Women's health clinics, which are a new style of outpatient care with services designed specially for women, have multiplied rapidly over the past two years in Japan.
Women's health clinics have moved away from the traditional clinic outpatient system of medical care and emphasize treatment of each patient comprehensively, viewing her as an individual woman. In addition to medical examinations conducted by women doctors, female patients are seeking medical care that focuses on each individual and want to feel comfortable enough to ask for the information they want. Medical examinations are conducted in private rooms to protect a patients' privacy and an appointment system has been introduced to allow enough time to consult with the doctor.
Including 12 national hospitals, Women's health clinic services are available in many city hospitals and private clinics all over Japan. The Women's health clinic network system began in 2003. Gender-specific medicine is now recognized to be important by medical doctors and patients.

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Although the plevalence of nontuberculous mycobacterial (NTM) lung disease has been increasing, the mechanism of the development of the disease remains unclear. Current diagnostic criteria for NTM lung disease in Japan which are the same as that of the American Thoracic Society, propose that a diagnosis can be made using a specimen taken by bronchial lavage. The cases diagnosed by bronchoscopy tends to have a better clinical outcome, however, there is an issue of how treatment response should be assessed.
Chronic infection with aspergillus species has been thought to be a static disease, however, several reports have revealed that some of these deteriorate lung function in a short period. In order to detect the disease at an earlier stage, novel diagnostic tools are required.

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DNA finger printing of bacteria by restriction fragment length polymorphism (RFLP) analysis based on insertion sequence (IS) 6110 is used for effective interventions in the control of tuberculosis.
RFLP analysis is used for judging the differences between bacterial strains detected from patient materials in outbreak cases. It is also used to confirm cross-contamination in Mycobacteriology laboratory and to distinguish endogenous reactivation from exogenous reinfection of tuberculosis. If patients are infected with bacteria having identical DNA fingerprints, they are considered to belong to a specific cluster. The proportion of clustering is assumed to reflect the recent tuberculosis transmission that has occurred within the community. High proportions (about 50%) were reported from the countries where the incidence of tuberculosis is high and low proportions (about 20%) were reported from the countries where the incidence of tuberculosis is low.
In Japan, a difference in the proportion by area was reported (7.7%-32%) . It was also reported that a high proportion of patients belonged to the groups respectively having the similar patterns. These findings might reflect the epidemiological characteristics of Japan; there are many elder patients having been mostly infected in the past period when the incidence of tuberculosis was very high.

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The onset of all diseases is more or less related to both environmental factors and hereditary factors. The onset of multiple chemical sensitivity (MCS) is undoubtedly closely related to environmental factors. The Quick Environmental Exposure and Sensitivity Inventory (QEESI) is a screening questionnaire for MCS which has four scales: symptom severity, chemical intolerance, other intolerance, and life impact. Thirty-two patients who visited our MCS clinic were interviewed using QEESI. All of them had some initial chemical exposure event at the onset of their symptoms. We examined the relationship between chemical intolerance and symptom severity, and the relationship between chemical intolerance and life impact. There was a strong correlation between the items of chemical intolerance such as insecticide, gasoline, paint or paint thinner, cleaning products and nail polish, nail polish remover or hairspray and each symptom, that is musculo skeletal symptom, cognitive symptom and neuromuscular symptom. The items of chemical intolerance such as diesel or gas engine exhaust, insecticide, and gasoline, which are regarded as outdoor environmental factors, had a strong influence on several items of life impact. Therefore we should appeal more to the government to improve outdoor environmental factors to prevent MCS.

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The services performed by pharmacists in the providing of health care has considerably changed from primal services consisting of the formulation. Pharmacists are expected to play the role of ensuring the rational use of pharmaceuticals during the course of Pharmacotherapy. In addition, they are also being required to contribute to greater efficiency in health care and management from the perspective of hospital administration.
At this symposium, Masato. Tateishi suggested the future direction of pharmacy from the standpoint of a committee member, based on a report of the “Committee for Examining the Desirable State of Pharmacy as National Hospital Organization” by the Discussion Groups of the Section Heads of Pharmacy of National Hospitals. Next, Kenji Hasegawa stated the desirable state of services provided, including past results, with respect to the efforts made by pharmacists from the perspective of hospital management in terms of health care, medical inventories and the use of generic drugs. Kazuhisa Hasebe mentioned the efforts being made with regard to the five major services of pharmacy that have been provided in the past along with services to be provided following establishment as a National Hospital Organization based on his experience of providing guidance to the pharmacy of a national hospital. In addition, Hisanori Sekiguchi proposed the desirable state of pharmacists in the future, including a discussion of educational issues and the problem of stationing pharmacists at hospitals in Japan. Finally, Hiroshi Isobe advised on the present state of pharmacists as a member of the health care team from the standpoint of physicians along with what will be expected of them in future.
As national hospitals continue to promote the concept of policy-based health care, pharmacists must be expected to demonstrate their professionalism with essential medicine as a member of the health care team, make national inter-hospital networks practical, and play a key role in ensuring patient safety.

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We investigated the status of non-invasive positive pressure ventilation (NPPV) in patients with stable chronic respiratory failure in Kyushu area covering the past 2 years, utilizing the national hospital network of respiratory diseases. Fifty-three cases, including 26 cases with sequelae of pulmonary tuberculosis and 20 with COPD, were reported. Although selection criteria for NPPV were similar in each hospital, the settings of NPPV apparatus were different to some degree: frequency, inspiratory pressure (IPAP), and its maximum pressure. NPPV was discon tinued in 15.5% of cases, partly because of ineffectiveness or at the patient's request. Effectiveness was evaluated starting from the point of view of reduction of symptoms, improvement of arterial blood gases, and decrease in exacerbations, resulting in an effective rate of 81.7% of cases in total. Complications, seen in 34.3%, included skin injury and contact pain on the face with the interface. It is suggested that NPPV may be useful for improving the quality of life of patients with stable chronic respiratory failure presenting hypercapnea.

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