In recent years, we have been told that the western medicine has developed the techniques of treatments on cancer, but the truth is that very few practical accomplishments has been made, while death rate from cancer has been steadily increasing. Although acupuncture has been thought to be ineffective in the treatments of cancer, nowadays we find some reports concerning its effectiveness in palliative cares, improvements of quality of life (QOL) and cancer regressions. Thus, this symposium was planned to investigate this theme. There were reports from appointed speakers on the acupuncturists' feelings of swung back and forth between joy and despair when treating patients with cancer, the experiences in treating her parents who died of lung cancer, and the patients who failed or rejected to be treated in western medicine but successfully treated using acupuncture eventually.
A panelist who practices acupuncture treatments in a hospital reported the effectiveness and indications on combined application of acupuncture and standard treatments for the patients in the terminal stage of cancer. He also reported that no correlation had been found between effective rates and duration (frequency) of treatments neither between stages (duration) of disorders and efficacy. Furthermore, if the environment of acupuncture treatment is well organized, he mentioned that acupuncture can produce a good deal of effect even in patients with terminal stage. He also reported that acupuncture will be able to influence on the physiology in autonomic nervous system, leading to the hyperactivity of parasympathetic nerve.
A panelist who practices his acupuncture treatments based on the theory of Professor Abo reported the effectiveness of acupuncture in improving QOL and in prolonging one's life. He showed an actual situation of the patient with scirrhous carcinoma who had prolonged his life for a long period using acupuncture treatment. He also demonstrated that radiotherapy, one of the three major medical treatments for cancer, will deprive the resistance of the patients.
A panelist who advocates salutogenesis demonstrated the possibility of the direct effectiveness of acupuncture treatment on cancer because acupuncture has significant effects in alleviating pains and enhancing the power of restoring human energy in patients with cancer. He mentioned the limitation of the treatments using “a theory of pathogenesis (modern medicine)” and the importance of the treatments using “a theory of salutogenesis (traditional medicine)”, and emphasized the necessity of acupuncture treatments as well as supplemental agents, and the importance of psychological approaches toward the mind of patients.
In this symposium, the efficacy of acupuncture treatments as palliative cares was indicated. Although there are few convincing evidences, the efficacy of acupuncture treatments as one of treatment methods for cancer may be demonstrated. Further integrative researches on the efficacy of acupuncture in patients with cancer are needed.

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In this paper we introduce recent developments in the studies of brain activation during somatosensory stimulationexploiting new technologies. Somatosensory stimulation such as acupuncture, inauces tocai activation in tne central nervous system. The electroencephalogram is a popular method to investigate this activation, however, it is difficult to identify the exact location of the activation site. Recent new technologies may provide more accurate localization. Besides magnetoencephalography (MEG), which recognizes the activated brain areas by an evoked magnetic field with induced current, two other methodologies, which take advantage of physiological phenomena occurring during brain activation, were used in this functional study. Following excitation of neurons, brain tissue is supplied with oxygen from oxyhemoglobin causing oxyhemoglobin to turn into deoxyhemoglobin. As a consequence deoxyhemoglobin increases in the brain tissue. In the near-infrared spectrum, the deoxyhemoglobin absorption peak shows higher signal intensity than that of oxyhemoglobin, for which reason activated brain areas can be identified by absorption maps. In functional magnetic resonance imaging (fMRI) activated area can be revealed with high spatial resolution due to the change in magnetic susceptibility of deoxygeneated blood. This paper describes fMRI studies employing these three methods for the evaluation of experiments using acupuncture for focal brain activation.

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In this seminar, the effects of acupuncture and moxibustion on muscle diseases and muscular functions/metabolism were reported, and the status of these techniques were summarized.
In the clinical study section, it was reported that the effects of treatment on muscle diseases and muscular functions were evaluated using objective criteria, such as electromyograms. In the review of the methods for the evaluation of muscular functions using surface electromyograms, the static electromyograms, dynamic electromyograms, and power-spectrum analysis were presented, and the effects of acupuncture and manual treatment on diseases mainly in locomotor organs and their problems were discussed. For example, 72.9% of the 48 patients with cervical dystonia were found to show improvement by 10 courses of acupuncture treatment, and effects were observed in all patients by electromyography. Similar effects were obtained with patients with drug-induced dystonia. In many of the patients with writer's cramp who underwent 10 courses of acupuncture treatment, improvement in writing tests, subjective evaluation, and the strength of pen stokes were observed.
In the review of the basic studies, the effects of acupuncture, electroacupuncture, and transcutaneous electrical nerve stimulation (TENS) on muscular tension, muscular metabolism (energy metabolism, intracellular pH, lactate metabolism), muscular circulation, and noxious and non-noxious motor reflex were surveyed, and their mechanisms and problems were discussed.

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The first Japan-Korea workshop on acupuncture and EBM was held on June 4, 2004 at Chiba in the 53rd annual scientific meeting of the JSAM. The purpose of this workshop was to exchange the experiences of clinical researches on acupuncture and moxibustion therapies, and to find out the issues and their solutions for developing the excellent clinical research to establish strong evidence. The final purpose was to develop aprotocol for the collaborative work between both countries.
Drs. Kawakita (JSAM) and Jang (KAMS) chaired the workshop. Three speakers from Japan (Drs Takahashi, Nabeta, and Tsukayama) and three Korean speakers (Drs Seo, Lee and Moon) presented their data on the clinical researches of acupuncture, moxibustion and bee-venom injection. After their paper presentations, various issues were discussed on their research methodology for establishing more strong evidence of acupuncture.We got interesting new findings and understood various issues for conducting clinical researches especially RCT.
Although we could not develop a protocol for the collaborative research in this workshop, it was very fruitful workshop as the first step for the future Japan-Korea collaborative clinical study. The most important product of this workshop was we could understand each other and we confirmed the necessity of the future collaborative clinical research on acupuncture.

