14-3 Climatotherapy in the world and the potential of Japanese climate and geographical features to health promotion and disease prevention / 日本温泉気候物理医学会雑誌

Objective: To review the related articles and consider the potential of Japanese climate and geographical features to health promotion and disease prevention in the context of health resort medicine. Method: To summarise the studies concerning climatotherapy in the world, PubMed database was searched from 1965 to 2014. Additional references were identified from bibliographical searches of included studies. Results: One hundred thirty-five articles were included. These articles were sorted according to the place of health resort and the objective: 1) At the Dead Sea, of maritime climate with natural sunlight and salt water, climatotherapy for psoriasis, atopic dermatitis, rheumatic diseases, vitiligo, uveitis, mycosis fungoides and hypertension; 2) At the Canary Islands, of subtropical maritime climate, climatotherapy for psoriasis, cerebral palsy and atopic dermatitis; 3) At the Alpine mountain area, of moderate- and high-altitude mountain climate, bronchial asthma, atopic eczema, chronic obstructive pulmonary disease (COPD), circulatory diseases, osteoporosis and metabolic syndrome; 4) At the North Sea, climatotherapy for bronchial asthma and atopic dermatitis; 5) At the Baltic Sea, climatotherapy for bronchial asthma, chronic bronchitis, psoriasis, pulmonary silicosis and children after rheumatic disease; 6) At the Island of Jerba in Tunisia, of the Mediterranean maritime climate, climatotherapy for fibromyalgia; 7) At the Adriatic Sea shore in Croatia, climatotherapy for bronchial asthma; 8) At the Black Sea shore, including Evpatoria health resort (Crimea), Azov Sea zone, Black Sea health resort and Sochi health resort, climatotherapy for chronic dermatoses, atherosclerosis, coronary heart disease, rheumatic heart disease, after lung resection in children and non-organized vacationers; 9) At the west coast of Caspian Sea shore, climatotherapy for cerebrovascular disorder; 10) At the mountain hospital in Kyrgyz, of high-altitude mountain climate, aplastic anaemia and idiopathic thrombocytopenic purpura; 11) At the north shore of Sea of Japan, climatotherapy for the children with oncological disease.   In Japan, the total length of coastline is 35,558 km, and the total number of islands is 6,852. The percentage of forest area is 66.4%, moderate-altitude mountain area (250-1,000m above sea level) is 45.0% and high-altitude mountain area (1,000-3,000m) is 6.4%. Climatic region distributes from the subtropical zone to the subarctic zone. Most of the coastal area is close to the mountain area. There are many health resorts for the forest therapy, balneotherapy and thalassotherapy. Conclusions: There would be a high potential of Japanese climate and geographical features as a health resort of climatotherapy and terrain kur to health promotion and disease prevention.

14-3Climatotherapy in the world and the potential of Japanese climate and geographical features to health promotion and disease prevention / 日本温泉気候物理医学会雑誌

<b>Objective: </b>To review the related articles and consider the potential of Japanese climate and geographical features to health promotion and disease prevention in the context of health resort medicine.<BR><b>Method: </b>To summarise the studies concerning climatotherapy in the world, PubMed database was searched from 1965 to 2014. Additional references were identified from bibliographical searches of included studies.<BR><b>Results: </b>One hundred thirty-five articles were included. These articles were sorted according to the place of health resort and the objective: 1) At the Dead Sea, of maritime climate with natural sunlight and salt water, climatotherapy for psoriasis, atopic dermatitis, rheumatic diseases, vitiligo, uveitis, mycosis fungoides and hypertension; 2) At the Canary Islands, of subtropical maritime climate, climatotherapy for psoriasis, cerebral palsy and atopic dermatitis; 3) At the Alpine mountain area, of moderate- and high-altitude mountain climate, bronchial asthma, atopic eczema, chronic obstructive pulmonary disease (COPD), circulatory diseases, osteoporosis and metabolic syndrome; 4) At the North Sea, climatotherapy for bronchial asthma and atopic dermatitis; 5) At the Baltic Sea, climatotherapy for bronchial asthma, chronic bronchitis, psoriasis, pulmonary silicosis and children after rheumatic disease; 6) At the Island of Jerba in Tunisia, of the Mediterranean maritime climate, climatotherapy for fibromyalgia; 7) At the Adriatic Sea shore in Croatia, climatotherapy for bronchial asthma; 8) At the Black Sea shore, including Evpatoria health resort (Crimea), Azov Sea zone, Black Sea health resort and Sochi health resort, climatotherapy for chronic dermatoses, atherosclerosis, coronary heart disease, rheumatic heart disease, after lung resection in children and non-organized vacationers; 9) At the west coast of Caspian Sea shore, climatotherapy for cerebrovascular disorder; 10) At the mountain hospital in Kyrgyz, of high-altitude mountain climate, aplastic anaemia and idiopathic thrombocytopenic purpura; 11) At the north shore of Sea of Japan, climatotherapy for the children with oncological disease.<BR>  In Japan, the total length of coastline is 35,558 km, and the total number of islands is 6,852. The percentage of forest area is 66.4%, moderate-altitude mountain area (250-1,000m above sea level) is 45.0% and high-altitude mountain area (1,000-3,000m) is 6.4%. Climatic region distributes from the subtropical zone to the subarctic zone. Most of the coastal area is close to the mountain area. There are many health resorts for the forest therapy, balneotherapy and thalassotherapy.<BR><b>Conclusions: </b>There would be a high potential of Japanese climate and geographical features as a health resort of climatotherapy and terrain kur to health promotion and disease prevention.

