We examined effects of electro-acupuncture on the jaw opening reflex. Using rats anesthetized with pentobarbital sodium (40mg/kg: intraperitoneal) the jaw opening reflex was evoked by electrical stimulation of the dental pulp. The reflex was evoked by electro-myograms were recorded from the digastric muscle, showing di- or triphasic potentials with latency of about 6 msec. The dental pulp stimulation was preceded by single pulse electroacupuncture (EA) of the fore- or hind-leg.
Facilitation followed by inhibition of the jaw opening reflex was induced by the EA. The facilitation lasted for about 20 msec and 30 msec in case of the fore- and hind-leg EAs, respectively. The following inhibition was observed up to about 300 msec and 400 msec after the fore- and hind-le2 EA9, respectively.
It is worthy of note that train pulse EAs diminished inhibition of the jaw opening reflex.

Effects of repetitive electro-acupuncture stimulation on the blink reflex were studied in 23 healthy adults. The blink reflex was elicited by an electrical stimulus of the supraorbital nerve. The reflex EMG's were recorded from the orbicularis oculi muscle. The EMG's were composed of the early component (R1), ipsilaterel to the supraorbital stimulation, with about 10m sec latency and the bilateral late ones (R2) with about 30m sec latency. Electro-acupuncture stimulations consisting of single pulse and a train pulse were given to the skin on “Hogu” point, respectively.
Single pulse electro-acupuncture stimulation inhibited the R2 components for 30m sec to 1 sec after the stimulation and its inhibitory effect reached maximum about 100m sec after it. The R2 components were also suppressed when the skin was stimulated by a train of ten pulses with frequency of 2c/s to 20c/s, but the inhibitory effect decreased significantly compared with that of single pulse stimulation. The inhibitory effect was also diminished by 10 to 200 pulses electro-acupuncture stimulation with a frequency of 2c/s.

Acupuncture effects are frequently modified by additional acupuncture stimulations. In this study we tried to clarify the mechanisms of such phenomena using the rat jaw opening reflex. The reflex response was elicited by an electrical stimulus of the tooth pulp. The reflex EMG's were recorded from the digastric muscles. Single electroacupuncture stimulation (CS1) was delivered to the skin of a rat.
CS1 facilitated the reflex for 20ms after the stimulation, and then inhibited it from 40ms to 250ms. When CS1 was preceded by another electroacupuncture stimulation (CS2), the facilitatory effect induced by CS1 was enhanced CS2-CS1 interval being within 10ms. Then the reflex was inhibited when CS2-CS1 interval was 40-150ms. On the other hand CS1's inhibitory effect was suppressed by CS2 and the reflex reappeared while CS2 preceded CS1 at an interval of 100ms to 1.5s.

The effects of local application of capsaicin (CAP) to peripheral nerves on electroacupuncture (EA) analgesia were behaviorally examined in the rats. Pain threshold, datermined by using a hot-plate and tail-flick methods, increased to 160-180% of the control value after EA, which was applied to the acupuncture points between LI-11 and LI-12 of the rat forepaw. After the local application of CAP to the radial, ulner and median nerves of the animal's right forepaw, the EA, applied to the treated forepaw, did not significantly change the pain threshold. In the same animals, the EA applied to the untreated side increased the threshold as high as that before the CAP treatment. This indecates that the EA became ineffective on the CAP treated side, this ineffectiveness of the EA cont inued until at last 15 days in the case of the single CAP treatment for 15min, on the peripheral nerves. The substance P (SP) concentration in the spinal dolsal horn (C5-7) of these animals, which was measured by radioimmunoassay, was about 40% lower in the CAP treated side than in the untreated side.
These results suggest that SP-containing primary afferents, of which nerve conduction was probably blocked by treatment whth CAP, convey information for EA analgesia.

Treatment of perianal and vulvar extramammary Paget disease (EMPD), rare intraepithelial malignancies, is often challenging because of its potential to spread into the anal canal. However, there is still no consensus regarding the optimal resection margin within the anal canal. Between 2004 and 2014, six patients (three with perianal EMPD and three with vulvar EMPD) in which the spread of Paget cells into the anal canal was highly suspected were referred to our department. To evaluate the disease extent within the anal canal, preoperative mapping biopsy of the anal canal was performed in five out of six patients. Two patients were positive for Paget cells within the anal canal (one at the dentate line and the other at 0.5 cm above the dentate line), whereas in three patients, Paget cell were present only in the skin of the anal verge. Using 1 cm margin within the anal canal from the positive biopsy sites, we performed anal-preserving wide local excision (WLE), and negative resection margins within the anal canal were confirmed in all five patients. The remaining one patient with perianal EMPD did not undergo mapping biopsy of the anal canal because preoperative colonoscopy revealed that the Paget cells had spread into the lower rectum. Therefore, WLE with abdominoperineal resection was performed. During the median follow-up period of 37.3 months, no local recurrence was observed in all patients. Our small case series suggest the usefulness of mapping biopsy of the anal canal for the treatment of perianal and vulvar EMPD.
Anal Canal* ; Biopsy* ; Colonoscopy ; Consensus ; Follow-Up Studies ; Humans ; Paget Disease, Extramammary* ; Rectum ; Recurrence ; Skin

Treatment of perianal and vulvar extramammary Paget disease (EMPD), rare intraepithelial malignancies, is often challenging because of its potential to spread into the anal canal. However, there is still no consensus regarding the optimal resection margin within the anal canal. Between 2004 and 2014, six patients (three with perianal EMPD and three with vulvar EMPD) in which the spread of Paget cells into the anal canal was highly suspected were referred to our department. To evaluate the disease extent within the anal canal, preoperative mapping biopsy of the anal canal was performed in five out of six patients. Two patients were positive for Paget cells within the anal canal (one at the dentate line and the other at 0.5 cm above the dentate line), whereas in three patients, Paget cell were present only in the skin of the anal verge. Using 1 cm margin within the anal canal from the positive biopsy sites, we performed anal-preserving wide local excision (WLE), and negative resection margins within the anal canal were confirmed in all five patients. The remaining one patient with perianal EMPD did not undergo mapping biopsy of the anal canal because preoperative colonoscopy revealed that the Paget cells had spread into the lower rectum. Therefore, WLE with abdominoperineal resection was performed. During the median follow-up period of 37.3 months, no local recurrence was observed in all patients. Our small case series suggest the usefulness of mapping biopsy of the anal canal for the treatment of perianal and vulvar EMPD.
Anal Canal* ; Biopsy* ; Colonoscopy ; Consensus ; Follow-Up Studies ; Humans ; Paget Disease, Extramammary* ; Rectum ; Recurrence ; Skin