The Role of Acupuncture and Moxibustion in Modern Medicine / 全日本鍼灸学会雑誌

The author has gained clinical experience in acupuncture and moxibustion at the Pain Clinic of the Department of Anesthesiology, the Department of Physical Medicine (now the Department of Allergy and Rheumatology), the Department of Geriatrics at the University of Tokyo Hospital and the Printing Bureau Hospital of the Ministry of Finance, psychiatric and internal medicine clinics, and integrated health care facilities. From our clinical experience and research in acupuncture and moxibustion, we believe that in order to position acupuncture and moxibustion in modern medicine, it is important to understand diseases and symptoms from a modern medical perspective, to understand the disease state, to provide treatment based on the disease state, and to evaluate and examine the efficacy and usefulness of acupuncture and moxibustion on a scientific basis. Acupuncture and moxibustion are characterized by the following: 1) Individualized patient care is possible, 2) treatment is possible even without a diagnosis, 3) there are few side effects that are harmful to the body, 4) it is possible to selectively approach the tissue near a lesion, and 5) as a non-pharmacotherapy, it can be combined with modern medical treatments (such as pharmacotherapy and psychotherapy). With these characteristics, acupuncture and moxibustion can be useful as non-invasive forms of treatment in modern medicine. Furthermore, what is required of acupuncture and moxibustion practitioners is the ability to cooperate with doctors and other medical professionals to gain a common understanding and mutual trust.

Survey research on the perceptions and issues of ordinary women regarding cosmetic acupuncture / 全日本鍼灸学会雑誌

[Objective] This study aimed to investigate the awareness and perceptions of cosmetic acupuncture among ordinary women.[Method] A questionnaire method was adopted, with a target population of 1,000 ordinary women living in Shizuoka prefecture, which is considered a suitable location for test marketing in Japan.Questionnaires were distributed through the Chambers of Commerce in the prefecture by age group, according to the population ratio, and responses were obtained. The items included (1) basic information; (2) presence and type of facial cosmetic concerns; (3) experience of acupuncture, awareness of cosmetic acupuncture, the medium through which they learned of it, perception of effects, and experience of cosmetic acupuncture; (4) effects and types of cosmetic acupuncture, presence or absence of adverse effects, current treatment status, desired treatment outcomes and reasons for seeking treatment, wishes from treatment clinics, and wishes from practitioners; and (5) 1 month's investment in beauty.[Result] The response rate was 56.2%, and 91.8% of the participants perceived that they had facial cosmetic concerns; 28.8% had experience with acupuncture, whereas 42.0% had knowledge regarding cosmetic acupuncture. Television (45.3%) was the primary source of information regarding this. The most prevalent perception of the effects of cosmetic acupuncture was lifting (44.8%), and 43.2% of the 521 participants inexperienced with cosmetic acupuncture consented to treatment. Participants mostly reported being somewhat interested in the procedure as their reason for wanting to receive treatment (45.3%). The most common reason for opting out of treatment was due to pain (52.6%). Of those who experienced cosmetic acupuncture, 60.0% said they experienced positive effects, and lifting (62.5%) is the most frequently perceived outcome, which matched the commonly held perception. However, among the participants, 45.0% reported negative effects, while 47.5% received the treatment two or more times in the past but did not continue. Participants mainly wanted clean treatment centers and skilled practitioners. The most common monthly investment in beauty was between 3,000 yen and 5,000 yen (28.5%).[Discussion/Conclusion] The results suggest that many women have cosmetic concerns regarding their faces and expect lifting from cosmetic acupuncture. The low treatment rate among women and their reasons for not seeking re-treatment were elucidated in this study, despite their degree of awareness. Further, the problems associated with the development of cosmetic acupuncture were clarified.

