Rapidly increasing numbers of acupuncturists in Japan has caused our places of activity to become increasingly important.
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.
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.
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.
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.
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.
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.
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.

Kampo medicines have been used for treatment by an increasing number of doctors in recent years, and are becoming more frequently prescribed in combination with Western drugs. In the present study, we conducted a questionnaire of outpatients at the Kampo Clinic of Keio University Hospital in order to determine their perceptions and compliance regarding Kampo medicines.Ninety eight percent of patients used Kampo medicines in granular form, and approximately 30% of these patients reported difficulty in taking medicine due to reasons such as “bad taste”. Sixty percent of patients used Kampo medicines three times daily. Patients most often forgot to take afternoon doses, and so desired doses once daily. Furthermore, the same number of patients preferred Kampo medicines in tablet form as those who preferred Kampo medicines in granular form.The present findings clarified patients' perceptions toward Kampo medicines. Doctors and pharmacists must provide suitable treatment for patients by recognizing their perceptions of Kampo medicines.
Medicine, Kampo ; Clinic ; Use of ; percent ; therapeutic aspects

Methods: We investigated patients who underwent surgical intervention for LL-OVC (L3, L4, and/or L5) with symptomatic foraminal and/or central stenosis from eight spine centers. Only patients with a minimum follow-up duration of 1 year were included. We developed new criteria to grade vertebral collapse severity (grade 1, 0%–25%; grade 2, 25%–50%; grade 3, 50%–75%; and grade 4, 75%–100%). The clinical features and outcomes were compared based on the collapse grade and surgical procedures performed (i.e., decompression alone, posterior lateral fusion [PLF], lateral interbody fusion [LIF], posterior/transforaminal interbody fusion [PLIF/TLIF], or vertebral column resection [VCR]). Results: In this study, 59 patients (average age, 77.4 years) were included. The average follow-up period was 24.6 months. The clinical outcome score (Japanese Orthopaedic Association score) was more favorable in the LIF and PLIF/TLIF groups than in the decompression alone, PLF, and VCR groups. The use of VCR was associated with a high rate of revision surgery (57.1%). No significant difference in clinical outcomes was observed between the collapse grades; however, grade 4 collapse was associated with a high rate of revision surgery (40.0%). Conclusions When treating LL-OVC, appropriate instrumented reconstruction with rigid intervertebral stability is necessary. According to our newly developed criteria, LIF may be a surgical option for any collapse grade. The use of VCR for grade 4 collapse is associated with a high rate of revision.

Methods: A retrospective multicenter study was conducted. The study participants included 345 patients who underwent surgery for spinal metastases from 2010 to 2020 at nine referral spine centers in Japan. Data for each patient were extracted from medical records. To identify the factors predicting survival prognosis after surgery, univariate analyses were performed using a Cox proportional hazards model. Results: The mean age was 65.9 years. Common primary tumors were lung (n=72), prostate (n=61), and breast (n=39), and 67.8% (n=234) presented with osteolytic lesions. The epidural spinal cord compression scale score 2 or 3 was recognized in 79.0% (n=271). Frankel grade A paralysis accounted for 1.4% (n=5), and 73.3% (n=253) were categorized as intermediate or high risk according to the new Katagiri score. The overall survival rates were -71.0% at 6 months, 57.4% at 12, and 43.3% at 24. In the univariate analysis, Frankel grade A (hazard ratio [HR], 3.59; 95% confidence interval [CI], 1.23–10.50; p<0.05), intermediate risk (HR, 3.34; 95% CI, 2.10–5.32; p<0.01), and high risk (HR, 7.77; 95% CI, 4.72–12.8; p<0.01) in the new Katagiri score were significantly associated with poor survival. On the contrary, postoperative chemotherapy (HR, 0.23; 95% CI, 0.15–0.36; p<0.01), radiation therapy (HR, 0.43; 95% CI, 0.26–0.70; p<0.01), and both adjuvant therapy (HR, 0.21; 95% CI, 0.14–0.32; p<0.01) were suggested to improve survival. Conclusions Surgical indications for patients with Frankel grade A or intermediate or high risk in the new Katagiri score should be carefully considered because of poor survival. Chemotherapy or radiation therapy should be considered after surgery for better survival.