The purpose of this study was to clarify difference in heating effect of the two types of bathing for the elderly, footbathing at 44°C and full bathing at 40°C.
The subjects of this study were nine elderly persons for footbathing (average 73.5 years old) and 10 elderly persons for full bathing (average 77.4 years old). The tympanic temperature was measured using a thermistor, sweat rate using the ventral capsule method, and blood pressure and heart rate using an autonomic spygmomanometer during control period 10 minutes before bathing, for 20 minutes during bathing, and for 10 minutes after bathing. Subjects wore plain clothes while taking a footbath time or swimming trunks while taking a full bathing. The ambient temperature was set to 20°C during the footbath or 26°C during the full bathing.
During the footbath, the tympanic temperature increased to 60% that of full bathing and a significant increase of sweat rate was observed. In contrast, during full bathing, a significant rise in systolic blood pressure was observed immediately after bathing started due to hydrostatic pressure and a significant drop of diastolic pressure was observed after bathing due to heating during bathing.
These findings suggest that the footbath is safe, does not cause any change in blood pressure and is expected to provide mild warming for the elderly.

The purpose of this study was to clarify effects of foot bathing at 44°C for the patients with hemiplegia. The subjects of this study were six patients with hemiplegia (average 71.6 years old) and six healthy volunteers (average 74.3 years old). Blood pressure and heart rate were measured using an autonomic spygmomanometer, tympanic temperature using a thermistor, and sweat rate using the ventrilated capsule method during the control period of 10 minutes before foot bathing, for 20 minutes during foot bathing, and for 10 minutes after foot bathing. Subjects wore a plain clothes while taking a footbath and the ambient temperature was set to 20°C. During foot bathing, heart rate was significantly increased, but blood pressure and pressure-rate product did not changed. Tympanic temperature was no significant changed in both subjects during foot bathing. But a significant increase of sweat rate was observed in patients. In healthy volunteers, in contrast, skin blood flow on the bottom of the foot was significant increased. These findings suggest that regulation system of cardiovascular is slightly declined in the patient, and patient's thermoregulatory system was difficult in healthy humans.

The purpose of this study was to clarify the effects of ingesting spa water on electrogastrography and heart rate variability in humans. The subjects were eight youths (average age 22.3 years old). We measured three and six circles per minute (cpm) power of electrogastrography (EGG), the high-frequency (HF: 0.15-0.4Hz) components, and the ratio of low-frequency (LF: 0.04-0.15Hz) components to HF components in heart rate variability (HRV) during 90 minutes. We also assessed the taste of water, pain or abnormalities in the stomach by questionnaire. The subjects ingested the spa water or purified water after thirty minutes, and ingested no water on a different day. The six cpm power of EGG, presumably reflecting instestinal activity, was significantly increased with spa water ingestion. The three cpm power of EGG, presumably reflecting stomach activity, did not change under any conditions. The HF components in HRV, presumably reflecting cardiac parasympathetic activity, tended to increase with ingestion of spa water. The ratio of LF to HF components in HRV, presumably reflecting cardiac sympathetic activity, significantly decreased with ingestion of spa and purified water. There was no difference in the answers of the questionnaire. These findings suggest that spa water ingestion activates instestinal activity, increasing parasympathetic nerve activity and suppressing sympathetic nerve activity in humans.

Purpose
 This study aimed to clarify the effects of footbath (FB) on motor functions (MFs).
Subjects
 The study population comprised 26 healthy volunteers (12 males and 14 females; age, 21-30years, Standard Deviation,25.5±2.8).
Method
 (1) Study design: The footbath group (FBG; 6 males, 8 females) received FB at 42°C for 20 min after 5-min rest. The control group (CG; 6 males, 6 females) was instructed to sit on the chair for 20 min after 5-min rest. (2) Evaluation of MFs: MF was evaluated using the following parameters: long sitting reach (LSR), grips (GP), quadriceps power, stick reaction, and functional reach (FR). MF was evaluated before the rest period (pre-MF) and after load application (post-MF). The results obtained from pre-MF and post-MF assessments were compared. (3) Measurement of tympanic membrane temperature (TM temp) : TM temp was measured every 1 min duimg load application and after the rest period.
Result
 TM temp: Significant increase in the TM temp in the FBG was observed at 18 min in the males and at 20 min in females.
 MF before and after FB: (1) Analysis of all 26 cases: There was no significant difference betweenthe pre-MF and post-MF parameters in both the FBG and CG. (2) Analysis of the findings in males only: The post-FR value in the FBG increased significantly as compared to the pre-FR value, although there was no significant difference between the pre-MF and post-MF results in the CG. (3)Analysis of the findings in females only: In the FBG, post-LSR value increased and the post-GP value decreased significantly as compared to the corresponding values, although there was no significant difference between the pre-MF and post-MF in the CG.
Conclusion
 Our results suggest that FB improves MF in healthy volunteers. Gender ditiference should be considered while establishing effective FB treatment programs in Balneology.

