Bathing in water (balneotherapy or spa therapy) has been frequently and widely used in classical medicine as a cure for diseases. This paper reviews the present literature on the use of balneotherapy in dermatologic, chronic musculoskeletal (inflammatory and non-inflammatory), metabolic and psychological conditions.
We performed a systematic review on related papers appearing in the Medline and Cochrane Library database from 1966 to 2003 that included randomized controlled and non-randomized clinical trials using balneotherapy. We also determined to reflect where possible the chemical compositions of spas.
The major dermatologic and musculoskeletal diseases that are frequently treated by balneotherapy with a remarkable rate of success are atopic dermatitis, psoriasis, rheumatoid arthritis (RA), ankylosing spondylitis, osteoarthritis and low back pain. Moreover, the effects of spa therapy on several metabolic conditions are discussed. The mechanisms by which broad spectrums of diseases respond to spa therapy probably incorporate chemical, thermal and mechanical effects.
The importance of balneotherapy either alone or as complement to other therapies should be considered after, or accompanying, orthodox medical treatments.

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Objective: The aims of this study were to determine the effects of heavy metals such as manganese on nicotinamide N-methyltransferase (EC 2.1.1.1) (NNMT) activity and to consider the possibility of involvement of NNMT activation in the pathogenesis of heavy metal induced Parkinson’s disease.
Methods: NNMT activity in supernatants separated from brain, liver and kidney homogenates of 5 elderly male Wistar rats by centrifugation were measured by high performance liquid chromatography system with fluorescence. NNMT activity under the conditon of 0.5 or 5.0 mM Mn²⁺, Fe²⁺, Cu²⁺ or Cd²⁺ was compared with control (no metal ion existence).
Results: NNMT activities in rat brain, liver and kidneys were significantly decreased by Cu²⁺, and those in the liver and kidneys were significantly decreased by Cd²⁺. Mn²⁺ reduced NNMT activity only in the liver. Fe²⁺ had no effect on NNMT activity.
Conclusions: No metal increased NNMT activity in this study, contrary to our hypothesis. Further study is needed to clarify the reason why the effects of Mn²⁺ and Fe²⁺ which have a high relevance to Parkinson’s disease on NNMT activity differ from those of Cu²⁺ and Cd²⁺.

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Objective: Docosahexaenoic acid (DHA) is known as a chemopreventive substance for cancers. Previously we reported that DHA induces apoptosis in HL-60 cells. The aim of this study was to clarify the role of phosphatidylinositol 3-kinase (PI3-kinase)/Akt signaling during DHA-induced apoptosis in HL-60 cells.
Methods: The inhibitory effects of dibutyryl cAMP (db-cAMP) or LY294002 (a specific inhibitor of the PI3-kinase/Akt pathway) on DHA-induced apoptosis in HL-60 cells were evaluated by the appearance of apoptosis, and from the activities of caspases (3 and 8), the phospholylation of Akt, and cleavage of Bid using DNA indexes, emzymatic measurement of fragmented substrates, and Western blotting, respectively.
Results: The pre-incubation of db-cAMP reduced the activation of caspasses (3 and 8) during the occurrence of DHA-induced apoptosis in HL-60. However, the inhibition of PI3-kinase/Akt signaling by LY294002 resulted in recovery of the caspases’ activities, appearance of apoptotic cells, and cleavage of the Bid molecule when LY294002 was co-treated with db-cAMP before the occurrence of DHA-induced apoptosis in HL-60. It was also confirmed that LY294002 strongly inhibited phospholylation of Akt during db-cAMP induced-reduction of DHA-induced apoptosis in HL-60.
Conclusion: We demonstrated that DHA-induced apoptosis was sensitive to the modulation of PI3-kinase activity by treatment with db-cAMP or LY294002. These results may provide new insights into the mechanisms of the anti-cancer activity of DHA.

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Objectives: The purpose of this study is to define and clarify the causes of differences in physique between urban students and rural students in China.
Methods: Subjects are 2,524 students (male, 838; female, 1686) who entered K University in Shanghai in September, 2001. The data used in this study is based upon K university’s Yearly Health Check Record and Students’ Family Condition Record. Correlation analysis, analysis of variance (ANOVA) and analysis of covariance (ANCOVA) were applied to analyze the relationships between physique and gross family income, family income per capita, latitude, air temperature, precipitation or altitude.
Results: Urban students’ height and weight are significantly greater than rural students’ in both males and females. Both male students and female students are significantly taller and heavier in accordance with per capita increases in students’ family income. The height and weight of male and female students whose parents are peasant farmers are least. With regard to the relationship between physique and urban-rural factors, the F value decreases clearly when family income per capita is taken as a covariate, while the F values slightly decrease also when factors of latitude etc. are taken as covariates. The main cause of differing family income is occupational difference between urban areas and rural ones.
Conclusion: Students born in urban areas are taller and heavier than those born in rural areas. The main cause of these differences is family income per capita. The main cause of variations in family income is the income difference in occupations.

