Orthostatic Disregulation (OD, a kind of dysautonomia) is a syndrome which indicates disfunction of vessel contraction reflex during static standing. OD patients often show some symptoms of fainting, dizziness, headache and the like or syncope when they are holding orthostatic posture. OD is more recognized especially in preadolescence and adolescence periods (9-15 yrs.) . Brück & Oltmann (1957), Okuni (1958) etc, have reported details about OD.
The purpose of this study was to obtain and discuss details relating to recent appearance of OD, physique, growth characteristics, cardio-vascular functions and physical fitness on OD children by the questionnaire method and some experiments.
2, 227 children in elementary and junior high school in Yokohama and Kamakura cities as sub jectswere first screened by the questionnaire. And 165 subjects out of 2, 227 were at random selected for data on Schellong standing test, passive head-up tilt and distance running.
The value of 9-29%, which was the ratio of false OD (+) appearance by the questionnaire method in this study, was recognized higher than the value of 5-20% by previous studies'. Physique on false OD (+) children was somewhat lean in comparison with the normal. And they had more height increase than the normal.
In physical fitness, distance running, 50 m dash, broad jump, ball throw, chinning exercise and back pull-over tests, OD children were inferior than the normal.
A concrete datum in syncope for standing was got in this study. When an OD child exhibited syncope, systolic blood pressure became 78 mmHg (rest 120-130 mmHg) and heart rate became 76 beats per minute (standing before syncope 100-110 beats per minute) . T wave in II, _aV_F and P wave in II, III (depression, negative waves etc.) of ECG varied from resting ECG. Judging from these data about ECG and blood pressure on standing test, passive head-up tilt, it was indicated that a reflex system of vessel contraction on OD child didn't work well, and that the heart of OD child was much stressed by gravity in orthostatic posture and changing posture than the normal.
In addition, a fact was proven that false OD (+) children (39.1% boys and 48.2% girls) didn't like sports and physical activities comparing with the normal (16.4% boys and 23.5% girls), It was statistically significant. Therefore, it is estimated that there is a relationship between appearance of OD and physical activities in daily life.

Kampo medicines have been used for treatment by an increasing number of doctors in recent years, and are becoming more frequently prescribed in combination with Western drugs. In the present study, we conducted a questionnaire of outpatients at the Kampo Clinic of Keio University Hospital in order to determine their perceptions and compliance regarding Kampo medicines.Ninety eight percent of patients used Kampo medicines in granular form, and approximately 30% of these patients reported difficulty in taking medicine due to reasons such as “bad taste”. Sixty percent of patients used Kampo medicines three times daily. Patients most often forgot to take afternoon doses, and so desired doses once daily. Furthermore, the same number of patients preferred Kampo medicines in tablet form as those who preferred Kampo medicines in granular form.The present findings clarified patients' perceptions toward Kampo medicines. Doctors and pharmacists must provide suitable treatment for patients by recognizing their perceptions of Kampo medicines.
Medicine, Kampo ; Clinic ; Use of ; percent ; therapeutic aspects

No abstract available.
Echocardiography ; Echocardiography, Three-Dimensional*

We investigated the effects on medical education of early exposure of undergraduate students to a summer camp for children with asthma. An objective evaluation by the editorial staff found final improvements in the following areas (in descending order of frequency): learning of basic medical behavior (91% of students); cooperative attitude of medical staff in general treatment with the patient and the patient's family (88%); understanding of childhood growth and development (80%); knowledge of childhood asthma (69%); and mastery of basic techniques for therapy and examination (41%). The differences in the ratio of improvement (%) before and after visiting the camp, were (in descending order of frequency): cooperative attitude of medical care staff in general medical treatment with the patient and the patient's family (47%); understanding of childhood growth and development (45%); knowledge of childhood asthma (38%); learning of basic medical manner (34%); and mastery of basic techniques for therapy and examination (25%). These findings suggest that a summer camp is useful for exposing undergraduate medical students to children with asthma and is effective for helping them understand patients and family-oriented pediatric medicine.

In Kampo medicine, a tongue examination, whereby the shape and color of the tongue is observed, is thought to reveal the constitution and condition of the patient. In Japan, numerous books on this tongue examination have been published. However, tongue findings are expressed differently in these books, and a standard description for such findings has yet to be established. A standard description would be useful when examining the tongue, and when educating students of Kampo medicine. We therefore compared how tongue colors and shapes were expressed in the Japanese literature on tongue examinations (12 publications).
Using these results, we have arrived at a standardized description for tongue findings in accordance with Kampo specialists of tongue diagnoses at many facilities. In the process, we focused on easily recognizable findings that can be noted with short clinical examination times, and that can also be understood by beginners.

We have developed and operated a browser-based questionnaire system for Kampo medicine based on conventional questionnaires and review of systems to reveal implicit Kampo wisdom both in patients' questionnaire data and in some Kampo specialists' examination data. However, the questionnaire data were found to be inaccurate because too many questions were included and cumbersome input steps were required. The purpose of the present study was to solve these problems and to develop a new patient-centered questionnaire system with fewer questions and an easier input method. After analyzing inquiry database from collaborating institutes and hospitals, we deleted, combined, and added questions. We changed the evaluation method of symptoms from a visual analogue scale to a simple staged evaluation, and introduced another method to evaluate the main symptoms in each time of visit using a visual analogue scale. At the same time, a tool for predicting Kampo pattern diagnoses based on the questionnaire data was implemented. We have already started collecting more accurate and reliable data using the new questionnaire system. It is expected to support routine practices and facilitate more precise clinical research on Kampo medicine.

We have previously reported on a predictive model for deficiency-excess pattern diagnosis that was unable to predict the medium pattern. In this study, we aimed to develop predictive models for deficiency, medium,and excess pattern diagnosis, and to confirm whether cutoff values for diagnosis differed between the clinics. We collected data from patients' first visit to one of six Kampo clinics in Japan from January 2012 to February 2015. Exclusion criteria included unwillingness to participate in the study, missing data, duplicate data, under 20 years old, 20 or less subjective symptoms, and irrelevant patterns. In total, 1,068 participants were included. Participants were surveyed using a 153-item questionnaire. We constructed a predictive model for deficiency, medium, and excess pattern diagnosis using a random forest algorithm from training data, and extracted the most important items. We calculated predictive values for each participant by applying their data to the predictive model, and created receiver operating characteristic (ROC) curves with excess-medium and medium-deficiency patterns. Furthermore, we calculated the cutoff value for these patterns in each clinic using ROC curves, and compared them. Body mass index and blood pressure were the most important items. In all clinics, the cutoff values for diagnosis of excess-medium and medium-deficiency patterns was > 0.5 and < 0.5, respectively. We created a predictive model for deficiency, medium, and excess pattern diagnosis from the data of six Kampo clinics in Japan. The cutoff values for these patterns fell within a narrow range in the six clinics.