bluuebunny/crossref_metadata_2025 huggingface dataset:
Post-Radiotherapy Acupuncture
Authors: Rajan Shanti
Published: April 2009

Shortly following mastectomy and radiotherapy 17 years ago for cancer of the breast, post-radiation brachial plexus neuralgia had developed, together with a weeping radiation ulcer along the scar. The lady also suffered from multiple sclerosis with peripheral sensation loss, such that she was unable to walk properly, often burnt her hands and arms, and could not manage fine movements of the fingers. Simple manual acupuncture treatment gave rapid pain relief, induced healing of the ulcer, and restored peripheral sensation.
Acupuncture in Neuromuscular Lesions of Animals
Authors: Altuğ ME , Tekeoğlu I , Alkan I , Atasoy N , Keleş I
Published: April 2009

Acupuncture treatments are described in a dog with thoracic disc herniation, a cat with spinal injury, a dog with neurological disorders caused by cerebral contusion and two cross-bred calves with spastic paresis. The beneficial effects of acupuncture are reported: notably improvements in the extensor thrust, patella and coccygeal reflexes, balance, defaecation and micturition.
The Cun Measurement System: An Investigation into Its Suitability in Current Practice
Authors: Coyle Meaghan , Aird Mark , Cobbin DM , Zaslawski C
Published: April 2009

The Chinese anatomical inch (cun) measurement system is an essential component of traditional point location methods used in acupuncture. This study used the cun system to investigate any variation between the traditional measurements and the sample means for selected finger measurements, and for the forearm and lower leg lengths obtained from 50 volunteer subjects randomly selected from staff and students of the College of Traditional Chinese Medicine, University of Technology, Sydney. Subjects were seated while the finger and arm measurements were recorded, and were standing for leg measurement. Data were converted to ratios for analysis, with the one cun measurement for the thumb designated as the standard.

There were significant differences between the traditional measurements and the sample means for all hand and leg measurements in the sample. The results were generally the same for gender and the age groups studied. The authors conclude that the cun measurement system does not provide accurate estimates for contemporary Australian adults with respect to hand and lower leg measurements nor, to a lesser extent, with respect to measurements of the forearm. Consequently, it is recommended that methods of point location that are less reliant on the cun measurements (such as the proportional method) should be used in preference to the cundependent directional method.
Treatment of Hot Flushes in Breast Cancer Patients with Acupuncture
Authors: Tukmachi Emad
Published: April 2009

A common treatment for post-menopausal hot flushes is to raise oestrogen levels with hormone replacement therapy. However this option is not considered suitable for breast cancer patients with hormone sensitive carcinoma, since an increase in oestrogen is contraindicated. This leaves little available as an effective conventional therapy.

There has been some evidence that acupuncture is a suitable treatment for hot flushes, so a series of 22 consecutive breast cancer patients referred by an oncologist for treatment of hot flushes were given a course of classical body acupuncture with two 20–30min treatment sessions per week for up to 7 weeks. The frequency of recorded hot flushes (both day and night) had improved significantly (p<0.001) by the end of treatment. All patients claimed some benefit and 82% had effective relief.
Treatment of Gout with Acupuncture
Authors: Jun Pang , Bo-ling Huang , Yu-shun Li , Yu-yan Zhou , Zhi-yong Han , Richardson Faye
Published: April 2009

Gout is a disorder of purine metabolism in which a high serum uric acid is found and there is deposit of urate crystals within joints causing exquisite pain and tenderness. The pharmacological treatment relies upon non-steroidal anti-inflammatory drugs in the acute stage, and prophylactic drugs in the chronic state to control the level of circulating uric acid.

In traditional Chinese medicine an over-rich diet is thought to cause a build-up of damp and heat internally that causes phlegm to stagnate. There is also disturbance of the Spleen and Kidney. Treatment thus involves Spleen and Stomach acupuncture points (SP.3 and 6, and ST.36 and 40) to control heat and damp and reduce phlegm. Other local points are used according to the joint involved.

A case history is discussed illustrating the treatment and a series of 10 patients is reported in which there is a 70% success in reducing the chronic level of serum uric acid and the frequency of acute attacks.
Acupuncture for Vulval and Back Pain: Phantom Needle Response?
Authors: Tang Alan
Published: April 2009

A patient's chronic vulval pain was unsuccessfully treated with acupuncture, while concurrent treatment for back pain was successful. Trigger points in the paraspinal muscles were needled with resultant cutaneous flares, some of which appeared in the spaces between needles, and might represent a new phenomenon of phantom needles.
Effect of Acupuncture on Knee Function in Advanced Osteoarthritis of the Knee: A Prospective, Non-Randomised Controlled Study
Authors: Tillu Abhay , Tillu Sumedha , Vowler Sarah
Published: April 2009

We report a prospective controlled trial, comparing acupuncture with no treatment, in patients with advanced osteoarthritis of the knee awaiting total knee replacement. Knee function was assessed at the beginning of study and at the end of two months, using four parameters: HSS score, time to walk 50 metres, time to climb 20 steps, and degree of pain. Acupuncture was given at four local points around the knee and at one distal point. The acupuncture group improved in all parameters, whereas the control group deteriorated, a finding that was highly statistically significant (p<0.0002). Further randomised-controlled trials with longer follow-up are required to confirm these findings.
The Reliable Measurement of Radial Pulse: Gender Differences in Pulse Profiles
Authors: King Emma , Cobbin Deirdre , Ryan Damien
Published: April 2009

