The effects of changing daily exercise habit on body fat, serum lipids and symptom-limited maximal exercise test (treadmill by Balke protocol) were evaluated in healthy males and males with mild hypertension (MHT) aged 30 to 59 yr during a period of one year. The subjects were selected from males who underwent physical examination. The results were as follows :
A. HEALTHY MALES
Study 1 : Subjects who exercised regularly (3 times or more/week) showed higher exercise tolerance and HDL cholesterol (HDLC) and less body fat. Compared to inactive subjects (sports 0-2 times/week), exercise tolerance was higher in the group who tried to walk as much as possible in their every day life.
Study 2 : Inactive subjects without a family history of HT were classified by percentage body fat into three groups (H, M and L) . The obese group showed lower exercise tolerance, higher total cholesterol (TC) and lower HDLC. Heart rate (HR) and systolic blood pressure (BPs) at the same load during the exercise test were higher in the obese group.
Study 3 : Revisited subjects who did not change their dietary habit for one year were selected from the average group of study 2. The subjects who increased their daily physical activity showed reduced body weight and body fat, increased exercise tolerance and HDLC, and lower HR and BPs under the same work load.
B. MALES WITH MILD HYPERTENSION
Study 4 : A similar study was conducted in inactive men with MHT (diastolic BP 90-104 mmHg), non-drug therapy at the first visit and no change in dietary habit for one year. Subjects who increased their daily activity for one year showed reduced body weight and body fat, and both resting BPs and BPd fell by 7 mmHg. HR and BPs decreased under the same work load.
These results suggest that an increase in daily physical activity improves physical fitness, reduces blood pressure and decreases body fat in previously healthy males and in males with MHT.

The purpose of this study was to detemine the effect of water intake on themoregulatory response during a round of golf (18 holes) in the heat (30-33°C, 55-70% RH) . Ten middle-aged male subjects participated in two separate golf rounds. During the first round the subjects played without fluid replacement (D), while in the second they received water replacement equal to weight loss in D (R) . With D, body weight loss of 3.8% was accompanied by a 13.3% reduction in calculated plasma volume (PV), while a small loss of body weight (0.5%) with an increase in PV of 4.6% was observed in R. A third round of golf by 5 of the subjects in cooler weather (20.4°C) without fluid replacement two months later resulted in heart rate and rectal temperature changes only slightly lower than during R. Golfing with D significantly elevated rectal temperatures and heart rates as compared to R. The rectal temperatures and heart rates at end of the 4.5-hr rounds were 39.4°C and 145 bpm, and 38.6°C and 116 bpm, in D and R, respectively. The serum enzymes, aspaartate aminotransferase, alamine aminotransferase, lactate dehydrogenase, and creatine kinase were measured at rest and after golfing. All enzyme levels increased signijicantly after golfing in D and to a lesser extent in R. The advantages of frequent fluid replacement during golf in high environmental temperatures was clearly demonstrated.

East Japan earthquake after cancer is not little survey about patients with palliative care and home health care. In this study, the cancer during an earthquake which aims to make recommendations for future large－scale disasters, and investigation of actual conditions of palliative care and home health care system or manual for basic data. Healthcare in the stricken coastal region 53 conducted semi－structured interviews. Results than cancer healthcare for patients with palliative care and home health care experience is 【cancer providing healthcare to patients with disabilities】【patient lost during the tsunami damage and evacuation oral medication continued failure】【failure of the medical provision of in－home patients by disruption of lifeline】【regional health providers and backward medical assistance and emergency medical group with disabilities】【mental care to medical staff】【disorder of the nuclear power plant accident community health providers】 of 6 organized by category. Be prepared for major disasters, disasters when cancer patients with palliative care and home care issues and how to respond it became evident.

