The purpose of this study was to review several kinds of checklists and statements of studies in human subjects, and to examine reporting methods in order to improve the quality of studies concerning hot springs.
For randomized controlled trials (RCTs), “the CONSORT Statement” (Moher et al. JAMA 2001) consisting of 22 terms is the most well known checklist. In addition, different versions and new checklists have been developed depending upon the content of the studies (such as intervention methods) or field of the studies. There is also “the QUOROM Statement” (Moher et al. Lancet 1999) for a systematic review (SR) of RCTs, “the TREND Statement” (Jarlais et al. Am J Public Health 2004) for nonrandomized controlled trials, “the STROBE Statement” (Elm et al. Ann Inter Med 2007) for observational studies, and “the MOOSE Checklist” (Stroup et al. JAMA 2000) as a SR of observational studies. With regard to studies on hot springs, however, terms in the checklists and the statements described above are insufficient or inappropriate because of difficulties in performing such studies in a blinded manner, and the diversity of intervention methods, such as the quellen charakter.
Improvement of the quality of reports is important for validation of evidence. In order to improve the quality of assessments and reports of studies on hot springs, it may be necessary to develop a unique checklist based on the above-described statements and checklists.

Purpose: The purpose of this study was to examine the influence of the exercise program for Osteoarthritis of the knee (knee OA) which American Geriatrics Society Panel on Exercise and Osteoarthritis (AGS) recommends on physical function in Japanese independent elderly with knee joint pain.Methods: Subjects of this study were 36 (7 males : aged 74.7±5.1 years, 29 females : aged 72.3±4.6 years) community-dwelling independent elderly with knee joint pain who voluntary participated in our exercise program. The program consisted of massage around knee, flexibility exercises in knee and ankle joints, and leg muscle development exercises. They performed these exercises twelve times for a month at regular intervals. Physical function were evaluated by the muscle strength during knee extension and flexion, the range of motion of knee joint and the center of pressure during upright standing. There were three times measurements at one month before starting of the program (the 1 st), immediately before beginning of the program (the 2 nd), and just after ending of the program (the 3 rd). Difference between change in measurement values during the observation period (subtract the 1 st from the 2 nd ; Δ1) and that during intervention period (subtract the 2 nd from the 3 rd ; Δ2) were analyzed by Students't-test.Results and Conclusion: There was significant difference between Δ1 (0.01±0.05 kg/wt) and Δ2 (0.04±0.05 kg/wt) on maximal muscle strength during knee extension. This result suggested that the exercise program recommended by AGS was improved the leg muscle strength in Japanese elderly with knee joint pain. However the effects of the exercise intervention were not clarified on the other physical function. As for the reasons it seems to affect the initial level of joint pain and physical function in the subjects. Therefore, reexamination of this point with a greater number of samples which the worse level of knee joint pain is needed in the future.

 The purpose of this study was to systemically review cohort studies of the preventive effects on locomotorium diseases in order to collectively evaluate the evidence.
 We searched the databases of PubMed, CINAHL, and lchushi-Web for papers published from1990 to September 17, 2009. The search was not limited by the language in which the paper was written.
 We found only one article (in Japanese) that fulfilled the eligibility criteria. Results in this article showed that bone fractures were significantly lower in the group with two times or more utilization of the hot spa bathing per year compared to the group with one time or less utilization per year, even after adjusting for the confounding effects of exercise habits and WHO-QOL. However, a metaanalysis could not be applied.
 We propose that it is necessary to conduct more cohort studies in which researchers choose suitable outcome measurements that assess long term effects.

Purpose : Rhythmic gymnasts sometimes develop severe iron-deficiency anemia. Preventing such anemia could thus enhance both their performance and health. We compared the relationship between a dietary intervention and RBC metabolism.Methods : Ten female rhythmic gymnasts were recruited for this study. Changes in the RBC delta-aminolevulinate dehydratase (δ-ALAD) activity were used as an index of biosynthesis, and changes in the haptoglobin (hp) were used to assess degradation.Results : During the one month intervention period, the athletes consumed traditional Japanese foods which provide 1500 kcal energy, 2 g/kg body weight protein, 200 g carbohydrate and 15 mg iron. No main effect of this intervention on the hematological indexes was observed. The δ-ALAD activity was significantly greater in August than in July or September. Hp concentration was significantly lower in August in comparison to the other periods.Conclusion : Dietary intervention might enhance the RBC turnover by increasing the capacity for erythrocyte biosynthesis and degradation.

