We analyzed 22 patients with muscle contraction headache who had been examined at the Oriental Medicine Clinic of the Second Department of Internal Medicine, Saitama Medical School.
There were more female patients than males. Most of the patients were from 31 to 45 years old. And most of the patients had suffered from the condition for one year or more. Many of the patients visited our outpatient clinic believing in the examination by Oriental medicine, after they had visited other departments such as neuro-internal medicine, etc. Of these patients, 40.9% had had underlying diseases, such as collagen diseases and intractable nervous system diseases. Anti-phlogistic analgesics, muscle relaxants and tranquilizers were prescribed as drug therapy for these patients. The drug therapy and acupuncture were markedly effective, effective or slightly effective, accounting for 77.2%.

Muscle contraction headache is often treated in Oriental medicine. There are, however, many problems in its diagnosis and therapy. In the present study, the pulse waves of the digital apical and the shallow temporal arteries of correspond to the way were observed and compared with those in healthy controls.
As a result, the height of the pulse was found to be markedly lower in patients than in controls. When these patients were treated by acupuncture, headache was improved, with the pulse height returning to the level for healthy persons.
Thus, observation of pulse waves of the digital apical and shallow temporal arteries of correspond to the way provides a useful criterion for the diagnosis of headache of this type. It can also serve as an index for judging the efficacy of treatment by acupuncture and moxibustion.

Muscle contraction headache is commonly treated in Oriental medicine, but there are various clinical problems involved. In the present study, electromyograms obtained at muscle fibers in the frontal belly and trapezius in patients with such headaches were compared with those in healthy controls.
Electrical discharge from the upper muscle fibers of the trapezius was increased in patients during exercise of the neck and the Amefuri test. In contrast, there was no difference in findings at the frontal belly between patients and controls. When the patients were treated by acupuncture, headache improved, and the pattern of electrical discharge from muscle fibers approximated to that for healthy controls.
Thus, observation of electromyograms at the upper muscle fibers of the trapezius provides a useful criterion for diagnosing headache of this type and can serve as an index for judging the efficacy of treatment by acupuncture and moxibustion.

Although the clinical usefulness of acupuncture has been widely accepted, quantitative analysis of the effects of acupuncture had received little attention. We therefore examined the pupillary dynamics before and after acupuncture treatment on 30 patients with tension type headaches and 15 healthy volunteers. We used open-loop video pupillography, which enables objective measurement of autonomic nervous functions, and obtained the results below.
1) In patients with tension type headaches, acupuncture reduced the pupillary area before photic stimulation (A1) (10min after: p<0.01, immediately after and 20min after: p<0.05) and increased maximum velocity (VC) and acceleration (AC) of constriction (p<0.01). However, no significant changes were observed in maximum velocity of dilatation (VD).
2) In healthy volunteers, acupuncture transiently increased VC alone (p<0.05), and no significant changes were observed in other parameters.
The above data suggested that open-loop video pupillography is a useful method to quantitatively analyze the effect of acupuncture on pupillary dynamics and that parasympathetic nervous functions play an important role in the effect of acupuncture in the patients with tension type headaches. Also, it is possible that acupuncture may affect the central nervous system at a higher level of the medulla spinalis.

Acupuncture and moxibustion are traditional medical treatments with a long history which have been practiced since ancient times in the East and are promising therapeutic methods for many diseases and symptoms. In recent years, a large number of basic and clinical studies in the field of acupuncture and moxibustion have been reported also from Europe and United States, and expectations for establishment of acupuncture and moxibustion as integrated medicine have grown. The establishment of the Department of Oriental Medicine at Saitama Medical University goes back to the year 1984, and since then, it has been involved in the treatment, research and education for about 25 years.
As to the treatment, close coordination with other departments has been developed;now, the number of patients seeking acupuncture and moxibustion treatment exceeds half of the total patient population, and some of the patients receive inpatient treatment. Acupuncture and moxibustion are given to patients with intractable pain, paralysis, or a series of unidentified complaints, for which the treatments have been found to be highly effective. It has been suggested that acupuncture and moxibustion are likely to play an important role in the setting of a medical university hospital.
As to the research, basic and clinical studies on acupuncture and moxibustion have been promoted, and effects and mechanism of action of acupuncture and moxibustion were investigated in the treatment of primary headache, stroke, facial palsy, rheumatoid arthritis, Sjogren's syndrome, nonspecific low back pain, etc. Studies using autonomic nerve function and immunity as indices of characteristics of the traditional medicine were conducted for their scientific elucidation.
In future, it is essential to enhance further coordination with specialists of other treatment departments, demonstrate efficacy and usefulness of acupuncture and moxibustion treatment, and promote evidence-based research work. It is my desire to give Japanese traditional medicine of acupuncture and moxibustion a clear position within medical university, have them established as integral medicine, and to offer to the world Japanese acupuncture and moxibustion treatment.

