Epicodylitis humeri lateralis is common in indivisuals whose occupations require frequent rotatory motion of the forearm. An ache appears over the outer aspect of the elbow and is reffered into the forearm. The patients with epicodylitis humeri lateralis were often treated by acupuncture therapy. We treated the patients by means of acupuncture therapy with silver spike point therapy and streching of the extensors of the forearm, in Meiji College of Oriental Medicine Hospital. In order to clarify the effect of our therapy, we valuated clinical results by using pain scale score. We treated 13 patients (male 4, female 9, mean age 49.2 years). In our therpy, acupuncture points and SSP points, which were on the area from the lateral epicondyle to the extensors of the forearm, were used. And we made the patients to do streching of extensors of the forearm. The pain scale scale score improved from 10 points to 3.8 points after the treatments, 15% were excellent, 77% were good, and 8% fair. The results suggested that our therapy improves the symptoms of epicodylitis humeri lateralis.

Objective:It is very important that oxidative stress is estimated for us to understand a player's condition in the field of sports. The purpose of this study was to investigate whether electroacupuncture has an effect on exercise-induced oxidative stress.
Methods:Ten healthy male volunteers participated in both the electroacupuncture (EA) group and the control group in a crossover design. EA at a frequency of 2 Hz and optimum intensity was performed in the subjects for 10 minutes in both the medial vastus muscles. During ergometer exercise by ramp load, respiratory metabolism including the RC point was recorded as the indication of energy metabolism. Blood was collected from the fingertips of the subjects, and then their levels of oxidative stress (d-ROMs test) and antioxidative (BAP test) were determined by using a Free Radical Analytical System (FRAS4, Wismell Instruments). Six measurements were taken;at rest, immediately after EA and following exercise, and at 20, 40, and 60 minutes following exercise.
Results:The RC point was significantly prolonged in the EA group compared with the control group. The level of oxidative stress (d-ROMs test) in the control group increased significantly at 20 minutes following exercise compared with rest (before exercise) and this increase was sustained until 60 minutes after exercise. In contrast, it did not significantly change in the EA group. Whereas the antioxidative level (BAP test) in the EA group significantly increased immediately following exercise compared with rest (before exercise), it did not increase in the control group.
Conclusion:These results suggest that electroacupuncture might enhance the antioxidative level (BAP test) and inhibit the level of oxidative stress (d-ROMs test) by effecting a change in respiratory metabolism. We propose that electroacupuncture might be useful for sports conditioning.

The osteoarthritis of knee joints in early stage were treated with acupuncture, SSP and therapeutic exercise. The clinical effect of this treatment was evaluated by the our original score methoed for osteoarthritis of knee joints, and the muscle strength of extensors of knee joint were measured. Symptoms of the osteoarthritis of knee joints were improved significantly and the power of the extensors increased by these treatments.

The patients with the spondylosis deformans of the lumbar spine are often treated by acupuncture therapy. Forty patients (male 28, female 12, mean age 61.2 years old) with spondylosis deformans of lumbar spine were treated by the acupuncture therapy with therapeutic exercise and silver spike point (SSP) therapy in Meiji College of Oriental Medicine Hospital. The purpose of this study is to evaluate the clinical effect of our therapy using our painscale score. In our therapy, acupuncture points (Dachangshu-BL25, Shenshu-BL23, Ciliao-BL32, Baohuang-BL53 etc.) and SSP points on erector spinae muscle and gluteal muscle were used. As the result of this study, 22.5 % had excellent effect and 55.0 % had good effect by our therapy. It was concluded that our therapy is one of considerably effective therapy for the spondylosis deformans of the lumbar spine.

We studied the clincal effect of the electrical acupuncture at pudendal nerve in four cases of lumbar spinal canal stenosis. The experimental effect of the direct electrical stimulation to the pudendal nerve on the blood flow of the sciatic nerve evaluated by Laser-Doppler flowmetry in anesthetized rats. Electrical acupuncture at pudendal nerve resulted in the improvement of the gait distance of all four cases. The specific effect of the electrical acupuncture at pudendal nerve was found in one case who did not show any improvement by the acupuncture at the intervertebral joint points. On one hand, the direct electrical stimulation to rats pudendal nerve resulted in the increase of the sciatic nerve blood flow, which were not evoked by administration of atropine. These results suggest that the electrical acupuncture at the pudensal nerve may be effective for the intermittent claudication of the lumbar spinal canal stenosis. The increased blood flow of the sciatic nerve may play one of the important roles in the effect via autonomic nervous system.

