The patient was 70-year-old man. Distal aortic arch aneurysm of the maximum diameter of 55 mm was pointed out by Computed tomography. He underwent total arch replacement with median sternotomy. The next day, white cloudy fluid was flowing out from his left thoracic drain, and the amount increased and chylothorax was diagnosis. We selected conservative therspy with fasting and octoleotide subcutaneous injection. After 19 days chylothorax did not improve. We performed percutaneous thoracic duct embolization which is minimam invasive therapy. After embolization, he could start the meal, and the chest drain was extubated. He was discharged in good condition 49 days after first operation.

Previously we reported effects of acupuncture to the stellate ganglion on measurements of skin electroconductivity by a Neurometer.
By using 8 healthy adults and 23 patients, we measured effects of electrical acupuncture to the stellate ganglion on carotid blood flow, deep tissue temperature, blood pressure and pulse rate in order to clarify the influence on functions of the autonomic nervous system.
After electrical acupuncture to the right stellate ganglion (SGA), the right and left carotid blood flow decreased with 4-9% and 7-12%, respectively. Deep tissue temperature of the right anterior forearm after SGA showed a little increase (with no significance), while the temperature increased with 0.4-0.7°C after the right stellate ganglion block (SGB). Deep tissue temperature of the left anterior forearm showed no significant change after SGA, while it increased with 0.1-0.3°C significantly after SGB. Systolic blood pressure increased with 2-4mmHg after SGA and this also increased with 9-11mmHg after SGB. Those increases were significant. While the pulse rate decreased (2bpm) significantly after SGA, it increased (4-6bpm) significantly after SGB.
Except the decreased pulse rate after SGA, the other data did not support a common hypothesis that electrical acupuncture to the stellate ganglion suppresses the sympathetic system as SGB.

Previously we reported that acupuncture to the stellate ganglion stimulates sympathetic nervous system while it decreases heart rate.
As it is said that R-R intervals in electrocardiogram (ECG) reflect functions of parasympathetic nervous system, we measured effects of electrical acupuncture to the stellate ganglion (SG) or traditional acupuncture points (AP) on the meridians (H7: SHENMEN and P4: HSIMEN) on R-R intervals in ECG by using 24 patients; 12 each in SG-group and AP-group.
Results are as follows; (1) Means of heart rate (HR) decreased with 1-3bpm in the both groups; (2) Coefficients of variation (CV) of HR increased with 1-2% in the both groups; (3) Means of R-R intervals prolonged with 39-47msec in the SG-group and 20-44msec in the AP-group, respectively; (4) CV of R-R intervals increased with 1% in the SG-group only.
It is suggested that acupuncture stimulates not only sympathetic nervous system, but also parasympathetic nervous system.

An accidental break of an acupuncture needle is one of the most serious complication in acupuncture.
A German Shepherd weighed 25kg was anesthetized with pentobarbital.
Then, unused 7 needles of 1.0, 1.5, 2.0, 2.5, 3.0, 3.5 and 4.0cm long each were inserted at 7 acupuncture points.
The movement of broken acupuncture needles were observed by X-ray for 72 days and pathological examination of tissue surrounding broken needles was also done.
While broken needles inserted nearby the joints were found moving much around, others inserted in the region of straight bones stayed almost.
The dog was dissected 72 days after the preparation. Three broken needles were found just beneath the muscular fascia and two broken needles were in the subcutaneous tissue. Another broken needle in the lumbar region was penetrated into the lumbar spinal cord and the other needle in the region of neck was lost.
Pathological examination showed chronic inflammatory changes such as cellular infiltration and muscle fiber necrosis in the lumbar spinal cord and the thigh region, but little changes in the other four regions.

On twenty patients and ten healthy adult volunteers, pain threshold was measured by a dolorimeter (Pain meter NYT-5) to clarify whether analgesic effects of electrical acupuncture on various body surface may be changed by acupuncture points or not.
Electrical acupuncture was performed to the traditional acupuncture points on the two meridians. A group is the combination of LI 10 (Shousanli) and LI 14 (Hoku) on the right side, the other is the combination of ST 36 (Tsusanli) and ST 40 (Liangchiu) on the right side.
Measured points of pain threshold are (1) face, (the point 2cm above from the center of both eyelids), (2) (3) left and right upper extremities (LI 11; Chuchih) and (4) (5) left and right lower extremities (ST 41; Chiehhsi).
In the Shousanli-Hoku group, pain thresholds of face, both upper extrimities increased significantly. However, those of both lower extremities were not significantly changed.
In the Tsusanli-Liangchiu group, pain thresholds of the upper and lower extremities on both sides increased significantly. However there were no significant changes in the forehead.
In comparison of two groups, increases of pain thresholds of both lower extremities were observed in significantly more cases with acupuncture to Tsusanli and Liangchiu points than those with Shousanli and Hoku points by the Chi-square test (p<0.01). From this fact, acupuncture of Tsusanli-Liangchiu points seems to be more effective on the lower extremities than that of the Shousanli-Hoku points.
Therefore, we conclude that effects on pain threshold by electrical acupuncture depend on various points on meridians and are not evenly shown on the whole body surface.

