The Anatomical Specificity Between Acupoints and the Facial Nerve: A Cadaveric Study.

Objective: This research was conducted to increase precision of point location and standardize acupoint targets in relation to the facial nerve (CN VII). Materials and Methods: A literature review, cadaver dissection, and electrostimulation of the CN VII were performed, focusing on the anatomical locations of the acupoints along the facial-nerve trajectory. The results were contrasted against established acupoint locations described in the 4th edition of Chinese Acupuncture and Moxibustion. Results: Triple Energizer (TE)-17 targets the facial nerve at its cranial exit; Qian Zheng at the facial nerve trunk; Tai Yang at the frontotemporal branch; Gallbladder (GB)-3 at the zygomatic branch; Small Intestine (SI)-18 at the buccal branch; Stomach (ST)-5 at the marginal mandibular branch; SI-17 at the cervical branch; TE-18 at the posterior auricular branch; TE-19 at the posterior auricular nerve; TE-20 at the superior auricular nerve; and TE-22 at the anterior auricular nerve. Conclusions: This study demonstrated the specificity with which acupuncture points are located in relation to the facial nerve. Standardization of facial acupuncture points to distinct branches of the facial nerve will facilitate reproducible research designs and interpractitioner reproducibility.

The Anatomical Relationship Between Acupoints of the Face and the Trigeminal Nerve.

Objective: Acupuncture continues to gain popularity as a first treatment option for a variety of conditions; however, an in-depth understanding of the relationships between the acupoints and the underlying anatomy of the human body is often unclear. This article updates the anatomical relationship between facial acupoints and the trigeminal nerve (CN V) and contrasts the results against the standard textbook Chinese Acupuncture and Moxibustion. Methods: A literature review, cadaver dissection, and a neuroanatomical stimulation of the CN V was conducted, focusing on the anatomical locations of the acupoints along the CN V on the face and nerve block targets. The results were contrasted against the standard acupoint location and nerve targets described in Chinese Acupuncture and Moxibustion. Results: The present article classifies CN V acupuncture targets according to 4 different types: (1) trunk; (2) bifurcation; (3) branch; and (4) anastomoses. The results of this exploration highlight the specificity with which acupoints are located in relation to the CN V. Areas of high nerve density correspond to several acupoints. Consequently, acupoints overlay closely with CN V branches as they emerge and bifurcate on the face. Conclusions: There is a clear and neuroanatomically relevant relationship between facial acupoints and the CN V.

Distinct Neuroanatomical Structures of Acupoints Kidney 1 to Kidney 8: A Cadaveric Study.

Objective: The Systematic Classic/Zhen Jiu Jia Yi Jing (ZJJYJ, ) is considered to be the first complete acupuncture manual to detail the location and meridian assignations of 349 acupuncture points. Despite numerous transcriptions and editing changes, many traditional acupuncturists adhere to the classics and rarely question their validity. However, ushering the use of acupuncture into the modern era requires examining acupuncture point locations objectively by comparing contemporary anatomical knowledge with classical texts. The aim of this research was to examine distinct neuroanatomical targets associated with acupuncture points to: (1) standardize the precise neuroanatomical target of each acupuncture point; and (2) crossreference neuroanatomical targets with classical point locations. This was done to demonstrate ancient authors' intentions when describing acupuncture points as coordinates used to stimulate the peripheral nervous system. Materials and Methods: The unique neuroanatomical targets associated with acupuncture points on the Foot Shao Yin Kidney meridian were defined. Specifically, KI 1 through KI 8 were examined by comparing classical point locations from the ZJJYJ with modern standardized textbook locations from Chinese Acupuncture and Moxibustion, current anatomical literature, the current authors' cadaver dissection research, and electrostimulation of acupuncture points in healthy volunteers. Results: KI 1-KI 8 correlated with motor entry points as well as with nerve branches and vessels derived from the posterior tibial neurovascular bundle. Conclusions: This research demonstrated a procedure to verify and standardize the distinct neuroanatomical structures of acupuncture points. Standardization of neuroanatomical targets of acupuncture points will enable researchers and clinicians to obtain reproducible results in clinical treatments and research protocols.

Neuroembryology of the Acupuncture Principal Meridians: Part 3. The Head and Neck.