To determine the Kampo therapy indications for global infertility treatment, and the criteria for objective and rational evaluation of its efficacy, we analyzed the sho (Zheng), type of ovarian dysfunction, types of Western drugs used concomitantly, length of treatment, age upon pregnancy, etc., in 100 women with infertility due to ovarian dysfunction as diagnosed by Western medicine who succeeded in becoming pregnant and giving live births, after Kampo therapies diagnosed by sho based on Hakko, Ki, Ketsu and Sui. The diagnosis of the sho in these women was compared with that in 2737 control women. Their types of sho by frequency were Kyo (51%), Shoyo (Hanhyo-Hanri) (69%), Jonetsu-Gekan (52%), Kigyaku (47%), Oketsu (71%) and Suidoku (67%). When compared to the control group, the percentage of women whose Sho was rated as Jitsu, Taiyo, Shoyo, Jonetsu-Gekan, Oketsu or Suidoku was significantly higher. The sho type Hyonetsu-Rikan was lower. The preparation sho, rated on the basis of a general assessment, was most frequently Kamishoyosan(55%). The predominant type of ovarian dysfunction was luteal dysfunction (73%), whose frequency was significantly higher than that in the control group. Of all women studied, 46% were treated with Kampo alone and 54% were treated with Kampo + Western medicine. In terms of the percentage of each type of ovarian dysfunction, there was no significant difference between the two groups. The Western drugs used in combination with Kampo therapy were hCG preparations (33%), terguride preparations (18%), clomiphene preparations (3%) and hMG preparations (6%). The period of treatment until pregnancy was significantly shorter in the Kampo alone group (5.0 ± 4.4months) than in the combined therapy group (9.5 ± 6.8months). These results allow us to make the following conclusions:1.The type of infertility indicated for Kampo medicine is infertility due to ovarian dysfunction as diagnosed by methods of Western medicine.2.Women who successfully became pregnant following Kampo medicine were often cases of Shoyo disease complicated by sho with Jonetsu-Gekan, accompanied by Kigyaku, Oketsu and Suidoku.3.Uncombined Kampo medicine may be effective in cases of severe infertility.4.If pregnancy does not occur within 5 or 6 months after the start of Kampo therapy, combined use of Western medicines should be considered.
Medicine, Kampo ; Therapeutic procedure ; Infertility ; Western Herbs and Botanicals ; Functional disorder

Clinical efficacy of tokishakuyakusan against immunologic recurrent abortion was evaluated using methods of diagnostic statistics. The subjects of this study were 38 women with recurrent abortion who had experienced a spontaneous abortion during their first trimester (within 12 weeks of pregnancy) twice, and who took tokishakuyakusan (extract granules) after development of their third pregnancy, but experienced spontaneous abortion again during their first trimester, with the karyotype of the aborted fetus being rated as 46, XX or 46, XY. The control group consisted of 244 women who had experienced 3 or more spontaneous abortions during their first trimester of pregnancy. The detection rates of autoimmune disorders and alloimmune disorders were compared statistically between the two groups. Neither the detection rate of autoimmune recurrent abortion nor the detection rate of alloimmune recurrent abortion differed significantly between the two groups, suggesting that tokishakuyakusan is not clinically effective against immunologic recurrent abortion. Tokishakuyakusan is estimated to prevent abortion caused by compromised luteal insufficiency of the uterus. Thus, saireito seems to provide a more rational means of Kampo therapy for immunologic recurrent abortion.
Unspecified Abortion ; immunologic ; tokishakuyakusan ; Therapeutic procedure ; Pregnancy Trimester, First

The efficacy of Saireito (a herbal preparation) against autoimmune recurrent abortion was evaluated clinically and immunologically. Saireito therapy was performed with 87 women having experienced 3 or more recurrent abortions in the early stages of pregnancy (less than 12 weeks gestation), and whose antinuclear antibody (ANA) and anti-cardiolipine antibody (ACA) test results were positive. The effects of this therapy on the percentage of women in whom abortion was successfully prevented (the abortion prevention rate), and on the antibody titer were investigated. Among the 49 women who became pregnant during the study period, the abortion prevention rate was 63.3%, the percentage of ANA positive cases was 65.6%(32/49), the percentage of ACA IgG and/or IgM positive cases (as evaluated by SRL methods) was 65.5%(29/49) and the percentage of both ANA and ACA IgG and /or IgM positive cases was 75.0%(12/49). Although the titer of ANA was not significantly reduced by this therapy, the titer of ACA IgM was reduced significantly.These results suggest that Saireito exerts its efficacy by suppressing humoral immunity through its adjustment of the Th1/Th 2 cytokine balance. This therapy is expected to be effective against ACA-positive recurrent abortion by reducing the effects of ACA. Furthermore, in 2 observed child birth cases whose ACA titer were not decreased by Saireito, different effective mechanisms were speculated; for example, suppression of platelet aggregation via saireito's component herbs (ninjin and bukuryou) similar to the effect seen with low-dose aspirin therapy, or its “risui” effect via its components (bukuryou, soujyutu, takusha and chorei).
Therapeutic procedure ; Unspecified Abortion ; Antinuclear Antibody Assay ; Antibodies ; Immunoglobulin M measurement

