Thirty-one outpatients with acute low back pain were all educated about activities of daily living. They also received spinal manipulation and SSP (TENS), and took NSAID for a certain period of time. Half of them were additionally exposed an electric field using HEAL THTRON, an electric field therapeutic decice, in order to analyze its efficacy.
The patients were randomly divided (non-blind test) into two groups. Those who received ordinary treatment were called the Non-HEALTHTRON group (NH-group); those who received HEALTHTRON treatment in addition to ordinary treatment were called the HEALTHTRON Treatment group (H-group). During the 15-day study period, the patients were subjected to a total of four electric field exposures using HEALTHTRON. Efficacy of the treatment was measured as an objective evaluation by measuring range of motion (ROM) using an inclinometer, and Peak torque and Total work using a dynamometer. A subjective evaluation was performed using the Oswestry Low Back Pain Disability Questionnaire, ADL pain questionnaire, Visual analog scale for Patient global assessment, VAS (Patient) and Visual analog scale for Physician global assessment, VAS (Physician). After ordinary treatment, significant improvement was found in all 31 patients with acute low back pain. The VAS (Physician), ADL pain questionnaire and ROM were more significantly improved in the H-group than in the NH-group.

The effect of the extracts of herb drugs in hydrotherapy was studied by recording skin surface temperature, intramuscular temperature, finger tip pletysmography and impedance pletysmography which were measured before taking the testee into the Hubbart tank containing 0.003% of B. H at 40°C for 10 minutes and at proper period until 2 hours after finishin the hydrotherapy.
The control study was done in simple water-bath in the same method.
30 testee were used for the test.
Results were as follows:
1. Skin surface temperature of B. H group showed 0.6-1.1°C higher than that of the control until 2 hours demonstrating significant difference.
2. Intramuscular temperature of B. H group showed 0.4-0.8°C higher than that of the control until 1 hour demonstrating significant difference. The difference in temperature however after 2 hours was not sifnificant.
3. The wave height of finger tip pletymography of B. H group was higher in significant difference, and presented 61% higher peak than the control at 50 minutes later.
4. IPG means blood flow of lower extremity, and then the wave peak height of B. H group showed significant difference against the control, especially the difference was the largest at 60 minute later.
We may conclude that the extracts of herb drugs in hydrotherapy played a role to promote blood circulation, suppress pain, relax the muscular tone, depress itching, make feel at home, keep the skin moisture and wash off the dirt well.

Biochemical and physiological effect of high voltage electric field was examined. Therapy by this method is considered to be a core technique in the field of rehabilitation and physical medicine.
Healthtron HES-30 (designed by the Hakuji Institute of Biological Science) was used to the patients with adult diseases, such as diabetes mellitus, hypertension, CVA, ischemic heart disease, obesity and gout, for 15 minutes in each treatment, 3 times a week.
1. Immediately after the treatment blood pressure decreased on the average by 18.6mmHg among the patients with systolic blood pressure of 160mmHg or more. But an increase of 5.5mmHg was observed among the patients with systolic blood pressure of 100mmHg or less. The varities in systolic blood pressure among the patients were significantly different from these among normotensives, who demonstrated the decrease of 5.8mmHg.
2. Percentage change in blood pressure, defined as the rate of the blood pressure reduced over the initial blood pressure, was positively correlated with the ren in ratio (r=0.8). The more related the blood pressure to sympathetic nerve, the more remarkable the percentage change.
3. Three of six patients with mild pituitary hormone insufficiency demonstrated symptomatic improvements together with the normalization of endocrinological distrubance. The urine sample indicated an increase of 17-OHCS and 17-KS. The serum cortisol also showed the normal U-shaped response. Rapid ACTH test showed the normalization of the previous delayed response. Pituitary reserve test also suggested the reactivation of the pituitary function.
4. Six (17%) of 35 patients with adult diseases showed the decreased TG level of 30mg/dl or more. Seven (27%) of 26 patients with high FFA level demonstrated the normal range. The improvement of the FFA level was observed in two of 4 patients with low FFA level due to hypofunction of the pituitary gland.
5. Total cholesterol level was not significantly altered. Among 18 patients with adult disease and with the low value of HDL-cholesterol, HDL-cholesterol level tended to increase
6. Thse particular findings were believed to suggest that the high voltage electric field has an effect of normalizing the abnormal blood pressure, and that the hypothalamus, pituitary gland and adrenal cortex were stimulated through the limbic system and reticular formation. Among the patients with adult disease, serum lipids seem to be affected in a favorable direction by this electric field.