This study was undertaken to determine whether healthy adults exhibited characteristic pulse profiles. Pulse characteristics measured for 83 women and 65 men included presence at the Traditional Chinese Medicine (TCM) locations ( Cun, Guan, Chi); and depth (superficial, middle, deep), overall pulse force, relative pulse force, pulse width and pulse rhythm. Most subjects had similar values for many of the characteristics investigated including relative pulse force at the three traditional palpation locations ( Cun, Guan and Chi), pulse width and pulse rhythm. There were some significant gender differences. The pulse was present beyond Chi in 90% of males compared with 56% of females. Female pulses tended to be less forceful compared with males. However, with the exception of overall force, there was little support for TCM assumptions of gender differences in pulse such as in left/right balance. There was some support for the use of the TCM palpation locations Cun, Guan and Chi to discriminate between pulses since there was significant differences in manifestations of some pulse characteristics among these locations.
Anatomy for the Acupuncturist – Facts & Fiction 1: The Head and Neck Region
Authors: Peuker Elmar , Cummings Mike
Published: April 2009

Knowledge of anatomy, and the skill to apply it, is arguably the most important facet of safe and competent acupuncture practice. The authors believe that an acupuncturist should always know where the tip of their needle lies with respect to the relevant anatomy so that vital structures can be avoided and the intended target for stimulation can be reached.
Low Back Pain in Pregnancy
Authors: Forrester Max
Published: April 2009

The aim of this case report is to discuss the subject of acupuncture in pregnancy and which acupuncture points, or areas, are safe to needle. Low back pain in a 21-year-old Caucasian primigravida at 24 weeks gestation was incapacitating and acupuncture was offered. Prior to pregnancy investigations had excluded a serious organic cause and acupuncture was employed successfully to control pain and improve function. Acupuncture can be offered to sufferers of low back pain in pregnancy after risk / benefit analysis is undertaken and informed patient consent is obtained.
Acupuncture for Low Back Pain in Pregnancy
Authors: Cummings Mike
Published: April 2009

Medical doctors are particularly cautious about using acupuncture in pregnancy. This derives from the mostly historical and anecdotal claims that acupuncture can promote abortion, coupled with the fact that spontaneous early pregnancy loss is common, and litigation is increasing. This case report describes the circumstances that lead to the author using deep paraspinal and periosteal acupuncture throughout a patient's pregnancy to help control her low back pain.
Acupuncture Research - the First 10 Years in Exeter
Authors: Ernst E
Published: April 2009

For 10 years, our unit has intensively researched the efficacy and safety of acupuncture. This is a brief summary of our work in this area. Specifically, it deals with the development of a sham needle, with various systematic reviews and prospective studies in the area of safety, and with our clinical trials and systematic reviews on efficacy. We also hope in the future that we will be able to contribute to the understanding of acupuncture as a therapeutic modality.
The Effect of Acupuncture on the Symptoms of Knee Osteoarthritis - An Open Randomised Controlled Study
Authors: Tukmachi Emad , Jubb Ronald , Dempsey Emma , Jones Peter
Published: April 2009

Background

Using an open randomised controlled study, we examined the effectiveness of manual and electroacupuncture on symptom relief for patients with osteoarthritis of the knee.

Methods

Patients with symptomatic osteoarthritis of the knee were randomised to one of three treatment groups. Group A had acupuncture alone, group B had acupuncture but continued on their symptomatic medication, and group C used their symptomatic medication for the first five weeks and then had a course of acupuncture added. Patients receiving acupuncture were treated twice weekly over five weeks. Needles were inserted (with manual and electrical stimulation) in acupuncture points for pain and stiffness, selected according to traditional acupuncture theory for treating Bi syndrome. Patients were assessed by a blinded observer before treatment, after five weeks’ treatment and at one month follow up, using a visual analogue pain scale (VAS) and the Western Ontario McMaster (WOMAC) questionnaire for osteoarthritis of the knee.

Results

The 30 patients in our study were well matched for age, body mass index, disease duration, baseline VAS pain score and baseline WOMAC scores. Repeated measure analyses gave a highly significant improvement in pain (VAS) after the courses of acupuncture in groups A (P=0.012) and B (P=0.001); there was no change in group C until after the course of acupuncture, when the improvement was significant (P=0.001). Similarly significant changes were seen with the WOMAC pain and stiffness scores. These benefits were maintained during the one month after the course of acupuncture. Patients’ rating of global assessment was higher than that of the acupuncturist.

Conclusion

We conclude that manual and electroacupuncture causes a significant improvement in the symptoms of osteoarthritis of the knee, either on its own or as an adjunct therapy, with no loss of benefit after one month.
Acupuncture and Moxibustion as An Adjunctive Treatment for Osteoarthritis of the Knee - a Large Case Series
Authors: Vas Jorge , Perea-Milla Emilio , Méndez Camila
Published: April 2009

Background

In 1997, the first Pain Management Unit, which was set up as part of primary health care within the Andalusian Public Health System, offered acupuncture among other therapies. This observational study was conducted in preparation for a randomised controlled trial.

