[Background] The numbers of clinics and practitioners of amma (traditional Japanese massage), acupuncture, and moxibustion are officially announced in the Report on Public Health Administration and Services. How-ever, it is highly possible that these data include non-practicing therapists, and do not show the number of therapists holding more than one license. Therefore, it is difficult to estimate the actual number of practicing therapists.
[Methods] We conducted a postal survey of 3, 084 therapists registered at 12 different public health centers in five prefectures including Tokyo, and asked (1) whether the therapists were still practicing at their registered clinics, and (2) how many of the three licenses (amma, acupuncture, moxibustion) they hold.
[Results] We found that 26.5 percent of the therapists were not practicing, and that 52.5 percent of people who had an amma license also had acupuncture and/or moxibustion licenses. Based on the present results, we estimate that, in 2002, there were 41, 500 amma clinics, 10, 300 acupuncture and moxibustion clinics, 71, 500 practicing amma therapists, and 54, 400 practicing acupuncturists.
[Conclusion] In conclusion, the data in tables 63 and 64 in the Report on Public Health Administration and Services should be downwardly revised in order to reflect the actual situation of the relevant clinics and practitioners.

Seven years ago, we began the “Toride Project” which aimed at organized care, mainly on based a low-protein diet (LPD), for chronic renal failure patients. This project cumulatively involved 486 patients, and 219 of them have been followed up at our hospital.
In this paper, we report the 12 patients who had before shown progressive deterioration of renal function and turned out stable (less than 5% change) in creatinine clearance (Ccr) for 12-54 months after involved in the project. Their diseases were chronic glomerulonephritis (CGN; 10 cases) and nephrosclerosis (NSC; 2 cases), and the mean Ccr was 20.9±1.3 (SE) ml/min (16-32 ml/min). All of them carried out the well maintained LPD (0.62±0.02 g/kg/day), and showed relatively low urinary protein excretion (UPE; 0.4±0.2g/day). In contrast, 10 other cases (CGN; 9, NSC; 1) showed persistent deterioratiom of renal function even if they continued the LPD (0.60±0.02 g/kg/day). They significantly showed higher UPE (1.6±0.3 g/day, p<0.05) than the 12 cases mentioned above. Moreover, frequent examination revealed that the day-to-day change in their protein intake was more widely distributed (coefficient of variation; 19.5±1.3% vs 10.8±0.6%, p<0.05).

Objective: The objective of the present study was to clarify the relationship between factors having an influence on obesity improvement programs and psychosocial factors from a more comprehensive point of view.
Methods: We studied a total of 43 subjects with a body mass index (BMI) of 25 kg/m2 or higher who wished to take part in an obesity improvement program and agreed to participate in the study. We conducted an obesity improvement program based on behavior change theories for three months and evaluated physical composition, mental health, social support, stress-coping and the like before intervention and immediately after completion of the program.
Results: The average weight showed a significant decrease from 69.0 } 8.8 kg to 65.7 } 8.7 kg before and after intervention (p<0.001), respectively. It was also shown that the presence or absence of chronic diseases, social support from a spouse and the decrease of avoidance stress coping were related to weight loss.
Conclusion: The findings suggest that it will be further necessary to continue working on the need to enhance awareness about stress with a view to preventing occurrence of rebound after the end of weight loss programs and acquisition coping techniques, apart from the cooperation of attending doctors, strengthening of social support from family and friends and managing stress for the duration of the program.

Magnetic compression anastomosis (MCA) is a minimally invasive method of performing choledochocholedochostomy without surgery in patients with biliary stricture or obstruction. We describe a successful case involving magnetic compression duct-to-duct biliary reconstruction in right-lobe living donor liver transplantation (RL-LDLT). Endoscopically, a samarium-cobalt (Sm-Co) rare-earth magnet was placed at the superior site of obstruction via the percutaneous transhepatic biliary drainage route, and another Sm-Co magnet was also placed at the inferior site of obstruction with the aid of an endoscope. MCA techniques enabled complete anastomosis without procedure-related complications. In conclusion, the MCA technique is a revolutionary method of performing choledochocholedochostomy in patients with biliary obstruction after LDLT.
Constriction, Pathologic ; Drainage ; Endoscopes ; Humans ; Liver ; Liver Transplantation ; Living Donors ; Magnetics ; Magnets