A 74-year-old man with chronic renal failure complained of back pain. Computed tomography revealed an infected thoracic pseudoaneurysm at the descending thoracic aorta. An endovascular stent graft was repaired with exclusion of a false aneurysm. After surgery, he complained of post-prandial cough, minor hemoptysis and deglutition with difficulty. Esophagoscopy and bronchoscopy showed a fistula between the left main bronchus and the esophageal diverticulum. Fistulectomy was planned after his general condition became stabilized, but the patient died of rebleeding on day 64 after stent grafting. The histological examination revealed a congenital bronchoesophageal fistula.

To investigate the effect of acupuncture treatment combined with extreme infra-red rays radiation, we measured both skin surface and deep temperature at the stimulated area and peripheral site. The subjects were seven healthy volunteers with no problems involving the skin or autonomic nervous system. Acupuncture stimulation was performed on the Subject's back in combination with extreme infra-red rays radiation. The skin surface and deep temperature were measured at both the stimulated area and peripheral site (sole of the foot) using a thermistor temperature sensor and deep tissue thermometer during stimulation. We also measured temperature at those sites during extreme infrared rays radiation without acupuncture stimulation as a control study. Acupuncture stimulation combined with extreme infra-red rays radiation on the subject's back increases both surface and deep temperature at both the stimulated area and the peripheral site (sole of the foot), while the radiation alone had no effect on the temperature at the peripheral site. We suggested that acupuncture treatment combined with extreme infra-red rays radiation was useful to increase skin surface and deep temperature not only at the stimulated area but also at the peripheral site.

We studied the effects of electro acupuncture stimulation of Baxie on local tolerance as an index of cold induced vasodilation (CIVD). The subjects consisted of 22 healthy adult volunteers. The skin temperature and skin blood flow in the middle finger were simultaneously examined before, during, and after immersion of the finger in cold water. Electroacupuncture stimulation at 1 Hz with a 66 to 100V intensity was performed for 5 minutes. Experiments of no stimulation and electroacupuncture stimulation were conducted on the same subject on different days.
The results revealed the following:
1. CIVD was caused by rapid increase of skin blood flow during immersion of the finger in cold water.
2. The minimum skin temperature, minimum skin blood flow, maximum skin blood flow, mean skin temperature in the rising phase of skin temperature, and the index of resistance to frostbite of the electroacupuncture stimulated group were higher than those of the unstilmulated group, and rates of skin temperature increase and decrease during immersion of the finger in cold water in the electroacupuncture stimulated group were significantly higher. These results show that electroacupuncture stimulation increases local cold tolerance in the finger.

We studied the effects of transcutaneous electrical nerve stimulation (TENS) of Baxie on local cold tolerance as an index of cold induced vasodilatation (CIVD). The subjects consisted of 22 healthy adult volunteers.
The skin temperature and skin blood flow in the middle finger were measured simultaneously before, during, and after immersing the finger in cold water. TENS at 1Hz with 100-V intensity was applied for 5 minutes before immersion of the finger.
Experiments were conducted with no stimulation and with TENS on the same subjects on different days.
The results revealed the following:
1. The minimum skin temperature and minimum skin blood flow during immersion of the finger in cold water were higher in the TENS group than in the control (no stimulation) group.
2. The maximum skin temperature, mean skin temperature, and increase and decrease of skin blood flow rate during immersion of the finger in cold water and in the rising phase of skin temperature were higher in the TENS group than in the control group.
3. The index of resistance to frostbite was higher in the TENS group than in the control group.
4. The number of fluctuations in skin temperature during immersion of the finger in cold water was significantly higher in the TENS group than in the control group.
5. The incidence of abnormal perception during immersion of the finger in cold water was lower in the TENS group than in the control group.
These results suggest that TENS enhances the local cold tolerance of fingers by suppressing SSA in the initial falling phase on skin temperature and increasing the motion of skin blood vessels in the rising phase of skin temperature.

The WFAS Houston 2016 annual conference was held in the Royal Sonesta Hotel, Houston, Texas, USA from 31 October to 2 November 2014. The theme of the conference was "East Meets West -Shaping the Future of Healthcare", and more than 900 acupuncture practitioners and scientists participated. The number of papers presented was 216, including 6 keynote lectures. Papers from Japan numbered 11.
At the Executive Committee (EC) meeting, 39 of the 76 EC members were present (10 EC members sent a letter of attorney in advance), including 3from Japan. Although Tokyo was approved as a host city of WFAS 2016 last year, we proposed changing the venue to the Tsukuba International Congress Center, which was approved.

