It is well known that individual differences exist in exercise capacity or trainability. Several studies have shown that these individual differences are brought about by environmental effects such as life-style, diet and genetics. The potential of several specific genes to cause individual differences in endurance capacity or trainability has been investigated. The angiotensin-converting enzyme (ACE) gene, which has insertion (I) /deletion (D) polymorphism, is one of the most studied genes. Montgomery et al. reported that elite high-altitude mountaineers had higher I allele frequency of the ACE gene than did sedentary males. Moreover, they reported that subjects with II homozygotes showed higher trainability during a 10-week endurance training program than did individuals with ID heterozygotes or DD homozygotes. However, the results reported by Rankinen et al. did not support their results in terms of the relation between ACE genotype and cardiorespiratory endurance. Although numerous studies have reported a relationship between these two items, it remains controversial. Furthermore, mitochondrial DNA (mtDNA), the creative kinase and the Na⁺-K⁺-ATPase ∂2 genes have been studied as genes that may dictate individual differences in endurance capacity or trainability. We are going to report about the relation between these genes and exercise capacity and trainability.

The ability to walk is just as important for the elderly as it is for young people. In fact, in the elderly, decreased mobility limits function in daily life and can lead to more serious situations (e.g., becoming bedridden) . The elderly population has increased over the last decade, and many researchers have studied the mobility of the elderly. However, the focus of most studies has been to facilitate recovery of bedridden individuals and prevent the elderly from becoming bedridden, and particularly to prevent fall-induced fractures, which often cause the elderly to become bedridden. However, about 70-80% of the elderly population do not require care, and it is necessary to conduct research on the maintenance of activities of daily living to make it possible for the elderly to work or volunteer. From this perspective, mobility is an important physical factor. Mobility is dependent on muscle activity and it has long been known that aging reduces muscle mass. Therefore, it is feasible to assume that reduced muscle mass leads to decreased ability to walk, and we have proven that there is a close correlation between the two. When presenting the idea of strength training to the elderly, it is appropriate to focus on the maintenance and improvement of mobility, not on the training itself. The results of our research can be summarized as follows:
Muscle mass decreases with age, with the legs being affected to a greater degree than the arms. Moreover, muscle atrophy is dependent on weakening of muscle fibers, especially fast-twitch (Type II) fibers. Reduced lower limb muscle mass increases the risk of falling and can decrease walking ability to a degree that can affect daily living activities.
In order to improve reduced muscle mass in aging, it is important to use an exercise program that is designed to strengthen fast-twitch fibers, which can be followed even by the elderly. Since walking therapy mostly mobilizes slow twitch fibers, it is not effective in preventing and improving muscle atrophy. It is important to have an exercise program that is designed to mobilize fast-twitch fibers.

The effects of endurance training and detraining on cardiac autonomic nervous system activity were studied by using the power spectral analysis of heart rate (HR) variability. Twenty-one sedentary male subjects were trained for 8 weeks using cycle ergometer exercise [70% of maximal oxygen uptake (VO₂max), 60 min, 3.4 times/wk] . Resting HR for 5 min was recorded before the training, after the 8-week training period, and after the 2-week and 4-week detraining period. The indices of cardiac parasympathetic and sympathetic nervous system activity were determined by Mem-Calc method, as the high frequency power (HF : 0.15-0.50 Hz) and the ratio of the low frequency power (LF : 0.04-0.15 Hz) to the HF (LF/HF), respectively. The VO₂max after the training and 4 weeks detraining period were significantly higher than the initial value (before training : 41 ± 1 ml/kg/min ; after training: 48±2, P<0.0001; after detraining: 46±2, P<0.001) . The HF was significantly in-creased by the training (P<0.05), and maintained the increased level for the 2-week detraining period (before training : 6.4±0.3 In ms²; after training: 7.0±0.2, P<0.01; after 2-week detrain-ing: 7.0±0.2, P<0.05) . The increase in the HF, however, disappeared after the 4-week detraining period (6.8±0.31n ms²) . The LF/HF did not show any significant changes during the training and detraining period. These results suggest that an endurance exercise with moderate intensity enhan-ces cardiac parasympathetic nervous system activity, but not cardiac sympathetic nervous system activity. The enhanced cardiac parasympathetic nervous system activity, however, may regress rapidly during detraining period.