Methods

We conducted a descriptive study of patients who had been diagnosed with osteoarthritis of the knee. The patients received weekly acupuncture treatment, and related techniques, from November 1997 to November 2000. We recorded: socio-demographic data; measures of effectiveness, including intensity and frequency of pain; the daily dose of analgesic and anti-inflammatory medication; the degree of incapacity; and sleep disorders caused by pain in the knee.

Results

The 563 patients who presented were mainly female (88%) with an average age of 65 years (±10.7); the average age of the male patients was 67 years (±11.8). The condition in most patients (95%) was chronic: 54% had the condition for 5-10 years and a further 23% for more than 10 years. Of the total, 85 (15%) abandoned treatment and were excluded from the evaluation, while 75% of the remainder achieved a reduction in pain of 45% or more. This study is intended to form the basis for a subsequent controlled clinical trial of the effectiveness of acupuncture as a treatment for osteoarthritis of the knee.

Conclusion

The degree of pain relief experienced by patients from acupuncture justifies a more rigorous study.
Case Report of Tension Pneumothorax Related to Acupuncture
Authors: Peuker Elmar
Published: April 2009

Although recent prospective studies came to the conclusion that the incidence of adverse events following acupuncture can be classified as minimal, many cases of acupuncture-related pneumothorax have been published over the years, among them some cases of tension pneumothorax. In this case, a slender woman received acupuncture from a fully trained medical acupuncturist including needling of the points LU1 in the subacromial region and BL13, which is a paravertebral point at the level of the spinous process of the third thoracic vertebra. During the final treatment, she experienced difficulties in breathing and pain in the left chest. On x ray examination a tension pneumothorax was diagnosed. Even though pneumothorax is the most frequently reported serious complication related to acupuncture, it is not an inevitable complication of acupuncture, and in most cases involves negligence from inadequate consideration of basic anatomy.
Debate – Patients Should be Encouraged to Treat Themselves
Authors: Campbell Anthony , Hopwood Val
Published: April 2009

In favour of self-acupuncture, this is a useful way to prolong the effects of acupuncture when the response is only brief or patients cannot attend frequently. If the patient is capable and the condition is suitable for self-acupuncture, patients can be taught how to do it and then seen for review. Patients should be provided with complete information sheets, and one example is presented. Against self-acupuncture, patient safety is paramount and would be compromised by teaching them how to do acupuncture. In addition, serious accidents have happened with self-acupuncture, including a death. Other arguments against it are that it is less effective than standard acupuncture, the patient misses out on the therapeutic relationship, and safer alternative methods exist.
Polar Acupuncture
Authors: Apps John
Published: April 2009

Musculoskeletal disorders are common in people who undertake adventure travel to the Antarctic, and in those who support them, because of the hard physical demands and lack of rest. This paper describes the successful use of acupuncture as first line treatment for ten patients in these circumstances, and comments on its advantages, particularly in its capacity to reduce the use of non-steroidal anti-inflammatory drugs.
Effect of Intensive Acupuncture on Pain-Related Social and Psychological Variables for Women with Chronic Neck and Shoulder Pain – An Rct with Six Month and Three Year Follow Up
Authors: He Dong , Høstmark Arne T , Veiersted Kaj Bo , Medbø Jon Ingulf
Published: April 2009

Objectives

This study examines whether intensive acupuncture treatment can improve several social and psychological variables for women with chronic pain in the neck and shoulders, and whether possible effects are long-lasting. The effects on pain have been reported elsewhere.

Methods

Twenty-four female office workers (47±9 years old, mean ± SD) who had had neck and shoulder pain for 12±9 years, were randomly assigned to a test group or a control group. Acupuncture was applied 10 times during three to four weeks either at presumed acupuncture points for pain (test group) or at sham points (control group). In addition, acupressure was given to patients between treatments, at either real or sham points. Questionnaires for social and psychological variables were completed before each treatment, just after the course, and six months and three years later.

Results

The pain-related activity impairment at work was significantly less in the test group than the controls by the end of treatment (P<0.04). Also there were significant differences between the groups for quality of sleep, anxiety, depression and satisfaction with life (P<0.05). At six months and three years follow ups the acupuncture group showed further improvements in most variables and was again significantly different from the control group.

Conclusion

Intensive acupuncture treatment may improve activity at work and several relevant social and psychological variables for women with chronic pain in the neck and shoulders. The effect may last for at least three years.
A Survey Comparing Tcm Diagnosis, Health Status and Medical Diagnosis in Women Undergoing Assisted Reproduction
Authors: Coyle Meaghan , Smith Caroline
Published: April 2009

Introduction

For many women, undergoing assisted reproductive technology can be a difficult experience, and can result in changes in physical and emotional health and wellbeing. Recent research has suggested that acupuncture may be helpful for women undergoing assisted reproductive technology. To date, there is no information describing the traditional Chinese medicine (TCM) syndromes seen in women undergoing assisted reproductive technology, or relationships between TCM and Western medicine diagnoses.

Objective

To examine the health status of women undergoing assisted reproductive technology from both Western and Chinese medicine perspectives.

