[Introduction] We reported that the effects of remote acupuncture point electrical stimulation on the BL 57, BL 58 and BL 60 to the BL 23's response. This study compared the influence of electrical and acupuncture stimulation on BL 40.
[Methods] The effects of acupuncture stimulation of BL 57, BL 58 and BL 60 were examined in 49 healthy volunteers without lumbago and 64 lumbago patients and measured change in the BL 23 response. All subjects gave informed consent prior to examination.
[Results] Pre-acupuncture stimulation of the BL 40 response of male group was significantly lower than female group. Male lumbago group and non-lumbago group of female significantly showed increase (p<0.01) by BL 57 acupuncture stimulation. On the other hand, only lumbago female group showed significantly increased (p<0.05) by BL 60 acupuncture stimulation, while lumbago patients remarkably influence showed that than non-lumbago group for the acupuncture stimulation.
These results indicate that acupuncture stimulation provides a stronger effect than electrical stimulation showed by the responding pattern of BL 23 after BL 57, 58 and 60 stimulation.
[Conclusion] The responsiveness of BL 23 might be variously influenced by the existence of lumbago, and gender difference following BL 57, BL 58 and BL 60 acupuncture stimulus along the BL meridian compared to the effects of electrical stimulation. Furthermore, the roles and mechanisms appeared different.

[Introduction] It is known that BL 23, which is a part of the Bladder Meridian could be used as a remote acupuncture stimulation point for the effective treatment of lumbago. This study was designed to consider whether remote acupuncture point stimulus from other meridian points such as GB 34, GB 35 along the Gallbladder Meridian exerted any influence on the BL-meridian as part of a series of research elucidating characteristics of that BL 23 response.
[Methods] The BL23 response after acupuncture stimulation of GB 34 and GB 35 was measured in 21 lumbago patients and 21 healthy volunteers without lumbago. We also measured the BL 23 response from the BL 40 and BL 57, GB 34 and GB 35 acupuncture points cross-over stimulation by 6 lumbago patients and 7 healthy subjects without lumbago to confirm the BL23 response property.
[Results] The BL 23 response was significantly increased (p<0.05) by an acupuncture stimulation of GB 34 in all subjects, except females without lumbago. Unexpectedly, it was shown that GB 34 acupuncture elicited a significantly stronger (p<0.01) BL 23 response. These new findings confirmed the effects of acupuncture stimulation BL 40 and BL 57, GB 34 and GB 35 acupuncture points by a cross-over methods on the same sub-jects in 6 lumbago patients and 7 healthy volunteers without lumbago.
[Conclusion] In conclusion, as a new finding, these results indicate that the BL 23 response on the Bladder Meridian system is not merely altered by acupuncture points along the same meridian system, but also capable of change from another meridian system such as the Gallbladder Meridian, especially stimulation from of the GB 35 acupuncture point.

INTRODUCTION : It has been suspected that the BL40 (Weizhong, Ichu) point could be used as a remote acupuncture stimulation point for the effective treatment of lumbago, because traditional remote acupuncture stimulation has shown, on occasion, dramatic effects for relieving chronic pain, especially lumbago, headaches and shoulder pain. We have reported that remote acupuncture point stimulation, such as “BL40-to-BL23 (Shenshu, Jinyu)” might be useful in the treatment of lumbago. An experiment was designed to identify the most effective points on the Bladder Meridian.
METHODS : We tested the electrical stimulation of BL57 (Chengshan, Shozan), BL58 (Feiyang, Hiyo) and BL60 (Kunlun, Konron) as far-points on the BL23 (Shenshu, Jinyu) in patients with slight to mild cases of lumago (24 adults, average age 31.2 y-o), who had given their informed consent beforehand. RESULTS : It was found that the respondent value (96.4 ± 4.8V, n=12) of BL40 on pre- stimulation in the male group was lower than that in the female group (86.1± 4.7V, n=12; p=0.07). When BL57 of lumbago patients was stimulated, the responsiveness of BL23 increased significantly in the male group (y=-0.04x+94.99; r=0.35, p<0.05), but declined in the female group (y=0.07x+102.55; r=0.44, p<0.01). When BL58 was stimulated, it had no apparent effect on the responsiveness of the male group, but that of the female group was reduced (y=-0.13x+99.00; r=0.85, p<0.001). In contrast, the responsiveness of BL23 to BL60 stimulation did not change in the male group but increased in the female group (y=0.12x+100.24; r=0.71, p<0.001). These results indicate that the stimulation on BL57, BL58 and BL60, which are far-points from BL23, had widely different effects on the responding pattern of BL23 in patients with lumbago.
CONCLUSION : The results confirm that remote acupuncture point stimulation might be valuable in the treatment of lumbago.

Aortoduodenal fistula is rare complication of nonoperative abdominal aortic aneurysm. We successfully treated a case of primary aortoenteric fistula associated with Behcet's Disease with two surgical intervention. The patient was 41 years old man. He admitted to our hospital because of severe shock due to enormous gastrointestinal hemorrhage. Emergency laparotomy revealed the inflammatory abdominalaneurysm ruptured into the duodenum. As the saccular aneurysm was densely adherent with duodenum and retoroperitoneum, graft replacement was abandoned. Primary closure of the perforated area of duodenum and the neck of aneurysm were performed. Axillofemoral bypass restored blood flow of the lower extremities. Three month after the operation, aortoduodenal fistula recurred. On the second operation, abdominal aorta was divided through retroperitoneal approach. However, primary closure of the enteric perforation with graft replacement of the aorta is considered as the first choice of the surgical treatment for aortoenteric fistula. In a case of difficult condition such as this patient with severe shock or retroperitoneal fibrosis, repair of the duodenum wall and division of the abdominal aorta with axillofemoral bypass is an alternative method of choice.