Comparison between conventional acupuncture and press tuck needle acupuncture for physical and psychological fatigue in office workers / 全日本鍼灸学会雑誌

[Aim] We compared the effects of acupuncture and press tuck needle (PTN) acupuncture in office workers with physical and psychological fatigue.[Design] A randomized, open-label, parallel-group, comparison study.[Setting] An acupuncture room in the A Clinic within the Kanto Metropolitan Area.[Patients] Clinic workers. The inclusion criteria were 20-45 years of age and awareness of physical and psychological fatigue. The exclusion criteria were fatigue-related diseases and symptoms, medical abnormalities, and history.[Intervention] The subjects were randomly allocated to either the acupuncture treatment group (ACP group) or PTN acupuncture treatment group (PTN group). The interventions were based on acupoints for fatigue symptoms as per previous reports and individualized treatment for physical symptoms, including neck and lower back pain, among others, and were performed twice a week for one month.[Evaluation methods] The visual analog scale (VAS) scores were the primary method for evaluating for physical and psychological fatigue at four weeks post-treatment. Other forms of measurement used were the VAS scores within groups immediately after treatment and to evaluate physical health, the Health Perceptions Questionnaire, General Health Questionnaire-12, and Short Form-36 responses; and salivary amylase levels were used.[Results] Thirteen of 14 subjects in the ACP group and 13 of 15 in the PTN group were included in the analysis. There was no significant difference between the groups for VAS scores. Evaluation, immediately before and after the intervention showed a significant decrease in VAS scores for physical fatigue in both groups. The ACP group showed a greater immediate change than the PTN group. In a comparison within each group, the VAS of psychological fatigue in the PTN group showed significant decrease after the eighth treatment.[Conclusions] Acupuncture may immediately improve physical fatigue in office workers. Moreover, the frequency of using PTN acupuncture may eventually decrease physical fatigue. Therefore, acupuncture and PTN acupuncture can help office workers' health.

Psychological and Physical Characteristics of Neck Pain in University Students / 日本温泉気候物理医学会雑誌

Objective: Neck pain is a very common complaint in the general population. However, little is known about the characteristics of this complaint. The aim of this study was to clarify the psychological and physical characteristics of neck pain. Method: The subjects were 13 adult men with complaints of neck pain (NP group, mean age 20.2±0.7 years) and 10 healthy volunteers (CON group, mean age 21.2±1.5 years). This study used findings of neck tenderness and muscle stiffness for evaluation of neck pain, and employed the visual analog scale (VAS) to record the subjects’ assessment of their pain. State-Trait Anxiety Inventory (STAI), MOS 36-Item Short-Form Health Survey (SF-36), VAS for evaluation of perceived stress, and measurements of salivary cortisol density levels were utilized to measure stress. The salivary cortisol density was measured by the enzyme immunity method of measurement (the ELISA method). In addition, saliva samples were collected between 9 AM to 10 AM. Results: The mean VAS score for neck pain in the NP group was 56.9±17.3. There was no significant difference in muscle stiffness between the groups. Tenderness of the upper trapezius fibers and right splenius capitis muscle were significantly higher in the NP group (p<0.05). The VAS score of perceived stress and the state anxiety of STAI were significantly higher in the NP group (p<0.05). The SF-36 score was significantly lower in the CON group (p<0.05). The trait anxiety of STAI and the salivary cortisol density were not significantly different. Conclusion: There was no significant difference in the salivary cortisol density levels between the two groups. The degrees of perceived stress and uneasiness were reported as higher in the NP group, while the degrees of psychological and physical health were lower. These findings suggest the role of psychosociological factors in neck pain.

Psychological and Physical Characteristics of Neck Pain in University Students / 日本温泉気候物理医学会雑誌

<b>Objective</b>: Neck pain is a very common complaint in the general population. However, little is known about the characteristics of this complaint. The aim of this study was to clarify the psychological and physical characteristics of neck pain.<BR><b>Method</b>: The subjects were 13 adult men with complaints of neck pain (NP group, mean age 20.2±0.7 years) and 10 healthy volunteers (CON group, mean age 21.2±1.5 years). This study used findings of neck tenderness and muscle stiffness for evaluation of neck pain, and employed the visual analog scale (VAS) to record the subjects’ assessment of their pain. State-Trait Anxiety Inventory (STAI), MOS 36-Item Short-Form Health Survey (SF-36), VAS for evaluation of perceived stress, and measurements of salivary cortisol density levels were utilized to measure stress. The salivary cortisol density was measured by the enzyme immunity method of measurement (the ELISA method). In addition, saliva samples were collected between 9 AM to 10 AM.<BR><b>Results</b>: The mean VAS score for neck pain in the NP group was 56.9±17.3. There was no significant difference in muscle stiffness between the groups. Tenderness of the upper trapezius fibers and right splenius capitis muscle were significantly higher in the NP group (p<0.05). The VAS score of perceived stress and the state anxiety of STAI were significantly higher in the NP group (p<0.05). The SF-36 score was significantly lower in the CON group (p<0.05). The trait anxiety of STAI and the salivary cortisol density were not significantly different.<BR><b>Conclusion</b>: There was no significant difference in the salivary cortisol density levels between the two groups. The degrees of perceived stress and uneasiness were reported as higher in the NP group, while the degrees of psychological and physical health were lower. These findings suggest the role of psychosociological factors in neck pain.

