The Ministry of Health and Welfare inaugurated an official recognition system for spa-based health promotion facilities in 1988 as part of its health promotion program. As a result, those facilities gradually increased across the country until the number of the recognized facilities reached 17 by February 1995.
The Japan Health & Research Institute has performed factfinding surveys on the use of these recognized spa-based health promotion facilities every year from the beginning of the recognition system. This paper reports the survey results obtained during these 5 years.
During the past 5 years, 275 males and 138 females used these spa-based health promotion facilities (with tax deductions applied to madical expenses). The number of male patients was about twice as large as that of female patients. Most males used the facilities because of diseases in the field of internal medicine, and most females, because of diseases in the field of orthopedic surgery.
We are planning to prepare a manual for evaluating the effects of spa therapy and assess the efficacy of spa therapy by including a new survey item of “clinical effects of spa therapy” in a questionnaire for a nationwide survey.

We investigated the system of emergency medical service in the Chuno area in Gifu prefecture.It was found that about 20,000 emergency cases were carried into the Emergency Medical Center (EMC) in Chuno Kosei Hospital annually. About 90% were patitents with mild disease or injury. During the past four years an increasing number of severely ill patients such as those acute myocardial infarction and cerebral apoplexy were transfered to our EMC from other hospitals in the Chuno area.We found that many emergency patients came to our EMC, which was not staffed with so many emergency care specialists nor equiped with so many beds for emergency patients. Therefore, we requested residents, family doctors, primary care clinics, common hospitals and administrators in the Chuno area, to contribute their share to emergency medical care together with EMC.In conclusion, we thought it necessary to build a better system of emergency medical care in this area promptly.
Area ; Medical ; Central ; Bale out ; medical care

The purpose of this study was to determine the age and habitual physical activity on re-oxygenation time in working muscles following maximal cycling exercise (CycEXmax). Twelve sedentary middle-aged (50±6), 13 sedentary elderly (66±3), 13 active middle-aged (53±5), and 20 active elderly (67±5) were evaluated the half re-oxygenation time (T1/2 reoxy) as an index of oxygen delivery, using near-infrared spectroscopy at the vastus lateralis (VL) and lateral head of the gastrocnemius (LG) after CycEXmax. T1/2 reoxys at VL and LG were significantly greater in the elderly subjects than in the middle-aged subjects in both sedentary and active groups. T1/2 reoxys at VL and LG of the active group were smaller than those of the sedentary group, regardless of age. The results of this study suggest that habitual physical activity may attenuate age-related prolongation in T1/2 reoxy in working muscles although ageing delay T1/2 reoxy in working muscles.

A case of abdominal aortic aneurysm associated with systemic lupus erythematosus (SLE) is described. SLE is rarely associated with aneurysm of great arteries. Histological investigation revealed marked infiltration of inflammatory cells in the aneurysmal aortic wall. Immunocytochemical analysis using anti-factor VIII-related antigen antibody showed a marked increase of the vasa vasorum with luminal narrowing due to intimal thickning. In this case the major etiology of aortic aneurysm is considered to be non-specific inflammation of the abdominal aorta, not arteriosclerosis.

Objective: Several evidence-based practice guidelines have been developed to better treat bipolar disorder. However, the articles cited in these guidelines were based on clinical or basic studies with specific conditional settings and were not sufficiently based on real-world clinical practice. In particular, there was little information on the doses of mood stabilizers. Methods: The MUlticenter treatment SUrvey on BIpolar disorder in Japanese psychiatric clinics (MUSUBI) is a study conducted to accumulate evidence on the real-world practical treatment of bipolar disorder. The questionnaire included patient characteristics such as comorbidities, mental status, treatment period, Global Assessment of Functioning (GAF) score, and details of pharmacological treatment. Results: Most patients received mood stabilizers such as lithium (n = 1,317), valproic acid (n = 808), carbamazepine (n = 136), and lamotrigine (n = 665). The dose of lithium was correlated with age, body weight, number of episodes, depression and GAF. The dose of valproic acid was correlated with body weight, number of episodes, presence of a rapid cycle and GAF. The dose of carbamazepine was correlated with age, mania, and the presence of a rapid cycle. The dose of lamotrigine was correlated with the number of episodes, depression, mania, psychotic features, and the presence of a rapid cycle. Doses of coadministered mood stabilizers were significantly correlated, except for the combination of valproic acid and lamotrigine. Conclusion The dose of mood stabilizers was selectively administered based on several factors, such as age, body composition, current mood status and functioning. Further prospective studies are required to confirm these findings.