Pulmonary arteriovenous fistula (PAVF) is a complication of the Glenn shunt. A 57-year-old tetralogy of Fallot (TOF) patient, who had undergone a Glenn shunt and TOF total correction, complained of dyspnea and cyanosis. PAVFs were present in the right lung, and right lung perfusion was nearly absent. After coil embolization, takedown of the Glenn shunt, and reconstruction of the right pulmonary artery, the patient's symptoms were relieved. Extrapulmonary radioisotope uptake caused by the PAVFs shown in lung perfusion scans decreased, and right lung perfusion increased gradually. Although the development and resolution of PAVFs after a Glenn shunt have been reported in the pediatric population, this may be the first report on this change in old age.
Arteriovenous Fistula* ; Cyanosis ; Dyspnea ; Embolization, Therapeutic ; Fontan Procedure ; Hepatopulmonary Syndrome ; Humans ; Lung ; Middle Aged* ; Perfusion ; Pulmonary Artery ; Tetralogy of Fallot*

Medicine, Kampo ; Viral ; Acute ; Therapeutic procedure ; Gastroenteritis

In Kampo medicine, chronic dermatitis is considered to be associated with unstable interaction among Ki, Ketsu and Sui. Urticaria is resistant to standard treatments in modern western medicine, so we applied a Kampo approach to improve imbalance among Ki, Ketsu and Sui. In this paper, we report three cases of chronic urticaria treated with Kampo medicines, i.e., main prescriptions with goshakusan for urticaria with anemia, keishikaryukotsuboreito for urticaria with stress, and bukuryoshigyakuto for cold urticaria with stress. We examined changes in palmoplantar sweating in response to the treatments to evaluate improvement in the circulation of Ki.The importance of Ki, Ketsu and Sui in chronic diseases was emphasized by Nangai Yoshimasu and Gonzan Goto as early as the Edo period. Urticaria is regarded as being due to disturbances of Ketsu and Sui that are often caused by systemic Ki disorders. Therefore, we consider that it is important to improve Ki stagnation in “spleen”, “lung” and “kidney” in the treatment of urticaria.
Urticaria ; Medicine, Kampo ; Systemic ; Dermatologic ; Therapeutic procedure

We report on a case of acute, sport-related back pain treated with pressing moxibustion and acupuncture therapy. A 15-year-old high school freshman fell on his back while shooting a basketball during a game. He felt acute back pain on the second day following his injury. We suspected a fracture and advised him to visit an orthopaedic surgeon, where he was diagnosed with a contusion. Upon return to us, we began acupuncture therapy of his inferior limb acupoints and pressing moxibustion of his contused muscle, while evaluating his pain using a numerical rating scale. He experienced pain relief after the second pressing moxibustion treatment. His numerical pain score changed for the better, and his treatment was ended after the third visit. In cases of pressing moxibustion, moxa sticks are directly pressed onto acupoints protected with non-flammable cloth. In Japan, however, the term moxibustion therapy generally indicates direct moxibustion. Therefore Japanese moxibustion therapists rarely choose the pressing moxibustion therapy option. This case suggests that pressing moxibustion for acute contused wounds or lower back pain is also effective.
Acute ; Back Pain ; Therapeutic procedure ; Pain ; therapeutic aspects

Aims : To clarify any difficulties that pharmacists and nurses may have when prescribing Kampo medicines to newly-admitted patients with a survey questionnaire at a local hospital ward.Methods : Questions for pharmacists on the handling of Kampo herbs, any perceived risks in the preparation of Kampo formulae powder extracts/pills, or in explaining Kampo medicines, based on their experiences. Also questions for nurses on the handling of Kampo medicines, as compared to western medicines, and any perceived risks in their administration at their ward.Result : All 7 pharmacists and 14 out of the 16 nurses surveyed completed their questionnaires. The pharmacists pointed out that Kampo preparation takes more time, although none perceived an increased risk with Kampo medicines, as compared to western medicines. Only 1 pharmacist had ever had experience explaining Kampo medicines to patients. The nurses, on the other hand, felt that Kampo treatments were somewhat more difficult to use, and perceived similar risk in their administration to patients.Conclusion : Both the pharmacists and nurses surveyed believed that the handling of herb medicines was somewhat difficult, but that these difficulties could be overcome with risk management. This suggests that pharmacist, nurse and office personnel education would be useful before Kampo medicines are administered to newly-admitted hospital patients.
Medicine, Kampo ; perceived risk ; seconds ; Therapeutic procedure ; Risk

