As a preparatory study for treating diabetic neuropathy by acupuncture, we investigated the effect of electroacupuncture on the sciatic blood flow in rats. Nerve blood flow was measured with a laser doppler flowmeter. Different treatments were applied to three groups of rats as follows:
1) those stimulated with low-frequency (1Hz, 5Hz) electroacupuncture,
2) those stimulated with high-frequency (20Hz, 100Hz) electroacupuncture and
3) those stimulated by pinching in the tails.
In the electroacupuncture groups, stimulation was applied to the plantae. While little change was observed in the rats stimulated with low-frequency electroacupuncture, temporary increases in both blood flow and blood pressure were observed in the rats stimulated with high-frequency electroacupuncture and in the rats subjected to pinch stimulation.
These reactions were all inhibited by the administration of phentolamine (α receptor blocker).
These results suggest that the increase in sciatic blood flow induced by high-frequency electroacupuncture and pinch simulation are dependent on the blood pressure.

We investigated whether TEAS affected intellect in the elderly, prevented the decline of daily activity and/or improved HDS-R and elderly activity valuation scale in 93 aged patients over 70.
As a result, HDS-R and the elderly activity valuation scale increased after 8 weeks, in the physical exercise group that also received TEAS treatment, indicating a tendency to improve. Improved intellect was measured by asking subject to guess the time and date, recollect some words, and remember five items in HDS-R. All items on the elderly activity valuation scale were improved except for hearing and appetite. Many patients showed increased scores in combination with TEAS. Before treatment, patients in both groups were divided into 4 subgroups by HDS-R score and change in HDS-R was investigated after treatment for 8 weeks. Those scoring 16 points or more on the initial test tended to show an increased score in both groups, those showing 11-15 points initially demonstrated an increased score only in exercise in the combined group, and those showing 10 points or less did not demonstrate any change in either group.
Based on these results, physical therapy combined with TEAS appeared to accelerate daily activity and promote intellect and cognition in the elderly.

To investigate the effect of electro-acupuncture stimulation (EAS) on insulin sensitivity in rats, we performed several stimulations on Otsuka Long Evans Tokushima Fatty (OLETF) rats, during euglycemic clamp. We divided OLETF rats into five groups according to the kind of the stimulation: EAS at vagal innervated region of the auricle (AVA), EAS at non-vagal innervated region of the auricle (ANVA), EAS on the back of the body (AB), pinching on the back of the body (PB), and no stimulation on the body (NS). These procedures were also applied on Long Evans Tokushima Otsuka (LETO) rats as a control study.
Furthermore, we performed long-term stimulation (from six to 24 weeks of age) on OLETF rats to assess the preventive effect of those stimulations on the formation of the insulin resistance. EAS of pulse duration 300ms, 1.5V, 1Hz was applied for 10 or 15minutes. As a result, the glucose infusion rate (GIR) showed significantly higher levels during stimulation of PB group in LETO rats. On the other hand, the GIR of AVA group in LETO rats and PB group in OLETF rats were decreased by stimulation. The GIR in AVA group and AB group after long-term stimulation were significantly higher than those of NS group in OLETF rats. These results suggested that EAS at the auricle and the back is useful for the prevention of the formation of insulin resistance when it's applied before onset of the symptoms in OLETF rats.

Recently, the importance of patient satisfaction emerged in the context of providing high-quality health care. However, the level of patient satisfaction with acupuncture treatment and the factors that influence satisfaction have not been investigated. We conducted a cross-sectional survey on the satisfaction of patients who consult acupuncture clinics and investigated factors that have a certain influence on the level of satisfaction using multivariate analysis.
Subjects in the present study consisted of 2210 patients who consulted acupuncture clinics that were randomly selected from the alumni association of Meiji University of Oriental Medicine. The survey was conducted between July 10 through July 23, 2000 using our original questionnaire which consists of questions about health state and basic information about the patient, environment of the clinic, assessment of the practitioner by the patient and overall patient satisfaction with the clinic. Sampling of the subject was made using stratified random sampling method and the questionnaires were returned directly from the patient by mail.
Of 2210 patients given the questionnaire, 1, 319 (59.7%) responded. Mean (SD) level of the total satisfaction with the clinic evaluated using 100 mm visual analogue scale (VAS) was 81.4 (13.8). Simple linear regression analysis showed that the degree of explanation given by the practitioner was significantly related to patient satisfaction, while multiple regression analysis showed that the effect of treatment, treatment skill of the practitioner, patient's reliance on the practitioner, clean environment of the consultation room, depth of the practitioner's understanding of the patient and willingness of the practitioner to answer questions were factors significantly related with the patient's satisfaction.
In the present study, there was high overall satisfaction among patients consulting acupuncture clinics and the factors influencing satisfaction could be classified into three kinds : factors relating to the quality of treatment, communication factors between the patient and practitioner, and environmental factors related to the clinic.

