On this coming June 12, 2009, the 2nd JSAM International Symposium on Evidence-based Acupuncture on "Evidence of the Effectiveness of Acupuncture for Low Back Pain"is to be held in Saitama. We briefly outline the background and expected controversial points in this symposium.
There are three sessions including 1) Present status of RCT research on low back pain, 2) Treatment method for low back pain in China, Korea and Japan based on the database research, and 3) Sham acupuncture. When we assess the effectiveness of acupuncture for low back pain within the realm of Evidence-Based Medicine, the following discussions may be expected:
1) Therapeutic effect of sham needling -are we able to distinguish placebo effect?
2) Masking using sham needle -are we able to conduct double-blind trials on acupuncture?
3) Specific treatment technique -which factors contribute to "more effective acupuncture technique"?
Most of invited speakers are specialists who published their papers on RCT or sham needle in top medical journals in the world. We hope that issues, such as working together with other medical professionals and reflecting evidence to medical policies, to be tackled in the future for the development of acupuncture will become clearer in this symposium.

The Fifth Session of the Sixth Executive Committee (EC), the Seventh General Assembly (GA), and the First Session of the Seventh EC and 2009 World Acupuncture Congress of the World Federation of Acupuncture-Moxibustion societies (WFAS) were held at European parliament in Strasbourg, France on 3-7 November 2009.
New EC members for the year of 2009-2013were elected in the GA. The Seventh EC commenced and now consists of 49 members. Host countries for the future meetings were also approved.
In the Seventh EC, the Japan Society of Acupuncture and Moxibustion (JSAM) made a proposal regarding WFAS administrative duties. It consisted of eight items, and among them, the request for making the minutes of EC meetings was most important because WFAS EC meeting minutes have never been sent to the EC members except once, for the Bali, Indonesia meeting in 2006.
Papers regarding acupuncture education, legislation, traditional research and scientific research were also presented in the academic meeting.
JSAM will continue to support the enhancement of the academic level of WFAS and make any necessary proposals toward the further development of WFAS.

STUDY DESIGN: Prospective cohort imaging study. PURPOSE: This study aimed to evaluate lumbar sagittal alignment and range of motion (ROM) using radiographs in a large asymptomatic cohort and identify sex-based differences and age-related changes in the subjects. OVERVIEW OF LITERATURE: Several researchers have tried to establish normal alignment and kinematic behavior of the lumbar spine, using plain radiographs. Few studies have employed a large and sex-and age-balanced cohort. METHODS: Total 627 healthy volunteers (at least 50 males and 50 females in each age decade, from the 3rd to the 8th decade) underwent whole spine radiography in the standing position; lumbar spine radiography was performed for all subjects in the recumbent position. Lumbar lordosis (LL, T12–S1) and ROM during flexion and extension were measured using a computer digitizer. RESULTS: The mean LL was 36.8°±13.2° in the recumbent position and 49.8°±11.2° in the standing position. The LL was greater in the standing position than in the recumbent position; further, LL was higher in females as compared to that in males. Local lordosis at each disk level increased incrementally with distal progression through the lumbar spine in both the positions. Local lordosis at L4–S1 was 29.8°±8.0° in the recumbent position and 34.2°±8.3° in the standing position and occupied 85.1% and 70.8% of the total LL, respectively. However, local lordosis in the standing position decreased with age at L2–3, L3–4, and L4–5 levels. Total lumbar ROM (T12–S1) decreased with age. The ROM in females was higher than that in males. CONCLUSIONS: We established the standard value and age-related changes in the lumbar alignment and ROM in each age decade in asymptomatic subjects. These data will be useful and provide the normal values for comparison in clinical practice to identify sex-based differences and age-related changes.
Animals ; Cohort Studies ; Female ; Healthy Volunteers ; Humans ; Lordosis ; Male ; Posture ; Prospective Studies ; Radiography ; Range of Motion, Articular ; Reference Values ; Spine

STUDY DESIGN: A retrospective study. PURPOSE: To examine the effectiveness of using an electrodiagnostic technique as a new approach in the clinical diagnosis of extraforaminal stenosis at L5-S1. OVERVIEW OF LITERATURE: We introduced a new effective approach to the diagnosis of extraforaminal stenosis at the lumbosacral junction using the existing electrophysiological evaluation technique. METHODS: A consecutive series of 124 patients with fifth lumbar radiculopathy were enrolled, comprising a group of 74 patients with spinal canal stenosis and a second group of 50 patients with extraforaminal stenosis at L5-S1. The technique involved inserting a pair of needle electrodes into the foraminal exit zone of the fifth lumbar spinal nerves, which were used to provide electrical stimulation. The compound muscle action potentials from each of the tibialis anterior muscles were recorded. RESULTS: The distal motor latency (DML) of the potentials ranged from 11.2 to 24.6 milliseconds in patients with extraforaminal stenosis. In contrast, the DML in patients with spinal canal stenosis ranged from 10.0 to 17.2 milliseconds. After comparing the DML of each of the 2 groups and at the same time comparing the differences in DML between the affected and unaffected side of each patient, we concluded there were statistically significant differences (p<0.01) between the 2 groups. Using receiver operating characteristic curve analysis, the cutoff values were calculated to be 15.2 milliseconds and 1.1 milliseconds, respectively. CONCLUSIONS: This approach using a means of DML measurement enables us to identify and localize lesions, which offers an advantage in diagnosing extraforaminal stenosis at L5-S1.
Action Potentials ; Constriction, Pathologic* ; Diagnosis* ; Diagnostic Techniques and Procedures ; Electric Stimulation ; Electrodes ; Humans ; Muscles ; Needles ; Radiculopathy ; Retrospective Studies ; ROC Curve ; Spinal Canal ; Spinal Nerves ; Spinal Stenosis