Purpose : This study was undertaken to clarify the effect of heme-iron supplementation on the prevention of iron-deficiency anemia in male collegiate distance runners.Methods : Forty-one male collegiate runners were divided into three groups, consisting of a heme-iron group (HI), a citrate-iron group (CI), and a non-iron group (NI). Iron tablets (heme-iron or citrate-iron) were administered at a dose of 7 mg per day for two months. The blood components and nutritional intakes were estimated before and after the intervention.Results : The nutritional intakes did not differ among the three groups. The red blood cell, hemoglobin, hematocrit, ferritin, Glutamic-Pyruvate Transferase and γ-Glutamyl Transpeptidase levels were unchanged throughout the experimental periods. After the intervention, the serum iron levels significantly decreased in the NI group but not in the iron-supplemented groups, while the reticulocytes counts increased among the three groups.Conclusion : The small amount of heme-iron supplementation was thus found to have a preventive effect on iron deficiency anemia without causing any negative side affects.

Purpose : This study was undertaken to examine the relationship between pedometer counts and food intake in Japanese elderly people.Methods : One-hundred-eighty healthy, community-dwelling elderly people were divided into three groups according to age. The number of steps taken by each subject was recorded with a pedometer over a 30-day period in August. The dietary and nutritional intakes were estimated using a food frequency questionnaire.Results : There was no significant difference in the pedometer counts between men and women. The number of steps significantly decreased with age (p<0.01). The intake of energy, protein and carbohydrate were significantly higher in men than in women (p<0.05), and they were nearly the same among the three aged groups. The calcium and vitamin C intakes after adjusting for sex and age increased with the number of daily steps, except for the intakes of energy, protein and carbohydrates.Conclusion : A higher number of daily steps was found to be associated with the calcium and vitamin C intakes.

Uterine tumors are the most common type of gynecologic neoplasm. Uterine leiomyosarcoma (LMS) is rare, accounting for 2% to 5% of tumors of the uterine body. Uterine LMS develops more often in the muscle tissue layer of the uterine body than in the uterine cervix. The development of gynecologic tumors is often correlated with female hormone secretion; however, the development of uterine LMS is not substantially correlated with hormonal conditions, and the risk factors are not yet known. Radiographic evaluation combined with PET/CT can be useless in the diagnosis and surveillance of uterine LMS. Importantly, a diagnostic biomarker, which distinguishes malignant LMS and benign tumor leiomyoma (LMA) is yet to be established. Accordingly, it is necessary to analyze risk factors associated with uterine LMS in order to establish a method of treatment. LMP2-deficient mice spontaneously develop uterine LMS, with a disease prevalence of ∼40% by 14 months of age. It is therefore of interest whether human uterine LMS shows a loss of LMP2 expression. We found LMP2 expression is absent in human LMS, but present in human LMA. Therefore, defective LMP2 expression may be one of the risk factors for LMS. LMP2 is potentially a diagnostic biomarker for uterine LMS, and gene therapy with LMP2-encording DNA may be a new therapeutic approach.
Animals ; Biomarkers, Tumor ; biosynthesis ; genetics ; Cysteine Endopeptidases ; biosynthesis ; genetics ; Down-Regulation ; Female ; Gene Deletion ; Humans ; Interferon Regulatory Factor-1 ; biosynthesis ; genetics ; Leiomyoma ; metabolism ; Leiomyosarcoma ; diagnosis ; genetics ; metabolism ; Mice ; Mice, Knockout ; Proteasome Endopeptidase Complex ; metabolism ; Uterine Neoplasms ; diagnosis ; genetics ; metabolism

Purpose: We have previously reported the physiological and biochemical effects of bath salts. In this study, we used bath additive containing artificial carbon dioxide and sodium chloride (S bath additive), and the acute effects of bathing once with S bath additive and chronic effects of daily bathing with S bath additive for 15 consecutive days were compared with the effects of bathing once in plain water. Improvement in 10 symptoms was investigated using a 5-point verbal rating scale (VRS). Methods: Nine patients aged 51-82 years (mean, 66.6 years) with cold intolerance and lower leg pain were treated with balneotherapy. Whole-body bathing at 40°C was performed for 10 min daily (day 1, bathing in plain water; days 2-16, bathing with S bath additive). On days 1, 2, and 16, changes in patient’s subjective symptoms were evaluated using a VRS ranging from -1 to +3. Results: Compared with bathing once in plain water, bathing once with S bath additive was improvement of coldness, body warmth, blood circulation promotion, limb warmth, lightness of foot, and coldness in limbs. Daily bathing with S bath additive for 15 days significantly improved all symptoms compared with bathing in plain water. A comparison between single and daily bathing with S bath additive showed that relieving fatigue and lumbago were significantly improved after consecutive bathing, demonstrating the benefits of long-term usage. Discussion: Bathing once with S bath additive had acute effects on symptoms associated with peripheral circulation, such as coldness in limbs, body warmth, and limb warmth. Daily bathing with S bath additive improved bone- and joint-related symptoms, such as lumbago and shoulder stiffness, demonstrating that the chronic effects of S bath additive differ from the acute ones. These results are consistent with previous studies on natural hot springs which found that the efficacy of short-term treatment was distinct from that obtained after >2 weeks of treatment.