Paradoxical increases in serum levels of highly chlorinated PCBs in aged women in clear contrast to robust decreases in dietary intakes from 1980 to 2003 in Japan

<p><b>OBJECTIVE</b>Exposure to polychlorinated biphenyls (PCBs) is considered to have culminated between 1950 and 1970 in Japan, and exposure through diet, the major exposure route, has decreased significantly over the last 10 years. The primary goal of the present study was to investigate the long-term trends and congener profiles of serum and dietary levels of PCBs using historical samples.</p><p><b>METHODS</b>Using banked samples collected in 1980, 1995, and 2003 surveys, we determined the daily intakes and serum concentrations of 13 PCB congeners (#74, #99, #118, #138, #146, #153, #156, #163, #164, #170, #180, #182, and #187) in women.</p><p><b>RESULTS</b>The total daily PCB intake [ng/day, geometric mean (geometric standard deviation)] decreased significantly from 523 (2.5) in 1980 to 63 (3.2) in 2003. The serum total PCB level (ng/g lipid) in women <40 years of age decreased significantly from 185 (1.8) in 1980 to 68 (1.8) in 2003. In contrast, the level in women >50 years of age increased significantly from 125 (1.7) in 1980 to 242 (1.7) in 2003. Specifically, the serum concentrations of hexa (#138, #146, #153, #156, #163, and #164) and hepta (#170, #180, #182, and #187) congeners increased significantly. A comparison of the serum PCB levels of women born from 1940 to 1953 revealed that their serum total PCB level was significantly higher in the 2003 survey [242 (1.7), n = 9] than in the 1995 [128 (2.0), n = 17] surveys. This increase in the total PCB level was attributable to increases in the hepta congener groups.</p><p><b>CONCLUSION</b>Present results suggest a decreased rate of elimination of hepta congeners with aging in females, rather than a birth-generation phenomenon.</p>

Positive Patch Test for Mercury Possibly from Exposure to Amalgam

Objectives: Mercury allergy is a serious health problem. We investigated the relationship between positive patch test for mercury and sources of mercury exposure, indicated by concentrations in biological samples from healthy medical students. Methods: Patch tests for mercury (Hg-PT) were performed on 580 students. For a group of 55 students with a positive Hg-PT result (Hg-PT(+)) and a reference group of 79 students with a negative Hg-PT result (Hg-PT(−)), mercury concentrations in urine (Hg-u) and hair (Hg-h) were measured. In our search for environmental indicators of mercury exposure, the level of fish intake and mercurochrome usage were determined using a self-administered questionnaire. The oral cavity was investigated and the numbers of decayed teeth filled with amalgam (NA) were counted by dentists. Results: For the male Hg-PT(+) group, Hg-u and Hg-h were higher than those of a male reference Hg-PT(−) group; Hg-u values obtained in the early morning and after supper were significantly different. Multiple regression analysis with Hg-u as the objective variable among all students showed that increases in the level of fish intake, mercurochrome usage, and the NA independently increased Hg-u measured in the early morning for both gender groups. NA significantly affected Hg-u. Conclusions: We showed that a higher NA was related to a higher Hg-u measured in the early morning. Therefore, exposure to amalgam may increase Hg-u. It was suggested that Hg-PT(+) might be related to a high Hg-u, and possibly to a high NA.

