Study of Fullness in the Chest that Lies Behind the Sho of Keikyososooushinbuto (桂姜棗草黄辛附湯) : Decoction of Ramulus Cinnamomi Subtracting Radix Paeoniae Adding Herba Ephedrae, Herba Asari and Radix Aconiti Praeparata / 日本東洋医学雑誌

I consider keikyososooushinbuto is compounded with Ephedra and Asarum to keishikyoshakuyakukabushito. I studied many successfully treated cases with keikyososooushinbuto to indicate the sho of it. Keishikyoshakuyakukabushito is formed from keishikyosyakuyakuto with coldness. In the text of keishikyoshakuyakuto of the “Shang Han Lun,” after treatment with the purgative, the stomach yang becomes weakened and the stomach yin reverses up to the chest pathologically. This critical condition deteriorates by the coldness into the debilitation of the heart yang, therefore the addition of Ephedra and Asarum is needed. I think this pathological state is the basis of the sho of keikyososooushinbuto. The symptoms of the clinical cases vary, and every part of the body can be affected. But I found the common physical signs of these cases, which have two points with tenderness ; one is located on the bilateral intercostal parts of the end of the sternum, and the other is on the muscle bedside the spines Th 12-L 1. These are the signs of the fullness in the chest described in the text of keishikyosyakuyakuto, which is the indispensable symptom when I use keikyososooushinbuto clinically.

Parameter optimization of low-dose Flash CT scan of the chest:an animal experiment / 实用放射学杂志

Objective To explore the optimized scanning parameters of low-dose un-enhanced chest CT with sinogram affirmed iterative reconstruction (SAFIRE).Methods Eleven healthy adult domestic dogs underwent chest scanning of 120 kV,100 kV,80 kV,70 kV with a fixed tube current of 65 mA and halved tube current of 32 mA with a fixed tube voltage of 100 kV.The data were reconstructed with filtered back projection (FBP)and SAFIRE (strength grade 3)respectively to obtain ten groups of images.The regular dose (120 kV/65 mA ) combining with FBP reconstruction was as normal control group,and other groups as experimental groups.CT dose index (CTDI), dose length product (DLP),and effective dose (ED)at different dose were compared,and average CT value,noise,signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR)and image quality score of ten groups of images were comparatively analyzed.Results No significant differences were found in average CT value for lung tissue,the superior vena cava,the aortic arch,and spinal muscles among ten groups (P >0.05),except adipose tissue (P 3),and the radiation dose of this group decreased by 81.33%.Conclusion Reconstructed with SAFRIE technology,the image quality of 100 kV/65 mA scanning of chest CT is similar to that of routinely reconstructed images in regular dose,while the image quality of 70 kV/65 mA scanning can not only meet the requirements of diagnosis but also obviously reduce radiation dose.

Study on low tube voltage scan and SAFIRE reconstruction in the chest of domestic dogs / 实用医学杂志

Objective To investigate the value of low tube voltage with sinogram affirmed iterative reconstruction (SAFIRE) through comparing the image quality of regular dose scanning with filtered back projection (FBP) reconstruction and low-dose scanning with SAFIRE. Methods Eleven healthy adult domestic dogs were scanned with different doses. The regular dose of 120 kV/65 mA in combination with FBP reconstruction was set as the normal control group, and 100 kV/65 mA plus SAFIRE reconstruction was used as the low kV group. The CT dose index (CTDI), dose length product (DLP), and the effective dose (ED) at different doses were compared, and the average CT value, noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and the image quality score of two groups of images were also analyzed. Results ED in the low kV groups was reduced by 39.33%compared to that in the normal control group. No significant differences were found in the average CT value of the same tissue among these two groups (P > 0.05). Compared with the normal control group, image noise of the lung tissue, superior vena cava and spinal muscle of low kV group were consistently decreased, SNR was in also creased, while the noise ratio contrast between superior vena cava and fat was increased. The image quality score of the low kV group was increased by 1.70%compared to that of the normal control group. Conclusion The low kV scan with SAFIRE technology can decrease the radiation dose and improve image quality in chest CT examination of domestic dogs, with a potential value in the clinical promotion and the application.

Mechanical principle of the respiration-driven variation of cardiac function——Echocardiographic study of the mechanical models / 中华超声影像学杂志

Objective To reveal the exact mechanical principle of the respiration-driven variation of cardiac function by observing the effect of respiratory intrathoracic pressure change (RIPC) on the mechanical models using echocardiography.Methods Model 1 was designed to observe the influence of RIPC on systemic and pulmonary venous return systems (SVR and PVR) respectively.Model 2,as an equivalent mechanical model of septal swing,was used to study the influence of RIPC on the motion of the interventricular septum (IVS).Results Model 1 demonstrated that the simulated RIPC had totally different influences on the simulated SVR and PVR.It increased the volume of the simulated right ventricle when the internal pressure was kept constant (8.16 cm H2O),while it had the opposite effect on PVR.Model 2demonstrated that there was a corresponding relationship between RIPC and the position of the simulated IVS which might be called pressure-position relationship.Conclusions The different anatomical arrangement of the two venous return systems leads to a different effect of RIPC on right and left ventricles,and thus generates a pressure gradient across IVS that tends to shift IVS left-and right-wards with respiration.The swing of the IVS changes the short axis diameters of the ventricles,thus their fillings and then their functions reciprocally.

