Multi-Acupuncture Point Injections and Their Anatomical Study in Relation to Neck and Shoulder Pain Syndrome (So-Called Katakori) in Japan.

Katakori is a symptom name that is unique to Japan, and refers to myofascial pain syndrome-like clinical signs in the shoulder girdle. Various methods of pain relief for katakori have been reported, but in the present study, we examined the clinical effects of multi-acupuncture point injections (MAPI) in the acupuncture points with which we empirically achieved an effect, as well as the anatomical sites affected by liquid medicine. The subjects were idiopathic katakori patients (n = 9), and three cadavers for anatomical investigation. BL-10, GB-21, LI-16, SI-14, and BL-38 as the WHO notation were selected as the acupuncture point. Injections of 1 mL of 1% w/v mepivacaine were introduced at the same time into each of these points in the patients. Assessment items were the Pain Relief Score and the therapeutic effect period. Dissections were centered at the puncture sites of cadavers. India ink was similarly injected into each point, and each site that was darkly-stained with India ink was evaluated. Katakori pain in the present study was significantly reduced by MAPI. Regardless of the presence or absence of trigger points, pain was significantly reduced in these cases. Dark staining with India ink at each of the points in the anatomical analysis was as follows: BL-10: over the rectus capitis posterior minor muscle and rectus capitis posterior major muscle fascia; GB-21: over the supraspinatus muscle fascia; LI-16: over the supraspinatus muscle fascia; SI-14: over the rhomboid muscle fascia; and BL-38: over the rhomboid muscle fascia. The anatomical study suggested that the drug effect was exerted on the muscles above and below the muscle fascia, as well as the peripheral nerves because the points of action in acupuncture were darkly-stained in the spaces between the muscle and the muscle fascia

Acetamiprid Accumulates in Different Amounts in Murine Brain Regions

Neonicotinoids such as acetamiprid (ACE) belong to a new and widely used single class of pesticides. Neonicotinoids mimic the chemical structure of nicotine and share agonist activity with the nicotine acetylcholine receptor (nAchR). Neonicotinoids are widely considered to be safe in humans; however, they have recently been implicated in a number of human health disorders. A wide range of musculoskeletal and neuromuscular disorders associated with high doses of neonicotinoids administered to animals have also been reported. Consequently, we used a mouse model to investigate the response of the central nervous system to ACE treatment. Our results show that exposure to ACE-containing water for three or seven days (decuple and centuple of no observable adverse effect level (NOAEL)/day) caused a decrease in body weight in 10-week old A/JJmsSlc (A/J) mice. However, the treatments did not affect brain histology or expression of CD34. ACE concentrations were significantly higher in the midbrain of ACE-treated mice than that of the normal and vehicle groups. Expression levels of α7, α4, and β2 nAChRs were found to be low in the olfactory bulb and midbrain of normal mice. Furthermore, in the experimental group (centuple ACE-containing water for seven days), β2 nAChR expression decreased in many brain regions. Information regarding the amount of accumulated ACE and expression levels of the acetylcholine receptor in each region of the brain is important for understanding any clinical symptoms that may be associated with ACE exposure

A summary of <i>katakori</i> patient backgrounds.

<p>A summary of <i>katakori</i> patient backgrounds, findings at each acupuncture point (presence or absence of PTs or TrPs), response during MAPI (presence or absence of an LTR), extent of symptom improvement after MAPI (PRS), and duration (days) of symptom improvement after MAPI. The acupuncture names in the table are written based on the WHO notations.</p><p>Abbreviations: PT tender point, TrP trigger point, LTR local twitch response, MAPI multi-acupuncture point injection</p><p>A summary of <i>katakori</i> patient backgrounds.</p

Schema of the injection sites for BL-10, GB-21, LI-16, SI-14, and BL-38.

<p>The red circles in the figure show the acupuncture point sites as follows: BL-21, outer margin of the suboccipital trapezius muscle; GB-21, midpoint of the transverse process of the seventh cervical vertebra (C7) and the outer margin of the acromion; LI-16, the outer margin of the supraspinatous fossa; SI-14, medial side of the superior angle of the scapula; and BL-38, medial margin midpoint of the scapula.</p

Photographs (a-e) and schematic illustrations (f-j) of the injection sites in BL-10 (a and f), GB-21 (b and g), LI-16 (c and h), SI-14 (d and i), and BL-38 (e and j) in a cadaver.

<p>Arrows and arrowheads indicate the suprascapular artery and nerve, respectively. Tr: Fascia of trapezius, Sc: Fascia of semispinalis capitis, Rma: Fascia of rectus capitis posterior major, Rmi: Fascia of rectus capitis posterior minor, Su: Fascia of supraspinatus, Rh: Fascia of rhomboid, Sca: Bone of scapula.</p

The muscles and nerves that are related to acupuncture points.

<p>Summarizes deeply-dyed sites of acupuncture point injection in cadavers.</p><p>Deep dyeing was observed in each muscle; nerves innervating the muscles are shown, as are the origin levels of the innervating nerves.</p><p>The muscles and nerves that are related to acupuncture points.</p