Background/Objectives: Since April 2006, smoking cessation treatment has been included in public health insurance coverage, although conditionally. The tobacco control program usually takes 12 weeks or so. When it comes to the form of treatment, most medical care facilities adopt nicotine replacement therapy (NRT) at their outpatient ward. The cessation success rates are considered not so high as before. In stead of treating nicotine-addict outpatients individually, our hospital has been offering a stop-smoking program all its own since 1999. This study was designed to examine the results of our efforts in the last six years retrospectively.Subjects/Methods: Enrolled for this study were 232 patients who had participated in our six-month smoking cessation program between 1999 and 2005. A non-smokingsupport team made up of a physician, pharmacist(s), nurses, dietitian(s) and physical therapist(s) takes care of groups of participating patients, each group consisting of 10 or less. The patients undergo behavior therapy throughout the 6-month period and NRT in the first eight weeks. Under the program, nutrition guidance is offered regularly by dietitians for weight control and physical exercises by physical therapists for relief from the stress due to abstinence from smoking. We took a questionnaire survey of all the subjects and worked out the ratios of those persons who had remained abstinent up to one year after they stopped smoking to the total.Results: The rates of abstinence maintained eight weeks, six months and one year after the start of cessation were 78.4%, 70.3% and 64.7%, respectively. Of those who were still abstinent, 78.0% replied that they found it easy to resist the urge to smoke cigarette thanks to the smoking cessation program.Conclusion: Our six-month participatory tobacco control program was found effective as high cessation rates were maintained.
Cessation of smoking ; seconds ; month ; week ; Smoking

We report a clinical study conducted to investigate the effects of Electric Field Therapy (EFT) generated by HEALTHTRON on the stiffness in the neck and shoulder area. In Japan, most cases of stiffness in the neck and shoulder area are caused by painfully hypertonic muscles due to various causes such as cervical damage, mechanical stress, disordered cutaneous sensation and psychogenic stress. Internal disorders can also be significant causes of the painful stiffness in the neck and shoulder area. Subjects were 62 outpatients with chief complaints of stiffness in the neck and shoulder area. Informed consent was obtained from each subject. The patients with organic and/or pathological changes in the muscloskeletal system, mental disorder, or internal disease were not included in this study according to the exclusion criteria for feasible focus in hypertonic muscles.
The present study consists of two comparisons, 1) standard treatment in our clinic vs. additional HEALTHTRON, by observing the visual analogue scale (VAS) of stiffness in the neck and shoulder area and general condition, lymphocyte percentage in peripheral blood, blood pressure, and 2) HEALTHTRON alone vs. direct-contact electric stimulation (DCES) alone by observing circulatory blood in the trapezium, and the changes of autonomic nervous activity by heart rate variability (HRV). Results of the first research revealed that the stiffness in the neck and shoulder area was improved more quickly by additional HEALTHTRON than by the standard treatment, according to the results of VAS analysis. The general conditions were also improved in the patients treated with the additional HEALTHTRON. The lymphocyte percentage was increased by the addition HEALTHTRON, which suggested that parasympathetic nerve get a predominant position. The average blood pressure in the hypertensive patients in both groups was decreased after the treatment in this investigation, but blood pressure did not change in the patients with hypotension. The second research found that the blood circulation in the trapezium increased in each group treated with HEALTHTRON or DCES; however, the differences between two groups were not statistically significant. No changes in activity of the autonomic regulation were observed in the patients treated with DCES from an analysis of HRV. In contrast, the sympathetic and parasympathetic nervous systems were activated by HEALTHTRON, according to HRV analysis. These results suggest that EFT (HEALTHTRON) are effective for treating stiffness in the neck and shoulder area, and improve the status of the autonomic nervous system.

