Reliability and Validity of Facial Check Sheet (FCS): Checklist for Self-Satisfaction with Cosmetic Acupuncture.

Background: In recent years, cosmetic acupuncture has gained popularity among individuals interested in improving their facial appearance. We have created an original facial check sheet (FCS) to obtain cosmetic acupuncture patients' perspectives on treatment outcomes. This study examined the reliability and validity of FCS. Methods: We conducted an Internet survey on the appearance of the facial region among Japanese women. A reliability analysis was performed between each item of FCS. A multiple comparison procedure was used to determine the relationship between the age group, the FCS score, and the number of terms used in the open-ended question. Results: The most frequently stated concern was blotchiness and hyperpigmented spots (47.2%, n = 67). The FCS items showed reliability (Cronbach α = 0.871). The number of extracted terms and the FCS score showed a moderate correlation (r = 0.407; p < 0.001). There was a significant relationship between age and FCS score (p = 0.005, r2 = 0.255), which indicated that the FCS score increases with aging. Conclusions: The FCS can be used as a practical tool to evaluate facial appearances and assess satisfaction levels of patients who underwent cosmetic acupuncture or other facial skin rejuvenation procedures.

Effect of Different Dosages of ST36 Indirect Moxibustion on the Skin Temperature of the Lower Legs and Feet.

Background: Indirect moxibustion (IM) has been previously performed between the spinous process while recording skin temperature of the trunk. However, moxibustion is often applied not only to acupuncture points on the back, but also to points located on the limbs. Thus, there is a need to investigate skin temperature (ST) responses following IM applied to the limbs. Methods: In Experiment 1 (Exp 1), subjects were randomly assigned to three groups: the left IM stimulation, right IM stimulation and control groups. In Experiment 2 (Exp 2), the subjects underwent two experimental sessions consisting of a single stimulation of IM or triple stimulations of IM. The IM stimulation was administered to the ST36 acupuncture point. A thermograph was used to obtain the ST on the lower limbs. Results: In Exp 1, the ST of the lower limbs increased in the stimulation groups whereas there was no increase in the non-stimulation group. In Exp 2, no significant response occurred between the single and triple stimulation of IM groups for all observed sites except for the left ankle ST. Conclusions: Lower limb ST increased following IM application to the ST36 point. No difference was observed between the dosage of the stimulation and ST responses.

Determination of symptoms associated with hiesho among young females using hie rating surveys.

OBJECTIVE: Hie (cold sensation) is one of the most well-known health complaints in Japan and elsewhere in East Asia. Those who suffer from severe hie are considered to have hiesho (cold disorder). This study was conducted to determine symptoms associated with hie in young females using a survey consisting of the hie scale and hie diary. METHODS: Two hundred and seventy-one participants were included for the analysis. Survey forms were distributed to the participants. Diagnosis of hiesho was determined by using the hie scale. A discriminant score of over -0.38 was considered hiesho. The Short Form-8 Health Survey Standard Version (SF-8) was used to measure health-related quality of life (QOL). The participants were also asked to respond to the questionnaire evaluating 14 physical and emotional symptoms, utilizing a six-level Likert scale item. RESULTS: The 1st factor (hie factor) was correlated with hie (r = 0.546), dry mouth (r = 0.332), lower-extremity edema (r = 0.450), headrushes (r = 0.470), shoulder stiffness (r = 0.311), headrushes with chills (r = 0.726), and fatigue (r = 0.359). Cronbach's α of the 1st factor was 0.748, which indicated reliability between the items. When hie factor was the dependent variable, standardized partial regression coefficient was ß = -0.387 for physical component score (P < 0.001) and ß = -0.243 for mental component score (P < 0.001). CONCLUSION: This study indicated that hiesho symptoms among young female adults were associated with bodily pain and general health perceptions of the SF-8 QOL survey.

Extraction of items identifying hiesho (cold disorder) and their utility in young males and females.