Background: Accumulating evidence from anatomical, physiologic, and neuroimaging research shows that Classical acupuncture points stimulate nerve trunks or their branches in the head, trunk, and extremities. The first part of this series revealed that phenomenon in the extremities. Principal meridian distributions mirror those of major peripheral nerves there and Classical acupuncture points are proximate to peripheral nerves there. These relationships were shown to be consistent with the linear neuroembryologic development of the extremities. The second part of this series revealed that, in the trunk, a neuroanatomical basis for the Principal meridians exists consistent with lateral folding in early fetal neuroembryologic development. Objective: The aim of this Part is to provide anatomical data that corroborates a neuroanatomical basis for the Principal meridians in the head and neck, which is consistent with the longitudinal and lateral folding that occurs in early fetal neuroembryologic development. Methods: Adobe Photoshop software was used to apply Classical acupuncture points and Principal meridians as layers superimposed on neuroanatomic images of the head and neck, allowing demonstration of their anatomical relationships. Results: The Principal meridian distributions in the head and region can be conceptualized as connecting branches of the cranial and/or cervical spinal nerves. Conclusions: Anatomical data support the conceptualization of acupuncture Principal meridians in the head and neck as connecting branches of the cranial and/or cervical spinal nerves and are consistent with neuroembryologic development. Overall, the acupuncture Principal meridians can be conceptualized to have a neuroanatomical substrate that is corroborated by developmental neuroembryology.

Functional role of conserved residues in the characteristic secretion NTPase motifs of the Pseudomonas aeruginosa type IV pilus motor proteins PilB, PilT and PilU.

Type IV pili are retractable protein fibres used by many bacterial pathogens for adherence, twitching motility, biofilm development and host colonization. In Pseudomonas aeruginosa, PilB and PilT are bipolar proteins belonging to the secretion NTPase superfamily, and power pilus extension and retraction, respectively, while the unipolar PilT paralogue PilU supports pilus retraction in an unknown manner. Assay of purified 6xHis-tagged PilB, PilT and PilU from P. aeruginosa showed that all three proteins have ATPase activities in vitro. Conserved residues in the Walker A (WA), Walker B (WB), Asp Box and His Box motifs characteristic of secretion NTPases were mutated, and complementation of twitching motility was tested. Mutation of conserved WA or WB residues in any of the three ATPases abrogated twitching motility, and for the WA mutant of PilT caused loss of polar localization. The requirement for three invariant acidic residues in the Asp Box motif, and for two invariant His residues in the His Box motif varied, with PilB being the least tolerant of changes. In all three proteins, the third acidic residue in the Asp Box and the second His of the His Box were crucial for function; mutation of these residues caused loss of PilT ATPase activity in vitro. Modelling of the effects of these mutations on the crystal structures of Aquifex aeolicus PilT and Vibrio cholerae EpsE (a PilB homologue) showed that the critical Asp Box and His Box residues contribute to a catalytic pocket that surrounds the ligand. These results provide experimental evidence differentiating widely conserved Asp and His Box residues that are essential for function from those whose roles are modulated by specific local environments.

Disparate subcellular localization patterns of Pseudomonas aeruginosa Type IV pilus ATPases involved in twitching motility.

The opportunistic pathogen Pseudomonas aeruginosa expresses polar type IV pili (TFP), which are responsible for adhesion to various materials and twitching motility on surfaces. Twitching occurs by alternate extension and retraction of TFP, which arise from assembly and disassembly of pilin subunits at the base of the pilus. The ATPase PilB promotes pilin assembly, while the ATPase PilT or PilU or both promote pilin dissociation. Fluorescent fusions to two of the three ATPases (PilT and PilU) were functional, as shown by complementation of the corresponding mutants. PilB and PilT fusions localized to both poles, while PilU fusions localized only to the piliated pole. To identify the portion of the ATPases required for localization, sequential C-terminal deletions of PilT and PilU were generated. The conserved His and Walker B boxes were dispensable for polar localization but were required for twitching motility, showing that localization and function could be uncoupled. Truncated fusions that retained polar localization maintained their distinctive distribution patterns. To dissect the cellular factors involved in establishing polarity, fusion protein localization was monitored with a panel of TFP mutants. The localization of yellow fluorescent protein (YFP)-PilT and YFP-PilU was independent of the subunit PilA, other TFP ATPases, and TFP-associated proteins previously shown to be associated with the membrane or exhibiting polar localization. In contrast, YFP-PilB exhibited diffuse cytoplasmic localization in a pilC mutant, suggesting that PilC is required for polar localization of PilB. Finally, localization studies performed with fluorescent ATPase chimeras of PilT and PilU demonstrated that information responsible for the characteristic localization patterns of the ATPases likely resides in their N termini.

Biofilm formation by hyperpiliated mutants of Pseudomonas aeruginosa.

Under static growth conditions, hyperpiliated, nontwitching pilT and pilU mutants of Pseudomonas aeruginosa formed dense biofilms, showing that adhesion, not twitching motility, is necessary for biofilm initiation. Under flow conditions, the pilT mutant formed mushroom-like structures larger than those of the wild type but the pilU mutant was defective in biofilm formation. Therefore, twitching motility affects the development of biofilm structure, possibly through modulation of detachment.