A study was conducted to determine the minimum quantity of leg exercise required to prevent disuse atrophy of the quadriceps femoris muscle during bed rest. The subjects were 10 normal young university students with a mean age of 21.1 years. First, analysis of rectified filtered electromyography (RFEMG) was performed on the rectus femoris and vastus medialis during walking with cadences of 100 steps/min and 150 steps/min. Then, the effects of straight leg raising (SLR), patella setting (PS), knee extension-flexion in a supine position (KEF) and knee extension in a sitting position (KE) were analysed for each muscle using the same method. Based on the value of RFEMG for each muscle during walking, the repetition number for each exercise was calculated. For the rectus femoris, the repetition number for each exercise corresponding to 10000 steps with a cadence of 100 steps/min was 289 for SLR, 466 for PS, 1255 for LEF and 1663 for KE. For the vastus medialis, the corresponding numbers were 1223, 381, 6367 and 2170, respectively. When the cadence increased to 150 steps/min, the repetition number of each exercise for each muscle also increased. These results indicate that high repetition exercise is recommendable to prevent disuse atrophy of the quadriceps femoris muscle. Therefore, the activity of patients should be increased to stimulate weakened muscles such as the quadriceps femoris during hospitalization.

The purpose of this study was to examine how S-R compatibility affected P 300, the stimulusevaluation process and response process. The P 300 component is thought to reflect information processing of stimuli. Previous studies used visual stimuli. In this study, we measured S-R compatibility effects on EMG-RT and P 300 using electrical somatosensory stimuli. Subjects performed the oddball task (Task 1) and the four-choice stimuli response task (Task 2) . They were presented electrical stimuli through ring electrodes on the index and little fingers of both hands and instructed to respond quickly to stimuli. S-R compatibility was decided by position of the stimuli. EMG-RT and P 300 latency for compatible and incompatible conditions were analyzed.
For ERP analysis, data of subjects who reacted faster to compatibility ware used. Neither P 300 latency nor amplitude differed significantly between compatibility and incompatibility in Tasks 1 and 2, but for Task 2, latency tended to be prolonged by incompatibility. Therefore, it is thought that S-R compatibility mainly has an effect on response processing. However, judging from the tendency of P 300 latency to be prolonged by incompatibility for Task 2, it was considered that there is the possibility that S-R compatibility influenced P 300 latency, even if using a somatosensory stimulus.

We experienced a clinical case of a patient with psychotic depression who ingested the residual saponated cresol solution from a 500ml bottle of cresol, a disinfectant, with the intention of committing suicide. Through this experience, we felt it neccessary to investigate the present commercial situation of cresol for domestic use, and to come up with some safty measares.All the 128 drugstores and pharmacies in four cities located in the Tohno area of Gifu Pref. (Mizunami, Toki, Tajimi and Ena) were queried by telephone about the sale and stock of cresol.Almost 80% of the drugstores in these four cities, excluding pharmacies, were found to deal in saponated cresol solutions. They carried a little more than two 500ml bottles of cresol on average. This volume exceeds an estimated adult lethal dose of 250ml.Although it is unlikely that an ordinary household will use the whole of 500ml bottle of the disinfectant at a time, the residual saponated cresol solution could increase the risk of accidental cresol poisoning at home.So, it would be desirable not to sell 500ml bottles in ordinary drugstores. Furthermore, before selling a bottle of cresol, the pharmacists, who have a specialized knowledge about it, should kindly explain to the user about its toxicity and usage.
cresol ; Solutions ; Area ; Disinfectants ; Cancer patients and suicide and depression

Our examination was performed on 1, 541 men and 3, 803 women. Reviewed were blood pressure, obesity, anemia, fatty tissue (lipide), liver function, urine-suger and protein, urobilinogen, and their abnormalities.
(1) High blood pressure was found in 53.7 % of the men and 68.3 % of the women, with higher rates found in the middle to older age groups of both men and women.
(2) Obesity, by the Minowa method, was found to be over 20 %, with the higher rate being in women. The tendency to obesity in men was found to decrease with age. In females, abnormalities of blood pressure, total cholesterol, triglyceride, thickness of subcutaneous fatty tissue (of the upper arm and shoulder blade areas) were discovered to be greater in proportion to obesity.
(3) Abnormalities in GPT were seen as 15.3 % in men and 7.3 % in women. According to age group in men: Those in their 30's, 21 %, in the 40's, 27.2 %, 50's, 12.7%, 60's, 9.1 %.
A study on the effects of alcholic beverage consumption will be included in the 1983 survey.

