Background
 In recent years, inbound tourists to Japan are increasing. Although they rarely suffer diseases or injuries during travels, they may feel anxiety for medical services in foreign countries. This study was aimed to consider how inbound tourists visiting Japan feel about Japanese medical cares.
Methods
 Inbound tourists who came to the Tokyo Sightseeing Information Center were investigated. The questionnaire composed of 12 items relating to Japanese medical cares and levels was made in three languages; English, Chinese and Korean.
Results
 A total of 163 tourists including 98 English speakers, 39 Korean speakers and 26 Chinese speakers were enrolled in the study. (1) Native English speakers had a high anxiety about the communication with Japanese medical staffs (p<0.001). (2) Chinese and Korean speakers subjective estimated the Japanese medical level low (p <0.001). (3) Chinese and Korean speakers had a high anxiety for medical costs while traveling (p<0.001). (4) In a case of emergency, English speakers mostly “look for a drugstore and a hospital”, while Chinese and Korean speakers mostly “contact a travel agency and a tour conductor”.
Conclusion
 Considering foreign tourists' needs vary with their nationality and culture, Medical staffs should support them to have desired medical care in Japan.

High-quality terminal care cannot be given without good communication and understanding among patients, their family members and health as well as medical professionals.Recently, we have taken a questionnaire survey on new inpatients in our hospital to sound them out on their thinkings about hospital care, and examined the findings along with the validity of survey.Many respondents including those contracting either benign or malignant diseases wished to be keptposted on what they are really up against and to partake in the decision-making process before treatment plans are put into practice. The recent questionnaire survey has proved to be worthwhile as a tool to know the wishes of hospitalized patients and suggested an effective way to promote the practice of obtaining informed consent before specific test and therapautic procedure.

We previously reported that a case of yokukansan efficaciousness for weight gain due to overeating behavior following bariatric surgery. The reason is considered that yokukansan stabilized the patient's mental state. So, we proposed that administration of oriental medicines for mental state might be a new way of treating obesity. We investigated the efficacy of mazindol, bofutsushosan or yokukansan for obese patients. We retrospectively reviewed clinical data to identify patients administered mazindol, bofutsushosan or yokukansan for treatment of obesity. The inclusion criteria were patients tolerant to medicine for 3 months, and who could be administered yokukansan for anger. A total of 107 patients met these selection criteria. After 3 months of drug administration, significantly body weight reduction was observed in either the mazindol group or yokukansan group. We also selected and analyzed patients with diabetes mellitus to clarify the efficacy of these drugs for glucose metabolism. Reduction in HbA1c was not significant in the groups. These results suggest that mental health problems are very important for the treatment of obesity. And we suggest that oriental medicine is an effective treatment for mental health in obesity patients.

Background: No consensus exists regarding which anthropometric measurements are related to bone mineral density (BMD), and this relationship may vary according to sex and age. A large Japanese cohort was analyzed to provide an understanding of the relationship between BMD and anthropometry while adjusting for known confounding factors. Methods: Our cohort included 10,827 participants who underwent multiple medical checkups including distal forearm BMD scans. Participants were stratified into four groups according to age (≥50 years or <50 years) and sex. The BMD values were adjusted for confounding factors, after which single and partial correlation analyses were performed. The prevalence of osteopenia was plotted for each weight index (weight or body mass index [BMI]) class. Results: Cross-sectional studies revealed that weight was more favorably correlated than BMI in the older group (R=0.278 and 0.212 in men and R=0.304 and 0.220 in women, respectively), whereas weight and BMI were weakly correlated in the younger age groups. The prevalence of osteopenia exhibited a negative linear relationship with weight among older women ≥50 years of age, and an accelerated increase was observed with decreasing weight in older men weighing <50 kg and younger women weighing <60 kg. When weight was replaced with BMI, the prevalence was low in most subgroups classified by weight. Conclusions Weight, rather than BMI, was the most important indicator of osteopenia but it might not be predictive of future bone loss.

Background/Aims: Intestinal Behçet disease is typically associated with ileocecal punched-out ulcers and significant morbidity and mortality. Intestinal ultrasound is a noninvasive imaging technique for disease monitoring. However, no previous reports have compared intestinal ultrasound with endoscopic ulcer activity or histopathological findings for intestinal Behçet disease. We evaluated the usefulness of intestinal ultrasound for assessing the activity of ileocecal ulcers in intestinal Behçet disease. Methods: We retrospectively compared intestinal ultrasound findings with 73 corresponding endoscopic images and 6 resected specimens. The intestinal ultrasound findings were assessed for 7 parameters (bowel wall thickness, vascularity [evaluated using the modified Limberg score with color Doppler], bowel wall stratification, white-plaque sign [strong hyperechogenic lines or spots], mesenteric lymphadenopathy, extramural phlegmons, and fistulas), and endoscopic ulcer activity was classified into active, healing, and scar stages. Histopathological findings were evaluated by consensus among experienced pathologists. Results: Bowel wall thickness (P< 0.001), vascularity (P< 0.001), loss of bowel wall stratification (P= 0.015), and white-plague sign (P= 0.013) were significantly exacerbated in the endoscopic active ulcer stage. Receiver operating characteristic curve analysis revealed that a bowel wall thickness of > 5.5 mm (sensitivity 89.7%, specificity 85.3%) was potentially useful for detecting active lesions. When compared with histopathological findings, an increase in bowel wall thickness reflected the ulcer marginal ridge, and the white-plaque sign reflected the ulcer bottom. Conclusions Intestinal ultrasound is useful for monitoring intestinal ulcer activity in intestinal Behçet disease.

Background: The National Cancer Center Institute for Cancer Control has trained regional palliative care coordinators to disseminate personnel promoting collaboration between cancer hospitals and regional institutions. We examined the effectiveness of the training. Methods: A questionnaire survey was conducted in February 2022 among facilities participating in the training sessions from 2016 to 2021. Results: One-hundred sixteen facilities responded. The results were classified as ‘positive change (78%)’ and ‘negative change (0%)’. Regarding ‘factors inhibiting the smooth transition of terminal cancer patients from hospital to home,’ ‘patients’ social background (e.g., living alone, old age, etc.) interferes with the transition to home care (88%)’ and ‘patients’ anxiety about home care (83%)’ were the most common factors. Conclusion: Nearly 80% of participants reported positive changes, indicating that the training has had a certain effect. With regard to inhibiting factors, we plan to consider how training should be conducted so that it can address the individual issues in each region.