We developed a periodic hypobaric hypoxic environment (PHHE) system. Characteristics of this system varied between decreased pressure at an altitude of 1,500 m for 180 seconds and increased pressure at an altitude of 0 m for 180 seconds. The present study aimed to determine the effects of PHHE on physiological responses during endurance exercise and recovery after exercise. This study included 12 healthy men, and they provided written informed consent. All subjects performed a cycling exercise for 30 minutes and recovered after exercise for 10 minutes. The exercise protocol was performed with 20% maximum oxygen uptake for 6 minutes (warm-up), 40 % for 18 minutes (main exercise), and 20 % for 6 minutes (cool down). We established two experimental conditions: exercise with the PHHE and the control (C). The C condition involved exercise using the PHHE at an altitude of 0 m, and the atmospheric pressure was not changed. In the PHHE condition, the atmospheric pressure was changed periodically from 967 to 817 hPa (the external pressure was 1,008 hPa). Subjects’ heart rate (HR), blood pressure (BP), arterial oxygen saturation (SpO₂), rating of perceived exertion, and respiratory responses were measured in both conditions. The SpO₂, HR and systolic BP during exercise were significantly lower in the PHHE condition than in the C condition. The HR post-exercise was significantly lower. After exercise, the ln HF, an index of cardiac parasympathetic nervous system modulation, was significantly higher. In conclusion, during endurance exercise, cardiocirculatory responses in the PHHE condition were decreased.

Triglyceride contents of liver, heart muscle and skeletal muscles (rectus femoris, tibiaris anterior, soleus, plantaris and extensir digitrum longus) were determined on 1, 3.5, 14, 18 and 21 months-old rats, and especially on 14 and 21 months-old rats composition of triglyceride fatty acids was analyzed and interrelation of these triglyceride contents with aging of rats was studied quantitively and qualitatively. Following results were obtained
1) Changs in liver and muscular triglyceride contents appeared on 14 months-old rats and were significant increase at 21 months-old rats.
2) Liver triglyceride content significantly decreased at 21 months-old rats (p<0.05) .
3) lrriglyceride contents of tibiaris anterior and extensor digitrum longus muscles were mostly unchangeable through the aging of rats.
4) But triglyceride contents of soleus, rectus femoris and plantaris muscles in 21 months-old rats significantly increased (p<0.05) and the individual difference was great.
5) In composition of triglyceride fatty acids, increase of C₁₈, C_18-1, C_18-2 and C_18-3 was observed in epididymal adipose tissue, soleus and rectus femoris muscle on 21 months-old rats, but in extensor digitrum longus and tibiaris anterior muscles.
From these results, changes of tissue triglyceride contents with aging of rats are different in each tissue and increase of triglyceride content is present with qualitative changes in composition of triglyceride fatty acids, increase of long chain and unsaturated fatty acids, and organic specificity, which is related to the functional changes with aging of rats is considered.

Recently, a long-term health concern has been identified in young Japanese women. These women have a high percentage of body fat despite a normal shape index indicator such as BMI. This condition is called marked obesity, and shows relative low lean body mass. Using an analogous determination, we investigated low percentage of muscle quantity (LM) in the extremities of young Japanese women (n=156) . The cross-sectional areas of muscle, subcutaneous fat, and bone were measured in the upper arm and thigh using ultrasonography. Extremity shape index (CSA_t/L) was defined as the total extremity cross-sectional area (CSA_t) divided by the length of the limb (L), Percent muscle in each extremity (% MA) was calculated from the ratio of muscle CSA to whole limb CSA. LM was defined as the percentage of muscle in the upper arm or thigh less than 1 SD below average and the limb shape index less than 1 SD above average. Nine of 91 subjects displayed LM for the upper arm. A similar proportion of subjects showed LM for the thigh (15/156) . The muscle mass and strength in the upper arm or thigh were compared between the subjects with LM and non-LM subjects with a similar shape index of extremity. There was a tendency towards lower muscle mass and muscle strength in the subjects with LM. From the same comparison, the subjects with LM showed a greater load on extremity muscles to sustain the body weight (i.e., body weight per unit of upper arm or thigh muscle CSA) . To mitigate the deleterious health consequences of low percent muscle quantity it is recommended that young Japanese women who display such a condition should participate in a resistance-training program.

Objectives: Chronic obstructive pulmonary disease (COPD) is a risk factor for osteoporosis. Nevertheless, much remains unclear regarding the bone metabolism dynamics associated with COPD. The present study focuses on the associations between the COPD severity and serum bone metabolism biomarkers. Methods: We enrolled 40 patients who visited the orthopedics departments at our institutions and underwent dual-energy X-ray absorptiometry between September 2015 and December 2017. Only male osteoporosis patients over 45 years of age were included, and 5 patients were excluded due to disease or use of internal medicines affecting bone metabolism. All subjects underwent lung function testing, spine radiography, and blood tests. We measured percent forced expiratory volume in 1 second (%FEV1), which reflects COPD severity, and we examined the relationships between %FEV1and serum levels of bone metabolism biomarkers. Results: All subjects were diagnosed with osteoporosis based on T-scores. %FEV1 correlated with body weight, body mass index (BMI), and Z-score/T-scores. %FEV1 moderately correlated with serum levels of alkaline phosphatase (ALP), procollagen type 1 N-terminal propeptide (P1NP), and tartrate-resistant acid phosphatase 5b in the partial correlation analysis adjusted for BMI or T-score in the lumbar vertebrae. We performed a hierarchical multiple regression analysis to identify that serum ALP and P1NP were the independent explanatory variables to %FEV1 independent of other factors. Conclusions The data suggest that the COPD severity in middle-aged and older men with osteoporosis associates with decreased bone formation. COPD patients may exhibit bone metabolism dynamics characterized by low bone turnover with osteogenesis dysfunction as COPD becomes severe.

