From around 1990, it has been suggested that our internal defense system is composed of two distinct elements ; local innate immunity principally arranged on surface areas to establish barriers against various pathogens, and systemic acquired immunity mainly seen in systemic compartments to survey and control internal damage and disorders. The former innate surface barrier is chiefly regulated via species-restricted CD 1 antigen-presenting molecules, through lipid/glycolipid antigens presented mainly by dendritic cells (DCs) and lacking antigen-specific memory through gene-rearrangements, while the latter acquired barrier is controlled by individually restricted MHC molecules and gains antigen-specific memory through gene-rearrangements. Surprisingly, it had been revealed more than 2,000 years before in the ancient Chinese medicine textbook, Ko-tei-nai-kei, that our defense system is also classified into two categories, named “defense-qi” and “nutritional-qi”, and shown that the former “defense-qi” is arranged at the surface of skin to control our sweat and interact with “muddy” substances, while the latter “nutritional-qi” is situated on and within blood vessels and produces purified nutrients from food, drink and other exogenous substances. In this review, based on our recent understanding of immunological progress and the modern concepts of immunity, the possible relationship between “defense-qi” and innate immunity as well as “nutritional-qi” and acquired immunity are discussed.

  To examine effects of travel and spa spring to bath death, that of visitors and residents were extracted from inquests from 1984 to 2007 at Naruko Police Office. Total bath death was 192, of which 128 visitors and 64 residents. Average number of visitors per year was 261,000, and average population of residents was 25,468. During first half period bath death of visitors was 80 and residents 15, whereas during latter half visitors 48 and residents 49. Despite day-trippers were as more as 1.5 times to 2.5 times than visitors, bath death of them was scarcely seen. Average mortality rate of bath death for 100,000 of visitors during first half was 225, and in latter half 174, while that of residents was 4.5 in first half and 17.4 in latter half. Therefore ratio of mortality rate of visitors to residents has been ten times or more. Bath death had increased in winter, at from 20:00 to 2:00, on over 40 Celsius degrees of temperature of bathtub, on 20 Celsius degrees or more of temperature difference between bathtub and room, in seniority from 75 to 85 years old, and in drinkers. It was suggested that because bath death was scarcely seen in day-trippers which were more than visitors, risk factor of bath death was not bathing or hot spring, but any combination of inadequate bathing, travel and staying. The maximum risk factor of bath death seemed to be ageing, and or the travel and staying seemed to become stronger stress for elders.

  Content We investigated 76 cases during the 6-year period from 1999 to 2005 in which a patient who developed a consciousness disorder while bathing was brought to the Emergency and Critical Care Center of Tokyo Women's Medical University Medical Center East. In. 86% of the cases the patient was in cardiopulmonary arrest, and they had a group of diseases with a poor prognosis in which the outcome was death, even the 6% of the patients who were resuscitated.
The most common age group was the 70-to 79-year group, which contained 46% of the patients, and those 70 years of age and older accounted for 70% of the total.
  Examination was possible in 16 cases, and the most common category, in 10 of them, was “drowning/suspicion of transient ischemic attack”. Adequate examinations were not performed on the patients who died in the outpatient department. Moreover, because the autopsy rate was low, it was impossible to make a definitive etiological diagnosis. However, the fact that “many were elderly persons whose autonomic nervous system's regulatory function is reduced” and that “the incidence was highest during the winter (53% during the 3 months from December to February)” suggests involvement of cardiovascular and cerebrovascular diseases secondary to changes in blood pressure. Many preventive measures have been described in the literature, and improvement in the resuscitation rate is expected as a result of becoming familiar with. and thoroughly implementing them. All 10 cases that occurred in public baths, where the time before discovery should have been short, were cases of cardiopulmonary arrest, and it is impossible to clearly explain why resuseitation attempts failed in all 10 of them. In order to identify the causative diseases we think it would be worthwhile to consider 1) performing a whole-body CT examination after confirming death, and 2) perforrning open-chest cardiac massage (only in patients brought to the hospital within a short time).

As for spontaneous case reports of suspected adverse drug reactions, the following problems are known, a part of phenomenon actually recognized to be side effects in clinical site is reported, moreover, the thing which report bias which fluctuate produces by a factor with the various rates exists, since an appearance ratio is incalculable, it cannot be adapted in the analysis technique for common side-effects data. Therefore, the search algorithm analyzing method of signal detection has been established. Japanese Adverse Drug Event Report database (abbreviation; JADER) is exhibited from Pharmaceuticals and Medical Devices Agency (abbreviation; PMDA) to April 2012, and can use anyone now without restrictions. It is expected that the quality of research of pharmacoepidemiology will improve by practical use of JADER. However, as for the present condition, there are few reports of the practical use example in a pharmaceutical company as a subject which tends to attract attention from “signal detection” as the practical use method, consequently regulatory agency should cope with. Although the pharmacoepidemiology group of the author Japanese Society for Biopharmaceutical Statistics is not comprehensive before public presentation of JADER, the list obtained by “case report line list search with which side effects are suspected” which PMDA offers was collected and put in a database, and practical use in a pharmaceutical company has been tried by referring to the examination method of pharmacoepidemiology. This paper explains the processing method of the JADER data for enabling signal detection. Using this method, application to the subject of much pharmacoepidemiology is performed actively, and it expects to contribute to improvement in the quality of research of pharmacoepidemiology.

Music therapy may be described as psychotherapy using music. Through music, the therapist shares something with a patient that can not be expressed in words, thus helping the patient progress while increasing the power of self healing and improving the quality of life. This is generally the case in artistically centered therapy. In this paper, I survey the present status, history, forms and objectives of music therapy in Japan, presenting the latest research on the effectiveness of music therapy for people with dementia and terminal patients, and describing the methods of music therapy in these areas.

Since the reexamination system of new drugs has been in place for about thirty years, it is necessary to reconsider its management. The time from the reexamination application of new drugs until issuance of the results takes several years recently. General drugs are applied during the reexamination application and are approved before reconfirmation of the efficacy and safety of new drugs. Therefore, the reexamination system is not effectively operated. Although the informations for proper use collected from post-marketing investigations and clinical trials, and spontaneous adverse reaction reports of new drugs, etc. during the reexamination period are utilized for its safety measures, the plan for effective use is not systematically managed. We propose an improved plan for a future reexamination system. Further, we propose the introduction of a risk management plan in Japan; the current one of which lags behind EU and US.