Physically trained and untrained preadolescent boys were examined experimentally for the effect of physical training on thermoregulatory responses to heat and cold. In summer they were asked to wear swimming pants and dip their legs up to the knees into water at 42.3°C for 60 minutes under given environmental conditions (30°C DB and 70% RH) . Then they were exposed to a given cold environment (18°C DB and 60% RH) in a resting posture for 60 minutes. Rectal and mean skin temperatures, total body sweat rate, puls rate, metabolism, etc, were measured. The pulse rate at rest was lower in those trained physically than in those untrained. The rectal temperature increased and decreased less remarkably during exposure to heat and cold, and the total body sweat rate to the increment of rectal temperature tended to be higher in those trained than in those untrained. The other variables measured during both cases of exposure failed to respond to physical training. These results suggested a possibility that physical training might be a means of improving the thermoregulation in preadolescents, although its effect might be inconsiderable.

To study the age difference in sweating during muscular exercise, two series of experiments were conducted under constant climatic conditions (29 ± 1°C DB, 60 ± 5 % RH, 0.45±0.05 m/sec air flow) . In series A, 7 to 20 years old male subjects undertook 5-minute running or pedalling of a bicycle ergometer in various seasons. In this series of experiments, pectoral sweat volume, sweat chloride concentration, rectal and mean skin temperatures were in general determined every 5 minutes and, when necessary, the total body sweat volume was calculated from the body weight loss. In series B, the age difference in the sweating in relation to physical training was studied. Subjects, 3 to 20 years old received experimental physical training of 5-minute or 500m-running. Before and after the training, a work load of 3- or 5-minute outdoor running was assigned to them. Furthermore, before and after the training, 10 and 11 years old subjects were given a fixed mechanical work rate on a bicycle ergometer. In these experiments, most of the parameters described above were measured. In series A, age differences in sweating during exercise were noticed to be dependent on the intensity of work load between pre- and post-adolescents. When the work load was heavy enough to cause a rapid increase in rectal temperature, the sweat volume became significantly less, the mean skin temperature was far higher, and the sweat chloride concentration was remarkably smaller in the pre-adolescent subjects than in the post-adolescent ones. In series B, an age difference in the effect of physical training was also found on sweating during exercise. The effect of physical training on sweating in the pre-adolescent individuals was generally less significant than in adults and sometimes showed a different pattern from that of adults. From these results, it can be concluded that sweating in the pre-adolescents is less adaptive, particularly to continuous severe exercise and that physical training is less effective in them than in the post-adolescents.

There are few reports on the long term efficacy of surgery for endocardial cushion defect (ECD) in elderly patients. We report a case with a successful course after ECD operation. A 70-year-old man was admitted with incomplete ECD, grade III mitral and tricuspid regurgitation, pulmonary hypertension and atrial fibrillation. The operative procedures included direct closure of the mitral cleft, pericardial patch closure for the ostium primum defect, direct closure of the tricuspid cleft and tricuspid annuloplasty. Pulmonary hypertension was improved after the operation, and he was discharged on the 41st day after the operation. Now, 3 years and 6 months after the operation, he has maintained an improved quality of life (QOL) with an uneventful postoperative course. The present report may suggest one solution for the long term effective treatment by operation for elderly patients who suffer from ECD, especially to achieve better QOL.

We evaluated the efficacy of evoked spinal potential (ESP) monitoring during thoracoabdominal aortic replacement to prevent intra-operative spinal ischemia. Nine patients underwent intraoperative ESP monitoring. The ESP was unchanged in 5 patients and decreased in 4 patients. However, ESP recovered in 2 of them by the following techniques: (1) perfusion of intercostal arteries, (2) elevation of distal bypass perfusion pressure, (3) slight hypothermia. Postoperative paraplegia occurred only 1 patient of the 2 whose ESP was not restored. The sensitivity and specificity of the efficacy of ESP monitoring were 100% and 87.5%, respectively. We concluded that ESP is the most useful monitoring for prevention of operative spinal ischemia during thoracoabdominal aortic replacement.

Purpose: To report a case of successful treatment using gabapentin against hot flashes due to LH-RH agonist in a patient with advanced prostate cancer. Case summary: A male patient in his seventies with advanced prostate cancer had hot flashes due to LH-RH agonist therapy. The patient began to notice hot flashes within a few months after starting hormone treatment. Oral gabapentin was administered at a starting dose of 400mg/day and was gradually escalated to 1,200mg/day. Within 7 days of administration, the patient achieved a partial improvement of his symptoms. After 17 days of gabapentin therapy, the hot flashes significantly improved. While the patient was taking a maintenance dose of 1,200mg/day, he remained to be asymptomatic. Conclusion: There are only a few reports (none in Japan) that show effectiveness of gabapentin against hot flashes due to hormone treatment in male patients with prostate cancer. Although the mechanism of the hot flash-relieving effect of gabapentin is not fully understood, this case report indicates that gabapentin may help treating patients suffering from intractable hot flashes. Palliat Care Res 2009; 4(2): 334-338

Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), is a chronic inflammatory disease of the gastrointestinal tract, with increasing prevalence worldwide. IBD Ahead is an international educational program that aims to explore questions commonly raised by clinicians about various areas of IBD care and to consolidate available published evidence and expert opinion into a consensus for the optimization of IBD management. Given differences in the epidemiology, clinical and genetic characteristics, management, and prognosis of IBD between patients in Japan and the rest of the world, this statement was formulated as the result of literature reviews and discussions among Japanese experts as part of the IBD Ahead program to consolidate statements of factors for disease prognosis in IBD. Evidence levels were assigned to summary statements in the following categories: disease progression in CD and UC; surgery, hospitalization, intestinal failure, and permanent stoma in CD; acute severe UC; colectomy in UC; and colorectal carcinoma and dysplasia in IBD. The goal is that this statement can aid in the optimization of the treatment strategy for Japanese patients with IBD and help identify high-risk patients that require early intervention, to provide a better long-term prognosis in these patients.
Asian Continental Ancestry Group ; Colectomy ; Colitis, Ulcerative ; Colorectal Neoplasms ; Consensus ; Crohn Disease ; Disease Management* ; Disease Progression ; Early Intervention (Education) ; Epidemiology ; Expert Testimony ; Gastrointestinal Tract ; Hospitalization ; Humans ; Inflammatory Bowel Diseases* ; Japan* ; Prevalence ; Prognosis