Japanese Kampo doctors usually understand amenorrhea as caused by oketsu (blood stasis) and kekkyo (blood insufficiency). In recent years, there have been a few case reports which describe patients treated only with prescriptions for junki function (the treatment of kiutsu or ki stasis). Our case was 37 year-old woman with amenorrhea from osteopathy manipulation a half year previously in London. Her usual menstruation had been normal. She had thoracic and sacral pain, joint click, epigastric pain, lower abdominal pain, hematuria and muscle stiffness but her usual daily living was not affected. No abnormality was noted with laboratory or imaging, or endocrinological tests. From a Kampo examination, she was diagnosed with hiesho (coldness) and kiutsu. We chose uyakujunkisan without white silkworm, with aconite root. Her arthralgia and hiesho improved one month later, and her menstruation re-started three months later. Uyakujunkisan is introduced in the Wazaikyokuho, and we believe this classical textbook indicates that this prescription can be used to treat amenorrhea. Ki abnormality is one of the most important complications of secondary amenorrhea and a prescription with junki function is important treatment option. Thus, in assessment of patients with amenorrhea,we feel it is important to focus on ki abnormality.

Physicians usually prescribe specific formulae which are classified as treating blood stasis for dysmenorrhea in Japanese Kampo medicine. Daisaikoto is not classified as the category and rarely used to treat dysmenorrhea. Here, we report 2 cases of dysmenorrhea that were successfully treated with daisaikoto. In case 1, the patient was a 19-year-old student. Menstrual pain worsened and accompanied premenstrual headache and vomiting, disturbing her to go college since she started her college life. Commercial non-steroidal anti-inflammatory drugs were not effective. Her Kampo abdominal findings included abdominal strength excessive, fukuman, kyokyokuman and tenderness in the peri-umbilical region. We diagnosed her as “excessive pattern”, “heat pattern”, “qi stasis”, and “blood stasis”. We prescribed extract of daisaikoto 7.5 g per day. Four weeks later, she reported improvement of premenstrual headache and vomiting. Twenty weeks later, she needed no more analgesics at menstrual period. In case 2, the patient was a 35-year-old mother. After entrance examinations of her son and moving, her menstrual pain, headache and irritability worsened. Her Kampo abdominal findings included abdominal strength slightly excessive, fukuman, kyokyokuman, shinka hiko, and tenderness in the peri-umbilical region. We diagnosed her as the same as case 1 and prescribed the same. Eight weeks later, she reported dissaperance of headache and irritability. Twenty weeks later, menstrual pain improved.

We report the case of a 17-year-old male who had involuntary movements treated with yokukansankashakuyakukoboku. He had first recognized the involuntary movement 6 years previously. His symptom could not be alleviated with neurological and psychological treatments, and he visited our clinic for treatment with Kampo medicine. His symptom gradually alleviated with yokukansankashakuyakukoboku. The ancient physician Sekki (薛已) created yokukansan in China's Ming Dynasty. Yokukansan and its various add-on combinations were used in the Edo Era of Japan. Keisetsu Ohtsuka then created yokukansankashakuyakukoboku, which is however now rarely used because there is no extract drug in Japan. There are markedly nervous patients however, who can be treated with this formula. Thus, the authors feel that more research needs to be done on the differences between yokukansan and yokukansankashakuyakukoboku.

We report 2 cases in which byakkokaninjinto was effective for general malaise in aging males. In 1939, climacterium disorders with general malaise were reported in aging men in America. Later, late-onset hypogo nadism (LOH) was defined, and guidelines for LOH syndrome were made.
We distinguished two cases of climacterium disorder with LOH syndrome in aging males. We used the AMS score (which is a diagnostic criteria for LOH syndrome) at the first medical examination.
Case 1 was a 48-year-old man suffering from serious headaches every day for which he took many analge sics. His AMS score was 27/85 at the first medical examination. Mild LOH syndrome was suspected in this case. Case 2 was a 48-year-old man suffering from frequent daily hot flashes. His AMS score was 42/85 and moderate LOH syndrome was suspected.
General malaise in aging males arises from a decrease in male hormone with aging and is treated with an drogen hormone replacement therapy (androgen HRT), while Kampo treatment is also a consideration. As Kampo treatments, hachimijiougan and kamishouyousan are usually chosen. Byakkokaninjinto was effective these patients who showed thirst and polydipsia.

Objective: To clarify consumer views on the new sale system of non-prescription drugs, self-medication, and purchases in drugstores after the revised Pharmaceutical Affairs Act in 2009.
Methods: The questionnaire was performed for 1,084 consumers on an enlightenment event of the proper use of non-prescription drugs and promotion of adequate self-medication held at Shinjuku Station that was a main terminal station.
Results: Among the respondents, the degree of recognition of the new sale system for non-prescription drugs was 67.7%.  There was approximately threefold increase from the previous survey in 2008.  The most common positive reason was, “The safety of non-prescription drugs was clarified by classification according to three risk levels.”  On the other hand, the most common negative reason was, “I was unable to reach the medicine I wanted without having to listen to the pharmacist’s explanation.”  When consumers want to purchase non-prescription drugs, 77.1 and 44.5% of the respondents nominated “pharmacy and/or drugstore” and “a convenience store,” respectively.  The practice of self-medication positively correlated with the words “the self-medication.”  In this study, a surge in consumer interest for self-medication and non-prescription drugs was felt.  However, while consumers were interested in the safety of non-prescription drugs, they also demanded convenience.
Conclusions: We thought that the role of experts such as pharmacists and registered salesclerks was to ensure safety, convenience, and understandability of consumers for non-prescription drugs.  In addition, to promote adequate self-medication, it was suggested that recognition of the words “self-medication” will be helped through events, the Internet, and the mass media.  It needs to be further explored.

