Purpose：To explore a methodology for evaluating end-of-life （EOL） cancer care using diagnosis procedure combination （DPC） administrative data. Methods： We investigated care provided to inpatients whose deaths were attributed to cancer and occurred between August 2010 and December 2012. We measured the quality of palliative care by dividing the decedents into two groups： those who died in the palliative care unit （PCU） and those who died in the general wards（GW）. Results： A total of 311 inpatient deaths were identified as cancer deaths. Of these, 147 patients were included in the PCU group and 164 in the GW group. We calculated the DPC data as follows： the rates of chemotherapy administered within 30 days before death （PCU 0％, GW 27％） and within 14 days before death （PCU 0％, GW 10％）, admission to the intensive care unit （PCU 0％, GW 2％）, life-sustaining interventions （PCU 0％, GW 3％）, rehabilitation sessions （PCU 10％, GW 26％）, emergency admission （PCU 2％, GW 27％）, and antibiotics （PCU 32％, GW 28％）. In the PCU group, rates of chemotherapy and emergency admission were significantly lower（＜0.0001；＜0.0001, respectively）, and rehabilitation sessions were significantly higher （p＝0.0002） than in the GW group. Conclusion： EOL care in a university hospital can be easily investigated using DPC data. Some limitations are the single-site study design, the health insurance system, and secondary use of administrative data. However, this methodology may be adapted to investigate the entire Japanese claim database and to evaluate EOL cancer care.

  Advanced Medicine such as IPS cell, STAP cell, Medical Megabank, BioBank, Robot Surgery, Remote Medical Care, and Future Medicine, has been emerging. China set Chinese medi-cine centered on herbal medicine as a part of national strategy, into which they put big money and many hands.   How healthcare should be? How advanced technology should be utilized? Where the Med-icine should go? What are the difference between health promotion and healthcare? And how do the both exist together?　How balneology should go with Genomic researches which has been actively conducted?   Current genomic researches mainly focus on resolving the genomic design and cause-effect relationship between the design and substantial expressions. Considering that these ex-pressions come under the influence of internal and external environments spatially and temporally, the researches on interaction with environment have got to be important. Due to the rise in health care costs, keeping good health and avoiding diseases have been well recognized worldwide. Although both evidence based health promotion and evidence based medicine become standard practice already, can we say that EBM (Evidence Based Medi-cine) is scientific indeed?   Balneology keeps and promotes good health reasonably using hot springs and natural environment surrounding the human body. It aims to avoid diseases or recover from dis-eases. In that sense, we can say that balneology is ahead of genomic researches. We, however, need more scientific support to prove that. In order to deal with a complex system interacting with external and internal environments, variables for analysis increase enormously.   In response to this current situation, I would like to think once again with you about the essence of balneology: What is insufficient? What is needed? In which direction should we be heading?

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The objective of this paper is to define the basis for the translational research and its knowledge framework in balneology aiming to approach the disease prevention. As a method to attain this objective, we advocate the knowledge framework that can bridge gene ontology (GO), balneologic ontology (BO), and clinical ontology (CO) virtually at a client site with three sided basic concepts as (1) the logically extended anatomical index from micro to macro, (2) the knowledge representation based on feature described logical conceptual unit, and (3) the EBM (Evidence Based Medicine) based quality evaluation of knowledge. As an result, the scheme and the prototype of the knowledge framework for the basic balneology was built. The logically extended anatomically hierarchical index could offer the seamless and logical continuity from genome to human/environment. The EBM based quality assessment enhanced the reliability of knowledge, and the knowledge representation based on the logical conceptual unit approach offered the unification of the different grain size knowledge.

In post-genome era, the greatest challenge of post-genome research is how we can apply genomic outcome to practical field like clinical medicine through discovering effective findings from its complex and meta-molecular network. From the viewpoint of reducing health care cost, preventive medicine that can avoid diseases should be essential target. Balneology that contains preventive medicine in part through unspecified bio-modulation effect should be a principal field of genome science based application. Balneology has expectations to be applied to practical clinical field or health promotion through translational research to modern medicine or health science. This translational research needs establishment of bridging knowledge and its bi-directional migration as the essence of translation. Integration of in silico knowledge among balneology, modern medicine, and genomic science is the fundamental basis of this translation. Single knowledge architecture that has anatomically hierarchical structure, logical conceptual unit and its supportive evidences makes integration logically seamless and establishes smooth translation. This paper reports knowledge architecture in balneologic translational research and its prototype.