Methods

One hundred and eighty women were included in the study. All underwent a TCM diagnosis, 177 (98.3%) completed the quality of life questionnaire SF36. Information about Western medicine diagnosis was collected from case notes and was available for 176 (97.7%) women.

Results

Women in the trial reported poorer health on several domains of the SF36 compared with the South Australian population. The most common TCM diagnosis was ‘Kidney Yang deficiency’, diagnosed for 53.9% of patients. A TCM diagnosis of Qi or ‘Blood stagnation’ was associated with poorer quality of life on the mental health, emotional role function and social function domains of the SF36. No associations were found between TCM diagnosis and physical or general health components of the SF36.

Conclusions

Associations between TCM and reproductive health diagnoses were demonstrated. Emotional health and wellbeing is an important aspect of patient care that needs to be addressed in clinical practice and research studies, as the findings suggest that this aspect of their health is often poorer during assisted reproductive technology.
A Tale of Two Foxes - Case Reports: 1. Radial Nerve Paralysis Treated with Acupuncture in a Wild Fox 2. Acupuncture in a Fox with Aggressive and Obsessive Behaviour
Authors: Lloret Lorena , Hayhoe Simon
Published: April 2009

Case 1

This is believed to be the first report of acupuncture treatment for traumatic radial nerve paralysis in a wild fox. From the first treatment, improvement in the range of mobility and sensation of the limb was evident. Additionally, the attitude of this wild animal changed from fear and aggression to complete cooperation: he lay peacefully during every treatment in a calm, drowsy state.

Case 2

This reports the calming effects of acupuncture on a fox which had been showing aggressive behaviour and obsessive circling following toxoplasma infection.
Are Minimal, Superficial Or Sham Acupuncture Procedures Acceptable as Inert Placebo Controls?
Authors: Lund Iréne , Lundeberg Thomas
Published: April 2009

Most controlled trials of acupuncture have used minimal, superficial, sham, or ‘placebo’ acupuncture. It has recently been demonstrated that light touch of the skin stimulates mechanoreceptors coupled to slow conducting unmyelinated (C) afferents resulting in activity in the insular region, but not in the somatosensory cortex. Activity in these C tactile afferents has been suggested to induce a ‘limbic touch’ response resulting in emotional and hormonal reactions. It is likely that, in many acupuncture studies, control procedures that are meant to be inert are in fact activating these C tactile afferents and consequently result in the alleviation of the affective component of pain. This could explain why control interventions are equally effective as acupuncture in alleviating pain conditions that are predominantly associated with affective components such as migraine or low back pain, but not those with a more pronounced sensory component, such as osteoarthritis of the knee or lateral epicondylalgia.
An Audit of Self Acupuncture for Chronic Musculoskeletal Pain
Authors: Teig Silje , Peacock Sue , Stevens Lorraine , Tordoff Kimberley , Maguire Edwina , Watson Paul
Published: April 2009

Background

Acupuncture is increasingly offered as a treatment for chronic pain, but continued treatment is expensive. Self acupuncture might offer a cost effective alternative. The aim of this project was to investigate the effectiveness and safety of self acupuncture in a pain clinic.

Methods

A retrospective audit was conducted by postal questionnaire of all patients with chronic pain who were taught self acupuncture as a home pain management strategy in the previous three years. The study was conducted by a researcher not involved in the patient's treatment. The patients selected for self acupuncture were those who had responded to acupuncture previously, met certain criteria, and had been taught self acupuncture successfully. Patients were taught self acupuncture using three acupuncture points (LI4, ST44, LR3).

Results

Of 52 eligible patients (70% female) who were approached, 38 valid questionnaires were returned, giving a response rate of 73.1%. Of these, 76.3% were female; 86.8% (33) still used self acupuncture and 13.3% (5) had stopped; 86.8% of the patients continued to experience pain reduction with self acupuncture. The reported pain relief gained was 5.7 (SD 2.6) measured on a visual analogue scale, improvement in quality of life was reported by 73.7% and no serious adverse effects were reported.

Conclusion

This audit suggests that self acupuncture is effective for pain relief and improves quality of life in this selected group of patients. Safety can be maintained provided that pre-selection is done with care, and appropriate training is carried out. Self acupuncture has considerable potential to reduce clinic waiting lists and appointment times for patients. Further research is required to determine the cost effectiveness of this approach.
Relief of Low Back Pain Immediately after Acupuncture Treatment – a Randomised, Placebo Controlled Trial
Authors: Inoue Motohiro , Kitakoji Hiroshi , Ishizaki Naoto , Tawa Munenori , Yano Tadashi , Katsumi Yasukazu , Kawakita Kenji
Published: April 2009

Background

The purpose of this study was to examine the immediate effect of single acupuncture stimulation to the most painful point in patients with low back pain.

