[Objective]To survey the current situation of infection control in clinical practice of acupuncture and to discuss the problems and strategy.
[Methods]The subjects were 1,000 acupuncture clinics enrolled in iTownPage in the Chubu region. The questionnaire was sent to them by mail in November 2008. The questions were the following; 1) Profile of respondent, 2) Hand hygiene, 3) Preparation of needling sites, 4) Sterilization and storage of needles and equipment and disposable products, 5) Disposable needle, 6) Hand-pressing (Oshi-de), 7) Infectious waste, 8) Awareness, efforts and self-evaluation of practitioner for infection control, and 9) Comments of this survey.
[Results]The collection rate was 22.2%. Washing time for less than 30 sec was 31.1%, Usage rate of a cloth towel was 67.7%, Hand antisepsis by the basin method was 18.9%, Usage rate of 50 %isopropyl alcohol was 19.8%, etc. 26.6%of all respondents answered that the possibility of infection in acupuncture and moxibustion therapy was very low and 50.9%of those responded that it was low. However, only 27.0%of the responders answered that infection control in their own clinics was appropriate. In addition, 72.5%of the responders belonged to the Japan Acupuncture and Moxibustion Association (JAMA) or the Japan Society of Acupuncture and Moxibustion (JSAM).
[Conclusion]Although some infection controls have been improved, many problems became clear. These problems are suggested to be caused by poor acknowledge, previous experience and wishful thinking of practitioners. It is necessary to continue activities to raise practitioner's awareness for infection control.

[Purpose]The reason is uncertain though it is assumed that to young people that there are a lot of Temporomandibular disorders (TMD). Then, the questionnaire survey concerning the mandible function was administered for university students, and the clinical trial of the acupuncture treatment that used sham acupuncture for the one where the problem was seen in the mandible function was tried.
[Method]We questioned students at Meiji University of Integrative Medicine by answer selection type concerning the mandible function. The acupuncture treatment was done on 16 students (21.5 ± 1.7 years old;mean ±S.D.) who had problems in the mandible function. The group was divided into two groups (the acupuncture group and the sham acupuncture group) at random. Each group received five acupuncture treatment sessions several times week in total. Outcome measures were pain intensity (visual analogue scale) and function of jaw (mouth opening and muscle power). Each evaluation was assumed to be done before beginning the treatment, and the effect of treatment was assumed to be the one evaluated as a therapeutic gain after one week.
[Result]University students who had some problem in the mandible function were 50%or more of the whole, and a lot of problems were joint noises. On the other hand, the acupuncture group was 67.1 ± 19.1 mm and the sham group was 65.6 ± 15.2 mm. Both groups showed reduction tendencies as the acupuncture group was 9.3± 7.8 mm and the sham group was 40.5 ± 16.7 mm. The acupuncture group reported less pain intensity than the sham acupuncture group (p = 0.0152, Mann-Whitney). However, the true and sham acupuncture groups did not change the function of the jaw.
[Conclusion]A lot of university students who had mandible function problems were unexpectedly regarded as necessary to treat at the early stage. On the other hand, these results suggest that true acupuncture procedures may be more effective on TMD in young patients than sham acupuncture procedures.

[Objective]Asperger's disorder, one of autism, is characterized by a limited radius of interest and activities and also difficulty in mutual social relationships. We treated a girl who developed school refusal due to general fatigue by directing our attention to the background of forming a symbiotic relationship with her mother, who had symptoms of depression. The symptoms of the both patients were improved by acupuncture treatment.
[Case]A 12-year-old girl complained of general fatigue. Since May X (year), the patient had complained of general fatigue and had started refusing to attend school. In August, she consulted the psychiatry department and was diagnosed with Asperger's disorder. While receiving educational counseling by the city, she started undergoing acupuncture treatment from May X+1 (year). Prior to that treatment, her mother, who had complaints of joint pain due to pustulosis palmaris and depression, had started acupuncture treatment in September X (year). We applied acupuncture treatment once in 1-2 weeks with the aim of tonifying the heart and spleen, and unblocking yang, the governor vessel. We conducted fact-finding on the spot in minute detail for both patients. We asked them to use a categorical scale and provide scores for symptoms, particularly body (general) fatigue, feeling of sound sleep, glow of hands and feet, headache and dejection.
[Result]We performed acupuncture treatment 28 times over 11 months and symptoms were a 30-50%improvement. The girl became able to go to classes for school-refusing children, which is managed autonomously, and also attended school events. Her mother's symptoms also scored similarly and stabilized.
[Conclusion]The symptoms of the patient were related to the condition of her mother and also physical and mental imbalances due to adolescence. We concluded that acupuncture treatment for both the mother and girl improved the symbiotic relationship between mother and child, providing success in both acupuncture effects and countenancing acceptance.