BACKGROUND/AIMS: Peyer's patches (PPs) are aggregates of lymphoid follicles that are mainly located in the distal ileum; they play a major role in mucosal immunity. We recently reported that patients with ulcerative colitis (UC) have alterations in PPs that can be detected using narrow-band imaging with magnifying endoscopy (NBI-ME). However, the usefulness of NBI-ME in UC treatment as a whole is still unknown. METHODS: We collected NBI-ME images of PPs from 67 UC patients who had undergone ileocolonoscopy. We evaluated changes in the villi using the "villi index," which is based on three categories: irregular formation, hyperemia, and altered vascular network pattern. The patients were divided into two groups on the basis of villi index: low (L)- and high (H)-types. We then determined the correlation between morphological alteration of the PPs and various clinical characteristics. In 52 patients who were in clinical remission, we also analyzed the correlation between NBI-ME findings of PPs and clinical recurrence. RESULTS: The time to clinical recurrence was significantly shorter in remissive UC patients with H-type PPs than in those with L-type PPs (P<0.01). Moreover, PP alterations were not correlated with age, sex, disease duration, clinical activity, endoscopic score, or extent of disease involvement. Multivariate analysis revealed that the existence of H-type PPs was an independent risk factor for clinical recurrence (hazard ratio, 3.3; P<0.01). CONCLUSIONS: UC patients with morphological alterations in PPs were at high risk of clinical relapse. Therefore, to predict the clinical course of UC, it may be useful to evaluate NBI-ME images of PPs.
Colitis, Ulcerative* ; Endoscopy* ; Humans ; Hyperemia ; Ileum ; Immunity, Mucosal ; Multivariate Analysis ; Peyer's Patches* ; Recurrence* ; Risk Factors ; Ulcer*

BACKGROUND/AIMS: Peyer's patches (PPs) are aggregates of lymphoid follicles that are mainly located in the distal ileum; they play a major role in mucosal immunity. We recently reported that patients with ulcerative colitis (UC) have alterations in PPs that can be detected using narrow-band imaging with magnifying endoscopy (NBI-ME). However, the usefulness of NBI-ME in UC treatment as a whole is still unknown. METHODS: We collected NBI-ME images of PPs from 67 UC patients who had undergone ileocolonoscopy. We evaluated changes in the villi using the "villi index," which is based on three categories: irregular formation, hyperemia, and altered vascular network pattern. The patients were divided into two groups on the basis of villi index: low (L)- and high (H)-types. We then determined the correlation between morphological alteration of the PPs and various clinical characteristics. In 52 patients who were in clinical remission, we also analyzed the correlation between NBI-ME findings of PPs and clinical recurrence. RESULTS: The time to clinical recurrence was significantly shorter in remissive UC patients with H-type PPs than in those with L-type PPs (P<0.01). Moreover, PP alterations were not correlated with age, sex, disease duration, clinical activity, endoscopic score, or extent of disease involvement. Multivariate analysis revealed that the existence of H-type PPs was an independent risk factor for clinical recurrence (hazard ratio, 3.3; P<0.01). CONCLUSIONS: UC patients with morphological alterations in PPs were at high risk of clinical relapse. Therefore, to predict the clinical course of UC, it may be useful to evaluate NBI-ME images of PPs.
Colitis, Ulcerative* ; Endoscopy* ; Humans ; Hyperemia ; Ileum ; Immunity, Mucosal ; Multivariate Analysis ; Peyer's Patches* ; Recurrence* ; Risk Factors ; Ulcer*

Objective: In order to ensure the safety of nursing home residents, it is very important to implement appropriate assistance to ensure compliance with necessary medication. The purpose of this study is to identify issues and to plan solutions for medication assistance.Design: We conducted a workshop involving care workers (CWs), nurses and pharmacists together.Methods: Using the KJ method, participants extracted problems related to medication assistance and planned solutions in a mixed group of CWs, nurses and pharmacists. Questionnaire surveys were conducted for the participants before, immediately after, and 3 months after the workshop.Results: A number of important and urgent issues related to medication assistance were identified. There were differences in the recognition patterns of the importance and urgency of the issues among the three categories of participants. In addition, many possible solutions were proposed. Among these solutions, 25% had been implemented by at least two participants. More than 75 % of participants felt that their awareness of the value of cooperation in medication assistance had been improved by participating in the workshop.Conclusion: These results suggest that a workshop with a group of CWs, nurses and pharmacists in one place is a useful approach for extracting problems and planning effective solutions related to cooperation in medication assistance.