Radioisotope renography, which is a technique for extracorporeal examination of kidney utilizing radionuclides, can provide the data of renal dynamics such as blood flow and excretion of urine about individual kidney. Since this technique allowes simple and noninvasive examination of renal functions, it is now commonly used clinically.
The present study was designed to elucidate a relationship between renal function and meridian point by using radioisotope renography. In this paper the effect of acupuncture applied placing-needle wlth low frequency wave to Shenshu (UB-23) of the urinary bladder channel of foot-taiyang on renal function, especially excretion of urine, was observed.
It was found that urinary elimination of radioisotope after acupuncture increased, although no marked change was noted on the pattern of renogram curve.

It is said that the R-R interval on an ECG, showing the period of the cardiac cycle, reflects the activity of the vagus.
In this paper, the changes in the R-R interval brought by acupuncture and moxibustion were investigated by using Ximen (P-4) and Shenmen (H-7).
In the case of acupuncture and/or moxibustion to Ximen as well as Shenmen, the prolonged R-R interval was noted, while the increased coefficient of alteration of R-R interval was showed in the case of acupuncture. The coefficient of the alteration showed a decrease, however, in the case of moxibustion to Shenmen. Remarkable reduction in the coefficient of the alteration were observed immediately after acupuncture to Ximen under administration of atropine, but moxibustion did not produce any remarkable fluctuations. On the other hand, acupuncture to Ximen under administration of propranolol produced no remarkable fluctuation, while moxibustion brought an increased coefficient of the alteration.
The results suggested that there were considerable variations in the influence on the autonomic nervous system which participated with the cardiac rhythm by different stimulation to the same meridian point.

Objective: We have examined the efficacy of our long-term resistant training program on physical ability, masticatory performance, and nutrition status in the elderly. We further have investigated the effects of thumbtack needle treatment used together with the training on the comprehensive QOL. Materials & Methods: Participants: Forty elderly participants aged 65 years or older who have been trained for more than three years at our fitness club (RTG). Sixteen elderly in RTG who were able to participate in a 3-year exercise evaluation have been examined the efficacy of our training program on physical ability.  The training program was set up on basis of one term that the training carried out twice a week for 3 months. This program was totally carried out for three years. Evaluation of the training effect has been conducted every after the each term. The items of physical fitness tests were divided into ten items including the knee extension strength and one-leg standing time with eyes open. The average nutrient intake of energy was calculated by using a meal questionnaire for diet content of 3 days prepared to RTG. The masticatory performance was evaluated by using color-chewing gum.  The thumbtack needle treatment was performed on two points of Zusanli (ST36 : Zusanli) and Sanyinjiao (SP6 : Sanyinjiao) for twenty-eight elderly in RTG during 2 weeks. The assessment of thumbtack needles treatment was performed by measurement of salivary cortisol and CgA, using SF-8TM questionnaire before and after the thumbtack needles treatment. Results & Discussion: The knee extension strength (kg) and one-leg standing time with eyes open (sec) were significantly increased. We recognized a significant positive correlation between the masticatory performance and knee extension strength, and between the masticatory performance and average nutrient intake of energy for 3days at the RTG. Furthermore, following the thumbtack needle treatment for two weeks, mean values of salivary cortisol after training was significantly decreased compared with those before training, but no significant change was recognized in mean values of salivary CgA. In the SF-8th questionnaire after the thumbtack needle treatment was performed, the mean value of PCS (Physical Component Summary) score increased significantly, and mean values of MCS (Mental Component Summary) score tended to increase. Additionally, mean values of RP (Role Physical) and VT (Vitality), GH (General Health) subscale scores were significantly improved.  The results of the present study demonstrate that our training program was effective for improving walking ability and balance ability as well as preventing the decline of the other exercise functions and maintaining the masticatory performance and good nutrient status in the elderly.  Consequently, we concluded that our training program was a successful approach to prevent locomotive syndrome and the care for the elderly. In addition, improvement of the mental and physical QOL and subjective health index were brought about by using the thumbtack needles treatment on the resistant training.

