The American Academy of Medical Acupuncture’s 24th Annual Symposium for Medical Acupuncture was held in Atlanta, Georgia, USA on April 27-29, 2012. The American Academy of Medical Acupuncture (AAMA) is an academic society made up mostly of doctors who are interested in acupuncture. This symposium had 11 lectures, 8workshops, 6oral presentations and 7 poster sessions. The contents of almost all presentations concerned acupuncture. There were 300 participants in the symposium. 20 companies took part in the exhibitions at this symposium, and the Japan Society of Acupuncture and Moxibustion (JSAM) was introduced with a large vertical banner in its exhibition booth, and leaflets from JSAM were distributed. I attended the symposium as a representative of the Department of International Affairs in JSAM.

2014 The American Academy of Medical Acupuncture (26 th Annual Symposium for Medical Acupuncture) was held in Denver, Colorado, USA on April 11-13. The symposium had 11 lectures, 13workshops, 4oral presentations and 6 poster sessions. All presentations were the contents that concerning acupuncture. There were 215 participants in the symposium. The above-mentioned presentations were not only research, but also included clinical practice, basic theory and therapeutic principle of acupuncture. Education of acupuncture for physicians sufficiently was considered in the symposium. Further, 16 companies took part in the exhibition of the symposium.

To clarify the effect of acupuncture on the skeletal muscle blood flow, measurements of muscle blood flow by hydrogen gas clealance method were taken on the left anterior tibial muscles of thirty rabbits (weighing about 2.5 to 3.3 kg) anesthetized with pentobarbital sodium (35mg/kg, i.v.). Arterial blood pressure in the common carotid artery and body temperature were also measured.
Blood flow was measured 6 times every 10 min. In the stimulation group, acupuncture needles were inserted into the center of the anterior tibial muscle before the third measurement and “sparrow pecking” was performed, then the needles were removed. In the denervation group, the sciatic nerve was cut to observe the influence of denervation on the effect of acupuncture.
In the stimulation group (n=12), a significant increase in blood flow to the muscles occurred after acupuncture stimulation, compared with the control group (n=12). The increase in blood flow in the stimulation group was maintained until the final measurement. Arterial blood pressure and body temperature did not change.
The blood flow values in the second and third measurements were 18.1 ± 2.2, and 17.6 ± 2.4, respectively, in the control group, and 17.8 ± 1.8 and 25.9 ± 2.2 ml/min/ 100g (mean ± S.E.) in the stimulation group. The changes in blood flow values from the second to the third measurement were -0.5 ± 0.3 ml/min/100g in the control group, and +8.2 ± 2.0 ml/min/100g in the stimulation group. An increase in blood flow after acupuncture stimulation also occurred in the denervation group (n=3).
Despite there being no change in arterial blood pressure. blood flow was increased after acupuncture stimulation, and the increment of blood flow after acupuncture stimulus was also observed in the denervation group. Therefore, the increment of blood flow seems to have been caused by vasodilation of the blood vessels induced by axon reflex.

[Objective]We report a case of electrical stimulation on pressure ulcers in the sacral region.
[Case]The patient was an 83-year-old female. She had received rehabilitation after a brain hemorrhage. A pressure ulcer was confirmed in her sacral region. Although medication treatment was used for 2 months, the pressure ulcer did not improve. Therefore, electrical stimulation was used with medication treatment.
[Method]Electrical stimulation with a bipolar pulse wave was used on the patient during five weeks. The frequency was 100 Hz, and the time of stimulation was 40 min. The strength of electrical stimulation was in a range of feeling electricity. An evaluation of the pressure ulcer in the sacral region was performed with evaluation of DESIGN (Japanese Society of Pressure Ulcers) by a nurse for 2 weeks.
[Results]Although the patient received only medication treatment during 2 months from the time the pressure ulcer was confirmed, the score of DESIGN aggravated from 4 points to 5 points. However, after that, the patient received electrical stimulation with medication. As the result, the score of DESIGN improved from 5 points to 0 points. There were 7 electrical stimulations.
[Discussion]We applied electrical stimulation to the pressure ulcer of the patient who was not improved with only medication therapy. The result was that the pressure ulcer improved dramatically. It is suggested that electrical stimulation was effective on the pressure ulcer. Furthermore, it was considered that the improvement of the pressure ulcer with electrical stimulation was related to the improvement of skin blood flow.