[Background]Functional abdominal pain syndrome (FAPS) represents a chronic pain disorder localized in the abdomen and the symptoms largely are unrelated to food intake and defecation, which differ from other painful functional gastrointestinal disorders.
We report a case of FAPS whose symptom was successfully improved by acupuncture.
[Case Report]A 75-year-old female had been hospitalized at Meiji University of Integrative Medicine Hospital because of left lower abdominal pain from which she had repeatedly suffered for more than 2 years. Despite strict medication, her symptom had not been improved. After admission to the hospital, according to recommendation by her physician, acupuncture treatment was started. The patient received TCM-based acupuncture treatments five times a week over 13weeks. Primary acupuncture points used for the patient were LV3(Taichong), SP6 (Sanyinjiao), ST36 (Zusanli) and PC6 (Neiguan). Evaluation of the left lower abdominal pain was carried out with a Visual Analogue Scale (VAS). The Gastrointestinal Symptom Rating Scale (GSRS) was used to evaluate QOL related to the digestive symptoms. VAS for the left lower abdominal pain showed a remarkable decrease immediately after the initial acupuncture session. The symptom disappeared within 4 weeks after commencement of the treatment and never appeared during her hospitalization. GSRS was also improved and it was maintained during hospitalization.
[Conclusion]We suggested that acupuncture treatment might be one of the useful, non-pharmacological alternatives for symptoms of FAPS.

An International Symposium for Developing an Acupuncture Standard of WFAS was held at the WFAS Office Building in Beijing on 18 May 2010. The aim of this meeting was to make the WFAS Industry Standard and to further develop the International Standard of Acupuncture and Moxibustion.
JSAM dispatched two representatives to the meeting as informal observers. The reason why JSAM did not send representatives formally is that there was a serious discrepancy regarding the resolution of the EC meeting between WFAS and JSAM. However, after the several discussions with WFAS, JSAM eventually decided to send informal representatives who have a right to speak. JSAM presented the necessary information about Japanese moxibustion as well as its techniques.

[Objective]To estimate the number and market size of clinics for acupuncture, moxibustion and amma (traditional Japanese massage) in operation to provide a baseline for regional medical care resources.
[Method]We conducted a postal survey by sending out questionnaires to 5,000 clinics and 1,000 on-call practitioners selected from 16,271 therapists (accounting for 21.0%of the total number in Japan) registered at 98 regional public health centers.
[Results]The survey yielded a response rate of 23%, out of which the rates of non-existing clinics and on-call practitioners at the registered addresses accounted for 20.6%and 31.5%respectively. The rates of the two categories, out of business or suspended, accounted for 12.4%and 41.3%respectively. From these figures complemented by a telephone directory survey, it is estimated that 49,710 clinics were in operation in early 2007. The average annual income for private clinics was 4.88 million yen, and 2.84 million yen for private on-call practitioners, while that of corporate clinics was 34.85 million yen and 16.33million yen for corporate on-call practitioners. Accordingly, the market size of the subject business is estimated at 315 billion yen as of 2006.
[Discussion]A major downward revision should be made in the data included in the national public health statistics. Considering the fact that there are over 16,000 clinics whose current status is unknown, it is desired that the government conduct a national fact-finding survey at an early date.
Conclusion:The total number of acupuncture, moxibustion and amma (traditional Japanese massage) clinics is estimated at 50,000 constituting a market size of 325 billion yen as of 2006.

[Objective]Capsaicin induces flare reaction in the human skin, and repetitive capsaicin applications induce capsaicin desensitization. To investigate the receptors related to flare reaction by acupuncture and moxibustion, we measured pain thresholds and flare reaction in two areas.
[Methods]Thirteen healthy volunteers with informed consent participated in this study. Capsaicin (0.1%) was applied repetitively (6 h/3days) to the forearm skin to desensitize the area. Then, mechanical and heat pain thresholds, flare reactions that induced by acupuncture and moxibustion were measured.
[Results]In the desensitized area, the heat pain threshold was significantly increased but the mechanical pain threshold did not change. Moxibustion induced flare reaction and it was significantly diminished under capsaicin desensitization. On the other hand, acupuncture induced flare reaction and it disappeared completely under capsaicin desensitization.
[Discussion and Conclusion]These results revealed that the flare reaction induced by acupuncture and moxibustion requires TRPV1 activation. For the moxibustion, flare reaction was significantly diminished under capsaicin desensitization but remained significant. Therefore we suggest that TRPV1 mainly mediates the flare reaction but other heat sensitive receptors might be involved in flare reaction. While the mechanical pain threshold was not changed under capsaicin desensitization, flare reaction induced by acupuncture disappeared completely. This suggests that flare reaction is not induced by the mechanical stimuli of acupuncture itself, but other factors such as inflammatory mediators released from damaged cell causing flare reaction by acupuncture.

