Purpose: The albumin-to-globulin ratio (AGR) is a recognized chronic inflammation marker. No evidence regarding the relationship between AGR level and ulcerative colitis (UC) exists. The aim of this study was to evaluate the association between AGR and clinical outcomes among Japanese subjects with UC. Methods: The study subjects consisted of 273 Japanese individuals with UC. AGR was divided into 4 categories (low, moderate, high, and very high). The definition of complete mucosal healing (MH) was based on the Mayo endoscopic subscore of 0. Clinical remission (CR) was defined as no rectal bleeding and no abnormally high stool frequency (<3 times per day). Results: The percentage of MH was 26.4%. High AGR and very high AGR were significantly positively correlated with CR (adjusted odds ratio [OR], 5.85; 95% confidence interval [CI], 2.52–14.18 and adjusted OR, 4.97; 95% CI, 2.14–12.04) and complete MH (adjusted OR, 4.03; 95% CI, 1.56–11.51 and adjusted OR, 5.22; 95% CI, 1.97–14.89), respectively after adjustment for confounding factors (P for trend=0.001). Only in the low C-reactive protein (CRP) group (≤0.1 mg/dL), very high AGR was significantly positively correlated with complete MH but not CR (adjusted OR, 4.38; 95% CI, 1.06–21.77; P for trend=0.017). In the high CRP group, no correlation between AGR and complete MH was found. Conclusion Among Japanese patients with UC, AGR may be independently positively correlated with complete MH. In particular, among UC patients with low CRP, AGR might be a useful complementary marker for complete MH.

  Foot and hand baths are used well in partial baths. It is thought that a warm temperature effect varies according to the size of warmed part in a partial bath, but it is not clear. The purpose of this study is to examine the thermal response on the size of warming area and position during foot and hand baths. The subjects were ten young individuals (all men, average age 23.2 ± 1.3 years), and these individuals partook in a 15-min foot and hand bath. Subjects submerged themselves up to the lower thigh and forearm in a bath at 42°C, in a seated position, rested in the position for five min, and then rested for an additional five min after bathing. There are five styles for baths (single thigh, both thighs, single forearm, both forearms, and no bath). Tympanic temperature was taken with a thermistor, skin blood flow with a laser Doppler flowmeter, and sweat rate with capsule method on the right side. We measured whether the subjects felt warm and comfortable. Tympanic temperature was significantly increased in both the foot and hand baths. Skin blood flow and sweat rate showed no change under any condition. Warm temperature and subjects’ feelings of comfort varied for all bathing conditions, in comparison with no bath. Warm temperature feeling was significant for both the foot and hand baths, in comparison with single baths. The change in these temperatures depended on the surface area warmth in the bath, and the response of the warming at different parts of body was suggested by various factors.

  A foot bath is one of the partial baths which soaks a foot in hot water. The effect makes the blood circulation of the part of the warmed foot better, and is effective for fatigue, edema, poor circulation, and sleep. The purpose in this study is to examine how aging influences the change of the autonomic nerve during a foot bath. The subjects were nine elderly individuals (four men, five women, average age of 73.5 ± 8.4 years old), eight young individuals (all men, average age of 25.5 ± 3.4 years old), and for a 20-minute foot bath, when I touched the lower thigh to the 41°C bath in a seated position for rest ten minutes, performed rest after a foot bath for five minutes. Tympanic temperature with a thermistor, skin blood flow with a laser Doppler flowmeter, and blood pressure and heart rate with an automatic sphygmomanometer were measured. In the younger subjects, tympanic temperature was significantly increased compared to the elderly subjects, and skin blood flow was significantly increased during the foot bath in the lower thigh with both subjects, and the younger subjects were significantly increased compared to the elderly subjects. The femor-skin blood flow significantly increased only in the young subjects. The blood pressure did not change in the young subjects during the foot bath, but the elderly subjects’ pressure dropped. The heart rate increase was shown in the young subjects; however, it was not shown in the elderly subjects. It is thought that an increase of the quantity of fat and decrease of the muscle volume due to aging, a decline in the flexibility of the blood vessel, and attenuation of the sensitivity of the receptor affect the change of these autonomic nerve functions.