Effects of 20km running uppn taking a low-carbohydrate, high-fat and protein diet on the changes in blood pressure, heart rate, body weight, skinf old thickness, blood components and urinary recordings in five healthy young men were investigated and the changes in these items which occured by taurine inducement were studied by double blind test method. The results were as follows:
1) As to the degree of decrease in body weight in 20km running, the case in taurine administration (T. A.) was more than in placebo administration (P. A.) .
2) As to the degree of increase in systolic pressure upon 20km running, T. A. was less than P. A. 3) The rate of creatine kinase isozyme (CK-MB) against creatine kinase (CK), which increased after 20km running in P. A., was possible to reduce by T. A.
4) T. A. was less than P.A. in the rate of increase in lactate dehydrogenase (LDH) on 20km running.
5) In P. A., triglyceride increased after 20km running, but in T. A., it decreased.
6) T. A, much influenced the rate of individual fatty acid composition on 20km running
7) T. A, was more than P. A. in the secretion of adrenaline on 20km running.
8) No changes were observed in other blood components and urinary kallikrein.

The present study was performed to investigate the effect of long distance walking upon physical functions for healthy male subjects. The first experiment was carried out in 1977, the second, in 1978, and the third, in 1979 in each autum season. At the first experiment, subjects began walking upon having breakfast, then ate and drank noting during first 30km, and took some foods during another 26km. Twelve hours and fifty minutes of time was spent for 56km walking including 15, 60, and 30 minutes rest periods in between. In the second experiment, subjects ate nothing after dinner of the previous evening and 35km walking took 6 hours during which some rest periods were taken for blood sampling. The third was 80km walking for two days. Subjects walked 40km in 8 hours in the first day and on the following day they walked 40km in ten hours and twenty minutes. They took foods and rest freely.
From the view points of the changes in blood and urinary recordings obtained from those three experiments, the influences of long distance walking on the body indicate as follows ;
1) In case of long distance walking while nothing to eat and drink, the rate of serum saturated fatty acids composition decreased and unsaturated fatty acids increased.
2) In a fasting state, blood glucose gradually decreased, LDH activity increased and blood lactate, GOT and GPT activity presented no significant changes on long distance walking.
3) It was shown that the longer distance to walk, the lesser tendency in blood triglyceride even though subjects take a carbohydrate rich diet while walking.
4) In fasting state, less than 35km walking without foods, the stress to the body seemed not to be critical.
5) More than 40km walking in a day, even though taking meals, would result a significantly severe stress for body.
6) As long as usual meals are taken, 80km walking for two days continuously, 40km in each day, would not result in such a physical stress over the following days.

Effects of 5 km running upon taking a low-carbohydrate, high-fat and protein diet on the body, in fourteen healthy young males and three healthy young females, all being affected by taurine inducement, were investigated by double blind test method. The results obtained were as follows ;
1) As to the degree of in heart rate upon 5 km running, in males, there were no differences between taurine administration group (M-group) and placebo administration group (P-group) . But in females, recordings in P-group were much larger than those of M-group.
2) As to the degree of increase in systolic blood pressure upon 5 km running, in males, no differences between both groups were observed, but in females, recordings in P-group were larger than those of M-group.
3) Both serum creatine kinase (CK) and creatine kinase isoenzyme (CK-MB) activities did not recover to pre-exercise levels during 3 days after 5 km running in both groups of both sexes.
4) In the rate of CK-MB against CK, not only P-group of females had extraordinary high levels immediately after 5 km running, but also P-group of both sexes had higher levels on 3rd and 5th day after 5 km runnning than M-group.
5) In both sexes P-group was larger than M-group in the degree of increase in blood lactate and serum triglyceride levels.
6) As to the changes in serum total protein levels, in males, no differences between both groups were observed, but in females, P-group had extraordinary low levels on 1st day after 5 km running and maintained low levels during 5 days recovery.
7) As to the changes in both serum total fatty acids levels and the rate of unsaturated fatty acids against total fatty acids, no differences were observed between both groups of both sexes.
8) As to the degree of increase in plasma noradrenalin and adrenalin levels, in males, no differences between both groups were observed, but in females, recordings in M-group were larger than those of P-group.

