1.Our Diagnostic Approach of Oriental Medicine to the Headache
Takeshi KUSUMI ; Michinari OKAMOTO
Journal of the Japan Society of Acupuncture and Moxibustion 1983;32(3):233-239
Headache is a common symptom frequently encountered by clinicians. According to epidemiological surveys at home and abroad, 60-70% of even healthy people have experienced some form of headache. It is remarkably diverse in nature, occurring singly in some cases and as a prodrome of a serious disease at its worst, and hard to grasp objectively.
We performed the oriental medical tests used by us in otorhinolaryngology (auscultation of vascular murmur, reaction elicited by the compression of carotid artery, puncture of stellate ganglion, measurement of facial skin temperature) on patients with headache, and obtained useful findings for diagnosis, selection of treatment and prognosis.
Vascular murmur and reaction to the compression of carotid artery were frequently detected in angiopathic headache or headaches associated in some way with vascular factors, and present on the side involved in headache in the majority of cases. The puncture of stellate ganglion can induce the alleviation of headache or its aggravation or recurrence. This change occurred most frequently in angiopathic headache, and next most frequently in post-traumatic headache. In patients who felt tenderness in the region of stellate ganglion on palpation of the neck, the puncture of stellate ganglion frequently induced a change, mostly to the worse, in headache. The facial skin temperature differed between the right and left side, and was frequently low on the affected side of the forehead or the cornea. It had a characteristic distribution in patients with headache who exhibited high temperature suggestive of inflammation. The skin temperature of the nose, moreover, tended to be higher in patients with headache as compared with normal subjects.
The results of tests performed by us on patients with headache are described above. They suggest that diagnosis from the standpoint of oriental medicine will be improved if the test results are suitably combined to grasp the pathologic process more accurately.
2.Trnsition of Nasal Obstruction and Temperature of Nasal Skin Area by Electric Acupuncture
Takeshi KUSUMI ; Michinari OKAMOTO
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 1982;45(3-4):68-75
By using the relation between nasal-obstruction and nasal skin temperature, the subjective change of nasal obstruction and the change of temperature in nasal skin area by thermography, coursed by 10 minutes electric acupuncture (Gohkoku-Naikan), were mutually connected with posture. So, that two changes between sitting posture and supine position was reported here. The subjects were patients with hyperesthetic rhinitis chiefly omplaining nasal obstruction.
The results; The sitting position was effective in subjective change of nasal obstruction and also it kept the nasalskin temperature low. In case of the subjects of an electric acupuncture after stellate ganglion block in sitting posture, no change of nasal obstruction and nasalskin temperature was recorded.
3.The Effects of Stellate Ganglion Stimulation and Stellate Ganglion Block for Tinnitus
Takeshi KUSUMI ; Kazuyuki HORIUCHI ; Michinari OKAMOTO
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 1981;45(2):1-5
The relationship between the subjective changes in tinnitus and recovery of the hearing loss was studied by applying SG (Stellate Ganglion) stimulation or SGB for the same patient. The results obtained are as follows.
1. Subjective tinnitus either decreased or increased in many cases after SG stimulation and SGB.
2. Application of SG stimulation or SGB for the same patient resulted in similar changes in many cases.
3. Tinnitus associated with sudden deafness increased in many cases after SG stimulation or SGB.
4. Tinnitus showed no change after SG stimulation or SGB in cases of fresh sudden deafness in which the hearing was not restored.
5. SG stimulation and SGB are supposed to be contrary to each other in the effect on the sympathetic nerve, but the two showed similar effects so far as tinnitus is concerned.
By effects SG stimulation and SGB therefore, one can estimate the individual difference, pathological phenomenon and the ability to response of the patients.
4.Relations Between Facial Pain and Acupuncture.
Takeshi KUSUMI ; Mari KUSUMI ; Takayuki HAGA ; Naohiko WATANABE ; Takehiko SANBE ; Hideo ASAGA ; Michinari OKAMOTO
Journal of the Japan Society of Acupuncture and Moxibustion 1993;43(1):7-13
Aim: AS stated in the past reports that approx, 75% of hralthy adulte have experienced it, headache is a symptom often experienced in the crinical peactice of acupuncture.
