Acupuncture has been recognized as an useful treatment for muscle pain, muscle fatigue and muscle hypertonus in sports medicine. This study developed an experimental model to investigate the effect of acupuncture on muscular disorders.
Twenty-seven rabbits, anesthetized with pentobarbital (i. v.) were used. The anterior tibial muscle was exposed, and the distal end of the tendon was cut then attached to the push-pull gauge and tension during the isometric contraction induced by electrical stimulation of the muscle was recorded.
The tension was measured immediately before and 15, 30, 45 and 60min after the electrical stimulation. The frequencies of 1, 10, 20, 30, and 50Hz were used as the conditioning stimulation (1ms in duration, 60s).
Tension was decreased after the conditioning electrical stimulation of muscle. High frequency of stimuli tended to induce a marked decrease in tension.
Acupuncture stimulation (leaving the needle in place for 10min) reduced the decrement of the evoked tension by 30Hz tetanic stimulus significantly (p<0.05), and enhanced the recovery. Occlusion of the blood vessel supplying the muscle potentiated the decrement of evoked tension, and acupuncture stimulation still reduced the initial decrement of the evoked tension, suggesting that acupuncture acted on the blood flow in the muscle. After transection of the nerve innervating the muscle, acupuncture stimulation still demonstreted the same effect.
These results suggest that the acupuncture stimulation induces vasodilatation by axon reflex and the subsequent increase in blood flow to the muscle induces the recovery of reduced tension by tetanic contraction.

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.

[Background/aim] Irritable bowel syndrome (IBS) is one of the most common gastrointestinal disorders, affecting more than 15 % of Western populations. It is characterized by a wide variety of persistent symptoms (abdominal pain or discomfort, bloating, transit disorders) without any clear organic causes. Because medical treatments are sometimes ineffective, some patients with IBS seek alternative therapies to manage the condition. The aim of the present study was to investigate the clinical effect of acupuncture treatment in patients with IBS.
[Method] Four patients with IBS were treated with acupuncture according to the way of Traditional Chinese Medicine. We employed reversal single-case study design in which an acupuncture treatment period (“period B”) was alternated with no treatment period (“period A”). Ten or twenty times acupuncture therapies were performed during the “period B” and the length of the “period A” was comparable with the “period B” GSRS, frequency of defecation, softness of the stool, intensity of abdominal pain or abdominal fullness, and POMS were recorded over the periods.
[Results] During the “period B”, three patients showed a remarkable improvement in lower abdominal pain, abdominal fullness and QOL evaluated with GSRS, while the psychological condition evaluated with POMS showed inconsistent changes without a remarkable improvement.
[Conclusion] The result of our study indicated that acupuncture might be useful for the management of IBS.

[Purpose] We report a case treated by acupuncture in a health care facility for the elderly to evaluate the effect of acupuncture on severe pulmonary emphysema.
[Case and methods] A 88 year-old man visited Meiji University of Oriental Medicine Hospital with dyspnea in March 2000 and was diagnosed with pulmonary emphysema. He was hospitalized in October 2002 because his chronic respiratory failure was worsening : oxygen therapy was started. After discharge from hospital, he entered a health care facility for the elderly and acupuncture treatment for lumbago was initiated. Thereafter, acupuncture treatment for dyspnea and stiff shoulder started. He was determined to be grade V according to Fletcher-Hugh-Jones classification of dyspnea. Spirometry of the patient before acupuncture for dyspnea showed 88.0 % in %VC, 38.2 % in FEV 1 %, and 30 % in %FEV 1, and the patient was diagnosed with chronic obstructive pulmonary disease of serious grade. Acupuncture treatment was performed once or twice a week, and acupuncture treatment for dyspnea was performed 21 times (total of 33 treatments).
[Results] Subjective symptoms of lumbago, stagger of the legs, and shoulder stiffness were evaluated with Numerical Scale or Pain Scale. The state of dyspnea was evaluated with Numerical Scale and Borg Scale, and exercise tolerance was evaluated with 6 min of walking. After 33 acupuncture treatments, dyspnea on exertion, exercise tolerance, and the findings of spirometry were not improved. But dyspnea on rest had disappeared with improvement in lumbago, stagger of the legs, and shoulder stiffness. These results indicate that acupuncture as a general treatment is effective for the improvement of dyspnea, especially in elderly patients whose general state of health is not good because of restriction in their ability to exercise in the course of daily life due to dyspnea of exercise such as lumbago, stagger of the legs, and shoulder stiffness.

[Objective] The effect of indirect moxibustion on cold symptoms was examined in elderly subjects living in a nursing home.
[Design] A single-case experimental design that enables clinical trials in small a number of subjects was used in this study.
[Methods] Two elderly subjects living in a nursing house participated for 16 weeks. The experimental periods were allocated at random as treatment periods and control periods of eight weeks each. During the treatment periods, subjects were treated with indirect moxibustion GV 14 and BL 12 (both sides) 3 units each, 3 times a week. Rating scores with 4 and/or 5 grades were used to evaluate common cold symptoms.
[Results] Concerning the presence of common cold, there were no significant differences between the treatment and control periods. Moreover, concerning common cold symptoms, there were no significant differences between treatment and control periods.
[Conclusion] Effects of an indirect moxibustion on the common cold symptoms were not detected in this study. We speculated that the living environment of these subjects and the intensity of stimulation were factors. Furthermore, we suspected that a single-case experimental design was unsuitable for common cold research.

