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Objective: The aim of the present study was to compare the effects of acupuncture treatment on arterial blood pressure (BP) and heart rate (HR) in patients with mild hypertension with high sympathetic tone with those of normotensive patients and to examine the effects on cardiac sympathetic nerve activity (CSNA) and vagal activity using heart rate variability (HRV) analysis. Design: Eight male patients with prehypertension or stage I hypertension and eight normotensive age-matched patients were included in this study. All patients had their systolic BP (SBP), diastolic BP (DBP), HR, and HRV measured. In addition, the ratio of low-frequency (LF) to high-frequency (HF) HRV and the power of the HF of the HRV were recorded. The study was conducted at Kansai University of Health Sciences in Japan. Interventions: Each patient underwent a single, 15-min-long acupuncture session. Acupuncture was applied to PC6, LI4, ST36, LR3 on both sides, and GV20. Results: SBP and HR decreased significantly in the hypertensive group during and after acupuncture compared with the baseline SBP and HR (p < 0.05). LF/HF was significantly reduced during acupuncture (p < 0.05), and HF was significantly increased after acupuncture in the hypertensive group (p < 0.05). However, there were no significant changes in LF/HF or HF in the control group. Conclusions: Acupuncture may reduce the BP and HR in patients with mild hypertension. An HRV analysis suggests that acupuncture may suppress the enhanced basal CSNA activity and increase the vagal nerve activity in patients with mild hypertension. Clinical Trial Registration number: UMIN000041249. [ABSTRACT FROM AUTHOR]