Effects of acupuncture were studied using various measurements on a case of PSS (Progressive Systemic Sclerosis) in which symptoms had not been improved by chemo-therapy nor rehabilitation. Acupuncture was undertaken in a therapy room with constant temperature and humidity. The measurements were done before and after the weekly treatment. Although skin temperature and the contact area of the hand showed significant changes, no obvious improvement was seen in systemic symptoms such as bowel movements. Point selection and measurements employed here differ from those of Maeda et al., there remain many questions including duration and mechanism. Since no other methods have been clinically established as effective for treating this disease, acupuncture should be considered.

Joint mobilization (i. e. intracapsular passive exercise) is now attracting clinicians' attention as manipulative therapy for pain of intervertebral joint disorder.
In the present paper, introducing a part of a mobilization technique for the lumbar and sacroiliac joint and our mobilization evaluating method, we report a comparative study on the efficacy of acupuncture and mobilization therapy using our “lumbago evaluation chart”.
METHOD
Fifteen lumbago outpatients (6 males and 9 females with average age of 41.6±16.28 years) of our physiotherapy department, who showed no remarkable radiographic changes, were divided into three groups: Acupucnture alone, mobilization alone, and both acupuncture and mobilization were, performed for A, B, and C group respectively. Their responses were compared on the evaluation chart.
The patients were asked to rate the severity of pain and disability on a four grade basis. Five movements were chosen from A. D. L. and the results were rated as “easy”, “difficult” and “impossible”. The following were measured for lumbar flexibility: the distance between the finger-tip and the floor; the maximum backward bending of the upper body; S. L. R.; the distance between the S₁ and an upper point on the skin (10cm in an erect posture) at the maximal flexion the distance between the top of the iliac crest and an upper point (10cm in an erect posture) at the maximal lateral flexion.
Tenderness was measured with an algesiometer (maximum 10kg). CHILLS were rated on a three-grade basis. All the measured values were rated so that the maximum number of the total points in the evaluation chart was 100. Another chart (a mobilization test chart) was made, in which the severity of STIFFNESS and PAIN was rated on the following basis: None=0, Minimal=1, Severe=2, and the maximum total was 50.
RESULT
1) As for the score of “TENDERNESS and CHILLS”, C group was significantly different from both A and B group at 10% level by t-test. As for the total score, C group was significatly different from A and B group at the 0.5% level.
2) C group showed high rated improvement in the score of “PAIN”, “TENDERNESS”, and “STIFFNESS” after treatment.
3) Tenderness was often detected at VU₅₂ Zhishi and VU₄₀ Weizhong, and lumbar vertebrae stiffness was often seen in the lower part.
CONCLUSION
1) An evaluation chart for lumbago was developed to rate the symptoms.
2) Lumbago pationts without remarkable x-ray findings underwent acupuncture alone, mobilization alone, or both acupuncture and mobilization. The score of the evaluation chart has shown that combined use of acupuncture and mobilization is more effective than solitary use of each therapy in relieving pain.

We executed an acupuncture therapy to 62 lumbar spinal canal stenosis cases who were diagnosed by CT, MRI photo state and clinical symptom and examined the result.
The 36 men and 26 women in this study had a mean age of 67.3 years.
An acupuncture was executed by aiming to give an effect to the soft tissues and a blood circulation around the area where the stenosis was recognized then pierced facet joint closely and deeply and gave an electric acupuncture stimulus.
14 cases were very good and 17 cases had good results according to the JOA score. No cases worsened.
We concluded an acupuncture treatment was effective for treating lumbar spinal canal stenosis.

