Having provided chemotherapy at its outpatients clinics since 2002, the Saku Central Hospital in February 2006 established a Chemotherapy Center for Patients Discharged from Hospital. At this center, pharmacists check doctors' prescriptions, review all medications patients have been taking and dispense the prescriptions in a sterilized state. In addition, they are assigned on a daily basis to collect information on, and give guidance to, the patients. At the outpatient clinics, the length of time that can be set aside for the tabulation of information from patients' case records and for contact with the patients is inevitably likited. Given this situation, we began case study meetings in order to share information about patients between pharmacists in charge of guidance on the control of drugs at the time of their hospitalization and those who are in charge of chemotherapy at the Center. Later, these case study meetings were joined by physicians and nurses who thought it necessary to share information, thus leading to the establishment of a Conference at the Center. At this conference, pharmacists introduce information about patients at the time of their hospital admission and a discussion begins with the participation of various hospital staff members to solve given problems. By so doing, it has become possible to come to grips with the conditions of inpatients, enabling us to shift to services at the Center smoothly and give proper guidance when a medication produces undesirable effects. We consider the Conference signifies a step forward to the practice of medical care by teams.
Central ; Hospitals ; Chemotherapy-Oncologic Procedure ; Information ; Therapeutic procedure

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.

  The purpose of this study was to clarify effects of foot bath at 42°C for 10 min on cerebral circulation and mental function in elderly persons. The subjects of this study were 12 elderly persons (average 83.1 years old). Tissue hemoglobin concentration and blood flow at the cerebral frontal cortex were measured using near-infrared spectroscopy and blood pressure and heart rate using an autonomic spygmomanometer during for each 10 minutes before foot bath, during foot bath, and after foot bath. We measured subject's arithmetic speed and mistaken numbers as mental function. During foot bath the blood flow and after foot bath oxyhemoglobin at frontal cortex were significantly increased. Heart rate was significant increased after foot bath. But deoxyhemoglobin and blood pressure did not changed during foot bath. In addition to arithmetic speed and mistaken numbers were same before and after foot bath. These findings suggest that cerebral circulation is changed by foot bath, but mental functions is not before and after foot bath.

This study examined the effect of hot-spring bathing (40 to 41°C) on salivary secretion and salivary secretory IgA (sIgA) in healthy volunteers. Ten volunteers (10 men, average 33.6±9.3 years old) bathed in a hot-spring for 10 minutes.
Saliva samples were collected before bathing, during bathing (from 5 to 7 min), and after bathing using the Saxon test. The saliva flow rates and sIgA concentration were determined and then the sIgA secretion rates were calculated.
The saliva flow rates increased significantly during the bathing (p<0.02) and decreased after bathing. The sIgA secretion rates during bathing were significantly higher than those before and after bathing (p<0.02).
The increases in saliva flow rates and sIgA secretion rates during bathing were considered to indicate the improvement of local immunity in the oral cavity and thus considered to be useful for preventing upper respiratory tract infections.

Measurement of bone mass (BM), especially in the lumbar vertebrae, is very important for diagnosis of osteoporosis. In this study, we compared BM values measured by computed X-ray densitometry (CXD) with those by quantitative computed tomography (QCT), and discussed differences between the two methods.
The subjects were 90 women and 3 men, aged 42-86 years, who visited our outpatient department of osteoporosis. Metacarpal bone density (ΣGS/D) and metacarpal index (MCI) in the second metacarpal bone were measured by CXD. QCT was uesd for measurement of bone mineral density (BMD) in the lumbar trabecular bone, where pronounced osteoporotic changes occur early. The mineral values of L3 were expressed as mineral equivalent of CaCO³ in mg/ cm³, and≤75 mg/cm³ of L3 values were judged to be loss of lumbar BMD.
There were negative correlations between age and ΣGS/D, MCI or L3 value, and positive correlations were found between ΣGS/D or MCI and L3 value. Based on the above criterion of lumbar BMD loss, sensitivity and specificity of ΣGS/D for lumbar bone loss were examined. If ΣGS /D of 2.30 (T score -2.7) was used as the cut-off point, the sensitivity was 69.8% and the specificity was 75.0%, and if ΣGS/D of 2.37 (T score -2.3) and 2.40 (T score -2.1) were employed, the sensitivity was 79.1% and 79.1%, while the specificity was 64.5% and 62.5%, respectively. We concluded that BM values of cortical bone and trabecular bone decrease with age, and that sensitivity and specificity of GS/D for diagnosis of lumbar BMD loss are not very high.

Recently, the palliative care team (PCT) at our hospital has included dentists. Among a total of 127 cancer patientsand required PCT intervention from 2009 to 2014, 17 patients (13.3%) had oral symptoms. Therefore, the PCT held discussions in order to determine the optimal way to treat each patient. Various symptoms, including oral pain, dry mouth, taste disturbance, furred tongue, excessive amounts of saliva, appetite loss, and trismus were treated by the dentists. As a result, the oral findings improved in all patients, while the oral symptoms improved in 16 of the 17 patients (94%). Thanks to the fact that dentists have joined the PCT, oral symptoms are effectively relieved, and PCT members now have an increased interest in oral cavity complications. Furthermore, conducting thorough examinations of the oral cavity by the PCT not only results in an improved QOL, but it has also increased the interest in the oral cavity on the part of the PCT. Therefore, more effective palliative care is expected to be achieved by promoting increased cooperation with more clinical departments.

PURPOSE: Due to adverse events, dose reduction or withdrawal of adjuvant chemotherapy is required for some patients. To identify the predictive factors for tolerability to postoperative adjuvant S-1 monotherapy in gastric cancer (GC) patients, we evaluated the predictive values of blood indicators. MATERIALS AND METHODS: We analyzed 98 patients with pStage II/III GC who underwent postoperative adjuvant S-1 monotherapy. We retrospectively analyzed correlations between 14 parameters obtained from perioperative routine blood tests to assess their influence on the withdrawal of postoperative adjuvant S-1 monotherapy, within 6 months after discontinuation. RESULTS: Postoperative adjuvant chemotherapy was discontinued in 21 patients (21.4%) within 6 months. Univariable analysis revealed that high preoperative albumin-bilirubin (ALBI) scores had the highest odds ratio (OR) for predicting the failure of adjuvant S-1 chemotherapy (OR, 6.47; 95% confidence interval [CI], 2.08–20.1; cutoff value, –2.696). The high ALBI group had a significantly shorter time to failure of postoperative adjuvant S-1monotherapy (hazard ratio, 3.48; 95% CI, 1.69–7.25; P=0.001). Multivariable analysis identified high preoperative ALBI score as an independent prognostic factor for tolerability (OR, 10.3; 95% CI, 2.33–45.8; P=0.002). CONCLUSIONS: Preoperative ALBI shows promise as an indicator associated with the tolerability of adjuvant S-1 monotherapy in patients with pStage II/III GC.
Chemotherapy, Adjuvant ; Drug Therapy ; Gastrectomy ; Hematologic Tests ; Humans ; Odds Ratio ; Retrospective Studies ; Stomach Neoplasms