We investigated the degree of fatigue among medical students during the second trial of the Common Achievement Tests, which use a computer-based testing (CBT) method. A revised questionnaire for subjective fatigue symptoms proposed by the Industrial Fatigue Research meeting of the Japan Society for Occupational Health was used to examine the degree of fatigue. The CBT examinee group (n=41) sat for the examination for 6 hours using video display terminals. Significant changes were seen in 19 of the 25 items for subjective symptoms. At the end of the test period, significant differences between the CBT examinee group and the lecture participant group (n=50) were found for 15 of the items for subjective symptoms. Subjective symptoms were classified into 5 categories: sleepiness, instability, displeasure, feeling languid, and blurred vision. In the CBT examinee group, rates of symptoms increased significantly in all 5 categories. The increase in the rate of “blurred vision” was especially marked.

Objective To investigate the relative relationship between the degrees of seriousness of obstructive sleep apnea hypopnea syndrome and the variation of blood pressure in exercise Methods 49 patients with obstructive sleep apnea hypopnea syndrome without using anti hypertension drugs, were used as our objectives We performed the exercise test with bicycle like instrument During the test, we measured the blood pressure, plasma lactic acid and arterial blood gases Then we analysed the blood pressure in exercise, BMI, clinical symptoms and the mean of the lowest SpO2 measured by over night polysomnography Results The variation of blood pressure in exercise was related to the clinical symptoms and the mean of the lowest SpO2, but not to the BMI Conclusion The degrees of seriousness of obstructive sleep apnea hypopnea syndrome may be related to the elevation of blood pressure

We examined the time course of soleus muscle fiber type composition. Soma area and succinate dehydrogenase (SDH) activity of soleus motoneurons during three weeks of hindlimb suspension (HS) in rats. Adult female Wistar rats (n=34, 252-288g BW) were divided into four groups: control (n=8), hindlimb suspended for one week (HS 1 wk, n=8), two weeks (HS 2 wk, n=9), and three weeks (HS 3 wk, n=9) . Soleus muscle fiber composition was calculated from transverse sections stained for myosin ATPase (preincubation pH 10.3, 4.3) . The fiber type composition did not change in the HS 1 wk, but in the HS 2 wk and HS 3 wk, the proportion of type I fibers decreased and that of type IIc and ha fibers increased. Using a fluorescent neuronal tracer nuclear yellow, motoneurons innervating the soleus muscle were identified, and the soma area and SDH activity were measured. The soma area did not change for up to two weeks of HS, but decreased in the HS 3 wk. Compared with control, SDH activity of soleus motoneurons decreased in the HS 1 wk. However, in the HS 2 wk, the activity increased to the level of control. In the HS 3 wk, the activity tended to increase further. Generally, muscle fibers and their motoneurons have unitary characteristics. However, these results suggest that change in soleus muscle fiber composition are not accompanied by changes in soma area and SDH activity in soleus motoneurons during three weeks of HS.

A study was conducted to clarify the effects of running intensity and duration of endurance training on myoglobin concentration ( [Mb] ) in rat skeletal muscles, and to clarify its temporal changes during the training. One hundred five male Wistar rats were divided into a training group and an untrained group. The training was carried out at 5 times a week for 12 weeks when the animals were 4 to 16 weeks of age. The training intensities were set at 20, 30 and 40 m/min with a duration of 60 min. The training duration was varied to 30, 60, 90 and 120 min when the rats were trained at 30 m/min. The temporal changes in the [Mb] were examined after the first, third and ninth week of training, during which the rats were trained at 40 m/min for 60 min per session. Three muscles (soleus: Sol, plantaris: P1, gastrocnemius-surface/deep: Gas-S, Gas-D) were analyzed for the [Mb] and citrate synthase activity (CS activity) . With regard to the intensity of training, the [Mb] increased with exercise intensity in Sol, Gas-D and P1, but not in Gas-S. P1 showed a greater increase of the [Mb] than Sol or Gas-D. On the other hand, CS activity in red muscle (Sol and Gas-D) increased even at low intensity, whereas white muscle (fast-twitch muscle: Pl and Gas-S) showed a significant increase in CS activity at an intensity of 40m/min. As to the duration of training, the [Mb] increased with the duration of running at 30 m/min of intensity, and showed the maximal adaptation with 90-min duration in all muscles except for Gas-S. Changes in CS activity according to the duration of running were similar to those for the [Mb] in all muscles. Finally, the [Mb] increased significantly with prolongation of the training period (after the 1 st, 3 rd and 9 th weeks training) in all muscles except Gas-S. However, the adaptive response of Mb tended to be delayed as compared with CS activity. These results suggest that 1) the response of Mb to training stimuli can depend on the muscle specificity (fiber type composition or the initial [Mb] ), and level of motor unit recruitment in usual, 2) Mb synthesis can be enhanced by an increase of training intensity, 3) a training duration of 90 min can bring out the Mb adaptation maximally and 4) the adaptive response of Mb would need more time as compared with CS activity.