A 73-year-old man visited our hospital with complaints of fever, epigastric painand jaundice. Laboratory examinations showed elevation of GOT, GPT, ALP, LAP and amylase. Abdominal ultrasonography revealed gall bladder stones. Endoscopic findings showed parapapillary diverticulum, but the common bile duct stone was not revealed by endoscopic retrograde cholangiography. He was conservatively treated and then discharged. Two months after, the patient was readmitted for cholecystitis and underwent cholecystectomy. After further 2 months, he was again admitted for the same symptoms as those on first admission. We diagnosed this case as Lemmel's syndrome and performed emergency endoscopy. Endoscopic findings revealed the meal rest inside the parapapillary diverticulum. After we removed the meal rest obstructing the orifice of the papilla of Vater using grasping forceps, we performed EST. Purulent bile gushed out from the orifice. Two years have elapsed since them. Cholangitis has not recurred during this period. Therefore, we concluded that EST is effective in treating Lemmel's syndrome.

A survey was carried out on how the To-no District is coping with the need of first aid for patients requiring life-supporting treatment before hospitalization. Although there were cities in this district where statistics on first aid were not available, the survey found that, during the 4-year period from 1994 through 1997, bystander CPR (cardiopulmonary resuscitation) saved 11.2% of the lives of patients with CPA (cardiopulmonary arrest). Incidentally, 11.3% of the population attended CPR courses offered by public institutions. Gifu Prefecture has helicopters for use in rescue work, but the survey found that some cities had not ever sponsored drills using helicopters in life-saving operations. Our findings revealed the indifference of the general public as well as administrators in this district toward emergency care. Public recognition of the importance of the care of suddenly ill or injured patients must be gained. Furthermore, acquisition of skills required for first aid by lay people and technical improvement of these skills in professional rescuers are necessary. The authors think that these are the community educational responsibility of hospitals and other medical institutions.

STUDY DESIGN: A retrospective study. PURPOSE: To examine the effectiveness of using an electrodiagnostic technique as a new approach in the clinical diagnosis of extraforaminal stenosis at L5-S1. OVERVIEW OF LITERATURE: We introduced a new effective approach to the diagnosis of extraforaminal stenosis at the lumbosacral junction using the existing electrophysiological evaluation technique. METHODS: A consecutive series of 124 patients with fifth lumbar radiculopathy were enrolled, comprising a group of 74 patients with spinal canal stenosis and a second group of 50 patients with extraforaminal stenosis at L5-S1. The technique involved inserting a pair of needle electrodes into the foraminal exit zone of the fifth lumbar spinal nerves, which were used to provide electrical stimulation. The compound muscle action potentials from each of the tibialis anterior muscles were recorded. RESULTS: The distal motor latency (DML) of the potentials ranged from 11.2 to 24.6 milliseconds in patients with extraforaminal stenosis. In contrast, the DML in patients with spinal canal stenosis ranged from 10.0 to 17.2 milliseconds. After comparing the DML of each of the 2 groups and at the same time comparing the differences in DML between the affected and unaffected side of each patient, we concluded there were statistically significant differences (p<0.01) between the 2 groups. Using receiver operating characteristic curve analysis, the cutoff values were calculated to be 15.2 milliseconds and 1.1 milliseconds, respectively. CONCLUSIONS: This approach using a means of DML measurement enables us to identify and localize lesions, which offers an advantage in diagnosing extraforaminal stenosis at L5-S1.
Action Potentials ; Constriction, Pathologic* ; Diagnosis* ; Diagnostic Techniques and Procedures ; Electric Stimulation ; Electrodes ; Humans ; Muscles ; Needles ; Radiculopathy ; Retrospective Studies ; ROC Curve ; Spinal Canal ; Spinal Nerves ; Spinal Stenosis