Effects of taurine on the functions of the body and metabolism with 3km running upon taking a diet, which is constituted of lowest possible amount of carbohydrate and highest possible amount of fat and protein, were investigated in 25 male and female subjects of age thirties by double blind test method. The results were as follows
1) Taurine administration (T. A.) proved to inhibit the degree of increase in heart rate and increase the maximal degree of pulse pressure in response to 3 km running.
2) T. A. proved to inhibit the degree of increase in serum creatine kinase isozyme MB (CK-MB) activities and CK-MB/CK ratio.
3) T. A. proved to inhibit the decrease of serum total protein values immediately before running and in the following morning. Similar trends in terms of the particuler times were observed, too, in the case of the degree of decrease of serum triglycerides values.
4) T. A. seemed to accelerate the utilization of saturated fatty acids especially.
5) Three kilometer running seemed to increase in serum taurine concentrations from several hours after running to the morning immediately after running.

The present study was performed to investigate the effects of 120 km walking, 40 km a day for 3 successive days on the condition that taking rest and foods freely, upon physical functions for healthy male and female subjects. All measurements were enforced at postabsorptive state early in the morning for the 10 successive days including the days of walking. Blood pressure, heart rate, and body weight were measured every morning. Blood samplings enforced, too. Urine collections were enforced from first day to 7 th day. The results obtained were as follows;
1) There were no changes in heart rate, blood pressure, and body weight, which were measured early in the morning, before and after 120 km walking.
2) Serum GOT and GPT activities had little changes, while serum LDH, α-HBDH, and CK activities increased gradually after walking.
3) Serum CK-MB activities, which indicate myocardial injury, increased after walking, on the contrary CK-MB/CK ratio decreased. It was suggested that effects of 120km walking to myocardium were rather than slight ones.
4) In spite of the same sorce in which serum CK-MB and LDH-1 were resulted, both did'nt exhibit same patterns in serum.
5) Serum lipids decreased gradually after walking.
6) Urinary excretion of creatinine and uric acid increased after 120km walking especially.
7) If it is allowed to take sufficient foods and rest, 120km walking, 40km a day for 3 successive days, would not result in such a physical stress over the following days.

Background: and PurposeThe coast of Kyushu Island on Ariake Sea in Japan is known to be an accumulation area for patients with a proline-to-leucine substitution mutation at residue 102 (P102L) of the human prion protein gene (PRNP), which is associated with Gerstmann–Sträussler–Scheinker disease. We designated this geographical distribution as the “Ariake PRNP P102L variant.” The purpose of this study was to characterize the clinical features of this variant. Methods: We enrolled patients with the PRNP P102L variant who were followed up at the Saga University Hospital from April 2002 to November 2019. The clinical information of patients were obtained from medical records, including clinical histories, brain magnetic resonance imaging (MRI), and electroencephalography (EEG). A brain autopsy was performed on one of the participants. Results: We enrolled 24 patients from 19 family lines, including 12 males. The mean age at symptom onset was 60.6 years (range, 41–77 years). The incidence rate of the Ariake PRNP P102L variant was 3.32/1,000,000 people per year in Saga city. The initial symptoms were ataxia (ataxic gait or dysarthria) in 19 patients (79.2%), cognitive impairment in 3 (12.5%), and leg paresthesia in 2 (8.3%). The median survival time from symptom onset among the 18 fatal cases was 63 months (range, 23–105 months). Brain MRI revealed no localized cerebellar atrophy, but sparse diffusion-weighted imaging abnormalities were detected in 16.7% of the patients. No periodic sharp-wave complexes were identified in EEG. Neuropathological investigations revealed uni- and multicentric prion protein (PrP) plaques in the cerebral cortex, putamen, thalamus, and cerebellum of one patient. Western blot analysis revealed 8-kDa proteinase-K-resistant PrP. Conclusions This is the first report of the accumulation area of a PRNP P102L variant on the coast of Ariake Sea. The Ariake PRNP P102L variant can be characterized by a relatively long disease duration with sparse abnormalities in brain MRI and EEG relative to previous reports. Detailed interviews to obtain information on the birthplace and the family history of related symptoms are important to diagnosing a PRNP P102L variant.