Objective: A majority of menstruating women experience some degree of regular recurrences of diverse symptoms-commonly known as premenstrual syndrome (PMS)-during the days before menstruation. Given the multifactorial etiology of PMS, no single treatment is universally recognized as effective, and many women turn to alternative modalities, including aromatherapy. The present study investigated therapeutic effects on premenstrual symptoms using fragrance from yuzu, a Japanese citrus fruit ( Citrus junos Sieb. ex Tanaka), and aromatherapy, from the perspective of autonomic nervous system function. Subjects: Seventeen women in their 20s with subjective premenstrual symptoms. Design: A single-blind randomized crossover study. Settings/Location: This study was performed at a laboratory in a university in Osaka, Japan. Subjects were examined on two separate occasions in the luteal phase. Outcome measures: Using two aromatic stimulation sources (yuzu and lavender used as the control), this experiment measured heart rate variability (HRV) reflecting autonomic nerve activity and the Profile of Mood States (POMS) as a psychologic index before and after aromatic stimulation. Results: A scant 10-min inhalation of the yuzu scent significantly decreased heart rate and increased high-frequency power of HRV, reflecting parasympathetic nerve activity, in the luteal phase. Additionally, POMS tests demonstrated that inhalation of the yuzu essential oil significantly decreased three negative subscales: tension-anxiety, anger-hostility, and fatigue-common premenstrual symptoms, together with a total mood disturbance as a global measure of affective state, as long as 35 min after the aroma stimulation. These premenstrual psychoneurophysiologic effects of yuzu fragrance did not differ from those of the effects of lavender. Conclusions: The present study indicated that short-term inhalation of yuzu fragrance could alleviate premenstrual emotional symptoms, which, at least in part, is attributable to the improvement of parasympathetic nervous system activity. This study further implies that yuzu fragrance aromatherapy might serve as an anti-PMS modality, given its comparable psychoneurophysiologic effects to those of lavender, a representative relaxing scent. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the immediate effects of traditional local thermal therapy with indirect moxibustion on renal hemodynamics in patients with chronic kidney disease (CKD) by using Doppler ultrasonography (US). Design: Examiner-blinded crossover study. Participants: Forty-three participants with CKD (mean age ± standard deviation [SD], 44 ± 15 years; estimated glomerular filtration rate, 69.5 ± 25.5 mL/min per 1.73 m2; 20 men and 23 women). Intervention: Participants received three successive treatment sessions of indirect moxibustion bilaterally at BL 23, a crucial acupuncture point, in the session. In the control session, the examiner was blinded by using smoke and aroma produced by moxibustion performed in an ashtray placed near the patient's body. Outcome measures: The main outcome measure was resistive index (RI) in the renal segmental arteries. Blood flow parameters, including RI, were measured for six renal segmental arteries by using Doppler US at rest (baseline), immediately after completion of moxibustion (post 1), and 10 minutes later (post 2). Adverse events were monitored during intervention. Results: In the control session, RI at post 1 (median [first, third quartile]: 0.587 [0.562, 0.626]) and post 2 (0.583 [0.567, 0.629]) did not change significantly compared with baseline (0.592 [0.563, 0.636]), while in the treatment session, RI at post 1 (0.565 [0.530, 0.618]) and post 2 (0.561 [0.533, 0.614]) decreased significantly compared with baseline (0.590 [0.550, 0.652]) ( p < 0.001 and p < 0.001, respectively). The reduction in RI from baseline to post 2 in treatment session was significantly greater than in control session (mean ± SD, −0.026 ± 0.028 versus −0.003 ± 0.028; mean difference, −0.023 [95% confidence interval, −0.036 to −0.010]; p = 0.001]. No adverse events, such as burns, were observed during the study period. Conclusion: Renal vascular resistance was decreased after indirect moxibustion therapy in patients with CKD. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to assess the effect of the daily practice of a yoga therapy program learnt during a single session of an integrated yoga intervention that was developed by us as a stress management tool for school employees. Subjects: Ninety school employees. Design: Case-control study. Three months after the intervention, the subjects were assigned to a daily practice group (case: n=43) and a nonconsecutive daily practice group (control: n=47) according to their daily practice level of the yoga therapy program. Interventions: The subjects participated in a stress management education program based on an integrated yoga therapy session. The program included psychological education and counseling about stress management and yoga theories, as well as the practices of asanas, pranayama, relaxation, and cognitive structure based on Indian philosophy. Outcome measures: Assessments were performed before and after the program using the Subjective Units of Distress for mind and body and the Two-Dimensional Mood Scale. The General Health Questionnaire 28 (GHQ28) was used to assess the mental health state before the intervention and at 3 months after the program. Results: The subjects showed significant increases in their levels of calmness, comfort, and cheerfulness ( p<0.001) and significant decreases in cognitive mind and body stress ( p<0.001) after participating in the integrated yoga program. A comparison of the total scores on the GHQ28 using a two-way analysis of variance showed significant differences between the two groups in terms of both interaction ( p=0.047) and the main effect ( p=0.026). Conclusions: The present results suggested that a single session of an integrated yoga program was effective for reducing stress and that the mental health of school employees was promoted by the daily practice of the yoga therapy program. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the immediate effects of indirect moxibustion, a traditional local thermal therapy, on renal hemodynamics by using Doppler ultrasonography (US). Design: Prospective observational study of postintervention changes in several variables. Setting: Gifu University Hospital, Gifu, Japan. Participants: Eleven healthy persons (7 men and 4 women; mean age±standard deviation, 32.6±5.7 years) were enrolled. Intervention: Indirect moxibustion was applied for 4 minutes to bilateral lower back acupuncture points (BL23). Each participant received 3 successive treatments. Outcome measures: The main outcome measurement was resistive index (RI) in the renal segmental arteries. Blood flow variables, including RI, were measured for 6 renal segmental arteries by Doppler US at rest (baseline), immediately after completion of moxibustion (post 1), and 10 minutes later (post 2). Participants were monitored for adverse events during the intervention. Results: The mean RI was 0.578±0.037 at baseline, 0.546±0.027 at post 1, and 0.547±0.032 at post 2. RI decreased significantly between post 1 and baseline (95% confidence interval [CI], −0.053 to −0.011; p=0.003) and between post 2 and baseline (95% CI, −0.052 to −0.009; p=0.005). No adverse events, such as burns, were observed. Conclusion: This study of the short-term effects of indirect moxibustion on renal hemodynamics in healthy persons showed that renal vascular resistance was reduced after the therapy. [ABSTRACT FROM AUTHOR]

Objectives: To clarify the effect of olfactory stimulation with perilla essential oil on human prefrontal cortex activity using near-infrared time-resolved spectroscopy. Design: Single-center prospective study. Methods: Nineteen female university students (mean age, 21.6±1.5 years) participated in the study. Perilla essential oil was used as an olfactory stimulant and air as a control. Oxyhemoglobin concentrations in the prefrontal cortex were measured by using near-infrared time-resolved spectroscopy when the participants were presented with the stimulant or control. Emotional effects were subjectively evaluated by using a modified semantic differential method. Results: Olfactory stimulation with the perilla essential oil significantly reduced the oxyhemoglobin concentration in the prefrontal cortex. No significant differences in the feelings of comfort or relaxation, which strongly reflect human mental status, were observed between the perilla essential oil and control periods. Conclusions: Olfactory stimulation with perilla essential oil reduced prefrontal cortex activity, thereby inducing physiologic relaxation. [ABSTRACT FROM AUTHOR]

