The skin has a special significance in acupuncture. In acupuncture, the skin is both a site of both examination and treatment while providing an interface for information exchange with the external world. Various findings that appear on the body surface should not simply be understood as dermatologic findings, but considered as a reflection of the internal condition of the body, the external world and the mental condition. From this perspective, although acupuncture treatment use only simple stimuli, such as needles, and stimulate only specific sites on the body surface, they can produce therapeutic effects and regulate physical and mental functions
In this symposium, we reviewed the relationship between skin and acupuncture by examining acupuncture and moxibustion treatments for specific dermatologic diseases and their clinical effects. As a result, we were able to reaffirm the above relationship from the perspective of an acupuncturist.
The methods and clinical effects of acupuncture and moxibustion treatment were introduced for atopic dermatitis (by Egawa), tinea unguium (by Dr. Menjou), and the dermatologic symptoms of connective tissue diseases (by Dr. Kasuya). Moreover, Dr. Kagawa presented his research results related to the effects of acupunctural stimulation on the condition of the skin. Based on these research results, the possible effects of acupuncture treatment were discussed based on extensive application in fields such as dermatology, cosmetics, and anti-ageing. Regarding the significance of the skin (body surface) within the practice of acupuncture, it was reconfirmed that the skin reflects the condition of the organs and the mind, and examination of the skin may elucidate both mental and physical health. In addition, we also discussed the body surface as a site of both examination and treatment, and investigated the efficacy, potential for further development, and significance of acupuncture, which connect the skin with systemic functions.

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The Research Committee for the Meridian Point held its third workshop at the 57th Annual Meeting of the Japan Society Acupuncture and Moxibustion in Kyoto. Evaluations and reports were presented on two topics.

The first topic:Study of PSC in Japan and China.
1) Literature search on PSC in China (Wang):A literature search on major studies on PSC in China since 1979 was conducted. The report introduces the definition, characteristics and the mechanism of PSC development together with meridian phenomena.

2) PSC in reference to the ryodoraku (Morikawa):Development of the reactive ryodo point in patients under hemodialysis or those who have had a total gastrectomy and the cases in which reactive ryodo points or needle sensation developed when specific regions were stimulated were reported. The relationship between reactive ryodo points and PSC was examined.

3) The mechanism by which PSC develops (Yamada):Neurotransmitter substances are released from sensory nerve endings during acupuncture stimulation. Absorbed by lymphatic vessels, these substances stimulate the smooth muscle of these vessels, thus causing the PSC. Based on factors such as transmission velocity and inhibitory factors, the mechanism by which PSC develops was investigated.

The second topic:Specific locations of meridian points and clinical effects of the meridian point.
1) Anatomical regions for GB 30 huantiao (Ozaki and Matsuoka):In establishing the international standard for the meridian points under the guidance of WHO, both Chinese and Japanese proposals were listed for GB 30. The clinical effects-presumably emanating from the subcutaneous structure when acupuncture stimuli are applied to these points in a direction perpendicular to the body surface-were comparatively evaluated.

2) Transition in the regions and main effects of GB 30 (Sakaguchi):As stated above, both Japanese and Chinese definitions were cited in establishing the international standard for GB 30 under the guidance of WHO. By quoting the classic literature from China and Japan, changes in the regions and main effects of GB 30 were comparatively evaluated.

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[Purpose]The purpose of this paper is to examine whether or not the Press Tack Needle (PTN) treatment enhances the recovery process from muscle fatigue which assists in the therapeutic exercise rehabilitation process. By using the PTN, this paper investigates the recovery effect of the fatigued muscle. Randomized controlled trials were used to compare outcomes.
[Method]Twenty-nine healthy male adults were chosen as subjects. However, crossover study was used to compare the PTN group and the sham group. After two sets of arm curl exercises with isotonic contraction at 10%weight of maximum voluntary contraction, the decrease percentage of exercise repetition was calculated. A PTN or sham was inserted at the posterior cervical region using the double masking method. After the intervention of the PTN or sham needle, the subjects were asked which intervention was inserted into them. A Kappa statistics value was used to evaluate the validity of the sham group and a Visual Analog Scale (VAS) was used to determine the upper arm fatigue.
[Result]The Kappa statistic value was 0.17. The decrease percentage of the exercise repetition of the PTN group was 35.4±20.1%, and of the sham group was 45.1±11.1%. The PTN group indicated a significantly smaller percentage than the sham group (p<0.01). Both groups showed no difference in Upper arm fatigue.
[Conclusion]The PTN seems to help in recovery from muscle fatigue. It is thought that by inserting the PTN, somato-automomic reflex was induced to promote the increase of blood flow in to the muscle. Faster recovery of physical function of the patient can be possible as well as the improvement of QOL. In conclusion, this investigation showed that the PTN treatment method can be useful in assisting in therapeutic exercise rehabilitation.

