Nutritional support for patients who develop cancer is necessary to increase their food intake, which is often insufficient due to the adverse effects of anticancer drugs and radiation treatment. In December 2011, our center introduced Bocchiri meals for cancer patients to improve their quality of life and support ongoing treatment. In this study, we examined the efficacy of Bocchiri meals, which were developed to help increase the amount of food intake during cancer treatment. Target patients were those who could eat half or less than half of their daily required food intake, averaged over 3 days.Patients could order the meal 2 h before serving time and it was served at the temperature and amount that individual patients requested.We evaluated age, sex, main disease, use of anticancer drugs, radiation treatment, time taken to eat the Bocchiri meals, number of orders made, average energy intake before and after eating the Bocchiri meals, and rate of eating a Bocchiri Meal with a side menu order. Average energy intake was increased from 226.6±14.8 kcal with regular meals to 294.1±15.3 kcal with Bocchiri meals. Furthermore, a strong correlation was seen after the Bocchiri meals were introduced between the rate of eating Bocchiri meals with a side menu order and average energy intake. These results suggest that Bocchiri meals may be an effective supportive nutritional measure to enhance food intake among cancer patients.

Opioid-switching (OS) is usually performed with conversion methods based on the equianalgesic dose table. However, the conversion ratios might lead to significant differences in clinical practice. No clear guideline exists for safe, effective switching from transdermal fentanyl (TF) to oxycodone injection (OXJ). We retrospectively investigated the adequate analgesia dose of OXJ in OS from TF by comparing with the equianalgesic calculated dose based on the conversion ratio of 1.0 : 41.7 between TF and OXJ. Patients with a pain scale score of 0 were assigned to the “NRS/VRS=0” group (n=4), and the remaining patients were assigned to the “NRS/VRS>0” group (n=27). During a 4-year period, 31 of 49 patients with cancer-related pain who underwent OS from TF to OXJ were investigated. All patients in the NRS/VRS=0 group (4/4, 100%) and most in the NRS/VRS>0 group (23/27, 85%) achieved adequate analgesia. Among the 27 patients with adequate analgesia, the median effective OXJ dose was 28% (interquartile range, 21-47) of the equianalgesic calculated dose in the well-controlled group and 103% (interquartile range, 71-164) in the poor analgesia group. Strong drowsiness developed in two patients the day after OS, and the OXJ dose was decreased. Our findings suggest that in patients without pain, it might be necessary to reduce the OXJ dose to approximately 30% of the equianalgesic calculated dose for safe OS from TF. Pain intensity and drowsiness due to an opioid overdose should be carefully monitored and may require dose adjustment.

To find the correlation between the inhibitory effects of hot-spring water on blood-pressure and its chemical composition, the effects of artificial spa bathing on lowering blood pressure were compared with those of hot-spring bathing on spontaneously hypertensive rats (SHR). Further, the induction of heat-shock proteins (HSP) in rat organs was quantitatively examined in order to clarify the mechanism of its action. Artificial spa (Na₂SO₄-Na₂HCO₃) bathing showed almost the same inhibitory effects on blood pressure as those of hot-spring bathing.
There was no significant difference in the catecholamine value in blood between both types of spa bathing, nor was there any difference from the values of the control group.
It was found that HSP molecules were induced in the brain, liver, and kidneys not only by hot-spring bathing but also by artificial spa bathing, with different inductive profiles from one organ to another.

A study was made on 15 healthy subjects to evaluate the efficacy of water immersion with commonly used raw materials on skin elasticity, viscoelasticity and hydration of stratum corneum.
Samples used in this study included 30, 60, 90g of sodium hydrogen carbonate and 60g of bath preparation containing 90% in weight of sodium hydrogen carbonate (Cool Bathcrin^®). These samples were dissolved into 200l of plain water kept at a temperature of 41°C. The duration of each bathing was 5min.
Skin elasticity (skin distensibility), skin viscoelasticity and hydration of stratum corneum improved in all types of water immersion including plain water immersion. The skin distensibility, viscoelasticity and hydration state showed a statistically significant increase after water immersion with sodium hydrogen carbonate as compared with those before water immersion. In the plain water immersion group, no significant differences were observed between the values before and after water immersion with the exception of skin hydration. However, a significantly higher rate of increase in skin hydration was observed in the groups of water immersion with sodium hydrogen carbonate as compared with the plain water immersion.
The above results show that alkaline salt, especially sodium hydrogen carbonate, improves skin distensibility, viscoelasticity, and hydration state. Furthermore, we recommend sodium hydrogen carbonate as one of the most useful components of bath preparation because it provides the suppleness, freshness, and smoothness of stratum corneum.