Objective: The diagnostic criteria for the metabolic syndrome (MetS) were published in Japan in April 2005. However, there have been no large-scale studies in rural areas to confirm these criteria. We examined the prevalence of MetS in subjects who had undergone a routine medical health checkup at our hospital, located in a rural area. This data was used to investigate the appropriateness of the diagnostic criteria for MetS.Subjects and Methods: The MetS status was examined retrospectively in 2340 subjects (1408 men, 932 women ; mean age 49.6 ± 9.7 years) who underwent a routine medical health checkup at our hospital between April 2004 and March 2005.Results: Of the 1408 men and 932 women, 209 men (14.8%) and 23 women (2.5%) were diagnosed with MetS. Forty-four men (3.1%) and 4 women (0.4%) met all three diagnostic criteria for metabolic disorders. In the female group, only 8.7% of the 932 women met the waist circumference criterion of ≥90 cm. Because this waist circumference criterion was used during the first screening but was not met by most of the women, they were eliminated from our study. Using receiver operating characteristic (ROC) analysis, the cutoff values for waist circumference were 85.0 cm (sensitivity 0.750, specificity 0.564) in men and 79.5 cm (sensitivity 0.787, specificity 0.709) in women. If the women's waist circumference criterion had been set at the value of ≥79.5 cm, this would have resulted in 48 (5.2%) women meeting the criterion.Conclusion: From the viewpoint of preventive medicine, the Japanese male MetS diagnostic criteria are fairly appropriate. However, for the women, the waist circumference criterion of ≥90 cm has been set too high and was not met by most of the female subjects. Therefore, the Japanese MetS criteria for women, particularly the cutoff value for waist circumference, requires further verification.
Human Females ; Male population group ; diagnostic criteria ; Japanese language ; Health

Recent studies showed that high biocompatibility and reduction of uremic toxin contributed to the improvement of freatment outcome in hemodialysis patients.Therefore, a high-flux membrane dialyzer, especially polysulfone (PS) membrane, was generally used in dialysis. However, it was suggested that the higher efficiency of reduction in uremic toxins might cause an increase in the albumin leakage through the dialyzer membrane during dialysis, resulting in a decrease in serum albumin concentration. In this study, we used two different dialyzer membranes with high biocompatibility, namely, ethylenevinylalcohol (EVAL) membrane and improved PS membrane with a very lower leakage of serum albumin. After using these two types of mambrane of six straight months, we examined the effect of each dialyzer membrane characteristic on the serum total protein and albumin concentration. The reduction rates of each uremic solute and serum total protein concentration were significantly higher. The serum albumin concentration and its rate of change with the passing of time tended to increase in the case of the PS membrane. But in the case of EVAL membrane, these values tended to decrease. These results suggested that the differences in the changes in the serum total protein and albumin concentration might result from the differences in the efficiency of the reduction of uremic toxins. Therefore, it is necessary to consider the usage of the dialyzer membrane with a higher reduction of uremic solutes and a lower leakage of serum albumin to add to the higher biocompatibility specially in hemodialysis patients with hypoproteinemia.
Membranes ; Concentration ; Reduction (chemical) ; Serum Albumin ; Hemodialysis

The effect of acupuncture on the autonomic nervous system was analyzed by simultaneous measurement of sympathetic skin response (SSR), sympathetic flow response (SFR) and Palmer emotional sweating evoked with electric stimuli to the forehead at random interval and intensity. The mutual relation of measurements by those parameters was examined electrophysiologically.
The subjects were ten healthy male volunteers. SSR at the left palm and SFR at the fingertip of the left forefinger were measured using laser doppler flowmetry, and emotional sweating at teh right palm was measured with the ventilated capsule method (hydrography). The measurements were performed in two sessions, with and without acupuncture stimulation that was given at L14 with the technique of sparrow picking (1Hz) for 1 minute and retaining the needle for 10 minutes. The amplitude of SSR, the reduction rate of SFR, and the sweat rate were measured before and after acupuncture stimulation, while those were measured before and after resting in the other session as a control study. As a result, habituation in each response was not seen and the correlation coefficient in each index was low, while SSR and Palmar sweating were inhibited significantly in the stimulation group only, and SFR was inhibited in both groups.
These results suggested that acupuncture stimulation might inhibit the activity of the skin sympathetic nerve system.

A 73-year-old man visited our hospital with complaints of fever, epigastric painand jaundice. Laboratory examinations showed elevation of GOT, GPT, ALP, LAP and amylase. Abdominal ultrasonography revealed gall bladder stones. Endoscopic findings showed parapapillary diverticulum, but the common bile duct stone was not revealed by endoscopic retrograde cholangiography. He was conservatively treated and then discharged. Two months after, the patient was readmitted for cholecystitis and underwent cholecystectomy. After further 2 months, he was again admitted for the same symptoms as those on first admission. We diagnosed this case as Lemmel's syndrome and performed emergency endoscopy. Endoscopic findings revealed the meal rest inside the parapapillary diverticulum. After we removed the meal rest obstructing the orifice of the papilla of Vater using grasping forceps, we performed EST. Purulent bile gushed out from the orifice. Two years have elapsed since them. Cholangitis has not recurred during this period. Therefore, we concluded that EST is effective in treating Lemmel's syndrome.