To investigate the scientific grounds for the effect of raspberry ketone bathing that is claimed to increase energy consumption by stimulating metabolism, a bathing experiment was conducted in 10 normal healthy adults.
As a result, no appreciable difference was detected among tap water, CO₂-enriched water and raspberry water in respect to blood pressure, pulse rate and depth thermometer readings, which suggested that bathing in warm raspberry water was safe, producing no marked load on the cardiovascular system. Changes in the skin surface temperature indicated slow elevation of body temperature, from which bathing in warm raspberry water was considered to produce no marked load on the body even if bathing lasted relatively long as compared with bathing in warm tap water or CO₂-enriched warm water. From the skin tissue blood flow data, it seemed likely that the increase in blood flow caused by bathing in warm raspberry water was produced, not by vasodilatation as in CO₂-enriched warm water bathing, but by such mechanisms as acceleration of metabolism. Data on insulin suggested that bathing in warm raspberry water affected the carbohydrate metabolism as compared with that in warm tap water or CO₂-enriched warm water. Since there was no difference among warm water groups in changes in the adrenocortical hormone “cortisol”, raspberry ketone bathing was considered not to have specific activity. Data on NK cell activity showed that bathing in warm raspberry water produced no appreciable effect on the immune system. It was suggested that measurement of β-endorphin should be performed after adjustment of psychological environments.
The results of expiration air analysis also indicated that, while bathing in CO₂-enriched warm water was related to changes in the cardiovascular system, bathing in warm raspberry ketone water produced no appreciable load on the cardiovascular system but consumed energy through acceleration of metabolic activities.

Skeletal muscle is comprised of multiple fiber types. Slow-twitch oxidative muscle fibers have greater capillary density compared with fast-twitch glycolytic fibers of skeletal muscle. To gain insight into the molecular mechanism underlying the difference of capillary density, we investigated whether the basal gene expression of vascular endothelial growth factor (VEGF), a major angiogenesis-related factor, and its transcriptional factors (hypoxia-inducible factor-1α, transforming growth factor-β1, c-jun, and c-fos) differs between these two fiber types of rat skeletal muscle. The mRNA expression of VEGF and its transcriptional factors was significantly higher in slow type fiber of muscle (soleus muscle) compared with fast type fiber of muscle (plantaris and tibialis anterior muscles). These results suggest that the difference of basal gene expression of VEGF and its transcriptional factors between slow and fast fiber types of skeletal muscle may partly contribute to the difference in capillary density between these two fiber types.

We evaluated the effects of SCP bathing on the body by compared with those of a-EG, one of major component of SCP, bathing and the control bathing with tap water alone. Healthy adults were used as the subjects. The effects of bathing on blood pressure and pulse rate were not significantly different among the three bathings, indicating that effects of SCP and α-EG bathing on the lung and heart were similar to those of an ordinary bathing. The surface skin temperature at the forehead decreased more slowly in the subjects after taking a SCP bathing than the other two, suggesting that SCP has temperature holding effects. Also, the results of deep body temperature suggested that α-EG might be related to the heat absorbing effects of SCP bathing, which were significantly marked than those of the other two bathings. The present results regarding the changes in blood flow and deep body temperature during bathing suggest that SCP might produce an environment that allows more rapid heat transfer from bath water to the body and less releasing it from the body. Therefore, we concluded that some component other than α-ethylglucoside would be involved in the heat transfer and moisturizing during SCP bathing. Measurement of skin water content indicated that a region directly contacting with hot water was moisturized in a short time, but this condition quickly returned to the pre-bath condition. Whereas, for regions not contacting with bath water, the skin was much more moisturized by taking SCP bath than the other two bathings. Therefore, it was concluded that SCP is effective for enhancement of skin moisturizing.

To investigate a relationship between gender differences in recovery from skeletal muscle fatigue and muscle oxygenation, we examined whether there is a difference in oxygen supply and consumption of the working muscles after intermittent handgrip exercise between young males and females using near-infrared spectroscopy (NIRS). Healthy young subjects (25.8±3.9 years ; males, n=10 ; females, n=10) repeated static maximal voluntary contractions (MVC) with a handgrip for 5 seconds followed by 5 seconds rest for a period of 4 minutes in Study 1. The MVC force was measured before, each minute during the handgrip exercise, and 2, 5, and 10 minutes following the exercise. In Study 2, the selected 10 subjects (males, n=5 ; females, n=5) performed the same exercise and their total- and deoxy- hemoglobin/myoglobin level was measured using the venous occlusion NIRS method; and O₂ supply index (OSI) and O₂ consumption index (OCI) calculated before and after the exercise. In Study 1, females exhibited higher %MVC force at the end of the exercise and during the recovery period than males (p<0.05). In Study 2, the %OSI was significantly lower in females than in males at 5 and 10 minutes in the recovery period (p<0.05), but no significant differences were detected in %OCI. Furthermore, %MVC of the recovery period correlated with %OCI of the recovery period in females (r=0.724, p=0.015), but not in males. These findings suggest that female working muscles can convert consumed oxygen more effectively after an intermittent handgrip exercise, and therefore, be able to recover muscle force faster.

