It is well known that spa therapy is quite useful for the so-called life-style related diseases. It is therefore speculated that the number of aged people to be cared by the public insurance of elderly care may be less in spa districts than in non spa districts. As a matter of fact it was demonstrated in Oita prefecture that the number of aged people qualified for receiving the care was significantly less in Beppu city and Yufuin town which are well known as spa resort than in the surrounding non spa city or towns.
This report is the result tallied up on the data from 38 prefectures all over Japan, regarding the number of aged people and hot springs. Although the ratio of number of aged people qualified for receiving the care to all aged people over 65 y-o is quite different among both the prefectures and the cities or towns under the same prefecture, the tendency of lower ratio in spa cities or towns than in the others was observed. It suggests the more prospective study is necessary on the effects of spa bathing on ADL disorders of aged people.

We report a case of pseudoaneurysm of the left internal iliac artery after intravesical Bacillus Calmette-Guerin (BCG) therapy for bladder cancer. A 75-year-old man was referred to us with lumbar pain and recurring fever. One year previously he was treated for bladder cancer with transurethral resection, followed by adjuvant intravesical BCG therapy lasting 11 months. Computed tomography scanning demonstrated a pseudoaneurysm and perianeurysmal inflammatory changes in the region of the left internal iliac artery. An emergency operation was performed under a diagnosis of impending rupture of the tuberculous left internal iliac arterial aneurysm. Because of the urinary tract stenosis, which was caused by the aneurysm, we inserted a ureteral stent preoperatively. We performed aneurysmectomy and femorofemoral cross over bypass. After 10 months of antituberculous chemotherapy, CT showed no recurrence of infectious aneurysm. Although intravesical BCG therapy is generally considered safe, serious complications including vascular complication have been reported. A mycotic origin should be considered when an aneurysm is discovered after BCG therapy. The prophylactic use of a ureteral stent in mycotic iliac arterial surgery may lead to minor complications.

In patients with the visceral fat type obesity, there is a high incidence of glucose and lipid metabolic abnormalities and hypertension. We obtained the following results from a study of the relationship between the degree of visceral fat obesity and metabolic and vascular complications in 98 obese patients with various complications.
1. Viceral fat obesity (V/S ratio ≥ 0.4) was found in 74% of the subjects. The incidence was higher in males than females. The highest incidence was observed in both men and women in thier 40s, and there was no increase with age.
2. The V/S ratio was high in patients with hyperlipidemia, diabetes, and fatty liver in that order. In the V/S ≥ 0.4 group, there was a higher incidence of hyperlipidemia and ischemic heart disease than in the V/S<0.4 group.
3. The V/S ratio was higher in the patients with two or more metabolic and vascular complications than in those with only one complication.
4. A questionnaire survey showed that there were many individuals who did almost no exercise and had a long history of obesity in the V/S ≥ 0.4 group.
5. The V/S ≥ 0.4 group had high triglyceride levels. There was a positive correlation between the V/ S ratio or V value and the trigyceride level, but no correlation between S value and triglyceride level.