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.

Objective:It is very important that oxidative stress is estimated for us to understand a player's condition in the field of sports. The purpose of this study was to investigate whether electroacupuncture has an effect on exercise-induced oxidative stress.
Methods:Ten healthy male volunteers participated in both the electroacupuncture (EA) group and the control group in a crossover design. EA at a frequency of 2 Hz and optimum intensity was performed in the subjects for 10 minutes in both the medial vastus muscles. During ergometer exercise by ramp load, respiratory metabolism including the RC point was recorded as the indication of energy metabolism. Blood was collected from the fingertips of the subjects, and then their levels of oxidative stress (d-ROMs test) and antioxidative (BAP test) were determined by using a Free Radical Analytical System (FRAS4, Wismell Instruments). Six measurements were taken;at rest, immediately after EA and following exercise, and at 20, 40, and 60 minutes following exercise.
Results:The RC point was significantly prolonged in the EA group compared with the control group. The level of oxidative stress (d-ROMs test) in the control group increased significantly at 20 minutes following exercise compared with rest (before exercise) and this increase was sustained until 60 minutes after exercise. In contrast, it did not significantly change in the EA group. Whereas the antioxidative level (BAP test) in the EA group significantly increased immediately following exercise compared with rest (before exercise), it did not increase in the control group.
Conclusion:These results suggest that electroacupuncture might enhance the antioxidative level (BAP test) and inhibit the level of oxidative stress (d-ROMs test) by effecting a change in respiratory metabolism. We propose that electroacupuncture might be useful for sports conditioning.

The Immunosuppressive effects of prostaglandin E₁ (PGE₁) used in cardiopulmonary bypass (CPB) operation were studied. We examined 30 patients, with ischemic heart diseases. The patients were divided into 3 groups: 11 patients given PGE₁ in group PG (G-PG), 10 patients given amurinon, a phosphodiesterase inhibiter, in group A (G-A), and 9 patients not given either of those drugs in the control group (G-C). Immunologically, lymphocyte subpopulations, and adhesion molecule expression on cell membrane and phagocytosis of neutrophils were analyzed before, at the time of, and after the operation until POD 7. The prominent effects of PGE₁ were observed on neutrophils. The expression of CD 62L, an adhesion molecule designated as L-selectin, on the cell surface membrane of neutrophils significantly increased during and after CPB in G-A and G-C, but it remained unchanged in G-PG during the observation period. Moreover, CPB caused an enhancement of the phagocytic activity of neutrophils in all groups, but its degree was much less in G-PG than in the other two groups. Among lymphocyte subpopulations, the number of CD 3⁺T-cells in G-PG rather than that of CD 20⁺B-cells reduced more greatly than those values observed in G-A and G-C. The decrease of T-cell number, throughout the observation period, in G-PG seemed to be mainly due to the decrease of the number of CD 4⁺T-cells designated as helper T-cells, although the number of CD 8⁺T-cells esignated as killer/suppressor T-cells slightly decreased on PODs 3 and 7. Amurinon, as a whole, did not exert any significant effect either on lymphocytes or on neutrophils in our experiments. Taken together, these results show that the treatment of patients with PGE₁ during CPB causes suppressive effects on immunorelevant cells. It may mitigate the activity of neutrophils, which are suspected as a possible culprit causing reperfusion injury. However, these suppressive effects, including the lowered numbers of CD 4⁺T-cells, may render the patients more vulnerable to infection. Much more intensive cares is required in these patients after operations.

Myocardial oxidative stress during retrograde continuous blood cardioplegia (RCBC) was evaluated in 35 patients undergoing elective aortocoronary bypass surgery. The patients were divided into three groups: Group C (n=12) received cold (20°C) RCBC, Group T (n=11) received tepid (30°C) RCBC, and Group W (n=12) received warm (36°C) RCBC. Myocardial oxidative stress was assessed by measuring the release of oxidized glutathione (GSSG), malondialdehyde (MDA), and myeloperoxidase (MPO) in the coronary sinus plasma before aortic clamping, at 1, 5, and 10min after unclamping. Myocardial oxygen uptake and lactate release were assessed at the same times. Both the hemodynamic recovery and the creatine kinase MB (CKMB) activity were measured perioperatively until 24h after unclamping. In Group C, a significant coronary sinus release of GSSG was found in the early reperfusion period in comparison to Groups T and W. However, the peak CK-MB activity was significantly lower in Group T than in Group W. No significant difference in the release of MDA or MPO was noted in the three groups. The recovery of oxygen uptake after unclamping was rapid in Group T. The recovery in the left and right ventricular functions and the myocardial lactate release were similar in the three groups. In conclusion, tepid RCBC is considered to protect the myocardium from ischemia-reperfusion injury better than cold or warm blood cardioplegia under retrograde continuous perfusion.

