[PURPOSE] To examine the safety of acupuncture treatment for breech presentation. [PARTICIPANTS AND METHODS] A retrospective study of cases in which acupuncture in the pelvic position was performed on hospitalized pregnant women with preterm labor in the pelvic position during the period March 1, 20XX-11 to December 28, 20XX was conducted. The survey items included maternal background, maternal and fetal status (including Non stress test), change in drug dosage for preterm labor, outcome of acupuncture treatment, and any adverse events due to acupuncture treatment. [RESULTS] There were 23 pregnant women who qualified for the study. All were receiving standard management of imminent preterm labor. The median number of acupuncture sessions was 7 per patient, for a total of 157 sessions. There was no significant increase in the number of uterine contractions within 24 hours of acupuncture treatment, and in no case was the fetal status assessed as non-reactive before delivery. There was no significant increase in drug dosage within 24 hours of acupuncture treatment. The rate of correction to the cephalic position was 39.1% (9/23 cases). Two adverse events (Grade 1) due to acupuncture treatment were observed, with a frequency of 1.3% (2 cases/157 sessions) per treatment. In addition, there were two cases in which ritodrine hydrochloride was increased within 24 hours of acupuncture treatment.[CONCLUSION] In our study population, there were no signs of fetal distress or worsening of uterine contractions. In the acupuncture treatment methods of our department, the possibility of adverse effects on the mother or fetus was considered low. However, there were two cases in which ritodrine hydrochloride was increased after acupuncture treatment. When providing acupuncture and moxibustion treatment to pregnant women, it is necessary to collaborate with obstetricians.

[Objective] To investigate effect on symptoms and safety of acupuncture and moxibustion for cancer-related fatigue.[Participants and methods] The subjects of the study were cancer patients hospitalized in palliative care who were treated with acupuncture for fatigue during the period from April 20XX-5 to October 20XX. Medical records were examined retrospectively. The main items investigated were changes in the symptom item of the STAS-J scores before and after the start of acupuncture treatment, and the frequency of adverse events.[Results] Thirty patients (14 women) were eligible for the study. All patients received standard palliative care. STAS-J improved within one week after the start of acupuncture treatment in 17 cases (56.7%), remained unchanged in 13 cases, and worsened in none of the cases. The number of acupuncture treatments was 14 per patient (median), for a total of 514 total treatments. No adverse events as defined by acupuncture safety guidelines were observed.[Conclusion] This report does not evaluate the impact of acupuncture alone because palliative care involves multidisciplinary care. However, the symptom item of the STAS-J improved in 56.7% of cases within one week after the start of acupuncture treatment, no cases worsened, and no adverse events were observed. Acupuncture and moxibustion is one of the methods worth trying in cases where symptoms of cancer-related fatigue do not improve with standard palliative care.

Although it is not yet common, certified Kampo (traditional Japanese medicine) doctors and acupuncturists are cooperating with each other to provide traditional medical treatment for patients in some general hospitals in Japan. In other hospitals, however, Kampo and acupuncture-moxibustion have not been introduced, and doctors only treat patients using modern Western medicine. Many doctors must already be aware that modern Western medicine is not the only approach for the treatment of patients, but they do not make any efforts to improve the situation by adopting traditional medicine. Here, we give some examples of hospitals in which acupuncture treatments are routinely provided, having a favorable effect on both patients as well as the hospitals themselves. We believe that these examples give us a good opportunity to consider the future of an ideal medical system in which modern Western medicine and traditional Japanese medicine are successfully integrated.

[PURPOSE] To evaluate the efficacy and safety of acupuncture and moxibustion treatments in breech presentation, we report correction rates and adverse events for correcting breech presentation in our department.[PARTICIPANTS AND METHODS] Subjects were pregnant women who were diagnosed with breech presentation in our obstetrics and gynecology department and started acupuncture and moxibustion treatment between April 1, 2009 and October 31, 2018. The target patients were retrospectively investigated by medical records. The main items investigated were the status of the pregnant women at the time of acupuncture and moxibustion initiation (presence or absence of threatened preterm labor), treatment position (sitting or lateral position), correction rates and occurrence of adverse events. Successful correction was defined as the rate of head position after acupuncture and moxibustion treatments. Adverse events were defined as "unfavorable medical events occurring during or after treatment, regardless of causation."[RESULTS] There were 371 pregnant women in the study; among them 57 women were diagnosed with threatened preterm labor at the start of acupuncture and moxibustion treatment, including 21 pregnant women who were in the hospital. The sitting position was used for treatment for 45.2% (168 cases) of subjects and lateral position was used for 54.7% (203 cases). The correction rates were 72.2% (268/371). In pregnant women with threatened preterm labor who were hospitalized at the time of acupuncture and moxibustion initiation, the correction rates were 28.6% (6/21 cases), which was significantly lower than that of outpatient pregnant women. There was no significant difference in the rate of correction by treatment position between sitting and lateral position. There were no adverse events of vagal reflexes when the left lateral position was treated. The frequency of adverse events per number of procedures was 1.1% (21/1916) and per number of cases was 5.7% (21/371 cases). There were two cases of rupture of membranes with no apparent causal relationship.[CONCLUSION] The safest position for treatment in pregnant women was considered to be the left lateral position. Most of the adverse events were minor or moderate, but there were two cases of rupture of membranes with no apparent causal relationship. When performing acupuncture and moxibustion for breech presentation, it is necessary to work closely with the patient's obstetrician.

