Effects of neck muscle training and their changes after discontinuation of training (detraining) were studied in 22 athletes (college American football players) and 19 non-athletes. The subjects underwent narrow grip shoulder shrug training using free weights (NGSS group), isometric training of the neck in pairs (PAIR group), or both types of training (COMB group) for 14 weeks, and were then detrained during the following 14 weeks. Extension and flexion muscle strength (maximum isometric muscle strength) of the neck were measured using a method in which subjects pulled a wire attached over the head in a sitting position at 2-week intervals after the start of training.The following results were obtained.
1. In the athletes, the flexion muscle strength increased by 16.9±5.6% (mean±standard deviation) in the COMB group and by 14.8±5.2% in the NGSS group, and the increases in these groups were significantly greater than the increase in the PAIR group (p<0.01) . The extension muscle strength also increased, most notably in the COMB group (12.2±4.7%) .
2. In the non-athletes, the flexion muscle strength increased by 29.4±7.2% in the COMB group, and this increase was significantly greater than that in the PA1R group (p<0.01) . This increase was also significantly greater than that in the COMB group of the athletes (p<0.01) . The extension muscle strength increased by 19.1±5.2% in the COMB group.
3. In the athletes, the flexion muscle strength of the COMB group was increased by 8.3% after 14 weeks of training and 14 weeks of detraining as compared with that at the start of training. In the non-athletes, the flexion and extension muscle strength of the COMB group increased by 17.4% and 9.8%, respectively, after the start of training.
These results suggest that narrow grip shoulder shrug training used for the development of muscle strength in the lower neck is effective for improving flexion as well as extension muscle strength, and that the decrease in muscle strength due to detraining can be reduced by combining this training with isometric training performed by the PAIR group.

The relationship between environmental conditions and water balance during training for baseball and American football was analyzed. The environmental conditions were assessed in terms of WBGT (wet-bulb globe temperature) based on NDB (natural dry-bulb temperature), NWB (natural wet-bulb temperature) and GT (globe temperature), as WBGT=0.7NWB+0.2GT+0.1NDB,
During baseball training, a commercially available sports drink was provided ad libitum, whereas during American football training, the effect of free water intake was compared between tap-water and sports drink. The sweat rate and the amount of water consumption were significantly correlated with WBGT under each experimental condition. Body weight loss was 0.2% body wt./h during baseball training, whereas during American football training, body weight loss was 0.5%/h with tap-water and 0.4%/h with sports drink on average, revealing a significantly higher value for tap-water.
These results indicate that both sweat loss and water intake during exercise increase with WBGT, and that body weight loss is maintained at a fairly constant level during exercise with free water intake, although the loss is significantly higher when tap-water is provided.

The relationship between environmental conditions and water balance during training for baseball and American football was analyzed. The environmental conditions were assessed in terms of WBGT (wet-bulb globe temperature) based on NDB (natural dry-bulb temperature), NWB (natural wet-bulb temperature) and GT (globe temperature), as WBGT=0.7NWB+0.2GT+0.1NDB,
During baseball training, a commercially available sports drink was provided ad libitum, whereas during American football training, the effect of free water intake was compared between tap-water and sports drink. The sweat rate and the amount of water consumption were significantly correlated with WBGT under each experimental condition. Body weight loss was 0.2% body wt./h during baseball training, whereas during American football training, body weight loss was 0.5%/h with tap-water and 0.4%/h with sports drink on average, revealing a significantly higher value for tap-water.
These results indicate that both sweat loss and water intake during exercise increase with WBGT, and that body weight loss is maintained at a fairly constant level during exercise with free water intake, although the loss is significantly higher when tap-water is provided.

We evaluated the association between respiratory symptoms and hydration volume during last 1 week of life in terminal cancer patients using retrospective study. The subjects were 138 terminally patients with malignancies. Patients were classified into two groups: the low hydration group (group L, n=85) who received 1,000 ml or less of artificial hydration per day in 1 week before death and high hydration group (group H, n=53) who received over 1,000 ml per day. We compared appearance of dyspnea and bronchial secretion on group L with group H. 64.1% of group H had dyspnea, and 52.8% had bronchial secretion. These fractions are significantly higher than group L (32.9%, 15.3%). In the results of multiple regression analysis, lung involvement (odds ratio: 3.55), hydration over 1,000 ml per day (3.54), and administration of opioid (0.40) were significantly related dyspnea. Lung involvement (7.29), hydration over 1,000 ml per day (4.43), and oral intake (0.31) were significantly related bronchial secretion. Our results provide preliminary evidence that excessive artificial hydration therapies influence the respiratory symptoms in terminal cancer patients. 1,000 ml of hydration may be used as a rough indication in terminal stage.

Introduction: This study used a meta-analysis to investigate factors related to dizziness/vertigo and their effect size in community-dwelling elderly people.Methods: The search terms "elderly," "dizzy," "community dwelling," and others were used, and a database search was conducted using Ichushi Web and PubMed.Result: In total, 10 studies were extracted. Meta-analysis calculated 28 items as significantly related factors: anxiety, fatigue, taking nitric acid drugs, taking anxiolytics, low self-rated health, memory impairment, depression, sleep disorder, dementia, cancer, balance failure, gait disturbance, physical dysfunction, taking diuretics, living alone, heart disease, fall history, rheumatoid arthritis, stroke, taking sleeping pills, taking multiple drugs, visual impairment, female, ADL impairment, osteoporosis, taking antihypertensive drugs, hypertension, and low education level.Conclusion: The above items may be key variables for investigating dizziness/vertigo in the future.

