A comparative study on spa bathing alone and bathing in combination with herbar medicine was carried out on 21 patients with vibration syndrome of grades III and IV.
Eleven patients (group A) were treated with spa bathing alone; the other ten patients (group B) were treated with spa bathing in combination with herbar medicine (“Goshajin-kigan, ” “Bushi-powder” or “Touki shigyaku kago syuusyo syoukyoutou, ” “Bushi-powder”). All patients were male from 55 to 73 years old.
Subjective symptoms, capillary blood flow volume, skin temperature, and velocity of peripheral nerve conduction were examined before and after each treatment.
In subjective symptoms, the ratio of improvement in group B was significantly higher than that in group A, especially in “numbness, ” “coldness, ” and “discoloration.”
Volume of capillary blood flow in group B was significantly larger than that in group A. Skin temperature in group B was significantly higher than that in group A. However, no significant difference was found in the velocity of peripheral nerve conduction before and after treatment or between group A and group B.

We investigated the influences of hot-spring bathing on the incidences of abortion and premature birth using questionnaires returned from 768 puerperal in-patients.
These patients were classified into four groups: 24 taking a hot-spring bath daily (group 1), 134 taking a bath with additives (group 2), 178 taking a plain water bath daily (group 3), and 35 taking a shower daily (group 4).
The incidence of threatened abortion among the ambulatory patients in each group was 4.2% for group 1, 11.9% for group 2, 9% for group 3, and 2.9% for group 4.
The incidence of threatened abortion among the hospitalized patients in each group was 4.2% for group 1, 6.7% for group 2, 4.5% for group 3, and 8.6% for group 4.
The incidence of threatened premature birth among the ambulatory patients in each group was 12.5% for group 1, 17.2% for group 2, 15.7% for group 3, and 14.3% for group 4.
The incidence of threatened premature birth among the hospitalized patients in each group was 0% for group 1, 7.5% for group 2, 3.4% for group 3, and 2.9% for group 4.
The incidence of vaginitis among the patients in each group was 50% for group 1, 43.4% for group 2, 46.6% for group 3, and 44.1% for group 4.
The incidence of premature rupture of membrane (PROM) among the patients in each group was 4.2% for group 1, 21.1% for group 2, 12.9% for group 3, and 22.9% for group 4.
The incidence of premature birth among the patients in each group was 0% for group 1, 3% for group 2, 2.8% for group 3, and 2.9% for group 4.
Among the 42 multiparas experiencing single delivery and being treated for threatened abortion, those who for more than 10 minutes daily showed a significant difference from ambulatory patients being treated for threatened abortion that required hospitalization.
Many of the 63 primiparas who did not use a labor accelerating medicine but bathed for more than 10 minutes daily delivered their babies within 1000 minutes.
Conclusion
The above suggests that pregnant women may bathe in hot-springs without problem but bathing for less than 10 minutes is recommended during early stage of pregnancy.

Objective：The Mini-Balance Evaluation Systems Test (Mini-BESTest) and Berg Balance Scale (BBS) are widely used to test balance function in adults. However, the information on the minimal clinically important difference (MCID) for the measure has not been consolidated. This review summarizes all available information on the MCID for the Mini-BESTest and BBS.Methods：We searched three electronic databases (PubMed, Cumulative Index to Nursing & Allied Health Literature, and Web of Knowledge) for relevant literature and additionally conducted a hand search.We included all articles that reported an MCID for the Mini-BESTest and BBS.We excluded articles if the MCID was determined by a procedure other than receiver operating characteristic (ROC) curve analysis. Articles were abstracted for information on participants, interventions, balance assessment documentation, and the determination of MCID.Results：A search yielded 21 articles on the Mini-BESTest and 87 articles on the BBS, four articles on the Mini-BESTest and six articles on the BBS were selected based on adherence to the inclusion and exclusion criteria. The MCIDs with an area under the ROC curve of 0.7 or greater ranged from 1.5-4.5 points for the Mini-BESTest and 3.5-6 points for the BBS.Conclusion：A change of 1.5-4.5 points for the Mini-BESTest and 3.5-6 points for the BBS may be clinically important across multiple patient groups.