Effect of Electroacupuncture on the Change in Glutathione Concentration in the Blood by Ergometer Exercise / 日本温泉気候物理医学会雑誌

Introduction   Redox state of glutathione as an oxidative stress marker changes by exercise. Therefore, oxidative stress marker has been used to evaluate the physical condition of athletes. In athletics it is important to prevent fatigue for peak performance. Acupuncture has been used for fatigue prevention of athletes. However, there is little scientific evidence to prove the effect. The purpose of this study is to examine the effects of electroacupuncture (EA) on the change in redox state of glutathione as an oxidative stress marker in the blood by ergometer exercise. Methods   In this crossover study, the EA and control (CONT) groups each included 12 healthy male volunteers. EA at 2 Hz and optimum intensity was performed on each subject at both the SP10 (Xuehai) and SP11 (Jimen) locations for 10 min before exercise. Respiratory metabolism was recorded during bicycle ergometer exercise by ramp rate until exhaustion. Blood samples were collected from the fingertip of each subject before and after exercise. Oxidized glutathione (GSSG) and total glutathione (tGSH) concentrations in the blood were biochemically determined as a marker of oxidative stress. The degree of fatigue before and after exercise was evaluated by the visual analogue scale (VAS). Results   The ventilatory threshold (VT) and the respiratory compensation point (RC), parameters of respiratory metabolism during exercise, did not differ significantly between the EA and CONT groups. Between both groups, the significant difference was not recognized to the amount of change in tGSH, GSSG, GSH, GSSG/tGSH by exercise. The GSSG/tGSH values after exercise was significantly lower than that before exercise in the EA group (p<0.05). In contrast, this level did not change significantly in the CONT group. The VAS values increased significantly after exercise in both groups (p<0.05); however, the VAS value in EA group showed a low tendency in comparison with that in CONT group. Discussion   VT and RC did not differ between the two groups, indicating that the level of exercise was nearly the same for both groups. In comparison of both groups, there was no significant difference on the amount of change of each glutathione parameters by exercise. On the other hand, The GSSG/tGSH and the VAS values after exercise were lower than those values before exercise in the EA group. Therefore, it might be possible that the EA affects the change of the glutathione due to the exercise. Our results might suggest that EA-mediated change of GSH bear some related to suppression of fatigue.

Effect of Electroacupuncture on the Change in Glutathione Concentration in the Blood by Ergometer Exercise / 日本温泉気候物理医学会雑誌

<B>Introduction</B><BR>  Redox state of glutathione as an oxidative stress marker changes by exercise. Therefore, oxidative stress marker has been used to evaluate the physical condition of athletes. In athletics it is important to prevent fatigue for peak performance. Acupuncture has been used for fatigue prevention of athletes. However, there is little scientific evidence to prove the effect. The purpose of this study is to examine the effects of electroacupuncture (EA) on the change in redox state of glutathione as an oxidative stress marker in the blood by ergometer exercise.<BR><B>Methods</B><BR>  In this crossover study, the EA and control (CONT) groups each included 12 healthy male volunteers. EA at 2 Hz and optimum intensity was performed on each subject at both the SP10 (Xuehai) and SP11 (Jimen) locations for 10 min before exercise. Respiratory metabolism was recorded during bicycle ergometer exercise by ramp rate until exhaustion. Blood samples were collected from the fingertip of each subject before and after exercise. Oxidized glutathione (GSSG) and total glutathione (tGSH) concentrations in the blood were biochemically determined as a marker of oxidative stress. The degree of fatigue before and after exercise was evaluated by the visual analogue scale (VAS).<BR><B>Results</B><BR>  The ventilatory threshold (VT) and the respiratory compensation point (RC), parameters of respiratory metabolism during exercise, did not differ significantly between the EA and CONT groups. Between both groups, the significant difference was not recognized to the amount of change in tGSH, GSSG, GSH, GSSG/tGSH by exercise. The GSSG/tGSH values after exercise was significantly lower than that before exercise in the EA group (p<0.05). In contrast, this level did not change significantly in the CONT group. The VAS values increased significantly after exercise in both groups (p<0.05); however, the VAS value in EA group showed a low tendency in comparison with that in CONT group.<BR><B>Discussion</B><BR>  VT and RC did not differ between the two groups, indicating that the level of exercise was nearly the same for both groups. In comparison of both groups, there was no significant difference on the amount of change of each glutathione parameters by exercise. On the other hand, The GSSG/tGSH and the VAS values after exercise were lower than those values before exercise in the EA group. Therefore, it might be possible that the EA affects the change of the glutathione due to the exercise. Our results might suggest that EA-mediated change of GSH bear some related to suppression of fatigue.

