Aims
Yufuin is one of the most famous spa resorts in Japan. However, little attention has been paid to public spa facilities from the viewpoint of their roles in health promotions for the residents. The Yufuin Onsenkan (spa facility) is located in the central portion of the Yufuin spa and has a complete set of spa baths and pools. The aim of this study is to assess the effect of spa-aqua therapy on various lifestyle-related diseases in collaboration with this public spa facility.
Methods
We have introduced spa-aqua therapy to patients who had been diagnosed and treated as having certain lifestyle-related diseases (diabetes, hypertension, hyperlipidemia, etc) in our outpatient clinic. One hundred and twenty-four patients consented to participate in the program of aqua exercises (30 minute walk) at least three times a week for more than three months under the supervision of medical doctors, aqua therapists, and public health nurses. These patients were assessed for clinical symptoms and laboratory data at 12 months following the spa-aqua therapy. Subsequently, brachial-ankle pulse wave velocity (baPWV) was measured on 92 healthy volunteers, 21 diabetes patients, and 39 hypertension patients to evaluate the effect of aqua-therapy on arteriosclerosis caused by lifestyle-related diseases.
Results
Decreases in clinical symptoms, improvement of laboratory data, and decreases in frequency and dosage of medical prescription were observed in 89 of 124 patients. Specifically, lowered levels of fasting blood sugar and hemoglobin Alc were observed in 20 of 24 diabetic patients and remarkable effects such as lowered blood pressure and decreased dosage of medicine and frequency of medical prescription were observed in 16 out of 20 hypertensive patients. As an index of arteriosclerosis caused by some lifestyle-related diseases, we also measured baPWV on 92 healthy volunteers, 21 diabetes patients, and 39 hypertensive patients before and after introduction of aqua-exercise. From the viewpoint of health insurance, annual medical fees of 35 patients, who were randomly selected from among 124 patients, decreased significantly after receiving aqua therapy combined with medicines. The baPWV values of diabetic and hypertensive patients were significantly higher than those of healthy volunteers before commencing aqua-exercise, and the baPWV values of diabetic and hypertensive patients did not improve significantly after six months of aqua-exercise, suggesting that a longer period of exercise is required.
Conclusion & Discussion
In collaboration with a public spa facility used daily by many residents, we succeeded in naturally introducing aqua-spa exercise to the usual habitual behavior of patients with lifestyle-related diseases. This kind of preliminary trial may have future potential not only of promoting health care for local residents but also providing prospects for health care businesses in spa resort areas.

A case report
A 70-year-old male with small bowel adenocarcinoma involving retroperitoneal invasion had undergone chemotherapy after non-curative operation. However, this patient had to discontinue the first and second lines of chemotherapies within one month due to serious side effects of anti-cancer agents. Subsequently, the patient complained of severe low-back pain and there was evidence of local recurrence around the resected small intestine. Therefore, phototherapy was applied three times a week to relieve the low-back pain while the patient underwent the third line of chemotherapy. It was interesting to note that these combination therapies coincidentally ameliorated the various side effects caused by anti-cancer drugs. For one year during the third line of chemotherapy, the patient had to temporarily discontinue chemotherapy only two times when phototherapy was not available for one week due to consecutive national holidays in May and November. The quality of life of this patient was well maintained, and he only needed to be hospitalized for the last two months before he died.
Epidemiological studies have shown a high incidence of cancer in people less exposed to solar rays. The sunshine “vitamin” 1 alpha, 25-dihydroxy vitamin D₃ (1, 25(OH)₂D₃) is involved in these epidemiological studies based on the evidence that 1, 25(OH)₂D₃ is an antiproliferative agent that may inhibit proliferation of cancer cells in vitro and development in animals. To elucidate the synergetic effect of phototherapy in combination with chemotherapy, we assayed serum levels of 1, 25(OH)₂D₃ in this patient compared with those of end-stage cancer patients undergoing chemotherapy alone. Serum levels of 1, 25(OH)₂D₃ in this patient after receiving the combination therapies were higher than those in other cancer patients treated with chemotherapy alone.
Our results indicate that phototherapy may be a good complementary therapy with chemotherapy for cancer patients.

For the purpose of pharmacists to be able to be more involved clinically, the pharmacy education system in Japan was revised in April 2006 and the term length of pharmacy education was extended from 4 years to 6 years.
The Japanese Society for Pharmacoepidemiology is deeply concerned about the new curriculum which will be adopted for the 6-year course, especially the handling of pharmacoepidemiology education. Two questionnaire surveys were sent to the dean of all schools of pharmacy to inquire whether they lecture pharmacoepidemiology and, if not, what study in pharmaceutical sciences would be most closely related to pharmacoepidemiology. The surveys were conducted just before and just after the introduction of the new system, in October 2005 and July 2007. The recovery of the first and second survey were 90% and 76%, respectively.
In the first survey only 17 universities (31%) had lectures on pharmacoepidemiology but in the second survey 31 universities (57%) did, and in 55% of these 31 universities the lecture was required. The result indicates that the understanding of professors of pharmacy school regarding the lecture have been gradually promoted and they feel that pharmacoepidemiology is going to be considered to be one of the essential lectures in pharmacy education in Japan. However, many responders indicated that pharmacoepidemiology was still an immature field of study and there are few appropriate textbooks and no teaching experts, and therefore, the society should take these matters into reconsideration.

Objective:
There have been a few reports on the specificity of the meridians and Acupuncture-points. In order to identify the specific effects of the meridians and Acupuncture-points, the functional relations between “the gallbladder Meridian and gallbladder” were investigated using the gallbladder's form as an index.
Materials and Methods:
Ten healthy male adult volunteers participated in the experiments in fasting conditions. The target organ was the gallbladder, and its form was measured with the ultrasonic diagnostic apparatus (Toshiba SSA-90A). The images of the gallbladder form were taken at the point when the major long axis of the cross-section of the gallbladder reached the peak. The cross-sectional area of the gallbladder was measured with the image analyzer. The measurement of the gallbladder form was conducted after 15 minutes lying on the back, taking images for 10 minutes before stimulation, for 30 minutes during and after stimulation, every two to five minutes. The acupuncture stimulation was given at the points of G34, G36, G37, G40 and G44 on the right side of the body. After getting the deqi, 1 minute of sparrow pecking needle technique and 1 minute of leaving needle technique were conducted three times. The effect of the G40 under the egg yolk loading were also investigated.
Results:
1) The stimulation of the G34, G36, G37, and G44 showed no effects on the gallbladder form. 2) The stimulation of the G40 caused the distension of the gallbladder form. 3) The stimulation of the G40 showed the suppressive effect on the contraction of the gallbladder due to the load of egg yolk.
As described above, the results of this study showed that there is an acupuncture-point on the gallbladder meridian to cause the distension of the gallbladder specifically. It suggests the existence of the specificity of acupuncture-point.