Quantification of tongue colour using machine learning in Kampo medicine

AbstractIntroductionThe evaluation of tongue colour has been an important approach to examine human health in Kampo medicine (traditional Japanese medicine) because the change in tongue colour may suggest physical or mental disorders. Several tongue colour quantification methods have been published to objectify clinical information among East Asian countries. However, reliable tongue colour analysis results among Japanese test persons are limited because of a lack of quantitative evaluation of tongue colour. We aimed to use advances in digital imaging processing to quantify and verify clinical data tongue colour diagnosis by characterising differences intongue features.MethodsThe DS01-B tongue colour information acquisition system was used to extract tongue images of 1080 Japanese test subjects. Evaluation of tongue colour, body and coating was performed by 10 experienced Kampo medicine physicians. The acquired images were classified into five tongue body colour categories and six tongue coating colour categories based on evaluations from 10 physicians with extensive Kampo medicine experience. K-means clustering algorithm was applied as a machine learning (the study of pattern recognition by computational learning) method to the acquired images to quantify tongue body and coating colour information.ResultsTongue body (n=550) and tongue coating (n=516) colour samples were classified and analysed. Clusters consisting of five tongue body colour categories and six tongue coating colour categories were experimentally described in the CIELAB colour space. Statistical differences were evident among the clinically primary tongue colours.ConclusionsClinically important tongue colour differences in Kampo medicine can be visualised by applying machine learning to tongue images taken under stable conditions. This has implications for developing globally unified, reliable tongue colour diagnostic criteria which could be used to explore the relevance between clinical status and tongue colour

Prevention and Recovery of COVID-19 Patients With Kampo Medicine: Review of Case Reports and Ongoing Clinical Trials

Coronavirus disease 2019 (COVID-19) spread to Japan in 2020, where the number of infected patients exceeded 250,000 and COVID-related deaths exceeded 3,500 in one year. Basic guidelines for infection control were implemented in Japan, and research and development of effective drugs and vaccines were promoted. This included considering Kampo medicine, which has a long history of treating recurring emerging viral infections. Considering the characteristics of the disease (inflammation of the upper and lower respiratory tract as well as potential neural damage and vasculitis), Kampo medicine could be considered as a treatment strategy due to its antiviral and anti-inflammatory effects induced by multiple active substances that could aid in disease prevention and recovery. In this study, case reports on the management of COVID-19 with Kampo medicine, which were published until March 31, 2021, were reviewed. The search strategy involved the use of Medline and hand-searching. Twenty two patients were treated using Kampo medicines with or without Western medicine, based on individual conditions. On the other hand, the effects of Kampo medicines as a potential preventive treatment (pre-infection), active treatment (especially in the acute and subacute stage), or treatment of sequelae to aid recovery (after infection) in the different stages of COVID-19 are being studied as research projects in the Japan Society for Oriental Medicine (JSOM). JSOM has also organized a pioneering project of clinical trials for COVID-19, some of which are now in progress

Clarifying the Destructive Influence of Gravitation Set in Infusion Pump

Import 22/07/2015Infuzní léčba je v současnosti jedním z nejběžnějších úkonů, prováděných ve zdravotnických zařízeních, a nachází uplatnění v širokém spektru případů. Samotný proces léčby může být uskutečněn dvěma způsoby – gravitační infuzí a použitím volumetrické infuzní pumpy. Princip infuze řízené volumetrickou pumpou klade specifické nároky na vlastnosti užívaných infuzních setů, přičemž pro zajištění důležité přesnosti průtoku je nezbytné dbát na určení daného setu pro použití s tlakovou metodou. V běžném zdravotnickém prostředí však existuje řada rizikových faktorů, jejichž vlivem může dojít k porušení této podmínky kompatibility a následnému použití volumetrické pumpy s nevhodnou administrativní soupravou, určenou pouze pro gravitační infuzi. Záměrem první části této práce je, na základě známých poznatků o negativních vlivech činnosti pumpy na přesnost léčby a o mechanických vlastnostech infuzních setů, teoreticky stanovit možné destrukční vlivy čerpadla infuzní pumpy na materiál gravitačního setu. Cílem druhé části je pokusit se prokázat negativní dopad mechanického namáhání gravitačního setu v infuzní pumpě na přesnost dávkování a vlastnosti materiálu použitého setu pomocí experimentálně získaných dat.Intravenous therapy is currently one of the most common operations performed in health care facilities, finding its use in a wide range of cases. The particular process of treatment can be implemented in two ways - using gravity-fed infusion and by use of volumetric infusion pump. The principle of infusion controlled by a volumetric pump lays specific demands on the quality of the infusion sets in use. When warranting the flow rate accuracy it is necessary to ensure suitability of the set for use with the pressure method. However, there are a number of risk factors in common medical situations, whose influence may lead to violating the terms of compatibility and the subsequent use of a volumetric pump with an improper administrative set made only for gravity-fed infusion. The aim of the first part of this work is the theoretical determination of the possible destructive effects of the infusion pump to the material of a gravity-fed administration set based on the evidence about the negative impacts of the pump on the flow rate accuracy and mechanical characteristics of the infusion sets. The goal of the second part is an effort to proof the negative impact of the mechanical stress of a gravity set in an infusion pump to dosage accuracy and the material properties of the used set through experimental data.450 - Katedra kybernetiky a biomedicínského inženýrstvívýborn