Method

A randomised, evaluator-blinded, sham controlled clinical trial was conducted in which 31 patients with low back pain were randomly allocated to either an acupuncture group (n=15) or a sham acupuncture group (n=16). Both acupuncture and sham acupuncture were performed at the most painful point on the lower back of the subjects. For the acupuncture group, a stainless steel needle was inserted to a depth of 20mm and manually stimulated (sparrow pecking method) for 20 seconds, while for the sham treatment a guide tube without a needle was placed at the point and tapped on the skin. Changes in low back pain were evaluated with a visual analogue scale (VAS) and the Schober test. Participants were also asked if they felt the needling sensation or not. The therapy and the evaluation were independently performed by two different acupuncturists. Results VAS score and the Schober test score showed significant improvement after treatment as compared with the sham group (P=0.02, 0.001, respectively). There were no significant differences in the needling sensation between the acupuncture and sham group.

Conclusion

These results suggest that acupuncture at the most painful point gives immediate relief of low back pain.
Electronic Publishing and Acupuncture in Medicine
Authors: White Adrian
Published: April 2009

The internet has fundamentally altered scientific publishing; this article discusses current models and how they affect this journal. The greatest innovation is a new range of open access journals published only on the internet, aimed at rapid publication and universal access. In most cases authors pay a publication charge for the overhead costs of the journal. Journals that are published by professional organisations primarily for their members have some functions other than publishing research, including clinical articles, conference reports and news items. A small number of these journals are permitting open access to their research reports. Commercial science publishing still exists, where profit for shareholders provides motivation in addition to the desire to spread knowledge for the benefit of all. A range of electronic databases now exists that offer various levels of listing and searching. Some databases provide direct links to journal articles, such as the LinkOut scheme in PubMed. Acupuncture in Medicine will continue to publish in paper format; all research articles will be available on open access, but non-subscribers will need to pay for certain other articles for the first 12 months after publication. All Acupuncture in Medicine articles will in future be included in the LinkOut scheme, and be presented to the databases electronically.
Epilepsy, Electroacupuncture and the Nucleus of the Solitary Tract
Authors: Cakmak Yusuf Ozgur
Published: April 2009

Vagal nerve stimulation and electroacupuncture have some promise as neuroprotective therapies for patients with poorly controlled epilepsy. It has been demonstrated that stimulation of acupuncture points on the extremities results in stimulation of the vagus nerve. It is possible that the antiepileptic effects of these two applications might be targeting the same centre in the brain. The nucleus of the solitary tract, which is a primary site at which vagal afferents terminate, is also the site for afferent pathways of facial, scalp and auricular acupuncture via trigeminal, cervical spinal and glossopharyngeal nerves. Taken together with laboratory findings, the neuroprotective pathways of electroacupuncture in epileptic models may stem from the collaboration of its anti-inflammatory and neurotrophic actions through the nucleus of the solitary tract via vagus nerve stimulation.
The Effectiveness of Acupuncture for Osteoarthritis of the Knee – a Systematic Review
Authors: White Adrian , Foster Nadine , Cummings Mike , Barlas Panos
Published: April 2009

Objective

To determine the effectiveness of acupuncture treatment for pain and function of patients with osteoarthritis of the knee.

Methods

A systematic review of randomised controlled trials was performed, including a meta-analysis which combined the results of trials that used adequate acupuncture treatment and used WOMAC scores to measure the effect. The internal validity (quality) and heterogeneity of studies were taken into account.

Results

Thirteen studies were available, of which eight, involving 2362 patients, could be combined. For both reduction of pain and improvement of function, acupuncture was significantly superior to sham acupuncture (P<0.05 for all comparisons) in both the short term and the long term. Compared with no additional intervention (usual care), acupuncture was again significantly superior for pain and function. The treatment effects were maintained after taking account of quality and heterogeneity in sensitivity analyses.

Conclusion

Acupuncture is an effective treatment for osteoarthritis of the knee. Its overall effect size is 0.8, and it can be considered instead of non-steroidal anti-inflammatory drugs for patients whose symptoms are not controlled by education, exercise, weight loss if appropriate and simple analgesics. Further research is necessary into the most efficient way of delivering acupuncture, and its longer term benefits.
Acupuncture for Knee Osteoarthritis – a Randomised Trial Using a Novel Sham
Authors: Manheimer Eric , Lim Byungmook , Lao Lixing , Berman Brian
Published: April 2009

Background

Evidence on the efficacy of acupuncture for reducing the pain and dysfunction of osteoarthritis is equivocal.

Objective

To determine whether acupuncture provides greater pain relief and improved function compared with sham acupuncture or education in patients with osteoarthritis of the knee.

Design

Randomised, controlled trial.

Setting

Two outpatient clinics (an integrative medicine facility and a rheumatology facility) located in academic teaching hospitals and one clinical trials facility.

Patients

570 patients with osteoarthritis of the knee (mean age [±SD], 65.5 ± 8.4 years).

Intervention

23 true acupuncture sessions over 26 weeks. Controls received 6 two-hour sessions over 12 weeks or 23 sham acupuncture sessions over 26 weeks.

Measurements

Primary outcomes were changes in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function scores at 8 and 26 weeks. Secondary outcomes were patient global assessment, 6-minute walk distance, and physical health scores of the 36-Item Short-Form Health Survey (SF-36).