The rectal tonsil is a rare polypoid lesion exclusively found in the rectum and is considered a reactive proliferation of the lymphoid tissue. Although this lesion is benign, we recommend that it should be differentiated from carcinoid or polypoid type of mucosa-associated lymphoid tissue lymphomas, based on gross findings. In this case report, we describe a case of rectal lesions with a unique appearance in a 41-year-old man. Colonoscopy revealed two 5-mm-sized nodules located opposite from each other on the left and right sides of the lower rectum. Endoscopic mucosal resection was conducted. Histopathologically, both lesions were mainly located in the submucosa and consisted of prominent lymphoid follicles with germinal centers of various sizes. No immunoreactivity of Bcl-2 was seen in the germinal centers. Immunohistochemical staining for kappa and lambda light chains revealed a polyclonal pattern. Therefore, these lesions were diagnosed as rectal tonsils.
Adult ; Carcinoid Tumor* ; Colonoscopy ; Germinal Center ; Humans ; Lymphoid Tissue ; Lymphoma, B-Cell, Marginal Zone* ; Palatine Tonsil* ; Rectum ; Twins*

A 2-month-old female Holstein calf and a 5-month-old female Japanese black calf presented with gingival vascular hamartoma located in the interdental space between the second and third mandibular incisors in the right and left mandibles, respectively. On radiographic or computed tomographic images, osteolytic changes appeared within the mandibular bones adjacent to the masses. The masses were removed along with affected mandibular bone by using unilateral rostral mandibulectomy. After surgery, both cases exhibited a normal appetite and grew normally, with no cosmetic changes or recurrences. Unilateral rostral mandibulectomy can be applied for invasive gingival vascular hamartomas associated with osteolytic changes.
Animals ; Appetite ; Asian Continental Ancestry Group ; Cattle ; Female ; Hamartoma ; Humans ; Incisor ; Infant ; Mandible ; Mandibular Osteotomy ; Radiography ; Recurrence

Background/Aims: Digital single-operator cholangioscopy (DSOC)-guided mapping biopsy (DMB) and tube-assisted mapping biopsy (TMB) are two techniques used for preoperative evaluation of biliary tract cancer (BTC). However, data regarding the diagnostic performance of these techniques are limited. Methods: We retrospectively examined consecutive patients with BTC who underwent either technique at our institution between 2018 and 2020. We evaluated the technical success rate, adequate tissue acquisition rate, and diagnostic performance of these techniques for the evaluation of lateral spread of BTC. Results: A total of 54 patients were included in the study. The technical success rate of reaching the target sites was 95% for DMB and 100% for TMB. The adequate tissue acquisition rate was 61% for DMB and 69% for TMB. The adequate tissue acquisition rate was low, especially for target sites beyond the secondary biliary radicles. The sensitivity of DMB alone was 39%, which improved to 65% when combined with visual impression. Experts demonstrated a higher negative predictive value and diagnostic accuracy with respect to both DSOC visual impression and DMB for the evaluation of lateral spread of BTC compared to trainees. Conclusions Adequate tissue acquisition rates were similar between the two techniques. Since DMB requires expertise, TMB may be an acceptable option when DSOC is unavailable or when DSOC expertise is limited.

Purpose: Accelerated atherosclerosis is a major complication in patients with end-stage renal disease and it plays an important role in the pathogenesis of erectile dysfunction (ED). However, the association between aortic calcification burden and the severity of ED remains unclear. The aim of the present study was to investigate this association in men undergoing dialysis. Materials and Methods: This cross-sectional study included 71 men undergoing peritoneal dialysis and/or hemodialysis between July 2016 and May 2018 at Mutsu General Hospital. ED was assessed with the Sexual Health Inventory for Men (SHIM). Patients were divided into the mild/moderate (SHIM score ≥8) and severe ED groups (SHIM score ≤7). Aortic calcification index (ACI) was examined as a clinical indicator of abdominal aortic calcification. Multivariable logistic regression analysis was performed to identify the significant factors associated with severe ED. Results: The median age of the study participants was 64 years; all had ED, with 64.8% having severe ED. In the multivariable analyses, a slight association was observed between ankle-brachial index and severe ED (odds ratio [OR], 0.058; p=0.072), whereas ACI was significantly associated with severe ED (OR, 1.022; p=0.022). Conclusions Aortic calcification burden was independently associated with severe ED.

Purpose: To evaluate the impact of severe erectile dysfunction (ED) on future major adverse cardiovascular events (MACE) in men on dialysis. Materials and Methods: This prospective cohort study included 71 men on dialysis. ED was assessed using the Sexual Health Inventory for Men (SHIM). Men were divided into the mild/moderate ED (SHIM score ≥8) and severe ED (SHIM score ≤7) groups. The primary endpoint was MACE-free survival. MACE was a composite of myocardial infarction, cardiovascular death, and stroke. The secondary endpoints were cardiac event-free survival and overall survival (OS). Moreover, the predictive abilities of severe ED for 5-year MACE, 5-year cardiac events, and 5-year overall mortality were evaluated. Results: The median age and follow-up period of the included men were 64 years and 58 months, respectively. The median SHIM score was 4.0; all had a degree of ED, and 64.7% had severe ED. In the background-adjusted multivariable analyses, severe ED was not significantly associated with shorter MACE-free survival (hazard ratio [HR], 1.890; 95% confidence interval [CI], 0.533–6.706; p=0.324), cardiac event-free survival (HR, 2.081; 95% CI, 0.687–6.304; p=0.195), and OS (HR, 0.817; 95% CI, 0.358–1.863; p=0.630). Severe ED did not significantly improve the predictive abilities for 5-year MACE, 5-year cardiac events, and 5-year overall mortality (p=0.110, p=0.101, and p=0.740, respectively). Conclusions ED severity was not associated with shorter MACE-free survival, cardiac event-free survival, or OS, and ED severity could not improve the predictive abilities for these outcomes in men undergoing dialysis.