The effect of acupuncture electrotherapy (AET) on siccative symptoms (dry eye, dry mouth) of patients with Sjögren's syndrome (SjS) was examined using changes in the lacrimary secretion volume, the salivary secretion volume, and the skin temperature on the face as well as the dry score.
1) The control group (n=10) was subjected to 1-Hz/30-Hz AET on the face and 1-Hz AET on the posterior neck and upper scapula region. Though, the 30-Hz AET on the face resulted in a significant increase in the lacrimary secretion volume, salivary secretion voloume, and skin temperature on the face, no clear changes were observed in response to stimulus at the posterior neck and upper scapula region.
2) In one group of SjS patients (n=15), 30-Hz AET on the face significant increased the lacrimary secretion volume and salivary secretion volume.
3) In a second group of SjS patients (n=7), no significant difference in effects with elapsed time was observed immediately after, 30 minutes after. 1 hour after, and 2 hours after applying 30-Hz AET on the face.
4) In a third groups of SjS patients (n=10), no significant difference in the cumulative effect of 30-Hz AET applied to the face was observed after the first, fifth and tenth treatments. However, the dry mouth score significantly decreased from the first treatment to the tenth treatment.
The above observations indicate that the effect of AET on siccative symptoms of SjS patients occurs in the order of trigeminal nerve, facila nerves, and glosspharygeal nerve reflexes (somatic-parasympathetic nerve reflex). They also indicate that the reactivity varies according to the frequency of stimulation provided, with high-frequency stimulation being particularly effective in salivation, suggesting that acupuncture may contribute to improving the QOL of patients by mitigating the subjective siccative symptoms experienced by them.

Twelve patients with chronic renal diseases who underwent hemodialysis in the Oriental Medicine Outpatient Clinic of a general hospital were analyzed. The ratio of female to male patients was high, and patients' ages ranged from 31 to 71 years, with a mean age of 53.3 years. Many patients had been receiving hemodialysis for a relatively long time at a frequency of three times a week in most cases. They thus had to maintain a fixed posture for 4-5h per day several times a week. Underlying diseases were chronic glomerulonephritis, diabetic nephropathy, polycystic kidney and nephrosclerosis. Blood biochemical examination revealed high levels of BUN, CRE and UA, while K, Na, Ca and Pi electrolytes were almost normal. The drug therapy consisted mainly of urate biosynthesis inhibitors and electrolyte metabolism amelioraters. Symptoms resulting from long-term maintenance of a fixed posture and abnormalities in K, Na, Ca and Pi electrolytes included headache, stiffness in the neck and shoulder, pain in the arms, low back pain, pain in the legs and pain in the knee joint. Acupuncture was slightly effective or better in 73.1% of the patients, and none of them showed aggravation.

This is a case report evaluating the improvement of activities of daily living (ADL) after TKA in stroke patient with hemiplegia and knee osteoarthritis. The case was a 73-year-old female with left hemiplegia caused by cerebral infarction. She also suffered from severe bilateral knee osteoarthritis and obesity. The hemiplegia and knee dysfunction disturbed her ADL. When she was admitted to our hospital, her FIM motor subscore was 23 and body mass index (BMI) was 36.0. She went on a diet and continued rehabilitation. Her knees were treated conservatively. Six months after the stroke, her FIM motor subscore was 35 and BMI was 29.8. For the purpose of pain relief and improvement of range of motion, right TKA was performed seven months after stroke. And left TKA and lengthening of the gastrocnemius were performed eleven months after her stroke. Rehabilitation was continued carefully in order to avoid deep venous thrombosis. In addition, a left obturator nerve block was performed as treatment for spasticity of her hip adductor muscle. Fifteen months after the stroke, her FIM motor subscore was 77 and BMI was 25.7. TKA is a common treatment for osteoarthritis but when a patient has a stroke, it is difficult to determine whether to perform surgery or not. In this case, bilateral TKA achieved improvement of ADL. We suggest that even if a patient has stroke hemiplegia, TKA should be considered for knee osteoarthritis based on the appropriate assessment and careful risk management.