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[Objective]To evaluate the efficacy of the different depth of acupuncture on the motor function and the pain with osteoarthritis of the knee.
[Design]Single blind randomized controlled trial.
[Method]Subjects were randomly allocated to one of two groups. Acupuncture needles were inserted about 3mm in the superficial acupuncture group and 10 to 20 mm in the deep acupuncture group. Subjects in both groups received the treatments for ten minutes on ten tender points. Acupuncture sessions were performed once a week for 8 weeks and without treatment 4 weeks.
[Outcome Measures]Pain intensity (visual analogue scale :VAS) , Objective evaluation of the motor function (Timed Up &Go test, 20m walking time, Time of going up and down stairs) and QOL (Western Ontario and MacMaster Universities osteoarthritis index :WOMAC).
All measurements were recorded at baseline, 4th, 8th and 11thweek.
[Result]Motor function improved significantly only in the superficial acupuncture group(P<0.05). The degree of pain decreased significantly in both groups (P<0.05).
[Conclusion]Superficial acupuncture provided the improvements on pain and motor function and contributed to the QOL improvement. Therefore the superficial acupuncture would be suggested to be one of the most effective method for the acupuncture treatment of OA of the knee.

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[Objective]In order to provide proper educational guidance to work-study students attending an acupuncture school, learning-related standards were prepared by conducting an exploratory inventory survey, and the relationships among willingness to learn, average test scores, and the number of absences was investigated.
[Methods]Subjects were 234 work-study students majoring in acupuncture at a vocational school. The construct validity of the standards and the verification validity of external variables were investigated using exploratory factor analysis and structural equation modeling.
[Results]The results of exploratory factor analysis revealed the following four factors affecting learning:fatigue, willingness to learn, career matching, and class environment. With verification validity, a model having the number of absences at the center matched the data well (GFI=0.959, AGFI=0.929, RMSEA=0.057, and CFI=0.912).
[Conclusion]For proper educational guidance, the establishment of guidance based on the number of absences-which is affected by willingness to learn and in turn affects average test scores-appears valid.

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[Objective]We examined the effects of acupuncture treatment at Sanyinjiao (SP6) on menstrual pain in female students. In addition, the correlation between the effects of acupuncture treatment and the neurosis were evaluated.
[Methods]Fifty-one female students were participated in this study as the subject. Acupuncture treatment using Ringheaded thumbtack needle were performed to bilateral SP6 for the three months. Non-treatment periods for three months were set in before and after acupuncture period, respectively. Patients received the Ringheaded thumbtack needle through four days in a week. The effectiveness of treatment was evaluated using the categorical scale for the severity of menstrual pain accompany with numbers of taking drugs for analgesic. To evaluate the correlation between effects of acupuncture and neurosis, the tendency of neurosis was confirmed by cornel medical index (CMI) and the perimenstrual symptoms were confirmed by menstrual distress questionnaire (MDQ).
[Results]Twenty-seven subjects were analyzed for evaluation in this present study. During Ringheaded thumbtack needle treatment periods (acupuncture periods), menstrual pain had reduced into 48%of subjects. The number of taking drugs for analgesic was decreased with the reduction of severity of menstrual pain during acupuncture periods (p<0.05). The correlation between the effect of acupuncture and the tendency of neurosis were observed. Acupuncture improved the menstrual pain in the subjects who belong to category I and/or II of CMI. However, no remarkable changes were observed in the III and/or IV subjects of CMI. Furthermore, the high score of fives specific pain into MDQ (shoulder pain, headache, etc) and negative feelings factor were obtained in subjects who accompany with strong menstrual pain still after acupuncture
[Discussion]These findings suggest that menstrual pain was reduced by Ringheaded thumbtack needle to bilateral SP6. Additionally this result was influenced by a psychological factor and/or some kind of pain which is not only menstrual pain.

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[Objective]To research a effect of prevention against cold syndrome by acupuncture
[Methods]I questioned 215 patients who come to the acupuncture and moxibustion clinic to oriental medical center group.
Contents of the question
From when you come to needle therapy
A:your body is strong for cold syndrome
B:no change
C:you are weak for cold syndrome
[Results]63.4%of the patients marked "A:your body is strong for cold syndrome ".Percentage of answered A.Come to oriental medical center group for
less than 2 years: 45.9%
over 2 years and less than 4 years: 63.3%
over 4 years: 82.8%
[Conclusions]Acupuncture is a good way for prevention against cold syndrome. And the result say that the more you come to acupuncture, the more you are strong for cold syndrome.

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