineteen non-insulin dependent diabetes mellitus (NIDDM) patients with obesity were divided into two groups, and a group of eight patients who could try exercise was treated with walking over 160 Calories per day, and a group of eleven patients who could not try exercise was treated with Boui-ougi-to, for six months. Although exercise is known as the treatment of visceral fat obesity, no significant improvement was observed in body mass index, visceral fat/ somatic fat (V/S) ratio, blood sugar, serum cholesterol level in the patient group with exercise, whereas in the patient group treated with Boui-ougi-to, serum cholesterol significantly decreased from 197±31mg/dl to 180±19mg/dl (p<0.01), and V/S ratio improved significantly from 0.84±0.56 to 0.64±0.30 (p<0.05). These observations suggest that treatment with Boui-ougi-to is effective for visceral fat obesity and has potential for the prevention of atherosclerosis.

Though the existence of glutamate-immunoreactive(GL-IR) neurons has been suggested in the nucleus ambiguous(NA) by immunocytochemistry, information regarding the distribution of neurons containing glutamate as a neurotransmitter has been to be elucidated. The author focused on distribution and morphology of GL-IR neurons in the NA, which were compared with cholera toxin beta-subunit(CTB) labeled neurons after its injection to the nodose ganglion(NG) in the cat. The results showed that the majority of neurons in the NA were immunoreactive to excitatory neurotransmitter glutamate, and they seemed to be distributed evenly without any special area of predilection or grouping pattern. The cellular shape was predominantly multipolar. GL-IR neurons showed some similarity in morphology and distribution pattern with CTB labeled cells.
Animals ; Cats* ; Cholera Toxin* ; Cholera* ; Glutamic Acid ; Immunohistochemistry ; Larynx ; Motor Neurons ; Neurons* ; Neurotransmitter Agents ; Nodose Ganglion*

BACKGROUND: Mizoribine (MZR) is an immunosuppressive drug used in Japan for treating patients with lupus nephritis and nephrotic syndrome and has been also reportedly effective in patients with immunoglobulin A (IgA) nephropathy. However, to date, few randomized control studies of MZR are performed in patients with IgA nephropathy. Therefore, this prospective, open-label, randomized, controlled trial aimed to investigate the efficacy and safety of adding MZR to standard treatment in these patients, and was conducted between April 1, 2009, and March 31, 2016, as a multicenter study. METHODS: Patients were randomly assigned (1:1) to receiving standard treatment plus MZR (MZR group) or standard treatment (control group). MZR was administered orally at a dose of 150 mg once daily for 12 months. RESULTS: Primary outcomes were the percentage reduction in urinary protein excretion from baseline and the rate of patients with hematuria disappearance 36 months after study initiation. Secondary outcomes were the rate of patients with proteinuria disappearance, clinical remission rate, absolute changes in estimated glomerular filtration rate from baseline, and the change in daily dose of prednisolone. Forty-two patients were randomly assigned to MZR (n = 21) and control groups (n = 21). Nine patients in MZR group and 15 patients in the control group completed the study. No significant differences were observed between the two groups with respect to primary and secondary outcomes. CONCLUSION: The addition of MZR to standard treatment has no beneficial effect on reducing urinary protein excretion and hematuria when treating patients with IgA nephropathy.
Glomerular Filtration Rate ; Glomerulonephritis, IGA* ; Hematuria ; Humans ; Immunoglobulin A* ; Immunoglobulins* ; Japan ; Lupus Nephritis ; Nephrotic Syndrome ; Prednisolone ; Prospective Studies ; Proteinuria