Abstract. Pachinko is a popular form of recreation in Japan. However, in recent years, along with Pachinko's popularity, "Pachinko dependence" has become topical news. The purpose of this study was to investigate beta-endorphin, catecholamines, immune system responses and heart rate during the playing of Pachinko. The following significant results were observed. (1) Plasma concentration of beta-endorphin increased before playing Pachinko and while in the Pachinko-center (p<0.05). (2) Beta-endorphin and norepinephrine increased when the player began to win (i.e. at "Feverstart") compared to baseline (p<0.05).(3) Beta-endorphin, norepinephrine and dopamine increased when the winning streak finished (i.e. at "Fever-end") compared to baseline (p<0.05-0.01). (4) Norepinephrine increased past 30 minutes after "Fever-end" compared to baseline(p<0.05). (5) Heart rate increased before "Fever-start" compared to baseline, peaked at "Feverstart" and rapidly decreased to match rates measured at rest. But the increase was observed from 200 seconds after "Fever-start" (p<0.05-0.001). (6) There was a positive correlation between the number of hours subjects played Pachinko in a week and the differences between beta-endorphin levels at "Fever-start" and those at rest (p<0.05). (7) The number of T-cells decreased while the number of NK cells increased at "Fever-start" compared to baseline (p<.05). These results suggest that intracerebral substances such as beta-endorphin and dopamine are involved in the habit-forming behavior associated with Pachinko.

This research, conducted in 1998 and 2008, uses go/no-go data to investigate the fundamentals of cognitive functioning in the inhibitory control ability of Japanese children. 844 subjects from kindergarten to junior high school participated in go/no-go task experiments. Performance of go/no-go tasks, which are frequently used to investigate response inhibition, measures a variety of cognitive components besides response inhibition. With normal brain development, the ability to inhibit responses improves substantially in adolescence. An increase over time in the error rate during the go/no-go tasks of subjects of the same age indicates that these processes are not functioning properly. Comparisons between the 1998 and 2008 data revealed several differences in error rates. In 2008, there were increases in the number of errors in groups from each age range. The comparison also revealed that overall error rates peaked at later ages in the 2008 subjects. Taken together, these results show changing conditions in the inhibitory function of the prefrontal cortex. However, the reason for these changing conditions remains unclear. While a lifestyle questionnaire revealed several differences in factors such as bedtimes and hours spent watching TV, analysis did not reveal a significant correlation.

Purpose This study aims to establish a Japanese-style healthcare program customized for Japan and Asia under ISO 9001: 2008 (ISO: International Organization for Standardization) to improve problem areas and to inspect the effectiveness of the program. Furthermore, the authors wanted to create this health program using the ISO widely available in Asian countries and make an international contribution. Design/methodology/approach The authors implemented a 6- to 10-month health program in Minowa Town, Matsumoto City and Nagano City in Japan. This study assessed findings from pedometric, anthropometric and blood pressure measurements and physical fitness, blood chemistry and brain function tests. Findings The comparisons were made by examining the interaction effects between groups of participants. Groups from three regions in Japan showed significant differences on the physical fitness tests; regarding the 10-meter obstacle walk, the results of the Minowa participants showed the greatest improvement and the Matsumoto participants showed the second greatest improvement. In the six-min walk, the time of the Minowa participants significantly improved. Research limitations/implications This health education program, which has been conducted by the Japanese authors since 1998, measures anthropometry, brain function and physical fitness and performs blood tests before and after the program and it measures energy consumption with a pedometer during the program. With the aim of improving exercise via encouragement from friends and a sense of community with fellow participants, participants learn together with hands-on training in tai chi and aerobics about the importance of ongoing exercise and proper nutrition. This health education met the Health Education ISO in 2014. Practical implications Since 2010, Nagano Prefecture, including Minowa Town, Matsumoto City and Nagano City, where our study was carried out, has been the area with the highest life expectancy rates in Japan. Social implications The authors want to make this health promotion through ISO widely available in Asian countries and an international contribution. Originality/value This study aimed to appropriately establish a Japanese-style healthcare program under the ISO 9001:2008 to improve problem areas and inspect its effectiveness.

This is a case report of chylous ascites caused by performing para-aortic lymph node dissection for a patient with cervical cancer. Postoperative chylous ascites is a rare condition that usually develops as a result of operative trauma to the thoracic duct, cisterna chyli, or their major tributaries. It has mainly occurred in thoracic operations, and chylous ascites has rarely been reported in gynecologic surgery. It is associated with serious nutritional and immunologic consequences due to the constant loss of protein and lymphocytes. Treatment that comprises conservative and surgical procedures is selected based on disease severity. We experienced massive chylous ascites after para-aortic surgery and successfully managed it conservatively with dietary intervention and parenteral nutrition.

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