The WFAS University Cooperation Working Committee and WFAS Standard Working Committee were held during 2009 WFAS World Acupuncture Congress at European Parliament in Strasbourg, France on 6 November 2009. Publishing an International Textbook of Acupuncture and Moxibustion was proposed in the WFAS University Cooperation Working Committee. Also establishing Making WFAS standards on acupuncture needles, nomenclature and location of auricular points, manipulation of moxibustion, and manipulation of scalp acupuncture were discussed and proposed in the WFAS Standard Working Committee.

Purpose: Escitalopram has been inadequately evaluated in cancer patients. Here, we report two patients with advanced cancer who benefited from escitalopram for depression. Case 1: A man aged in his 50s had postoperative recurrence of rectal cancer. He was diagnosed with a major depressive episode according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). The score of the Hamilton Rating Scale for Depression (HAMD-17) was 20 points. He began treatment with 10 mg/day of escitalopram. His symptoms began to improve at about 14 days, and the HAMD-17 score was 4 points at 23 days, suggesting a marked improvement. Case 2: A woman aged in her 50s had cancer of the external auditory canal. She was diagnosed with a major depressive episode according to DSM-IV-TR. The score of HAMD-17 was 26 points. She began treatment with 10 mg/day of escitalopram. Her symptoms began to improve at 15 days, and the HAMD-17 score at 28 days was 13 points, suggesting a marked improvement. In both cases, serious side effects, clear exacerbation of depression, and withdrawal syndrome due to acute drug deprivation associated with worsening of the symptoms were not noted. Conclusion: Escitalopram is considered a useful drug for depression in patients with advanced cancer.

Acupuncture and moxibustion were introduced to Japan from China in the 6 th Century. Since then our ancestors adapted these unique techniques and knowledge to our climate and ethnicity, and eventually developed the Japanese system of acupuncture and moxibustion.
Whether acupuncture and moxibustion therapy is successful or not depends on the knowledge and skill of the individual acupuncturist. However, in recent years, the role of medical doctors, nurses, physical therapist and other medical professionals working as a team has become particularly important, with some acupuncturist starting to work in university hospitals as part of these teams, and contributing to patient well-being.
In this paper, to elucidate the roles of acupuncture and moxibustion in modern medicine, we show how acupuncture and moxibustion are applied in university hospitals, and how acupuncturists evaluate the effectiveness of their acupuncture and moxibustion.

Acupuncture and moxibustion were introduced to Japan from China in the 6 th Century. Since then our ancestors adapted these unique techniques and knowledge to our climate and ethnicity, and eventually developed the Japanese system of acupuncture and moxibustion.Whether acupuncture and moxibustion therapy is successful or not depends on the knowledge and skill of the individual acupuncturist. However, in recent years, the role of medical doctors, nurses, physical therapist and other medical professionals working as a team has become particularly important, with some acupuncturist starting to work in university hospitals as part of these teams, and contributing to patient well-being.In this paper, to elucidate the roles of acupuncture and moxibustion in modern medicine, we show how acupuncture and moxibustion are applied in university hospitals, and how acupuncturists evaluate the effectiveness of their acupuncture and moxibustion.
Acupuncture ; seconds ; Moxibustion ; Hospitals, University ; Hospitals

  [Objectives] The aim of this study was to evaluate the changes in serum brain-derived neurotrophic factor (BDNF) concentrations during 15 min of combined hot bath and bicycle ergometer endurance exercise in healthy young men.  [Methods] The experiment was conducted in a parallel design. The subjects were 10 healthy men (aged 23.7±0.8 years). The experimental group performed a combination of head-out water immersion (HOI) at 40°C and bicycle ergometer exercise (40°C HOI-ex), while the control group performed only HOI at 40°C (40°C HOI). After 30 min of rest, 40°C HOI-ex or 40°C HOI was performed for 15 min, followed by a 30 min recovery period. During the experiment, heart rate, blood pressure, and core temperature (esophageal temperature) were continuously measured. Blood samples were collected at four time points: after rest, immediately after intervention, 15 min after recovery, and 30 min after recovery. Serum BDNF, P-selectin, platelet count, hemoglobin, hematocrit, plasma cortisol, and lactic acid were then measured.  [Results] A significant increase in serum BDNF concentrations was observed immediately after intervention and 15 min after recovery in the 40°C HOI-ex group compared with the values taken after resting. No changes in serum BDNF concentrations were observed in the 40°C HOI group. Core temperatures significantly increased immediately after intervention, 15 min after recovery, and 30 min after recovery compared with resting for both 40°C HOI-ex and 40°C HOI groups, with between-group differences. Platelet counts were unchanged in both 40°C HOI and 40°C HOI-ex groups. A significant increase in P-selectin was observed immediately after intervention and 15 min after recovery in the 40°C HOI-ex group compared with when at rest. No changes in P-selectin were observed in 40°C HOI.  [Discussion] The combination of hyperthermia and exercise can increase serum BDNF in a short time of 15 min by an additive effect, and the increase in serum BDNF in this study may be platelet-derived.