We report a clinical study conducted to investigate the effects of Electric Field Therapy (EFT) generated by HEALTHTRON on the stiffness in the neck and shoulder area. In Japan, most cases of stiffness in the neck and shoulder area are caused by painfully hypertonic muscles due to various causes such as cervical damage, mechanical stress, disordered cutaneous sensation and psychogenic stress. Internal disorders can also be significant causes of the painful stiffness in the neck and shoulder area. Subjects were 62 outpatients with chief complaints of stiffness in the neck and shoulder area. Informed consent was obtained from each subject. The patients with organic and/or pathological changes in the muscloskeletal system, mental disorder, or internal disease were not included in this study according to the exclusion criteria for feasible focus in hypertonic muscles.
The present study consists of two comparisons, 1) standard treatment in our clinic vs. additional HEALTHTRON, by observing the visual analogue scale (VAS) of stiffness in the neck and shoulder area and general condition, lymphocyte percentage in peripheral blood, blood pressure, and 2) HEALTHTRON alone vs. direct-contact electric stimulation (DCES) alone by observing circulatory blood in the trapezium, and the changes of autonomic nervous activity by heart rate variability (HRV). Results of the first research revealed that the stiffness in the neck and shoulder area was improved more quickly by additional HEALTHTRON than by the standard treatment, according to the results of VAS analysis. The general conditions were also improved in the patients treated with the additional HEALTHTRON. The lymphocyte percentage was increased by the addition HEALTHTRON, which suggested that parasympathetic nerve get a predominant position. The average blood pressure in the hypertensive patients in both groups was decreased after the treatment in this investigation, but blood pressure did not change in the patients with hypotension. The second research found that the blood circulation in the trapezium increased in each group treated with HEALTHTRON or DCES; however, the differences between two groups were not statistically significant. No changes in activity of the autonomic regulation were observed in the patients treated with DCES from an analysis of HRV. In contrast, the sympathetic and parasympathetic nervous systems were activated by HEALTHTRON, according to HRV analysis. These results suggest that EFT (HEALTHTRON) are effective for treating stiffness in the neck and shoulder area, and improve the status of the autonomic nervous system.

The effect of the granules composed of Natril siccatus and herbal extracts in hydrotherapy was studied by recording skin surface temperature, deep body temperature from the intact skin, pletysmography, impedance pletysmography, blood pressure and subjective evaluation. These were measured before taking the testee into the Hubbart tank containing 0.0085% of herb granules at 40°C for 10 minutes, soon after taking a bath and at proper period until 2 hours.
The control study was done in simple water-bath in the same method. 30 testee were used for the test.
Results were as follows:
1. Skin surface temperature of H. G. group showed significant higher at the distal area of the extremities compaired with the control group.
2. Deep body temperature of H. G. group showed significant higher at right heel (10mm depth from the skin), palm (5mm) and calf (30mm) against the control.
3. The wave height of pletysmography of the index and the first toe of H. G. group was higher than the control at 100 minutes later.
4. IPG of H. G. group showed significant difference in upper and lower extremities against the control.
5. The change of the blood pressure showed no difference between two groups.
6. The subjective evaluation was scored and the t-test showed significant difference against the control, especially the difference was the most marked in utility feeling, and the effect of keeping warmth was in significant difference.
We may conclude that the H. G. in hydrotherapy has a sweet smell, make fell at home, keep warmth and play a role to promote blood circulation.

We introduced active educational methods in medical ethics education and evaluated their effect on medical students. Three methods were used: 1) small-group discussion to clarify the clinical ethical issues, 2) self-study to analyze examples of doctors' explanations to patients, and 3) self-study with videotapes to recognize informed consent. We asked students to write a report on each subject of the three studies. Before grading their reports, we determined a standard answer for each subject and marked their reports according to an absolute standard. We found the mean value and standard error of the students' scores in study 1 were significantly higher than those in study 2 or 3. These results suggest that small-group discussion is an effective educational method and useful in the analysis of clinical ethical issues.