It is reported that changes in immunological system are one of the underlining mechanisms of balneotherapy effects. Since there is no study concerning the mechanisms how balneotherapy with a simple thermals works, we tried to examine both the changes of immunological functions and stress relieving effect of balneotherapy. Fourteen inpatients (mean age 63 years) suffering from such as cerebrovascular diseases participated in the present study. Before and after 6-week balneotherapy, lymphocyte subset counts, levels of cytokines (IL-4, IL-6, IF-γ etc.) were determined and lymphocyte blastogenetic tests were also performed. In addition, stress barometers (urinary 17-ketosteroidsulfate (17KSS)/17hydroxycorticosteroid (17OHCS)) were measured. As a result, no significant changes in cytokine levels were observed. Percentage of T cell count decreased and that of B cell increased. Percentage of suppressor T cell count decreased and that of helper and killer T cell tended to increase (not significant). Lymphocyte blastogenetic tests by ConA and PWM showed enhanced responses and urinary 17KSS/17OHCS levels increased after balneotherapy. From these findings, it is suggested that 6-week balneotherapy with a simple thermals has a potential of augmenting immunological functions and also possesses stress relieving effect.
Hemiplegia after a cerebrovascular event is a complication that causes problems in daily life such as difficulty of walking and may lead to social disadvantages. Furthermore, various subsequent health issues that accompany hemiplegia tend to hinder rehabilitation. In particular, Shoulder-Hand Syndrome (SHS) is an intractably painful disease with primary symptoms of pain and swelling in the upper limbs of patients. We investigated the effect of the acupuncture treatment on those patients with hemiplegia after a cerebrovascular event who are suspected to have SHS because of such symptoms as pain, swelling, and paresthesia in the upper limb of the affected side by measuring the changes in the numerical scale (NS), Gibbons' RSD score, and range of motion (ROM) in upper extremities. The present study consisted of 13 hemiplegic subjects (eight males, five females) with pain, swelling, and paresthesia in the upper limbs. Acupuncture treatment was applied twice a week for over two months. Specifically electrical acupuncture and/or the retaining needle technique was applied to the upper extremities for 20 minutes in each session. Of 13 participants, 10 showed a significant decrease in NS (reduced by five or more points), eight showed improvement of the swelling in the upper limbs, and nine showed reduction in paresthesia. From these results, we concluded that the acupuncture treatment was effective for SHS that accompanies hemiplegia after a cerebrovascular event and that the improvement of the peripheral blood flow might play an important role in generating treatment effects.
Poor circulation is considered to be a cause of stiff shoulders, but there have been no studies on deep hemodynamics and the subjective estimation/palpation of stiff shoulders. We evaluated the relationship between deep hemodynamics and the degree of the subjective estimation/palpation of stiff shoulders by near-infrared spectrophotometry. The subjects were 146 patients who visited our center and 23 healthy volunteers. Deep hemodynamics (tissue oxygen saturation: StO2, total hemoglobin concentration: total Hb) was measured in the scapular region of the bilateral shoulders using a deep hemodynamics measurement system (PSA-IIIN, Biomedical Science), and its relationship with the severity of the subjective estimation of stiff shoulders (5-grade rating) and that of palpation (4-grade rating) was evaluated. Deep hemodynamic values were affected by the body mass index (BMI) that is highly correlated with subcutaneous fat thickness. Therefore, analysis was performed in 70 patients and 8 healthy volunteers with BMI of 20-24 that does not affect hemodynamic values. Compared with the healthy volunteers, patients who reported marked shoulder stiffness showed a significant decrease in total Hb, and that who reported shoulder stiffness showed a significant decrease in StO2. On the other hand, compared with the healthy volunteers, patients with marked shoulder stiffness observed by palpation showed significant decreases in both StO2 and total Hb; the decreases were more marked with more marked stiffness. These results suggested that deep hemodynamics is a diagnostic parameter of stiff shoulders.