Objective : We analyzed changes in the affected side motor function according to the region and severity of motor paralysis in patients during convalescent rehabilitation. Methods : The subjects recruited were 1,903 hemiplegic patients with primary stroke from a supratentorial unilateral lesion, for which a full-time integrated treatment (FIT) program was implemented. We excluded patients with severe complications, those in whom the stroke recurred or its condition rapidly changed during hospitalization, and those in whom the duration from the onset to admission to our hospital was 61 days or longer. The remaining 1,634 patients served as the study subjects, from among whom we chose 917 patients who had been hospitalized for 8 weeks or longer. The affected side motor function was assessed using 5 motor items of the Stroke Impairment Assessment Set (SIAS) every 2 weeks starting from admission. Results and Conclusion : The affected side motor function significantly improved from admission to a convalescent rehabilitation ward through to week 8 in stroke patients, who were actively engaged in daily routines and had mainly walking and ADL exercise. In addition, improvement was more likely to occur for the lower-limb compared to upper-limb, as well as for the proximal compared to distal motor function. This tendency was more marked for more severe cases of paralyses.

  Recently, the medical incident reporting system has been used in many hospitals andstrategies for prevent accidents from occurring are being put in place. During the period of three months from April through June 2008, a total of 36 incidents were reported in our hospital. Of the total, 15 incidents (41.6%) took place owing to personnel's inattention. Our way of taking preventive measures was reactive, and we tended to become oblivious of the latest accident over time and repeated the same mistake. In order to maintain our consciousness on accident prevention, we have recently started using 10 minutes during the morning assembly to remind ourselves of what we should do -- such as identifyingpatients, confirming injections and medications, and exchanging needles -- through role-play and questions and answers. Three months after this practice got started, the number of the accidents due to inattention reduced to seven cases. In response to a questionnaire survey, almost all the nurses said that the repeated practice helped raise their awareness of accident prevention. The use of 10 minutes in the morning for accident prevention enabled them to start their work with their seat belt fastened. We thought this also contributed to accident reduction.

Typically, Japanese Kampo doctors use formulas classified for treating blood stasis, to treat pain. However,there have been few reported cases where pain was treated with formulas classified for treating qi stagnation. Here, we report a case of right lateral epicondylitis in a 48-year-old woman who was treated with a focus on qi stagnation and with uyakujunkisan. She underwent conservative treatment at an orthopedic clinic for ten months, but her pain was not relieved. Hence, she opted for Kampo treatment. She was in a state of melancholy, felt heaviness throughout her body, and had irregular menstruation. These symptoms were mainly related to qi stagnation, and hence, we chose uyakujunkisan without white silkworm, but with aconite root. One month later, the stiffness in her shoulder improved and the pain was reduced. Magnetic resonance imaging taken 2 months later showed an improvement in the lesion. Nine months later, her menstruation became regular, and 11 months later, the pain had almost completely resolved and she could comfortably perform activities of daily living. Uyakujunkisan is introduced in the classical textbooks, and we interpret uyakujunkisan as a formula that can treat pain with qi stagnation. In Kampo treatment, effective pain treatment involves consideration of not only local blood stasis but also general qi stagnation.

In atrioventricular (AV) discordance, a morphologic tricuspid valve functioning as a systemic AV valve often becomes incompetent and needs to be replaced. However, mitral valve replacement concomitant with tricuspid valve replacement is unusual in the disease. Here, we report a case of successful double AV valve replacement long after functional biventricular repair in AV discordance. A 32-year-old man with AV discordance was admitted with orthopnea. He had undergone the Rastelli procedure at age 10 and removal of the deteriorated conduit valve at age 24. Preoperative examinations revealed not only tricuspid but also mitral regurgitation. Both deteriorated valves were replaced with mechanical valves. In AV discordance after Rastelli procedure, a non-valved conduit may accelerate mitral deterioration because pulmonary hypertension from tricuspid regurgitation increases the afterload of the pulmonary ventricle.

Review of the effects of acupuncture and moxibustion on brain function and cerebral disorders in human and animals was presented. Firstly, in basic research on experimental animals, the change of cerebral blood flow induced by acupuncture and its mechanisms had been reviewed. Nextly, the effect of acupuncture and moxibustion on human brain function that measured from fMRI, PET, magnetoencephalography (MEG), EEG (including event related potential) have documented in the review of basic research on humans. Finally, effectiveness of acupuncture and moxibustion on stroke was reviewed, and its possibility of QOL-improvement of the patients was discussed.