[Objective]This case evaluates the effects of acupuncture for a Parkinson's Disease patient with frozen gait.
[Case]Patient:a 58-year-old male. Chief complaints were frozen gait and fatigue of legs. The gait disturbance was realized about three years ago, and has been gradually worsening. The Hoehn &Yahr stage is III. Treatment:The patient received medication and acupuncture treatment once a week or two for 18 months. Electric acupuncture treatment was adopted on arms and lower legs, and lone needles on the back and legs. Measurements:Outcome measures were timed in a 10 m walk and turn for frozen gait and Visual Analogue Scale (VAS) for fatigue of legs.
[Results]From a long term point of view, there were no significant changes for the outcomes measured. However just after the treatment VAS was statistically improved, and the patient reported a comfortable feeling.
[Conclusion]The effect of acupuncture for frozen gait was not seen, but the improvement in fatigue of legs was noted, and the patient felt comfortable after the treatment.

[Objective]More accurate data on the positional relationship between the acupuncture points belonging to the bladder meridian on the posterior aspect of the lower limb and their surrounding structures are discussed to get the effective methods for acupuncture.
[Methods]Detailed dissections on the surrounding anatomical structures of the acupuncture points were performed on three cadavers of the Unit of Clinical Anatomy, Graduate School, Tokyo Medical and Dental University.
[Results] 1. BL36 (Chengfu (Chinese), Shofu (Japanese)) and BL37 (Yinmen, Inmon) were situated medial to the posterior femoral cutaneous nerve and the sciatic nerve.
2. BL38 (Fuxi, Fugeki) and BL39 (Weiyang, Iyo) were situated on or near the common peroneal nerve along the media border of the biceps femoris tendon.
3. BL40 (Weizhong, Ichu), BL55 (Heyang, Goyo), BL56 (Chengjin, Shokin), BL57 (Chengshan, Shozan), BL58 (Feiyang, Hiyo), BL59 (Fuyang, Fuyo), BL60 (Kunlun, Konron), BL61 (Pucan, Bokushin) and BL62 (Shenmai, Shinmyaku) were situated along the medial sural cutaneous nerve, sural nerve and small saphenous vein.
4. BL40, BL55, BL56, BL57 were situated along the tibial nerve, the popliteal and posterior tibial arteries deep to the soleus.
[Conclusion] 1. The posterior femoral cutaneous nerve and the sciatic nerve tend to run laterally to BL36 and BL37, so it is necessary to apply the acupunctural treatment lateral to BL36 and BL37 to stimulate these two nerves.
2. The sural nerve and small saphenous vein gradually tend to approach the acupuncture points toward the distal part of the posterior aspect of the leg.
3. BL40, BL55, BL56 and BL57 are shown as the acupuncture stimulation points to the tibial nerve passing the deep part of the posterior aspect of the leg.

[Objective]We performed a questionnaire for the purpose of investigating the present conditions of infection control education in Japanese acupuncture schools and to discuss the problems.
[Methods]We conducted a postal survey by sending out questionnaires to 153acupuncture schools in Japan from December 2008 to March 2009.
[Results]Replies were obtained from 69.9%of the schools (107 out of 153schools). In their responses, 65%of the schools taught hand-washing with soap and alcohol-based hand rub as methods of hand hygiene. Moreover 58%of the schools used only single use needles (SUNs), 40%used both reusable and single use needles, and 2%used only reusable needles. However, single use was observed only at 25%of the schools that introduced SUNs.
Furthermore, we inquired whether the students were taught to use sterilized gloves and finger cots. The results illustrated that a proportion of schools provided the instruction;the proportion of constant instruction was 17%, that of the instructor's option was 35%, that of no requisite was 48%.
[Conclusion]From the above-mentioned results, it became clear that the direction for use of SUNs was not instructed adequately. In addition, this aseptic technique for puncture is not yet standardized in the school's education. It is necessary to realize the measures based on evidence and to employ them in educational programs at acupuncture schools.

We examined the effects of acupuncture therapy on 41 patients with various levels of periarthritis scapulohumeralis. These patients were classified into two groups: one consisting of 20 patients having no contracture, those of freezing type (age 61.0±9.0; suffering period 3.0±5.1 months) and the other consisting of 21 patients having contracture, those of frozen type (age 53.8±7.3; suffering period 5.8±7.8 months).
As a result, we found that acupuncture therapy relieved pain more effectively in patients having no spontaneous pain than in those having spontaneous pain regardless of the presence or absence of contracture. We next investigated the effects of this therapy by the patient types. In the group of 20 freezing-type patients, which includes only six patients having spontaneous pain, pain relief was relatively easily obtained as indicated by the pain score after the therapy of 3.6±1.8. In the group of 21 frozen-type patients, which includes 13 patients having spontaneous pain, however, it was difficult to obtain sufficient pain relief as indicated by the pain score of 5.7±2.8. There was a statistically significant difference (P<0.002) between these scores. This shows that acupuncture therapy is more effective on freezing-type patients than on frozen-type patients.
Therapy also improved the range of motion. In many freezing-type patients, the range of motion was expanded due to pain relief. The abduction ROM expanded from 151.8±39.0° before therapy to 163.8±25.0° after acupuncture therapy. In frozen-type patients, however, the range of motion did not expanded significantly (87.6±24.1° before to 94.8±21.1° after therapy). The above results suggest that acupuncture therapy is effective for relieving the pain of periarthritis scapulohumeralis and that this therapy is particularly effective when applied to those patients having no spontaneous pain before they enter into the frozen phase.

We executed an acupuncture therapy to 62 lumbar spinal canal stenosis cases who were diagnosed by CT, MRI photo state and clinical symptom and examined the result.
The 36 men and 26 women in this study had a mean age of 67.3 years.
An acupuncture was executed by aiming to give an effect to the soft tissues and a blood circulation around the area where the stenosis was recognized then pierced facet joint closely and deeply and gave an electric acupuncture stimulus.
14 cases were very good and 17 cases had good results according to the JOA score. No cases worsened.
We concluded an acupuncture treatment was effective for treating lumbar spinal canal stenosis.

Poor circulation is considered to be a cause of stiff shoulders, but there have been no studies on deep hemodynamics and the subjective estimation/palpation of stiff shoulders. We evaluated the relationship between deep hemodynamics and the degree of the subjective estimation/palpation of stiff shoulders by near-infrared spectrophotometry.
The subjects were 146 patients who visited our center and 23 healthy volunteers. Deep hemodynamics (tissue oxygen saturation: StO₂, total hemoglobin concentration: total Hb) was measured in the scapular region of the bilateral shoulders using a deep hemodynamics measurement system (PSA-IIIN, Biomedical Science), and its relationship with the severity of the subjective estimation of stiff shoulders (5-grade rating) and that of palpation (4-grade rating) was evaluated. Deep hemodynamic values were affected by the body mass index (BMI) that is highly correlated with subcutaneous fat thickness. Therefore, analysis was performed in 70 patients and 8 healthy volunteers with BMI of 20-24 that does not affect hemodynamic values. Compared with the healthy volunteers, patients who reported marked shoulder stiffness showed a significant decrease in total Hb, and that who reported shoulder stiffness showed a significant decrease in StO₂. On the other hand, compared with the healthy volunteers, patients with marked shoulder stiffness observed by palpation showed significant decreases in both StO₂ and total Hb; the decreases were more marked with more marked stiffness. These results suggested that deep hemodynamics is a diagnostic parameter of stiff shoulders.