  The purpose of this study was to clarify the effects of ingesting chloridquellen and bicarbonate spring waters on electrogastrography and heart rate variability in humans. The subjects were ten young adults (average age 21.9 years old). Three and six cycles per minute (cpm) frequency of electrogastrography (EGG) were measured, as well as the high-frequency (HF: 0.15-0.40Hz) components, and the ratio of low-frequency (LF: 0.04-0.15Hz) components to HF components in heart rate variability (HRV) during 90 minutes. The taste of the water and pain or abnormalities in the stomach were also assessed by having the subjects answer a questionnaire. The subjects ingested the spa water or purified water and were asked to respond to the questionnaire after thirty minutes, and they also ingested no water on a different day and were questioned. The EGG-6 cpm frequency, presumably reflecting intestinal activity, did not change under any conditions. The EGG-3 cpm frequency, presumably reflecting stomach activity, significantly increased with bicarbonate spring waters immediately after ingestion and decreased after 30 min. Additionally, the 3 cpm frequency significantly increased with ingestion of purified water over the course of 30 min. The HF components in HRV, presumably reflecting cardiac parasympathetic activity, did not change under any conditions. The ratio of LF to HF components in HRV, presumably reflecting cardiac sympathetic activity, significantly increased with ingestion of purified water immediately and after 15 min, and bicarbonate spring waters after 30 min. There was a difference between ingestion of chloridquellen and purified water in the answers concerning the taste of the water in the questionnaire. These findings suggest that the constituent parts of chloridquellen water and other factors activate stomach and autonomic nervous activities in humans.

Objectives: Radon (222Rn) is a noble gas and a component of water in many hot spring spas. The Hot Springs Law and the Guideline of Analytical Methods of Mineral Springs (revised edition) of Japan classify springs containing 74 Bq/kg or more of radon as “hot springs” and those with radon levels exceeding 111 Bq/kg as “medical springs”, also called “radioactive springs”. Komono Town, one of the foremost spa and health resort destinations in Mie Prefecture, is the site of many radioactive springs. For the purpose of regional vitalization of this area through radioactive springs, it is necessary to confirm the safety and effectiveness of their use. To evaluate the exposure dose due to radioactive spring usage, it is important to measure radon concentration in air, especially in high-humidity air such as in bathing rooms. Methods: The concentration of radon in air was analyzed using an activated charcoal detector (PICO-RAD; AccuStar Labs) with a desiccant (Drierite; 8-mesh anhydrous calcium sulfate; W.A. Hammond Drierite Company, Ltd.) and a liquid scintillation counter (LSC LB-5; Hitachi Aloka Medical, Ltd.). A DPO (2,5-diphenyloxazole) + POPOP (1,4-bis- (5-phenyl-2-oxazolyl)-benzene) toluene solution (Wako Pure Chemical Industries, Ltd.) was used as a liquid scintillator. Activated charcoal detectors were set up in and around the radioactive spring facilities. Results and Discussion: In a radioactive spring facility, radon concentration in air in the bathing room and changing room were relatively high at about 50 Bq/m3. In the corridor on all floors and at the entrance, these values were approximately 10-30 Bq/m3, indicating that radon in hot spring water diffuses into the air and spreads within the facility. Outdoors, radon concentration was 12.5 Bq/m3 at a campsite near the discharge point of the radioactive spring.   Exposure dose is calculated under the assumption of a two-day stay, during which the visitor will use the bath for several hours. The results obtained show that the exposure dose at the hot spring facility is lower than the exposure dose from daily environmental radiation or medical devices. These conclusions are considered sufficient to confirm the safety of the hot spring facility.