[Objective]The present study investigated the relationship between subjective symptoms of katakori (shoulder stiffness) and shoulder hardness which was examined both with clinical palpation and a mechanical device, as well as the correlation between these two measurements.
[Methods]Subjects were enrolled to the study if they had a stiff shoulder on the day of the visit (katakori group, n = 60) or if they had no experience of katakori in their lifetime (non-katakori group, n = 10). The intensity of the katakori was evaluated with a visual analogue scale (VAS). Shoulder hardness was evaluated at acupoint Jianjing (GB21) and at the point where the subject felt the most intensive symptom by both palpation of experienced acupuncturists who were unaware of the allocation and a hardness meter. The method of acupuncture treatment was decided by acupuncturists who were not an evaluator of the hardness.
[Results and Discussion]There was no significant relationship in the hardness measured with the device and palpation between the katakori group and non-katakori group. Also, the intensity of katakori (VAS) and the changes after treatment showed no significant correlation with the hardness and its changes. These results support the validity of our clinical experience that patients who complain of severe shoulder stiffness do not always have a hard shoulder.

The present study investigated the effect of moxibustion for 4 weeks on insulin resistance in Otsuka-Long-Evans Tokushima Fatty (OLETF) rats, a model of spontaneous noninsulin-dependent diabetes mellitus (NIDDM). Glucose infusion rate (GIR) in the moxibustion group was higher than that in the control group. This finding suggests that moxibustion may be effective for insulin resistance.

[Objective] We studied the relationship between circadian blood pressure variations and oriental medical observations in the elderly.
[Methods] Subjects in the present study were 39 elderly patients who were aged 65 or older. For measurement of circadian blood pressure variations, ambulatory blood pressure monitoring (ABPM) was used. Meiji Oriental Medical Score (MOS) and Qi, Blood, Body Fluids Score (developed by Terasawa et al.) were used to evaluate Oriental Medical Status of the subjects.
[Results and Discussion] In the subjects who showed abnormality in circadian blood pressure variations, symptoms of Lung, Kidney and Qi deficiency were identified using MOS, blood deficiency and Qi stagnation were identified using Qi, Blood, Body Fluids Score. The number of the oriental medical symptoms were significantly greater in the subjects who showed abnormalities in circadian blood pressure variations compared with the other subjects. We concluded that oriental medical observations would be helpful to suggest existence of abnormalities in circadian blood pressure variations in elderly with hypertension

[Objective] To estimate the average cost per acupuncture treatment and to assess patients' opinions about the cost of the treatment in Japan.
[Methods] We summarized data concerning the cost of acupuncture treatment and patients' opinions about its cost in a survey that was conducted in July 2000 among patients who visited acupuncture clinics where thepractitioners were the members of alumni association of Meiji University of Oriental Medicine.
[Results] Of 2, 210 questionnaires distributed to the subjects, 1, 319 (59.7%) responded and 1, 264 (57.2%) were relevant to the analysis. 425 (33.6%), 331 (26.2%) and 203 (16.1%) paid 3, 001-4, 000 yen, 2, 001-3, 000 yen and 1, 001-2, 000 yen per treatment, respectively. The average (95%CI) fee paid by patients who wanted the treatment to be 'cheaper' (group 1), and 'slightly cheaper' (group 2) was 3, 310 yen (3081-3538) and 3, 508 yen (3328-3689), respectively. Among those who thought the fee was 'reasonable' (group 3), it was 3, 060 yen (2, 947-3, 172). For those who were able to pay more (group 4), it was 2, 927 yen (2655-3188). The average (95%CI) fee which were considered as 'reasonable' by each group, classified according to opinion, were 2, 080 (1, 906-2, 254), 2, 411 (2, 292-2, 529), 3, 046 (2, 930-3, 161) and 3, 923 (3, 582-4, 263) for groups 1, 2, 3 and 4, re-spectively. The 'reasonable' and 'maximum' costs suggested by the patients were significantly correlated with the current fees paid. Patients' satisfaction with the treatment, which was evaluated with VAS, was related to the opinion of the patients on the cost per treatment.
[Conclusion] Most of the respondents paid 3, 001-4000 yen for an acupuncture session, although the reasonable cost suggested by the patients varied according to the current cost and the patients' satisfaction with the treatment.

Fecal microbiota transplantation (FMT) has been reported as a safe and effective therapy in patients with refractory and recurrent Clostridium difficile infection (CDI). FMT has also been reported as a promising therapy in patients with ulcerative colitis (UC). Both, CDI and UC, are believed to be caused by dysbiosis, such as altered compositions or decreased diversity of the intestinal microbiota. This report describes a patient with UC in remission with a second recurrent episode of CDI, who was treated with FMT. A single FMT performed via colonoscopy completely resolved the patient's diarrhea and eradicated C. difficile bacteriologically without any severe complications. Molecular biological analysis of the patient's fecal microbiota showed that FMT could dramatically change the altered composition of intestinal microbiota and restore its diversity. Despite the restoration of the intestinal microbiota, FMT could not prevent a relapse of UC in this patient. However, it improved the intestinal symptoms of CDI and could prevent further recurrences of CDI.
Clostridium difficile ; Clostridium ; Colitis, Ulcerative ; Colonoscopy ; Diarrhea ; Dysbiosis ; Fecal Microbiota Transplantation ; Gastrointestinal Microbiome ; Humans ; Microbiota ; Recurrence ; Ulcer