Positive patch test for mercury possibly from exposure to amalgam

<p><b>OBJECTIVES</b>Mercury allergy is a serious health problem. We investigated the relationship between positive patch test for mercury and sources of mercury exposure, indicated by concentrations in biological samples from healthy medical students.</p><p><b>METHODS</b>Patch tests for mercury (Hg-PT) were performed on 580 students. For a group of 55 students with a positive Hg-PT result (Hg-PT(+)) and a reference group of 79 students with a negative Hg-PT result (Hg-PT)(-)), mercury concentrations in urine (Hg-u) and hair (Hg-h) were measured. In our search for environmental indicators of mercury exposure, the level of fish intake and mercurochrome usage were determined using a self-administered questionnaire. The oral cavity was investigated and the numbers of decayed teeth filled with amalgam (NA) were counted by dentists.</p><p><b>RESULTS</b>For the male Hg-PT(+) group, Hg-u and Hg-h were higher than those of a male reference Hg-PT(-) group; Hg-u values obtained in the early morning and after supper were significantly different. Multiple regression analysis with Hg-u as the objective variable among all students showed that increases in the level of fish intake, mercurochrome usage, and the NA independently increased Hg-u measured in the early morning for both gender groups. NA significantly affected Hg-u.</p><p><b>CONCLUSIONS</b>We showed that a higher NA was related to a higher Hg-u measured in the early morning. Therefore, exposure to amalgam may increase Hg-u. It was suggested that Hg-PT(+) might be related to a high Hg-u, and possibly to a high NA.</p>

Factors affecting the estimated maximal oxygen uptake: a follow-up study of participants in the total health promotion plan

<p><b>OBJECTIVES</b>To elucidate the effects of risk factors for arteriosclerosis on estimated VO(2) max and obtain useful information to advise enterprise employees.</p><p><b>SUBJECTS</b>One hundred and nineteen male and 87 female enterprise employees underwent exercise tests for health evaluation in the Total Health Promotion Plan at the Fukui Occupational Health Center between April 1990 and March 1993.</p><p><b>METHODS</b>Multiple regression analysis was performed using estimated VO(2) max as the dependent variable, and percent body fat, blood pressure, blood tests, habitual physical activity, number of cigarettes smoked and alcohol consumption as independent variables in the first and second year, and for yearly changes in these variables.</p><p><b>RESULTS</b>The significant variables selected were as follows: in the first year, systolic blood pressure and percent body fat in males, and age in females; in the second year, diastolic blood pressure and habitual physical activity in males and systolic blood pressure in females; for yearly changes in each variable, cigarettes in males and percent body fat in females were selected.</p><p><b>CONCLUSION</b>It was suggested that guidance to reduce cigarettes in males, and to keep a proper percent body fat in females would be effective in maintaining the estimated VO(2) max.</p>

Effects of exercise intensity on circulating leukocyte subpopulations

<p><b>OBJECTIVES</b>The purpose of this study was to examine the relation between exercise intensity and immune function.</p><p><b>METHODS</b>Ten healthy young males underwent a constant work rate exercise of three levels, 90%, 80% and 70% ventilatory threshold (VT) work rate, for 20 min on a bicycle ergometer. These work rates were calculated for each individual based on his VT work rate obtained by the incremental exercise tests. Blood samples were collected before and after the exercise, and immune function indices were measured.</p><p><b>RESULTS</b>Compared with the obtained[Formula: see text] at[Formula: see text] in the incremental test, the[Formula: see text] with the exercise of 70% VT work rate was at a similar level and the one with the exercise of 90% or 80% VT work rate had a significantly greater value. The numbers of leukocytes and neutrophils significantly increased in the 90% and 70% VT work rate groups. In 80% VT work rate group, the CD4/CD8 ratio was significantly depressed. The CD16(+)CD57(-) (%), natural killer cell populations, had a tendency to increase at 80% VT work rate, and also the CD16(+)CD57(-) (%) had a similar tendency at 90% or 80% VT work rate.</p><p><b>CONCLUSIONS</b>This study shows that moderate exercise reaching or exceeding the VT level acutely affects T cell and NK cell subsets.</p>

Factors Affecting the Estimated Maximal Oxygen Uptake: a Follow-Up Study of Participants in the Total Health Promotion Plan

Objectives: To elucidate the effects of risk factors for arteriosclerosis on estimated VO2max and obtain useful information to advise enterprise employees. Subjects: One hundred and nineteen male and 87 female enterprise employees underwent exercise tests for health evaluation in the Total Health Promotion Plan at the Fukui Occupational Health Center between April 1990 and March 1993. Methods: Multiple regression analysis was performed using estimated VO2max as the dependent variable, and percent body fat, blood pressure, blood tests, habitual physical activity, number of cigarettes smoked and alcohol consumption as independent variables in the first and second year, and for yearly changes in these variables. Results: The significant variables selected were as follows: in the first year, systolic blood pressure and percent body fat in males, and age in females; in the second year, diastolic blood pressure and habitual physical activity in males and systolic blood pressure in females; for yearly changes in each variable, cigarettes in males and percent body fat in females were selected. Conclusion: It was suggested that guidance to reduce cigarettes in males, and to keep a proper percent body fat in females would be effective in maintaining the estimated VO2max.