Modelo de contorno ativo crisp: nova técnica de segmentação dos pulmões em imagens de TC / Active contour modes crisp: new technique for segmentation the lungs in CT images

Este trabalho propõe um novo método de contornos ativos (MCA), chamado de MCA Crisp, e o avalia na segmentação dos pulmões em imagens de Tomografia Computadorizada (TC). O MCA consiste em traçar uma curva inicial em torno ou dentro de um objeto de interesse. Esta curva se deforma, conforme algumas energias que atuam sobre a mesma, deslocando-a até as bordas do objeto. Este processo é realizado por iterações sucessivas de minimização de uma dada energia, associada à curva. Aplicando MCAs descritos na literatura na segmentação dos pulmões em imagens de TC, constatam-se limitações. Neste contexto, propõe‑-se o MCA Crisp para suprir tais limitações, propondo uma inicialização automática e uma nova energia externa baseada em regras e nas densidades radiológicas pulmonares. Realiza-se uma comparação entre os MCAs Tradicional, Balão, GVF e o método proposto para demonstrar a superioridade do novo método. Em seguida, para validar o MCA Crisp realiza-se uma análise qualitativa junto a um médico especialista na área de Pneumologia do Hospital Universitário Walter Cantídio da Universidade Federal do Ceará. Nesta análise, são utilizados 100  pulmões em imagens de TC. A eficiência da segmentação foi avaliada em  5 categorias, obtendo os seguintes resultados:   73% ótimas, sem falhas, 20% aceitáveis, com pequenos erros, 7% razoáveis, com erros grosseiros e  0% ruim, segmentando apenas uma pequena parte do pulmão, e  0% péssima, obtendo uma segmentação totalmente errada. Conclui-se que o MCA Crisp é um método útil para segmentar os pulmões em imagens de TC e com potencial para integrar sistemas que auxiliem o diagnóstico médico.

This paper proposes a new Active Contour Model (ACM), called ACM Crisp, and evaluates the segmentation of lungs in computed tomography (CT) images. An ACM draws a curve around or within the object of interest. This curve changes its shape, when some energy acts on it and moves towards the edges of the object. This process is performed by successive iterations of minimization of a given energy, associated with the curve. The ACMs described in the literature have limitations when used for segmentations of CT lung images. The ACM Crisp model overcomes these limitations, since it proposes automatic initiation and new external energy based on rules and radiological pulmonary densities. The paper compares other ACMs with the proposed method, which is shown to be superior. In order to validate the algorithm a medical expert in the field of Pulmonology of the Walter Cantídio University Hospital from the Federal University of Ceará carried out a qualitative analysis. In these analyses  100 CT lung images were used. The segmentation efficiency was evaluated into  5 categories with the following results for the ACM Crisp: 73% excellent, without errors, 20% acceptable, with small errors, and  7% reasonable, with large errors, 0% poor, covering only a small part of the lung, and  0% very bad, making a totally incorrect segmentation. In conclusion the ACM Crisp is considered a useful algorithm to segment CT lung images, and with potential to integrate medical diagnosis systems.

A Case Report of an Obstinate Belch Successfully Treated with Goshuyuto / 日本東洋医学雑誌

We report a case of an obstinate belch successfully treated with goshuyuto. The patient was a 74-year-old female. She had been hospitalized seven times in the past due to the belch, abdominal distention and anorexia, and had been prescribed various Kampo formulas. But her symptoms fluctuated up and down. The obstinate belch essentially disappeared after administering goshuyuto, and her appetite improved. Many of Kampo formulas that treat belchs are related to Shoyobyo (shao yang bing), but we consider that goshuyuto may be effective for a belch, which is yin-related and accompanied with stiffness and rigidity below the heart, and fullness in the chest and hypochondrium.

Four Cases of Panic Disorder Successfully Treated with Shishi-hakuhi-to / 日本東洋医学雑誌

Shishi-hakuhi-to was prescribed for four patients with panic disorder and sleep disturbance who requested the extract. As indications for the usage of this formulation, discomfort and restlessness of the chest for which Gardeniae Fructus has proved efficacious against, were used. Symptoms such as palpitation, chest discomfort, hot flash, anxiety and insomnia improved promptly with Shishi-hakuhi-to administration. The four patients had several common points, that is, menopause, hot flash and dysesthesia, but no agoraphobia. So far, Shishi-hakuhi-to had been used for liver dysfunction and dermatological diseases. Our results suggest that Shishi-hakuhi-to might be useful for cases with psychiatric diseases such as panic disorder.

Effect of Lianggesan on T Helper Cell Shift in Rats with Acute Lung Injury Induced by Endotoxin / 中医杂志

Objective To investigate the molecular mechanism of inflamation development and anti-inflamation response of Lianggesan Decoction(Decoction for cooling the chest) on endotoxin-induced acute lung injury rats. Methods The rat models with acute lung injury were made by lipopolysaccharide(LPS) through intravenous injection.The high,middle and low dosage of Lianggesan Decoction were given by gastric perfusion and compared with dexamethasone(DXM).The contents of Th1 and Th2 in peripheral blood and bronchoalveolar lavage fluid(BALF) were measured at different time points to observe the changes in Th1/Th2.Results In the model group,Th1/Th2 in peripheral blood and BALF was gradually lowering,the difference was significant compared with those of the blank group(P