Characteristics of Shoulder Periarthritis Patients Developing Articular Contracture during Acupuncture Therapy / 日本温泉気候物理医学会雑誌

 Forty-one patients with periarthritis with no evident articular contracture at the start of acupuncture (at the first presentation) were divided into 13 subjects who developed articular contracture during acupuncture (transition group) and 28 subjects who did not (non-transition group), and the clinical characteristics of the two groups were compared.  The following results were obtained. (1) The mean age of the subjects was significantly higher in the transition group than in the non-transition group (58.5±6.8 years vs. 52.1±9.6 years). (2) The percentage of subjects in the transition group was significantly higher in the subjects not clearly diagnosed as having no contracture at the first presentation than clearly diagnosed as no contracture (57% vs. 19%). (3) The percentage of subjects in the transition group was significantly higher in the subjects in whom the lesion site was enlarged or could not be identified than independent (50% vs. 17%). (4) The percentage of subjects in the transition group was significantly higher in the subjects with nocturnal pain than without (64% vs. 15%). (5) The transition group was unlikely to show improvement of pain or restriction of the range of motion with acupuncture as compared to the non-transition group.  The possibility of developing articular contracture should be considered while providing treatment by acupuncture and guidance to patients showing the above tendencies.

Characteristics of Shoulder Periarthritis Patients Developing Articular Contracture during Acupuncture Therapy / 日本温泉気候物理医学会雑誌

 Forty-one patients with periarthritis with no evident articular contracture at the start of acupuncture (at the first presentation) were divided into 13 subjects who developed articular contracture during acupuncture (transition group) and 28 subjects who did not (non-transition group), and the clinical characteristics of the two groups were compared.<br> The following results were obtained. (1) The mean age of the subjects was significantly higher in the transition group than in the non-transition group (58.5±6.8 years vs. 52.1±9.6 years). (2) The percentage of subjects in the transition group was significantly higher in the subjects not clearly diagnosed as having no contracture at the first presentation than clearly diagnosed as no contracture (57% vs. 19%). (3) The percentage of subjects in the transition group was significantly higher in the subjects in whom the lesion site was enlarged or could not be identified than independent (50% vs. 17%). (4) The percentage of subjects in the transition group was significantly higher in the subjects with nocturnal pain than without (64% vs. 15%). (5) The transition group was unlikely to show improvement of pain or restriction of the range of motion with acupuncture as compared to the non-transition group.<br> The possibility of developing articular contracture should be considered while providing treatment by acupuncture and guidance to patients showing the above tendencies.

Questionnaire survey on infection control and prevention education in acupuncture schools / 全日本鍼灸学会雑誌

[Objective]We performed a questionnaire for the purpose of investigating the present conditions of infection control education in Japanese acupuncture schools and to discuss the problems.<BR>[Methods]We conducted a postal survey by sending out questionnaires to 153acupuncture schools in Japan from December 2008 to March 2009.<BR>[Results]Replies were obtained from 69.9%of the schools (107 out of 153schools). In their responses, 65%of the schools taught hand-washing with soap and alcohol-based hand rub as methods of hand hygiene. Moreover 58%of the schools used only single use needles (SUNs), 40%used both reusable and single use needles, and 2%used only reusable needles. However, single use was observed only at 25%of the schools that introduced SUNs.<BR>Furthermore, we inquired whether the students were taught to use sterilized gloves and finger cots. The results illustrated that a proportion of schools provided the instruction;the proportion of constant instruction was 17%, that of the instructor's option was 35%, that of no requisite was 48%. <BR>[Conclusion]From the above-mentioned results, it became clear that the direction for use of SUNs was not instructed adequately. In addition, this aseptic technique for puncture is not yet standardized in the school's education. It is necessary to realize the measures based on evidence and to employ them in educational programs at acupuncture schools.

