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.

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.

A 67-year-old man receiving treatment for choledocholithiasis was found to have an abdominal aortic aneurysm on CT. The maximum diameter of the aneurysm was 60mm, and the isthmus of a horseshoe kidney was also observed. A total of four renal arteries, two each on the right and left sides, was detected by angiography and helical CT. Two of four arteries bifurcated from the aneurysm. Laparotomy confirmed the presence of a fifth renal artery, which extended from the left common iliac artery to the isthmus. It was not difficult to free the isthmus from the aneurysm. A Y-shaped prosthesis was placed between the normal portion of the aorta and the common iliac arteries without severing the isthmus. The left renal artery arose from the aneurysm and was reconstructed with 6mm knitted Dacron. The right renal artery, which was located below the isthmus, was ligated. The absence of postoperative renal dysfunction confirmed the patency of the reconstructed renal artery. Eleven such cases have been reported in Japan, including the present case. In 5 cases, renal artery reconstruction was performed, and the isthmus was preserved in 8 cases. However, the sites of renal artery bifurcation were correctly detected preoperatively in only 3 of these patients. It appears that accurate preoperative imaging is very important, along with renal artery reconstruction.

In order to avoid the risk of COVID-19 among our clinic staffs, remote medical care using tablet-type devices was conducted in our fever outpatient clinic. In about 5 months, there were 87 patients with COVID-19 diagnosed by PCR test. Among them, 24 patients (15 men and 9 women, average age 36.2 years) were treated with Kampo medicine. Four of 24 patients required hospitalization. All patients, including those hospitalized cases, improved their symptoms during the observation period. We believe that Kampo medicine is effective in the early treatment of COVID-19. In addition, we consider that remote medical care using tablet-type devices is one of the useful methods in the treatment of highly contagious infectious diseases.

The effectiveness of acupuncture in treating rhinitis due to allergic reaction to housedust and mites was tested by inducing an allergic response through a nasal mucosa test and observing the influence of acupuncture stimulation in the stellate ganglion. Stimulating the ganglion of the same side as that nasal passage which was most strongly blocked obtained suppression of nasal drip on that side with improvement in clearance of the nasal air passage in four out of five subjects. This is thought to be due to the excitation of the sympathetic nervous system in the cervical region.
Next, acupuncture therapy was coupled with conservative therapy to test their usefulness in combination. Seven subjects were treated for allergic rhinitis and of these, six subjects' subjective symptoms (such as nasal obstruction) improved immediately after the acupuncture stimulation. Of these six subjects, two subjects' improved condition continued while the other four subjects' relief lasted only one day.
Then five of the subjects were given long term acupuncture treatment with all five subjects having a complete improvement of their nasal allergy symptoms to housedust and mites.

The lower one-third point of a line connecting the posterior superior iliac spine and the middle of the lower margin of the ischial tuberosity is used as the acupuncture point to the pudendal nerve. The present study anatomically examined the positional relation between a needle inserted in the acupuncture point and the pudendal nerve as well as examined the projection region of the nerve to the body surface, using the bilateral pudendal nerves of 18 Japanese cadavers.
The needle inseted in the acupuncture point to the pudendal nerve missed the nerve caudally or laterocaudally in many cases, but with twelve cases directly pricking the caudal portion of the nerve. The pudendal nerve lying on the sacrospinous ligament was projected just on or lateral to a line connecting the posterior superior iliac spine and the medial edge of the lower margin of the ischial tuberosity, and in rostro-caudal direction the pudendal nerve was situated in a range 50 to 60% from the top of that line. The height of the sacral cornua corresponded to that of the rostral half of the pudendal nerve lying on the sacrospinous ligament or that more rostral than the rostral tip of the nerve, and the height of the lower tip of the coccyx corresponded to that more caudal than the caudal tip of the nerve.

A 75-year-oldm an with an aortocaval fistula as a complication of aortoiliac aneurysm visited our hospital. He complained of shortness of breath and melena. Physical examination revealed a pulsating abdominal mass with thrill and continuous murmur. Chest X ray showed cardiomegaly with pulmonary congestion. CT scan showed infrarenal aortoiliac aneurysm and echo Doppler scan revealed aortocaval communication at the inferior caval bifurcation. Aortoiliac bifurcated graft and patch reconstruction of IVC were performed. The postoperative course was uneventful, and his congestive heart failure and hepatorenal dysfunction immediately improved.

The severity of mitral regurgitation (MR) and tricuspid regurgitation (TR) was evaluated semiquantitatively by Doppler color flow imaging. The maximum MR area/body surface area (MRA/BSA) correlated significantly to the severity of angiographyic changes (tau=0.897). The maximum TR area/body surface area (TRA/BSA) also correlated significantly to the severity in angiography (tau=0.874). The cutoff values were 0.5, 2, 4, and 8cm²/m² for MRA/BSA and 1, 2.5, 5, and 10cm²/m² for TRA/BSA. Fourteen children (mean age 4.2 years) underwent repair of partial atrioventricular septal defects (P-AVSD) from 1985 to 1992. The cleft in the anterior leaflet was closed in the mitral valve; other procedures such as annuloplasty were not performed. They have been followed for periods from 7 months to 7 years and 5 months (mean 4 years); they were examined by echo cardiography and the Holter electrical cardiogram at the end of the period. MR had reduced to grade 0-II in all cases. No patients were given any medication, and all remained in NYHA Functional Class I. Paroxysmal supraventricular tachycardia developed in only one patient. We concluded that no annuloplasty in mitral valve is needed in children suffering from P-AVSD.

A 74-year-old woman was first admitted to our hospital for orthopnea, and was given a diagnosis of severe congestive cardiac failure caused by myocardial infarction. Coronary angiography revealed severe triple vessel disease, with a totally obstructed left anterior descending artery (LAD) and right coronary artery. First diagonal branch (Dx1) was 90% stenotic, and left circumflex artery was also 90% stenotic in its proximal portion (segment 11; #11). There was no stenotic lesion in the obtuse marginal branch or posterolateral branch, which are the usual target branches for the left circumflex branch (LCx). But they were too small to be grafted. Left ventriculography showed severe left ventricular dysfunction (ejection fraction; 31%). Saphenous vein grafting (SVG) to the distal portion of #11 and sequential SVG to the LAD and Dx1 were performed. Postoperative angiography proved that these grafts were patent. The patient was discharged on the 46th postoperative day after an uneventful course.