Effects of Sitting and Supine Positions on Tongue Color as Measured by Tongue Image Analyzing System and Its Relation to Biometric Information.

Tongue diagnosis is one of the important diagnostic methods in Kampo (traditional Japanese) medicine, in which the color and shape of the tongue are used to determine the patient's constitution and systemic symptoms. Tongue diagnosis is performed with the patient in the sitting or supine positions; however, the differences in tongue color in these two different positions have not been analyzed. We developed tongue image analyzing system (TIAS), which can quantify tongue color by capturing tongue images in the sitting and supine positions. We analyzed the effects on tongue color in two different body positions. Tongue color was quantified as L∗a∗b∗ from tongue images of 18 patients in two different body positions by taking images with TIAS. The CIEDE 2000 color difference equation (ΔE00) was used to assess the difference in tongue color in two different body positions. Correlations were also determined between ΔE00, physical characteristics, and laboratory test values. The mean and median ΔE00 for 18 patients were 2.85 and 2.34, respectively. Of these patients, 77.8% had a ΔE00 < 4.1. A weak positive correlation was obtained between ΔE00 and systolic blood pressure and fasting plasma glucose. Approximately 80% of patients' tongue color did not change between the sitting and supine positions. This indicates that the diagnostic results of tongue color are trustworthy even if medical professionals perform tongue diagnosis in two different body positions.

Case Report: Acupuncture is an effective treatment for olfactory dysfunction in the post COVID-19 condition.

Olfactory dysfunction in the post COVID-19 condition reported worldwide are refractory for some patients. For this reason, appropriate treatment is desired. In this article, we describe two cases of olfactory dysfunction in the post COVID-19 condition that was improved by traditional acupuncture treatment. By using the Yingxiang point (LI20), which is said to improve the sense of smell since ancient times, acupuncture treatment was performed 1-2 times a week in two patients about 6 and 7 months after the diagnosis of COVID-19. Acupuncture needles with a body length of 30 mm and a body diameter of 0.16 mm were inserted about 10 mm deep into the skin. We stimulated LI20 of the right and left sides until the patients felt the de qi sensation (acupuncture resonance), and left needles in the points for about 15 min. Immediately after the acupuncture treatment, the symptoms of olfactory dysfunction were alleviated, and the improvement in olfactory dysfunction lasted for 2-4 days. As the number of acupuncture treatments increased, the time until the flareup of olfactory dysfunction was prolonged, and the symptoms tended to decrease. In our experience, the acupuncture treatment was effective in a short period for treating residual olfactory dysfunction of the post COVID-19 condition, suggesting that acupuncture may serve as an adjunct to modern medical treatment, and it may also be a new option for patients who are resistant to Western medical treatment or unable to continue treatment because of side effects. In conclusion, acupuncture may be a new option for patients who are resistant to modern medical treatment or who are unable to continue treatment because of side effects.

Role of Blood Stasis Syndrome of Kampo Medicine in the Early Pathogenic Stage of Atherosclerosis: A Retrospective Cross-Sectional Study.

In Kampo medicine, blood stasis (BS) syndrome is strongly associated with microangiopathy and can lead to atherosclerosis. Vascular endothelial dysfunction (VED), evaluated through flow-mediated dilation (FMD), plays an important role in the early stages of atherosclerosis. However, the association of BS syndrome with VED, as determined using FMD, has not been reported. This study investigated the association between BS syndrome and VED using FMD. Forty-one patients with normal glucose tolerance or impaired glucose tolerance (IGT) and without macrovascular complications were evaluated using FMD from May 2017 to August 2017. Based on the BS score, the patients were divided into the non-BS (n = 19) and BS syndrome (n = 22) groups. Physical and background characteristics, physiological function test results, and laboratory data were compared. Univariate analysis revealed that FMD and a history of dyslipidemia/IGT were significantly different between the two groups (p < 0.05). Multiple logistic regression analysis showed that BS syndrome was significantly associated with FMD (odds ratio: 6.26; p=0.03) after adjusting for the history of dyslipidemia/IGT. The receiver operating characteristic curve showed that the area under the curve for BS syndrome (0.74; p < 0.001) and history of IGT (p < 0.007) provided good diagnostic accuracy for FMD. The area under the curve for "BS syndrome + IGT" showed very good accuracy (0.80; p < 0.0001) and was higher than that for BS syndrome or IGT alone. In conclusion, the results of this study suggest that the BS score in Kampo medicine could be a useful tool for detecting the early pathogenic stages of atherosclerosis.