Anatomical study on the positional relationship between the meridians/acupuncture points and their surrounding structures-On the meridian/acupuncture points on the posterior aspect of the lower limb- / 全日本鍼灸学会雑誌

[Objective]More accurate data on the positional relationship between the acupuncture points belonging to the bladder meridian on the posterior aspect of the lower limb and their surrounding structures are discussed to get the effective methods for acupuncture.<BR>[Methods]Detailed dissections on the surrounding anatomical structures of the acupuncture points were performed on three cadavers of the Unit of Clinical Anatomy, Graduate School, Tokyo Medical and Dental University.<BR>[Results] 1. BL36 (Chengfu (Chinese), Shofu (Japanese)) and BL37 (Yinmen, Inmon) were situated medial to the posterior femoral cutaneous nerve and the sciatic nerve.<BR> 2. BL38 (Fuxi, Fugeki) and BL39 (Weiyang, Iyo) were situated on or near the common peroneal nerve along the media border of the biceps femoris tendon.<BR> 3. BL40 (Weizhong, Ichu), BL55 (Heyang, Goyo), BL56 (Chengjin, Shokin), BL57 (Chengshan, Shozan), BL58 (Feiyang, Hiyo), BL59 (Fuyang, Fuyo), BL60 (Kunlun, Konron), BL61 (Pucan, Bokushin) and BL62 (Shenmai, Shinmyaku) were situated along the medial sural cutaneous nerve, sural nerve and small saphenous vein.<BR> 4. BL40, BL55, BL56, BL57 were situated along the tibial nerve, the popliteal and posterior tibial arteries deep to the soleus.<BR>[Conclusion] 1. The posterior femoral cutaneous nerve and the sciatic nerve tend to run laterally to BL36 and BL37, so it is necessary to apply the acupunctural treatment lateral to BL36 and BL37 to stimulate these two nerves.<BR> 2. The sural nerve and small saphenous vein gradually tend to approach the acupuncture points toward the distal part of the posterior aspect of the leg.<BR> 3. BL40, BL55, BL56 and BL57 are shown as the acupuncture stimulation points to the tibial nerve passing the deep part of the posterior aspect of the leg.

Acupuncture treatment in a Parkinson's Disease patient with frozen gait / 全日本鍼灸学会雑誌

[Objective]This case evaluates the effects of acupuncture for a Parkinson's Disease patient with frozen gait.<BR>[Case]Patient:a 58-year-old male. Chief complaints were frozen gait and fatigue of legs. The gait disturbance was realized about three years ago, and has been gradually worsening. The Hoehn &Yahr stage is III. Treatment:The patient received medication and acupuncture treatment once a week or two for 18 months. Electric acupuncture treatment was adopted on arms and lower legs, and lone needles on the back and legs. Measurements:Outcome measures were timed in a 10 m walk and turn for frozen gait and Visual Analogue Scale (VAS) for fatigue of legs.<BR>[Results]From a long term point of view, there were no significant changes for the outcomes measured. However just after the treatment VAS was statistically improved, and the patient reported a comfortable feeling.<BR>[Conclusion]The effect of acupuncture for frozen gait was not seen, but the improvement in fatigue of legs was noted, and the patient felt comfortable after the treatment.

