The purpose of this study was to examine the effect of fructose ingestion on maximal exercise performance capacity following prolonged steady-state exercise compared with glucose or placebo ingestion, in 7 male college students (age 23.3±0.7 yr, height 171.3±1.9 cm, weight 68.4±1.4 kg, Vo2max 3.5±0.2 L/min, mean ± SEM) . The subjects cycled constantly on an ergometer at 59± 2 % Vo2max for 100 min divided in the middle by a 5-min rest, and then performed 10 min of all-out self-paced cycling. They ingested either 8 % fructose solution (F), 8 % glucose solution (G) or artifi-cially sweetened placebo (P) before and during exercise (at 20, 40, 65, 85 mm) . Before exercise and at 50 and 100 min of exercise and 5 min after the performance ride, blood samples were collected for determination of the concentrations of blood lactate, serum glucose and serum FFA. In the G trial, the serum FFA level was significantly lower than in the P and F trials at any of the time points dur-ing and after exercise (vs. P ; p<0.01, vs. F ; p<0.05) . However, glucose ingestion maintained serum glucose at a significantly higher level during and after exercise than placebo ingestion (p< 0.01) and improved the total work output in the 10-min performance ride (G vs. P ; 135± 8 KJ vs. 128± 8 KJ, p<0.05) . Although in the F trial, the serum FFA level was elevated during exercise compared to that in the G trial and the serum glucose level was significantly higher than in the P trial (vs. P ; p<0.01), the blood lactate level after exercise was lower than in the G trial and total work output was similar to that in the P trial (123± 8 KJ, vs. G ; p<0.01) . These results indicate that fructose ingestion before and during exercise cannot improve the ability to perform high-intensity exercise late in prolonged exercise despite maintaining the serum glucose level.

A study was conducted to examine the relationship between percent body fat (%fat) and medical examination parameters. The subjects were 250 women aged 17 to 68 years, who neither drank nor smoked. The results obtained were as follows:
After controlling for the effects of age and maximal oxygen intake per kilogram body weight (VO₂max/wt), %fat showed a significant correlation with high-density lipoprotein cholesterol (HDL-C), total cholesterol/HDL-C ratio (TC/HDL-C), β-lipoprotein (β-L), glutamic oxaloacetic transaminase (GOT), glutamic pyruvic tansaminase (GPT), uric acid (UA), white blood cell count (WBC), red blood cell count (RBC), systolic blood pressure (SBP), and diastolic blood pressure (DBP) . Values of %fat calculated from each regression equation when HDL-C=38mg/dl, TC/HDL-C=4.9, β-L=500 mg/dl, GOT=41mu/ml, GPT=46 mu/ml, UA=5.7mg/dl, WBC=8500/mm3, RBC=520×104/mm3, SBP=159 mmHg, and DBP=94 mmHg were 32.2%, 31.9%, 30.8%, 35.4%, 36.4%, 31.8%, 30.7%, 35.0%, 33.8% and 32.6%, respectively.
The subjects were then divided into 2 groups, above (above group) or below (below group) 30%, 31%, 32%, 33%, 34% or 35% body fat. Wherever the subjects were divided into 2 groups at these values of %fat, the above group showed a significantly higer occurrence of abnormal values for medical parameters than the below group.
The subjects were further divided into 3 groups: 154 subjects with %fat below 29.9% (N group), 47 subjects with %fat between 30% and 34.9% (MO group), and 49 subjects with %fat above 35% (O group) . The O group showed significantly higher occurrence of abnormal values for medical parameters than the MO and N groups. The O group also showed a significantly higher mean value of DBP than the MO and N groups. Furthermore, the O group showed a significantly lower mean value of HDL-C and significantly higher mean values of TC/HDL-C, UA, GOT, GPT, SBP, FBS than the N group. There was no significant difference between the N and MO groups in the occurrence of abnormal values for medical parameters. However, the MO group showed a significantly lower mean value of HDL-C and significantly higher mean values of TC/HDL-C, UA and β-L.
These results suggest that the values of medical parameters become poorer when %fat exceeds 30%, a level widely used in Japan as a criterion for evaluation of obesity.
The subjects were further divided into 3 groups: 50 subjects who were non-obese and fit (NF group) ; 104 subjects who were non-obese and unfit (NU group) ; 88 subjects who were obese and unfit (OU group) . There were significant differences in the occurrence of abnormal values for medical parameters among these groups. The NF group showed the lowest values, followed by the NU and OU groups. Thus, it seems preferable to evaluate individuals using a combination of %fat and VO₂max/wt.

