[Objective]The skin is the biggest organ in the body. The human epidermis functions as a defence against various antigens in addition to physical and bio-chemical protection. The dermis consists of dense connective tissue which contains the circulatory system and sensory nerve endings. In this paper, regional differences in the structures of human skin are described.
[Materials and Methods]The skin of different regions in the human body was examined by optical and electron microscopy and by utilizing various morphological techniques.
[Results and Discussion]Epidermis:The cornified layer in the finger pulp and heel, which receives strong mechanical stimuli, is considerably thicker than other regions. The germinal layer consisting of spinous and basal layers becomes thinner with aging. Langerhans cells that produce antigens are scattered in the germinal layer. Furthermore, Merkel cells situated at the basal layer are found in the finger pulp, bottom of the foot and the hair disks of limbs. These cells are involved in the sense of touch or pressure. Dermis:The dermis is divided into the papillary and reticular layers, which consist of loose and dense connective tissue, respectively. In the papillary layer, fibrocytes and mast cells are distributed. Large-sized dermal papillae are found the in finger pulp and bottom of the foot, but there are also a few small papillae in other regions. In large papillae, loops of blood capillaries and Meissner's tactile corpuscles were observed. In addition, large-sized lymphatic capillaries are present in the papillary layer.A dense network of free endings, which are situated beneath the epidermis and are responsible for thermal nociception, are abundant in the face, palm, forearm and sacrum. Corpuscles of Vater-Pacini situated in the deep dermis or subcutaneous tissue are found in the finger pulp, and bottom of the foot.
[Conclusion]In conclusion, it is likely that acupuncture and moxibustion may directly or indirectly stimulate Langerhans cells, Merkel cells, fibrocytes, mast cells or various nerve endings.

1) The historical development to date of the systems of medical education and medical licensure were reviewed, and the quantitative and qualitative evolution of medical schools was divided into 7 stages.2) In the early Meiji era, persons who had already practiced medicine could apply to receive a medical license. Until the Taisho era, medical licenses were granted either to graduates of medical universities and relevant special schools or to those who passed the national examination. Thus, the criteria for medical license were not uniform during this period.3) Before the end of World War II, medical schools aimed to improve the quality of medical education so that their graduates could receive medical licenses without taking the national examination and to raise their status to the level of universities. However, because the types of medical schools during this period varied and included imperial universities, colleges, and specialty schools, the quality of medical education also varied.4) After World War II, the introduction of the state examination for the license to practice medicine and a new university system standardized medical education to guarantee its quality.5) The quantitative expansion of the medical education occurred mainly in the 12 years after 1919, in the 7 years after 1939 and during the war, and in the 10 years after 1970, and, except for the years of violent change before 1887, the number of medical schools has otherwise remained stable.

A 65-year-old man was referred to our hospital in April 2003 with a pancreas tumor detected by a thorough medical checkup. Computed tomography (CT) showed swelling of the pancreatic body and tail, and magnetic resonance cholangiopancreatography (MRCP) showed only the main pancreatic duct in the head of the pancreas. Diagnosing autoimmune pancreatitis, we observed the patient without medication. However, one year later CT showed stenosis of the splenic artery and portal vein accompanied by development of collateral circulation around the pancreas. He had no symptoms, and CT showed no changes in the pancreatic swelling.;;He was admitted to our hospital on January 6, 2005, presenting with a history of jaundice which first appeared on January 1, 2005, and increased collateral circulation around the pancreas with pancreatic swelling were seen on CT. We started prednisolone therapy at 40 mg/day for exacerbation of autoimmune pancreatitis. Serum bilirubin levels improved from 11.9 mg/dl to 2.5 mg/dl, and pancreatic swelling also improved four weeks after starting therapy.;;We present a rare case of autoimmune pancreatitis that developed marked collateral circulations.
X-Ray Computed Tomography ; Pancreatitis ; Collateral Circulation ; Pancreatic polypeptide, avian ; Swelling