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Knowledge and procedures regarding safe acupuncture practices often include conjecture and anecdotes lack-ing scientific evidence. In order to improve the safety standards of acupuncture, we should collect, scrutinize, and apply evidence on the safe management of acupuncture. We, the Committee for Safe Acupuncture, have commenced collecting and reviewing relevant evidence published. Subjects in 2004 were as follows :
1. The present situation of safety education and damages (by Katai)
2. Hand washing and finger disinfection (by Ishizaki)
3. Disinfection of the needle insertion area (by Umeda)
4. Procedures of needle insertion and removal (by Miyamoto)
5. Safe insertion depth (by Yamashita)
6. Environmental sanitation (by Egawa)
We hope that the knowledge and questions which come to light through the present work will influence school education, clinical practice, manual editing and research activities.

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[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

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[objective] Using a questionnaire survey, we investigated the state of clinical training for Anma-Massage-Shiatsu, Acupuncture and Moxibustion at Japanese acupuncture school training centers (included were schools for the blind and colleges for the non visually impaired)
[DesignandMethods] We sent a 5 point questionnaire consisting of 49 questions concerning the state of clinicaltraining to 121 acupuncture schools in Japan. All these schools are listed in the 2002' List of Colleges published by the Foundation for Training and Licensure Examination in Anma-Massage-Shiatsu, Acupuncture and Moxibustion.
[Results] The response rate was 82.6% (100/121). Ninety-two schools have Acupuncture clinics open to the publicand 7 schools have Western Medical Clinics. Twenty-four percent of the schools in the survey have not registered their acupuncture clinics with the Governor of the Prefecture. Of the schools that responded 93.1% used disposable acupuncture needles, although 85.2% of the schools did not use needles only once, as recommended. While 49.4% (42/85) of the schools reported some adverse events at their clinics, 49.0% of the schools hold a liability insurance. Many acupuncture clinics at schools for the blind were established before the 1930's. During their clinical training, students at these schools are responsible for the majority (93.8%) of the patients' treatments. Clinical fees at these acupuncture clinics were under 525 yen. On the other hand, most of these clinics at acupuncture colleges for the non visually impaired were established in the 1990's after an amendment in the Law. Therapists at these colleges are largely responsible (82.1 %) for clinical treatments during the students' clinical training. Fees at these clinics were between 1576 yen and 2100 yen.
[Conclusion] The state of clinical training for Japanese Anma-Massage-Shiatsu, Acupuncture and Moxibustion education was only elucidated to a small extent. Clinics must improve safety precautions and reassess risk management strategies. Another survey is necessary to define global standards of clinical acupuncture and moxibustion styles. In order to suggest standard policies for clinical management further study is necessary.

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[Objective and method] We developed a questionnaire for 117 second graders in the fiscal year of 1999 in order to perform curriculum evaluation of Meridians and Acupuncture Points. Furthermore, based on the result, a part of the curriculum was changed and the effect was examined. Curriculum evaluation, using the same questionnaire which in the fiscal year of 1999, was performed for 117 second graders in the fiscal year of 2000, and compared with the results in the fiscal year of 1999.
[Results] Of the items addressed, “Teachers were eager”, “Teachers responded to the question or consultation well”, and “Materials were useful to understanding” had higher scores. On the other hand, “Time was spent effectively”, “Progress of the lesson was suitable”, “The class was well prepared” and “Time to perform practical skills was suitable” had lower scores. After the change of the curriculum method, the results indicated that the following items; “The class was well prepared”, “Time was spent effectively”, “Teachers responded to the question or consultation well”, “Progress of the lesson was suitable”, “Time to perform practical skills was suitable” and “Materials were useful to understanding” showed a significant increase in the affirmative opinion as compared with the fiscal year of 1999.
[Conclusion] The curriculum evaluation by the students was useful for improvement of the curriculum and increased the students' motivation to study.

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[Objective] It is necessary to administer anti-cholinergic agents or glucagon during gastroscopy for inhibition of gastric peristalsis. However, application of these drugs are limited in patients with glaucoma, hypertension, benign prostate hyperplasia, heart disease, or diabetes mellitus because of possible adverse events.
Based on the report that acupuncture stimulation at CV 12 (Zhonguan, Chukan) inhibited gastric activity, we studied whether the acupuncture at CV 12 could be applicable as an alternative to these drugs.
[Method] Subjects in the present study were 60 patients who underwent gastroscopy at Meiji University of Oriental Medicine Hospital. They were allocated into two groups; acupuncture group (mean [SD] age, 66 [10]) and drug group (mean [SD] age, 64 [13])
Patients in the acupuncture group were given manual stimulation at CV 12 with an acupuncture needle for 10 minutes before examination and during gastroscopy.
After examination, a gastroscopist evaluated the magnitude of the peristalsis and disturbance during the examination using the visual analogue scale (VAS) and a 4-grade categorical scale.
Patients in the drug group were pre-administered anti-cholinergic drug or glucagon, and evaluated with the same scale.
[Results and Discussion] Inhibition score in the acupuncture group was lower but not statistically significant, as compared with the drug group, and the effect of acupuncture stimulation was acceptable to allow examination of the patients without severe disturbance.
Acupuncture may be a useful non-pharmacologic alternative to anti-cholinergic drugs and glucagon to inhibit gastric movement during gastroscopy, when these drugs could not be administered.

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