The Relationship between “Shofuku-Fujin” (Abnormality of Abdominal Examination in Japanese Kampo Medicine) and Body Composition by Bioelectrical Impedance Analysis: A Cross-Sectional Study

Shofuku-fujin is an abnormal physical finding in Kampo medical practice. It is assumed to be often found in the elderly and contributes to the selection of Kampo formulas used mainly in elderly patients. However, few objective reports about Shofuku-fujin have been published to date. The aim of this study was to clarify the clinical features of patients showing Shofuku-fujin by using bioelectrical impedance analysis (BIA) and to objectively assess the potential clinical implications of these findings. We conducted a cross-sectional study of 1330 patients who visited our institute to undergo a medical examination by using data collected from September 2010 to March 2016. We extracted data on patient sex and age, anthropometric data, and body composition data that could potentially affect the appearance of Shofuku-fujin. Logistic regression analyses were performed by sex to analyze the various factors related to the appearance of Shofuku-fujin. Of the 1330 patients, the data of 386 men and 942 women were used for analysis. Multivariate logistic regression analysis showed that Shofuku-fujin was associated with older age (odds ratio (OR), 1.07; 95% confidence interval (CI), 1.05–1.10; p < 0.001), lower skeletal muscle mass index (SMI) (OR, 0.60; 95% CI, 0.43–0.85; p = 0.004), and lower body fat percentage (OR, 0.89; 95% CI, 0.85–0.93; p < 0.001) in men and older age (OR, 1.06; 95% CI, 1.04–1.07, p < 0.001) and lower body fat percentage (OR, 0.94; 95% CI, 0.92–0.96; p < 0.001) in women. On the basis of these results, the factors causing the appearance of Shofuku-fujin were aging, decreased muscle mass, and decreased body fat in men and aging and decreased body fat in women. Our results demonstrated that it may be better to consider a loss of muscle mass when examining a male patient with Shofuku-fujin

Possible anti-inflammatory role of Zingiberis processum rhizoma, one component of the Kampo formula daikenchuto, against neutrophil infiltration through muscarinic acetylcholine receptor activation

Zingiberis processum rhizoma (ZPR) is a major active component of daikenchuto (DKT), which induces anti-inflammatory action by inhibiting macrophage infiltration. However, it is unclear whether ZPR is related to DKT-induced anti-inflammatory action via a reduction of neutrophil infiltration against postoperative ileus (POI). In this study, we orally administered individual herbal components of DKT to mice four times before and after intestinal manipulation (IM). The anti-inflammatory action of each crude drug was evaluated by histochemical analysis of relevant molecules. The results showed that treatment with all herbal components of DKT significantly inhibits neutrophil infiltration. This inhibition of neutrophil infiltration by ZPR was significantly reduced in 5-hydroxytryptamine receptor 4 (5-HT4R) knockout (KO) mice but not in alpha-7 nicotinic acetylcholine receptor (α7nAChR) KO mice. Also, transient receptor potential ankyrin 1 (TRPA1) and muscarinic acetylcholine receptor (mAChR) antagonists partly and significantly inhibited the amelioration of neutrophil infiltration by ZPR. Therefore, DKT-induced anti-inflammatory action, mediated by inhibition of neutrophil infiltration in POI, depends, in part, on the effects of ZPR. ZPR activates TRPA1 channels, possibly in enterochromaffin (EC) cells, to release 5-HT. This 5-HT stimulates 5-HT4R in the myenteric plexus neurons to release acetylcholine, which, in turn, activates mAChR to inhibit inflammation in POI. Keywords: Anti-inflammatory activity, Postoperative ileus, Zingiberis processum rhizoma, Neutrophil infiltration, Daikenchut

Antiviral Effect of Ephedrine Alkaloids-Free Ephedra Herb Extract against SARS-CoV-2 In Vitro

We report for the first time that ephedrine alkaloids-free Ephedra Herb extract (EFE) directly inhibits the replication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in vitro and that the addition of EFE to the culture medium before viral infection reduces virus titers in the culture supernatant of SARS-CoV-2, including those of variant strains, by more than 99%, 24 h after infection. The addition of Ephedra Herb macromolecule condensed-tannin, which is the main active ingredient responsible for the anticancer, pain suppression, and anti-influenza effects of EFE, similarly suppressed virus production in the culture supernatant by 99% before infection and by more than 90% after infection. Since EFE does not have the side effects caused by ephedrine alkaloids, such as hypertension, palpitations, and insomnia, our results showed the potential of EFE as a safe therapeutic agent against coronavirus disease 2019