Effects of Exercise Intensity on Circulating Leukocyte Subpopulations

Objectives: The purpose of this study was to examine the relation between exercise intensity and immune function. Methods: Ten healthy young males underwent a constant work rate exercise of three levels, 90%, 80% and 70% ventilatory threshold (VT) work rate, for 20 min on a bicycle ergometer. These work rates were calculated for each individual based on his VT work rate obtained by the incremental exercise tests. Blood samples were collected before and after the exercise, and immune function indices were measured. Results: Compared with the obtained Vo2 at VT (VTVo2) in the incremental test, the Vo2 with the exercise of 70% VT work rate was at a similar level and the one with the exercise of 90% or 80% VT work rate had a significantly greater value. The numbers of leukocytes and neutrophils significantly increased in the 90% and 70% VT work rate groups. In 80% VT work rate group, the CD4/CD8 ratio was significantly depressed. The CD16+CD57− (%), natural killer cell populations, had a tendency to increase at 80% VT work rate, and also the CD16+CD57 + (%) had a similar tendency at 90% or 80% VT work rate. Conclusions: This study shows that moderate exercise reaching or exceeding the VT level acutely affects T cell and NK cell subsets.

Factors That Influence Functional Prognosis in Elderly Patients with Hip Fracture

The purpose of this study was to evaluate in aged patients with hip fracture, the degree of recovery at discharge and after discharge relative to the pre-fracture walking level, to clarify the factors involved in unsuccessful recovery. The patients were 189 patients aged 60 years and older who underwent surgery between 1988 and 1994. Patients who died within 1 year or lacked data on walking were excluded. Multiple logistic regression analysis was applied to data on the walking level before fracture, that at discharge, and the best walking level after discharge, to clarify factors involved in unsuccessful recovery. The rate of recovery to the pre-fracture level was 55.1% at discharge. Unsuccessful recovery at discharge was influenced by prior dementia, a history of cerebrovascular diseases, and an age of 85 or more years. Analysis showed an “after-discharge” recovery rate of 63.2%. Prior dementia and the residence outside one’s own home influenced unsuccessful recovery rate. These findings suggested that it is important to provide patients with such factors a more effective postoperative rehabilitation program not merely the standard rehabilitation program. In addition, a walking rehabilitation program should be offered to those who were re-hospitalized or admitted to other health care facilities.

Rate of Mortality with Hip Fracture and its Prognostic Factors in an elderly Japanese population

The purpose of this study was to clarify the survival rates and prognostic factors in elderly Japanese patients with hip fractures. This study investigated the outcome of 256 patients aged 60 years and older with surgically treated hip fractures. Information including age, gender, duration of hospitalization, place of residence before fracture and at discharge, and level of mobility before fracture and at discharge was obtained from patient records. The survival of the patients after discharge was determined by mail surveys supplemented with telephone inquiries.The observed survival rates were significantly lower than the expected survival rates (p<0.001, by Mantel Haenszel test). The short-term mortality rates were 6% for six months and 12.7% for one year, which were lower than previously reported rates in Western countries. Significantly higher hazard ratios (HR) for mortality adjusted for age and gender were observed in patients who had lived in places other than their own home before fracture (HR=2.67(1.63-4.3)), were discharged to places other than their own home (Nursing home HR=2.25 (1.24-4.1) or to a non-orthopedic unit (HR=5.95 (3.12-11.34)), those requiring full-time assistance for mobility at discharge (HR=5.71 (3.59-9.01)), and those who had stayed in a hospital for fewer than 40 days (HR=2.20 (1.38-3.51)). After adjusting for the effects of all the potential prognostic factors, discharge to places other than their own home and the lowest level of mobility at discharge remained significant factors causing adverse effects on survival.Therefore, to improve the prognosis, patients should be allowed to recover to a level at which they can ambulate with some assistance, enabling them return to their own homes.

A Cross-sectional Population-based Study on Senile Dementia in a Rural City

All residents aged 65 or over in a rural city (n=5340) were studied with a self−administered questionnaire on psychiatric symptoms, physical health status, medical history, and environmental factors. After the screening, the clinical diagnosis of senile dementia was made by psychiatrists. The overall prevalence was 4.0% among responders staying at home (201/4969). The prevalence increased with age for both males and females and tended to be higher for females than males. The multilogistic analysis of the above variables showed that in the cerebrovascular type, stroke and inactive physical status might be risk factors for both gender groups. For the Alzheimer’s type, age and inactive physical status might be risk factors. For overall dementia, age, stroke, and inactive physical status might be risk factors.