[Objective]The skin is the biggest organ in the body. The human epidermis functions as a defence against various antigens in addition to physical and bio-chemical protection. The dermis consists of dense connective tissue which contains the circulatory system and sensory nerve endings. In this paper, regional differences in the structures of human skin are described.
[Materials and Methods]The skin of different regions in the human body was examined by optical and electron microscopy and by utilizing various morphological techniques.
[Results and Discussion]Epidermis:The cornified layer in the finger pulp and heel, which receives strong mechanical stimuli, is considerably thicker than other regions. The germinal layer consisting of spinous and basal layers becomes thinner with aging. Langerhans cells that produce antigens are scattered in the germinal layer. Furthermore, Merkel cells situated at the basal layer are found in the finger pulp, bottom of the foot and the hair disks of limbs. These cells are involved in the sense of touch or pressure. Dermis:The dermis is divided into the papillary and reticular layers, which consist of loose and dense connective tissue, respectively. In the papillary layer, fibrocytes and mast cells are distributed. Large-sized dermal papillae are found the in finger pulp and bottom of the foot, but there are also a few small papillae in other regions. In large papillae, loops of blood capillaries and Meissner's tactile corpuscles were observed. In addition, large-sized lymphatic capillaries are present in the papillary layer.A dense network of free endings, which are situated beneath the epidermis and are responsible for thermal nociception, are abundant in the face, palm, forearm and sacrum. Corpuscles of Vater-Pacini situated in the deep dermis or subcutaneous tissue are found in the finger pulp, and bottom of the foot.
[Conclusion]In conclusion, it is likely that acupuncture and moxibustion may directly or indirectly stimulate Langerhans cells, Merkel cells, fibrocytes, mast cells or various nerve endings.

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Various approaches to stroke rehabilitation, such as facilitation techniques including proprioceptive neuromuscural facilitation techniques (PNF), Brunnstrom's approach, and Bobath's approach, have been studied to improve the functional recovery of hemiplegia due to brain damage. However, there is some controversy surrounding these facilitation techniques with regard to their efficacy in stroke rehabilitation. Specifically, there is insufficient evidence that these techniques are superior to conventional exercise therapies.
Recent studies have shown that brain plasticity results in functional recovery in humans. Recovery depends on the plasticity of the synapse, and changes in the strength of a synapse are controlled by a basic mechanism:An increase in synaptic efficacy arises from the repeated stimulation of the postsynaptic cell by the presynaptic cell. The basic theory of repetitive facilitation exercises (RFE) using novel facilitation methods for the hemiplegic limb mainly aim to strengthen the neuronal circuits through the injured descending motor tracts by repetition of the movements that are to be recovered. The patient's intentions to move the hemiplegic limb are realized by using multiple sensory stimulations to target the neural circuits related to each movement. The effects of RFE on the functional recovery of hemiplegic limbs have been confirmed by scientific studies.
Combined therapy using vibratory or electrical stimulation might promote efficacy of RFEs for patients with hemiplegia.

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[Objective]Menstrual disorders are generic symptoms that appear during a menstrual cycle. In this study we examined three years of medical records retrospectively in order to investigate the effects of acupuncture treatment on menstrual disorders. We compared a group of women with diseases 'D'with to no diseases 'N'with respect to the effects of short-term acupuncture treatment.
[Methodology]Subjects for this research were 203women with menstrual disorders who came to our office during the period January 2009 -March 2012. The only treatment they were given was traditional Chinese medicine. We used BL 32, BL 35, GV 2, GV 4, and SP 6 as acupuncture points. We inserted stainless steel acupuncture needles (40 mm long, 1.8 mm in diameter) to a depth of 20 mm at BL 32 and 10 mm at SP 6. Other points were treated three times with kyubu-moxibution (burnt 90%). Treatment was provided once every 1-2 weeks. A Menstrual Distress Questionnaire (MDQ) was used to judge treatment effectiveness. We classified the 203women into two groups;one was 'D'group (n = 46) and the other was 'N'group (n = 157). Concerning the eight items from the MDQ we compared each woman's condition before the first treatment after one menstrual cycle. This time we paid attention to premenstrual and menstrual periods. 'D'group was observed through three menstrual cycles.
[Results]The average number of treatments during one menstrual cycle was 2.2. Both groups had reduced scores for 6 prementstrual symptoms (p < 0.05). During menstrual period, 'D'had reduced scores for 3items, 'N'had reduced scores for 5 items;(p < 0.05). 'D'confirmed continuous effects of treatment. The effects on premenstrual symptoms were confirmed, "Pain"during all three menstrual cycles, "Water retention"during the second and third menstrual cycles, and "Concentration"during the third menstrual cycle. The effects during the menstrual period were also confirmed, "Pain"for all three menstrual cycles, and "Water retention"and "Behavioral change"during the third menstrual period (p < 0.05).
[Discussion]Concerning the effects of acupuncture treatment for menstrual disorders, 'D'had higher MDQ scores than 'N'. After one menstrual cycle, 'D'showed less improvement of MDQ items than 'N'. But continuous acupuncture treatments reduced menstrual disorder symptoms for 'D'.
[Conclusion]We have confirmed the effects of acupuncture treatment on menstrual cycle symptoms. In one menstrual cycle, 'N'showed more improvement than 'D'. But during three menstrual cycles 'N'experienced continuous effects of treatment.