BACKGROUND/AIMS: Infliximab (IFX), an antibody to tumor necrosis factor, (TNF)-alpha has efficacy in treating Crohn's disease (CD). However, knowledge of the potential effects of IFX on patients' immune profiles is lacking. The purpose of this study was to reveal the immunological effects of IFX. METHODS: Twenty-two patients with a CD activity index (CDAI) of 194.2+/-92.9 and an average duration of disease of 3.26 months and 21 healthy controls were included. Patients were to have their first IFX remission induction therapy with 3 infusions (5 mg/kg) at weeks 0, 2, and 6. Oral 5-aminosalicylic acid was the only ongoing medication in the patient population. Blood samples at baseline, 12 hours after the first infusion and at week 14 were labeled with anti-CD4/CD25 antibodies for immunohistochemical measurement of regulatory T-cells (Treg). Serum cytokines and chemokines were measured by suspension array and ELISA. RESULTS: CDAI significantly decreased prior to the second IFX infusion (p<0.001). Clinical remission rates were 77.3% and 91% by the second and third infusions, respectively. At baseline, interleukin (IL)-6 (p<0.03), IL-8 (p<0.03), IL-10 (p=0.050), IL-13 (p<0.01), transforming growth factor-beta1 (p<0.01), and 'regulated on activation, normal T cell expressed and secreted' (RANTES) (p<0.01) were elevated in patients. After the initial IFX infusion, TNF-alpha (p<0.04), IL-6 (p<0.03), interferon (IFN)-gamma (p<0.04), IFN-gamma-inducible protein-10 (p<0.01), monocyte chemoattractant protein-1 (p<0.01), macrophage inflammatory protein-1beta (p<0.01), and RANTES (p<0.01) were decreased. IFX infusion was associated with an increase in Treg (p<0.01) and a decrease in the Th1 (IFN-gamma)/Th2 (IL-4) ratio (p<0.03). CONCLUSIONS: IFX use was associated with restoration of the Th1/Th2 balance after a single infusion and seemed to promote induction of naive Th0 lymphocytes to Treg. This knowledge should have clinical relevance.
Antibodies ; Antibodies, Monoclonal ; Chemokine CCL2 ; Chemokine CCL5 ; Chemokines ; Crohn Disease ; Cytokines ; Humans ; Immune System ; Interferons ; Interleukin-10 ; Interleukin-13 ; Interleukin-6 ; Interleukin-8 ; Interleukins ; Lymphocytes ; Macrophages ; Mesalamine ; Remission Induction ; T-Lymphocytes, Regulatory ; Tumor Necrosis Factor-alpha ; Infliximab

Early detection and treatment decrease the mortality rate associated with gastric cancer (GC). However, the natural history of GC remains unclear. An 85-year-old woman was referred to our hospital for evaluation of a gastric tumor. Esophagogastroduodenoscopy identified a 6 mm, flat-elevated lesion at the lesser curvature of the antrum. A biopsy specimen showed a well-differentiated tubular adenocarcinoma. The depth of the lesion was estimated to be intramucosal. Although the lesion met the indications for endoscopic resection, periodic endoscopic follow-up was performed due to the patient's advanced age and comorbidities. The mucosal GC invaded into the submucosa 3 years later, and finally progressed to advanced cancer 5 years after the initial examination. The patient died of tumor hemorrhage 6.4 years after the initial examination. In this case, mucosal GC progressed to advanced GC, eventually leading to the patient's death from GC. Early and appropriate treatment is required to prevent GC-related death.
Adenocarcinoma ; Aged, 80 and over ; Biopsy ; Comorbidity ; Endoscopy, Digestive System ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Mortality ; Natural History* ; Stomach Neoplasms*

In Mongolian gerbils, bilateral common carotid artery occlusion (BCCAO) for several minutes induces ischemia, due to an incomplete circle of Willis, resulting in delayed neuronal cell death in the Cornet d'Ammon 1 (CA1) region of the hippocampus. Neuronal cell death in the hippocampus and changes in behavior were examined after BCCAO was performed for 5 min in the gerbils. One day after BCCAO, the pyramidal neurons of the CA1 region of the hippocampus showed degenerative changes (clumped chromatin in nuclei). At 5 and 10 days after BCCAO, extensive neuronal cell death was observed in the hippocampal CA1 region. Cognitive performance was evaluated by using the radial maze and passive avoidance tests. In the radial maze test, which examines win-stay performance, the number of errors was significantly higher in ischemic gerbils than in sham-operated gerbils on days 1 and 2 post-operation. In the passive avoidance test, the latency and freezing times were significantly shorter in ischemic gerbils than in sham-operated gerbils on the days 1, 2, and 4–6 post-operation. These results indicate that transient forebrain ischemia impairs cognitive performance, even immediately after the ischemic insult when there are only subtle signs of neuronal cell death.
CA1 Region, Hippocampal ; Carotid Artery, Common ; Cell Death ; Chromatin ; Circle of Willis ; Freezing ; Gerbillinae ; Hippocampus ; Ischemia ; Neurons ; Prosencephalon ; Pyramidal Cells