Results

Participants in the true acupuncture group experienced greater improvement in WOMAC function scores than the sham acupuncture group at 8 weeks (mean difference, −2.9 [95% CI, −5.0 to −0.8]; P=0.01) but not in WOMAC pain score (mean difference, −0.5 [CI, −1.2 to 0.2]; P=0.18) or the patient global assessment (mean difference, 0.16 [CI, −0.02 to 0.34]; P> 0.2). At 26 weeks, the true acupuncture group experienced significantly greater improvement than the sham group in the WOMAC function score (mean difference, −2.5 [CI, −4.7 to −0.4]; P=0.01), WOMAC pain score (mean difference, −0.87 [CI, −1.58 to −0.16]; P=0.003), and patient global assessment (mean difference, 0.26 [CI, 0.07 to 0.45]; P=0.02).

Limitations

At 26 weeks, 43% of the participants in the education group and 25% in each of the true and sham acupuncture groups were not available for analysis.

Conclusions

Acupuncture seems to provide improvement in function and pain relief as an adjunctive therapy for osteoarthritis of the knee when compared with credible sham acupuncture and education control groups.
The Natural History of Back Pain after a Randomised Controlled Trial of Acupuncture Vs Usual Care – Long Term Outcomes
Authors: Prady Stephanie L , Thomas Kate , Esmonde Lisa , Crouch Simon , MacPherson Hugh
Published: April 2009

Introduction

There is growing evidence about the effectiveness of acupuncture in the short term treatment of chronic low back pain but little is known about long term outcomes. To address this question we followed up participants of a past randomised controlled trial of acupuncture to assess outcomes after 5.5 to 7 years.

Methods

A postal questionnaire assessing pain, quality of life, disability, experience with back pain and healthcare resource use was sent to all 239 participants of the York Acupuncture for Back Pain trial.

Results

Response to the survey was low at 43.9%. Pain measured by the SF-36 Bodily Pain dimension was maintained in the acupuncture group since the last follow up 3.5 to 5 years previously. The usual care group had improved over the intervening years and there was now no evidence of a difference between the groups (difference −0.4 points, 95% confidence interval −10.1 to 9.7). The results were unchanged on sensitivity analysis using multiple imputation. In both groups back pain had not completely resolved and worry about back health was moderate. Physiotherapy and acupuncture were used at similar rates for continuing treatment.

Discussion

We theorise that exposure to a short course of acupuncture speeds natural recovery from a back pain episode, but improvements plateau after two years. Acupuncture is often accessed privately for long term management of back pain but is rarely available within the health service. While our study methods were robust, the low response rate means that our findings should be interpreted with caution.
Point Injection as An Alternative Acupuncture Technique – An Exploratory Study of Responses in Healthy Subjects
Authors: Strudwick Mark W , Hinks Roderick C , Choy S T Boris
Published: April 2009

Introduction

Point injection as a therapeutic technique is well documented, but its physiological effects have not been formally compared with traditional acupuncture. One aim of this study was to compare the effects of the two techniques at one acupuncture point, as a step towards understanding the mode of action of point injection and validating its clinical use. A second aim was to explore whether repeated point injection at the same site might provide a way of increasing the dose of stimulation, in the hope of identifying a dose response curve which could be an alternative strategy to placebo control in demonstrating the biological effects of acupuncture.

Methods

Sixty nine healthy subjects (age range 18–56 years, mean 29.9; 48 females) completed the study, which employed a counterbalanced experimental design with two stimulation sessions of LI4 approximately one week apart. One half of the participants received point injection first, and the other half received traditional acupuncture first. Baseline physiological data were recorded, then measurements were made before, during and after stimulation; each subject also reported needle sensation ( de qi). The measures were heart rate, derived pressure rate product and mean arterial pressure.

Results

Although stronger sensations of de qi were reported with point injection, no significant differences were found for mean heart rate (HR), pressure rate product (PRP) and mean arterial pressure (MAP) before and after stimulation by the two techniques. No subject gender or age bias was encountered and previous exposure to acupuncture had no effect on outcome. Power spectral analysis of heart rate variability (HRV) made on data from a small subset (n=10) of this cohort also showed no significant differences in autonomic response.

Conclusion

Point injection and traditional acupuncture seem to provoke similar physiological responses, although the greater needle sensation seen with point injection might indicate it could have more powerful clinical effects. Further studies of repeated point injection are necessary to indicate whether this technique may provide a method of increased strength of point stimulation, as an alternative to traditional needling in acupuncture research.
Treatment of Juvenile Stroke Using Yamamoto New Scalp Acupuncture (Ynsa) – a Case Report
Authors: Yamamoto Toshikatsu , Schockert Thomas , Boroojerdi Babak
Published: April 2009

In Germany, stroke affects approximately 300 children each year. Treatment options for stroke patients, particularly for children, are limited. A case is described of an 18 month old girl with hemiparesis, who showed a considerable degree of recovery over the course of 21 months while receiving Yamamoto New Scalp Acupuncture using soft laser. This may represent a new option for the therapy of such patients.
Trigger Point Acupuncture for Treatment of Knee Osteoarthritis – a Preliminary Rct for a Pragmatic Trial
Authors: Itoh Kazunori , Hirota Satoko , Katsumi Yasukazu , Ochi Hideki , Kitakoji Hiroshi
Published: April 2009

Background

There is evidence for the efficacy of acupuncture treatment in knee osteoarthritis, but it remains unclear which acupuncture modes are most effective. We evaluated the effects of trigger point acupuncture on pain and quality of life in knee osteoarthritis patients, compared with acupuncture at standard points, and sham acupuncture.