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[Objective]Although warm-tube moxibustion is easy-to-use in acupuncture therapy, the timing of moxa removal varies among practitioners. In the present study, we used near infrared spectroscopy (NIRS) to compare effects of different durations of moxibustion stimulation on improvement in local circulation as measured by changes in blood oxygenation dynamics in muscle tissue.
[Methods]Twelve healthy adults underwent warm-tube moxibustion with a single cone applied to the upper right shoulder region;measurements of tissue blood oxygenation dynamics (ΔOxy-Hb, ΔTotal-Hb) were obtained at intervals of 0.5 s. Control measurements were first taken for 15 min without intervention (Control);then, subjects received moxibustion 2 min after the start of measurement and had the moxa removed at the following time points: 30 s after patients experienced heat pain (Removal 30, moxibustion group); 45 s after heat pain (Removal 45, moxibustion group);or did not have the moxa removed (Continuous moxibustion group). These 4 different conditions were compared. Additionally, we determined the burning temperature of moxa and the skin temperature and intensity of heat pain sensation at the site of moxibustion.
[Results]Compared with the Control, the Removal 30, Removal 45, and Continuous moxibustion groups had significant increases in ΔOxy-Hb, ΔTotal-Hb, and skin temperature, with no significant differences among the moxibustion groups. No significant difference in the intensity of heat pain sensation was observed among the moxibustion groups. All moxibustion groups began to show rapid increases in both ΔTotal-Hb and ΔOxy-Hb around the time when subjects began to feel heat pain, suggesting that the axon reflex evoked by noxious stimuli of heat pain increased blood volume and arterial blood flow.
[Conclusion]Hemodynamic improvement in muscle tissue through the use of continuous warm-tube moxibustion for 30 s or longer after the occurrence of heat pain was confirmed.

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[Objective]The purpose of this study was the analysis of factors that are connected with acupuncturists'hand hygiene, and suggestions for improvement of hand hygiene inclinical practice of acupuncture.
[Design]A cross-sectional study.
[Methods]Subjects were 122 acupuncturists. Using a questionnaire, we investigated the difference in years of experience, daily number of patients, therapy policy, method of needle insertion, education, gender and age according to the difference in hand hygiene behavior. Furthermore, each items relation to hand hygiene behavior was examined.
[Results]The number of valid responses was 109 (89.3%). The group that does not wash its hands had a younger average age (P<0.01), shortness of clinical experience (P<0.01), and much higher number of patients per day (P<0.05) as compared with the group that washes its hands. The group with the behavior of using tools to prevent bare hands from touching needles (tools such as individual finger stalls) had a high ratio of a policy of contemporary medicine (P<0.05) and experience of education (P<0.05) as compared with the group using bare hands. Neglectfulness of hand washing was associated with younger age [odds ratio (OR) = 1.10, 95%confidence interval (CI) = 1.01-1.20]and higher daily number of patients (OR = 0.90, 95%CI = 0.83-0.98). Furthermore, behaviors of the use of tools such as individual finger stalls was related to experience of education (OR = 3.45, 95%CI = 1.27-9.36).
[Conclusion]Performance of hand washing before therapy is related with youth and greater numbers of patients per day, which cause hygiene neglect. Educational experience promotes the use of tools such as individual finger stalls.

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[Objective] The purpose of this study is to examine the effects of press tack needles (PTNs) on subjective assessment of symptoms such as heaviness, stiffness and lassitude in the lower limbs during walking, or in everyday life. Sham PTNs are used for the purpose of comparison.
[Methods] The subject is a male in his seventies who has a daily routine of walking 10,000 steps; experiences heaviness, stiffness and lassitude in his lower limbs; and has spinal or internal disease. Intervention: PTNs or sham PTNs are randomly chosen and worn on the subject's body for two days. The subject fills out a questionnaire regarding subjective assessment of symptom relief in his lower limbs during the following three time periods; in advance of the use of PTN, in the evening during the use of PTN, and the following evening. PTNs are applied to a total of 10 sites around both sides of his lower limbs depending on symptomatic or tender areas. Assessment: A questionnaire, in which a Visual Analog Scale (VAS) is introduced, is filled out three times per trial, that is, thirty records from ten trials are finally kept. Differences can be seen in the result answered the following evening. The results regarding the use of PTNs and the results regarding the use of sham PTN are analyzed respectively by randomization test (R test).
[Result] Significant difference was shown in the heaviness of the lower limbs for both the PTN and sham in the evening of the next day (P < 0.05). Significant difference was shown in the stiffness of the lower limbs for both the PTN and sham in the evening of the next day (P < 0.05).
[Conclusion] A PTN is attached for two days when there is a feeling in the lower limbs of heaviness and stiffness, even with spinal disease, liver disease or varicose veins in the lower extremities. It is suggested that PTNs are effective in decrease of symptoms.

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