[Purpose]Acupuncture stimulation is known to improve visual acuity. Since this improvement was frequently disassociated with refractive change, we determined the mechanism by examining the patients without lens accommodation.
[Methods]Patients (n = 30) receiving cataract surgery in 2005 at Meiji University of Oriental Medicine Hospital were examined (mean age: 73.0). Bilateral LI4, Taiyang and shang-jingming points were stimulated by acupuncture needles for 10 min (acupoints stimulation). On a different day, the same patients received sham points stimulation at 1 cm above or lateral from the above-mentioned acupoints. Both uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) was measured with a logMAR scale at pre-and post-acupuncture stimulations. Furthermore, the patients with improved UCVA and BCVA typically (n = 4) received topical tropicamide eyedrops for suppression of pupil diameter change. UCVA and BCVA were measured at pre-and post-acupuncture stimulation.
[Results]Acupoints stimulation significantly improved both UCVA (0.39 to 0.30, p < 0.0006) and BCVA (0.15 to 0.08, p < 0.0001). Although sham points stimulation also significantly improved both UCVA (0.38 to 0.32, p < 0.02) and BCVA (0.14 to 0.09, p < 0.0001), there was no significant difference in comparison with acupoints stimulation controls. Under mydriasis after tropicamide eyedrops, acupuncture stimulation did not improved UCVA, and the variation of BCVA was significantly different from control (p < 0.013).
[Discussion]Acupuncture stimulation improved UCVA and BCVA even in elderly patients that lack accommodation. Our results imply that as pupil diameter changes, a subsequent pinhole effect may be a critical mechanism for UCVA and BCVA improvement by acupuncture stimulation. In addition, the phenomena are not specific effects of acupoints and imply a response via sensory nerves.

[Objective]To aleviate incidents and prevent medical accidents in acupuncture and moxibustion therapy, we constructed an incident report (IR) system at the Center of Acupuncture Science, Meiji University of Integrative Medicine.
[Methods]The IR system was operated with the center staff as reporters. The staff reported incidents when encountered or found. The cases of incidents were added up per item, and the contents of incidents fed back per month to staff and students. The feedback was given orally at a morning assembly, and a feedback poster was put up.
[Results]There were 146 cases from July 2004 to September 2005. The contents of incidents were 96 cases concerning the environment of treatment, 0for incidents before treatment and 50 during or after treatment. The largest number of incidents in the environment of treatment was 66 cases for inappropriate disposal of instruments. The largest number of incidents during or after treatment was 12 cases in nearly forgetting to remove acupuncture needles from the body.
[Discussion]Ten mean cases per month occurred as incidents. However, it was clear that the incidents in most cases could have been prevented if the acupuncturist had been noticed and took measures to deal with the situation. To prevent medical accidents, we consider a need to continuously feed back the contents of incidents to instructors and students and call them to their attention.

The 2012 WFAS International Congress and Workshop on Acupuncture were held at Mason Pines Hotel in Bandung, Indonesia on November 16-18, 2012. The last congress held in Indonesia was in 2006 in Bali. This was the second congress held in Indonesia since the establishment of the WFAS in 1987.
The number of participants in the workshop and in the congress were 109 and 260, respectively, from 24 countries. There were seven keynote lectures and 51 oral presentations, including 5 by Japanese scientists.
In addition, the 4th session of the 7th Executive Committee of WFAS was held on November 16, 2012 from 10 a.m. to 6 p.m. at Mason Pines Hotel.
In this report, the agenda, a discussion of the WFAS Executive Committee meeting, and an outline of the oral presentations are introduced.

