Sixty-two embalmed cadavers of elderly Japanese individuals, ranged in age from 44-98 years (48 males, 14 females), were completely dissected, and the weights of skin plus subcutaneous adipose tissue (SSATW) and Triceps Surae Muscle (TSMW) determined. Then subcutaneous adipose tissue free weight (SSATFW) was determined by subtracting SSATW from body weight (BW) .
SSATW and percentage of SSATW relative to BW in females (8.9 kg, 19.8%) were larger than those in males (6.1 kg, 12.7%) . On the other hand, TSMW and percentage of TSMW relative to BW in males (313.6 g, 0.65%) were larger than those in females (210.6g, 0.49%) . BW, SSATFW, TSMW were highly correlated (p<0.01) with each other in males. However, in females, TSMW was not significantly correlated (p>0.05) with those variables. The slopes of regression lines for SSATW against BW and SSATFW for females were about twice as steep as those for males.
From these results, it was suggested that females carried a higher proportion of their adipose tissue externally than males and relationship between muscle weight and inner adipose tissue weight in females was more variable than in males.

Despite the recent progress in physiological studies of acupuncture, few morphological studies from the viewpoint that acupuncture stimulation produces with a small tissue injury have been reported. In this study, we evaluated the mechanism of acupuncture stimulation by a histopathological approach. First, we confirmed the tissue structure from the skin to the muscle layer in a corpse. In the human body, free terminals (endings) of unmyelinated nerve fibers (1.5μmin diameter, Group III or Group IV) were present subcutaneously or in the endomysium of muscle tissues. Next, the extent of tissue injury caused by insertion of needles 0.20-0.95mm in diameter evaluated in human and animal tissues. The extent of the injury was in proportional to the diameter of the needle. These confirmed that acupuncture stimulation is clearly a small tissue injury. Also, the free terminals (endings) of unmyelinated nerves similar to those observe in the human tissue were obsurved in the endmysium near the injury site. These morphological findings suggest that acupuncture stimulation is related to Group III or Group IV fibers.

More than 3 years have passed since the guideline for infection prevention at acupuncture and moxibustion clinics was issued. We studied changes in the attitude toward sanitization of the environment and consciousness about infection prevention at acupuncture and moxibustion clinics during this period. The subjects were members of the Acupuncture and Moxibustion Societies of Kyoto and Osaka (n=349). About 70% of the subjects felt anxiety about infections, and nearly 80% of them were interested in sanitizing the clinics. More than half (57%) of the subjects were using both disposable and reusable needles, and about half the subjects disposed of used needles without sterilization. Concerning the linen, pillow covers were changed for every patient by about 70% of the subjects, but towels and sheets were changed by only 20% and 10%, respectively. White coats were changed within 1 week by about 70% of the subjects. Most subjects answered that the clinics were cleaned everyday, but less than a half of them sterilize slippers. About half the subjects answered that curtains were washed every 3-6 months. Autoclaves were placed in only 90% of the clinics. Attention to preventive measures against infection of therapists tended to diminish with increase in the clinical experience.

Recently, magnetic resonance imaging (MRI) has brought significant advancements in the diagnosis of spinal disorders. But there is much debate about the abnormalities detected by MRI clinically. In this study, we try to clarify the correlation between spinal abnormalities detected by MRI and physical signs in 45 patients with neck, shoulder, and low back pain. Physical signs were segmental sensory disturbance, amyotrophy, and radicular pain, and the abnormalities of MRI were bulging, protrution, extrution, and osteophytes. MRI showed a symptomatic change, that is a false positive (abnormality of MRI^* (+), physical sign^** (-)), in 26 of the 45 patients (57.7%), a true positive (+, ^**+) in 15 of 45 patients (31.1%), a true negative (^*+, ^**-) in the remaining 5 patients (11.1%).
These results suggested that the physical signs are more important than the abnormalities of MRI in patients with neck, shoulder and low back pain. We think that the acupuncture therapist should carry out a more detailed physical examination of the patients clinically.

