Objective: To investigate an association between the gut microbiome and efficacy of poly(ADP-ribose) polymerase inhibitors (PARPi) in ovarian cancer. Methods: This study conducted fecal microbiome analysis (16S rRNA gene sequencing) and circulating tumor DNA (ctDNA) profiling for ovarian cancer patients who underwent PARPi maintenance therapy. Fecal and blood samples were collected at the baseline and the progressive disease (PD) or last follow-up. The relative abundance of gut microbes and progression-free survival (PFS) were analyzed using linear discriminant analysis of effect size and the Cox proportional hazard model according to BRCA1/2 mutation (BRCA1/2mut) status detected by ctDNA sequencing. Results: Baseline samples were available from 23 BRCA1/2mut-positive patients and 33 BRCA1/2mut-negative patients. The microbes enriched in the baseline samples with long PFS were Bifidobacterium, Roseburia, Dialister, Butyricicoccus, and Bilophila for BRCA1/2mut-positive patients and Phascolarctobacterium for BRCA1/2mut-negative patients. In multivariate analyses dividing patients by the median values of relative abundances, no bacteria were associated with PFS in BRCA1/2mut-positive patients, whereas high Phascolarctobacterium abundances (≥1.11%) was significantly associated with longer PFS in BRCA1/2mut-negative patients (median 14.0 vs. 5.9 months, hazard ratio=0.28; 95% confidence interval=0.11–0.69; p=0.014). In the last samples, the relative abundances of Phascolarctobacterium were significantly higher in patients without PD (n=5) than those with PD (n=15) (median 1.25% vs. 0.06%; p=0.016). Conclusion High fecal composition of Phascolarctobacterium was associated with prolonged PFS in patients with BRCA1/2mut-negative ovarian cancer receiving PARPi therapy. Our results would provide new insights for future research.

[Objectives]The purpose of this study is to clarify the effect of acupuncture sensation on the body sway during a one-legged stance.[Methods] The study participants were 16 healthy adults (mean age 21.8±1.6 years). The study design was a crossover method, wherein the same individuals participated in the acupuncture stimulation condition and the control condition at intervals of more than one week. Evaluation was performed before and after each intervention by holding a one-legged stance for 40 seconds on a force plate. A total of six items of body sway were measured, including: circumferential area, rectangular area, effective value area, total trajectory length, unit trajectory length, and unit area trajectory length. In addition, Visual analog scale (VAS) was used to evaluate the ease with which the lower leg was subjected to force during measurement. In the acupuncture stimulation condition, single acupuncture was performed on the lower limb muscle group of the measuring leg, and the VAS of the acupuncture sensation was evaluated at the time of stimulation and at the end of measurement. Stainless steel disposable acupuncture needles (length: 50 mm, diameter: 0.20 mm.) were used for stimulation. The stimulation sites were the ST32, ST37, BL37, BL57, and GB37 of the test leg, and acupuncture needles were inserted to the desired depth and removed when sensation was felt. The control condition was the supine position for five minutes. Comparisons were made between the pre- and post-acupuncture stimulation conditions and the pre- and post-control conditions(body sway, lower leg VAS, acupuncture sensation VAS). [Results] There was no significant difference between the two conditions in terms of body sway. However, the VAS of lower limb effort was significantly lower, from 78.0±14.9 mm to 63.1±17.0 mm before and after the intervention (p<0.05). On the other hand, in the control condition, there was no significant difference from 79.5±12.3 mm to 75.2±12.7 mm before and after rest. The VAS of acupuncture sensation was 50.4±14.3 mm during stimulation and 9.8±9.0 mm at the end of measurement, which was significantly lower (p<0.05). [Conclusion] Acupuncture sensation did not affect the body sway before and after acupuncture stimulation. However, the subjective sensation of weakness appeared, suggesting that acupuncture stimulation may cause a transient sensation of weakness.

