Acupuncture and Moxibustion are useful traditional medicine that are widely applicable for various kinds of health care services including health maintenance, health promotion or palliative care. Conventional medicine has been developed focusing mainly on curing diseases. However, recent changes in the medical structure that is characterized by an increase in the elderly and chronic diseases emphasize the importance of preventive or amenity medicine or medicine that focuses more on welfare services. Since a unitary system of modern medicine was not suitable to respond to these demands, the necessity of medicine that cares for patients with the view point of welfare has emerged. Also, from the viewpoint of holistic medicine, traditional therapies as complementary and alternative medicine (CAM) have been attracting public attention and extending its field of application. These changes suggest the importance of an integrated approach from the viewpoint of patient oriented, holistic, and welfare medicine. We herein discuss the 'Role of Acupuncture and Moxibustion in Welfare'. In order to understand the situation, we need a common point of view to mediate between welfare and medicine with the knowledge of the relationship between these systems. We should discuss how acupuncture and moxibustion medicine can bear the role as well as its possibilities. Outlines of the presentations by invited specialists are as following;Dr. Tadakazu Kumatani will present the relationship between medicine and welfare. He will introduce social workers who support care-at-home or rehabilitation by assisting the patients and their families to solve or regulate economic, psychological and social problems in the health care system as well as their histories. Dr. Ippei Watanabe will state the idea and viewpoint that is common between welfare and acupuncture and moxibustion, and Dr. Tadasu Matsumoto will introduce practical applications of acupuncture and moxibustion in welfare and will state the usefulness and possibilities of acupuncture and moxibustion in the field.
When we view society in the future, medicine is expected to be developed in cooperation with welfare systems. It is necessary for specialists in each field to cooperate. Also, it is necessary to develop a welfare-medical system to provide sufficient services in compliance with demands of each patient, which is based on a firm idea. We would like to suggest role of acupuncture in welfare systems as well as its future and ideas.

To investigate the effect of acupuncture treatment combined with extreme infra-red rays radiation, we measured both skin surface and deep temperature at the stimulated area and peripheral site. The subjects were seven healthy volunteers with no problems involving the skin or autonomic nervous system. Acupuncture stimulation was performed on the Subject's back in combination with extreme infra-red rays radiation. The skin surface and deep temperature were measured at both the stimulated area and peripheral site (sole of the foot) using a thermistor temperature sensor and deep tissue thermometer during stimulation. We also measured temperature at those sites during extreme infrared rays radiation without acupuncture stimulation as a control study. Acupuncture stimulation combined with extreme infra-red rays radiation on the subject's back increases both surface and deep temperature at both the stimulated area and the peripheral site (sole of the foot), while the radiation alone had no effect on the temperature at the peripheral site. We suggested that acupuncture treatment combined with extreme infra-red rays radiation was useful to increase skin surface and deep temperature not only at the stimulated area but also at the peripheral site.

Review of the effects of acupuncture and moxibustion on brain function and cerebral disorders in human and animals was presented. Firstly, in basic research on experimental animals, the change of cerebral blood flow induced by acupuncture and its mechanisms had been reviewed. Nextly, the effect of acupuncture and moxibustion on human brain function that measured from fMRI, PET, magnetoencephalography (MEG), EEG (including event related potential) have documented in the review of basic research on humans. Finally, effectiveness of acupuncture and moxibustion on stroke was reviewed, and its possibility of QOL-improvement of the patients was discussed.

Although De-qi sensation induced by acupuncture stimulation has been considered one of the conditions for good acupuncture effects, its physiological significance has not been clarified. Therefore, we examined the influence of De-qi sensation on the central nervous system (CNS) by measuring the event-related potential (ERP) induced by acupuncture stimulation.
Tests were conducted on nine healthy adult males. Acupuncture stimulation was given to these subjects, and ERPs were collected from three locations of the head, Fz, Cz, and Pz, using both ear lobes as reference electrodes. For control data, surface electric stimulation was given to the same subjects and ERPs were collected from the same locations. Acupuncture stimuli or electric stimuli were given to the left-side LI10 32 times at random intervals of 4 to 7 sec. To analyze ERPs, ERPs in response to 32 trials were averaged using a DP 1100 system (a signal processor made by NEC SANEI, LTD.).
The latency of the ERP triggered by acupuncture stimulation was approximately P350msec, while that of the ERP triggered by electric stimulation was found to be approximately P250msec, resulting in a difference of P100msec. These results suggest that the De-qi sensation induced by acupuncture stimulation may strongly influence the CNS functions, especially the processing recognition of CNS. It is suggested that this acupuncture stimuli related potential may not be p-LPC.