For two infertile couples with normal tubal function and spermatogenesis, who were diagnosed with infertility attributed to lack of competent ovum with poor grade embryo in spite of having received timing therapy and step-up therapy (artificial fertilization from husband ; AIH and in vitro fertilization and embryo transfer ; IVF-ET), Kampo-only therapies diagnosed according to their “Zheng” syndrome-type consisting of one cycle of tokishigyakukagoshuyushokyoto, and two cycles of kamishoyosan and anchusan was performed. As a result, both women became pregnant and gave live births. The causes of infertility in these two cases were analyzed, and problems with step-up therapy, commonly used in Western medicine and efficacy of Kampo-therapy diagnosed according to their Zheng were evaluated from the standpoint of Western medicine.Kampo-therapy diagnosed by Zheng was found to improve the follicular and luteal functions as well as related functions. The two cases presented were diagnosed as infertile due to ovarian dysfunction on the basis of therapeutic diagnosis. The indications of IVF-ET are tubal and male infertilities, not to be ovarian dysfunctional infertility.For infertility due to ovarian dysfunction, Kampo-therapy diagnosed by Zheng with Kuoketsu and Risui effects are drugs of first choice, rather than clomiphene, which has an anti-estrogen activity.
Therapeutic procedure ; Medicine, Kampo ; Infertility ; Ovarian ; Ovum

Background: Necrotizing fasciitis is a rare but severe condition associated with high mortality. We encountered a patient with severe and rapidly progressing necrotizing fasciitis. Patient: A 40-year-old male was hit by a tractor and received a wide laceration wound spanning the length of his posterior thigh. Soon after the accident, the wound was washed and debridement was performed. Two days postoperatively, we observed septic changes in the wound and diagnosed this condition as necrotizing fasciitis. Consequently, the patient's leg was amputated at the thigh. The patient, however, developed toxic shock syndrome after the amputation. Endotoxin adsorption using a polymyxin B-immobilized fiber column was performed for 2 days. Finally, a hip joint amputation was performed after 11 days, following which the patient's general condition gradually improved. Discussion: Treatment for necrotizing fasciitis should be initiated promptly. Early debridement is associated with a significant decrease in mortality. In severe conditions, endotoxin and cytokine removal by blood purification is one of the most effective treatments. Although group A streptococci are widely known as "flesh-eating bacteria," we should also consider a wide variety of pathogenic organisms to be the probable cause of severe necrotizing fasciitis. Conclusion: Management of necrotizing fasciitis requires careful investigation as well as an aggressive therapeutic approach, which may include urgent surgical intervention. In addition to surgery, endotoxin adsorption therapy should be considered.
Patients ; Fasciitis ; Endotoxins ; Therapeutic procedure ; Amputation

OBJECTIVESThe aim of this study was to survey the prevalence of fascioliasis in slaughtered cattle in order to provide breeders with feedback which may prevent cattle fascioliasis, as well as human fascioliasis.

METHODSThe results of meat inspection and the information extracted from the Discriminative Data Base on Individual Livestock in Japan were analyzed statistically in 6,224 cattle slaughtered at the Tsuyama Abattoir during the fiscal year 2002.

RESULTSThe age-adjusted fascioliasis and cholangitis rates of all cattle were 2.0% and 7.2%, respectively. When analyzed by cattle breed, both rates were significantly higher in Japanese native cattle than in Holstein or Jersey (Chi-square test, p<0.01). The cattle raised in Okayama Prefecture, Tochigi Prefecture and Shimane Prefecture were significantly different from cattle raised in other prefectures in the age-adjusted fascioliasis and cholangitis rates.

CONCLUSIONThe age-adjusted fascioliasis and cholangitis rates of all cattle can be considered as nationwide rates for slaughtered cattle. The results of the comparisons suggest that cattle fascioliasis is related to feeding with rice straw and that the measures to prevent cattle fascioliasis might differ a mong prefectural governments.

Methods: We enrolled 20 patients (13 men and seven women) who underwent DB-ACLR between October 2017 and March 2019. The mean patient age was 28.5 years. The ipsilateral ST tendon was measured using ultrasonography before surgery. Measurements included the diameter and breadth of the short-axis image. The cross-sectional area (CSA) was calculated from these measurements. During surgery, when two grafts with diameters of ≥ 5.0 mm could not be made, the G tendon was also harvested. Patients were categorized into two groups: the ST group where only the ST tendon was harvested, and the semitendinosus gracilis tendon (STG) group where the ST and G tendons were both harvested. The CSA value was compared between the two groups, and the cutoff value was calculated. Results: In the ST group (n = 8), the mean diameter and breadth of the semitendinosus tendon were 4.21 and 2.34 mm, respectively. In the STG group (n = 12), the mean diameter and breadth of the ST tendon were 3.39 and 1.78 mm, respectively.The CSAs calculated for the ST group and the STG group were 7.74 mm 2 and 4.79 mm 2, respectively. A cutoff value of 7.0 mm 2was found to correspond to a specificity and sensitivity to harvest the G tendon of 87.5% and 75.0%, respectively. Conclusions The preoperative CSA of the ST tendon determined using ultrasonography can, therefore, be informative for deciding whether to harvest the G tendon for DB-ACLR. The results of this study provide valuable information for graft selection in anterior cruciate ligament reconstruction.Level of Evidence: IV (Retrospective case series design).