Study on the sites of nerve entrance in innervation of skeletal muscles is important in the field of anatomy, histology, physiology and pathology, and since 19 th century, many researchers have been engaged in the macroscopical investigations on nerve entrance of muscles. However, their results were not always precise, because they seemed to employ macroscopical methods without measuring a length of muscles and a distance between origin and insertion of various muscles in thigh
In this paper, first, the muscle length was determined by measuring the distance between origin and insertion directly (designated here as“direct method”) or by measuring the length of muscles along their course (designated here as“indirect method”) by scale. Concomitantly, the number and diameter of major innervated nerves of each muscle were also examined. Next, the distance between nerve entrance and the origin of 9 thigh muscles were carefully measured. The difference of the values obtained referring to sex and age was also surveyed. Adding to it, the correlation between the sites of nerve entrance and that of muscle belly was also studied. The details of respite were ae fn11imr
1) The values of muscle length obtained from direct and indirect methods were compared in paying attention to each belly of muscles. 10 specimens in M, sartorius and M, rectus femoris were used for it. The difference of values between direct and indirect methods was negligible, that is, only 1 to 2.5% difference are there respectively.
2) The number of major nerve entering into each muscle were one or two. The number of major nerves and their diameter (parenthesized) of 21 specimens were as follow; one (1.6 mm) for M, sartorius, two (1.6 mm) for M. rectus femoris, two (2.4 mm) for M, vastus medialis and M. vastus lateralis, one (1.8 mm) for M, gracilis, one (1.7 mm) for M. adductor longus, two (2.4 mm) for M, biceps femoris (caput longum), two (2.5 mm) for M, semitendinosus and two (2.6 mm) for M, semimembranosus.
3) Using 41 specimens, the sites of nerve entrance where one or two major nerves were entered into thigh muscles were measured with the indirect methods. The sites of nerve entrance were indicated with the ratio calculated from the formula described in Result-C. Their sites were 21.4% from the origin for M, sartorius, 14.9% and 25.5% for M. rectus femoris, 22.6% and 39.3% for M. vastus medialis, 17.0% and 35.1% for M, vastus lateralis, 22.3% for M, gracilis, 44.7% for M, adductor longus, 22.1% and 38.6% for M. biceps femoris (caput longum), 15.5% and 43.0% for M. semitendinosus, and 46.7% and 61.7% for M, semimembranosus. However, the difference in the sites of nerve entrance related to sex and age was hardly in those specimens.
4) The difference between the sites of nerve entrance (either one or two) and muscle belly was evident in M, vastus medialis and M, adductor longus. The values of deviation in M. vastus medialis and M. adductor longus stood about at 20%. The difference of the other muscles (M. sartorius, M, rectus femoris, M, vastus lateralis, M, gracilis, M, biceps femoris; caput longum, M, semitendinosus, M, semimembranosus) stood at 3 to 7%.
5) Some discussions were devoted to the relationship of sites between nerve entrance in anatomy and motor point in kinesiology.

Extremely few studies have been published on the site of belly of thigh muscles. In our studies, 41 specimens (from 27 male and 14 female subjects) for anatomical investigation were used to examine the site of belly, which had often been employed for surface electromyogram. Not to say, “the belly of muscle” means the site showing the maximal value of circumference of each muscle.
The results were as follows.
1) Using nine thigh muscles, the full length of each muscle and the distance from the origin to the belly were directly measured at the first steps in the present study. Ratio of the distance from the origin to the full length was calculated. The ratio, as the average of all subjects, was 24.4% for M. sartorius, 30.8% for M. rectus femoris, 59.2% for M, vastus medialis, and 32.8% for M. vastus lateralis in the frontal aspect of thigh; 15.2% for M. gracilis, 67.9% for M. adductor longus in the inner aspect of thigh; and 44.1% for M. biceps femoris (caput longum), 29.3% for M. semitendinosus, and 65.5% for M, semimembranosus in the posterior aspect of thigh. However, no significant difference was found between the sex as well as age in the value of ratio.
2) Secondarily, “the cross section method” in this paper was used to evaluate the site of belly and measure the size of cross sections of M. sartorius and M, rectus femoris. The values were obtained from 3 specimens. The belly of M. sartorius was found at the site of 29% from the origin and that of M. rectus femoris was at 33%. The size of each cross sections was 1.3cm² and 3.5cm² respectively.
3) In addition, computed tomography was employed for 5 male adults to find the site of belly of M, sartorius and M. rectus femoris. The results were compared with those of specimens mentioned in 2) . The findings from the computed tomography showed the belly at the site of 25-29% from the origin for M, sartorius and 29-33% for M. rectus femoris. The size of cross sections of each muscle measured 2.9cm² and 11.4cm² respectively. These sites were confirmed to be coincided with those of anatomical specimens.
4) It can be, therefore, concluded that the values obtained from the direct method are applicable to those of living persons.