A 45-year-old woman with an 8-year history of systemic lupus erythematosus (SLE) was admitted with complaints of sudden onset of chest and back pain and syncopal attack. Aortography showed DeBakey type I acute aortic dissection. She has been maintained on a small dose of corticosteroids (prednisone 5mg/day). After antihypertensive drug treatment, a replacement of the total aortic arch and arch vessels was successfully performed. The postoperative course was uneventful and she has had no relapse of SLE.

We herein review the early results of minimally invasive coronary artery bypass (MIDCAB). From April 1994 to November 1998, 23 patients underwent MIDCAB, and 12 patients underwent coronary artery bypass grafting with cardiopulmonary bypass (CABG). We compared and analyzed the findings of these two groups. Regarding preoperative factors, the MIDCAB group included elderly patients, while the CABG group consisted of younger patients. However, the frequency of hemodialysis, respiratory disorders and cerebral vascular accidents did not differ significantly between the 2 groups. Regarding perioperative factors, the MIDCAB group needed a shorter operation time, and also had a lower bleeding volume, and a low incidence of blood transfusion. Regarding the postoperative course, the MIDCAB group needed a shorter artificial respiration time, and a shorter postoperative hospital stay, and no mortality was observed. The graft patency of the MIDCAB group was lower (88%) than the CABG group (100%). However, the graft patency of the MIDCAB group reached 94% after we used a stabilizer in the operation. In conclusion, the operation results of the MIDCAB group were comparatively better than those of the CABG group. Thanks to recent technological advances, the results of MIDCAB continue to improve. Though MIDCAB remains an invaluable operative modality for the treatment of one-vessel disease, surgeons must be careful to select appropriate candidates for this operative method.

A 47-year-old man was admitted with symptoms of angina pectoris. After evaluating the patient, coronary artery bypass grafting (CABG) was performed. First, the left internal thoracic artery (LITA) was grafted to the obtuse marginal branch (OM), and then the right gastroepiploic artery (RGEA) was grafted to the posterior descending branch (PD). Just after completing anastomosis, we performed intraoperative thermal coronary angiography. The RGEA-PD was patent. However, the LITA-OM was not patent on thermal coronary angiography. After a re-anastomosis was done at the LITA-OM, thermal coronary angiography was again performed and the LITA-OM was found to be patent. The postoperative course was uneventful, and all grafts were patent on postoperative angiography. In conclusion, intraoperative thermal coronary angiography was found to be useful for CABG.

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.

Physical fitness of 900 volunteers over 60 years of age were analyzed using a 6-item battery test to obtain fundamental data on the fitness status of the aged Japanese. The test battery consisted of stepping, vertical jump, grip strength, breath holding, body flexion and one-leg balancing, and could be performed safely with relatively mild physical stress in the elderly after simple screening by measurement of resting blood pressure and oral check on mobility problems of the knee and the hip. Males showed significantly higher values in vertical jump, grip strength and breath holding, while females showed significantly higher values in body flexion. There were no sex differences in stepping and one-leg balancing. Lowing trend was found in the score with age in all items except breath holding, but the extent of the reduction differed among the measure elements of fitness. Most of measured items showed significant correlations each other. The values obtained with this test are considered to be useful for future analysis of the fitness of aged people and also to determine the exercise appropriate for them.

[Objective]Daily repetitive exercise is known to be necessary for players in sports. In this study, to further explore the potential functions of acupuncture, we studied whether electroacupuncture (EA) stimulation has efficacy for repetitive exercise-induced oxidative stress.
[Methods]Six healthy male volunteers participated in both the non-treatment control group and the EA group in a crossover design. EA stimulation was applied to both the medial vastus muscles at 2 Hz and optimum intensity for each subject during ten min just before each exercise period. The subject performed ergometer exercise for 20 min with 75%of maximal oxygen uptake each day. This exercise period was performed once a day for three consecutive days. Blood lactate level (BLL) and plasma lipid peroxide (LP) concentration were measured as the markers for metabolism and oxidative stress, respectively. Visual Analogue Scale (VAS) was used to evaluate the individual level of fatigue due to exercise.
[Results]During and just after the exercise period, each value of BLL in the EA group was lower than the same points in the control group. Whereas LP concentrations before the exercise period on the first day in the control group was higher than the values in the same points on the second and third days. LP concentrations before the exercise period in the EA group were almost the same levels for three days. Furthermore, after the exercise period for the three consecutive days, LP concentrations and VAS in the EA group were lower than each value of the same points in the control group, and especially, the alteration of VAS showed a significant difference.
[Conclusion]The increased tendency of LP concentrations before the exercise period for three days in the control group indicated that repetitive exercise induced the accumulation of excess lipid peroxide. It might be suggested that EA stimulation suppressed subjective fatigue by an enhanced energy metabolic rate and decreased production of lipid peroxide. Hence the evidence strongly supported that EA stimulation might be useful for sports conditioning.