[Objective] This report describes a patient with bilateral peripheral facial paralysis who was strongly suspected to have neurosarcoidosis and whose facial paralysis improved after acupuncture treatment.[Case] A 73-year-old man developed right facial nerve paralysis on July 24, X followed by left facial nerve paralysis three days later. The patient visited our Department of Neurology on August 2 and was hospitalized the next day. Upon examination, neurosarcoidosis was strongly suspected, and steroid pulse therapy was performed until he was discharged from the hospital on August 26. On September 13, still experiencing bilateral facial paralysis, the patient was referred to our department for acupuncture treatment. The patient's height was 159 cm and weight was 48.6 kg. Valley signs and pathologic reflexes were negative, and deep tendon reflexes and sensory tests of the upper and lower extremities were normal. MMT was fair only for the dorsiflexion movement of the left ankle. The Yanagihara score was 26 on the right and 10 on the left. Facial muscle contraction response to electrical acupuncture stimulation targeting the facial nerve showed contraction at 0.04 mA on the right side and no contraction at 0.30 mA on the left side. According to these examinations, the right side was considered to be mildly paralyzed and the left side was considered to be severely paralyzed, and acupuncture was performed to improve the symptoms of paralysis and prevent sequelae.[Treatment] Acupuncture was applied to GB2 and ST7 on the right side of the face. On the left side, acupuncture needles were placed on the frontalis muscle, orbicularis oculi muscle, elevator muscle of upper lip and wing of nose, nasalis muscle, zygomaticus major and minor muscle, orbicularis oris muscle, depressor angle oris muscle, and platysma muscle. From the 106th day of illness, asynchronous electroacupuncture was applied to the left side only. Acupuncture was performed once or twice a week for 10 minutes per session. The degree of paralysis was assessed by the Yanagihara score.[Progress] Acupuncture was combined with corticosteroids prescribed by the Department of Neurology. As a result, the right side had a score of 38 points after 170 days after start of illness and the left side had a score of 38 points after 204 days.[Discussion and Conclusion] The combined treatment of medication and acupuncture was effective and showed excellent results for this patient taking into account the degree of facial nerve damage. Acupuncture may be considered as an effective treatment option for bilateral peripheral facial paralysis.

Objective: The soybean has long been an important protein source for approximately 5000 years in Oriental countries. Therefore, soy protein has been widely investigated for its variety of function. However, the side effects had been reported for its close structure of the female hormone, estrogen. In this report, we prepare a new soy peptide derivative and focus on the potency, with special attention to the linkage of peripheral leukocytes in number, emotional hormone and brain blood flow.
Method: Dried powder of soybean-protein or peptide were administered orally at dosage 8g (dry weight) suspension, the blood sample was collected before and after one week at the same hour and served for assessment in order to avoid circadian rhythm.
Results: The cell numbers were up-regulated in the group that had a smaller number of leukocytes before the test, but in the larger number group before the test, they were down-regulated in the soybean-protein and peptide. Therefore, when the number of all subjects were totaled and make mean, indicating no difference. As for the leukocyte subsets, lymphocyte numbers of CD_11b⁺ cells, and CD₅₆⁺ cells significantly increased after ingestion of a single gradient in the soybean-peptide group. On the contrary, only CD₁₉⁺ cell counts were down regulated. In the soybean-peptide group, the adrenalin level in serum, which is regarded as one of the emotional hormones, was down regulated, and another emotional hormone, dopamine, was up regulated. There were no change of CD positive cells and emotional hormones in the soy protein and placebo group. In NIRS, a significant increase in amplitude of all the frequency bands was observed in the peptide group just after 5 min of administration by the sample, peptide.
Conclusion: These results indicate that the soybean peptides can regulate the leukocyte subsets and emotional hormones are also closely related with the change of the brain blood flow in healthy young volunteers.