The patient was a 73-year-old woman. She had been treated for squamous cell carcinoma of the lung (cT3N3M0, Stage IIIC) at our department. The patient had low back pain due to retroperitoneal lymph node metastasis; in June 2022, this was exacerbated as lung cancer progressed. She had difficulty in body movements due to edema in both lower limbs, in addition to the pain. Consequently, she was urgently admitted on July 8 and received radiotherapy (30 Gy/10 fractions) for retroperitoneal lymph node metastasis. She was being given tapentadol at a dose of 200 mg/day for relief of her pain. However, she was switched to fentanyl patch at a dose of 1200 µg/day during her hospitalization, which resulted in relief of low back pain. The underlying disease causing the edema was investigated. Based on physical and laboratory findings and medical history, lymphedema associated with retroperitoneal lymph node metastases was diagnosed. On day 31 of hospitalization, the patient was allowed to be temporarily discharged from the hospital because the edema had improved and the activity of daily living around the bed had increased. Treatment methods for lymphedema associated with lymph node metastasis have not been established, but the efficacy of radiotherapy has been reported. We have herein reported a case of lymphedema that was improved by radiotherapy after it was differentiated from other diagnoses.

[Introduction] We report our experience with a patient with panic disorder (PD) , which suggests the importance of building a trusting relationship between the patient and the acupuncturist.[Case] A 69-year-old woman with PD presented to our acupuncture clinic with anxiety and difficulty breathing. Her symptoms appeared six months prior, and later, she presented to the emergency department of A Hospital with dyspnea and nausea. Shehad a significant medical history of RLS and rheumatoid arthritis. She was diagnosed with PD at the Department of Oriental Medicine of the same hospital. Her symptoms improved with herbal remedies; however, anxiety and difficulty breathing persisted. Her symptoms at the first acupuncture visit were dyspnea, chest tightness, and anxiety regarding seizures that occurred once or twice a week. She also experienced insomnia and nocturnal hot flashes in her legs. She had no panic attacks or prevailing anxiety, and her neurological and cardiovascular parameters were normal. During the treatment period of 91 days, 14 acupuncture and moxibustion treatments were performed once a week. GV20, PC6, HT7, ST36, SP6, LV3, GB20, BL13, BL15, LI4, BL23, and BL33 were used for mood symptoms, and KI9, BL57, and KI3 were used for toe symptoms. After the second visit, BL10, GB21, and SL14 were performed for neck and shoulder symptoms, and Ex-LE10 and plantar nerve acupuncture were performed for coldness in the lower extremities. Moxibustion was applied to SP6, KI3, and LV3.[Course] After the initiation of acupuncture, anxiety and difficulty breathing were almost resolved by the second treatment session; however, insomnia and hot flashes in the lower extremities worsened in the seventh round of treatment. The patient had also hoped for the resolution of the insomnia-related symptoms using acupuncture. However, since acupuncture was ineffective, we explained the need for specialized treatment and referred her case to a psychiatrist. She was diagnosed with restless leg syndrome, and treatment was initiated using pramipexole, which improved hersymptoms.[Discussion] In this case, acupuncture and moxibustion treatment were effective for the symptoms associated with panic disorder. Additionally, the importance of providing opportunities for appropriate medical consultations as needed was demonstrated.

[Objective] This study aimed to investigate the awareness and perceptions of cosmetic acupuncture among ordinary women.[Method] A questionnaire method was adopted, with a target population of 1,000 ordinary women living in Shizuoka prefecture, which is considered a suitable location for test marketing in Japan.Questionnaires were distributed through the Chambers of Commerce in the prefecture by age group, according to the population ratio, and responses were obtained. The items included (1) basic information; (2) presence and type of facial cosmetic concerns; (3) experience of acupuncture, awareness of cosmetic acupuncture, the medium through which they learned of it, perception of effects, and experience of cosmetic acupuncture; (4) effects and types of cosmetic acupuncture, presence or absence of adverse effects, current treatment status, desired treatment outcomes and reasons for seeking treatment, wishes from treatment clinics, and wishes from practitioners; and (5) 1 month's investment in beauty.[Result] The response rate was 56.2%, and 91.8% of the participants perceived that they had facial cosmetic concerns; 28.8% had experience with acupuncture, whereas 42.0% had knowledge regarding cosmetic acupuncture. Television (45.3%) was the primary source of information regarding this. The most prevalent perception of the effects of cosmetic acupuncture was lifting (44.8%), and 43.2% of the 521 participants inexperienced with cosmetic acupuncture consented to treatment. Participants mostly reported being somewhat interested in the procedure as their reason for wanting to receive treatment (45.3%). The most common reason for opting out of treatment was due to pain (52.6%). Of those who experienced cosmetic acupuncture, 60.0% said they experienced positive effects, and lifting (62.5%) is the most frequently perceived outcome, which matched the commonly held perception. However, among the participants, 45.0% reported negative effects, while 47.5% received the treatment two or more times in the past but did not continue. Participants mainly wanted clean treatment centers and skilled practitioners. The most common monthly investment in beauty was between 3,000 yen and 5,000 yen (28.5%).[Discussion/Conclusion] The results suggest that many women have cosmetic concerns regarding their faces and expect lifting from cosmetic acupuncture. The low treatment rate among women and their reasons for not seeking re-treatment were elucidated in this study, despite their degree of awareness. Further, the problems associated with the development of cosmetic acupuncture were clarified.

