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.

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.

Remedial education in the basic sciences (biology, physics, and chemistry) for medical students was introduced at Kinki University in 1993. The effects and problems of premedical education were examined on the basis of a questionnaire to students and of scores on biology examinations at the time of university entrance and at the end of the first academic year. From 1999 through 2002, the average percentage of incoming freshmen who had not taken a biology course in senior high school ranged from 45.8% to 61.6%. The average score of these students on biology examinations was 23.2 to 29 points higher at the end of the first academic year than at university entrance. Thus, we found that remedial education helped improve these results. However, according to the questionnaire 26.4% of students who received remedial education felt that it had had no effect. Even at the end of the first academic year, the difference in the average score between students who had studied biology in high school and those who had not was 17 points.

1)Training elderly simulated patients (SPs) will enhance elderly persons' contribution to education. Such training will also help universities contribute to the community and help elderly persons be more productive in their activities.
2)Training programs for elderly SPs and follow–up seminars focusing on the display of symptoms requested by participants were held. The aim of this program was to train SPs to participate in the preclinical educational activities of the university. The participants evaluated the program to be satisfactory.

1) This study involved an educational evaluation of preclinical practice with simulated patients (SPs) by students in the departments of nursing, physiotherapy, and occupational therapy. The scores were highly correlated with the usefulness of SPs, the conviction and the realism of the performances of SPs, and feedback from SPs. Students required SPs to accurately mimic symptoms and to give them critical feedback. Follow-up sessions are required regarding performance as SPs.
2) Preclinical practice with SPs helped students grasp the reality of practice, enhance preparations, and help them recognize their role as professionals based on feedbacks from SPs.

The Ministry of Health and Welfare of Japan is planning a pooling system for multiple-choice questions (MCQs) for the national examination for medical practitioners. To clarify possible problems of such a system, a field study was performed by 10 medical schools in Japan using 90 MCQs from previous examinations. Nine hundred twenty-four 6th-year students participated in the field test. For each MCQ, the correct-response rates at the originating school and those obtained in the field test were significantly correlated. Thus, the correct-response rates to questions on the field test could be predicted from the rates at the originating schools. However, for each question the correct-response rate was significantly higher for students of the originating school than for students of other schools. In the national examination, care should be taken to prevent differences in scores on the basis of question sources.

Methods: Thirty patients with ASD aged ≥50 years who were admitted to our hospital between July 2016 and September 2019 were included in this study. X-ray parameters (i.e., sagittal vertical axis, pelvic tilt, and pelvic incidence minus lumbar lordosis) were evaluated from the full-length standing radiographs of the subjects. Trunk and hip extensor strength was evaluated using a hand-held dynamometer. Dynamic postural changes (i.e., sagittal trunk shift during standing, sagittal trunk shift during gait, and delta sagittal trunk shift) were assessed using a three-dimensional motion analysis system. The relationships between dynamic postural change and various X-ray parameters, as well as trunk and hip extensor strength, were examined using multivariable analysis. Results: Multivariable analysis showed that hip extensor strength is the factor most strongly associated with dynamic postural change among the X-ray parameters and physical functions assessed in this study (β=−0.41, R2=0.12). Conclusions We demonstrated the association between dynamic postural change and hip extensor strength in patients with ASD. Our results may be useful to healthcare providers treating patients with ASD. Interventions for dynamic postural change in patients with ASD should focus on hip extensor strength.

Methods: Thirty patients with LSS scheduled for spine surgery participated in this study. Lower limb pain was assessed using the Visual Analog Scale (VAS), and the patients were divided into two groups based on the mean scores (patients with scores above and below the mean were classified as the high-VAS and low-VAS groups, respectively). The kinematics of the spine, pelvis, and hip joints during gait were then measured using a 3D motion analysis system. Student paired t -tests were used to compare the angles of the spine, pelvis, and hip during gait between the two groups. Results: Compared to those in the low-VAS group, the spine was significantly extended and bent toward the more painful lower limb side, and the pelvis was significantly anteriorly tilted among individuals in the high-VAS group. Conclusions Patients with LSS experiencing severe pain in their lower limb tend to keep the spine in a more extended position, bend laterally toward the painful side, and have an anteriorly tilted pelvic posture. The dynamic spinal and pelvic alignment was closely related to the intensity of the lower limb pain.

Objective: This study assessed the regional disparities and the associated factors in the implementation of cardiac rehabilitation in Japan.Materials and Methods: Regional disparities were investigated by comparing the number of cardiac rehabilitation units in each of 47 prefectures in Japan based on the National Database of Health Insurance Claims Open Data published by the Ministry of Health, Labour, and Welfare. The relationships between the numbers of inpatient and outpatient cardiac rehabilitation units and the numbers of registered instructors of cardiac rehabilitation, board-certified physiatrists, and board-certified cardiologists were examined.Results: The region with the highest and lowest numbers of inpatient units showed 11,620.5 and 1,650.2 population-adjusted cardiac rehabilitation units adjusted per 100,000 population, respectively, corresponding to a 7.0-fold difference. Meanwhile, 4,865.3 and 238.6 units were present in the regions with the highest and lowest numbers of outpatient units, respectively, corresponding to a 20.4-fold regional disparity. Our analysis showed that the population-adjusted number of inpatient cardiac rehabilitation units was significantly associated with the population-adjusted numbers of registered instructors of cardiac rehabilitation (r=0.647, P<0.001) and board-certified cardiologists (r=0.445, P=0.002) but only marginally associated with the population-adjusted number of board-certified physiatrists (r=0.329, P=0.024). Moreover, the population-adjusted number of outpatient cardiac rehabilitation units was significantly associated with the population-adjusted numbers of registered instructors of cardiac rehabilitation (r=0.406, P=0.005) and board-certified cardiologists (r=0.450, P=0.002) but not with the population-adjusted number of board-certified physiatrists (r=0.078, P=0.603).Conclusion: Large regional disparities were observed during the implementation of cardiac rehabilitation. Increased numbers of cardiac rehabilitation instructors and cardiac rehabilitation practices are expected to eliminate these regional differences in cardiac rehabilitation practices.