Fifteen patients were operated on infective endocarditis (IE). We studied indication for operation, operative methods and results. There were 13 male and 2 female patients and the mean age of these patients was 48.5 years. 8 cases were inactive IE and 3 of them were prosthetic valve endocarditis (PVE). The patients consisted of 4 cases of aortic valve regurgetation, 2 cases of mitral valve regurgetation, 3 cases of PVE and 3 cases of VSD. Casual bacteria were positive for blood culture in 5 cases. The following bacteria findings were found: Streptcoccus viridans in 3 patients, gram-negative bacteria and Staphylococcus each in one case. Valve cultures were positive in 3 cases: There were gram-positive bacteria in 2 patients and Enterococcus in one case. Vegetations were present in all native valves and the echocardiogram was useful for these findings. There were 3 perioperative deaths (20%) and 2 of those patients were active PVE. All patients with IE who develop progressive congestive heart failure and cerebral emboli should have prompt valve relacement. In paticular active PVE still has high mortality rate.

The patient was a 43-year-old male who presented with heart murmur. Echocardiography, chest CT, and cardiac catheterization data showed extracardiac extension of an aneurysm of the noncoronary sinus, compressing the right atrium, right ventricular outflow tract, and superior vena cava. Severe aortic regurgitation was also recognized. The aneurysm was incised under extracorporeal circulation. The orifice of the aneurysm was closed, and the elongated annulus of the noncoronary sinus was corrected with woven Dacron patch. Mild aortic regurgitation was shown on postoperative aortogram, and the case is being carefully followed up.

A Pulmonary arterial flow-directed catheter (Oxymetry 93A-741-7.5F), combining the fiberoptic reflectometric system of continuous measurement of mixed venous blood oxygen saturation (SvO₂) was used for hemodynamic measurements including thermodilution cardiac output estimation and hemoglobin value in 21 cases of open heart surgery. Immediately after open heart surgery there was low correlation between Hb (hemoglobin value) and SvO₂ (r=0.513, p<0.05). However there was no correlation between SvO₂ and cardiac function (pulmonary capillary wedge pressure and cardiac index). With almost normal Hb (10-13g/dl) the average cardiac index (CI) in cases of SvO₂ less than 60% was 2.47l/min/m² which was significantly lower than those with SvO₂ more than 60% (p<0.01). With normal CI (2.5-4.0l/min/m²) the average Hb in cases of SvO₂ less than 60% was 7.40g/dl which was significantly lower than those of more than 60% (p<0.01). This study suggested that there is low cardiac function or severe anemia in the state of SvO₂ less than 60%.

For the purpose of estimating the analgesic mechanisums of the electroacupuncture stimulation and relating the adrenocortical function with its analgesic effect, the deviation value of the pain threshold by the stimulation and β-endorphin, Met-enkephalin lebels in the cerebrospinal fluid [CSF] and also cortisol lebel in the blood were observed in experimented dogs.
The both lebels of CSF and cortisol lebel in blood were significantly increased by the electroacupuncture analgesia. These result suggest that in this analgesia, the hypophysis-adrenal cortex system was activated simultaneously with the production of an endogeneous opiate. Using a new designed pain meter system [non-contact thermal stimulator] for the small animals, increasing of the pain threshold lebels was observed objectively.

Aortic valve replacement was carried out for aortic regurgitation in Behçet's disease. A prosthetic valve was fixed using reinforced felt-strip mattress sutures. Difficulty to ensure adequate myocardial protection due to ostial stenosis in the right coronary artery resulted in the occurrence of intraoperative myocardial infarction. Right ventricular assist with the help of a centrifugal pump was employed to obtain successful recovery from right cardiac failure. It was noted that at operation attention should have been paid to the aortic valve and also to abnormalities of the coronary artery and that control of the inflammatory reaction by steroids was essential before and after the operation.

We studied the effects of granulocytic elastase (GEL) and fibronectin (FN) on the coagulation and fibrinolytic system when using cardiopulmonary bypass (CPB). Blood sampling was performed before CPB (Pre), just after CPB (Post) the 1st postoperative day (PD1) and the second postoperative day (PD2). Laboratory parameters were GEL, FN, fibrinogen (Fib), prothrombin time (PT), fibrin degradation products (FDP), D dimer (D-D), α2 plasmin inhibitor plasmin complex (PIC) and antithrombin III (AT III). The level of GEL was highest and that of FN was lowest at Post. The levels of Fib, PT and AT III were lowest and that of PIC was highest just after CPB. The levels of FDP and D-D were highest on PD1. The levels of GEL and D-D correlated just after CPB and on PD1 and PD2. The level of GEL correlated with that of PIC on PD1. These results demonstrated that the level of FN decreased with CPB. And it was expected that CPB time affected the level of GEL. The levels of GEL affects D-D and PIC which are fibrinolysic factors particularly related to secondary fibrinolysis.