The purpose of this study was to observe the effect of training on morphological properties in the collagen fibers of tendons. Wistar strain rats at 7 weeks old were assigned to high speed endurance (H), moderate speed endurance (M), jump training (J) and control (C) groups. The amount of exercise for H group (speed at 30m/min for 60 minutes) and M group (speed at 17m/min for 75 minutes) was equalized according to the amount of oxygen consumed during training. As for the anaerobic training (J group), rats made high jumping form the standing position, wearing jacket with 50% of body weight, 50 times/day, which lasted for 4-5 minutes. The training period was designed for 5 days per week for 16 weeks.
The follwing is a summary of the results obtained:
1) Increases in fiber areas of both Slow-Twitch (ST) and Fast-Twitch (FT) fibers were observed in the H, M and J groups. The ST fiber area of H group was significantly larger than that of C group. Significant increase in FT fiber area was observed in both M and J groups.
2) Hypertrophy of collagen fiber in gastrocnemius muscle tendon was observed in Hand M groups; especially, M group showed much larger increase than H group. It tended to be greater for J group as compared with C group.
3) Collagen fiber area and diameter of tendon in plantar muscle were slightly larger for H and M groups relative to C group, but these differences were not significant.
These results suggested that both types of aerobic training induced hypertrophy in the collagen fibers of the tendons and increased the tensile strength; especially, the group which trained longer hours induced the higher effect.

Effects of treadmill running and restricted food intake on the metabolism of protein in several tissues were studied in male Wistar rats, aged 5 weeks and weighing about 100 g. Rats were divided into control group under free food intake (C), sedentary group under restricted food intake (Sr), exercise group under restricted food intake (Er), Food intake was restricted approximately to 66% of fed ad libitum for control group. Exercise program consisted of treadmill running for 60 minutes a day at 30 m/min on 6 days a week for 12 weeks.
A. The effects of sedentary under restricted food intake.
When compared with C
1) Lowering of body weight and increment in mg tissue/g body weight ratios. (M. Gastrocnemius, Liver, Brain, Testis, M. Soleus, M. Plantaris)
2) Significantly low level of protein content in gastrocnemius muscles, liver and kidney.
3) Inhibition in incorporation of ¹⁴C-amino acid mixture into brain and kidney protein in vivo.
B. The effects of exercise under restricted food intake.
i) compared with C
The effects were the same as those of Sr.
ii) compared with Sr
1) Lowering of body weight and increment in mg tissue/g body weight ratios. (Liver, Heart, Kidney, Testis)
2) Significantly low level of protein content in gastrocnemius muscles.
From this study it was suggested that, under the food restriction of long duration, the maintenance of protein content in brain in spite of the decrease of protein content in the other tissues indicated the existence of internal mechanism for life conservation in severe environment. And loaded with exercise under food restriction, protein content in gastra cnemius muscles decreased. Therefore, it was conceivable that skeletal muscles protein was consumed as energy for exercise.

The purpose of this study was to evaluate the effectiveness of water exercise, including functional mobility in water, performed either once or twice a week in elderly who require nursing care. Twenty-one subjects were assigned to two groups. Ten subjects trained once a week for 6 months. Eleven subjects trained twice a week for 6 months. Water exercise consisted of warming up on land and walking,ADL exercise,resistance training, stretching and relaxation in water. Functional mobility was evaluated by FIM during pre-exercise,after 3 months and 6 months. There were significant improvements in functional mobility after 6 months compared to pre-exercise in both groups. Functional mobility in the group who trained once a week did not improve at 3 months compared to pre-exercise. Although the group who trained twice a week showed a dramatic improvement in functional mobility after 3 months compared to pre-exercise, and no change after 3 months compared to after 6 months. These results indicate that water exercise once or twice a week for 6 months, including functional mobility in elderly who require nursing care, can improve functional mobility, especially, exercise twice a week could improve it within 3 months.

Fibroma of the tendon sheath (FTS) involving the temporomandibular joint (TMJ) is very rare. A case of FTS arising from the synovial membrane of the TMJ is presented. The patient was a 17-year-old male with jaw opening pain and clicking in the left TMJ. MRI, arthrotomography, and arthroscopy showed a well-circumscribed mass that was localized in the superior articular cavity of the left TMJ. The tumor was removed with the attached synovial membrane. Macroscopic, histological and immunohistological features of the intra-articular tumor were identical to FTS. There have been no signs of recurrence in the 6 years since surgery.

It is said that Ryodoraku reflects the dysfunction of the autonomic nerve in spite of no objective evidence for the theory.
Using 60 patients received right stellate ganglion block, we measured 24 typical determinate points of ryodoraku with a neurometer and an electrodermometer.
With a neurometer, an average current value of 6 points of the right upper extremity decreased in 52% as well as that of 6 points of the left decreased in 62%. Both the right and the left lower extremities decreased in 91% and 85%.
With an electrodermometer, the average impedance of the right upper extremity increased in 108%.
Finally, the sympathetic blockade showed decrease in a current value with a neurometer and increase in impedance with an electrodermometer.