 We have previously reported that hot-spring hydrotherapy for a short duration can change hormone levels in the blood and quantitatively as well as qualitatively regulate leukocytes and their subpopulations. In this study, we examined the effect of hot-spring hydrotherapy on the lymphocytes expressing β₂-adrenergic receptors (β₂-ARs). We obtained peripheral blood from 9 healthy volunteers (age, 49.7±11.2 years) at the same sampling time before and after (the next day) hot-spring hydrotherapy, and measured the total and differential leukocyte counts and the levels of 3 catecholamines (adrenaline, noradrenaline, and dopamine). We also analyzed the β₂-AR of lymphocyte subsets by combination with fluorescent monoclonal antibodies (CD3, CD4, CD 8, CD 19, and CD56) by using flow cytometry.
 The number of granulocytes significantly decreased after hot-spring hydrotherapy (p < 0.05). The ratio of β₂-AR⁺ CD4⁺ cells and β₂-AR⁺ CD3⁺ cells was low, but that of β₂-AR⁺ CD56⁺ cells and β₂-AR⁺ CD8⁺ cells was high. The CD8⁺ cell and CD56⁺ cell counts tended to increase after hot-spring hydrotherapy, but no significant variation was found in the β₂-AR⁺ cells of each subset. Adrenaline levels also significantly decreased after hot-spring hydrotherapy (p < 0.05). The rate of change in adrenaline levels before and after hot-spring hydrotherapy was highly correlated with the rate of change in the levels of CD56⁺, CD8⁺, and β₂-AR⁺ CD56⁺ cells. Thus, we found a difference in thepercentage of β₂-AR-expressing cells in the lymphocyte subsets. Therefore, it is possible that a short duration of hot-spring hydrotherapy decreased adrenaline levels and quantitatively influenced the natural killer cells and CD8⁺ cells, which express large amounts of β₂-AR.

We report a case of type A dissecting aneurysm occurring after aortic valve replacement (AVR). The patient was a 67-year-old man with a history of AVR 4 years previously. Preoperative CT scan revealed a type A dissecting aneurysm 10cm in diameter, close to the sternum. Under preparation for selective cerebral perfusion (SCP), re-do median sternotomy was safely performed using partial extracorporeal circulation (ECC) via a femoral artery and vein. Because of severe adhesion in the upper part of the ascending aorta and aortic arch, a graft replacement of the ascending aorta was impossible. Under SCP via bilateral common carotid arteries exposed in the neck, the entry of the dissection, which was located in the previous aortotomy line, was closed with an ePTFE patch. SCP via bilateral common carotid arteries exposed in the neck appeared to be very useful and safe for such patients at risk for injury to the aorta during re-do median sternotomy and with severe adhesion, which made it difficult to establish SCP via the usual operative field. Although graft replacement is the standard operation for the treatment of the ascending aortic dissection, patch closure of the entry should be considered as a second-choice method in some case.

To evaluate the effects of acupuncture on the immune system, the leukocyte, monocytes, lymphocyte and lymphocyte surface markers, CD2, CD4, CD8, CD11b, CD16, CD19 and CD56 in the peripheral blood of seventeen healthy volunteers were counted. The leukocyte above CD⁺ cell counts significantly increased after acupuncture. The results indicate that acupuncture may regulate the immune system and can increase the activity of cellular and humoral immunity and NK cell.
According to the percentage of lymphocytes or granulocytes, volunteers were divided into two types, those with more than 70% of granulocyte were recognized as G type and those with more than 40% of lymphocyte were divided into L type. Interestingly, before and after the treatment of acupuncture, the number of granulocytes and lymphocytes had a negative relationships. Namely we found an increase in the lymphocytes as well as a decrease in the granulocytes in the G type. On the other hand in the L type, we found an increase in the granulocytes and a decrease in the lymphocytes. Therefore we suggest that acupuncture can enhance the activity that maintains the balance of the immune function.

We have simultaneously proved that cell populations taking charge of immunity in human peripheral blood can be regulated quantitatively by acupuncture. Now we investigated the effect of acupuncture qualitatively on cytokine production by lymphocyte cells in human peripheral blood.
The number of IL-1β, IL-4 and IFN-γ containing cells, which are closely associated with macrophage, humoral immunity and cellular immunity respectively, were measured by FACScan. We found a significant increase in IFN-γ containing cells after acupuncture. According to this result together with previous results, the enhancement of CD4⁺ and CD56⁺ cell counts, the treatment of acupuncture can promote the activity of cellular immunity as well as NK cell.