The author has gained clinical experience in acupuncture and moxibustion at the Pain Clinic of the Department of Anesthesiology, the Department of Physical Medicine (now the Department of Allergy and Rheumatology), the Department of Geriatrics at the University of Tokyo Hospital and the Printing Bureau Hospital of the Ministry of Finance, psychiatric and internal medicine clinics, and integrated health care facilities. From our clinical experience and research in acupuncture and moxibustion, we believe that in order to position acupuncture and moxibustion in modern medicine, it is important to understand diseases and symptoms from a modern medical perspective, to understand the disease state, to provide treatment based on the disease state, and to evaluate and examine the efficacy and usefulness of acupuncture and moxibustion on a scientific basis. Acupuncture and moxibustion are characterized by the following: 1) Individualized patient care is possible, 2) treatment is possible even without a diagnosis, 3) there are few side effects that are harmful to the body, 4) it is possible to selectively approach the tissue near a lesion, and 5) as a non-pharmacotherapy, it can be combined with modern medical treatments (such as pharmacotherapy and psychotherapy). With these characteristics, acupuncture and moxibustion can be useful as non-invasive forms of treatment in modern medicine. Furthermore, what is required of acupuncture and moxibustion practitioners is the ability to cooperate with doctors and other medical professionals to gain a common understanding and mutual trust.

[Aim] We compared the effects of acupuncture and press tuck needle (PTN) acupuncture in office workers with physical and psychological fatigue.[Design] A randomized, open-label, parallel-group, comparison study.[Setting] An acupuncture room in the A Clinic within the Kanto Metropolitan Area.[Patients] Clinic workers. The inclusion criteria were 20-45 years of age and awareness of physical and psychological fatigue. The exclusion criteria were fatigue-related diseases and symptoms, medical abnormalities, and history.[Intervention] The subjects were randomly allocated to either the acupuncture treatment group (ACP group) or PTN acupuncture treatment group (PTN group). The interventions were based on acupoints for fatigue symptoms as per previous reports and individualized treatment for physical symptoms, including neck and lower back pain, among others, and were performed twice a week for one month.[Evaluation methods] The visual analog scale (VAS) scores were the primary method for evaluating for physical and psychological fatigue at four weeks post-treatment. Other forms of measurement used were the VAS scores within groups immediately after treatment and to evaluate physical health, the Health Perceptions Questionnaire, General Health Questionnaire-12, and Short Form-36 responses; and salivary amylase levels were used.[Results] Thirteen of 14 subjects in the ACP group and 13 of 15 in the PTN group were included in the analysis. There was no significant difference between the groups for VAS scores. Evaluation, immediately before and after the intervention showed a significant decrease in VAS scores for physical fatigue in both groups. The ACP group showed a greater immediate change than the PTN group. In a comparison within each group, the VAS of psychological fatigue in the PTN group showed significant decrease after the eighth treatment.[Conclusions] Acupuncture may immediately improve physical fatigue in office workers. Moreover, the frequency of using PTN acupuncture may eventually decrease physical fatigue. Therefore, acupuncture and PTN acupuncture can help office workers' health.