Objective：The Mini-Balance Evaluation Systems Test (Mini-BESTest) and Berg Balance Scale (BBS) are widely used to test balance function in adults. However, the information on the minimal clinically important difference (MCID) for the measure has not been consolidated. This review summarizes all available information on the MCID for the Mini-BESTest and BBS.Methods：We searched three electronic databases (PubMed, Cumulative Index to Nursing & Allied Health Literature, and Web of Knowledge) for relevant literature and additionally conducted a hand search.We included all articles that reported an MCID for the Mini-BESTest and BBS.We excluded articles if the MCID was determined by a procedure other than receiver operating characteristic (ROC) curve analysis. Articles were abstracted for information on participants, interventions, balance assessment documentation, and the determination of MCID.Results：A search yielded 21 articles on the Mini-BESTest and 87 articles on the BBS, four articles on the Mini-BESTest and six articles on the BBS were selected based on adherence to the inclusion and exclusion criteria. The MCIDs with an area under the ROC curve of 0.7 or greater ranged from 1.5-4.5 points for the Mini-BESTest and 3.5-6 points for the BBS.Conclusion：A change of 1.5-4.5 points for the Mini-BESTest and 3.5-6 points for the BBS may be clinically important across multiple patient groups.

We present the case of a 76-year-old man who underwent preoperative endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) for obstructive jaundice caused by pancreatic head cancer. The patient had obstructive jaundice and cholangitis during neoadjuvant chemotherapy. Transpapillary biliary drainage using endoscopic retrograde cholangiopancreatography was attempted; however, it was unsuccessful because of duodenal tumor invasion. Therefore, EUS-HGS was performed. Jaundice and cholangitis improved promptly after EUS-HGS, and stent obstruction and migration were not observed before surgery. The stent was safely removed during surgery, and no postoperative complications occurred. Most studies of EUS-HGS for preoperative biliary drainage have been small and retrospective, and few have examined the safety of intraoperative stent removal. The fistula in our patient was promptly identified and the stent was safely removed despite the relatively limited field of view during robot-assisted laparoscopy.The promising findings of our case report can be used to inform EUS-based surgical strategies for biliary drainage with obstructive jaundice.

We present the case of a 76-year-old man who underwent preoperative endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) for obstructive jaundice caused by pancreatic head cancer. The patient had obstructive jaundice and cholangitis during neoadjuvant chemotherapy. Transpapillary biliary drainage using endoscopic retrograde cholangiopancreatography was attempted; however, it was unsuccessful because of duodenal tumor invasion. Therefore, EUS-HGS was performed. Jaundice and cholangitis improved promptly after EUS-HGS, and stent obstruction and migration were not observed before surgery. The stent was safely removed during surgery, and no postoperative complications occurred. Most studies of EUS-HGS for preoperative biliary drainage have been small and retrospective, and few have examined the safety of intraoperative stent removal. The fistula in our patient was promptly identified and the stent was safely removed despite the relatively limited field of view during robot-assisted laparoscopy.The promising findings of our case report can be used to inform EUS-based surgical strategies for biliary drainage with obstructive jaundice.

We present the case of a 76-year-old man who underwent preoperative endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) for obstructive jaundice caused by pancreatic head cancer. The patient had obstructive jaundice and cholangitis during neoadjuvant chemotherapy. Transpapillary biliary drainage using endoscopic retrograde cholangiopancreatography was attempted; however, it was unsuccessful because of duodenal tumor invasion. Therefore, EUS-HGS was performed. Jaundice and cholangitis improved promptly after EUS-HGS, and stent obstruction and migration were not observed before surgery. The stent was safely removed during surgery, and no postoperative complications occurred. Most studies of EUS-HGS for preoperative biliary drainage have been small and retrospective, and few have examined the safety of intraoperative stent removal. The fistula in our patient was promptly identified and the stent was safely removed despite the relatively limited field of view during robot-assisted laparoscopy.The promising findings of our case report can be used to inform EUS-based surgical strategies for biliary drainage with obstructive jaundice.