Risk factors for stroke after coronary artery bypass grafting (CABG) were assessed. We retrospectively investigated 681 consecutive patients who underwent isolated, first-time CABG at our institute between 1987 and 1998. Ninety-eight patients (14%) had a history of preoperative stroke. They tended to be older and with a higher incidence of peripheral vascular disease (PVD) than those without preoperative stroke. In spite of several techniques for prevention of postoperative stroke, such as the aortic non-touch technique, 14 patients (2.0%) suffered postoperative stroke. Postoperative stroke was diagnosed soon after surgery in 7 patients (50%), and the causes of stroke in these patients seemed to be intraoperative manipulation of the ascending aorta in 5, and hypoperfusion during cardiopulmonary bypass in two. Stroke in the remaining 7 patients occurred after normal awakening from anesthesia, and the cause was unknown. We then compared the patients with postoperative stroke (n=14) to those without postoperative stroke (n=667). Statistical analysis demonstrated no significant difference between the two groups in variables such as history of preoperative stroke, duration of cardiopulmonary bypass, and prevalence of PVD. Four (29%) of the patients with postoperative stroke died, due mainly to aspiration pneumonia. The morbidity and mortality of the patients who suffered postoperative stroke were very high.

Background : Constraint-induced movement therapy (CI therapy) is a rehabilitation treatment that effectively improves upper extremity function in patients with chronic hemiparesis after stroke. In Japan, no previous studies have shown the effects of CI therapy in a large size sample, and the Simple Test for Evaluating Hand Function (STEF), a standard assessment tool for upper extremity function, is rarely used to evaluate the effects of CI therapy. Little is known regarding the factors capable of predicting the outcome of CI therapy. The present study aimed to examine potential predictors of outcomes after CI therapy and the effects of CI therapy using STEF. Methods : This study included patients with hemiparesis in the chronic stage of stroke (≥180 days from onset). We compared upper extremity function before and after CI therapy intervention, which involved 5 hours per day for 10 consecutive weekdays of training. We assessed upper extremity function using the STEF, Wolf Motor Function Test-functional ability scale (WMFT-FAS) before and after intervention, and investigated potential predictors (age, gender, time since stroke, type of stroke, side of stroke, hand dominance, spasticity). Results : There were 107 subjects. Our comparison revealed that both STEF and WMFT-FAS scores improved significantly following intervention, from means of 31.3 to 42.7 points and 51.8 to 57.0 points, respectively. No significant predictors that influenced the functional outcome were identified. Conclusion : CI therapy is effective for improving upper extremity function. It is important not to exclude people from CI therapy based on any supposed predictors.

Celiac artery aneurysm (CAA) is very rare. We report a case of CAA with type IIIb aortic dissection (DA) which was treated surgically. A 60-year-old man who had an abnormal enlargement of the aorta on abdominal ultrasonography was admitted to our hospital. Angiography and CT scan revealed CAA with type IIIb DA. His general condition was stable and surgery was performed electively. The CAA was exposed through a median laparotomy. It was found to be about 3cm in diameter. As vascular reconstruction seemed difficult and the proper hepatic artery showed good pulsation after clamping the common hepatic artery, we decided to perform celiac artery aneurysmectomy without vascular reconstruction. Except for transient liver dysfunction, there was no other complication and he was discharged on the 24th postoperative day. During surgery for CAA, when collateral perfusion from the SMA to the liver is adequate, it seems that vascular reconstruction is not always necessary as shown by this case.

Osaka City has the highest tuberculosis (TB) notification rates in Japan. In the period 1999–2003, the TB control programme was strengthened, and the Stop TB Strategy was implemented to reduce the number of notified cases. The objective of this study was to assess the effect of these control activities in Osaka City, including the implementation of directly observed treatment (DOT), by analysing TB surveillance and routinely collected data. We reviewed the surveillance data of all sputum smear-positive pulmonary tuberculosis (PTB) cases registered in the Osaka City Public Health Office from 2001 to 2008 and data collected from the routine TB programme. The DOT implementation rate increased from 0% in 2001 to 68% in 2008 for smear-positive PTB cases of the general public and to 61% for all PTB cases of the homeless. The proportion of smear-positive PTB cases that had treatment failure and default combined, declined from 8.0% (52 of 650) in 2001 to 3.6% (20 of 548) in 2006. The proportion of cases among the homeless with previous treatment declined from 28% in 2001 to 15% in 2008. The proportion of cases with multidrug resistant-TB (MDR-TB) among those without previous treatment declined from 1.7% in 2001 to 0.9% in 2008. It is logical that reduction in the failure and default rate would lead to the reduction of cases with previous treatment and TB transmission, including resistant TB, therefore to the reduction of MDR-TB rates.

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.