Objective: Previous studies have reported that the practice of meditation can have beneficial physiologic and mental effects. Therefore, Zen trainees who regularly practice meditation might have high quality-of-life scores and high levels of general mental health; however, no previous study has tested these relationships. This article reports on a study that examined how rigorous professional training affected the International Quality of Life (QOL) Assessment Short Form-36 (SF-36) and General Health Questionnaire-28 (GHQ-28) scores of Zen trainees in Japanese monasteries. Design: This was a single-center questionnaire-based study. Settings/location: The study was conducted in Rinzai Zen monasteries. Subject interventions: Anonymous and confidential surveys containing the SF-36 and GHQ-28 were distributed by mail, and 256 questionnaires were collected from Rinzai Zen monasteries. Outcome measures: One hundred ninety-eight complete questionnaires were collected and the participants were divided according to their training length: group I (<1 year), group II (1-3 years), and group III (≥3 years). One-way analysis of variance and Tukey test for multiple comparison were conducted on normally distributed data, and the Kruskal-Wallis test was performed on non-normally distributed data. Results: The SF-36 seven subscale scores (physical functioning, role-physical, body pain, general health, vitality, role-emotional, and mental health) of the longer-length training group were significantly higher compared to other groups. The SF-36 MCS (mental component summary) score among the groups were significantly different, and the scores of group III were significantly higher compared to the scores of group I. Furthermore, the GHQ-28 total and subscales (somatization, anxiety, social dysfunction, and depression) scores of longer-length training were significantly lower (better). Conclusions: These findings suggest that Zen professional training, including inward-attention practices, improves the QOL and general mental health of trainees, even in a tough and distressing environment. However, detailed qualitative and longitudinal studies are required to fully assess these effects. [ABSTRACT FROM AUTHOR]

Background: Acupuncture is used worldwide in medical treatment. However, needle insertion damages the skin and patients sometimes feel pain. To avoid such drawbacks, an acupoint stimulation device using focused ultrasound has been developed. Ultrasound stimulation does not damage the skin like acupuncture does because ultrasound can deliver vibration energy to soft tissues noninvasively. Objectives: The aim of this study was to clarify the effect of acupoint stimulation using focused ultrasound. Subjects: Fifty (50) healthy volunteers (40 males and 10 females) were included in this experiment. Design: Subjects were randomly assigned to two groups. LR-3 was stimulated bilaterally for 36 seconds by focused ultrasound and conventional acupuncture. Brachial artery blood flow volume was monitored by an ultrasound with an echo-tracking system. The hemodynamic parameters were measured before, during, and 30, 60, 180 seconds after stimulation. Results: During stimulation, the blood flow volume of the acupuncture stimulation group decreased significantly ( p<0.05) compared with resting value, but that of the focused ultrasound stimulation group did not decrease. Blood flow volume of both groups increased gradually and showed significant increase at 180 seconds after stimulation ( p<0.05). Conclusions: Blood flow volume was increased significantly by both focused ultrasound stimulation and conventional acupuncture. Although a significant decrease of blood flow volume during acupuncture stimulation was observed, no such decrease was observed during ultrasound stimulation. Findings of the present study show that noninvasive stimulation of acupoints by focused ultrasound is as effective as conventional acupuncture in blood flow volume of the brachial artery. [ABSTRACT FROM AUTHOR]

Objectives: This study investigated if nitric oxide (NO) and/or prostaglandin (PG) are responsible for cutaneous vasodilation during warm moxibustion-like thermal stimulation (WMTS). Design: For two protocols, two microdialysis membranes were placed in the medial forearm skin. In the first protocol ( n=8), the sites were randomly assigned and perfused with NG-nitro- l-arginine methyl ester hydrochloride ( l-NAME), an NO synthase inhibitor or Ringer's solution (control site). Similarly, two microdialysis membranes were placed in the medial forearm skin in the second protocol ( n=6). One site was perfused with ketorolac (Keto), the cyclo-oxygenase (COX) pathway inhibitor, and the other site was perfused with Ringer's solution (control site). In both protocols, cutaneous vasodilation was induced using WMTS with an electronic warm moxibustion treatment appliance. After 10 minutes of baseline recording, WMTS was applied to the forearm skin for 20 minutes and recovery was monitored over a period of 20 minutes. Skin blood flow (SkBF) at each site was measured using laser-Doppler flowmetry. Cutaneous vascular conductance (CVC) was calculated as laser-Doppler flux/mean arterial blood pressure (BP). Settings/location: The study was conducted in a laboratory at the Kansai University of Health Sciences. Subjects: The subjects were 14 healthy male volunteers. Interventions: WMTS was applied to the medial forearm skin using an electronic warm moxibustion treatment appliance. Outcome measures: SkBF, skin temperature (Tsk), core body temperature (Tc), heart rate (HR), and BP were outcome measures. Results: In the first protocol, peak CVC values during WMTS at the site perfused with l-NAME were significantly decreased, compared to those at the control site ( p<0.05). In the second protocol, peak CVC values during WMTS did not differ between the control site and the Keto site ( p>0.05). Conclusions: These data demonstrate that NO is involved in the mechanism of cutaneous vasodilation induced by WMTS. Furthermore, increases in CVC despite inhibition of the COX pathway suggest that PG does not contribute to cutaneous vasodilation during WMTS. [ABSTRACT FROM AUTHOR]