Anatomical study on the positional relationship between the meridians/acupuncture points and their surrounding structures-Relationship between the composition of the pelvic plexus and hachiryoketsu- / 全日本鍼灸学会雑誌

[Objective]More accurate data of the relationship between the composition and distribution of the pelvic plexus and hachiryoketsu is discussed to get an effective acupuncture method.<BR>[Methods]Detailed dissections were performed under a stereomicroscope in five cadavers belonging to the Unit of Clinical Anatomy, Graduate School, Tokyo Medical and Dental University.<BR>[Results]1. The pelvic plexus is composed of the sympathetic hypogastric nerve and sacral splanchnic nerve, and the parasympathetic pelvic splanchnic nerve.<BR>(1) The hypogastric nerve arises from the superior hypogastric plexus contributing constantly to the second and third lumbar splanchnic nerves, and enters the postero-superior horn of the pelvic plexus. The sacral splanchnic nerves arise from the third and fourth lumbar gangalia and enter the postero-inferior horn of the pelvic plexus.<BR>(2) The pelvic splanchnic nerves mainly arise from the most ventral layer of the ventral primary of the third and fourth sacral nerves, and enter the postero-inferior horn of the pelvic plexus. These nerves tend to compose the common trunk with the pudendal nerve and the nerve to the levator ani. <BR> 2. The visceral branches of the pelvic plexus do not originate and distribute equally, but tend to divide into I-IV groups. Especially, group III is considered important clinically as these nerves are related to sexual and voiding functions.<BR>[Conclusion] 1. BL33(Zhongliao, Churyo) and BL34 (Xialiao, Geryo) are suggested to have an effect on the function of the intrapelvic organs as these acupuncture points can stimulate the pelvic splanchnic nerves directly rather than BL31 (Shangliao, Joryo) and BL32 (Ciliao, Jiryo).<BR> 2. The point of the needle into the hachiryoketsu reaches the side of the rectum, so treating with a needle to the median direction should be avoided or paid attention to.

The Effect of Acupuncture Therapy on Arteriosclerosis Obliterans (ASO) / 日本温泉気候物理医学会雑誌

We evaluated the clinical effect of acupuncture treatment on 21 patients with Arteriosclerosis Obliterans (ASO). Severity of ASO was grade I in one case, II in 17 cases, III in two cases, and IV in one case (Fontaine classification). Mainly low-frequency electroacupuncture was applied to inpatients two to four times per week and to outpatients, once or twice a week. Effects on claudication distance (ICD), pain, coldness, and Ankle Brachial Pressure Index (ABPI) were assessed on inpatients by comparing the status before starting treatment with that before the acupuncture treatment at the 17th visit. We also assessed the thermograph and plasma calcitonin gene-related peptide (CGRP) of the lower extremities.<br>Improved warmth, increased intermittent limping distance, and relief of pain during walking were observed in patients of grade I and II (Fontaine classification of severity). No improvement of symptoms was observed in patients of grade III and IV. No change in ABPI was observed in any patient. Surface temperatures in the peripheral extremities were significantly elevated from 15 minutes after insertion of the needles until 15 minutes after removal. A significant increase in plasma CGRP was observed immediately after the treatment.<br>These findings suggest that acupuncture treatment may be effective for some symptoms of grade I and II ASO and that improvement of peripheral circulation via vascular dilatation may be involved in the mechanism of action.

Where Should I Play an Active Part?-In the Era of increasing Number of Acupuncturist Rapidly- / 全日本鍼灸学会雑誌

Rapidly increasing numbers of acupuncturists in Japan has caused our places of activity to become increasingly important.<BR>A symposium was held by acupuncturists who play an active role in various areas of acupuncture. We all came together with the purpose of examining our clinical conditions and to make recommendations for the future. The necessity of how to expand the capacity and locations of acupuncture practice cannot be overestimated.<BR>The chairperson of the symposium reported that due to the increasing number of acupuncturists, it is hard to find employment for graduates, and reported the results of a questionnaire (initiated by The Japanese Journal of Acupuncture & Manual Therapies (IDO NO NIPPON-SHI) demonstrating that some practitioners are changing the conditions of their professions.<BR>The first panelist, who had experienced practicing acupuncture in a hospital, reported on the role and characteristics of acupuncture practice and ways to maintain relationships with doctors, nurses and other medical care staff members. Also he addressed the issue of prospects for the future among other topics.<BR>The second panelist, who had not been able to find a useful place for on-the-job training following graduation, told of her experience making home-visits and practicing at a clinic. At first, she had found attracting patients to her home-visits quite difficult, so she advertised herself with a local TV station to increase her name recognition, and then she succeed to practice her own clinic. Now she thinks it is necessary to acquire clinical and academic knowledge as well as technical skills.<BR>The third panelist, who specialized in acupuncture in the field of sports disorders, was eager to improve and expand the methods and techniques in this field to better demonstrate the merits of acupuncture treatment for sports disorders. Moreover, he insisted on the importance of acquiring knowledge concerning athletic rehabilitation and technical skills. Also, clinical practice is imperative.<BR>The last panelist, a university teacher, suggested that it is necessary to set up high educational standards and faculty development activities supported by the school. Accordingly, improved standards at schools as well as more research justifying acupuncture efficacy would facilitate greater social demand for acupuncture and thereby setting reasonable expectations for patients and other medical professionals.<BR>In addition, two other acupuncturists and a student from an acupuncture school made speechesabout theirmisgivings regarding their future prospects. One has been working in a hospital for two years since his graduation; the other is a student at a teacher training institution. The student entering her second-year of acupuncture school became a mother. These acupuncturists and a student all expressed their concerns and hopes for the future of their profession.