Medicine, Kampo ; Pulmonary evaluation ; Therapeutic procedure ; Geriatrics

We report a case with various postoperative abdominal symptoms that were successfully treated with Kampo medicine. A 58-year-old Japanese female had nausea, eructation, epigastric pain, lower abdominal pain and anorexia that appeared just after laparoscopic nephrectomy for renal cell carcinoma. No abnormal findings were discovered by gastroenterological examinations. Western medical therapy was not successful. We used bukuryoin under the interpretation that nausea and eructation represent phlegm-fluid retention in the chest. The bukuryoin therapy cleared up her nausea and eructation in about one week. Additionally, her epigastric pain, lower abdominal pain and anorexia were cured by use of anchusan.
Therapeutic procedure ; Medicine, Kampo ; symptoms <1> ; Postoperative Period ; Nausea

We investigated the clinical efficacy of concomitant Kampo treatments, expected to have immediate effect in improving outcomes with western drug therapies for Japanese cedar pollinosis. Twenty cases using shoseiryuto, considered a first-line drug for allergic rhinitis, were studied. The resultant efficacy rate was 45%. The efficacy rate for 24 cases using eppikajutsuto, by contrast, was 64%. The latter cases demonstrated far better therapeutic result than the former. In 7 cases using maoto + eppikajutsuto (as simplified daiseiryuto), another prescription we often use for serious illness, the resultant efficacy rate was 72%. Of these, the most favorable effect resulted in 16 cases using shoseiryuto + gokoto, which resulted in an efficacy rate of 87%. We had originally developed this prescription in order to improve the effectiveness of mao and sekko as anti-inflammatories. There were no cases where patients needed to be dosed with an oral steroid. The only notable event was one patient who complained of stomachache as an adverse drug reaction. In conclusion, we can say that the overall therapeutic outcome with 11 different Kampo medicines was extremely satisfactory: an efficacy rate of 83%. These marked improvements in clinical efficacy were made by using Kampo medicines together with a western drug used for the treatment of Japanese cedar pollinosis.
Medicine, Kampo ; Japanese language ; Clinical ; Therapeutic procedure ; Western Herbs and Botanicals

Recently, the number of athletes who receive acupuncture therapy is increasing. However, most of these athletes receive acupuncture therapy with single-acupuncture and/or electro-acupuncture to a local point, or a trigger point. We experienced two water polo athletes who were improved using acupuncture and moxibustion therapy with “zuisho” therapy. Case 1 was 16 year old man. He became aware of pain in his right thumb after training, which continued with extended training time, a numbness in his left hand appeared more, and he received acupuncture and moxibustion therapy. These symptoms disappeared immediately with acupuncture and moxibustion therapy using the standard traditional methods, such as contact needling to a yuan point, and in situ acupuncture to a back shu point, etc. Case 2 was 17 year old man. He received acupuncture and moxibustion therapy for lumbago and stiffness of the neck. These symptoms disappeared immediately after acupuncture and moxibustion therapy using the standard traditional methods such as contact needling to a yuan point, and inserting needles into a back shu point, an extra meridian, etc. In these two cases, symptoms were improved with “zuisho” therapy, and both could continue with longer and more strenuous training. This suggests that acupuncture and moxibustion therapy using the standard traditional methods are useful for athletes.
Acupuncture ; Therapeutic procedure ; symptoms <1> ; Training ; Water

Two brothers with nocturnal enuresis, aged 8 and 7 years, were brought to our clinic. They had had nocturnal enuresis since early childhood, necessitating the use of disposable diapers every night. Their past histories were unremarkable, and a family history revealed that their father had experienced the same disorder until he was 12 years of age. On physical examination, we noted hypertonic abdominal muscles and high sensitivity to tickling in the 8-year-old boy, and no remarkable finding in the 7-year-old boy. Initially, the elder brother was treated with saikokeishito extract ; the younger brother, with kakkonto extract. Because these extracts were ineffective, rokumigan extract was later added. The combination therapies cured the nocturnal enuresis in both the children. The fact that these patients were brothers and that their father had the same disorder as a child indicates that the cause of nocturnal enuresis observed in the parent and the siblings might be related to “kidney qi deficiency”.
Enuresis ; Brother, NOS ; Therapeutic procedure ; success ; Night time