The purpose of this study was to investigate the usage of the lower limb muscles (quadriceps femoris : QF, m. vastus lateralis : VL, m. rectus lemons : RF, m. vastus medialis : VM, m. vastus intermidialis : VI, hamstring : HM, m. gastrocnemius : UN, tihialis anterior : TA) and blood lactic acid concentration during uphill ( : UR +5 %) and downhill running ( : DR - 5 %) . We used magnetic resonance imaging (MRI) as one of the major indices. Seven healthy male volunteers participated in this study. T 2-weighted MR imaging, muscle surface temperature and blood lactic acid concentration were measured before and after UR and DR. In MRI imaging, the T2 value was defined as the area in which a high signal appeared after exercise.
The value of the blood lactic acid concentration of UR was higher than that of DR (p<0.001) . After DR, the muscle surface temperature of RF was lower in comparison with other muscles (p< 0.05) . After UR, the T2 value of RF (p<0.05), HM (p<0.01) and UN (p<0.05) was higher than after DR exercise. During UR, a positive correlation (r=0.818) existed between the T 2 value of GN and blood lactic acid concentration (P<0.05) . During DR, a positive correlation (r=0.739) was also observed between the T 2 value of QF and blood lactic acid concentration (p<0.05) .
From these results, we conclude that (1) the pattern of usage of lower limb muscles differs during UR and DR, (2) the most mobilized muscles in the lower limbs for UR are GN and HM, and (3) the most mobilized muscle in the lower limbs for DR is QF, respectively. These findings show that different exercises affect the blood lactic acid concentration differently.

The purpose of this study was to analyze morphological and functional changes in the left ventricular muscle mass and vessel diameters of the arteries in young competitive athletes of various sports and evaluate the correlation between the heart and arterial vessel under the training environment in this latter half of the growth period. The subjects were 51 male college student athletes (mean age, 19.6±0.4 years) of 6 competitive sports (archery, weight lifting, swimming, short-distance races, middle-distance races, and long-distance races) . The diameters of the right and left common carotid arteries, right and left radial arteries, right and left foot dorsal arteries, and the aorta and the left ventricular muscle mass (LVM) were measured by Doppler echocardiography. To minimize the influences of the physique and body weight associated with growth and sport types, all data obtained by measurement were corrected by body surface area. The sum of the diameters of all the above arteries (total arterial diameter : TAD) was obtained to evaluate its correlation with the left ventricular muscle mass. The diameter of the foot dorsal artery was significantly higher in the long-distance runners than in the sprinters (P<0.05) . The diameter of the radial artery according to the 6 types of sport was the highest for weight lifting, followed in order by archery, longdistance races, middle-distance races, swimming, and short-distance races, showing a significant difference between weight lifting and short-distance races (P<0.05 ) . TAD was high for generalized endurance sports and correlated with the left ventricular muscle mass (r=0.893) . Thus, the arterial diameters significantly differed among competitive sports and were particularly increased for endurance exercise. The diameters of the local arteries used for local exercise were also increased. When TAD as a new parameter and its ratio per body surface area were calculated, there was a high correlation between the heart (left ventricular muscle mass) and the arterial diameter. These results suggest that exercise adaptation can he evaluated in the arterial system in svstemic circulation as well as the nervous and muscular systems.

