Introduction: Recent advances in cancer therapy have enabled long-term survival even in patients with advanced disease; however, chronic postoperative pain and other long-term treatment-related adverse effects have emerged as new challenges. Here, we report a case in which spinal cord stimulation (SCS) was introduced for post-thoracotomy pain syndrome (PTPS) following thoracic malignancy surgery, successfully achieving pain relief and opioid dose reduction in a patient with established opioid dependence. Case: The patient, a 32-year-old woman, developed persistent neuropathic pain after surgery. Some pharmacologic therapies were ineffective, leading to increased opioid use and eventual dependence. Following SCS implantation, pain improved with marked improvement in activities of daily living. Conclusion: SCS represents an effective option for intractable pain such as PTPS and may contribute to improved quality of life and reduced opioid reliance in cancer survivors.

PURPOSE: Bupivacaine is commonly used for the treatment of back pain and the diagnosis of its origin. Nonunion is sometimes observed after spinal fusion surgery; however, whether the nonunion causes pain is controversial. In the current study, we aimed to detect painful nonunion by injecting bupivacaine into the disc space of patients with nonunion after anterior lumbar interbody fusion (ALIF) surgery for discogenic low back pain. MATERIALS AND METHODS: From 52 patients with low back pain, we selected 42 who showed disc degeneration at only one level (L4-L5 or L5-S1) on magnetic resonance imaging and were diagnosed by pain provocation on discography and pain relief by discoblock (the injection of bupivacaine). They underwent ALIF surgery. If the patients showed low back pain and nonunion 2 years after surgery, we injected bupivacaine into the nonunion disc space. Patients showing pain relief after injection of bupivacaine underwent additional posterior fixation using pedicle screws. These patients were followed up 2 years after the revision surgery. RESULTS: Of the 42 patient subjects, 7 showed nonunion. Four of them did not show low back pain; whereas 3 showed moderate or severe low back pain. These 3 patients showed pain reduction after injection of bupivacaine into their nonunion disc space and underwent additional posterior fixation. They showed bony union and pain relief 2 years after the revision surgery. CONCLUSION: Injection of bupivacaine into the nonunion disc space after ALIF surgery for discogenic low back pain is useful for diagnosis of the origin of pain.
Back Pain ; Bupivacaine* ; Diagnosis ; Humans ; Intervertebral Disc ; Intervertebral Disc Degeneration ; Low Back Pain* ; Magnetic Resonance Imaging ; Methods ; Spinal Fusion ; Spine

Case: Cancer patients without impaired glucose tolerance developed hypoglycemia during the administration of quetiapine. After increasing the amount of the drug, hypoglycemia was developed in the wake of fasting. Discussion: There is a possibility that quetiapine inhibited the hypoglycemic compensatory reactions during starvation. Conclusion: In cancer patients taking quetiapine, it is necessary to observe the onset of symptoms of hypoglycemia as well as hyperglycemia in mind. And blood glucose measurement on a regular basis is desirable.

Academic dissertations on Kampo medicine have a certain peculiarity about them, when they are drawn up by the rules of western medical writing. Compared to western medicine, oriental medicine tends to employ more subjective terms, because of its many humanistic elements.Study objectives, methods, results and discussions however, need to be stated objectively in a way that makes a paper easy to understand for both referees and readers. Although it would be ideal to use designated terms when making objective statements, there are in fact many terms that have multiple meanings, which need to be clarified in a paper. And when presenting new evidence, one must declare how far any problems have been resolved, as clearly as possible.We have explained the recent changes to our regulations for contributors, regarding Kampo formulae naming conventions, abstract word counts, and contributions by mail. Here we discuss how our editing work proceeds, and our thoughts on how papers are re-reviewed or rejected.
Medicine, Kampo ; Medicine ; Academic Dissertations [Publication Type] ; counts ; Review [Publication Type]