Methods

Thirty patients (27 women, 3 men; aged 61–82 years) with non-radiating knee osteoarthritis pain for at least six months and normal neurological examination were randomised to one of three groups for the study period of 21 weeks. Each group received five acupuncture treatment sessions. The standard acupuncture point group ( n=10) received treatment at traditional acupuncture points for knee pain; the trigger point acupuncture group ( n=10) received treatment at trigger points; and the third group ( n=10) received sham acupuncture treatment at the trigger points. Outcome measures were pain intensity (visual analogue scale, VAS) and WOMAC index (Western Ontario and McMaster Universities Arthritis Index). The groups were compared by the area under the curve method.

Results

Five patients dropped out of the study because of lack of improvement, and one patient (in the trigger point acupuncture group) dropped out because of deterioration of symptoms; the remaining 24 patients were included in the analysis. After treatment, the trigger point acupuncture group reported less pain intensity on VAS than the standard acupuncture or sham treatment group, but both the trigger point acupuncture and standard acupuncture groups reported improvement of function of knee. There was a significant reduction in pain intensity between pre-treatment and five weeks after treatment for the trigger point acupuncture (P<0.01) and standard acupuncture groups (P<0.01) included in the analysis, but not for the sham treatment group. Group comparison using the area under the curves demonstrated a significant difference only between trigger point acupuncture and sham treatment groups analysed (P<0.025 for VAS, and P<0.031 for WOMAC).

Conclusion

These results suggest that trigger point acupuncture therapy may be more effective for osteoarthritis of the knee in some elderly patients than standard acupuncture therapy.
Pudendal Nerve Electroacupuncture for Lumbar Spinal Canal Stenosis – a Case Series
Authors: Inoue Motohiro , Hojo Tatsuya , Nakajima Miwa , Kitakoji Hiroshi , Itoi Megumi , Katsumi Yasukazu
Published: April 2009

Objective

To investigate the effectiveness of pudendal nerve electroacupuncture for lumbar and lower limb symptoms in patients with lumbar spinal canal stenosis for whom acupuncture of the lumbar and lower limb muscles had been ineffective.

Methods

Nine patients with lumbar spinal canal stenosis for whom conventional acupuncture at the lumbar and lower limb muscles had no effect. Pudendal nerve electroacupuncture was performed eight times (once per week). VAS scores and continuous walking distance were used to evaluate changes in symptoms.

Results

The following changes in symptoms occurred after pudendal nerve electroacupuncture: low back pain was improved from 45.3±17.4mm (mean ± SD) to 39.2±14.0mm, lower limb pain was improved from 61.1±5.6mm to 35.4±11.9mm, lower limb dysaesthesia was improved from 63.9±8.4mm to 46.9±16.2mm, and continuous walking distance was improved from 100.0±35.4m to 250.0±136.9m.

Conclusion

Pudendal nerve electroacupuncture may be an effective treatment for lumbar and lower limb symptoms due to spinal canal stenosis, and is potentially useful in patients who have not responded to conventional acupuncture.
Effects of Minimal Acupuncture in Children with Infantile Colic – a Prospective, Quasi-Randomised Single Blind Controlled Trial
Authors: Reinthal Marianne , Andersson Sven , Gustafsson Marianne , Plos Kaety , Lund Iréne , Lundeberg Thomas , Rosén Karl Gustaf
Published: April 2009

Background

Colic causes crying in 10–30% of infants and is one of the primary reasons parents seek health care. Treatments are generally not totally effective and some cause side effects. In this study we aimed to test the effect of light needling (minimal acupuncture) on crying.

Methods

Forty children (median six weeks of age) with excessive crying unresponsive to conventional therapies, were recruited from 21 Child Welfare Clinics within an area of western Sweden, and quasi-randomised to control or light needling treatment. Parents were unaware of which group their child was assigned to. Children were given light needling acupuncture on one point (LI4) on both hands for approximately 20 seconds on four occasions, or received the same care except needling. Parental assessment questionnaires were used pre- and post-treatment to assess crying intensity, frequency, duration of crying and pain related behaviour throughout the day in six hour periods.

Results

Light needling resulted in a significant reduction in the rated crying intensity (assessed by a numeric rating scale, 0 to 10). For example, during the morning time period 0600–1200 hours, the median (range) rated crying intensity changed from 6 (1 to 9) pre-treatment to 2 (0 to 5) post-treatment (P=0.002), in the light needling group. The corresponding ratings for the children in the control group was 6 (0 to 10) and 5 (0 to 10) respectively. The difference between the groups was significant (P=0.016). There were also significant differences between the groups for the afternoon (1200–1800 hours), and evening (1800–midnight) time periods. Pain related behaviour like facial expression, was also significantly less pronounced in the light needling group as compared to the control group post-treatment, (P=0.027). The parents rated the light needling as more effective in improving symptoms than the control group (P<0.001).