Executive members of the World Federation of Acupuncture and Moxibustion Societies (WFAS) are elected in the general assembly (GA), which is held once every four years. In addition, member societies that will host the upcoming WFAS conferences over the next 4 years are determined in the GA.
Japan hosted the 3rd World Congress of Acupuncture and Moxibustion in 1993, but has not been invited to host the WFAS annual conference for the past 20 years. In the 8 th WFAS GA held in the Sydney Convention Centre Darling Harbour, Sydney, Australia on 1 November 2013, Japan was elected as the host country for the 2016 WFAS Annual Conference. Thus, the 2016 WFAS Annual Conference will be held in Tokyo, and hosted by the Japan Society of Acupuncture and Moxibustion (JSAM) and Japanese Traditional Acupuncture and Moxibustion Society (JTAMS).
In the election of Executive Members, Shuichi Katai was elected as vice-president of WFAS and Ikuro Wakayama and Naoto Ishizaki were elected as executive members. The term for executive members is four years. In addition, Kiichiro Tsutani, former vice-president of WFAS, was appointed as honorable vice-president, and Yukio Kurosu, former honorable vice-president, was appointed as advisor.
Academic programs were carried out for three days from 2 November 2013. In the WFAS conferences usually more than half of the papers are presented in Chinese, but in Sydney, most papers were presented in English. There were one invited lecture and 13presentations from Japan.

[Objective] There are two types of image the students have towards elderly people, positive and negative, and it is thought to be difficult for students to interact with elderly people when negative images are the most powerful. Changes in the students' feelings towards elderly people during their time in a nursing home are of importance when assessing the project's educational effectiveness. Given this factor, we have researched the changes in the students' impression towards elderly people before and after the project.
[Method] We carried out a research questionnaire before and after the project.
[Results] Number of valid response was 106 before the project (response rate 89.8%), and 56 after the project (response rate 47.5%). Over half (56%) of the students said that their image of elderly people changed after the project. Negative image comes from realising elderly people's physical disability and difficulty in having conversations with them, and positive image comes from understanding elderly people more by interacting with them.
[Conclusions] Although there was a growing awareness of elderly people and some of the students changed their feeling towards them, there are still students who have a negative image. We think that it is important to provide methods of approaches before and during the project to minimise these negative images.

[Purpose] We report a case treated by acupuncture in a health care facility for the elderly to evaluate the effect of acupuncture on severe pulmonary emphysema.
[Case and methods] A 88 year-old man visited Meiji University of Oriental Medicine Hospital with dyspnea in March 2000 and was diagnosed with pulmonary emphysema. He was hospitalized in October 2002 because his chronic respiratory failure was worsening : oxygen therapy was started. After discharge from hospital, he entered a health care facility for the elderly and acupuncture treatment for lumbago was initiated. Thereafter, acupuncture treatment for dyspnea and stiff shoulder started. He was determined to be grade V according to Fletcher-Hugh-Jones classification of dyspnea. Spirometry of the patient before acupuncture for dyspnea showed 88.0 % in %VC, 38.2 % in FEV 1 %, and 30 % in %FEV 1, and the patient was diagnosed with chronic obstructive pulmonary disease of serious grade. Acupuncture treatment was performed once or twice a week, and acupuncture treatment for dyspnea was performed 21 times (total of 33 treatments).
[Results] Subjective symptoms of lumbago, stagger of the legs, and shoulder stiffness were evaluated with Numerical Scale or Pain Scale. The state of dyspnea was evaluated with Numerical Scale and Borg Scale, and exercise tolerance was evaluated with 6 min of walking. After 33 acupuncture treatments, dyspnea on exertion, exercise tolerance, and the findings of spirometry were not improved. But dyspnea on rest had disappeared with improvement in lumbago, stagger of the legs, and shoulder stiffness. These results indicate that acupuncture as a general treatment is effective for the improvement of dyspnea, especially in elderly patients whose general state of health is not good because of restriction in their ability to exercise in the course of daily life due to dyspnea of exercise such as lumbago, stagger of the legs, and shoulder stiffness.