The purpose of this study was to compare changes in oxygenation in the Vastus Lateralis (VL) and Rectus Femoris (RF) muscles during a ramp-loaded bicycle exercise. Twelve healthy males participated in the experiment. The test consisted of a leg arterial occlusion at rest and a ramp-loaded exercise (20 watts/min) using a bicycle ergometer until exhaustion. The changes in deoxygenation in each muscle was measured by near infrared spectrometer (NIRS) . The probes of NIRS were placed on VL and RF approximately 12 cm above the right knee. Oxy-Hb/Mb signals from NIRS were calculated as 100% at rest, with 0 % being the lowest value during the leg arterial occlusion. Pulmonary gas exchanges (VE, VO₂, VCO₂) were measured with an expiratory gas analyzer. In 10 subjects, muscle oxygenation level in VL decreased linearly until the deoxygenation limiting point (DOLP) -the point in exercise at which the deoxygenation rate decreases noticeably. However, in 2 subjects, the DOLP was not detected, and the muscle oxygenation level decreased linearly until exhaustion. The muscle oxygenation level in RF also decreased linearly until 70%VO₂max, although the deoxygenation rate was smaller than that in VL. Thereafter, the muscle oxygenation level in RF continued to decrease until exhaustion. No DOLP was found in any subjects in RF. Compared with the muscle oxygenation level in RF at any points during the exercise, those in VL were lower until 90%VO₂max (P<0.001) . However, the difference in muscle oxygenation levels between VL and RF at exhaustion was not noted. This study indicated that the patterns of deoxygenation in VL and RF during a ramploaded bicycle exercise were different.

Case：A 57 year-old man, who had received home oxygen therapy and noninvasive ventilation（NIV）as outpatient, was admitted to our hospital because he felt shortness of breath. He could not eat meals because he was required to receive NIV in all days. He therefore was admitted to our palliative care unit（PCU）on a permanent basis in order to improve the quality of his life. In the PCU, he could take a bath, eat meals and appreciate local folk songs while receiving NIV. Complications were only desaturation and feeling shortness of breath while bathing or eating. Conclusions：NIV may be a useful device for the patients with terminal respiratory failure.

High-sensitivity C-reactive protein (CRP) is a novel risk factor for coronary artery disease. It is well known that body weight loss is effective in reducing serum CRP concentration ; however, the effect of exercise training on serum CRP concentration has not been fully elucidated. The purpose of this study was to examine the effect of a 24-week exercise training program on serum CRP concentration in 169 healthy middle-aged and elderly subjects (65.9±6.4 years). Each subject underwent baseline testing (peak oxygen uptake, daily physical activity, body weight, and serum CRP levels), and repeated these tests on completion of the training program. The subjects were classified into 2 groups based on initial CRP levels : normal<1.0 mg/L, n=139, and high≥1.0mg/L, n=30. On completion of the program, both daily physical activity and peak oxygen uptake increased significantly (+33.9±72.4%, p<0.0001, +5.4±14.7%, p=0.014, respectively). However, body weight did not change significantly. In addition, CRP levels of the entire group did not change significantly. However, CRP levels significantly decreased among the high baseline CRP group (from 1.82±0.81 mg/L to 0.98±0.59 mg/L, p<0.0001). It was concluded that serum CRP levels are reduced without body weight loss in response to exercise training in healthy middle-aged and elderly subjects with high initial CRP levels.