Electro-acupuncture for Facial Palsy with Synkinesis / 全日本鍼灸学会雑誌

[Objective] For one facial palsy subject with synkinesis, we applied asynchronous 100Hz EAT and examined the effects. We also examined changes in the effects according to various frequencies.<BR>[Methods] We applied EAT to Mm.faciales, and the evaluation was based mainly on EMG findings (the EMG amplitude, EMG survival continuance time) as well as facial palsy score, VAS, ENoG. We examined changes after treatment and observed the process.<BR>[Results] Change in EMG amplitude were not recognized, but the EMG persistance was shortened after treatment and during the process of observation. VAS, facial palsy score, and ENoG were improved. EMG persistance was not changed by 1 Hz EAT, was prolonged by 30Hz EAT, and was shortened by 100 Hz EAT.<BR>[Conclusion] One hundred Hz EAT shortened EMG persistance, and reduced the subjective symptoms of synkinesis. In addition, we were able to improve facial palsy score and ENoG value.

Effect of Moxibustion on the Hemodynamics of Cutaneous and Subcutaneous Tissue.-Comparison between Five-cone and Seven-cone Moxibustion- / 全日本鍼灸学会雑誌

[Objective] Using a near infrared spectrometer and laser Doppler blood flowmeter, we investigated how the number of moxa applications influences blood flow at moxibustion and peripheral sites.<BR>[Method] The subjects were nine healthy adult males, aged 25-28 years (average age 25.4). Skin blood flow was measured with a laser Doppler blood flowmeter while changes in the deep tissue (deep subcutaneous level and muscle surface course level) blood volume were measured with a near infrared spectroscopy. Each of the probes was located at the moxibustion treatment site and 20 mm away from the site.<BR>On different days, measurements were taken from a control group not receiving stimulation, groups receiving five-cone and seven-cone moxibution (2 mg of moxa per application), respectively.<BR>Measurements of the control group were taken for 25 minutes, while measurements for the other two groups were taken for 5 minutes before conducting moxibustion and for 20 minutes directly after completion of moxibustion.<BR>[Results and Discussion] The skin blood flow demonstrated an further increased tendency after seven-cone moxibustion than five-cone moxibustion. This seemed to be due to the strong flare phenomenon affecting cutaneous blood flow quantity by increasing the number of moxibustion cones.<BR>The effect of moxibustion on skin blood flow volume is suggested to be due to the strong flare phenomenon induced by increasing the number of moxibustion. The effect to the deep tissue indicated a tendency for the blood flow volume to decrease.<BR>It is considered that further detailed experiment will be necessary in the future regarding these ambiguous points.

The Effects of Electroacupuncture Stimulation on Circulation in Human Ocular Fundus / 日本温泉気候物理医学会雑誌

The effect of electroacupuncture (EA) stimulation on tissue circulation in the human ocular fundus (choroidal blood flow) was studied in 11 adult healthy volunteers (6 males and 5 females, age 31.5±5.7y) who had no physical or ocular disease. Using the laser speckle method, normalized blur (NB) values, a quantitative index for tissue blood flow, were measured over an area of choroid between the macula and the optic nerve papilla with no discrete visible vessel. The EA stimulation was applied between BL 10 and GB 20 and between GB 21 and SI 13 on the right side for 15 minutes at 1Hz with an intensity which cause slight muscle contraction. The NB value and intraocular pressure (IOP) in both side eyes, blood pressure (BP) and pulse rate (PR) were measured at baseline time, immediately after EA, and every 5 minutes after EA up to 15 minutes. These procedures were repeated on the same subjects as a control trial on another day. The NB value of choroid on the stimulated side significantly increased following EA stimulation compared with the control value, while that in the unstimulated side showed no significant change. No significant change was observed in BP, IOP or ocular perfusion pressure throughout the experimental period.