A man in his 60s, who was diagnosed as having postoperative recurrent gastric cancer with lymph node and spinal metastases, was admitted to our palliative care unit (PCU). He was unable to receive further aggressive chemotherapy for cancer because of bilateral hydronephrosis and chronic renal failure. He had chronic urethral infection and hence required continuous antibiotic administration. Although his infection was well controlled with antibiotics, his oral intake gradually declined. Seventeen days after admission, he developed systemic hemorrhage, including hematuria and oral bleeding. Coagulation tests revealed that the patient had markedly prolonged prothrombin time (PT) and activated partial thromboplastin time (APTT) but no thrombocytopenia, fibrinogen consumption, or increased fibrin/fibrinogen degradation products (FDP) level. Serum level of protein induced by vitamin K absence or antagonist II (PIVKA-II) was markedly high, and vitamin K level was below the lower limit of the reference range. After he was administered intravenous vitamin K, his symptoms markedly improved. Many patients with advanced cancers tend to have malnutrition, anorexia, and chronic infection that require antibiotic administration. Prophylactic administration of vitamin K might be sometimes necessary for preventing catastrophic hemorrhage.

To investigate whether magnesium abnormalities are associated with the administration of magnesium-containing laxatives in a palliative care setting, we measured the serum magnesium levels in 48 patients with advanced cancer at our palliative care unit (PCU). The mean magnesium concentration in all patients was 2.09 mg/dl (confidence interval [CI], 1.38-3.62). Patients receiving magnesium-containing laxatives (n=38) showed significantly higher serum magnesium concentrations than patients without laxatives (n=10) (2.17 mg/dl vs 1.8 mg/dl, p=0.006). Although 10 patients had serum magnesium abnormalities (hypomagnesemia, 8 and hypermagnesemia, 2), we did not observe clinical manifestation associated with magnesium abnormalities. Interestingly, neither the duration nor the dose of laxatives correlated with serum magnesium concentration. Overall, patients at the PCU tend to have magnesium abnormalities and their symptoms may be analogous to those of advanced cancer patients; in particular, terminal patients with such symptoms might be considered to have magnesium abnormalities.

A case of isolated left coronary artery ostial stenosis treated successfully by the saphenous vein patch plasty is reported. A 49-year-old woman was referred for surgery because of unstable angina with subendcardial infarction on ECG. Coronary angiogram showed isolated severe stenosis of left coronary artery ostium without stenotic lesion in the periphery and right coronary artery. At surgery, the aorta was incised obliquely downward to the left coronary ostium and this incision was further extended 8mm distally in the main trunk. Atheromatous left coronary ostium was enlarged with the saphenous vein patch. Postoperatively, angina disappeared and aortic root angioram revealed a well dilated ostium. At 1 year follow-up, the patient remains asymptomatic.

We have previously reported on a predictive model for deficiency-excess pattern diagnosis that was unable to predict the medium pattern. In this study, we aimed to develop predictive models for deficiency, medium,and excess pattern diagnosis, and to confirm whether cutoff values for diagnosis differed between the clinics. We collected data from patients' first visit to one of six Kampo clinics in Japan from January 2012 to February 2015. Exclusion criteria included unwillingness to participate in the study, missing data, duplicate data, under 20 years old, 20 or less subjective symptoms, and irrelevant patterns. In total, 1,068 participants were included. Participants were surveyed using a 153-item questionnaire. We constructed a predictive model for deficiency, medium, and excess pattern diagnosis using a random forest algorithm from training data, and extracted the most important items. We calculated predictive values for each participant by applying their data to the predictive model, and created receiver operating characteristic (ROC) curves with excess-medium and medium-deficiency patterns. Furthermore, we calculated the cutoff value for these patterns in each clinic using ROC curves, and compared them. Body mass index and blood pressure were the most important items. In all clinics, the cutoff values for diagnosis of excess-medium and medium-deficiency patterns was > 0.5 and < 0.5, respectively. We created a predictive model for deficiency, medium, and excess pattern diagnosis from the data of six Kampo clinics in Japan. The cutoff values for these patterns fell within a narrow range in the six clinics.