Herb supplies can become unstable because of climate change and the economic development of herb exporters. In this paper, in order to increase the self-sufficiency of herbal resources we examined the possibil ity of changing to herb crop production from tobacco, for which demand is declining. Firstly, we considered demand, quality and the price of raw herb materials to make recommendations for corrections, and selected Angelica (A. ) acutiloba and Bupleurum (B. ) falcatum Linne. Next, we compared the profitability of tobacco and the herbs. Profit margins for A. acutiloba were less than for tobacco. It was thought that the profitability of A. acutiloba could become equivalent to tobacco if an adjustment subsidy were provided. The self-sufficiency rate for A. acutiloba would be one hundred percent with 35 million yen in every year. Although the profitabil ity of B. falcatum has exceeded tobacco, its selling price was about 3 times that of imports, while the price of medical B. falcatum was lower than its selling price. It was thought that the price competitiveness problem of B. falcatum can be covered if a production subsidy is provided, and to reach a 50 percent B. falcatum self sufficiency rate with 660 million yen per year.

Clozapine is well-known for successful use in schizophrenic patients treatment resistant to other antipsychotics. However, even with clozapine, 25% of schizophrenic patients are not in remission. Recently, as adjunctive treatment with clozapine, electroconvulsive therapy has been reported to be an effective and safe adjunctive treatment. We report a Japanese schizophrenic woman who was not in remission with clozapine alone but with both clozapine and electroconvulsive therapy.
Antipsychotic Agents ; Asian Continental Ancestry Group* ; Clozapine* ; Electroconvulsive Therapy* ; Female ; Humans ; Lithium ; Schizophrenia*

Nasu-Hakola disease (NHD) is a rare autosomal recessive neuropsychiatric disorder characterized by bone cysts, fractures, and cognitive impairment. Two genes are responsible for the development of NHD; TYROBP and TREM2. Although it presents with typical signs and symptoms, diagnosing this disease remains difficult. This case report describes a male with NHD with no family or past history of bone fractures who was diagnosed using exome sequencing. His frontal lobe psychiatric symptoms recovered partially following treatment with sodium valproate, but not with an antipsychotic.
Bone Cysts ; Consanguinity* ; Exome* ; Fractures, Bone ; Frontal Lobe ; Humans ; Male ; Sodium* ; Valproic Acid*

Along with clinical practice and education, research is among the most important activities for medical doctors. The same is true in cardiovascular surgery: Young cardiovascular surgeons are expected to improve their surgical techniques and prioritize their clinical practice. However, their perspective on the role of research in their field of expertise is unknown. Therefore, we conducted a survey of and discussion with young cardiovascular surgeons to clarify their thoughts and concerns about performing research. Here we review and report the survey and discussion results.

Schizophrenic patients resistant to antipsychotics are diagnosed as having treatment-refractory schizophrenia, and they are treated with clozapine. However, clozapine is sometimes combined with electroconvulsive therapy (ECT) if clozapine monotherapy fails. In this report, a severe treatment-refractory schizophrenic patient who did not respond to clozapine even with ECT, but who recovered with asenapine monotherapy, is presented. Asenapine, considered a serotonin spectrum dopamine modulator, is a new atypical antipsychotic with unique pharmacological features that is used not only for schizophrenia, but also for bipolar disorder. The unique features of asenapine may be effective for some treatment-refractory schizophrenic patients.
Antipsychotic Agents ; Bipolar Disorder ; Clozapine ; Dopamine ; Electroconvulsive Therapy ; Humans ; Recurrence ; Schizophrenia ; Serotonin ; Suicide

OBJECTIVE: Donepezil is used to improve cognitive impairment of dementia with Lewy bodies (DLB). Visuo-spatial dysfunction is a well-known symptom of DLB. Non-verbal Raven’s Colored Progressive Matrices (RCPM) were used to assess both visual perception and reasoning ability in DLB subjects treated with donepezil. METHODS: Twenty-one DLB patients (mean age, 78.7±4.5 years) were enrolled. RCPM assessment was performed at the time of starting donepezil and within one year after starting donepezil. RESULTS: There were significant improvements of RCPM in the total scores between one year donepezil treatment (p=0.013), in both Set A score (p=0.002) and Set AB score (p=0.015), but trend in the Set B score (p=0.083). CONCLUSION: Donepezil is useful for improving visuo-spatial impairment in DLB, but not for problem-solving impairment.
Cholinesterase Inhibitors ; Cognition Disorders ; Dementia* ; Humans ; Lewy Bodies* ; Lewy Body Disease ; Spatial Processing ; Visual Perception