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This article describes the first reported case of myasthenia gravis (MG) seropositive for both acetylcholine receptor antibody and low-density lipoprotein receptor-related protein 4 antibody, complicated by autoimmune polyglandular syndrome (APS) type 3. The patient exhibited myasthenic weakness restricted to the ocular muscles and ptosis. Severe clinical deterioration ensued with predominant bulbar symptoms. MG rapidly worsened, the patient was intubated, and agranulocytosis due to thiamazole was also present, so it was necessary to perform thyroidectomy with tracheostomy and thymectomy in two phases. Both the double-seropositive MG and the APS were involved in the patient's rapid deterioration.

Graves' disease (GD) and Hashimoto's disease (HD) are autoimmune thyroid disorders distinguished by the presence or absence of antithyrotropin receptor (TSHR) antibodies (TRAb). TSHR gene polymorphisms determine the amount of TSHR expressed, which may in turn influence TRAb production. The FANTOM5 project identified six GD-associated single nucleotide polymorphisms (SNPs) within the enhancer regions of the TSHR and unknown genes. This study examined the association of 11 TSHR and unknown gene polymorphisms, five of which are located in TSHR enhancer regions, with the development and prognosis of GD and HD.SNPs of the TSHR and unknown genes were genotyped in 180 GD patients, including 62 patients with intractable GD and 48 patients with GD in remission; 151 HD patients, including 65 patients with severe HD and 40 patients with mild HD; and 111 healthy controls.The rs4411444 GG genotype and G allele, the rs2300519 AA genotype, and the rs179247 AA genotype and A allele were more frequent in GD patients than they were in controls. These same genotypes and alleles, in addition to the rs2300519 A allele and rs4903961 GG genotype and G allele, were more frequent in patients with intractable GD than they were in controls and patients with GD in remission. Interestingly, the rs2300519 TT genotype and T allele, rs4903961 CC genotype and C allele, and rs179247 GG genotype, all of which are minor genotypes and alleles among the evaluated SNPs, were more frequent in HD patients than they were in controls, but there were no differences in the frequencies of these genotypes and alleles between patients with severe HD and mild HD. Among the evaluated SNPs, the rs4411444 GG genotype and the rs4903961 C allele in the enhancer regions of the TSHR gene were most strongly associated with the development of GD, especially intractable disease, and that of HD, respectively.Among the evaluated TSHR gene SNPs, the rs4411444 GG genotype and the rs4903961 C allele in the enhancer regions of the TSHR gene were most strongly associated with the development of GD, especially intractable disease, and that of HD, respectively.

釣藤散が有効な頭痛の患者タイプを多変量解析により検討した。51名の頭痛患者に対して随証治療にて釣藤散を投与し，このうち1カ月間服用した46名（男性13人，女性33人，中央値48歳，範囲19－77歳，片頭痛31例，緊張型頭痛14例，混合型頭痛1例）を対象とした。随伴症状，体質傾向，舌所見，腹部所見，年齢，性別，身長，体重，高血圧の有無の計38項目を説明変数とし，頭痛改善の有無を目的変数として，多次元クロス表分析により最適な説明変数とその組み合わせを検討した。この結果，単変量解析では，重要な順に「朝の頭痛」，「めまい・ふらつき感」，「不眠」，「体重」，「耳鳴」，「舌下静脈怒張」となった。これは，「朝の頭痛」という口訣を統計学的に支持する結果となった。多変量解析では，「朝の頭痛」，「舌下静脈怒張」と「頸肩こり」の組み合わせが，釣藤散による頭痛改善を予測する最適なモデルとなった。抑肝散証では「背中の張り」を重視するのに対して，釣藤散では「頸肩こり」が頭痛改善を予測する情報として有用であったことは，両者の鑑別に役立つものと考えられた。

Antioxidative effects of Taheebo extract, obtained from the bulk of Tabebuia avellanedae Lorents and Griseb, were examined by two assay methods for radical scavenging activity on DPPH and inhibitory effect on linoleic acid peroxidation. In the case of the DPPH method, Taheebo showed the electron donating ability to DPPH and its ability corresponded to that of trolox in the present experimantal condition. On the other hand, in the autoxidation of liloleic acid, Taheebo extract showed the most inhibitory effect in teas tested (green tea and oolong tea.). These results suggested that Taheebo extract was a desirable antioxidant.

Aim: Premenstrual syndrome (PMS) affects 40–80% of women. Japanese herbal medicine, known as Kampo, is frequently prescribed for PMS, so we examined the efficacy of Kamishoyosan using two methods: first, the second derivative of the fingertip photoplethysmogram (SDPTG) evaluating vascular age (VA), and second, a self-assessment questionnaire on subjective symptoms. Methods: The SDPTG was recorded in 45 patients with PMS (mean ± SD = 32 ± 6 years of age) before (0 M), on the first (1 M) and third (3 M) month of therapy. Patients answered a questionnaire (44 questions) on their complaints every month. The reproducibility of the SDPTG was confirmed with 15 normal volunteers (33 ± 9 years of age). Results: In patients with older VA than their chronological age (Age) before therapy, we found linear correlations of the VA–Age differences at 1 M versus 0 M (y = 0.45x + 1.59, standard error of estimate [SEE] = 6.13 years), and at 3 M versus 0 M (y = 0.18x + 4.09, SEE = 6.03 years). The VA–Age decreased from 11.3 ± 6.4 (0 M) to 6.6 ± 6.7 (1 M) and 6.1 ± 6.0 years (3 M) (P