[Objective]More accurate anatomical data is discussed to reveal the surrounding structures of the new and former BL54 (Zhibian, Chippen) according to the positional modification of acupuncture points by WHO (2006), and also to demonstrate the acupuncture stimulation points to the sciatic nerve as effective methods for acupuncture treatment of the pain in the lower back.
[Methods]Detailed dissections were performed on the surrounding structures of the acupuncture points of the bladder meridian at the gluteal region and the posterior aspect of the thigh in three cadavers at the Unit of Clinical Anatomy, Graduate School, Tokyo Medical and Dental University.
[Results] 1. The new BL54 (WHO, 2006) was situated at or near the infrapiriform foramen, with the posterior femoral cutaneous nerve, inferior gulteal nerve and vessels and sciatic nerve passing through.
2. The former BL54 was situated at or near the suprapiriform foramen with the inferior gulteal nerve and vessels passing through.
3. The acupuncture stimulation points to the sciatic nerve at the gluteal region and the posterior aspect of the thigh were as follows;(1) the initial portion of the sciatic nerve, (2) the infrapiriform foramen (new BL54, WHO), (3) the lateral one third point of the line connecting the sacrococcygeal junction and the greater trochanter, (4) the midpont of the line connecting the ischial tuberosity and the greater trochanter, (5) the point about 1 cm lateral to BL36 (Chengfu, Shofu), (6) the medial half portion of the biceps femoris muscle lateral to BL37 (Yinmen, Inmon).
[Conclusion] 1. The new and former BL54 are situated near the main nerves and vessels of the gluteal region and the posterior aspect of the thigh, so are considered as effective points for the acupunctural treatment.
2. The six positions are showed as the acupuncture stimulation points to the sciatic nerve in the gluteal region and the posterior aspect of the thigh.

[Purpose]Ginger-partitioned moxibustion is indirect moxibustion of putting sliced ginger between the skin and the moxa. It can give mild stimulation with damp heat. The characteristic of the temperature by the thickness of the ginger was investigated with a temperature sensor without changing the weight of the moxa. Moreover, the relation between the result of a questionnaire on thermal sense and maximum temperature was investigated by applying different thicknesses of ginger-partitioned moxibustion to participants.
[Method]A thermometer was fixed on a wood board 3mm thick. Ginger was cut in a 2 cm square, in three kinds of thickness; 3mm, 5mm, and 7 mm. The temperature change was measured every 30 seconds when the cone-shaped moxa (weight: 200 mg, diameter: 2cm, height: 2cm) was burnt on the ginger for each thickness. Next, the thermal sense of the human body was investigated for ginger-partitioned moxibustion. The maximum temperature of ginger-partitioned moxibustion to the forearm of participants was measured by the thermometer set between the sliced ginger and skin. After moxibustion, we did a questionnaire survey about thermal sense and comfort sense.
[Result]As a result of measuring the temperature on the wood board, the maximum temperature decreased and the time to reach the maximum temperature took a long time according to ginger thickness. Ginger-partitioned moxibustion applied to the human body resulted in a correlation between thermal sense and the maximum temperature. The thinner sliced ginger had the stronger thermal sense. Participants who answered little comfort, comfortable or very comfortable were 5/10 people in the 3mm thickness sliced ginger, 9/12 people in the 5 mm ginger group, and 5/9 persons in the7 mm ginger group.
[Discussion and Conclusion]The thickness of ginger can be an important factor that influences the quantity of stimulus of ginger-partitioned moxibustion. In investigating the comfort sense, the stimulation of ginger-partitioned moxibustion was expected to give the comfort. But four of ten participants who received ginger-partitioned moxibustion with a 3mm thickness felt uncomfortable. If we apply ginger-partitioned moxibustion of 200 mg to patients without discomfort, it is undesirable that the ginger thickness be 5 mm or less.

[Introduction]Recently, in the development of information technology, VDT workers are increasing rapidly. Physical and mental health symptoms associated with working at visual display terminals (VDTs) are controversial. However, there are few studies about the effect of acupuncture treatment on eye fatigue, neck and shoulder stiffness that many VDT workers have.
Therefore, in this prospective study, we examined the effect of acupuncture treatment for complaints of VDT workers.
[Methods]Sixty-one VDT workers participated as subjects (41 males, 20 females). Acupuncture sessions were performed once a week for four weeks. Acupuncture points were decided by the patient's muscleskeletal distress.
Disposable press tack needles were used. Visual Analogue Scale (VAS) was used to determine eye fatigue, neck and shoulder stiffness. Improvements of each VAS were evaluated. Then we analyzed improvement on shoulder and neck stiffness associated with eye fatigue.
[Results]The neck and shoulder distress of patients was reduced in four weeks by acupuncture treatment. A regular correlation between the improvement rate of eye fatigue and neck/shoulder stiffness was observed.
[Conclusion]The neck and shoulder stiffness was improved by acupuncture treatment. According to improved symptoms, eye fatigue was mitigated as well. Thus it was suggested that utility of acupuncture is high in the field of industrial medicine.