PURPOSE: Atrial natriuretic peptide (ANP) has a variety of pharmacologic effects, including natriuresis, diuresis, vasodilatation, and suppression of the renin-angiotensin system. A recent study showed that ANP infusion improved hypoxemia and pulmonary hypertension in a lung injury model. On the other hand, the pulse contour cardiac output (PiCCO(TM)) system (Pulsion Medical Systems, Munich, Germany) allows monitoring of the intravascular volume status and may be used to guide volume therapy in severe sepsis and critically ill patients. MATERIALS AND METHODS: We treated 10 pulmonary edema patients without heart disease with human ANP (HANP). The patients were divided into two groups: a group with normal Intrathoracic Blood Volume (ITBV) (900-1100 mL/m2) (n = 6), and a group with abnormal ITBV (n = 4), as measured by the PiCCOtrade mark device; the extravascular lung water (EVLW) and pulmonary vascular permeability index (PVPI) in the two groups were compared. RESULTS: The average patient age was 63.9 +/- 14.4 years. The normal ITBV group showed significant improvement of the EVLW (before, 16.7 +/- 2.7 mL/kg; after, 10.5 +/- 3.6 mL/kg; p = 0.0020) and PVPI (before, 3.2 +/- 0.3; after, 2.1 +/- 0.7; p = 0.0214) after the treatment. The abnormal ITBV group showed no significant improvement of either the EVLW (before, 16.3 +/- 8.9 mL/kg; after, 18.8 +/- 9.6 mL/kg; p = 0.8387) or PVPI (before, 2.3 +/- 0.8; after, 2.7 +/- 1.3; p = 0.2782) after the treatment. In both groups, the EVLW and PVPI were strongly correlated with the chest X-ray findings. CONCLUSION: We conclude that HANP supplementation may improve the EVLW and PVPI in pulmonary edema patients without heart disease with a normal ITBV. The PiCCO(TM) system seems to be a useful device for the management of pulmonary edema.
Aged ; Atrial Natriuretic Factor/administration & dosage/*therapeutic use ; Cardiac Output/*drug effects/*physiology ; Female ; Humans ; Injections, Intravenous ; Male ; Middle Aged ; Monitoring, Physiologic/*instrumentation ; Pulmonary Edema/*drug therapy/*physiopathology

OBJECTIVE: This study aimed to evaluate the efficacy of magnetic resonance (MR) imaging in differentiating between cutaneous basal cell carcinoma (cBCC) and cutaneous squamous cell carcinoma (cSCC) in the head and neck region.MATERIALS AND METHODS: Among patients with cutaneous head and neck cancers, 14 with primary cBCCs and 15 with primary cSCCs with a histologic tumor height of ≥ 4 mm underwent MR examinations; the findings were then examined for correlations.RESULTS: cBCCs (71%) occurred more frequently on the nose than cSCCs (13%) (p < 0.01). The maximum diameter (23.5 ± 7.2 mm vs. 12.7 ± 4.5 mm; p < 0.01) and diameter-to-height ratio (2.8 ± 0.9 vs. 1.7 ± 0.4; p < 0.01) were significantly greater in cSCCs than in cBCCs. Superficial ulcer formation (67% vs. 21%; p < 0.05), protrusion into the subcutaneous tissue (60% vs. 21%; p < 0.05), ill-demarcated deep tumor margins (60% vs. 7%; p < 0.01), and peritumoral fat stranding (93% vs. 7%; p < 0.01) were more frequently observed in cSCCs than in cBCCs. Intratumoral T2-hyperintense foci (57% vs. 13%; p < 0.05) were more frequently observed in cBCCs than in cSCCs.CONCLUSION: cBCCs predominantly occurred on the nose with intratumoral T2-hyperintense foci, whereas cSCCs predominantly exhibited a flattened configuration, superficial ulcer formation, protrusion into the subcutaneous tissue, ill-demarcated deep tumor margin, and peritumoral fat stranding.
Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Epithelial Cells ; Head ; Humans ; Magnetic Resonance Imaging ; Neck ; Nose ; Skin Neoplasms ; Subcutaneous Tissue ; Ulcer