Human skin sections of the Goukoku (LI·4)-corresponding area and its surroudings were collected and they were stained with H. E. dyes. Abundant nerve fibers and blood vessels were observed in the Goukoku (LI·4)-corresponding area, while their numbers were slightly decreased in the non-acupoint area on the meridian. Their numbers in the extra-meridian non-acupoint area were the lowest.
Substance P-containing nerve fibers were examined by histochemistry in the same areas, and many of them were observed in the Goukoku (LI·4)-corresponding area. And further more, they were closely associated with lymphatic vessels. These findings suggest the mechanism that Substance-P secreted by the stimulation of acupoint, is transported to the lymph node via lymphatic vessels, thus leading the stimulation of the lymphatic system.
Lymphatic vessels with abundant smooth muscles were predominantly noted in the Goukoku (LI·4)-corresponding area and scarcely in the non-acupoint area by fluorescent stain. This finding suggests that hypersensitive one may feel the contraction of lymphatic smooth muscle induced by the Substance-P as a phenomenon of propagated sensations along the meridians (PSM).

A 72-year-old man presented with abdominal aortic aneurysm (AAA) and was referred to our hospital by his physician. A computed tomography revealed a 95-mm AAA with three right renal arteries. The main right renal artery branched from the AAA, and two remaining arteries branched from the same level as the left renal artery. The patient underwent AAA repair and main right renal artery reconstruction without any renal protection. After the operation, renal function did not deteriorate. 3D-CT was useful for diagnosing renal artery branching, evaluation of renal blood perfusion, and determining the operation method.

BACKGROUND: The effectiveness of surveillance to identify extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) carriers is controversial during a non-outbreak situation. We performed additional stool cultures for ESBL-E among intensive care unit (ICU) patients already under active surveillance by means of sputum and urine cultures. We aimed to assess the efficacy of stool cultures for screening for ESBL-E in a non-outbreak situation. METHODS: We conducted a retrospective cohort study in an ICU. Sputum and urine samples were cultured for ESBL-E surveillance purposes from January to September 2013 (phase 1). Stool cultures were routinely performed in addition from January to September 2014 (phase 2). Antimicrobial use density values and clinical outcomes were investigated and compared between phase 1 and 2. RESULTS: We identified 512 and 478 patients in phase 1 and phase 2, respectively. ESBL-E were found in the feces of 65 (13.6%) patients in phase 2. The antimicrobial use density values (expressed as defined daily doses per 1,000 bed-days) were not significantly different between the two phases for fluoroquinolones (7 vs. 10, p = 0.376), third-generation cephalosporins (24.2 vs. 29.5, p = 0.724), tazobactam/piperacillin (44.6 vs. 57.3, p = 0.489), and carbapenems (73 vs. 55.5, p = 0.222). Moreover, there were no significant differences in ICU mortality and length of stay (11.5% vs. 9.8%, p = 0.412, and 9 vs. 10 days, p = 0.28, respectively). CONCLUSIONS: Stool culture seemed ineffective in improving the antimicrobial use density of broad-spectrum antimicrobials, clinical outcomes, and ICU length of stay, and is not recommended for surveillance of ESBL-E in a non-outbreak situation.
Asian Continental Ancestry Group* ; beta-Lactamases ; Carbapenems ; Cephalosporins ; Cohort Studies ; Critical Care* ; Disease Outbreaks ; Enterobacteriaceae* ; Epidemiology ; Feces ; Fluoroquinolones ; Humans ; Intensive Care Units* ; Length of Stay ; Mass Screening ; Mortality ; Retrospective Studies* ; Sputum

We report a case of serous gonarthritis with nonproductive cough successfully treated with Eppikajutsuto. A 37-year-old Japanese man developed a right genicular arthrocele with nonproductive cough, in October X. Over 100 ml of serous synovial fluid was drained via an arthrocentesis puncture procedure. Although he was treated with nonsteroidal anti-inflammatory agents by an orthopedist, under a diagnosis of serous gonarthritis, his symptoms did not improve. Laboratory findings suggested inflammatory conditions (serum CRP 3.4 mg/dl, ESR 76 mm/h). At the time of his first visit in January X+1, orthopedic examinations revealed that rheumatoid arthritis was unlikely, based on negative physical and laboratory findings. A contrast MRI knee joint scan did not demonstrate any tumor-like mass of synovium which would indicate pigmented villonodular synovitis. And orthopedists found it difficult to specify the cause of his serous gonarthritis. After a common cold in December X, cough stimulated by cold exposure was superimposed on serous gonarthritis.We utilized Eppikajutsuto under the interpretation that both his genicular arthrocele and nonproductive cough were due to a “sui” disturbance. This Eppikajutsuto therapy reduced his genicular arthrocele and nonproductive cough in1month. His symptoms and inflammatory reactions were completely improved in 3 months, regardless of gradual withdrawal of his medication.
Coughing ; Upper case ecks ; symptoms <1> ; Serous ; Treated with