Effects of acupunctural therapy against headache hace already been reported in many cases, but few reports hace been published so far on the use of acupunctural stimulation for the purpose of diagnosis. In the past 15 years, we used the acupunctural stimulation dor diagnosis of tinnitus and headache and ecaluated the meanings of uts use.
In the present study, we examind the cases whose pains could be reproduced by the acupunctula stimulation in the patients with pain who were introduced to us for diagnosis from the Department of otorhinolaryngology of our hospital.
Ptients and method: Of the patients with pain as the chige complaints whise diagmoses were requested to the Oriental Medicine clinic from the Department of Otorhinolaryngology of Showa University since April 1982 up until October 1990, thise whi complained of facial pain were subjected to our diagnosis, previding that they had no abnormalities in the otorhinolaryngological and ophthalmological checks.
A stainless steel needle (50mm Mo. 20) was usedfor theusting into block points of greater occiptal nerce and the possible relationship between the pain and the sense of reacting sense was examind at the time of thrusting.
Results: 1) It could be reconfirmed that the reacting sensation was produced deep in the inner part and in the epicanthal area of eyes by the neadle thrusting to block points of the greater occipital berce. 2) Ammong the patients who had been teated nefor against trigeminal neuralgia or what were claimed to be pains of eyes of buknown causes, there were cases withe pains coincidental with pathological symptoms such a manner that the reacting sensation by the neadle thrusting (1) resembled the nature of the pain and (2) wads coincidental with that of the affected regions, and (3) the pain could be reproduced by the acupunctural stimulatiom in synchronization with the acupuncturalhandling of the neadle. 3) The efficary of the acupunctueal treatments was higher in those whose pains could be reproducedby the acupunctueal stimulation.
Summaary: The stimulations to the block points of the greater occipital berve caused reacting sessation deep in the inner part of eyes. By utilizing this sensation for diagnostic purposes, sone cases could be properly diagnosed. On the ground of these fundungs it can be claimed that the acupunctueal stimulation according to the method in our present study would be one of the useful methods for cheeck of the pain and also for therapeutic treatment in view of the therapeutic meanings of the findings described in the subparagraphe of (1) through (3) in the paragraph 2) and in the paragraph 3) of the above-mentioned “Results”.
5.Skin temperature change as a resalt of PCP-S application.
Takeshi KUSUMI ; Kasie ISHII ; Mari KUSUMI ; Hideyo ASAKA ; Michinari OKAMOTO ; Hiroyuki ZUSHO
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 1987;50(3):121-138
Attention has been focussed more in recent years on health control for the middle/advance-aged, in the midst of so-called aged society or complicated society. As one of the measures, sports with the purpose of health promotion/stress removal have been more vigorously made, contrary to which, sporting disturbances, accompanied by abrupt sports, are on the increase. Many cases, however, with muscular pain and light joint sprain etc. are treated personally with poultices/adhesives of a chilling type, while various warming adhesives with its warming therapy happen to demonstrate an effect or another against chronic stiff shoulder and lumbago, due to long-lasting stress. Nowadays, adhesives of both such chilling and warming types are available on market; muscular pains and stiffness being practically treated casually with warming therapy (warming sensation).
The warming effect of PCP-S was investigated by using thermography, the result of which runs as follows.
1. Application of PCP-S adhesives caused a clear dermal temperature increase, with a significant difference from the un-treated control and the side opposite to the applied.
2. The comparison between PCP-S and O-S, removed of its active extract, proved a skin temperature increase due to capsicum extract and not due to a change in dressing the dermal surface of the skin.
3. Result of the comparison in temperature increase between the application for 60 minutes and 120 minutes recognized the peak to occur at 60-70 minutes.
4. A more significant dermal warming effect was seen on main body than on upper limbs.
5. Sensation of warming, prickling and light pain sensation occurd in that order, with no suspension of its application due to pain.
6.Effects of electric acupunctural stimulation through one hand against reactions in the vascular system in nasal mucosa due to changes in physical position.
Takeshi KUSUMI ; Mari KUSUMI ; Masako TERASAKI ; Fumio ISHIZAKI ; Hideyo ASAKA ; Michinari OKAMOTO
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 1990;53(3):153-158
Effects of electric acupunctural stimulation though one hand against reactions in the vascular system in nasal mucosa due to changes in physical position were examined in the present study. The results are as followed;
1) That the reactions in the vascular system in nasal mucosa by changes in physical position indicated a rise in the resistance in the nostril which was made the lower side and a drop in the resistance in the nostril which was made the upper side and that this finding had reproducibility.