Post-malaria neurological syndrome (PMNS) is a rare complication after the treatment of falciparum malaria. We describe a case of a 56-year-old man who developed ataxia, tremor, and confusion 16 days after a successful treatment of falciparum malaria with artesunate followed by mefloquine. Magnetic resonance imaging of the brain revealed no abnormality, and he recovered spontaneously without any specific treatment including corticosteroids. Inflammatory changes were found in the cerebrospinal fluid, suggesting a localized inflammatory reaction as the cause of the syndrome.

PURPOSE: Ticlopidine hydrochloride, an antiplatelet agent, is believed to have saved life years in many patients with ischemic cerebral vascular diseases in Japan. But severe adverse events have also been reported. The current investigation aimed to compare two hypothetical cohorts treated with and without ticlopidine in terms of risks and benefits of ticlopidine treatment using Markov model.
METHODS: We conducted Markov decision analysis to estimate the number of lives saved and the increase in quality-adjusted life years (QALYs) over the past 20 years by ticlopidine in Japan. Two cohorts of 60-year-old male patients with previous histories of cerebral infarction, one of which treated with ticlopidine and the other not treated with ticlopidine, were compared with respect to the number of deaths and quality of life (QOL) . Data incorporated were the probabilities of the recurrence of cerebral infarction and the associated mortality, adverse events of the drug, and the utility of health status treated with ticlopidine.
RESULTS: Approximately 1, 630, 000 patients were estimated to be on ticlopidine for variable periods of time during the past 20 years in Japan. With treatment, 17, 130 lives were saved, while 1, 338 patients died because of cerebral bleeding, agranulocytosis, severe hepatic dysfunction, or thrombotic thrombocytic purpura, resulting in a net benefit of 15, 792 lives saved by ticlopidine over the past 20 years. In terms of QOL, there was a total increase of 382, 191 QALYs. Sensitivity analyses showed that the older the patients when ticlopidine therapy was started, the smaller the benefits that were gained by treatment.
CONCLUSIONS: Ticlopidine is considered to have made a great contribution in savingmany lives and improving QALYs in the past 20 years in Japan. This kind of analysis based on Markov model can be employed to demonstrate effectiveness of drugs and medical technologies in terms of population health outcomes.

Qualitative research has gained greater attention in medical research, but it might seem to be unscientific because qualitative and quantitative research methods are grounded in different paradigm.
In this article, we introduce three major qualitative research methods frequently used in studies of patient-doctor communications: 1) in-depth interviews; 2) focus group interviews and, 3) semi-structured interviews.
Each qualitative research method has different or common advantages and disadvantages, and which methods should be used depends on the study objectives. Qualitative research and quantitative research are complementary: while quantitative research explains the prevalence or variation of an issue, qualitative research explains the reasons or processes of that prevalence or variation. Combination of the two methods enables the gathering of more comprehensive and explanatory results.

The engaging>30 minutes of physical activity (PA) at 4-6 METs has been recommended for the prevention of cardiovascular disease. We determined whether relatively low intensity (i. e., 3-5 METs) PA inhibits the age-related central arterial stiffening, a risk of cardiovascular disease. In the cross-sectional study, the association between carotid arterial properties (via ultrasound system) and daily PA (via electric accelerometer) were studied in 172 normotensive people (41-82 yrs). People engaging>30 min/day of PA corresponding to 3-5 METs had a significantly lower beta-stiffness index than sedentary peers after adjusting for covariates (i. e., age and PA time at more than 6 METs). In the interventional study, beta-stiffness index of nine normotensive postmenopausal women was significantly decreased after the 12-week aerobic training (cycling at 80% of ventiratory threshold, ≈4 METs, 30 min/day, 5 days/week). These results suggest that the increase in daily PA at 3-5 METs inhibits the age-related carotid arterial stiffening.

1) We compiled lists of accredited training hospitals for postgraduate education from the matching program list and of hospitals that employ board-certified specialists in emergency medicine.We then evaluated the number of training hospitals that employ board-certified specialists.
2) There are 1072 accredited hospitals for postgraduate education. However, only 546 (50.8%) of these hospitals employ board-certified specialists in emergency medicine.
3) Accredited training hospitals with emergency-medicine specialists are prevalent in Okinawa, Tokushima, and Kagawa prefectures.However, the prevalence of these hospitals is surprisingly low in metropolitan areas.