OBJECTIVE: Hie (cold sensation) is one of the most common health complaints in Japan. Those who suffer from severe hie are considered as having hiesho (cold disorder). However, exact hiesho symptoms have not been defined clearly and the decision as to whether a person suffers from hiesho is subjective and based on self-awareness. The study was conducted in attempt to develop a standardized hiesho diagnostic scale. METHODS: Subjects comprised 1 146 students. From the self-awareness of hiesho symptoms, males and females were divided into hiesho and non-hiesho groups. Physical, behavioral and adaptive characteristics were compared using the 24-item questionnaire (four-grade survey) and indicators for hiesho symptoms were extracted. Based on the scores, a receiver operating characteristic curve was drawn for the total ordinal scale score of the extracted items in relation to the presence and absence of hiesho symptoms, and an optimal cutoff value was determined. RESULTS: The self-awareness of having hiesho was found in 23.2% males and in 55.6% females. The sensitivity was 84.5% for males and 83.3% for females in the hiesho groups, and the specificity was 86.0% for males and 85.2% for females in the non-hiesho groups. CONCLUSION: A questionnaire consisting of the extracted items may be useful to identify hiesho in young males and females with a high level of accuracy.

Tongue diagnosis: relationship between sublingual tongue morphology in three tongue protrusion angles and menstrual clinical symptoms.

OBJECTIVE: The morphological and color characteristics of the tongue sublingual veins (SLVs) can manifest differently within the subjects, depending on the way their tongue is curled upward. This study was conducted in order to investigate the clinical relevancy of tongue SLV diagnosis in relation to menstrual clinical symptoms (pain, clots, heavy, and scanty), using three different inspection procedures (IP1, IP2, and IP3). METHODS: Three-hundred and seventy-seven female patients were asked to stick out their tongues in three specific ways which were intended to create different tongue protrusion angles. The SLV parameters for thickness (TK), length (LE), color (CL), shape (SP), and nodules (ND) were then evaluated. RESULTS: According to the results of the Wald χ2 test, IP1 provides the best model for pain (R2=0.155), IP3 for clots (R2=0.437), IP2 for heavy (R2=0.268), and scanty (R2=0.192). Abnormal SLV diagnostic parameters were most strongly associated with the clinical symptom of clots (R2=0.492). CONCLUSION: While the study showed the relations between tongue SLV features and menstrual clinical symptoms, as well it showed that IP2 was the best overall predictor for the symptomatic indexes used in this study, and using one particular SLV inspection procedure may not be sufficient. The application of a particular inspection method alone may cause under- or over-estimation of SLV abnormalities.

Influence of different durations of electroacupuncture stimulation on skin blood flow and muscle blood volume.

OBJECTIVE: To determine whether skin blood flow (SBF) and muscle blood volume (MBV) responses differ according to the duration of electroacupuncture (EA) stimulation. METHODS: Two experiments were conducted. In Experiment 1, healthy male students (n=20) were randomly divided into two groups (an EA group and a no-stimulation group). In Experiment 2, healthy male students (n=37) were randomly divided into three groups with different stimulation durations of EA (5, 10 and 15 min). EA stimulation on the quadriceps femoris muscle was administered with a frequency of 1 Hz. SBF and MBV were estimated before, during and after stimulation. RESULTS: In Experiment 1 there was a significant difference between the groups (p=0.001). In the EA stimulation group, MBV increased immediately following EA (p=0.045) and 5 min (p=0.005) and 10 min (p=0.002) after EA compared with baseline. No significant change was observed in the no-stimulation group. In Experiment 2 there was no significant difference between the groups. All three stimulation durations (5, 10 and 15 min) yielded increases in MBV after stimulation compared with baseline. SBF following stimulation for 5 and 10 min was increased compared with baseline. CONCLUSIONS: Based on these findings, we consider that 10 min EA stimulation could be a sufficient duration to induce a blood flow response in a clinical situation when increasing the blood flow is desirable.

Difference between the effects of one-site and three-site abdominal hot-stone stimulation on the skin-temperature changes of the lower limbs.