Objectives: This study investigated the effect of a brief, simple, home-based yoga program on body pain and health status in child-care workers. Design: This was a randomized, controlled trial comparing a home-based yoga group and a control group. Participants: The trial comprised 98 healthy female nursery school and kindergarten teachers. Interventions: A DVD of a simple home-based yoga program was provided for a period of 2 weeks. Outcome measures: The primary outcome measure was the reported change in body pain at 2 weeks (after intervention) and 4 weeks (follow-up). The secondary outcome measure was the 30-item General Health Questionnaire (GHQ30) score and physical function. Results: The 67 yoga group participants reported improved menstrual pain at 4 weeks; menstrual pain was reduced from 57.0±27.8 to 37.8±26.7 in the yoga group, versus 52.4±36.5 to 46.9±32.1 in the control group (change from baseline in the yoga group versus change from baseline in the control group, −15.3 points; p=0.044). The total GHQ30 score and the GHQ subscale scores ('sleep disturbance' and 'anxiety and dysphoria') improved significantly at 4 weeks in the yoga group, but not in the control group. In the good-adherence group, low back pain improved during the intervention ( p=0.006) and follow-up ( p=0.001) periods. Menstrual pain was also improved ( p=0.044). No adverse events were observed. Conclusions: A home-based simple yoga program may improve the health status of child-care workers. [ABSTRACT FROM AUTHOR]

Background: Insulin resistance is a prominent feature of polycystic ovary syndrome (PCOS), and insulin-sensitizing drugs are used to induce ovulation. Recently, it was reported that an extract from Maitake mushroom ( Grifola frondosa) improves insulin resistance. Objectives: The objective was to explore the effects of Maitake extract (SX-fraction: MSX) to induce ovulation in patients with PCOS in comparison with and in combination with clomiphene citrate (CC). Design: We conducted an open trial with 80 patients with PCOS at three clinics in Japan. Seventy-two (72) new patients were randomly assigned to receive MSX or CC monotherapy for up to 12 weeks. Eighteen (18) patients who did not respond to MSX or CC were subjected to combination therapy of MSX and CC for up to 16 weeks. Eight (8) patients with documented history of failure to CC received combination therapy from the beginning. Ovulation was assessed by ultrasonography. Results: Twenty-six (26) patients in the MSX group and 31 in the CC group were evaluated for ovulation. The ovulation rates for MSX and CC were as follows: 76.9% (20/26) and 93.5% (29/31), respectively by the patients (NS), and 41.7% (30/72) and 69.9% (58/83), respectively, by the cycles ( p = 0.0006). In the combination therapy, 7 of 7 patients who failed in MSX monotherapy and 6 of 8 patients who failed in CC monotherapy showed ovulation. Conclusions: The present study suggests that MSX alone may induce ovulation in PCOS patients and may be useful as an adjunct therapy for patients who failed first-line CC treatment. [ABSTRACT FROM AUTHOR]

Objectives: To verify the effectiveness of aromatherapy massage on elderly patients under long-term hospitalization. Design: Aromatherapy massage was performed twice a week for a total of eight times. Setting: Nursing home. Subjects: Elderly women under long-term hospitalization. Interventions: Questionnaire and measurement of stress marker levels (salivary amylase activity) before and after the first, fifth, and eighth aromatherapy massages. Outcome measures: Questionnaire (Face scale, General Health Questionnaire-12 [GHQ-12]), measurement of salivary amylase activity. Results: A decrease in stress after aromatherapy massage compared to before each massage was confirmed at all measurement times and with the stress marker. No marked reduction was observed in Face scale or saliva amylase activity as a whole over the long term, although decreasing tendencies were seen. Marked reductions in GHQ-12 were observed over the long term. Conclusions: Aroma massage appears likely to prove effective in reducing psychological stress among elderly patients under long-term hospitalization. [ABSTRACT FROM AUTHOR]