Hiccups can sometimes become intractable. We report two cases of hiccups in which acupuncture practices to the lump of the infraspinatus muscle (Terasawa point) were effective. Case 1 was an 85-year-old male, an inpatient with bacterial pleuritis. His hiccups had persisted for 11 days. Several pharmacotherapeutic approaches were partially effective, but the hiccups were not completely abolished. In situ acupuncture therapy to bilateral Terasawa points was done, and his hiccups disappeared the next day. Case 2 was a 68-year-old male. He experienced insufficient sleep due to hiccups. We inserted needles into bilateral Terasawa points and heated the surrounding area with an electrothermo-acupuncture device using a curved heating plate. When this combination therapy was done, his hiccups disappeared during treatment. Acupuncture at the Terasawa point is one of the therapeutic approaches for hiccups and a rapid effect can be expected.

A 59-year-old man, diagnosed with severe mitral regurgitation, moderate tricuspid regurgitation, and chronic atrial fibrillation with situs inversus totalis, was referred to our hospital. A median sternotomy approach was performed. The surgeon operated from the left side of the operating table, and had an excellent exposure to the mitral and tricuspid valves during the operation. The mitral valve was repaired with the posterior cusp plication technique and ring annuloplasty. The tricuspid valve was repaired with ring annuloplasty. We use a conventional semi rigid ring turned over, because the tricuspid valve has an asymmetric configuration. FullMAZE, and left atrial appendage closure were performed, too. The postoperative course was uneventful.

We report four cases of anxiety disorder where psychiatric symptoms were effectively treated with combination therapy utilizing keishikaryukotsuboreito and kanbakutaisoto, which are two herbal formulas. The patients had common symptoms and experienced episodes leading to emotional stress. Moreover, in all four cases aggravation of psychiatric symptoms due to emotional stress, re-experience and memory retrieval were commonly observed. Additional treatment with kanbakutaisoto was effective for such aggravation. On the objective assessment, rapid pulse, deficient pulse, weak abdominal strength and brisk pulsation in the supraumbilical region were present. Yawning was not necessarily present. There are many patients with anxiety disorder or mental disorder associated with emotional stress, and Kampo treatment is often considered to be effective for these cases. However, a single administration of Kampo extract formulae does not often provide adequate results. When a single Kampo administration is ineffective, the combination of keishikaryukotsuboreito and kanbakutaisoto may be useful.