OBJECTIVE: To determine whether any difference exists in the skin-temperature responses of the lower limbs to hot-stone application relative to one-site and three-site abdominal application. METHODS: Twenty-five female students participated in experimental sessions after a random allocation: 14 participants received a hot-stone application on the umbilicus, superior-umbilicus, and inferior-umbilicus regions (hereafter referred to as the three-site stimulation group); and 11 participants received the hot-stone application on the umbilicus region only (hereafter referred to as the one-site stimulation group). Heated stones were applied for 9 min to participants in both groups. Four arbitrary frames (the lower leg, ankle, proximal foot, and distal foot regions) were created in order to observe and analyze the skin temperature of a lower limb using a thermograph. Observation periods were as follows: before hot-stone stimulation, immediately after stimulation, and 5, 10, 15, and 20 min after stimulation. RESULTS: There was a significant offset interaction of distal foot skin temperature between the groups. The left-side distal foot skin temperature increased at 15 and 20 min following the three-site abdominal hot-stone stimulation. The right-side distal foot skin temperature increased immediately and at 5, 10, 15, and 20 min following the three-site abdominal hot-stone stimulation. No significant change in distal foot skin temperature was observed following the one-site stimulation. CONCLUSION: Lower-limb skin temperature was altered following hot-stone stimulation applied to the abdomen, and the one-site stimulation and three-site stimulation yielded different distal foot skin-temperature reactions.

[Effects of acupuncture treatment on natural killer cell activity, pulse rate, and pain reduction for older adults: an uncontrolled, observational study].

OBJECTIVE: The aim of this study was to examine the changes in natural killer (NK) cell activity, pulse rate, and pain intensity among older adults before and after acupuncture treatment. METHODS: Fifty-six individuals (16 males and 40 females), age 60 to 82 years (mean age 72.4 ± 5.0), who were experiencing pain in the shoulder, low back, or knee, participated in the study. NK cell activity, leukocyte differentiation (granulocytes and lymphocytes), pulse rate, and blood pressure values obtained. Pain intensity was used to analyze NK cell activity, leukocytes (granulocyte counts and granulocyte-to-lymphocyte ratio), and the VAS score in accordance with the location of pain complaints before and after acupuncture treatment. RESULTS: NK cell activity decreased after acupuncture treatment for pain in the shoulder-pain and knee-pain groups. Further, the lymphocyte and granulocyte counts increased after acupuncture treatment for the shoulder-pain group. Pulse rate decreased for the shoulder-pain, low-back-pain, and knee-pain groups after acupuncture treatment. The VAS score decreased after acupuncture treatment for the shoulder-pain, low-back-pain, and knee-pain groups. CONCLUSION: This study showed that in older adults, acupuncture treatment decreases pulse rate, relieves pain in the shoulder, low back, and knee, and reduces NK-cell activity.

Is there any difference in human pupillary reaction to acupuncture between light- and dark-adaptive conditions?

OBJECTIVES: To determine if acupuncture stimulation elicits a pupillary response under light adaptation and whether there is any difference in the pupillary response between light and dark adaptation environments during acupuncture stimulation. METHODS: The participants consisted of 55 healthy individuals who had no known eye diseases or pupil abnormalities. Experiment 1 compared pupillary responses between acupuncture stimulation and no-stimulation groups under light adaptation. Experiment 2 compared pupillary responses to acupuncture between two conditions (dark and light adaptation) with a two-period repeated measurement crossover design. For both experiments the pupil diameter was continuously measured for 3 min before stimulation, during stimulation and for 3 min after stimulation. For all acupuncture stimulation interventions an acupuncture needle was inserted superficially at the TE5 acupuncture point followed by gentle tapping stimulation for 90 s. RESULTS: In experiment 1 the pupil diameter was significantly decreased during (p<0.01) and after stimulation (p<0.0001) compared with the pupil diameter before stimulation under light adaptation. No significant difference was noted in the serial changes in pupil diameter in the no-stimulation group. In experiment 2 the pupil diameter was significantly decreased 90 s after stimulation (p<0.05) and 150 s after stimulation (p<0.05) under light adaptation conditions. Furthermore, the pupil diameter was significantly decreased 120 s after stimulation (p<0.05) and 150 s after stimulation (p<0.01) under dark adaptation conditions. No significant difference in the serial changes in pupil diameter was noted between the groups. CONCLUSIONS: This study shows that pupil constriction occurs following acupuncture stimulation under light adaptation and this response is no different from that seen under dark adaptation.

Is there a difference between the effects of one-point and three-point indirect moxibustion stimulation on skin temperature changes of the posterior trunk surface?