2) That no rise in the resistance in the nostril was found out even when the nostril treated in advance with adrenalinon its mucosa was made the lower side in the lateral decubitus, but that the resistance in the untreated nostril (with adrenalin) rose up when it was made the lower side.
3) That the electric acupunctural stimulation through one hand caused no adverse effect upon the rise in the resistance in the nostril on the lower sidle in the lateral decubitus, thought it was the side given the stimulation.
7.Electromyographic Changes Induced by Caloric Stimulation of the Semicircular Canals and by Neck Movement. Investigation of the F wave on the evoked electromyograms of the upper extremity and the surface electromyograms of the posterior cervical region.
Nobuyoshi KOIWA ; Kazuki TOKORO ; Masahide MACHIDA ; Taichi TABATA ; Okuto KIMURA ; Tomohiko YAMAMOTO ; Shin TORISAWA ; Takeshi KUSUMI ; Naohiko WATANABE
Journal of the Japan Society of Acupuncture and Moxibustion 2000;50(3):439-449
We assumed that changes in the excitability of motor nerves play some role in the stiffness of the neck, shoulders, and extremities in patients with vertigo. To obtain a better understanding of this phenomenon, we stimulated the receptors involved in body equilibrium with external stimuli, i.e., 1) caloric stimulation of the semicircular canals and 2) neck movements, and investigated changes in the F wave and the surface electromyogram (S-EMG) of the posterior cervical region.
The subjects were 40 healthy adults. Caloric stimulation of the semicircular canals was performed by infusing15°C water, and changes in the F wave examined. In addition, changes in the S-EMG by stimulation at temperatures of 5°C or 44°C were investigated. We examined changes in the F wave by the neck movements in association with theresults of the blindfold ed vertical writing test. The F wave of a patient with vertigo was also examined.
During vertigo induced by caloric stimulation of the semicircular canals, the excitability of the F wave on both the stimulated and non-stimulated sides increased, the S-EMGs showed decreased excitability on both the stimulated and non-stimulated sides during maximum voluntary contraction in the subject who experienced severe vertigo, nystagmus, and nausea. The changes in the F wave induced by the neck movements were small. However, excitability increased more significantly during posterior flexion than during other movements, and the angle of deviation of the letters written blindly tended to deviate most markedly toward the left during posterior flexion. The F wave of the patient with vertigo showed excitability, but it tended to decrease as the vertigo diminished.
These findings suggest that vertigo is accompanied by changes in the excitability of motor nerves. These changes are somehow related to the muscle stiffening that results from vertigo.
8.Approach for Advanced Cancer Patients with Bone Metastases by the Bone Metastasis Board: A Single-institution Retrospective Study
Masahiro KAWAHIRA ; Fumihiko NAKAMURA ; Hirofumi SHIMADA ; Mariko NISHI ; Takahiro IWATSUBO ; Takako SHIOMITSU ; Hiroshi MAEDA ; Ayaka OSAKO ; Kunihiro MIYAZAKI ; Yusuke KUSUMI ; Akitoshi MURATA ; Hiroko OSAKO ; Takeshi HORI
Palliative Care Research 2023;18(1):61-66
Prevention, early diagnosis, and early treatment of skeletal-related events (SREs) are important in the treatment of potential or current cases of bone metastasis. In August 2020, our hospital established the bone metastasis team and the bone metastasis board (BMB) started actively engaging in activities aimed at improving the outcome of bone metastasis. We retrospectively examined whether a combined modality therapy started in the diagnosis of bone metastases could prevent the onset of SREs and whether it could prolong survival and improve activities of daily living. The 75 advanced cancer patients who underwent BMB at our hospital from August 1, 2020 to July 31, 2022 were divided into two groups according to when BMB performed before and after SREs for comparative analysis. Numerical Rating Scale improved, however Performance Status did not improve in both groups, and there was no difference in survival between the both groups (15.3 vs. 9.0 months, HR: 0.74, 95%; CI: 0.42–1.29, p=0.29). In conclusion, patients who suffered from SREs from the time of bone metastasis diagnosis were treated early. However, the incidence of SREs after BMB in our hospital was 22.6%, and it is necessary to actively work to prevent SREs in the future.