Conclusion

Four treatments with light needling on one point in the hand may alleviate crying and pain related behaviour without any noted side effects.
A New Approach to Smoking Cessation
Authors: Kusumi Y T
Published: April 2009

518 chronic smokers received a new modality of stop-smoking therapy. The therapy consists of behaviour modification therapy and ear acupuncture treatment where microelectric stimuii are transmitted to the auricular branches of the vagus nerve in the ear. 308 patients (59.5%) stopped smoking completely. 84 patients 06.2%) reduced the number of cigarettes smoked. 126 patients (24.3%) did not respond to therapy. Since the reasons for smoking are complex, comprehensive psycho-logical and physiological approaches are more effective for stop-smoking therapy.
Longtimetreatment of Headache in National Health Centre
Authors: Junnila Seppo Y T
Published: April 2009

The effectiveness of acupuncture for use in the prophylaxis and treatment of chronic headache in patients at a national heaith care centre was evaluated by means of an eight year long follow-up study. 88 female and 27 male patients were interviewed after a two to eight year long period of acupuncture treatments. 18% of the patients feit the treatment ineffective and one patient reported an increase of the symptoms. in total 74% of patients got more than 30% relief of symptoms which lasted on an average 22 months. 75% of patients who had used analgesics before acupuncture could reduce the dose by more than 50%.
Neuropathic Pain: A New Theory for Chronic Pain of Intrinsic Origin
Authors: Gunn C Chan
Published: April 2009

Why is acupuncture accepted in the East, especially for the treatment of chronic pain, but not in the West? One reason is that the modus operandi of acupuncture is not fully understood; another is the enigmatic nature of chronic pain. This article introduces a new concept of chronic pain, and suggests how acupuncture may relieve it.

Chronic pain may arise from sources that are extrinsic to the nervous system (for example, ongoing injury or inflammation), but it can also be intrinsic and the result of abnormal hypersensitivity (supersensitivity) in neuropathic or partially denervated structures. Neuropathic pain typically affects the musculoskeletal system, and a pivotal component of this type of pain is muscle spasm or shortening. Spasm can cause pain localised to muscle, but sustained muscle spasm or shortening mechanically overloads tendons and their attachments, and can produce pain in these structures.

Since neuropathic pain is different from nociception or inflammation, its treatment is also distinct (desensitisation of supersensitivity). Most physical treatment modalities for this type of pain, such as heat, massage or transcutaneous electrical nerve stimulation (TENS), desensitise by reflex stimulation of the affected part via its intact innervation. However these modalities are passive and limited in scope. Stimulation ends when their application is terminated. In contrast, injection techniques, including acupuncture, are more effective and long-lasting, because the tissue injury that they produce can unleash the body's healing source of bioenergy through the current of injury. Tissue injury also releases the platelet-derived growth factor (PDGF), which can promote healing.
TRANSLATING SOLITONS TO SYMPLECTIC AND LAGRANGIAN MEAN CURVATURE FLOWS
Authors: HAN XIAOLI , LI JIAYU
Published: April 2009

In this paper, we construct finite blow-up examples for symplectic mean curvature flows and we study properties of symplectic translating solitons. We prove that, the Kähler angle α of a symplectic translating soliton with max |A| = 1 satisfies that [Formula: see text] where T is the direction in which the surface translates.
INTERSECTION COHOMOLOGY, MONODROMY AND THE MILNOR FIBER
Authors: MASSEY DAVID B.
Published: April 2009

We say that a complex analytic space, X, is an intersection cohomology manifold if and only if the shifted constant sheaf on X is isomorphic to intersection cohomology; with field coefficients, this is quickly seen to be equivalent to X being a homology manifold. Given an analytic function f on an intersection cohomology manifold, we describe a simple relation between V(f) being an intersection cohomology manifold and the vanishing cycle Milnor monodromy of f. We then describe how the Sebastiani–Thom isomorphism allows us to easily produce intersection cohomology manifolds with arbitrary singular sets. Finally, as an easy application, we obtain restrictions on the cohomology of the Milnor fiber of a hypersurface with a special type of one-dimensional critical locus.
EVOLUTION OF VARIABLE MODIFIED CHAPLYGIN GAS MODEL
Authors: XING LILI , GUI YUANXING , XU LIXIN , LU JIANBO
Published: April 2009

We consider a variable modified Chaplygin gas (VMCG) model with unified dark energy and dark matter. Some cosmological quantities are studied, such as the state parameter of dark energy wde, the fractional energy densities Ωi(i respectively denotes baryons, dark matter, dark energy), the deceleration parameter q and the growth index f. By analysis, we find that the state parameter of dark energy can cross the phantom divide wΛ= -1, the behavior of VMCG is similar to radiation in the early time and will be quinessence model in the future. Therefore the universe will not end up with Big Rip.
PALINDROME PRESENTATIONS OF RATIONAL KNOTS
Authors: CAVICCHIOLI ALBERTO , REPOVŠ DUŠAN , SPAGGIARI FULVIA
Published: April 2009

We give explicit palindrome presentations of the groups of rational knots, i.e. presentations with relators which read the same forwards and backwards. This answers a question posed by Hilden, Tejada and Toro in 2002. Using such presentations we obtain simple alternative proofs of some classical results concerning the Alexander polynomial of all rational knots and the character variety of certain rational knots. Finally, we derive a new recursive description of the SL(2, ℂ) character variety of twist knots.