We report a case with an intractable jugular sense of discomfort, with dryness and nonproductive cough successfully treated with soshikokito. A 62-year-old Japanese man developed jugular sense of discomfort with dryness and nonproductive cough, after odontotherapy in October. Although he was treated with Western drugs by an otolaryngologist, under the diagnosis of xerostomia with no mechanical problems, his symptoms did not disappear. The symptoms followed a protracted course, and he further developed a loss of appetite. At the time of first visit in October, otorhinolaryngological studies showed no structural lesions or problems, with the exception of minimum salivation in the normal range on a gum test. There was no evidence of dry eyes. With the diagnosis of xerostomia, Bakumondoto-go-hangekobokuto was administered for a month but showed no sign of improvement. Making a shift to bukuryoin-go-hangekobokuto regained his appetite, but did not produce any improvement on dryness. We then utilized soshikokito under the interpretation that both dryness and nonproductive cough is ki-gyaku. The soshikokito therapy reduced his dryness in a month's time. Additionally, his nonproductive cough gradually decreased, and within 11 months after, he had no symptoms, regardless of a gradual medication withdrawal.
Coughing ; symptoms <1> ; seconds ; month ; Peripartum discomfort

BACKGROUND: The effectiveness of surveillance to identify extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) carriers is controversial during a non-outbreak situation. We performed additional stool cultures for ESBL-E among intensive care unit (ICU) patients already under active surveillance by means of sputum and urine cultures. We aimed to assess the efficacy of stool cultures for screening for ESBL-E in a non-outbreak situation. METHODS: We conducted a retrospective cohort study in an ICU. Sputum and urine samples were cultured for ESBL-E surveillance purposes from January to September 2013 (phase 1). Stool cultures were routinely performed in addition from January to September 2014 (phase 2). Antimicrobial use density values and clinical outcomes were investigated and compared between phase 1 and 2. RESULTS: We identified 512 and 478 patients in phase 1 and phase 2, respectively. ESBL-E were found in the feces of 65 (13.6%) patients in phase 2. The antimicrobial use density values (expressed as defined daily doses per 1,000 bed-days) were not significantly different between the two phases for fluoroquinolones (7 vs. 10, p = 0.376), third-generation cephalosporins (24.2 vs. 29.5, p = 0.724), tazobactam/piperacillin (44.6 vs. 57.3, p = 0.489), and carbapenems (73 vs. 55.5, p = 0.222). Moreover, there were no significant differences in ICU mortality and length of stay (11.5% vs. 9.8%, p = 0.412, and 9 vs. 10 days, p = 0.28, respectively). CONCLUSIONS: Stool culture seemed ineffective in improving the antimicrobial use density of broad-spectrum antimicrobials, clinical outcomes, and ICU length of stay, and is not recommended for surveillance of ESBL-E in a non-outbreak situation.
Asian Continental Ancestry Group ; beta-Lactamases ; Carbapenems ; Cephalosporins ; Cohort Studies ; Critical Care ; Disease Outbreaks ; Enterobacteriaceae ; Epidemiology ; Feces ; Fluoroquinolones ; Humans ; Intensive Care Units ; Length of Stay ; Mass Screening ; Mortality ; Retrospective Studies ; Sputum

INTRODUCTIONCandidaemia, recognised as a fairly common disease among intensive care unit (ICU) patients, carries a poor prognosis. However, as studies on the prognostic factors associated with candidaemia in ICU patients are limited, this study aimed to establish the best prognostic factor for ICU patients with candidaemia in a tertiary care hospital in Japan.

METHODSWe conducted a retrospective cohort study of patients with candidaemia in the emergency ICU at Fukuoka University Hospital, Fukuoka, Japan, from April 2010 to March 2015. Demographic and clinical data was collected from the patients' medical records and laboratory databases.

RESULTSA total of 25 patients were included in the study. However, 18 patients died during hospitalisation, resulting in an in-hospital mortality rate of 72.0%. The variables of Sequential Organ Failure Assessment (SOFA) score and cumulative number of risk factors for invasive candidiasis showed significant differences between patients in the survivor and non-survivor groups (p < 0.05). The areas under the receiver operating characteristic curves for the SOFA score and cumulative number of risk factors for invasive candidiasis were 0.873 (95% confidence interval [CI] 0.72-1.00) and 0.937 (95% CI 0.84-1.00), respectively.

CONCLUSIONOur results suggest that the cumulative number of risk factors for invasive candidiasis was the most useful prognostic indicator for candidaemia in ICU patients.