The term “half exterior half interior” is not found in the Oriental Medical Classic, the ‘Shang Han Lun’. Rather, the phrase “half outside and half inside” appears. It was Cheng Wu Ji that first used the term “half exterior half interior” in the phrase “Those in whom the disease-causing agent is half in the exterior and half in the interior are considered to be of the fever manifestation-type” appearing in his ‘Shang Han Ming Li Lun’. In the ‘Zhu Jie Shang Han Lun’ which Cheng Wu Ji wrote shortly afterwards, he explains that the phrase “half outside and half inside” found in the ‘Shang Han Lun’ means half exterior and half interior. Since this commentary on the ‘Shang Han Lun’ was more frequently published and more widely circulated than the original text, it is thought to be this explanation that accounts for the popularization of the term “half exterior half interior”.

We sent out questionnaires to out-patients that were receiving treatment at our Kampo clinic to determine their level of awareness concerning Kampo medicine.
The patients were particularly concerned about side effects, and the most frequent reason given for choosing Kampo was that it had few side effects. Although most felt that there were almost no side effects associated with Kampo, there were some that thought Kampo had absolutely no side effects, or that it could cause serious side effects. These responses indicate the need to explain any potential side effects fully to patients. Also among the responses were criticisms of Western medicine, people who reported that Western medicine had not helped them and those that felt they could not rely on Western medicine.
The expectations in Kampo for disease treatment were high, and the effectivectiveness of treatment was also highly rated. Moreover, there were expectations in other aspects of Kampo medicine that cannot be found in Western medicine, such as improvement of the constitution, health maintenance, disease prevention and increased stamina. The responses indicated that patients seeking treatment by Kampo were not satisfied with Western medicine, and were looking for a treatment method they could rely on in Kampo medicine.

Objective: The care of patients with Alzheimer’s disease (AD) has a significant impact on the life of caregivers.  Some of the major daily tasks for caregivers are the administering and management of patients’ medications.  The aims of the present study were to evaluate the current state of administering and management of medications by caregivers, and the usefulness of medicated patches for improving compliance.
Methods: We sent questionnaires to 62 caregivers of AD patients, and 60 responses were analyzed (response rate: 96.8%).
Results: We found that approximately half of caregivers had some difficulties with administering and managing medications.  A total of 80% of caregivers took less than 3 min to administer and manage medications.  Approximately half of caregivers responded that patches were useful, but 15% stated that current medications were not the cause of difficulties.  These respondents were concerned that patches may result in adverse skin reactions.
Conclusions: The results of this survey indicate that caregivers do not have difficulties with administering and managing medications, and further concern is needed about the usefulness of medicated patches.

The purpose of this study was to analyze the relationship between activity pattern and temporal changes in the oxygen dynamics of human femoral medial vastus muscles. Oxygen dynamics were evaluated from the surface of the body by near-infrared spectroscopy (NIRS) . Arterial occlusion tests were performed in the femoral region at a cuff pressure of 300 mmHg. Exercise type and speed were controlled by CYBEX 6000. The exercise types examined were concentric contraction (CON) and eccentric contraction (ECC) . The 3 angular velocities of 90, 120 and 180 degrees were used as the exercise speeds. Exercise was performed continuously 60 times at maximum effort. The subjects were 7 healthy males with a mean age of 19.6±0.5 years. A transient decrease in oxygen concentration was observed during circulatory occlusion ; and rapid hyperemia occurred immediately after the removal of pressure. Oxygen concentration peaked above the control level and then returned to the initial level. In the CON exercise, the initial decrease in oxygen concentration was the largest at CON 90, and a gradual increase in oxygen concentration was clearly observed during exercise. In the recovery stage, after exercise at CON 90, 120 and 180, oxygen concentration exceeded the control level before exercise, then peaked and returned to the initial level. In the ECC exercise, an initial decrease in oxygen concentration was similar to that in the CON exercise, but a gradual increase in oxygen concentration was not observed during the exercise ; nor did oxygen concentration exceed the control level in the recovery stage after the exercise.
These results indicate that an increase in oxygen level after the removal of arterial occlusion, during and after the CON exercise was much higher than the control level before the exercise, sug-gesting the involvement of reactive hyperemia and exercise hyperemia.