We investigated the effects of bathing with bath preparation (sodium sulfate, sodium chloride, 30g/200l) on the thermal preservability in healthy volunteers. We also investigated these effects on the antioxidative defense system in patients with vibration syndrome (VS). In these investigations, we measured the activities of erythrocyte superoxide dismutase (SOD).
After immersion at 41°C for 5min, forearm skin temperature, photoplethysmograph, and transepidermal water loss increased significantly as compared with those after bathing in a plain water.
After bathing for 4 weeks at around 40°C for 10min, activities of erythrocyte SOD increased significantly.
These data indicate that bathing with the bath preparation has a stronger effect on thermal preservability in healthy volunteers and activation of the antioxidative defense system in patients with vibration syndrome due to a significant increase in activities of erythrocyte SOD.

In this study, we investigated the effect of bathing with cut crude drugs on thermal preservability, water holding capacity, and smoothness of the feel. After immersion with cut crude drugs of 5min at 41°C, the forearm skin core temperature was significantly higher than after plain water bathing. Water sorption-desorption tests on the skin in vivo with cut crude drug extract for the functional assessment of the stratum corneum revealed that the GARENIAE FRUCTUS extract, all of cut crude drugs extract, and FOENICULI FRUCTUS extract are significantly superior to plain water bathing in water holding capacity.
Furthermore, an evaluation using a skin model revealed that cut crude drugs have effects significantly superior to that of plain water bathing in increasing the smoothness of the feel. The above results clarified that bathing with cut crude drugs has a stronger effect on thermal preservability and that their extract increases water holding capacity and smoothness of the feel.

To clarify a mechanism of psychologic relaxation by artificial hot spring, the effect of hot spring bathing on psychologic sweating was studied in 11 healthy subjects (1 female and 10 males, age 26±5.7 years). After lying in the supine position for 5 minutes, the subjects were asked to take a bath with plain water or artificial hot spring for 5 minutes in the sitting position. The temperature of the bath was 40°C. To prepare the artificial hot spring, sodium sulfate tablet (Tsumura & Co.) was solved in 200L of plain water. For the measurement of psychologic sweating, Perspiro (Suzuken, Co. Ltd) was used. Sensor was attached to the first finger by biphasic adhesive tape. The psychologic sweating was induced by deep respiration, mental arithmetic, hand grip, blood pressure measurement and blood sampling. There were no statistical significant differences of CV value, heart rate, blood pressures, catecholamine values and serum β endorphin levels before and after the bathing. The psychologic sweating markedly decreased after the bathing (11.5±19.6 to 1.1±2.7 for plain water bathing, 14.9±21.9 to 1.6±5.1 for artificial hot spring, N. S.).
The decrease in psychologic sweating after bathing suggests the action of psychologic relaxation by bathing.

Papillary muscle rupture is one of the common complications of acute myocardial infarction. We report a case of 77-years-old man with an acute posterior papillary muscle rupture without obvious coronary artery disease. The patient presented with cardiogenic shock and pulmonary edema. Emergency coronary angiogram showed no obstruction in coronary arteries. An echocardiogram and right heart catheterization data suggested acute mitral regurgitation caused by ruptured posterior papillary muscle. Percutaneous cardiopulmonary support was induced because of his unstable hemodynamics, and then emergency mitral valve replacement was performed. Intraoperative findings suggested some ischemic changes in the posterior papillary muscle. Pathologically, both old and new ischemic lesion presented in the same papillary muscle. Moreover, severe thickening of a small vessel wall was noted. This case presented one of the possible mechanisms of so-called idiopathic papillary muscle rupture.