We studied the effects of transcutaneous electrical nerve stimulation (TENS) of Baxie on local cold tolerance as an index of cold induced vasodilatation (CIVD). The subjects consisted of 22 healthy adult volunteers.
The skin temperature and skin blood flow in the middle finger were measured simultaneously before, during, and after immersing the finger in cold water. TENS at 1Hz with 100-V intensity was applied for 5 minutes before immersion of the finger.
Experiments were conducted with no stimulation and with TENS on the same subjects on different days.
The results revealed the following:
1. The minimum skin temperature and minimum skin blood flow during immersion of the finger in cold water were higher in the TENS group than in the control (no stimulation) group.
2. The maximum skin temperature, mean skin temperature, and increase and decrease of skin blood flow rate during immersion of the finger in cold water and in the rising phase of skin temperature were higher in the TENS group than in the control group.
3. The index of resistance to frostbite was higher in the TENS group than in the control group.
4. The number of fluctuations in skin temperature during immersion of the finger in cold water was significantly higher in the TENS group than in the control group.
5. The incidence of abnormal perception during immersion of the finger in cold water was lower in the TENS group than in the control group.
These results suggest that TENS enhances the local cold tolerance of fingers by suppressing SSA in the initial falling phase on skin temperature and increasing the motion of skin blood vessels in the rising phase of skin temperature.

We studied the effects of electro acupuncture stimulation of Baxie on local tolerance as an index of cold induced vasodilation (CIVD). The subjects consisted of 22 healthy adult volunteers. The skin temperature and skin blood flow in the middle finger were simultaneously examined before, during, and after immersion of the finger in cold water. Electroacupuncture stimulation at 1 Hz with a 66 to 100V intensity was performed for 5 minutes. Experiments of no stimulation and electroacupuncture stimulation were conducted on the same subject on different days.
The results revealed the following:
1. CIVD was caused by rapid increase of skin blood flow during immersion of the finger in cold water.
2. The minimum skin temperature, minimum skin blood flow, maximum skin blood flow, mean skin temperature in the rising phase of skin temperature, and the index of resistance to frostbite of the electroacupuncture stimulated group were higher than those of the unstilmulated group, and rates of skin temperature increase and decrease during immersion of the finger in cold water in the electroacupuncture stimulated group were significantly higher. These results show that electroacupuncture stimulation increases local cold tolerance in the finger.

In order to examine the attitudes of medical students toward oriental medicine before and after lecture course, self-administered questionnaires were given the medical students of Kyoto Prefectural University of Medicine. Eighteen percent of the students had some experience with the prescription of Kampo medicine by doctors; 53% had used Kampo medicine purchased in pharmacies, and 13% had been treated with acupuncture and moxibustion. Eighty-four percent of the students were interested in oriental medicine; 82% thought that oriental medicine was worth learning; 76% thought that oriental medicine was essential in contemporary medicine and 54% wanted to introduce oriental medicine into their clinical practice in the future. These percentages increased after the lecture course to 92%, 85%, 87% and 62%, respectively.

It is well known that haloperidol is effective in the management of nausea and vomiting in cancer patients and that midazolam is used for inducing sedation in patients with delirium. Both the drugs are frequently used in a clinical setting, but there have been only few reports thus far on the concomitant administration of these 2 drugs. We report the case of a patient with massive ascites due to peritoneal carcinomatosis who had severe nausea and vomiting and went into a delirious state. This patient received a concomitant continuous infusion of haloperidol and midazolam for the management of these symptoms. Both haloperidol (up to 1.87mg/h) and midazolam (up to 1.87mg/h) were infused intravenously. For about 20 days, the nausea, vomiting and delirium were well under control without the development of any life threatening toxicities. Concomitant haloperidol and midazolam infusion was found to be a safe and effective therapy for the management of nausea and vomiting in the patient. Palliat Care Res 2009; 4(1): 312-316

Opioids are potent analgesics mostly used for severe cancer and chronic noncancer pain. However, their efficacy and safety in acute noncancer pain are debatable. We describe the case of an 82-year-old male with severe back pain due to bacteremic Staphylococcus aureus spondylitis and paravertebral abscess. Pain in such cases is usually controlled by non-steroidal anti-inflammatory drugs (NSAIDs). However, this patient was administered morphine (oral, then intravenous; up to 23 mg/day) because acetaminophen and NSAIDs did not ameliorate pain. Considerable pain relief was achieved without toxicity, and the dose of morphine was tapered through 35 days. No symptoms of addiction or withdrawal were observed during or after this 35-day period. Thus, morphine appears to be safe and effective in the management of severe, acute noncancer pain in patients with bacterial spondylitis. Palliat Care Res 2010; 5(2): 327-331

A 60-year-old male was diagnosed as having sarcoidosis four months previously because of bilateral hilar lymphadenopathy seen on a chest X-ray, uveitis, and elevation of serum angiotensin converting enzyme. In summer, the patient suffered from hypercalcemia, hypercalciuria, and renal dysfunction. Renal biopsy showed interstitial nephritis with gallium scintigraphy demonstrating high uptake in the bilateral hilum, eyes, and kidneys. Corticosteroid treatment was effective in remarkably improving the renal disorder and radiographic abnormalities.
The calcium metabolic abnormalities and the granulomatous interstitial nephritis showed a marked response to corticosteroid therapy, so that immediate administration of corticosteroid may be justified even in cases without histological evidences. Gallium scintigraphy is suggested to be useful in noninvasive examination in acute stage of sarcoidosis.