To prevent lifestyle related diseases, it is important to modify lifestyle behavior. The control of mental stress level and prevention of mental stress-related diseases have become one of the most important problems in Japan. To check mental stress level objectively during the early stage of stress-related diseases and determine appropriate coping methods, it is necessary to design a useful index for mental stress. Cortisol is a steroid hormone secreted by the adrenal cortex. This is an essential hormone to human survival, and plays a key role in adaptation to stress. In another review, we concluded that cortisol appears to be an adequate index for mental stress. However, lifestyle factors such as alcohol drinking, smoking, lack of exercise etc., are strongly associated with mental stress. Thus, in this review, we focus on the relationship between cortisol and lifestyle. The present findings suggested that lifestyle factors; smoking, alcohol drinking, exercise, sleep and nutrition are strongly associated with cortisol levels, and it may be impossible to determine whether alterations in cortisol levels are due to mental stress. It was suggested that those lifestyle effects on not only mental stress itself but also cortisol levels should be considered, when assessing mental stress by cortisol levels.
Stress, Psychological ; Life Style ; Hydrocortisone ; Review [Publication Type] ; Hydrocortisone measurement

The incidences of diseases related to mental stress are increasing in Japan. Mental stress, unacknowledged for long periods, has been shown to lead to the development of a number of diseases. Thus, an index for mental stress is important to induce awareness of its presence. We focused on the relationship between cortisol and mental stress in this review. We will discuss both the usefulness and problems of cortisol as a mental stress index by summarizing the relationship between cortisol and mental stress. The present findings suggested that cortisol appears to be an adequate index for mental stress. However, there are several problems; the present group clarifies these problems and builds the comprehensive mental stress assessment systems by using saliva samples.
Stress, Psychological ; Hydrocortisone ; Review [Publication Type] ; Stress bismuth subsalicylate ; Hydrocortisone measurement

PURPOSE: This study investigated the preemptive analgesic effects of Morphine and Ketorolac on postoperative pain, cortisol, O2 saturation and heart rate for the first 24 hr after abdominal surgery. METHODS: Data collection was performed from April 1 to September 30, 2006. Forty patients undergoing a gastrectomy under general anesthesia were randomly allocated to the experimental or control group. The experimental group (20 patients) was administered Morphine and Ketorolac approximately 1 hr prior to skin incision, but the control group (20 patients) was administered Morphine and Ketorolac at peritoneum closure through a patient-controlled analgesia (PCA) pump. Postoperative pain, blood pressure, heart rate, cortisol, O2 saturation, frequency of the PCA button pressed and doses of additional analgesics were observed through post operative 24 hr. Collected data was analyzed using t-test, chi-square test, repeated measures ANOVA, and Bonferroni methods. RESULTS: Postoperative pain, cortisol, the frequency of PCA button pressed, and dose of additional analgesics of the experimental group were significantly lower than the control group. There were no statistical differences in blood pressure, heart rate and O2 saturation between the experimental group and control group. CONCLUSIONS: We concluded that administration of morphine and ketorolac at 1 hr prior to skin incision resulted in decreasing postoperative pain, but it didn't affect blood pressure, heart rate or O2 saturation for 24 hr after abdominal surgery.
Aged ; Analgesics/*administration & dosage ; Blood Pressure ; Female ; Heart Rate ; Humans ; Hydrocortisone/analysis ; Injections, Intravenous ; Ketorolac/*administration & dosage ; Male ; Middle Aged ; Morphine/*administration & dosage ; Oximetry ; Pain Measurement ; Pain, Postoperative/*prevention & control

BACKGROUND: Authors have undertaken this study to see if the choice of anesthesia can directly or indirectly provide immunomodulation for cytokines, to determine the relationship of cytokines and hypothalamo-pituitary-adrenal axis in stomach cancer surgery patients, and also to see whether the amount of morphine administration and choice of analgesia can influence cytokine release, and possibly immunity. METHODS: Total 19 gastric cancer surgery patients were randomly assigned in double-blind fashion into two groups. Group-G (n=9) was provided with general anesthesia plus morphine intravenous patient controlled analgesia (IV-PCA), whereas group-GE (n=10) with preemptive epidural and general anesthesia plus continuous epidural analgesia for control of postoperative pain. At predetermined time interval, proinflammatory cytokines and stress hormones were evaluated with visual analog pain scale. Simultaneous assessments of operating and anesthesia time, total morphine doses, the time to recovery of gastrointestinal function and incidences of complications were also made. RESULTS: Demographic data, the durations of operation and anesthesia and recovery of gastrointestinal function were similar in both groups. Total morphine doses were approximately four times greater in group-G. Secretions of interleukin-1 beta , TNF and epinephrine were blocked by preemptive epidural anesthesia, meanwhile, interleukin-6 as well as ACTH and cortisol were not. After 24 hours after skin incision, the differences of cytokines, ACTH and cortisol between two groups were dissipated. In spite of these hormonal findings, visual analog pain scale could not disclose any differences. Incidences of complications were statistically insignificant except that of itching in group-GE. CONCLUSION: Preemptive epidural anesthesia and analgesia can partially block only some of cytokines and stress hormones, and these effects do not have clinically relevant long term influences. The amounts and means of morphine administered by continuous epidural analgesia block or IV-PCA demonstrated no evidence of immunosuppression at clinical dose range.
Adrenocorticotropic Hormone ; Analgesia ; Analgesia, Epidural ; Analgesia, Patient-Controlled ; Anesthesia and Analgesia* ; Anesthesia* ; Anesthesia, Epidural ; Anesthesia, General ; Axis, Cervical Vertebra ; Cytokines ; Epinephrine ; Humans ; Hydrocortisone ; Immunomodulation* ; Immunosuppression ; Incidence ; Interleukin-1beta ; Interleukin-6 ; Morphine ; Pain Measurement ; Pain, Postoperative ; Pruritus ; Skin ; Stomach Neoplasms* ; Stomach*