Effect of Ephedra Herb on Erlotinib Resistance in c-Met-Overexpressing Non-Small-Cell Lung Cancer Cell Line, H1993, through Promotion of Endocytosis and Degradation of c-Met

Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (EGFR-TKIs) are used to treat non-small-cell lung cancer (NSCLC), harboring an EGFR-activating mutation. However, acquired resistance to these treatments emerges after a few years. One of causes of resistance to EGFR-TKIs is a high level of c-Met amplification or c-Met protein overexpression/hyperactivation. Therefore, combination therapy with EGFR-TKIs and a c-Met inhibitor is thought to be effective treatment for patients with NSCLC resistance carrying c-Met amplification and/or protein hyperactivation. Ephedra Herb is a crude drug and is used in Japan as a component in many Kampo formulae. We previously reported that Ephedra Herb extract (EHE) inhibits HGF-induced phosphorylation of c-Met by preventing c-Met tyrosine kinase activity. Thus, we investigated the combination effect of EHE and erlotinib, an EGFR-TKI, on growth of H1993 cells, an erlotinib-resistant NSCLC cell line with overexpression of c-Met. The EHE and erlotinib combination proved to be effective in suppression of the growth of H1993 xenograft tumors and on inhibition of proliferation of H1993 cells, suggesting that EHE is effective in rescuing NSCLC cells from erlotinib resistance. Moreover, EHE not only inhibited the phosphorylation of c-Met, but also downregulated the expression of c-Met by facilitating clathrin-mediated endocytosis and lysosomal degradation of c-Met. EHE also promoted downregulation of the expression of EGFR and phosphorylation of EGFR. Ephedrine alkaloids-free Ephedra Herb extract (EFE) had the same effects as EHE, and the 40% MeOH fraction from EFE, which mainly contained the high-molecular mass condensed tannins, decreased the expression levels of c-Met, pMet, EGFR, and pEGFR to almost the same level as EFE. These results suggest that recovery from resistance to erlotinib by EHE is derived from the high-molecular mass condensed tannins and that EHE may be suitable for treatment of c-Met-overexpressing NSCLC with resistance to EGFR-TKIs

Kososan, a Kampo medicine, prevents a social avoidance behavior and attenuates neuroinflammation in socially defeated mice

Abstract Background Kososan, a Kampo (traditional Japanese herbal) medicine, has been used for the therapy of depressive mood in humans. However, evidence for the antidepressant efficacy of kososan and potential mechanisms are lacking. Recently, it has been recognized that stress triggers neuroinflammation and suppresses adult neurogenesis, leading to depression and anxiety. Here, we examined whether kososan extract affected social behavior in mice exposed to chronic social defeat stress (CSDS), an animal model of prolonged psychosocial stress, and neuroinflammation induced by CSDS. Methods In the CSDS paradigm, C57BL/6J mice were exposed to 10 min of social defeat stress from an aggressive CD-1 mouse for 10 consecutive days (days 1–10). Kososan extract (1.0 g/kg) was administered orally once daily for 12 days (days 1–12). On day 11, the social avoidance test was performed to examine depressive- and anxious-like behaviors. To characterize the impacts of kososan on neuroinflammation and adult neurogenesis, immunochemical analyses and ex vivo microglial stimulation assay with lipopolysaccharide (LPS) were performed on days 13–15. Results Oral administration of kososan extract alleviated social avoidance, depression- and anxiety-like behaviors, caused by CSDS exposure. CSDS exposure resulted in neuroinflammation, as indicated by the increased accumulation of microglia, the resident immune cells of the brain, and their activation in the hippocampus, which was reversed to normal levels by treatment with kososan extract. Additionally, in ex vivo studies, CSDS exposure potentiated the microglial pro-inflammatory response to a subsequent LPS challenge, an effect that was also blunted by kososan extract treatment. Indeed, the modulatory effect of kososan extract on neuroinflammation appears to be due to a hippocampal increase in an anti-inflammatory phenotype of microglia while sparing an increased pro-inflammatory phenotype of microglia caused by CSDS. Moreover, reduced adult hippocampal neurogenesis in defeated mice was recovered by kososan extract treatment. Conclusions Our findings suggest that kososan extract prevents a social avoidant behavior in socially defeated mice that is partially mediated by the downregulation of hippocampal neuroinflammation, presumably by the relative increased anti-inflammatory microglia and regulation of adult hippocampal neurogenesis. Our present study also provides novel evidence for the beneficial effects of kososan on depression/anxiety and the possible underlying mechanisms