Seven patients with hemiplegia due to cerebral apoplexy and 5 subjects without any sign of cardiovascular abnormalities (as the contol cases) were used in this study. Systemic blood pressure by sphygmomanometer, digital blood pressure and digital blood flow by digital plethysmograph were recorded and the peripheral vascular resistance was calculated from the values. The extensibility of arterial wall was calculated from transmission time of the pulse wave and length of the vessel. The effect of bathing therapy in hot spring water (sodium sulphate spring; bathing temperature ranging from 41-43C; bathing duration ad libitum) on the peripheral vascular hemodynamics was examined.
1. Effects of single bathing
In patients with hemiplegia, systolic blood pressure decreased 40mm Hg in the paralyzed, but slightly in the unparalyzed side, and also the decrease of digital blood pressure was greater in the former than in the latter. Digital blood flow increased and the peripheral vascular resistance decreased in both sides, and the rate of change was much greater in the paralyzed than in the unparalyzed side, respectively.
In the control cases, the changes were fairly comparable to those in the unparalyzed side of the patients except the extensibility of the arterial wall which was manifest in both sides of the patients but only scarce in the control subjects.
2. Effects of repeated bathing
In patients with hemiplegia who had taken the bathing therapy for 30-90 days, the digital blood flow increased and the paripheral vascular resistance decreased but without noticeable differences between the paralyzed and the unparalyzed side, and the size of the increase or the decrease was almost equal to that in the control subjects. Increase in the extensibility of arterial wall was found more in the patients than in the controls. In general the effects of repeated bathing were less distinguished than those of single bathing.

Inhaled corticosteroids should be taken continuously. As the methods of inhalation vary depending on the pharmaceutical preparations of inhaled corticosteroids, satisfactory effects cannot be expected without proper inhalation. This paper deals with the assessment of inhalational skills with the use of a manual of corticosteroid inhalation and a check sheet of patients’ performance. The effective inhalation as judge by the combination of the speed and the time needed for inhalation was assessed with the help of the training device for inhalation of each inhaled corticosteroid. The average scores of inhalational skills were increased significantly as follow ; aerosol : from 3.8 to 4.9 (p=0.035), Turbuhaler: from 2.6 to 3.0 (p=0.003), discus: from 4.9 to 6.0 (p<0.001). Among 7 in patients (38.9%) who were insufficient in inhalational ability, except for 1 patient who interrupted medication, 4 and 2 patients were improved in the speed and the time needed for inhalation, respectively. It was suggested to advise physicians to dispense alternative preparations of inhaled corticosteroids depending on the repeated evaluation of the inhalational ability.

Inhaled corticosteroids should be taken continuously. As the methods of inhalation vary depending on the pharmaceutical preparations of inhaled corticosteroids, satisfactory effects cannot be expected without proper inhalation. This paper deals with the assessment of inhalational skills with the use of a manual of corticosteroid inhalation and a check sheet of patients’ performance. The effective inhalation as judge by the combination of the speed and the time needed for inhalation was assessed with the help of the training device for inhalation of each inhaled corticosteroid. The average scores of inhalational skills were increased significantly as follow ; aerosol : from 3.8 to 4.9 (p=0.035), Turbuhaler: from 2.6 to 3.0 (p=0.003), discus: from 4.9 to 6.0 (p<0.001). Among 7 in patients (38.9%) who were insufficient in inhalational ability, except for 1 patient who interrupted medication, 4 and 2 patients were improved in the speed and the time needed for inhalation, respectively. It was suggested to advise physicians to dispense alternative preparations of inhaled corticosteroids depending on the repeated evaluation of the inhalational ability.