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Objectives: We investigated psychological well-being and associated factors among elderly Hansen’s Disease (HD) patients in three national leprosaria in Japan.
Methods: Three questionnaires on physical and social factors, and psychological well-being based on the 12-item of General Health Questionnaire (GHQ-12) were used to survey all HD patients admitted to three leprosaria in Japan. The number of respondents over 65 years old who completed all 12 items of GHQ-12 was 754 (459 men and 295 women) with a response rate of 80.9%. Data were analyzed by t-test and analysis of covariance (ANCOVA) to determine factors associated with psychological well-being.
Results: The impairment in 8 physical functions, walking, eating, and toileting for both men and women, bathing for men, and vision, dressing and grooming for women, were significantly related to high GHQ-12 scores by t-test and ANCOVA. Having no close friends, less frequent contact with neighbors, and no or less frequent participation in group activities in men, and inactive daily life style in male and female HD patients, were related to high GHQ-12 scores by both analyses.
Conclusion: The present results showed that physical factors and inactive daily life style were related to psychological well-being for both men and women. Social factors were related to psychological well-being among elderly male HD patients in Japan. Further follow-up study is necessary to examine the causal relationships among psychological well-being and associated factors.

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Objectives: Exposure misclassification is a major obstacle to obtain accurate dose-response relationships. In order to solve this problem, the impact of hair treatment on total mercury in hair was assessed in Japanese women.
Methods: A cross-sectional study was carried out among 327 women at age 24-49 years to determine hair mercury levels and estimate daily mercury intakes from seafood by using a food frequency questionnaire.
Results: Hair mercury levels in the women and daily mercury intake ranged from 0.11 to 6.86 (median 1.63) μg/g and from 0.77 to 144.9 (median 15.0) μg/day, respectively. The hair mercury was positively correlated with the daily mercury intake (p<0.001). When the women were divided into two subgroups based on artificial hair-waving, hair coloring/dyeing, residence (non-fishing and fishing areas), and working status, a significant difference in the hair mercury level was observed between the women with and without artificial hair-waving only (p<0.001). The multiple regression analysis showed that the log-transformed hair mercury level was significantly related to the log-transformed daily mercury intake (standardized regression coefficient βs=0.307) and artificial hair-waving (βs=−0.276); but not to hair coloring/dyeing, residence, working status or age. Permanent hair treatment was estimated to reduce total mercury in hair by approximately 30%, after adjusting for daily mercury intake and other possible factors.
Conclusions: These findings suggest that hair mercury is not the best biomarker of methylmercury exposure when a study population includes women with artificial hair-waving.

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We made a bibliographic search for Japanese and non-Japanese literature on tuberculosis control programs to study the current public health policies for tuberculosis control in Japan especially in regard to cost-effectiveness. Then, we compared the Japanese strategies for tuberculosis control with those in other countries including the United States, and those recommended by World Health Organization (WHO). The current trend of tuberculosis incidence in the Japanese community demonstrates major differences from the situation that had prompted installation of tuberculosis control measures several decades ago. The tuberculosis control measures should be targeted to the elderly people (over 65 years old) because of the following three aspects. (1) A continuing decline of tuberculosis in the young Japanese population, particularly children who might attain benefits from BCG immunization; (2) The enhancement of the prevalence among the elderly people who are not covered by a uniform national surveillance strategy; (3) Cost-ineffectiveness of Mass Miniature Radiography (MMR) being used as a means to screen for tuberculosis. The cost-effectiveness issue must be considered more seriously, and the WHO recommendations especially in regard with the DOTS (directly-observed treatment, short course) strategy need to be incorporated more effectively into the national program since the incidence of drug resistant tuberculosis in Japan has been recently increasing. Finally, we propose to limit BCG immunization further and to discontinue annual MMR in the young population, and instead to develop effective strategies of both active and passive case finding in the elderly through public and community health services.

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