Acupuncture could modulate the immune responses and is clinically used for the treatment of some allergicand immunological disorders. But the benefits of the clinical use of acupuncture for the treatment of theimmunoligical diseases have not been fully established. Further, the mechanisms by which acupuncture affects the immune responses have not been clarified. Here, we review the reports about the clinical effects of acupuncture on immunological diseases and about the basic mechanisms of immune modulation by the acupuncture. From these reports and our experimental data, acupuncture could influence the amount of cytokines produced by immunocompetent cells, so we present the hypothetical mechanisms of immunoregulatory action of acupuncture.

We have detected Hepatitis B viral DNA on the surface of needles after removing acupuncture needles. Using a polymerase chain reaction we confirmed a band specific for Hepatitis B virus in one out of two patients who are known carriers. Our study indicates that acupuncture needles represent one possible sources of viral infection.

We examined whether wiping acupuncture needles with cotton could remove Hepatitis C viruses (HCV) adhering to the needles. The needles were incubated in the serum from patients infected with HCV, then the needles were wiped with dry cotton or cotton soaked in 80% ethanol. RNA was extracted from these needles and the HCV genome was amplified by reverse transcription-polymerase chain reaction (RT-PCR). The results indicated that the HCV genome was not detected when the needles were wiped with dry cotton. However, in one of two experiments, the HCV genome was detected after wiping the needles with cotton soaked in ethanol. We also examined the HCV contamination on the needles extracted from patients infected with HCV. The HCV genome was detected on extracted needles that were not wiped with cotton, but the genome was not found on needles wiped with cotton at the time of extraction. Therefore, wiping acupuncture needles with cotton might effectively remove HCV on the contaminated needles, but the viruses could not always be re-moved by simply wiping the needles with cotton.

[Objective]This study aimed to identify the attitudes toward and the perceptions of the interrelation between acupuncture/moxibustion and immune system for clinical acupuncturists in Japan. A questionnaire survey was conducted as the second periodical action of the Immunological Research Committee for Acupuncture and Moxibustion.
[Methods]Clinical acupuncturists in the 43vocational colleges belonging to the Japan College Association of Oriental Medicine and 6 universities having an acupuncturist-education course were surveyed.
[Results]The response rate of this survey was 27.4%(263/960). Fifty six percent of responders expressed a positive view that the acupuncture/moxibustion had therapeutic effect to augment the body defense against infection, and 83%of them had the perception that acupuncture/moxibustion therapy could act as the preventive medicine. However, only 11%of those responders usually carried out the therapeutic evaluations after their treatments, and the other acupuncturists relied their assessment upon the statement from the patients alone.
[Conclusion]From the basic concepts of evidence-based medicine, the present study demonstrates that the urgent introduction of the noninvasive and objective procedure by which acupuncturists assess the degree of immune defense in their clinical institution is important.

The immunological research committee for acupuncture and moxibustion, which was primarily organized in 2004, has investigated previous reports on basic research describing the immunological effect with acupuncture and/or moxibustion treatment.
According to the on-line database, we firstly selected 724 reports by keyword searches, which were finally narrowed down to 52 reports on experimental animal tests and 42 reports on clinical tests (72 English articles and 22 Japanese articles) by careful sorting. Then, we analyzed information such as the condition of acupuncture and/or moxibustion stimulation, subject of the test, and immunological parameter for assessment in the 94 reports.
The findings showed that the previous research was performed under inconsistent methods that were difficult to organize, and it is suggested that more comparable and reproducible experiments are required for the progression of this research area in the future.

No abstract available.
Polymerase Chain Reaction*

Background: With improvements in the safety and stability of surgeries, the number of orthognathic surgeries is increasing. Most patients who undergo orthognathic surgeries are younger, and the number of orthognathic surgeries for patients with comorbidities is also increasing. We report a survey and clinical investigation of patients with comorbidities who underwent orthognathic surgeries at our department to improve the safety of orthognathic surgery. Results: The participants included 296 men and 712 women, with a mean age of 28 years (13–19 years, n=144; 20–29 years, n=483; 30–39 years, n=236; 40–49 years, n=102; 50–59 years, n=39; ≥60 years, n=4). In total, 347 patients underwent one-stage Le Fort type I osteotomy and sagittal split ramus osteotomy (SSRO), 243 underwent SSRO, 287 underwent plate removal, 126 underwent genioplasty and plate removal, and five underwent other surgeries. In total, 529 patients had comorbidities (52%), including allergic diseases (n=220, 33%), respiratory diseases (n=107, 16%), neurologic and psychiatric diseases (n=69, 10%), gynecologic diseases (n=28, 4%), hematologic diseases (n=27, 4%), cardiovascular diseases (n=24, 4%), digestive diseases (n=22, 3%), metabolic and endocrine diseases (n=18, 3%), spinal diseases (n=11, 2%), ophthalmologic diseases (n=11, 2%), renal and urological diseases (n=9, 1%), and other diseases (n=117, 18%). Among the patients with comorbidities, 11 with hemorrhagic diatheses (hemophilia and von Willebrand disease), arrhythmia (atrioventricular block), psychiatric disease (adjustment disorder), and metabolic disease (diabetes) required cautious perioperative management. The patient with hemophilia was managed with regular low-dose recombinant factor VIII replacement therapy, and the patient with type I diabetes mellitus was administered continuous insulin infusion and sliding-scale insulin therapy; both patients had an uneventful course. Conclusions The study findings suggest that with the increase in orthognathic surgeries, oral and maxillofacial surgeons should adequately manage cases requiring cautious perioperative control and highlight the importance of preoperative screening. Despite the well-established safety and postoperative stability of orthognathic surgeries, oral surgeons should adopt appropriate additional preventive measures for patients with comorbidities.