[OBJECTIVE] In recent years, acupuncture treatment for cancer patients has spread worldwide. However, in Japan, there are few facilities where acupuncture and moxibustion treatment is being carried out in a hospital, and in introducing acupuncture treatment as part of palliative care is rare. In this study, we investigated the current situation at our hospital where acupuncturists are participating in the palliative care team of the hospital.[PARTICIPANTS AND METHODS] Subjects were patients with cancer in our hospital who were hospitalized to receive the best supportive care for their condition and who had started acupuncture treatment between April 8, 2011 and November 13, 2017. The target patients were retrospectively investigated by medical records. [RESULTS] Of the 75 patients, 72 (96%) were Performance Status 3 and 4. Thirty-seven (49%) had oxygen therapy. Fifty-five patients (73%) had pleural fluid or ascites during acupuncture and moxibustion treatment, and 50 patients (67%) had edema. In the treatment of acupuncture, Contact Needle Therapy was used to avoid the risk of infection and bleeding, and in the moxibustion treatment, scarring moxibustion was not used to avoid the risk of burns and infection. Fifty-nine patients (79%) had a positive opinion of the acupuncture treatment. Forty-five patients (66%) requested acupuncture within two days of their death. There were 3 adverse events, but all were mild and transient, .[CONCLUSION] In the acupuncture treatment at our hospital for patients in the terminal stage of cancer, treatment was performed taking into consideration the risks to the patient, and there were no serious adverse events. There were many positive feedbacks from patients who received acupuncture, suggesting that acupuncture may be useful for alleviating symptoms at the end stage of cancer.

PURPOSE : To create a receiver operating characteristic curve (ROC curve) to screen for excessive sensitivity to cold (ESC).
PARTICIPANTS AND METHODS : Subjects were 99 women who visited a specialty outpatient clinic for ESC. The controls were 371 female nurses. A numerical rating scale (NRS ; from 0 indicating someone is asymptomatic to 10 indicating profound discomfort) was used to determine the extent of chills in both groups. ROC curves were created to distinguish ESC based on their score on the NRS. An ROC curve was created for each premenopausal and postmenopausal woman.
RESULTS : The ESC group had a mean score on the NRS of 7.3 (95% confidence interval [CI] : 6.9 to 7.6) while normal subjects had a mean score of 4.0 (CI : 3.7 to 4.3). The ESC group had a significantly higher mean score on the NRS. When the cut-off point for the NRS was set at ≥5, it had 98% sensitivity and 54% specificity for distinguishing premenopausal ESC. Similarly, that cut-off point had 96% sensitivity and 67% specificity for distinguishing postmenopausal ESC.
CONCLUSION : If an individual with chills has an NRS score of ≥5, that individual may be experiencing discomfort sufficient to warrant being seen by a medical facility. Using an NRS to assess chills should help to screen for ESC.

We present 16 cases effectively treated using the traditional Japanese herbal formulation tokishakuyakusan with the crude extract jio (tokishakuyakusan and shimotsuto). All patients were women with a median age of 35.5 years (range : 22-62 years). Cases included infertility (n = 5), dermatological disease (n = 5), gynecological disease (n = 2), excessive sensitivity to cold (n = 2), mental nerve paresthesia (n = 1), and general fatigue (n = 1). All patients had sho for tokishakuyakusan and high degree of ketsu deficiency. All patients with infertility became pregnant within one year. The symptom severity of other patients decreased to less than half compared with their initial visit. Cases of palmoplantar pustulosis and chronic eczema improved without topical corticosteroids. Our results suggest that tokishakuyakusan with jio is a suitable treatment for patients who have sho for tokishakuyakusan and high degree of ketsu deficiency.

PURPOSE : To examine the therapeutic efficacy of contact needle therapy (CNT) for peripheral facial paralysis
STUDY DESIGN : Case series study
METHODS : A total of 15 patients (Bell's palsy, 13 cases ; Ramsay Hunt syndrome) with peripheral facial paralysis who first visited between April 1, 2008 and March 31, 2013 and received CNT were examined in this study. Using the Yanagihara paralysis score, complete recovery was defined as a score improved to 36 within about 6 months of paralysis onset, and without moderate or worsened residual morbid synergic movements.
RESULTS : In all cases, the patient had received standard otological treatment. Median age was 65 years (range, 23-84 years). Median interval from onset of paralysis to first acupuncture treatment was 13 days (range, 4-105 days). Eight patients had an electroneurography (ENoG) value of < 10%. Eight patients achieved complete recovery. Two of the 8 patients with complete recovery had an ENoG value of < 10%.
CONCLUSION : Not only in-situ acupuncture and electroacupuncture treatments, but also CNT may represent effective acupuncture treatments for peripheral facial paralysis.

PURPOSE : To determine risk factors for excessive sensitivity to cold (ESC) in relation to physical features.DESIGN : A prospective cohort study carried out between July 7 and November 14,2008.PARTICIPANTS AND METHODS : Seventy female junior college students with no ESC at baseline, and a median age of 20 years, participated. We used a numerical rating scale (NRS) to classify each ESC sensation over the five days in this July-November period.To confirm physical symptoms, we used Terasawa's diagnostic scores for ki, ketsu, and sui. We defined ESC as mean NRSgeq ≥ 5.RESULTS : We documented 17 participants with ESC in November. The multivariate adjusted odds ratio for ESC was11.6 (95% CI 1.9 to 97.5) for the physical characteristic “edema”. Participants with ESC were shorter in stature than participants without ESC (-5.9cm ; 95% CI -8.6 to -3.1).CONCLUSION : Participants with edema and short stature have a high risk for ESC.