We plotted the distribution of long-lived persons derived from the national register of long-lived persons as of fiscal years of 1980 (N=1, 349) and 2000 (N=17, 740) prepared by the Ministry of Health and Welfare to investigate various factors such as medical climatology and geography on healthy aging. The data were plotted on a map of Japan classified into various living environments, such as coastal areas, forests, and mountainous areas. In addition, we investigated universal elements and transforming elements through year-by-year comparisons over a period of 20 years. Japan was divided into nine climatic districts Hokkaido, the Japan Sea area, the Pacific Ocean area, the Sanriku district, the Tokai district, the inland district, the Seto Inland Sea district, the Northern Kyushu district, the Nankai district, and the South-western Islands. Consequently, we found a common trend that relatively warm climates and climates in coastal areas are favorable for longevity. However, the following trends were also recognized as transforming elements that cannot be ignored: 1. A remarkable improvements in the rate (number of long-lived people per 100, 000 population) in cold climate regions, i.e., the Japan sea area, inland area, and Hokkaido; 2. A remarkable shift of higher rates from coastal areas, which are contaminated by industrial plants, to inland flat areas. As a result, it has become clear that research on factors of healthy aging, especially in cold climate regions, have to be made in the future.
Effects of spa therapy on asthma were studied in 64 patients with asthma in relation to the generation of leukotrienes B4 (LTB4) and C4 (LTC4) and bronchial hyperresponsiveness. 1. The efficacy of spa therapy was marked in 12 (18.8%), and moderate in 45 (70.3%) of 64 patients with asthma, and slight or no efficacy of the therapy was observed in the residual 7 patients (10.9%). 2. Bronchial hyperresponsiveness to methacholine was the highest in patients with slight or no efficacy of spa therapy, however, there were no significant differences among the three groups classified by clinical efficacy. 3. The generation of LTC4 by leucocytes was significantly higher in patients with slight or no efficacy compared with the generation in those with marked (p<0.01) and moderate efficacy (p<0.001). However, there were no significant differences in the generation of LTB4 among them. 4. The generation of LTC4 before spa therapy significantly decreased in patients with marked (p<0.001) and moderate efficacy (p<0.01) after spa therapy, but not in those with slight or no efficacy. The generation of LTB4 was not significantly different before and after spa therapy among patients with marked, moderate, and slight or no efficacy. These results show that the efficacy of spa therapy for patients with asthma is closely related to the generation of LTC4 by leucocytes, and that the generation of LTC4 significantly decreases after spa therapy in patients with spa efficacy.
Effect of balneotherapy is said to be obtained by continuous bathing in hot spring for 2-4 weeks. However, a short staying at spa for bathing therapy is quite usual in Japan nowadays. So we conducted an investigation on the effect of bathing therapy at spa for 3-7 days (short group), comparing with the effect of the therapy for 14 days or more (long group), through the collaboration of balneologists in all over Japan. The total of 215 cases, having rheumatic, cardiovascular, metabolic, psycho-neurological, postoperative, skin or digestive diseases, of whom 135 were in the short group and 80, in the long group, were analysed for the influence of spa therapy on the patient's quality of life (QOL). Both the severity of disease by doctor's evaluation through visual analogue scale method and the patient's QOL state assessed by patient through the Face Scale method were improved significantly in both groups after the spa therapy. The disease severity and the patient's QOL state at the end of spa therapy were not changed significantly thereafter through 1 month in both groups. Patient's activities of daily living (ADL), appetite, sleep, pain, itch and fatigue, which will make up the patient's QOL, were also improved significantly after the spa therapy, if they had been disturbed or present, in both groups. All these states at the end of spa therapy were not changed significantly at 1 month after the end of spa therapy in both groups. These results may substantiate the rightfulness of patient's assessment of QOL. The tendency to normalization was found in the body weight, blood pressure and passage too after the spa therapy in both groups. A skin rash, itching or slight thermal crisis was observed in 13 cases as the side effects of spa therapy. None of them was serious. From the above results it is concluded that a short staying spa therapy for 3-7 days is effective as well as the standard long therapy on patient's QOL, and the effects last about 1 month long at least.