More than 3 years have passed since the guideline for infection prevention at acupuncture and moxibustion clinics was issued. We studied changes in the attitude toward sanitization of the environment and consciousness about infection prevention at acupuncture and moxibustion clinics during this period. The subjects were members of the Acupuncture and Moxibustion Societies of Kyoto and Osaka (n=349). About 70% of the subjects felt anxiety about infections, and nearly 80% of them were interested in sanitizing the clinics. More than half (57%) of the subjects were using both disposable and reusable needles, and about half the subjects disposed of used needles without sterilization. Concerning the linen, pillow covers were changed for every patient by about 70% of the subjects, but towels and sheets were changed by only 20% and 10%, respectively. White coats were changed within 1 week by about 70% of the subjects. Most subjects answered that the clinics were cleaned everyday, but less than a half of them sterilize slippers. About half the subjects answered that curtains were washed every 3-6 months. Autoclaves were placed in only 90% of the clinics. Attention to preventive measures against infection of therapists tended to diminish with increase in the clinical experience.

　　A 48-year-old man with jaundice was referred to our hospital. Endoscopic retrograde cholangiography showed primary sclerosing cholangitis. Endoscopic biliary drainage was not successful because of highly viscous bile, so we performed percutaneous trans-gallbladder drainage (PTGBD), which was able to reduce the total serum bilirubin level from 8 to 10mg/ml. Subsequently, an indwelling drainage catheter was placed in the gallbladder for 13 months. However, liver atrophy worsened with the gradual progression of hepatic failure. Twelve months later, he complained of dyspnea. Computed abdominal tomography showed that the drainage catheter had perforated the diaphragm and become exposed to the chest cavity. In spite of intensive care, the patient died of liver failure while waiting for a liver transplant. Careful attention should be paid to the possibility of this serious complication in such patients.

Methods: We examined the computed tomography scans from the thoracic vertebra to the sacrum used to diagnose DISH in 140 patients (98 men and 42 women; average age, 78.6 years). We compared patients who did (n=52) and did not have (n=88) fractures at the continuous vertebral bodies fused by bone bridges. The relationship between the vertebral fractures and the maximum number of vertebrae that are bony cross-linked with contiguous adjacent vertebrae (max VB) from the thoracic vertebra to the sacrum or from the lumbar vertebra to the sacrum and proximal femur BMD were analyzed using a logistic regression model. Results: We found that after adjusting for the confounding factors, higher max VB, both from the thoracic vertebrae to the sacrum and the lumbar vertebrae to the sacrum, was associated with a higher risk of vertebral fractures. This difference was statistically significant. The risk was higher when only the lumbar vertebrae to the sacrum was considered (thoracic vertebrae to the sacrum: odds ratio, 1.21; p<0.05; lumbar vertebrae to the sacrum: odds ratio, 2.78; p<0.01). Moreover, low proximal femur BMD in DISH patients raises the fracture risk (odds ratio, 0.47; p<0.01). Conclusions Many continuous vertebral bone bridges, especially those that extend to the lumbar spine and low proximal femur BMD, are risk factors for fracture in DISH patients.

