Using healthy volunteers, we examined the influence of emulsified oil and a low concentration of CO₂ gas on cutaneous blood flow in the forearm. The forearm of each subject was immersed in 25 liters of warm water containing either 10 ppm emulsified oil or 60 ppm CO₂ gas or both. Forearm cutaneous blood flow was measured for 20 minutes. Emulsified oil had no effect on cutaneous blood flow, whereas CO₂ gas caused a gradual and significant increase. When CO₂ gas was used with emulsified oil, cutaneous blood flow was significantly increased in comparison to CO₂ alone, suggesting that emulsified oil enhances the vasodilation caused by CO₂. We then prepared bath salts releasing CO₂ and emulsified oil, and tested for their influence on sweating function in sixteen healthy adults. Each subject bathed daily 10 minutes either in tap water (control group) or in tap water dissolving bath salts releasing CO₂ and emulsified oil (bath-salts group) at 40°C for successive 14 days. A sweating test was performed before and after the session of bathing. In the bath-salts group, the baseline tympanic temperature after successive bathing tended to be lower than that before successive bathing. Although the rise of body temperature during the heat exposure was not different between the groups, sweating rate was significantly greater after successive bathing. The analysis of the rate of sweat expulsion suggested that the greater sweat rate after the successive bathing is mediated by the central mechanism for sweating. Such changes were not observed in the control group. Thus, successive bathing using bath salts that release CO₂ and emulsified oil may have a beneficial effect on sweating function.

  【Purpose】The number of deaths in the bathtub in the home is increasing year by year, of which about 90% are people over 65 years old. The purpose of this study was to verify the hypothesis that the effect on the circulatory dynamics would be less if one took a half-body bath first and then a whole- body bath after a certain period of time, rather than suddenly taking a whole- body bath.

  【Methods】The subjects were ten healthy community elderly men (70.3 ± 4.0 years old). The subjects were bathed at 39°C and 41°C, respectively, with two immersion methods of a 6-min whole body bath and a 3 min whole-body bath after a 3 min half-bath (6 min total). Measured items were systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse (PR), oxygen saturation (SpO₂), and forehead skin temperature. The subjective thermal sensation and comfort were also confirmed verbally. Measurements were carried out in the sitting posture before bathing, within 1 min after bathing, after 2 min, 3 min, and 5 min, just after the bath, and 5 min after sitting rest.

  【Results】In both SBP (p = .010) and DBP (p = .019), the interaction between bathing conditions and measurement time was significant. SBP was greatly affected by temperature regardless of whether or not stepped immersion was used, and blood pressure decreased immediately after bathing at 41°C. DBP showed a significant decrease during bathing at 41°C compared with the whole-body bath after half-body bathing.

  【Discussion】The SBP was markedly decreased immediately after taking a bath at a temperature of 41°C regardless of whether or not the subject was gradually immersed. It is thought that the condition is similar to that of orthostatic hypotension. Furthermore, DBP also showed a decrease of 10 mmHg or more, corresponding to changes during orthostatic hypotension, when bathing only with a whole-body bath at a temperature of 41°C. On the other hand, in the whole-body bath after half-body bathing, the decrease in DBP was less than 10 mmHg even at 41°C.

  Background and Purpose: Hie-symptom is more common in women, with complains of strong cold sensation of fingers and lower limbs during cold weather. From the cyanotic findings of hands and thighs and dark venous blood, blood stasis due to excessive peripheral vein contraction was suspected. Then we studied the changes of sublingual and body surface temperature, venous gas partial pressure in the warm and cold conditions. To examine the role of thermo-dilating effects of nitric oxide (NO), the effects oral administration PDE 5 inhibitor Tadarafil (TDF) were also studied.

  Subjects and Methods: The subjects were 10 women (31 +- 8.8 yrs) with Hie-symptom and 7 women (26+-3.7 yrs) without Hie-symptom, BMI, blood pressure, heart rate,sublingual and peripheral body surface temperature (hand and lower limb), venous and arterial blood gas partial pressure, and fingertip arterial oxygen saturation were measured. The measurement was carried out at warm indoors (about 23°C) and cold outdoors (about 12°C). Then 10 mg TDF tablet was taken and all measurements were repeated again at the same time on the next day.

  Results: There was no difference in fingertip arterial blood oxygen saturation in both groups either at indoor or outdoor conditions, and even after taking TDF. In the cold outdoor, the subjects with Hie-symptom, compared to without Hie-symptom, showed significantly lower body surface temperature and venous blood pO₂, and increased pCO₂. After taking TDF, although sublingual temperature and the decrease in body surface temperature outside the room improved in both groups, the improvement was greater in Hie-symptom.

