A 53-year-old man presented with a painful, non-healing ischemic ulcer of the left fifth toe. The patient was initially treated conservatively for 4 months with local debridement and medication with antiplatelet therapy but his symptoms and the ulcer was refractory. A computed tomography revealed a bulky, irregular, gritty, localized calcification of the infra-renal aorta and was compatible with the so-called “coral reef aorta”. Angiography confirmed the findings of the CT scan, and there was no evidence of occlusive lesions in the distal runoff vessels. A diagnosis of blue toe syndrome secondary to infra-renal coral reef aorta was made. In order to prevent further embolization, the patient underwent aortic excision with PTFE grafting via a retroperitoneal incision. In order to increase the microcirculation of the toe and to aid in the healing of the ulcer, a lumbar sympathectomy was performed simultaneously. The ulcer healed completely on postoperative day 47. The treatment method for coral reef aorta depends on the presence or absence of global ischemia of the lower extremity and embolic complications.

Purpose: The purpose of this study is to clarify the factors related to the content of consultation in the cancer nursing outpatient department of Gunma University Hospital. Method: A retrospective survey was conducted with 1084 cases, excluding the unknown cases, from 1308 consultations in FY2019. Survey items included age, gender, consulter, number of uses, treatment status, consultation content, etc. We conducted χ2 tests, and binomial logistic regression analysis between the content of the consultation and the attributes of the user. Results: The treatment-related content was associated with the following factors: 70s or older, family/relatives only, presence of recurrence/metastasis, first use, pre-treatment, urinary organs, uterine/ovary, and unknown primary. The body-related content was associated with the following factors: under treatment, post-treatment, no recurrence/metastasis, and digestive organs. The mental health-related content was associated with 30s or younger, 40s–60s, patient only, and second time or more. The social aspects-related content was associated with the following factors: patient only, family/relatives only, no recurrence/metastasis, and breast. Conclusion: The results reveal that associated factors differ by consultation content. These findings can be used to prepare for consultation based on the relevant associated factors.

Since students who would like to study Kampo medicine more have no opportunity to communicate each other in Northern Japanese Universities, we newly started joint study conferences held by medical students in 2013. The objectives of this paper are to report on these annually held student-based Kampo study conferences in the Hokkaido and Tohoku areas, and the ways each university studies Kampo medicine. In the conference, the students reported on their club activities. Then they studied the history of Kampo medicine and simulation of abdominal diagnosis, and performed group work on case reports together. The number of student participants in these conferences has tripled over 3 years from 18 to 58 (for a total of 111 participants). All members were satisfied with the content. And this reflects medical students' need for a wider perception of Kampo medicine, rather than a limited one gained in their university club activities. We hope this conference will play a major role in other nationwide student-based Kampo study conferences in the years to come.

The background and course of Kampo treatment in 39 patients with uncontrollable otolaryngeal symptoms treated between April 2013 and March 2016, in the Department of Kampo Medicine at Tohoku University Hospital, were analyzed retrospectively. An improvement in overall symptoms was noted with Kampo treatment in 28 of 39 cases (71%). The commonly reported subjective symptoms included glossodynia (7 cases), postnasal drip (4 cases), oral discomfort (4 cases), dizziness (3 cases), and taste disorder (3 cases). Analysis using the classification of qi, blood, and fluid revealed that cases with qi stagnation pattern (15 of 18 cases) were effectively treated with Kampo treatment. Prior reports support our finding that smoothing qi with Kampo medicine is effective in alleviating some chronic symptoms. The symptoms improved within 6 weeks after the treatment was initiated. Therefore, a 6-week period can be considered sufficient to determine the effectiveness of Kampo medicine. Many of the patients for whom Kampo treatment was not effective had depression and domestic stress. In conclusion, Kampo treatment may be effectively used to treat uncontrollable, chronic otolaryngeal symptoms in selected cases that are unresponsive to Western medicine.