At present, there is no photographic evidence of splitting of the trapezius and sternocleidomastoid muscles (SCMs), which share a common anlage that extends caudally toward the limb bud in the embryo at a length of 9 mm. Therefore, the aim of the present study was to identify which structures divide the caudal end of the common anlage at the first sign of splitting into two muscles. In 11 mm-long specimens, the SCM and trapezius muscles were identified as a single mesenchymal condensation. In 15 and 18 mm-long specimens, the SCM and trapezius muscles were separated and extended posteriorly and lymphatic tissues appeared in a primitive lateral cervical space surrounded by the SCM (anterior). In 21 mm-long specimens, the lymphatic vessels were dilated and the accompanying afferents were forming connections with the subcutaneous tissue through a space between the SCM and trapezius muscles. In 27 mm-long specimens, cutaneous lymphatic vessels were evident and had entered the deep tissue between the SCM and trapezius muscles. Vascular dilation may be viewed as a result of less mechanical stress or pressure after muscle splitting.

Purpose: The albumin-to-globulin ratio (AGR) is a recognized chronic inflammation marker. No evidence regarding the relationship between AGR level and ulcerative colitis (UC) exists. The aim of this study was to evaluate the association between AGR and clinical outcomes among Japanese subjects with UC. Methods: The study subjects consisted of 273 Japanese individuals with UC. AGR was divided into 4 categories (low, moderate, high, and very high). The definition of complete mucosal healing (MH) was based on the Mayo endoscopic subscore of 0. Clinical remission (CR) was defined as no rectal bleeding and no abnormally high stool frequency (<3 times per day). Results: The percentage of MH was 26.4%. High AGR and very high AGR were significantly positively correlated with CR (adjusted odds ratio [OR], 5.85; 95% confidence interval [CI], 2.52–14.18 and adjusted OR, 4.97; 95% CI, 2.14–12.04) and complete MH (adjusted OR, 4.03; 95% CI, 1.56–11.51 and adjusted OR, 5.22; 95% CI, 1.97–14.89), respectively after adjustment for confounding factors (P for trend=0.001). Only in the low C-reactive protein (CRP) group (≤0.1 mg/dL), very high AGR was significantly positively correlated with complete MH but not CR (adjusted OR, 4.38; 95% CI, 1.06–21.77; P for trend=0.017). In the high CRP group, no correlation between AGR and complete MH was found. Conclusion Among Japanese patients with UC, AGR may be independently positively correlated with complete MH. In particular, among UC patients with low CRP, AGR might be a useful complementary marker for complete MH.

To screen for additional treatment targets against tongue cancer, we evaluated the contributions of extracellular signal-related kinase (ERK), AKT and ezrin in cancer development. Immunohistochemical staining showed that ERK and ezrin expressions were significantly higher in invasive squamous cell carcinoma than in carcinoma in situ. To investigate the roles of ERK and ezrin in cancer development, we used the non-woven silica fibre sheet Cellbed with a structure resembling the loose connective tissue morphology in a novel 3D culture system. We confirmed that the 3D system using Cellbed accurately mimicked cancer cell morphology in vivo. Furthermore, cell projections were much more apparent in 3D-cultured tongue cancer cell lines than in 2D cultures. Typically, under conventional 2D culture conditions, F-actin and cortactin are colocalized in the form of puncta within cells. However, in the 3D-cultured cells, colocalization was mainly observed at the cell margins, including the projections. Projections containing F-actin and cortactin colocalization were predicted to be invadopodia. Although suppressing ezrin expression with small interfering RNA transfection caused no marked changes in morphology, cell projection formation was decreased, and the tumour thickness in vertical sections after 3D culture was markedly decreased after suppressing ERK activity because both the invasion ability and proliferation were inhibited. An association between cortactin activation as well as ERK activity and invadopodia formation was detected. Our novel 3D culture systems using Cellbed™ are simple and useful for in vitro studies before conducting animal experiments. ERK contributes to tongue cancer development by increasing both cancer cell proliferation and migration via cortactin activation.
Carcinoma in Situ ; metabolism ; pathology ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Cell Culture Techniques ; methods ; Cell Movement ; Cell Proliferation ; Cytoskeletal Proteins ; metabolism ; Extracellular Signal-Regulated MAP Kinases ; metabolism ; Humans ; Neoplasm Invasiveness ; pathology ; Phosphorylation ; Podosomes ; pathology ; Proto-Oncogene Proteins c-akt ; metabolism ; Silicon Dioxide ; Tongue Neoplasms ; metabolism ; pathology ; Tumor Cells, Cultured