Combination Image Analysis of Tongue Color and Sublingual Vein Improves the Diagnostic Accuracy of Oketsu (Blood Stasis) in Kampo Medicine.

Aim: In tongue diagnosis, a dark purple tongue and enlarged sublingual vein are important findings of Oketsu (blood stasis). However, the association between the tongue color and the sublingual vein has not been reported. This study investigated the association between the tongue color values and the sublingual vein width using tongue image analyzing system (TIAS) for the objective assessment of blood stasis. Methods: A total of 38 patients (age 68.7 ± 11.3 years, 14 men and 24 women) who visited the Department of Kampo Medicine at Chiba University Hospital were included. Physical findings, blood test results, blood stasis score from medical records, and tongue images obtained with TIAS were analyzed. The patients were classified into two groups: patients with a sublingual vein width of ≤2.5 mm (20 patients) and those with a width of >2.5 mm (18 patients). The physical findings and the blood test results of the two groups were analyzed by Wilcoxon's rank-sum test or χ2-test, whereas logistic regression analysis was used to determine the association between the tongue color values and sublingual vein width. Receiver operating characteristic (ROC) analysis was used to differentiate blood stasis. Results: The color values significantly related to the sublingual vein width (mm) were the P1-L* and P4-L* (darkness of the tongue edge and tongue apex) and the P1-b* and P2-b* (blueness of the tongue edge and tongue posterior). The area under the curve was greater for the combination of the tongue color values and the sublingual vein width than that for either of them. Conclusion: This study demonstrated an objective evaluation of blood stasis in the tongue of patients with dark-blue discoloration and an enlarged sublingual vein. In addition, the combination of the tongue color and the sublingual vein is expected to facilitate a more reliable diagnosis of blood stasis.

The mechanism of weight-loss promoting effects of oil heated with vegetable protein.

We have previously reported that a soy oil-containing experimental diet (fat-free AIN93G containing oil thermally processed with soybean protein followed by filtration), inhibited body weight increases without any adverse effects when given ad libitum to male Wistar rats for 12 weeks. In the present paper, the mechanism of weight-loss promoting effects was investigated. Fasted 10-week-old rats were fed a slurry composed of AIN93G (fat-free), Cr(2)O(3) (marker), water, and 7 wt% soy oil or fresh oil (control) and sacrificed at 20, 60, 90, 120, 150, 210, 270 or 360 min. The stomach, small intestine, cecum, colon and feces were then collected to determine the distribution of the slurry in the digestive tract. The results indicated that the content was transferred faster from stomach to small intestine in the soy oil group than in the control group. Fecal excretion (derived from a commercial standard diet ingested before slurry administration) in the soy oil group was significantly higher than in the control group. Digestive enzyme activities, lipase, sucrose, and maltose, were not inhibited by soy oil. In addition, feces collected in the 12-week feeding experiment were more in the dry weight and contained higher levels of nitrogen and water in the soy oil group than in the control group, revealing that an increased amount of nutrition was continuously excreted in the former group. The above-described findings suggest that soy oil stimulated peristalsis of the gastrointestinal tract and that colon contents are actively excreted, resulting in safe and steady body weight decreases.

A novel body weight-loss promoting oil prepared with vegetable protein.

It has been reported that oil thermally processed with wheat gluten (gluten oil) exhibited safe weight-loss promoting effects in animal experiments. However, as the oil has a high color index, and its chemical properties and smell differ from those of fresh oil, it is uncertain if the oil will find market acceptance. In order to resolve the issue, frying oil was heated with soybean protein under reduced pressure (soybean protein oil), resulting in a product with an appearance, chemical properties and smell comparable to those of fresh oil. This improved oil was mixed (7 wt%) with powdered AIN93G no fat, defined standard diet and fed to 10-week-old Wistar rats ad libitum. The experimental rats grew normally, ingesting the same amount as that of the control rats; however, there was a negative correlation between body weight increases and fecal weight increases. After the 12-week feeding period, all the rats were sacrificed to obtain blood and organs. In the experimental group, liver weight, retroperitoneal fat tissue weight and serum triacylglycerol (TG) levels decreased significantly. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), and histological analysis supported the safety of the improved oil. In conclusion, it was found that soybean protein oil inhibited body weight increases without any adverse effects in animal experiments. The oil holds promise as a novel dieting oil that steadily decreases body weight at an appropriate rate.