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.

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.

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.

A study was made on 15 healthy subjects to evaluate the efficacy of water immersion with commonly used raw materials on skin elasticity, viscoelasticity and hydration of stratum corneum.
Samples used in this study included 30, 60, 90g of sodium hydrogen carbonate and 60g of bath preparation containing 90% in weight of sodium hydrogen carbonate (Cool Bathcrin^®). These samples were dissolved into 200l of plain water kept at a temperature of 41°C. The duration of each bathing was 5min.
Skin elasticity (skin distensibility), skin viscoelasticity and hydration of stratum corneum improved in all types of water immersion including plain water immersion. The skin distensibility, viscoelasticity and hydration state showed a statistically significant increase after water immersion with sodium hydrogen carbonate as compared with those before water immersion. In the plain water immersion group, no significant differences were observed between the values before and after water immersion with the exception of skin hydration. However, a significantly higher rate of increase in skin hydration was observed in the groups of water immersion with sodium hydrogen carbonate as compared with the plain water immersion.
The above results show that alkaline salt, especially sodium hydrogen carbonate, improves skin distensibility, viscoelasticity, and hydration state. Furthermore, we recommend sodium hydrogen carbonate as one of the most useful components of bath preparation because it provides the suppleness, freshness, and smoothness of stratum corneum.

The effects of physical exercise on psychologic variables during mental stress were evaluated. On each of two different days (for intraindividual control) 20 healthy dental students carried out four (modified) d2-tests (3.5min available for each test). After two such tests there was a rest period of 5 minutes. During this intermission either a standardized physical exercise was performed or -the other day- (cross over, balanced) the volunteers rested in a sitting position while listening to relaxing music. After the rest period another two d2-tests were carried out. Thereafter a questionnaire (“adjective list”, in German) defining 15 subscales (categories of the state of well-being) was completed by all volunteers to quantify parameters of their actual mood. For intraindividual control the results of the subscales obtained on both days were compared by the paired student-t-test. In the test with physical exercise during the break the scores of the subscale being activated were significantly (p<0.05) higher than in the test with music. The other subscales showed no significant difference. In all tests the scores of the d2-tests reflecting the capability to concentrate showed an increase after the break, which was significantly higher, if physical exercise was performed during the break. Physical exercise can alleviate certain symptoms of mental stress. Feeling more active is the predominant subjective effect.

Two experiments were performed to clarify the effects of balneotherapy on platelet glutathione metabolism. One experiment, in which healthy men were subjected to water immersion at temperatures of 25°C, 36°C, and 42°C for 10min, showed that the level of platelet lipid peroxides (LPO) tended to increase at 25°C and 42°C, suggesting the presence of oxidative stress at these temperatures. When an antioxidative defense system was induced at these temperatures, the levels of platelet glutathione (GSH), glutathione peroxidase (GPX) and glutathione reductase (GR) activities increased. The other experiment, in which 4 weeks of balneotherapy was applied to type II (non-insulin-dependent) diabetic patients, showed that the level of GSH on admission correlated well with that of fasting plasma glucose (FPG, r=0.692, p<0.050). After 4 weeks of balneotherpy, the level of GSH increased (p<0.01) in well-controlled patients (FPG<150mg/dl) and decreased (p<0.05) in poorly controlled patients (FPG≥150mg/dl), There was a negative correlation between GPX activities and the level of FPG (r=-0.430, p<0.05). After the balneotherapy, the activity increased in five patients, decreased in three patients, and showed no changes in four patients.
These results indicate that, in diabetic patients, 1) platelet GSH synthesis is obviously induced in response to oxidative stress, 2) lowered GPX activities suggest an impaired antioxidative defense system, and 3) platelet glutathione metabolism was partly improved by 4 weeks of balneotherapy but depended on the control status of plasma glucose levels. From these findings, we conclude that 1) patients whose platelet antioxidative defense system is damaged such as those with diabetes mellitus should not take hot or cold bath, and that 2) balneotherapy improves platelet glutathione metabolism, leading to normalization of platelet aggregability.

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.