A study was conducted to derive a criterion for evaluation of obesity based on relationships between percent body fat (%fat) and clinical parameters. The subjects were 457 men aged 18 to 73 years. The results obtained were as follows:
After controlling for the effects of age, maximal oxygen intake per kilogram body weight (VO₂max/wt), alcohol intake and cigarette smoking, %fat showed significant correlations with high-density lipoprotein cholesterol (HDL-C), total cholesterol/HDL-C ratio (TC/HDL-C), fasting blood sugar (FBS), glutamic oxaloacetic transaminase (GOT), glutamic pyruvic transaminase (GPT), γ-glutamyl transpeptidase (γ-GTP), white blood cell count (WBC), red blood cell count (RBC), systolic blood pressure (SBP), and diastolic blood pressure (DBP) . Values of %fat estimated from borderline values of these clinical parameters ranged from 17.9% to 20.4%.
When the subjects were divided into 11 groups from a below 12% fat group to an above 22% fat group, the 18%, 20%, 21% and above 22% fat groups showed significantly higher occurrence of abnormal values for clinical parameters than the below 12% fat group.
When the subjects were divided into 2 groups, i, e, above (above group) or below (below group) 18%, 19%, 20%, or 21% body fat, the above group always showed a significantly higher occurrence of abnormal values for clinical parameters than the below group.
The subjects were further divided into 3 groups: 250 subjects with %fat below 17.9% (N group), 63 subjects with %fat between 18% and 19.9% (MO group), and 144 subjects with %fat above 20% (O group) . The O group showed the highest occurrence of abnormal values for clinical parameters, followed in order by the MO and N groups. These differences were significant. The O group showed a significantly lower mean value of HDL-C and significantly higher mean values of TC, TC/HDL-C, TG, GPT, SBP, DBP and FBS than the N group. The O group also showed significantly higher mean values for WBC and RBC than the MO and N groups. The O and MO groups showed significantly higer mean values of β-L, γ-GTP and UA than the N group.
From these results and the fact that a value above 20% fat is widely used as a criterion for evaluation of obesity, men with a %fat range of 18.0% to 19.9% are defined as mildly obese, whereas those with above 20% fat are defined as obese.
The subjects were further divided into 3 gooups: %fat below (non-obese) or above (obese) 20%, and VO₂max/wt above (fit) or below (unfit) values recommended by the Ministry of Public Welfare for each age group. One hundred fifty-one subjects were non-obese and fit (NF group), 142 subjects were non-obese and unfit (NU group) and 107 subjects were obese and unfit (OU group) . The NF group showed the lowest occurrence of abnormal values for clinical parameters, followed in order by the NU and OU groups. These differences were significant. Thus, it seems appropriate to evaluate obesity by using a combination of %fat and VO₂max/wt.

The Consensus of this Committee is:

1) To change the name of the present committee from "Premedical Education Committee" to "Committee on Behavioral and Social Science" ; accordingly to discuss theoretical foundations, clinical application, learning objectives and outcomes of behavioral and social science in Japanese medical schools.

2) To collect actual case studies of teaching behavioral and social sciences in Japanese medical schools and create a database for such practices.

3) To develop behavioral and social science curriculum content in Japanese medical schools.

4) To organize training courses for teaching methods for behavioral and social science curricula and develop standardized teaching methods and materials.

Objective: The objective of this study was to clarify the light stability of cyclosporin fine granules 17%?? Mylan ??(CsA-FG) after packaging by a dividing and packing machine.
Methods: CsA-FG packaged within cellophane-laminate paper was stored under three different covering conditions: (stored uncovered, in a medicine bag, or in a light shielding bag).  In these covering conditions, we examined changes in the residual rate and elution pattern of CsA for up to 12 weeks in the differently covered samples stored at room temperature under fluorescent lighting.
Results: Under the light exposure condition, the residual rate decreased with time and fell below 95 percent at 12th week.  Although a slight decline in the residual rate was observed in samples stored in the medicine bag at 12th week, the rate was less than 5%.  On the other hand, no change in the residual rate was observed for samples stored in the light shielding bag storage for up to 12 weeks.  There was no change in the elution pattern of CsA in any group, except the decline in the elution rate caused as the resulting from the decline in the residual rate.
Conclusion: In this study, we have clarified that the packaged CsA-FG covered by stored in a medicine bag or light shielding bag is stable for up to 12 weeks under normal storage conditions.  However, CsA-FG should be stored in a light shielding bag or undergo the split dispensation, if it’s stored in a more severe lighting condition and/or if it is to be stored for more than three months.

