Herbal medicines have been used in Japan for more than 1500 years and traditional Japanese medicines (Kampo medicines) are now fully integrated into the modern healthcare system. In total, 148 Kampo formulae are officially approved as prescription drugs and covered by the national health insurance system in Japan. However, despite their long track record of clinical use, the multi-targeted, multi-component properties of Kampo medicines, which are fundamentally different from Western medicines, have made it difficult to create a suitable framework for conducting well-designed, large-scale clinical trials. In turn, this has led to misconceptions among western trained physicians concerning the paucity of scientific evidence for the beneficial effects of Kampo medicines. Fortunately, there has been a recent surge in scientifically robust data from basic and clinical studies for some of the Kampo medicines, e.g., daikenchuto (TU-100). Numerous basic and clinical studies on TU-100, including placebo-controlled double-blind studies for various gastrointestinal disorders, and absorption, distribution, metabolism and excretion (ADME) studies, have been conducted or are in the process of being conducted in both Japan and the USA. Clinical studies suggest that TU-100 is beneficial for postoperative complications, especially ileus and abdominal bloating. ADME and basic studies indicate that the effect of TU-100 is a composite of numerous actions mediated by multiple compounds supplied via multiple routes. In addition to known mechanisms of action via enteric/sensory nerve stimulation, novel mechanisms via the TRPA1 channel and two pore domain potassium channels have recently been elucidated. TU-100 compounds target these channels with and without absorption, both before and after metabolic activation by enteric flora, with different timings and possibly with synergism.

67of the 30 cases had seizures at the time of divorce and nine (30%) had neuropsychiatric complications. Seven cases (two men and five women) had divorced because of having epilepsy or epileptic seizures. Six (86%) of the seven cases had not informed their spouses that they had epilepsy.Conclusions: In this study, we determined that epileptic seizures and neuropsychiatric complications have negative effects on social status. We emphasize that both seizures and neuropsychiatric complications should be carefully managed to improve the QOL in adult patients with epilepsy. A more aggressive therapy, such as treatment with new antiepileptic drugs and surgical treatment, should be considered when poor social prognosis is anticipated. ).Purpose: Angelman syndrome is now diagnosed appropriately because of the development of the fluorescence in situ hybridization (FISH) method. We encountered two cases of this syndrome, and the follow-up studies until adulthood produced some interesting clinical findings.Case Reports: Case 1 was a 23-year-old man. Albinism, delayed speech development, hyperactivity, avoidance of eye contact, and hypersalivation were noticed. Cerebral palsy -was suspected. He could walk independently by age 2 years but could not speak a single word. At age 3 years, epileptic seizures developed and were observed frequently until age 10 years. At that time, his condition was consistent with epilepsia partialis continua because of tremors of the left hand and a continuation of the electroencephalographic (EEG) findings of spikes on the midtemporal and right central regions. The epileptic attacks were controlled with clonazepam (CZP). A constant happy demeanor has been noticed but outbursts of laughter have not been observed. Diffuse high-amplitude slow-wave activity with intermittent spike-wave discharges, which are the characteristic EEG features of Angelman syndrome, disappeared and spike-wave-like discharges over the frontal area were observed thereafter. The present clinical features are severe intellectual disability, happy disposition, clumsy and awkward gait without palsy, oculocutaneous albinism, and semiopened large mouth with protruding tongue and salivation. A chromosomal analysis disclosed 46XYde1(15)(qI l.lql2), and the FISH method detected the deletion of the signal SNRNP.Case 2 was a 20-year-old man. Intellectual disability and hyperactivity had been noticed since infancy. Cerebral palsy was suspected. He could walk independently by 3 years and 6 months but could not speak a single word. The initial epileptic seizure occurred at age 2 years and 7 months. However, no seizures were observed after age 9 years. He has had a constant happy demeanor but no outbursts of laughter. At the present, he shows severe intellectual disability, happy disposition, clumsy and awkward gait without palsy, hypopigmented skin color, and semiopened large mouth with protruding tongue and salivation. EEG examination during childhood revealed the characteristic EEG activities of Angelman syndrome, diffuse high-amplitude...

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