Objectives: Radon (222Rn) is a noble gas found in the water of hot spring spas (“onsen”). In Japan, the Hot Springs Law and the Guideline of Analytical Methods of Mineral Springs (revised) classify springs containing 74 Bq/kg of radon as “hot springs” and those with levels exceeding 111 Bq/kg as “medical springs”, also called “radioactive springs”. According to the notification article (the Nature Conservation Bureau of the Ministry of the Environment in Japan), bathing in a radioactive springs may alleviate the effects of gout, arteriosclerosis, and hypertension as well as chronic conditions such as cholecystitis, gallstones, and skin and gynecological diseases. Drinking water from these springs may treat gout, chronic digestive disorders, chronic cholecystitis, gallstones, neuralgia, muscle pain, and arthralgia. To determine exposure doses from radioactive springs, it is important to establish an easy and accurate method of measuring radon concentration in water and humid air in bathing areas. Methods: This study measured the concentration of airborne radon using an activated charcoal detector (PICO-RAD: AccuStar Labs), desiccant (Drierite; 8 mesh of anhydrous calcium sulfate: W.A. Hammond Drierite Company, Ltd.), a liquid scintillation counter (LSC LB-5: Hitachi Aloka Medical, Ltd.), and 2,5-diphenyloxazole(DPO) + 1,4-bis (5-phenyl-2-oxazolyl) benzene(POPOP) toluene solution (Wako Pure Chemical Industries, Ltd.) were used as the liquid scintillator. Results and Conclusions: This study evaluated radon exposure doses due to radioactive spring at a spa in Komono town, Mie prefecture. After water was piped from hot spring storage tanks into bathtubs, only 5.3-18.0% of the radon remained in the water. Two days later, only 0.25% remained, likely due to radioactive decay and increased diffusion into the air from bathing and recirculating filters. Thus, we investigated radon levels in the humid bathroom air around the radioactive hot spring and determined the total radon exposure from spa water and air. The total exposure dose was calculated assuming a two-day stay, during which customers used the bath for some number of hours. Our findings confirm the safety and efficacy of the hot spring facility. This study was supported in part by a grant from the Daido Life Welfare Foundation.

  We previously reported that in patients with Alzheimer’s disease (AD), the number of baths that patients report taking at their first evaluation at a memory clinic was significantly decreased in comparison to before the onset of dementia. Based on this research, we thought further longitudinal evaluation was needed regarding the relationship between the number of baths, cognitive impairment and depression state after AD progression. In the present study, we reevaluate the number of baths; cognitive function tests (Hasegawa’s Dementia Scale-Revised [HDS-R], Mini Mental State Examination [MMSE] and Wechsler Adult Intelligence Scale-Revised [WAIS-R]); and the depression assessment (Zung Self-rating Depression Scale [SDS]) 1 year after first evaluation.   At the first evaluation, the average number of baths taken by 65 AD patients (16 male, 49 female; range: 64-90 years, average: 79.5±5.6 years), was 5.6±1.6 bathsweek. At the reevaluation, this number had decreased to 4.9±1.9 bathsweek. In the WAIS-R, a significant positive correlation was found between the score change in number of baths and the change in performance intelligence quotient (PIQ) and total intelligence quotient (TIQ). However, no significant correlation was found between the score change in number of baths and the change in HDS-R, MMSE, or verbal intelligence quotient in WAIS-R or SDS.   We further evaluated the present series by dividing the study population into two subtypes: a group of patients in which the number of baths decreased 1 year after the first evaluation, and a group in which there was no change. There were no significant differences in background factors (e.g. average age at first evaluation) between the groups. Although, no significant difference was observed between the groups in number of baths before dementia onset (both were 6.7 timesweek), a significant difference was found at the first evaluation (5.3 bathsweek vs 5.9 bathsweek, respectively). No significant differences were observed between the groups in cognitive function test or depression assessment at the first evaluation. However, on reevaluation the group with the decreased number of baths showed significantly lower PIQ and TIQ scores in WAIS-R and a significantly higher SDS score.   The results of the present study suggested that number of baths decreased along with the progression of AD and the greatest participating factor was the practical dysfunction reflected by the PIQ score in WAIS-R. Furthermore, we considered the existence of two subtypes: patients in whom the number of baths decreases with AD progression and those in whom there is no change.