Adenocarcinoma currently accounts for 10–25% of all uterine cervical carcinomas and has a variety of histopathological subtypes. Among them, mucinous carcinoma gastric type is not associated with high-risk human papillomavirus (HPV) infection and a poor prognosis, while villoglandular carcinoma has an association with high-risk HPV infection and a good prognosis. They show relatively characteristic imaging findings which can be suggested by magnetic resonance imaging (MRI), though the former is sometimes difficult to be distinguished from lobular endocervical glandular hyperplasia. Various kinds of other tumors including squamous cell carcinoma should be also differentiated on MRI, while it is currently difficult to distinguish them on MRI, and HPV screening and pathological confirmation are usually necessary for definite diagnosis and further patient management.
Adenocarcinoma ; Adenocarcinoma, Mucinous ; Carcinoma, Squamous Cell ; Diagnosis ; Humans ; Hyperplasia ; Magnetic Resonance Imaging ; Mass Screening ; Prognosis ; Uterine Cervical Neoplasms ; Uterus

Objectives: Chronic obstructive pulmonary disease (COPD) is a risk factor for osteoporosis. Nevertheless, much remains unclear regarding the bone metabolism dynamics associated with COPD. The present study focuses on the associations between the COPD severity and serum bone metabolism biomarkers. Methods: We enrolled 40 patients who visited the orthopedics departments at our institutions and underwent dual-energy X-ray absorptiometry between September 2015 and December 2017. Only male osteoporosis patients over 45 years of age were included, and 5 patients were excluded due to disease or use of internal medicines affecting bone metabolism. All subjects underwent lung function testing, spine radiography, and blood tests. We measured percent forced expiratory volume in 1 second (%FEV1), which reflects COPD severity, and we examined the relationships between %FEV1and serum levels of bone metabolism biomarkers. Results: All subjects were diagnosed with osteoporosis based on T-scores. %FEV1 correlated with body weight, body mass index (BMI), and Z-score/T-scores. %FEV1 moderately correlated with serum levels of alkaline phosphatase (ALP), procollagen type 1 N-terminal propeptide (P1NP), and tartrate-resistant acid phosphatase 5b in the partial correlation analysis adjusted for BMI or T-score in the lumbar vertebrae. We performed a hierarchical multiple regression analysis to identify that serum ALP and P1NP were the independent explanatory variables to %FEV1 independent of other factors. Conclusions The data suggest that the COPD severity in middle-aged and older men with osteoporosis associates with decreased bone formation. COPD patients may exhibit bone metabolism dynamics characterized by low bone turnover with osteogenesis dysfunction as COPD becomes severe.

Background: and Purpose Differences in measurement of the extent of acute ischemic stroke using the Alberta Stroke Program Early Computed Tomographic Score (ASPECTS) by non-contrast computed tomography (CT-ASPECTS stratum) and diffusion-weighted imaging (DWI-ASPECTS stratum) may impact the efficacy of endovascular therapy (EVT) in patients with a large ischemic core. Methods: The RESCUE-Japan LIMIT (Recovery by Endovascular Salvage for Cerebral Ultra-acute Embolism Japan–Large IscheMIc core Trial) was a multicenter, open-label, randomized clinical trial that evaluated the efficacy and safety of EVT in patients with ASPECTS of 3–5. CT-ASPECTS was prioritized when both CT-ASPECTS and DWI-ASPECTS were measured. The effects of EVT on the modified Rankin Scale (mRS) score at 90 days were assessed separately for each stratum. Results: Among 183 patients, 112 (EVT group, 53; No-EVT group, 59) were in the CT-ASPECTS stratum and 71 (EVT group, 40; No-EVT group, 31) in the DWI-ASPECTS stratum. The common odds ratio (OR) (95% confidence interval) of the EVT group for one scale shift of the mRS score toward 0 was 1.29 (0.65–2.54) compared to the No-EVT group in CT-ASPECTS stratum, and 6.15 (2.46–16.3) in DWI-ASPECTS stratum with significant interaction between treatment assignment and mode of imaging study (P=0.002). There were significant interactions in the improvement of the National Institutes of Health Stroke Scale score at 48 hours (CT-ASPECTS stratum: OR, 1.95; DWIASPECTS stratum: OR, 14.5; interaction P=0.035) and mortality at 90 days (CT-ASPECTS stratum: OR, 2.07; DWI-ASPECTS stratum: OR, 0.23; interaction P=0.008). Conclusion Patients with ASPECTS of 3–5 on MRI benefitted more from EVT than those with ASPECTS of 3–5 on CT.

Background: and Purpose Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year. Methods: We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020). Results: There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P<0.0001) and 2020 (41.4%; 95% CI, 37.0 to 46.0; P<0.0001). A COVID-19 diagnosis was present in 7.6% (132/1,738) of CVT hospitalizations. CVT was present in 0.04% (103/292,080) of COVID-19 hospitalizations. During the first pandemic year, CVT mortality was higher in patients who were COVID positive compared to COVID negative patients (8/53 [15.0%] vs. 41/910 [4.5%], P=0.004). There was an increase in CVT mortality during the first 5 months of pandemic years 2020 and 2021 compared to the first 5 months of the pre-pandemic year 2019 (2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03). In the first 5 months of 2021, there were 26 cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), resulting in six deaths. Conclusions During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year. COVID-19 diagnosis was associated with higher CVT in-hospital mortality. During the first 5 months of 2021, there was an increase in CVT hospitalization volume and increase in CVT-related mortality, partially attributable to VITT.