With the advancement and complexity on present society it has been called the “age of depression”. One gets the feeling that depression, following a singular path of increase in recent years is one sort of “sickness of the era”. This time we conducted a screening test for masked depression, selected those showing such a tendency, and here report the remarkable improvement in a short period of time the condition of depression using acupuncture.
Method: Nakajima's test for masked depression (abbr MD test) was carried out on students from Meiji special school of Oriental Medicine and Meiji Junior College of Acupuncture and Moxibustion and screened 65 subjects with depression tendencies. Twenty-seven of these 65 subjects were randomly selected and divided into two groups of 16 in “actual group” and 11 in “placebo group”. Acupuncture method: In the actual group six acupoints that commonly applied on the psychic disease were used as follows; HYAKUE (GV 20), SHINCHU (GV 12), SHIN-YU (BL 15), KOKETSU (CV 14), SHINMON (HT 7) and SAN-INKO (SP 6) and the other hand in the placebo group five acupoints close to these in the former group but which are not directly related to psychic disease were applied as follows; TOH-DO (GV 13), FU-MON (BL 12), SUIBUN (CV 9), GEREN (LI 8) and KENSYO (GB 39). Acupuncture was performed for 10 minutes stationally by using gold needle (0.20mm wide, 40mm length) and was undertaken three times in a week for four weeks. Its clinical effect was evaluated by the MD test and the CMI test every two weeks.
Results: 1) In the actual group the score on the MD test averaged out to a return to normal range within two weeks whereas in the placebo group even after four weeks the score still remained in the sphere of depression.
2) In the actual group a 80% of the subjects showed in area IV (the sphere of neurosis) on the CMI test was resistant to the therapy. Even they did not relieve into the sphere of normality.
3) The acupuncture therapy indicated a tendency to the improvement of both physical and psychic symptoms in the actual group.
Conclusion: It was demonstrated that the acupuncture therapy applying acupoints suitable for psychic disease brought rappydly improvement of not only psychic symptoms but also physical symptoms and then gave a relief from the condition of depression.

The purpose of this study was to introduce our patient-specific bioactive porous titanium implant manufactured using selective laser melting (SLM) and to establish the efficacy and safety of the implant for stand-alone anterior cervical discectomy and fusion (ACDF) based on a prospective clinical trial. We designed a customized ACDF implant using patient-specific data and manufactured the implant using SLM. We produced a bioactive surface through a specific chemical and thermal treatment. Using this implant, we surgically treated four patients with cervical degenerative disc disease and evaluated the clinical and radiological results. We achieved successful bony union in all but one patient without autologous bone grafting within 1 year. We observed no implant subsidence during the follow-up period, and all clinical parameters improved significantly after surgery, with no reported implant-related adverse effects. Our customized bioactive porous titanium implant is a safe and promising implant for stand-alone ACDF.

The purpose of this study was to introduce our patient-specific bioactive porous titanium implant manufactured using selective laser melting (SLM) and to establish the efficacy and safety of the implant for stand-alone anterior cervical discectomy and fusion (ACDF) based on a prospective clinical trial. We designed a customized ACDF implant using patient-specific data and manufactured the implant using SLM. We produced a bioactive surface through a specific chemical and thermal treatment. Using this implant, we surgically treated four patients with cervical degenerative disc disease and evaluated the clinical and radiological results. We achieved successful bony union in all but one patient without autologous bone grafting within 1 year. We observed no implant subsidence during the follow-up period, and all clinical parameters improved significantly after surgery, with no reported implant-related adverse effects. Our customized bioactive porous titanium implant is a safe and promising implant for stand-alone ACDF.

Methods: For this prospective multicenter study, 40 patients were followed up through radiologic and clinical examinations for at least 1 year postoperatively. All surgical procedures were either single- or double-level LLIF using bioactive porous titanium spacers without bone grafts. Results: Four patients were excluded from the study owing to aggravation from other comorbidities. Another 36 patients, including 26 and 10 with single- and double-level LLIFs, respectively, participated in the follow-up. The mean age at the time of surgery was 63.7 years. The mean operating time was 50.5 minutes per level. The mean estimated intraoperative blood loss was 11.6 mL per level. Clinical scores improved in all cases and were maintained throughout the follow-up period. The intervertebral bony union rates were 67.4% and 84.8% at 6 and 12 months, respectively. Endplate cyst signs were observed in 13.0% and 8.7% of patients at 6 and 12 months, respectively. Fused segmental angles were maintained throughout the follow-up period, indicating no cage subsidence. Conclusions Single- and double-level LLIFs using bioactive porous titanium spacers without bone grafts were found to be minimally invasive, resulting in clinical and imaging results comparable with conventional procedures. Therefore, this type of implant may be an option for minimally invasive spinal fusion surgery.