Introduction: Stainless steel needles are mainly used in acupuncture treatment, but material considerations are crucial for patients with metal allergies. This report presents a case of acupuncture treatment administered without inducing allergic symptoms in the patient, achieved through effective collaboration with medical specialists.

  Case: The patient was a 35-year-old woman. Complaints were menstrual symptoms, neck and lumbar pain, the former appeared after the birth of her second child at the age of 24, and the latter was felt chronically. She visited our department because she wanted to receive kampo medicine and acupuncture treatment. It was also reported that she had metal allergy symptoms. Therefore, after consultation with the allergist of our department, a full examination was requested at the dermatology department. In the meantime, our department suspected PMS, PMDD, and muscular or joint pain. First, we started acupuncture treatment using titanium press tack needles and resin contact needles to address muscular or joint pain, taking metal allergies into consideration. The frequency was once every two weeks. One month later, a patch test result was positive for nickel. Nevertheless, she still requested acupuncture treatment, and we consulted with the allergist regarding her case. Then, with her consent, the silicone-coated stainless steel acupuncture needles were inserted into the distal part of the limbs and remained in place for 15 min. During this time, we observed her skin and instructed her to closely monitor it and report any changes at her next visit. From the fifth treatment onward, additional acupuncture needles were placed in the neck and lumbar region, all without any allergic symptoms being observed.

  　Discussion and Conclusion: In this case, acupuncture treatment was performed safely in the medical cooperation. In the future, we would like to further examine the establishment of acupuncture treatment with high safety for patients with metal allergy symptoms and collaboration with medical specialists.

  Background: Despite the large population affected by chemotherapy-induced peripheral neuropathy (CIPN), no agents are recommended for its prevention and management. Thus, research on non-pharmacological therapies is currently ongoing. Here, we report the results of >3 years of anma (Japanese massage) therapy in a cancer survivor with CIPN.

  Patient Presentation: A 67-year-old Japanese woman with pain and numbness in the lower extremities was unable to wear shoes due to discomfort. In 202X-5, the patient underwent surgery for clear cell carcinoma of the ovary, followed by 6 cycles of adjuvant chemotherapy with paclitaxel and carboplatin, and the above symptoms appeared. Weekly 30-min anma therapy sessions were started in January 202X, and visual analog scale scores for pain and numbness gradually decreased. The patient reported that the range of the affected area decreased, and she could start wearing shoes made from soft materials. This outcome may be explained not only by the gate control theory but also by activation of endogenous analgesic mechanisms via the central nervous system through the application of tactile and pressure stimulation in anma therapy. After 3 years, vibratory sensitivity had recovered in 6 of the 8 areas on vibratory sense examination. A nerve conduction study revealed that the ability to evoke action potentials had recovered and that nerve conduction velocities had improved. Anma therapy may improve circulation and affect the nervous system.

  Conclusion: These results suggest that continuing anma therapy might yield benefits for cancer survivors with CIPN. Comparative studies with a larger sample size are needed.

  Background: In recent years, Finnish sauna bathing has been reported to have beneficial health effects, such as reducing the risk of hypertension and dementia. Although tub bathing in Japan, which is used daily by the Japanese, differs from sauna bathing, there are a few reports on its potential effects in reducing the risk of cardiovascular disease and depressive symptoms, but no reports on dementia. Therefore, we aimed to investigate the association between bathing and incident dementia in Japanese community-dwelling older people using large longitudinal data.

  Methods and Results: We used data from the Japan Gerontological Evaluation Study (JAGES), which included community-dwelling older people aged ≥65 years who were not certified for long-term care. The baseline survey was conducted in 2010, and the onset of dementia was assessed using records from Japan’s long-term care insurance system. After excluding respondents with missing data on bathing frequency in summer and winter separately, a total of 7,509 individuals were analysed for summer and 7,590 for winter. Bathing frequency was divided into two groups: low frequency (0-6 times/week) and high frequency (≥7 times/week). To examine the association between bathing frequency and incident dementia, we performed survival analysis using the competing risk model and calculated sub hazard ratios (SHRs) and 95% confidence intervals (CIs). During 9 years of follow-up, 1,430 (17.2%) cases of dementia were identified in 8,317 individuals. In the crude model, the high-frequency bathing group showed a significantly lower risk of incident dementia, and this association remained significant after full adjustment, with SHRs of 0.74 (95% CI: 0.62-0.88) in summer and 0.82 (95% CI: 0.70-0.97) in winter.

  Conclusions: High-frequency bathing was associated with a lower risk of incident dementia among Japanese community-dwelling older adults. This finding suggests that tub bathing, one of the lifestyle habits of older people in Japan, may contribute to preventing dementia.

  Purpose: In this case report, we examined the effects of an aquatic exercise program on respiratory and knee extensor muscle strength in a 72-year-old female patient with knee osteoarthritis and reduced respiratory muscle strength. Decreased respiratory muscle strength is linked to a diminished coughing capacity, which increases the risk of atelectasis and pneumonia, particularly in older individuals with limited physical activity. This study reports the effects of aquatic exercise on a patient with knee osteoarthritis and decreased respiratory muscle strength.

  Methods: The patient participated in an 8-week aquatic exercise regimen, including walking in water at a depth above the fourth intercostal level, to achieve 60% of the predicted maximum heart rate. The pre- and post-intervention measurements included knee extension strength, grip strength, respiratory muscle pressure, vital capacity, and 6-meter walking speed.

  Results: Improvements in expiratory muscle strength, bilateral knee extension strength, and walking speed were observed after the intervention.

  Conclusions: Buoyancy of the aquatic environment minimizes joint load, whereas water viscosity provides resistance and enhances muscle strength without adverse effects. The increase in expiratory muscle strength suggests a potential training effect on the respiratory muscles owing to hydrostatic pressure resistance. These findings underscore the value of aquatic exercise in patients with musculoskeletal limitations and suggest its utility in maintaining respiratory function in older populations. Future research should explore long-term effects and include broader sample sizes to validate these outcomes.

  Spa therapy in Misasa (Tottori Prefecture, Japan) is renowned worldwide for its radon therapy (particularly high-concentration radon hot-air bath therapy) along with mine therapy in Bad Gastein (Austria) and Montana (USA). Radon therapy is indicated for diseases related to the respiratory system, pain, digestive disorders, chronic degeneration, and aging caused by reactive oxygen species; however, most of these indications are based on empirical prescriptions. To address this, the authors have been conducting basic research to experimentally and mathematically identify significant radon and its progeny exposure pathways and their related behaviors in the body. The aim is to quantitatively evaluate the relationship between the biological reactions caused by radon inhalation and the absorbed doses in tissues and organs, and to elucidate new mechanisms related to these indications. Therefore, the mechanisms are being elucidated in terms of a series of moderate physiological stimuli caused by small amounts of oxidative stress induced by radon inhalation. Specifically, radon inhalation enhances antioxidant, immune regulation, and damage-repair functions; promotes anti-inflammation, hormone secretion, and circulatory metabolism; and induces apoptosis and heat shock proteins. New indications have been suggested, including inflammatory and neuropathic pain, inflammatory edema, gastric mucosal damage, ulcerative colitis, hyperuricemia, type 1 diabetes, liver and kidney damage, transient cerebral ischemia, and depression. Furthermore, combining radon therapy with antioxidants and therapeutic agents has been suggested to synergistically enhance the disease-suppressing effects of the therapy. Further clinical verification of the combined effects of radon therapy and conventional treatments is required to reduce the dosage of drugs that cause severe side effects.