We have continued a study on the preventive effects of acupuncture on recurrent tonsillitis. Among 239 patients with tonsillitis examined in 1980, 200 were included in the category of recurrent tonsillitis, showing a fever four or more times a year.
The preventive effects of acupuncture in these 200 patients are reported in this paper.
The subjects were 200 patients with recurrent tonsillitis treated in our department in 1980. The frequency, number of days and severity of fever and other symptoms (conditions of the nose and throat, snoring, colds and general condition) were followed for one year after the acupuncture treatment.
Of the 200 patients, 171, excluding the 29 in whom the results of research could not be obtained, were analyzed. With regard to the frequency of fever, the number of patients with a fever 12 or more times a year decreased from 102 before acupuncture therapy to nine after the treatment. The number of patients who did not have any fever and who had a fever one to three times after treatment was 30 and 69, respectively. Thus, 40.4% were not included in the category of recurrent tonsillitis, even though fever was present. In addition, there was a decrease in the severity and number of days of fever.
Favorable effects of the treatment on symptoms other than fever, such as conditions of the nose and throat, snoring, resistance to colds and general condition, were noted in more than 50% of the patients who did not have any fever after treatment or had a fever half as frequently as before treatment.
When the preventive effects on fever were determined according to age, improvement was observed in all age groups. From the viewpoint of the prevention of repetition of a high fever, the best results were obtained in patients 6-11 years of age, followed by those five years old or less.
Acupuncture treatment for recurrent tonsillitis is not so effective as tonsillectomy. However, we consider that acupuncture treatment is worth using prior to tonsillectomy to prevent the relapse of recurrent tonsillitis, taking into account operative stress on the living body and economic and personal problems arising from tonsillectomy.

OBJECTIVEThe purpose of this study is to delineate the association between residents' perception of the neighborhood's environments and walking time in objectively different regions in Japan.

METHODSTwo regions were selected as high and low walkable regions on the basis of differences in their residential density, mixed land use and street connectivity. The subjects in this study were participants in a health promotion program focused on walking sponsored by local governments. A questionnaire was sent to the participants asking about how their perception of the neighborhood's environment related to walking, and the time spent walking per week. There were 237 residents from the high walkable region and 195 from the low walkable region who completed the study survey.

RESULTSThe high walkable region had a larger residential density, a high mixed land use and a higher street connectivity than the low walkable region. Walking time, and the scores of the perception of the neighborhood's environment for the high walkable region residents were significantly higher than those for the low walkable region residents. Thus, residents' perception of the neighborhood's environment generally reflected the actual physical environmental characteristics. Residents in the high walkable region whose scores for accessibility and aesthetics were high, spent significantly more walking time. Residents in the low walkable region whose scores for accessibility, safety, convenience and aesthetics were high, spent significantly more walking time.

CONCLUSIONThe study results suggested that the neighborhood's environment may influence daily walking time. The perceptions of the neighborhood's environmental factors that correlate with walking times differ between the different regional physical environments. Therefore, to promote physical activity, the consideration of environmental factors unique to residents' neighborhood's environments is needed.

We have conducted acupuncture treatment for prevening the relapse of recurrent tonsillitis. We previously noted the effectiveness of this treatment in 121 of 239 patients treated in 1980, especially in elementary school children. In the present study, we compared the annual days of absence from school and the body dimensions of children with tonsillitis given acupuncture treatment with those having tonsillar hypertrophy chosen by a school study, although there is a question on the latter's propriety as a control group in a strict sense, in order to investigate the degree of spontaneous healing included in the preventive effects of acupuncture treatment on the relapse of recurrent tonsillitis.
By May 1983, our reseach was completed in 22 children with tonsillitis given acupuncture treatment and 19 with tonsillar hypertrophy not given such therapy. In children with tonsillitis given acupuncture treatment, the average annual days of absence from school before treatment was 14.0, which was more than that for all children in the S elementary school, and that in the year after treatment was 6.5, approximating that for all children in the school. In children with tonsillar hypertrophy not given acupuncture treatment, the average number of days of absence was close to that for all children in the S elementary school in both years.
Among 14 children with tonsillitis given acupuncture treatment, lower values of height and weight were noted in eight and 12 children, respectively, at the beginning of treatment, as compared with the national averages. The body dimensions of children with tonsillar hypertrophy not given acupuncture treatment were similar to the national averages. Of 14 children with tonsillitis given acupuncture treatment, an increase to a value exceeding the national average was observed with both the height and weight in six children, the height in two and the weight in one within the year after treatment.
The above results show that children with tonsillitis have a problem from the educational and developmental standpoint, even if they do not have a focal tonsil. We think that acupuncture treatment is worth attempting prior to tonsillectomy, although it is not so surely effective as tonsillectomy, when the severity of operative stress on the living body due to tonsillectomy and the burden of medical expenses and the load on the patient's family caused by hospitalization are taken into consideration.

OBJECTIVEPrevious studies on the association between physical activity (PA) and neighborhood environments (NE) focused on either objectively measuring the NE or the residents' perception of NE. Here, we investigate which actual or perceived NE is associated with residents' PA in Japan.

METHODSTwo regions with an objectively assessed high and low residential density, land use mix-diversity, and street connectivity, respectively, were identified in one city. The subjects were selected using a stratified random sampling method by sex and age in each region. The NE of the subjects was objectively measured using the Geographic Information System (GIS), and the subjects' perception of the NE was assessed using a questionnaire. The daily total number of walking steps was measured with an accelerometer, and walking and cycling time were assessed by a questionnaire.

RESULTSFor the female subjects, the mean cycling time, subjectively assessed as a means of transport, was significantly longer in the group with a high GIS score for the number of land use types, while the score for total number of walking steps was significantly higher among those who were aware of places to walk to, and cycling time for transport was longer for those who perceived an accessibility to post offices, banks/credit unions, gymnasiums/fitness facilities, and amusement facilities in their neighborhood. For the male subjects, the score for walking time for leisure was longer for those who perceived aesthetics and an accessibility to parks, and the score for total walking steps was significantly higher for those who perceived an accessibility to bookstores or rental video stores in their neighborhood.

CONCLUSIONSThe results to this study demonstrate that daily PA was high among female subjects living in a NE with land use mix-diversity, and who had an awareness of places to walk to and the accessibility to facilities for daily necessities in their neighborhood. For male subjects, daily PA was high among those who perceived the aesthetics of and accessibility to facilities for pleasure in their neighborhood. Further research is needed to determine the association between PA and NE on the basis of sex differences.