OBJECTIVE: To determine whether any difference exists in responses to indirect moxibustion relative to thermal stimulation sites. METHODS: Twenty one healthy men of mean±SD age 22.5±6.1 years were randomly divided into two groups, one receiving a single moxibustion stimulation in three locations (the three-point stimulation group, n=10 participants) and the other receiving three stimulations in one location (the one-point stimulation group, n=11 participants). The thermal stimulation sites were GV14, GV9 and GV4 acupuncture points. A thermograph was used to obtain the skin temperature on the posterior trunks of the participants. To analyse skin temperature, four arbitrary frames (the scapular, interscapular, lumbar and vertebral regions) were made on the posterior trunk. RESULT: An increase in skin temperature on the posterior trunk was observed following both one- and three-point moxibustion administrations. The skin temperature of the lumbar region showed a significant increase after three-point stimulation compared with single-point stimulation (p=0.011). There was also a significant increase in skin temperature of the spinal region after three-point stimulation compared with one-point stimulation (p=0.046). CONCLUSION: Administration of single moxibustion doses on the GV14, GV9 and GV4 points produces greater changes in skin temperature than three applications of moxibustion to the GV14 point only.

Is there a difference between the effects of single and triple indirect moxibustion stimulations on skin temperature changes of the posterior trunk surface?

OBJECTIVES: To determine whether any difference exists in responses to indirect moxibustion (IM) relative to thermal stimulation duration. METHODS: In experiment 1, 9 subjects attended two experimental sessions consisting of single stimulation with IM or triple stimulation with IM, using a crossover design. A K-type thermocouple temperature probe was fixed on the skin surface at the GV14 acupuncture point. IM stimulation was administered to the top of the probe in order to measure the temperature curve. In addition, each subject evaluated his or her subjective feeling of heat on a visual analogue scale after each stimulation. Experiment 2 was conducted on 42 participants, divided into three groups according to the envelope allocation method: single stimulation with IM (n=20), triple stimulation with IM (n=11) and a control group (n=11). A thermograph was used to obtain the skin temperature on the posterior trunk of the participant. To analyse skin temperature, four arbitrary frames (the scapular, interscapular, lumbar and vertebral regions) were made on the posterior trunk. RESULT: In experiment 1, no significant difference in maximum temperature was found in IM and subjective feeling of heat intensity between single and triple stimulation with IM. In experiment 2, increases in skin temperature occurred on the posterior trunk, but no differences in skin temperature occurred between the groups receiving single and triple stimulation with IM. CONCLUSION: No difference exists in the skin temperature response to moxibustion between the single and triple stimulation with IM.

Is there any difference in human pupillary reaction when different acupuncture points are stimulated?

OBJECTIVES: To determine if there is any difference in pupillary response among different acupuncture stimulation sites. METHODS: The subjects were 14 healthy males who had no known eye diseases or abnormality in their pupils. They received five different interventions: no acupuncture stimulation (hereinafter 'no-stimulation') and acupuncture stimulation at four sites (TE5, ST7, CV12 and ST36). The Latin square design was used to allocate stimulation order. For all acupuncture stimulation interventions, a disposable acupuncture needle was inserted superficially at the acupuncture point. Gentle repetitive tapping stimulation was applied manually during the subject's exhalation phase of respiration, for 90 s. The pupil diameter was continuously measured for 2 min before stimulation, during stimulation and for 2 min after stimulation. Statistical analysis was conducted on serial changes in pupil diameter during acupuncture stimulation on each respective site and during non-stimulation session by analysis of variance and Fisher (least significant difference) multiple comparison, with linear analysis using a mixed model. RESULTS: Pupil diameter reduction occurred at 30 s after stimulation on ST7 (p=0.008) and 60 s after stimulation (p=0.014) compared with pre-stimulation. The decrease of pupillary diameter occurred 60 s after stimulation on TE5 (p=0.028) compared with pre-stimulation. On ST36, CV12 and during the non-stimulation intervention, no significant change in the pupil diameter was observed. CONCLUSIONS: Pupillary reaction varies depending on the different stimulation sites.

Pupillary response induced by acupuncture stimulation--an experimental study.

