Treating tinnitus with modern Western medicines is difficult. Several studies have reported that Kampo medicines are efficacious for treating tinnitus, and therefore, it is expected that these medicines will gain widespread use in the future for tinnitus treatment. We retrospectively examined the efficacy of Kampo medicines prescribed on the basis of Kampo diagnoses for chronic tinnitus patients. The study population included 331 patients (114 men, 217 women) and average age was 57.8 years. The overall effective rate of Kampo medicines in tinnitus was 38.4% and increased to 64.6% after including effects for the accompanying symptoms (e.g., dizziness, insomnia, and headache). Hangekobokuto was prescribed most frequently. The effective rate for hangekobokuto in tinnitus was 32.1% and significantly increased when it was used in combination with a herb, chotoko (Hook of Uncaria, rhynchophylla Miquel) (p < 0.05, Fisher's exact test). The effects and modern pharmacological action of chotoko indicate that it may be effective for tinnitus. Given that tinnitus was intractable in study subjects who had been treated using other therapy approaches earlier (84% of the population), the findings indicate that Kampo medicine may be partially effective for tinnitus.

Dizziness and vertigo are frequent complaints in the clinic, but standardized treatments have not yet been established. Here we report three cases of dizziness and vertigo successfully treated with takushato. Case 1 involved a 38-year-old woman who experienced dizziness, which had made her feel as if she was sea sick for 2 years, and which was worsening. After taking takushato for a month, her dizziness improved.Because she complained of an abnormal pharyngeal sensation, her prescription was changed to hangekobokuto in combination with takushato, and her dizziness almost disappeared 2 months after her first visit. Case 2 involved a 61-year-old woman who had had dizziness and vertigo for 4 months. Although no abnormality was observed on MRI, she developed labile vertigo a few days later. After taking takushato for a month, she felt no dizziness or vertigo at all. Case 3 involved a 67-year-old woman in whom labile vertigo had developed even while supine for 2 months, and although receiving medication for a diagnosis of benign paroxysmal positional vertigo, did not improve. Triple dose takushato was remarkably effective, and improved her otological findings. Takushato is one hopeful option for the medical treatment of refractory dizziness and vertigo.

Takushato is a Kampo formula used for the treatment of dizziness and vertigo. Signs and symptoms suggestive of fluid retention have been regarded as clinical indications for takushato administration, but it is not clear if improvement of these signs and symptoms is related to the clinical efficacy of takushato, so we analyzed the correlation among these factors. Twenty patients who suffered from dizziness and vertigo were treated with takushato for 4 weeks. Before and after treatment, subjective symptoms and objective data including vestibular function tests were assessed, and correlation among the factors was analyzed. Improvement of patients' total symptoms was significantly correlated with improvement of fluid retention scores. Furthermore, improvement in vestibular function tests showed a trend toward correlation with that of fluid retention scores.These results suggest that improvement in the signs and symptoms of fluid retention is related to the clinical efficacy of takushato. We conclude that the presence of fluid retention is a reasonable clinical indication for takushato administration.

OBJECTIVE: Many studies have reported pre-processing effects for brain volumetry; however, no study has investigated whether non-parametric non-uniform intensity normalization (N3) correction processing results in reduced system dependency when using an atlas-based method. To address this shortcoming, the present study assessed whether N3 correction processing provides reduced system dependency in atlas-based volumetry. MATERIALS AND METHODS: Contiguous sagittal T1-weighted images of the brain were obtained from 21 healthy participants, by using five magnetic resonance protocols. After image preprocessing using the Statistical Parametric Mapping 5 software, we measured the structural volume of the segmented images with the WFU-PickAtlas software. We applied six different bias-correction levels (Regularization 10, Regularization 0.0001, Regularization 0, Regularization 10 with N3, Regularization 0.0001 with N3, and Regularization 0 with N3) to each set of images. The structural volume change ratio (%) was defined as the change ratio (%) = (100 x [measured volume - mean volume of five magnetic resonance protocols] / mean volume of five magnetic resonance protocols) for each bias-correction level. RESULTS: A low change ratio was synonymous with lower system dependency. The results showed that the images with the N3 correction had a lower change ratio compared with those without the N3 correction. CONCLUSION: The present study is the first atlas-based volumetry study to show that the precision of atlas-based volumetry improves when using N3-corrected images. Therefore, correction for signal intensity non-uniformity is strongly advised for multi-scanner or multi-site imaging trials.
Adult ; Atlases as Topic ; Brain Mapping/*methods ; Female ; Humans ; Image Enhancement/methods ; Image Processing, Computer-Assisted/*methods ; Magnetic Resonance Imaging/*methods ; Male ; Middle Aged ; Software ; Statistics, Nonparametric

Pneumonia is common among elderly patients and the incidence among older adults is increasing in aging societies. If pulmonologists were to treat all cases of pneumonia, their work volume would be immense and the risk of burnout would increase. We reviewed cases of consecutive patients 70 years of age or older who were treated for pneumonia between November 2017 and October 2018 at Akita Kousei Medical Center. Of a total of 372 patients recruited for this study (214 men, mean age 85.6 years), 288 patients recovered and 84 (29.2%) died. The duration of admission differed significantly between the cardiovascular department and surgery department (p=0.03), between the renal unit of the internal medicine department and the neurosurgery department (p=0.01), and the renal unit of the internal medicine department and the surgery department (p=0.0005). Outcome was not significantly different among departments. It is crucial that pulmonologists and non-pulmonologists collaborate to treat pneumonia in old adults.