Videofluoroscopic examination of swallowing (VF) is widely used for evaluating swallowing function. However, pulmonary complications after VF are seldom evaluated. We checked residual barium sulfate on chest X-rays and early pulmonary complication after VF. One hundred and ninety-eight patients underwent VF and chest X-rays. Eighty-six patients who did not aspirate during VF had no residual barium on their chest X-rays. One hundred and twelve patients aspirated during VF, but only 40 of these patients showed residual barium on their chest X-rays. Ten patients had fever after VF, but no significant relationship was observed between fever and residual barium on chest X-rays or aspiration. Aspiration was not correlated with mobility or cognitive status. One case had pneumonia after VF, but VF did not seem to be the cause of the pneumonia. In conclusion, no severe early pulmonary complications after VF were observed. It is difficult to predict early pulmonary complications from chest X-rays.

Traditional western medical diagnosis and treatment strategies for a patient with persistent anorexia and weight loss failed to yield any positive results, and thus we changed to an eastern treatment modality employ­ing the use of byakkokaninjinto, which resulted in successful treatment of the anorexia and its associated symptoms. An 83-­year-­old man presenting with phlegm and anorexia visited our hospital. Upon examination, we iden­tified subpleural ground-­glass and reticular opacities via chest CT. The patient was diagnosed with idiopathic interstitial pneumonia in the outpatient setting. Due to persistent anorexia and weight loss, we conducted thor­ough examinations of gastrointestinal system to supplement our overall workup ;however, the cause of the anorexia could not be identified. Meanwhile the patient lost 30 kg within a span of 6 months and was hospital­ized. He failed to present with any neurological disorders, collagen/endocrine disease or mental illnesses. A full systemic review was unable to identify the cause of the underlying anorexia but we focused on the pa­tient's complaint of coldness in the neck, upper limbs, ankles/feet and abnormal warmth in the forehead, which made him seek and ingest cold foods. Given these findings, we have established an eastern medical diagnosis for the anorexia as ketsugyaku, netsuketsu and initiated treatment using byakkokaninjinto. After starting a regimen of byakkokaninjinto, the patient noticed increased dietary intake and the various cold and heat sensa­tions distributed throughout his body dissipated. Assuming an open stance on adopting traditional Chinese medical practice into anorexia treatment could prove valuable in certain cases.