Pain is one of the most common symptoms of disease, and is thought to be an indication of an underlying pathology, but in some patients it is not possible to identify a pathophysiological mechanism or to find a well-known disease or pathology as the underlying condition. The evaluation of the patient with pain is frequently complex, because pain is a perception rather than a sensation. Now the diagnosis of pain intensity is based on patient’s interpretation of a sensation, emotional response, and associated behavior. Newly discovered signal transduction pathway which uses nitric oxide (NO) to modulate the function of the vascular smooth muscle cells through mechanical wall shear stress (WSS) mechanism. WSS is a linear function of the blood flow rate and is inversely related to the third power of the vessel radius. Wall shear stress is influence smooth muscle tone changing arterial lumen. In turn, the changes in arterial lumen regulate the shear stress. Such the arterial lumen is controlled by flow-related wall shear stress using NO pathway. On the other hand NO is clearly identified as a paracrine (local hormone) effector molecule. NO as paracrine signals exert the dilator effect of a variety of others endogenous vasoactive substances such adenosine, serotonin, substance P, bradykinin, histamine. Al these vasoactive substances also involved in pain mechanism at all levels as pain signaling or transmitters. Measuring the effect of pain on the vasomotor tone can help as more understand the pathophysiology of pain which may serve as a technique for objectively monitoring pain. In this brief review we analyze the possible interactions between pain and vascular smooth muscle cells tone as a way for pain evaluation ussing blood flow patterns.


CLINICAL CORRELATION BETWEEN CUTANEOUS BIOELECTRIC POTENTIAL AND THERMOGRAPHIC IMAGING OF BLOOD FLOW
M. Piquemal, MD, Dip Eng
Villa Aurelia, Casilla Correo 2899, Asuncion, Paraguay

The bio-difference recording electrodermal potential (Bio-DDP) is a measurement of the electrical field emitted by cells. The field, Pontigny hypothesized, is generated by epidermal phenomena, dermal vascular ionic charge transport and local nervous regulatory centers. This study provides additional evidence that dermal vascular ionic charge transport contributes to acupuncture point electrodermal potential. The correlation between these variables seems related to historical clinical knowledge about the association between Shu points and specific organ functioning. In the future, a refined bio-DDP might be utilized to diagnosis functional and organic disorders as well as help science to better understand pathophysiologic mechanisms.

ACUPUNCTURE TECHNIQUES IN STRESS SYNDROMES. A REPORT
A.F.van Gelder, MD
Kralingseweg 306, 3066 RB Rotterdam,
The Netherlands e-mail: gelder@iveg.nl

The article deals with acupuncture diagnosis and therapy concerning stress related problems. The used strategies are based on the observation that stress related symptoms can be divided into two categories; a non-specific response and a more specific response to stress. First the author explains why and how the non-specific symptoms develop and how the subsequently treatment by certain acupuncture points and techniques is performed. The specific response to stress is divided into four pathological patterns in which the kidney energy plays a central role. The furthermore involved Zang organs including diagnosis and specific treatment are described.


EXPERIENCE WITH ACUPUNCTURE FOR ACUTE PROBLEMS IN PRIMARY CARE
Noah Samuels, MD
Shoresh Medical Center, P.O.B.28048, Jerusalem, Israel

Acupuncture, now recognized as an effective treatment for many ailments, is taught in medical schools throughout the U.S., though it is unclear as to its implementation in primary care medicine. This article describes a primary care physician’s experience with some of the uses of acupuncture for acute syndromes in his daily practice. Hyperemesis gravidum, acute torticollis, acute low back pain and pruritis have all been shown to respond to acupuncture, and are frequent complaints in the primary care practice. This option should be offered to patients by their physicians.

THE THERAPY OF NOGIER`S MIDDLE LAYER
S. Leib, MD
Nibelungenstr. 6, 86152 Augsburg, Germany

The theory of the three functional layers, developed by Dr. Nogier, is an integral part of modern auricular medicine. In the article presented here, the middle layer is described in detail, as is its relationship to the other two layers. The effectiveness of homeopathic and homeotoxicologic remedies on the middle layer, as measured by Nogier’s reflex (VAS), is described as well.