Thirty-nine years old woman had a severe renovascular hyper-tension with Takayasu's arteritis Her left renal artery stenosis was treated with percutaneous transluminal angioplasty (PTA) three times. Six months after the third PTA, the left renal artery was occluded, and left renal failure occurred. Aorto-renal bypass surgery with a prosthetic graft was performed. Blood pressure dropped to normal range, and left renal function began to recover. Although PTA is an effective method in the treatment of renovascular hypertension, an incidence of restenosis after PTA is higher in Takayasu's arteritis rather than atherosclerotic lesions. Five months after renal revascularization, hypertension recurred in this case. However the aorto-renal bypass graft was patent accompanied by no symptoms. This aorto-renal bypass surgery can be considered effective in this condition.

STUDY DESIGN: A retrospective study. PURPOSE: To examine the effectiveness of using an electrodiagnostic technique as a new approach in the clinical diagnosis of extraforaminal stenosis at L5-S1. OVERVIEW OF LITERATURE: We introduced a new effective approach to the diagnosis of extraforaminal stenosis at the lumbosacral junction using the existing electrophysiological evaluation technique. METHODS: A consecutive series of 124 patients with fifth lumbar radiculopathy were enrolled, comprising a group of 74 patients with spinal canal stenosis and a second group of 50 patients with extraforaminal stenosis at L5-S1. The technique involved inserting a pair of needle electrodes into the foraminal exit zone of the fifth lumbar spinal nerves, which were used to provide electrical stimulation. The compound muscle action potentials from each of the tibialis anterior muscles were recorded. RESULTS: The distal motor latency (DML) of the potentials ranged from 11.2 to 24.6 milliseconds in patients with extraforaminal stenosis. In contrast, the DML in patients with spinal canal stenosis ranged from 10.0 to 17.2 milliseconds. After comparing the DML of each of the 2 groups and at the same time comparing the differences in DML between the affected and unaffected side of each patient, we concluded there were statistically significant differences (p<0.01) between the 2 groups. Using receiver operating characteristic curve analysis, the cutoff values were calculated to be 15.2 milliseconds and 1.1 milliseconds, respectively. CONCLUSIONS: This approach using a means of DML measurement enables us to identify and localize lesions, which offers an advantage in diagnosing extraforaminal stenosis at L5-S1.
Action Potentials ; Constriction, Pathologic* ; Diagnosis* ; Diagnostic Techniques and Procedures ; Electric Stimulation ; Electrodes ; Humans ; Muscles ; Needles ; Radiculopathy ; Retrospective Studies ; ROC Curve ; Spinal Canal ; Spinal Nerves ; Spinal Stenosis

Fifty-five adult patients with atrial septal defect (ASD) were surgically treated. In the preoperative study, 6 patients showed high pulmonary artery systolic pressure (>50mmHg). However, there was no linear relation between PAP and age, nor between Q_p/Q_s and PAP. As for the additional surgical procedures, MVR (1), MAP (1), TAP (3), OPC (2) were carried out with ASD closure in 7 patients. Post-operative evaluation with echocardiography revealed increase in the left ventricular chamber size, decrease in the severity of tricuspid regurgitation and same grade mitral regurgitation compaired with pre-operative level. From these data, the prediction of the atrioventricular valve regurgitation after ASD closure seemed to be difficult just from the preoperative evaluation, Transesophageal echocardiography was useful for the evaluation of residual atrioventricular valve regurgitation during operation in the cases of ASD with over II grade regurgitation preoperatively.

OBJECTIVESThe objective of this metallomics study is to investigate comprehensively some relationships between cancer risk and minerals, including essential and toxic metals.

METHODSTwenty-four minerals including essential and toxic metals in scalp hair samples from 124 solid-cancer patients and 86 control subjects were measured with inductively coupled plasma mass spectrometry (ICP-MS), and the association of cancer with minerals was statistically analyzed with multiple logistic regression analysis.

RESULTSMultiple logistic regression analysis demonstrated that several minerals are significantly correlated to cancer, positively or inversely. The most cancer-correlated mineral was iodine (I) with the highest correlation coefficient of r = 0.301, followed by arsenic (As; r = 0.267), zinc (Zn; r = 0.261), and sodium (Na; r = 0.190), with p < 0.01 for each case. In contrast, selenium (Se) was inversely correlated to cancer (r = -0.161, p < 0.05), followed by vanadium (V) (r = -0.128). Multiple linear regression value was highly significantly correlated with probability of cancer (R (2) = 0.437, p < 0.0001), and the area under the receiver-operating characteristic (ROC) curve was calculated to be 0.918. In addition, using contingency table analysis and the chi-square test, the precision of discrimination for cancer was estimated to be 0.871 (chi-square = 99.1, p < 0.0001).

CONCLUSIONSThese findings suggest that some minerals such as arsenic, selenium, and probably iodine, zinc, sodium, and vanadium contribute to regulation of cancer and also that metallomics study using multiple logistic regression analysis is a useful tool for estimating cancer risk.