[Purpose] We know of no reports on the effects of electro-acupuncture (EA) stimulation, on human skeletal muscle blood flow (MBF), examined quantitatively with a direct method. Therefore, we investigated changes in MBF before, during and after EA with a new clearance method. [Methods] Ten healthy adult volunteers (8 men and 2 women; median age 30.5 years) were given EA to the trapezius at the BL 10 and GB 21 acupoints, employing the left trapezius as the non-EA side to contrast with the right trapezius as the EA side, and using stainless needles of 50 mm length and 0.18 mm gauge. MBF data were surveyed for 2 minutes before EA, for 4 minutes during EA, and for 4 minutes after EA, and a total of10minutes were analyzed l(?). Blood pressure and heart rate were simultaneously measured. [Results] MBF on the EA side increased significantly during EA (p < 0.05). On the other hand, diastolic blood pressure and heart rate were shown to decrease during EA (p < 0.05). [Discussion] These results, showing that MBF increased on the EA side, while diastolic blood pressure and heart rate decreased, suggest a regional muscle pump action with EA. [Conclusion] In evaluating a new, direct means of quantitatively examining _99mTc0_4- clearance, an increase in MBF with right side EA stimulation was clearly shown. Because the present method is simpler and easier, and higher in accuracy than past methods, we believe it may be used more aggressively in future clinical studies of acupuncture/moxibustion.

Background/Aims: Thiopurines are key drugs for inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD). Recently, NUDT15 polymorphism (R139C, c.415C > T) has been shown to be associated with thiopurineinduced adverse events in Asian populations. In patients with the C/T genotype, low-dose thiopurine treatment is recommended, but its long-term efficacy and tolerability remain unclear. This study aimed to uncover the long-term efficacy and appropriate dosage of thiopurine for IBD patients with the C/T genotype. Methods: A total of 210 patients with IBD (103 UC and 107 CD) determined to have NUDT15 R139C variants were enrolled. Clinical data were retrospectively reviewed from medical records. Results: Of 46 patients (21.9%) with the C/T genotype, 30 patients (65.2%) were treated with thiopurines. Three of whom (10.0%) discontinued thiopurine treatment due to adverse events and 27 of whom continued. The median maintenance dosage of 6-mercaptopurine was 0.25 mg/kg/day (range, 0.19–0.36 mg/kg/day), and 6-thioguanine nucleotides level was 230 (104–298) pmol/8 × 108 red blood cells. Cumulative thiopurine continuation rates for 120 months for patients with the C/C and C/T genotypes were not significantly different (P= 0.895). Cumulative non-relapse rates in the patients with UC treated with thiopurine monotherapy and surgery-free rates in CD patients treated with combination therapy (thiopurines and anti-tumor necrosis factor-α agents) for maintenance remission were not significantly different at 60 months (C/C vs. C/T, P= 0.339 and P= 0.422, respectively). Conclusions Low-dose thiopurine treatment is an effective and acceptable treatment for patients with C/T genotype.

We report on an apparently healthy woman in her 50s who noticed pain in the left side of her neck anteriorly and was prescribed an antimicrobial agent at a nearby clinic. However, she developed hypotension and hypoxemia and was brought to our hospital. Laboratory investigations revealed evidence of inflammation, and imaging findings showed low-density areas corresponding to the left lobe of the thyroid gland. The low-density areas extended to the superior mediastinum, raising suspicion of a thyroid gland mediastinal abscess. We performed inferior mediastinal drainage with video-assisted thoracoscopic surgery and resection of the left lobe of the thyroid gland. Culture of mediastinal aspirate yielded Streptococcus viridans. Based on these findings, the final diagnosis was descent-related mediastinitis secondary to acute suppurative thyroiditis.

An 82 year-old-woman was referred to our hospital because of infiltrative shadow of the lingula in 201X. She was asymptomatic, so we followed up with imaging observation. After 1 year, the infiltrative shadow had progressed, so we performed bronchoscopy. Glandular epithelium with the mild aberrant type was detected, but did not lead to a definitive diagnosis. There was increased eosinophilic compartmentalization of immune response in the bronchoalveolar lavage, so we started treatment with corticosteroids for chronic eosinophilic pneumonia. However, there was no improvement of the shadow. Subsequent computed tomography-guided lung biopsy revealed evidence of papillary adenocarcinoma.