Clinical Study of Electro-Acupuncture Therapy -(EAT)-Examination of muscle-EAT and nerve-EAT- / 日本温泉気候物理医学会雑誌

We investigated the difference between muscle-EAT and nerve-EAT basically and clinically. A basic study was performed on healthy adult males. The skin blood flow, deep-tissue temperature, deep hemodynamics, heart rate, and deep-pain threshold were adopted as indexes, and they were compared for a total of three groups: the muscle stimulation-EA group, nerve stimulation-EA group and control group (no stimulation). An acupuncture needle was inserted into the gastrocnemius muscle for muscle stimulation-EA and another needle into the tibial nerve in the femoral region for nerve stimulation-EA. Electric current was then applied at 1Hz for 15 minutes after the flexibility of the foot joint was conformed. Each index was measured after it became stable and was recorded from 10 minutes before starting stimulation until 20 minutes after ending stimulation.<br>A clinical study was performed on 41 patients with cervical radiculopathy. Muscle-EAT was applied to the patients as the first choice. Cases graded five points or less in pain score (10-point method) after one month were included in the muscle-EAT group. Cases graded six points or more were subjected to nerve-EAT and were included in the nerve-EAT group. The therapeutic results in these two groups were examined for a period of three months at intervals of one month based on the pain score and the evaluation criteria for the results of treatment of cervical radiculopathy.<br>As a result, we found that the skin blood flow significantly increased on the stimulated side in both the muscle stimulation-EA and nerve stimulation-EA group. The increase was greater in the nerve stimulation group than in the muscle stimulation group. The deep-tissue temperature rose significantly on the stimulated side in the nerve stimulation-EA group. Regarding the deep hemodynamics, deoxy Hb decreased significantly in the nerve stimulation-EA group. No difference was found in heart rate between the two groups. The deep-pain threshold was significantly raised by nerve stimulation.<br>Patients with cervical radiculopathy who did not respond to continuous muscle-EAT for one month were subjected to nerve-EAT. After three months (two months after changing to nerve-EAT), similar improvements were found in both groups. Significant improvement of paresthesia was obtained with nerve-EAT.<br>These results suggested that the nerve-EAT influences the peripheral circulation and the deep pain threshold more effectively, enhancing the clinical efficacy.

Relations of Stiff Shoulders with Deep Hemodynamics Values / 日本温泉気候物理医学会雑誌

Poor circulation is considered to be a cause of stiff shoulders, but there have been no studies on deep hemodynamics and the subjective estimation/palpation of stiff shoulders. We evaluated the relationship between deep hemodynamics and the degree of the subjective estimation/palpation of stiff shoulders by near-infrared spectrophotometry.<br>The subjects were 146 patients who visited our center and 23 healthy volunteers. Deep hemodynamics (tissue oxygen saturation: StO₂, total hemoglobin concentration: total Hb) was measured in the scapular region of the bilateral shoulders using a deep hemodynamics measurement system (PSA-IIIN, Biomedical Science), and its relationship with the severity of the subjective estimation of stiff shoulders (5-grade rating) and that of palpation (4-grade rating) was evaluated. Deep hemodynamic values were affected by the body mass index (BMI) that is highly correlated with subcutaneous fat thickness. Therefore, analysis was performed in 70 patients and 8 healthy volunteers with BMI of 20-24 that does not affect hemodynamic values. Compared with the healthy volunteers, patients who reported marked shoulder stiffness showed a significant decrease in total Hb, and that who reported shoulder stiffness showed a significant decrease in StO₂. On the other hand, compared with the healthy volunteers, patients with marked shoulder stiffness observed by palpation showed significant decreases in both StO₂ and total Hb; the decreases were more marked with more marked stiffness. These results suggested that deep hemodynamics is a diagnostic parameter of stiff shoulders.