Postgraduate residents face formidable stress. Unfortunately, many residents withdraw from training programs because of reactions to stress, such as depression. We performed a comprehensive study to examine the working conditions and stress of residents to improve the conditions of resident-training programs and reduce levels of stress.
1) The study examined 548 first-year residents starting postgraduate clinical training at 41 hospitals in Japan. A selfadministered questionnaire, which included questions about working conditions, job stressors, buffer factors, and stress reactions, was answered before and 2 months after the start of training.
2) A total of 318 subjects completed the survey.Of these subjects, 80 (25.2%) had depression after the start of training.
3) Job stress patterns of residents were characterized by high workload and extremely low “reward from work” and “Job control.”
4) Many residents had depression after the start of training.To improve residency programs, program directors should recognize the specific characteristics of residents' job stress and focus on buffer factors.

We report herein the case of an 18-year-old man who underwent endoscopic resection for an osteoid osteoma in the seventh cervical facet joint. The patient had experienced right neck pain for approximately one year, but no neurological abnormalities were noted. Cervical magnetic resonance imaging suggested an osteoid osteoma in the superior articular process of the seventh cervical vertebra. The tumor was resected microendoscopically. Operative time was 1 hour 29 minutes, and blood loss was 5 mL. During the two years since surgery, the patient has remained pain free with no cervical spine instability. We thus propose microendoscopic surgery for osteoid osteoma developing in a posterior element of the cervical spine is a potentially effective operative procedure.
Diskectomy ; Humans ; Magnetic Resonance Imaging ; Neck Pain ; Operative Time ; Osteoma, Osteoid ; Spine ; Surgical Procedures, Operative ; Zygapophyseal Joint

To explore the efficacy and safety of switching from once-daily basal insulin therapy to once-daily pre-meal injection insulin degludec/insulin aspart (IDegAsp) with respect to the glycemic control of participants with type 2 diabetes mellitus (T2DM).

Background/Aims: The objective of this research is to examine factors related to irritable bowel syndrome (IBS) prevalence in a large population-based study. Methods: A cross-sectional study was conducted with participants in the Miyagi part of the Tohoku Medical Megabank Project CommunityBased cohort study who completed the Rome II Modular Questionnaire. Multivariate odds ratios (ORs) for the presence of IBS and 95% confidence intervals (95% CIs) for the reference group were calculated for each factor. Additionally, a stratified analysis was performed by sex and age group (20-49 years, 50-64 years, and ≥ 65 years). Results: Among 16 252 participants, 3025 (18.6%) had IBS, comprising 750 men (15.5%) and 2275 women (19.9%). Multivariate ORs for the presence of IBS decreased significantly with each year of age (OR, 0.98; 95% CI, 0.98-0.99). Moreover, compared with the reference group, ORs for the presence of IBS were significantly higher in individuals whose home was partially damaged by the Great East Japan Earthquake, those with < 16 years of education, those who spent less time walking, those with high perceived stress (1.77, 1.57-2.01), those with high psychological distress (1.58, 1.36-1.82), and those with high symptoms of depression (1.76, 1.60-1.94). In stratified analyses, a significant relationship was found between psychological factors and IBS prevalence in all sex and age groups. Conclusions This large cross-sectional population-based cohort study identified several factors associated with IBS prevalence. Psychological factors were significantly associated with IBS prevalence across all age groups and sexes.

PURPOSE: Pain from osteoarthritis (OA) is generally classified as nociceptive (inflammatory). Animal models of knee OA have shown that sensory nerve fibers innervating the knee are significantly damaged with destruction of subchondral bone junction, and induce neuropathic pain (NP). Our objective was to examine NP in the knees of OA patients using painDETECT (an NP questionnaire) and to evaluate the relationship between NP, pain intensity, and stage of OA. MATERIALS AND METHODS: Ninety-two knee OA patients were evaluated in this study. Pain scores using Visual Analogue Scales (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), painDETECT, duration of symptoms, severity of OA using the Kellgren-Lawrence (KL) system, and amount of joint fluid were evaluated and compared using a Spearman's correlation coefficient by rank test. RESULTS: Our study identified at least 5.4% of our knee OA patients as likely to have NP and 15.2% as possibly having NP. The painDETECT score was significantly correlated with the VAS and WOMAC pain severity. Compared with the painDETECT score, there was a tendency for positive correlation with the KL grade, and tendency for negative correlation with the existence and amount of joint fluid, but these correlations were not significant. CONCLUSION: PainDETECT scores classified 5.4% of pain from knee OA as NP. NP tended to be seen in patients with less joint fluid and increased KL grade, both of which corresponded to late stages of OA. It is important to consider the existence of NP in the treatment of knee OA pain.
Aged ; Aged, 80 and over ; Female ; Humans ; Knee/pathology/physiopathology ; Male ; Middle Aged ; Neuralgia/*physiopathology ; Osteoarthritis, Knee/*physiopathology