Pneumonia is one of major causes of cough, which sometimes resists medication and remarkably deteriorates QOL of the patient. We report a case of pneumonia in a person suffering from severe cough and pain in the general body accompanied by cough for which conventional medication did not work but was improved by acupuncture treatment.
A 47-year-old woman was diagnosed by her physician with pneumonia on August 2, 200X. Although antibiotics were administered, her symptoms were not improved. She visited Meiji University of Integrative Medicine Hospital and was hospitalized on the same day. Despite strict medication with antibiotics, antitussive agent and expectorant during hospitalization, her severe cough and body pain remained unchanged.
Acupuncture treatment was then started on August 7. The basic meridian points used were LU1 (Zhongfu), LU5 (Chize), BL13(Feishu), LU7 (Leique), LI4 (Hegu), GB20 (Fengchi), GB14 (Danzhui), ST12 (Quepen), ST11 (Qishe), and CV22 (Tiantu). The acupuncture needles were retained for ten minutes at these points in each session. After ten acupuncture treatments for over seven days, the VAS for body pain accompanied by cough showed a remarkable improvement. Also, significant relief in cough was observed every time immediately after treatment.
We suggested that acupuncture treatment might be useful for cough and/or pain in the body accompanied by cough in a patient with pneumonia.

[Introduction]Insomnia and anxiety are major symptoms of depression and severely limit the daily activities of depressed patients. We report the case of a depressed patient who had developed liver dysfunction caused by medication and whose depression was successfully managed by acupuncture after discontinuation of antidepressants.
[Case]A 37 years-old male had been taking noradrenergic and specific serotonergic antidepressant (NaSSA) and Chai Fu Jia Long Gu Mu Li Tang Jia Wei Gui pi Tang for insomnia and anxiety due to depression. Although his symptoms had improved by the medication, abnormalities in his liver functions were found after 3months of medication. After he was diagnosed as having drug-induced liver damage, he was admitted to Meiji University's Integrative Medicine Hospital and all medication was replaced by Glycyrrhizin and Glutathione. Consequently his depression and symptoms returned. We then tried to relieve his symptoms by applying acupuncture, which was prescribed according to traditional Chinese medical diagnosis (TCM diagnosis, Heart Yin Deficiency , Liver Qi Stagnation , and Kidney Yin Deficiency ).
[Results]After 4 acupuncture treatments, the patient's duration and depth of sleep considerably improved compared with that before the acupuncture sessions, and comparable results were maintained until discharge. Beck Depression Inventory (BDI) scores were also markedly improved from 'moderate depression'(24 points) at the beginning of treatment to 'minimal depression'(8 points) at the end (9th treatment, 16 days from the first session).
[Conclusion]The results of this case suggest that acupuncture treatment may be an effective alternative for anti-depressants when there is a limitation to administer those drugs.

[Background]Functional abdominal pain syndrome (FAPS) represents a chronic pain disorder localized in the abdomen and the symptoms largely are unrelated to food intake and defecation, which differ from other painful functional gastrointestinal disorders.
We report a case of FAPS whose symptom was successfully improved by acupuncture.
[Case Report]A 75-year-old female had been hospitalized at Meiji University of Integrative Medicine Hospital because of left lower abdominal pain from which she had repeatedly suffered for more than 2 years. Despite strict medication, her symptom had not been improved. After admission to the hospital, according to recommendation by her physician, acupuncture treatment was started. The patient received TCM-based acupuncture treatments five times a week over 13weeks. Primary acupuncture points used for the patient were LV3(Taichong), SP6 (Sanyinjiao), ST36 (Zusanli) and PC6 (Neiguan). Evaluation of the left lower abdominal pain was carried out with a Visual Analogue Scale (VAS). The Gastrointestinal Symptom Rating Scale (GSRS) was used to evaluate QOL related to the digestive symptoms. VAS for the left lower abdominal pain showed a remarkable decrease immediately after the initial acupuncture session. The symptom disappeared within 4 weeks after commencement of the treatment and never appeared during her hospitalization. GSRS was also improved and it was maintained during hospitalization.
[Conclusion]We suggested that acupuncture treatment might be one of the useful, non-pharmacological alternatives for symptoms of FAPS.

OBJECTIVEThe effects of alcohol consumption on coronary risk factors (CRFs) and insulin resistance (IR) have seemed equivocal in previous studies. This study aimed to clarify the implications of low fasting blood insulin observed in alcohol consumers as related to CRFs and IR.

METHODSA cross-sectional observation in 2133 middle-aged healthy Japanese men for associations of increases in alcohol consumption, fasting serum insulin concentration and serum gammaglutamyltransferase (GGT) activity with the major CRFs of high systolic blood pressure (SBP), fasting serum glucose, triglycerides (TG), total- and LDL-cholesterol (tCh&LDLc) and low serum HDL-cholesterol (HDLc).

RESULTSIncreased alcohol consumption was related to higher SBP, serum GGT, glucose and HDLc, and lower serum LDLc and insulin. Although high serum insulin was significantly related to all of the CRFs in all nondrinkers, moderate drinkers consuming up to 59 ml of alcohol per day and excessive drinkers consuming more, the means of SBP, serum glucose and HDLc were significantly higher and serum LDLc was lower in drinkers than in nondrinkers at any level of serum insulin, indicating that the good and bad profiles of CRFs in alcohol consumers are independent of their low fasting serum insulin. High serum GGT related to increased alcohol consumption and/or body weight was significantly associated with high serum insulin and all of the CRFs in all categories of alcohol consumption.

CONCLUSIONSLow fasting serum insulin observed in drinkers does not imply improved CRFs, and thus may not imply improved IR. High serum GGT may reflect increased IR in both drinkers and nondrinkers.