BACKGROUND: Motion sickness is a common transportation issue worldwide. Vestibular dysfunction has been reported to be a key etiology of motion sickness. However, there are limited technologies for alleviating motion sickness. METHODS: The most appropriate frequency (Hz) and level (dBZ) of pure tone for modulation of vestibular function were determined by an ex vivo study using murine utricle explants. The preventive effects of the selected pure tone on motion sickness were then confirmed by using a beam balance test in mice. The alleviating effects of pure tone on motion sickness induced by a swing, driving simulator or real car were objectively assessed by using posturography and electrocardiography (ECG) and were subjectively assessed by using the Motion Sickness Assessment Questionnaire (MSAQ) in humans. RESULTS: The effect of short-term (≤5 min) exposure to a pure tone of 80-85 dBZ (= 60.9-65.9 dBA) at 100 Hz on motion sickness was investigated in mice and humans. A mouse study showed a long-lasting (≥120 min) alleviative effect on shaking-mediated exacerbated beam test scores by 5-min exposure to a pure tone of 85 dBZ at 100 Hz, which was ex vivo determined as a sound activating vestibular function, before shaking. Human studies further showed that 1-min exposure to a pure tone of 80-85 dBZ (= 60.9-65.9 dBA) at 100 Hz before shaking improved the increased envelope areas in posturography caused by the shakings of a swing, a driving simulator and a vehicle. Driving simulator-mediated activation of sympathetic nerves assessed by the heart rate variable (HRV) and vehicle-mediated increased scores of the MSAQ were improved by pure tone exposure before the shaking. CONCLUSION: Since the exacerbated results of posturography and HRV reflect shaking-mediated imbalance and autonomic dysfunction, respectively, the results suggest that the imbalance and autonomic dysregulation in motion sickness could be improved by just 1-min exposure to a pure tone with daily exposable sound pressure levels. TRIAL REGISTRATION Registration number: UMIN000022413 (2016/05/23-2023/04/19) and UMIN000053735 (2024/02/29-present).
Motion Sickness/therapy* ; Animals ; Mice ; Humans ; Male ; Adult ; Female ; Sound ; Middle Aged ; Young Adult ; Mice, Inbred C57BL

A 17-year-old male was admitted to our hospital because of strong abdominal pain. His symptoms gradually worsened even after hospitalization, and contrast computed tomography (CT) revealed hemorrhage in the abdominal cavity. Interventional radiology (IVR) was performed to identify the bleeding site. No obvious source of bleeding was identifiable on IVR, so we opted to perform laparoscopic examination and hemostasis. The intraperitoneal finding was hematoma in the omentum, and omentectomy was performed for idiopathic omental hemorrhage because there was no history of trauma. The postoperative course was good and the patient was discharged after postoperative day 4. Performing laparoscopic surgery for omental hemorrhage facilitated minimally invasive treatment with a short hospital stay.

[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.

We present here a rare case of coronary artery bypass grafting through a left thoracotomy after substernal gastric interposition for esophageal cancer. A 58-year-old man, who had undergone esophagectomy and substernal gastric interposition 11 years previously, was admitted for cerebral infarction from which he made a good recovery without any complication. At this time, the patient was diagnosed as having coronary artery disease on electrocardiogram. Cardiac catheterization revealed triple vessel disease. Coronary artery bypass grafting to the left anterior descending artery and obtuse marginal branch through a left thoracotomy was performed using a radial artery Y-graft under femorofemoral bypass. The aorta was cross-clamped and the heart was arrested with antegrade cold cardioplegic solution for the distal anastomosis of the left anterior descending artery and the obtuse marginal branch which was embedded within the myocardium. The postoperative angiography showed good coronary flow. Left thoracotomy approach provides a good exposure of the left coronary artery. This approach, therefore, is advocated as an alternative method for cases requiring coronary artery bypass but in which median sternotomy is difficult, such as the present case. The appropriate procedure for the site of thoracotomy, supporting methods, choice of graft, and the site of graft anastomosis should be selected in each patient.

Rheumatic tricuspid stenosis has become rare recently. A 54-year-old woman had undergone mitral valve replacement with a Carpentier-Edwards bioprosthesis for mitral stenosis 22 years previously and had undergone repeat mitral valve replacement for prosthetic valve failure 10 years later. She was admitted with severe leg edema. Cardiac catheterization revealed pulmonary hypertension and tricuspid stenosis with a diastolic pressure gradient of 6mmHg across the tricuspid valve. Tricuspid valve replacement was performed with a Hancock bioprosthesis. The postoperative course was uneventful and her edema improved markedly. This case suggested that careful follow-up to detect progression of tricuspid stenosis is necessary in patients with rheumatic valve disease and pulmonary hypertension.