To evaluate the contribution of adenosine (AD) to exercise capacity, plasma concentrations of AD were assessed before, during and after dynamic exercise in 6 healthy men (24-32yr) . The exercise protocol was a symptom-limited ramp exercise test. Blood pressure, heart rate and respiratory gas exchange parameters were monitored throughout the exercise test. The first exercise test (EX 1) was performed to determine the anaerobic threshold (AT) . The second exercise test (EX 2) was performed 2 days after EX 1 and blood samples for assay of AD, lactate and norepinephrine (NE) were taken from the cubital vein at rest, before and after AT, at peak exercise, and 5, 10, 15min after EX 2. Blood for assay of AD was collected into a vaccum tube with EDTA, dipyridamole and 2'-deoxycoformycin. Plasma AD concentrations were measured by the RIA.
The mean AD concentration±S. D. at rest, before and after AT, at peak exercise, 5, 10 and 15min after exercise was 22±11.8pmol/ml, 45±20.7, 63±33.6, 123±82.1, 186±146.9, 154±127.7 and 150±68.5, respectively. A significant increase of AD concentration was observed during the period from before AT until 15 min after exercise, as compared with that at rest. There was a significant relation between AD and lactate (r=0, 54, p<0.01), but there was no significant relation between AD and NE (r=0.08) .
It is concluded that AD may be a contributing factor to increase exercise capacity through its vasodilation effect, suggesting a paracrine interaction between the exercising skeletal muscle and blood vessels.

Tutorials were introduced to the 1st-year curriculum of Kanazawa Medical University in 1994. The aim of this educational program was to help our students develop, (1) a scientific way of thinking, (2) the ability to identify and solve problems, (3) a positive attitude toward study, and (4) the ability to make logical presentations. The tutorials succeeded in teaching our students methods of self-learning and group-learning. Furthermore, results of the evaluation of each student by this tutorial was comparable with those of the term-end evaluation, which is supposed to reflect the general ability of students.

We previously reported that the tutorial system had a beneficial effect on our students' scores on term-end examinations in 1994: the assessments of the tutorials correlated positively with the results of the term-end test. This time we analyzed each student's assessment of the tutorials, results of the term-end examinations, and responses to a follow-up questionnaire to determine what abilities the tutorial system helped students develop. The results suggest that tutorials help medical students develop analytical ability: a prerequisite for the problem-solving process.

The small-group-learning course “Introduction to Medical English” was introduced to the 1st-year students' curriculum in 1994. The effects of this course were examined by analyzing students questionnaires and by comparing results of the term-end examination. The following results were obtained. 1) Results of the term-end examination (multiple-choice method) showed a normal distribution. 2) Results of the questionnaires suggest that although medical English seemed difficult at first, the course produced a good response from students which conventional courses could not. These results suggest that “Introduction to Medical English” has a valuable role at the start of medical education.

We have previously reported that tutorials help medical students develop analytical ability, which is necessary for problem-solving. In this study we analyzed students' assessments of tutorials, results of term-end examinations, and posttutorial questionnaires to determine whether tutorials help students develop interests and proper attitudes for studying. The results suggest that our tutorials are not sufficient for medical students to develop interests and proper attitudes for studying.