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I'd like to talk to you now about some

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of our work that I've been doing in

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conjunction with jung-bae who's an

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acupuncturist Yong is actually an

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interesting chap he was going to be here

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today but was unable to he's not only

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acupuncturist but he actually also has a

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PhD in high-energy physics from UC

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Berkeley so that's a I don't know many

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acupuncturist that are high-energy

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physicists and acupuncturist too but

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show you some of the some of our work

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it's been ongoing for a number of years

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with with acupuncture acupuncture as you

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well know is a major component of

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oriental medicine but it's been very

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difficult to reconcile with medicine

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because oriental medicine more or less

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energy based Western medicine more

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molecular based but in spite of all of

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that there are certainly a number of

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documented correlates with acupuncture

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looking at nerve pathway activation

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release of neurotransmitters and

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hormones and a variety of other

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activities our initial study with

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acupuncture goes back to 1996 1998 this

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give you a little bit of history here

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and which we looked at correlations

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between specific brain cortices and

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corresponding acupoints stimulation the

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classical functional magnetic resonance

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imaging experiment you do is to

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stimulate the visual cortex by light

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flashes so someone's in an fMRI device

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you turn on flashing lights visual

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cortex lights up we repeated those same

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experiments except no flashing lights we

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blindfolded the subject we had the

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acupuncturist stimulate B l67 an

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acupuncture point in the foot related to

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vision and yeah the visual cortex lights

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up here are some fMRI images the one on

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the left the individual is looking at

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flashing lights and the visual cortex

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lights up the center B slide is the same

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individual blindfolded acupuncture

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stimulation of B l67 acupuncture one in

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foot-related vision visual cortex lights

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up

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what you see in the brain is just noise

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these findings were published back in

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1998 and Proceedings of National Academy

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we continued on this work using

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ultrasound to really determine the

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feasibility of using ultrasound to at

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first stimulate acupuncture sought sites

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and then to actually image these

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acupuncture sites as well the ultrasound

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parameters that we use for the

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stimulation were based on work that

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we've done previously and just very

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quickly we used a focus transducer

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operating at five megahertz highly

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focused working in intensive levels

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between five to eight watts per square

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centimeter

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the ultrasound stimulation was applied

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to this acupuncture point the o-67

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vision related acupuncture point and it

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turns out that the ultrasound

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stimulation is actually

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indistinguishable from applying a needle

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to that same acupuncture point it also

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turns out that a wide range of

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ultrasound parameters could produce the

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simulation but lower levels of

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ultrasound those below about five watts

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per square centimeter would not produce

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a stimulation by the way these

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ultrasound levels are above those that

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are used diagnostically but below those

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that are known produced any kind of

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deleterious effects we moved on to try

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to image acupuncture points and

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conventional imaging conventional

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ultrasound imaging failed miserably

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operating at three and a half seven half

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ten megahertz typical ultrasound imaging

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device is imaging of acupuncture points

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was really unremarkable we understand

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why but due to the fact that acupuncture

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points appear to have the same

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reflectivity as a surrounding tissue

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however measurements at somewhat higher

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frequencies 50 megahertz Center

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frequencies showed the enhanced ultra

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sound attenuation through an acupuncture

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point and without going any kind of

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details let me just suffice it to say

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given the time

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constraints that the slide at the top is

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kind of a reflected signal through soft

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tissue these are these are 11

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millimeters in depth and moving over to

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acupuncture site what we see is enhanced

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attenuation over that acupuncture site

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highly distinguished from just normal

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soft tissue this in fact led us to

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develop a data acquisition system

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operating at 50 megahertz on which we

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digitize the reflected signals we refer

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to those as a lines send out a pulse of

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ultrasound look at the reflections that

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come back that's known as an a-line we

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recorded a two-dimensional grid of these

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a lines and then calculated using some

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signal processing techniques that we had

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developed years ago in our lab along

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each line to measure the attenuation of

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each acupuncture point and then to

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reconstruct that and here is what a this

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bee l67 actually looks like the top of

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the skin is up here scales here in

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millimeters three dimensionally and what

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you see are basically foci of constant

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attenuation or elasticity defining that

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acupuncture point and with a little

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visualization or if I take off my

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classes it actually actually looks like

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a three-dimensional acupuncture point

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and maybe if your vision is as bad as

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mine you can take off your glasses and

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it'll look much better but I'll show you

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some images later that are actually much

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much better than this curiously enough

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these acupuncture points don't stay in

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the same place they move around this is

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a typical size of the acupuncture point

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this is in a particular individual of a

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12-day period and notice you start out

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here and over 12 days the acupuncture

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point comes out over here and this

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process is actually it turns out well

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known to many many acupuncturist I was a

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little surprised to find this out but

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the acupuncture points do actually

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change in size and shape over time and

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they move around a little bit well a

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summary so far acupuncture points

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correspond to regions of enhanced

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elasticity increased ultrasound

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attenuation

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they change in size shape and even

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location over short periods of time and

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using quantitative ultrasound methods we

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can actually image these acupuncture

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points and ultrasound at higher

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intensities can actually stimulate those

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points a couple of references we first

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reported on this at the 20th annual

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meeting back in La Jolla in 2001 and

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some additional work at the meeting at

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University of Virginia in 2002 and this

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was also published 2004 in medical

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acupuncture and in acoustic imaging the

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objectives of the ongoing study and what

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I'd really like to talk to you about

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today is to obtain ultra sound

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attenuation images of acupuncture points

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during the stimulation of those points

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and also to investigate communication

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between acupuncture points along the

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same Meridian here we built a new data

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acquisition system that was a actually

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at 50 megahertz transducer array it's 10

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by 10 elements each element is about a

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two tenths of a millimeter square

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operating center frequencies of 50

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megahertz so it's a 10 by 10 array so it

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means a hundred elements we're going to

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record these individual a lines from

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each transducer and digitize them at 200

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megahertz and we're going to fire each

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one of these hundred elements at the

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same time record information and then

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put together the data to reconstruct an

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attenuation image or elasticity image of

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the acupuncture points now each element

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of this array is connected to a separate

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pulsar and receiver so if you come into

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our lab you'll see a rack of a hundred

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pcs it's kind of brute force but it does

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work actually we have a hundred and one

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pcs because one PC basically controls

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the process and the other hundred pcs

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record the data from each one of these

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elements in the array each PC has about

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five gigabytes of fast memory and so in

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about three seconds when we turn this

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thing on we record about a half a

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terabyte of data

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so this will keep graduate students busy

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for a long period of time and in fact

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the the images that are going to show

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you are sort of jumpy they don't move

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smoothly and they don't smooth move move

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smoothly because of the limited number

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of graduate students I have to work on

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this stuff okay

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here's what an acupuncture point looks

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like this is BL 67 this is about a

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millimeter or so in dimension here and

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now let's see what happens when you

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actually stimulate that acupuncture

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point top of the skin is here we're

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about three millimeters in depth from

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the scan let's see what happens when we

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actually stimulate this acupuncture

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point you get the same thing whether

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it's a needle or a pulse of ultrasound

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the point actually twists around the

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needle actually twisting around the

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needle as you stimulate now the

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acupuncture point that we're stimulating

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is B l67 in the foot here and now what

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I'd like to do is stimulate this

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acupuncture point and then let's take