OBJECTIVES: To investigate whether acupuncture stimulation affects autonomic nerve function by measuring pupil diameters with electronic pupillography. METHODS: Two studies were conducted (Experiment 1 and 2) in the Tsukuba University of Technology, Tsukuba, Japan. Experiment 1 examined the responses before, during and after acupuncture. Experiment 2 compared acupuncture and a no acupuncture control in a two period, repeated measurement crossover design. Twelve healthy male university students were recruited for Experiment 1 and nine healthy male university students for Experiment 2. The intervention was superficial acupuncture at the acupuncture point TE5. Following the insertion, gentle repetitive tapping stimulation was applied during the subject's exhalation phase in a sitting position for 90 seconds. The main outcome measures in Experiment 1 were pupil diameter, heart rate, pulse wave and blood pressure. In both experiments, pupil diameter was measured for three minutes before acupuncture stimulation, during stimulation and for three minutes after stimulation. RESULTS: In Experiment 1, a decrease in pupil diameter was observed after acupuncture stimulation (P=0.018) and a decrease in heart rate was observed during the stimulation (P=0.049). Moreover, a significant decrease of pulse wave amplitude was observed during and after acupuncture stimulation. In Experiment 2, a decrease in pupil diameter occurred after acupuncture stimulation (P=0.007), whereas no change occurred under the no acupuncture control. CONCLUSIONS: It is thought that the pupillary constriction observed after gentle, superficial acupuncture stimulation may be attributed to an increase of parasympathetic nerve function. Further study is necessary in order to further clarify the duration of the observed response and to elucidate the mechanisms behind it.

Effect of massage on blood flow and muscle fatigue following isometric lumbar exercise.

BACKGROUND: This study attempted to investigate the influence of massage on the skin and the intramuscular circulatory changes associated with localized muscle fatigue. MATERIAL/METHODS: Twenty-nine healthy male subjects participated in two experimental sessions (massage and rest conditions). Subjects lay prone on the table and were instructed to extend their trunks until the inferior portion of their rib cage no longer rested on the table. Subjects held this position for 90 seconds (Load I). Subjects then either received massage on the lumbar region or rested for 5 minutes, then repeated the same load (Load II). Skin blood flow (SBF), muscle blood volume (MBV), skin temperature (ST), and subjects' subjective feelings of fatigue were evaluated using Visual Analogue Scale (VAS). RESULTS: An increase of MBV between pre- and post-load II periods was higher after massage than after rest (p<0.05). An increase of SBF at pre- and post-load II was observed only under massage condition. An increase of SBF between post-load I and pre-load II periods was higher after massage than after rest (p<0.05). An increase of ST between post-load I and post-load II periods was greater after massage than after rest (p<0.05). The VAS score was lower with massage than with rest in the post-treatment period (p<0.01). CONCLUSIONS: A significant difference was observed between massage and rest condition on VAS for muscle fatigue. Lumbar massage administration also appeared to have some effect on increasing skin temperature and enhancement of blood flow in local regions.

The effect of massage on localized lumbar muscle fatigue.

BACKGROUND: There is not enough evidence to support the efficacy of massage for muscle fatigue despite wide utilization of the modality in various clinical settings. This study investigated the influence of massage application on localized back muscle fatigue. METHODS: Twenty-nine healthy subjects participated in two experimental sessions (massage and rest conditions). On each test day, subjects were asked to lie in the prone position on a treatment table and perform sustained back extension for 90 seconds. Subjects then either received massage on the lumbar region or rested for a 5 minute duration, then repeated the back extension movement. The median frequency (MDF), mean power frequency (MNF), and root mean square (RMS) amplitude of electromyographic signals during the 90 second sustained lumbar muscle contraction were analyzed. The subjective feeling of fatigue was then evaluated using the Visual Analogue Scale (VAS). RESULTS: MDF and MNF significantly declined with time under all conditions. There was no significant difference in MDF, MNF or RMS value change between before and after massage, or between rest and massage conditions. There was a significant increase in fatigue VAS at the end of the 2nd back extension with rest condition. There was a significant difference in fatigue VAS change between massage and rest condition. CONCLUSIONS: A significant difference was observed between massage and rest condition on VAS for muscle fatigue. On EMG analysis, there were no significant differences to conclude that massage stimulation influenced the myoelectrical muscle fatigue, which is associated with metabolic and electrical changes.