  In Japan, the Hot Springs Law and the Guideline of Analytical Methods of Mineral Springs (revised) classify springs containing 74 Bq/kg of radon as “hot springs” and those with radon levels exceeding 111 Bq/kg as “medical springs” called “radioactive spring”. Radon is a noble gas that easily diffuses in air.   This study evaluates exposure dose due to radon when using a radioactive spring at a spa in the Toriido area, Komono town, Mie district, Mie prefecture.   After bath water was supplied through a pipe from hot spring storage tanks to bathtubs, only 5.3-18.0% of radon remained in the water. Two days later, only 0.3-0.4% of the radon remained in the bath water due to radioactive decay and diffusion into air being increased by bathing and recirculation filtering.   The calculated effective dose from bathing in radioactive hot spring was 2.8-12.0 nSv, and that from drinking radioactive hot spring water was 5.1-23.3 nSv. To determine the total effective dose from use of the hot spring facility that may effects on human health, it is necessary to analyze radon concentrations not only in the water but also the surrounding air.

Background: Nasal obstruction is an annoying condition. In this study, we evaluated the effects of hot spring bathing at 41 to 42°C using a rhinomanometer. Methods: Ten healthy adult volunteers (10 men, mean age of 27.8±4.4 years) were asked to bathe in a hot spring for 10 minutes. Using a rhinomanometer (HI-801), nasal resistance was measured before and after bathing by active anterior rhinomanometry. Total nasal resistance was calculated using Ohm’s law formula with right and left nasal resistance values (1/T=1/R+1/L, T: bilateral resistance, R: right resistance, L: left resistance). Resistance at ΔP=100 Pa was used for evaluation. Results: Right and left nasal resistance values were significantly decreased after bathing in subjects with a pre-bathing nasal resistance of greater than 0.75 Pa/cm3/s (inspiratory, P=0.0117; expiratory, P=0.0277; Wilcoxon t-test). No significant change was observed in subjects with a pre-bathing nasal resistance of below 0.75 Pa/cm3/s.Post-bathing total nasal resistance was significantly decreased in subjects with a pre-bathing nasal resistance of greater than 0.5 Pa/cm3/s (P=0.0115; Wilcoxon t-test). Conclusion: This study showed that nasal obstruction can be improved by hot spring bathing, which may contribute to the reasons why cold symptoms are relieved by hot spring bathing.

 Because bathing frequency decrease as Alzheimer disease (AD) worsens, we investigated the relation between cognitive disfunction and bathing frequency.  We asked AD patients and their caregivers about the number of times the patient bathed per week before onset of dementia and the time of first clinical consultation. We investigated the relation between scores from a cognitive function test (Hasegawa’s Dementia Scale-Revised [HDS-R], the Mini Mental State Examination [MMSE] and Wechsler Adult Intelligence Scale-Revised [WAIS-R]), and a depression assessment (Zung Self-rating Depression Scale [SDS]) and number of baths taken per week.  Before onset of dementia, the average number of baths taken by 89 AD patients (26 men, 63 women; range: 63-90 years, average: 79.8 years), was 6.6 times/week. At evaluation time, this number had decreased significantly to 5.3 times/week (p<0.001). A significant positive correlation was found between perfomance Intelligence Quotient (IQ) and total IQ of the WAIS-R and number of baths (p<0.001, p<0.01, respectively). No significant correlation coefficient was found between HDS-R, MMSE, verbal IQ of the WAIS-R and the SDS and number of baths. Reasons of the patients gave for less frequent bathing were that bathing was troublesome or was forgotten and that thermoregulation of bath water had become impossible.  The results suggested that in AD patients, number of baths taken decreased with aggravation of cognitive dysfunction and that there were multiple participating factors including memory disturbance, depressive state, and, particularly, executive dysfunction.