  Consideration and Conclusion: Because of normal fingertip arterial blood oxygen saturation, Hie-symptom is not considered to be a disorder of the cardiopulmonary/arterial system. From a significant decrease in peripheral body surface temperature, and peripheral venous blood pO₂, and an increase in pCO₂ of Hie-symptom in cold outdoors, it is considered that blood stasis by excessive constriction of peripheral veins or arteriovenous anastomosis (AVA) by the cold. The better effects of oral TDF, in Hie-symptom seems to predict the involvement of NO or cGMP in blood stasis.

  A 53-year-old Japanese man living in Thailand who was diagnosed with prostate cancer was scheduled for a prostate biopsy due to increased serum PSA. Two days prior to his admission, he returned to Japan. The next day he was taken for pre-operative screening and blood tests, which revealed extremely high serum creatine kinase (CK) levels (13,631 IU/L). The following day, his serum CK increased to 29,836 IU/L with 100% type MM isozyme. In addition, his serum myoglobin was 3,289.0 ng/mL and his urinary myoglobin was 26,000 ng/mL. Based on these test results, the patient was diagnosed with rhabdomyolysis.

  The patient revealed that he had gone to a public bath and bathed in an “electric bath” for a total of 90 min over the previous 2 days. During hospitalization, he remained asymptomatic and had no renal dysfunction. The prostate biopsy was performed as scheduled and he was given post-procedure care, including intravenous administration of saline. The patient’s serum CK peaked at 42,355 IU/L on the second day of hospitalization, and on the fifth day it decreased to 5,979 IU/L and he was discharged without any complications.

  After a retrospective review of literature, only three reports were found mentioning an “electric bath”. Two of these reports were related to asymptomatic hyper-CK-emia caused by the electric bath, and one was a case related to the malfunction of an implantable cardioverter defibrillator due to an electric bath. The former two reports concluded that increased time in the electric bath was related to the observed increase in CK level. Since extended bathing in electric baths may cause rhabdomyolysis, further investigation is required to determine what duration of use is safe.

  Objective: The purpose of this research is to clarify whether the current situation of the lower back pain prevention education of manual therapists is different between the colleges for sighted persons and those for the visually impaired. This research investigated the current situation of the guidance using an up-and-down type treatment table and the current situation of lower back pain prevention education at manual therapist colleges in Japan.

  Method: A mail-in survey was conducted for 85 colleges providing a manual therapist training program. For data analysis, descriptive statistics were used to calculate proportions. The type of colleges and implementation of lower back pain prevention education were chi-square tested against other questions.

  Results: Of the 52 colleges that responded to the survey form, those for sighted persons which offered lower back pain prevention education numbered 8 of 8 (100%), while such institutions for the visually impaired were 22 of 44 (50%) (p<0.001). Among the 51 colleges responding to the question about the up-and-down treatment table, 1 in 8 (12.5%) institutions for the sighted used the device, as did 43 of 43 (100%) (p<0.001) institutions for the visually impaired. Of the 44 colleges which use the up-and-down type treatment table, 38 (86.4%) taught the height of the treatment table and 43 (97.7%) taught the posture, but there was no common guidance method used by a majority of the colleges. Among the 44 colleges using the up-and-down type treatment table, those which provided lower back pain prevention education and taught the height of the treatment table were 23 of 23 (100％) (p＝0.008).

  Discussion: Manual therapist colleges have paid attention to teaching a posture, but that instruction is not connected to lower back pain prevention by teaching the height of a treatment table. Training colleges need a common teaching method to give systematic lower back pain prevention education.

  Conclusion: Manual therapist training differs by environment for sighted and visually impaired students, suggesting that teaching method of lower back pain prevention education is different.

  In the present day when the space structure of the spa has been transformed, creation of a relaxation space appropriate for a long stay is in demand. The Onsen Stay promotion plan of the Ministry of the Environment calls for the creation of an expanded relaxation space and experience which utilizes local resources including the ambient surroundings. Furthermore, in the present age, which is said to be a stress society, there is room for the viewpoint that “existence of high-quality communication with the external environment of a spa relieves stress”. This justifies our investigation into whether there is a situation that the external environment of the spa is applied as a relaxation space for long stays.

  Therefore, in national hot spring health resorts designated as the spas that promoted the Onsen Stay policy, I investigated what kind of program was carried to raise demand for a long-term stays. In this report, I investigate and report on Ruri Highland spa, Hamasaka spa, Umegashima spa, Hatake spa, Hirayu spa, Tazawa spa, Kakeyu spa, and Ichirino spa. I clarified that there were five methods for the making of programs to raise stay demand. Combinations of these five are possible. And I clarified that if these methods analyzed the external environment of the spa appropriate for a long stay, stay demand might be raised for a long term, as shown by an example.

  I concluded that the possibility of long stays is raised when the external environment including cultural history resources and surroundings nature were utilized, including the creation of various walks and walking courses.