[Objective and Patients] We carried out surveys of urinary condition and its change, and anxiety and depression status and its change in 44 male outpatients with a chief complaint of urinary difficulty. In these surveys, we distributed questionnaires of the International Prostate Symptom Score (IPSS) and the Hospital Anxiety and Depression Scale (HAD Scale) to the patients twice-at their first visit and six monthslater.
[Results] The survey using the IPSS found that the urinary condition improved in 27 patients in six months, deteriorated in five and did not change in 12. The HAD Scale survey found that psychologicasl status improved in 17 patients, deteriorated in 11 and did not change in 16. The patients who had better points in the second IPSS test showed a tendency to make a good QOL score and get an improved state on the HAD Scale. However, the HAD Scale deteriorated in some of the patients who got improved IPSS.
[Conclusions] Although the patients who got better results in the second IPSS trial showed a tendency to get better marks on the HAD Scale, patients' anxiety and depression condition might have been affected by other factors than urinary difficulty.

Objective: The psychophysiological and immunological effects of exposure to different varieties of essential oils on fatigue were extensively investigated in students performing personal computer tasks.
Design: Randomized crossover study
Methods: This study was approved by the Kyoto Prefectural University of Medicine Research Ethics Committee, and informed consents were obtained from all subjects. Eight healthy male university students with mean age of 22.38±1.30 (range 21–24) who served as the subjects in this study were given a 120-minute personal computer task with 10-minute rest period before and after the task.
During the course of performing PC task, subjects were either exposed to one of the five essential oil odors (grapefruit, peppermint, true lavender, blend A, blend B) or not exposed to any odor at all, serving as the control in the study. Each of the six odor setting were carried out on separate days upon which psychophysiological and immunological parameters of fatigue in the subjects were evaluated.
Results and Conclusions: The results of this study suggest that exposure to essential oil odors affects the autonomic nervous and immunological system when engaged in a personal computer task. Moreover, different varieties of essential oils cause different vital reactions. In particular, peppermint essential oil exhibits fatigue-reducing effects.

Using atomic absorption spectrophotometry, we measured serum mineral (Fe, Cu, Z n, Mg, Ca, K, Na) concentrations in blood of male athletes participating in a triathlon competition held at Nakajima, Ehime in 1989. The athletes were divided into a young group (n=9, 24.2±3.6 yr) and a middle-aged group (n=9, 49.3±4.4 yr) . Blood samples were taken on the day before the competition, at the finish, on the following day and for eight days after.
Immediately after the race, the concentrations of iron, calcium and potassium were increased significantly in sera taken from both groups, and those of copper and zinc were found to be increased only in the young group. In the middle-aged group, serum magnesium and sodium concentrations were decreased significantly. On the day after the race, most of the serum mineral concentrations had returned to values similar to those measured before the race, although the serum sodium concentration in the middle-aged group was still below the previous value, and this low level persisted for eight days after the race in both groups.
Noticeable differences between the young and middle-aged groups were that recovery of increased iron concentration in serum tended to be prolonged in the middle-aged group, and the concentrations of serum copper and zinc were higher than those in the young group throughout the measurement period, with only small changes evident before and after the race. By contrast, serum potassium concentration in the middle-aged group was lower than in the young group throughout the measurement period.

A 75-year-old woman underwent endovascular stent-grafting for a descending thoracic aortic aneurysm, followed by video-assisted thoracoscopic right upper lobectomy for concomitant lung cancer in a later procedure. Two custom-made endovascular spiral Z stents covered with woven Dacron (DuPont Co., Wilmington, DE, USA) were delivered via the femoral artery under local anesthesia using pull-through technique. Intraoperative angiograms showed successful exclusion of the aneurysm without any endoleakage. Conventional surgical treatments for both diseases in this patient would have required bilateral thoracotomy either in a simultaneous or staged fashion and entail risks of postoperative pulmonary dysfunction and progression of the cancer. Endovascular stent-grafting offered potential superior operative results and quality of postoperative life in this patient with concomitant descending thoracic aortic aneurysm and cancer of the right lung.

The present study was performed to investigate the effects of 120 km walking, 40 km a day for 3 successive days on the condition that taking rest and foods freely, upon physical functions for healthy male and female subjects. All measurements were enforced at postabsorptive state early in the morning for the 10 successive days including the days of walking. Blood pressure, heart rate, and body weight were measured every morning. Blood samplings enforced, too. Urine collections were enforced from first day to 7 th day. The results obtained were as follows;
1) There were no changes in heart rate, blood pressure, and body weight, which were measured early in the morning, before and after 120 km walking.
2) Serum GOT and GPT activities had little changes, while serum LDH, α-HBDH, and CK activities increased gradually after walking.
3) Serum CK-MB activities, which indicate myocardial injury, increased after walking, on the contrary CK-MB/CK ratio decreased. It was suggested that effects of 120km walking to myocardium were rather than slight ones.
4) In spite of the same sorce in which serum CK-MB and LDH-1 were resulted, both did'nt exhibit same patterns in serum.
5) Serum lipids decreased gradually after walking.
6) Urinary excretion of creatinine and uric acid increased after 120km walking especially.
7) If it is allowed to take sufficient foods and rest, 120km walking, 40km a day for 3 successive days, would not result in such a physical stress over the following days.

We collected and analyzed large-scale data concerning the fall of stroke inpatients in convalescent rehabilitation wards. Three hundred seventy-four of 1,107 inpatients experienced one fall or more, and 16 factors associated with falls were clarified by the chi-square test. To extract the significant item from a multifactor, the logistic regression analysis of 16 factors was carried out, and we developed an assessment sheet for the risk degree of first fall prediction in stroke inpatients. We selected eight variables as the items on the assessment sheet : history of previous falls, central paralysis, visual impairment, sensory disturbance, urinary incontinence, use of psychotropic medicines, mode of locomotion, and cognitive impairment. The total score of the assessment sheet was ranged from 0 to 10 and the mean score of fallers (6.4±1.5) among subjects was significantly higher than that of non-fallers (5.1±1.9) (p <0.001). When the subjects were classified into three groups, a significant difference (p<0.001) in the tendency of fall incidence in term of days after admission was found among the three groups on the basis of the Kaplan-Meier survival curve.

Background : The effects of rehabilitation on hemodialysis patients are unknown. We assessed the effects and investigated the association between rehabilitation treatment effects and all-cause mortality. Methods : This prospective cohort study included 120 patients on maintenance hemodialysis. ADL was assessed using the Functional Independence Measure (FIM) score (total points, 126), which comprises 13 motor items (total points, 91) and five cognitive items (total points, 35). A survival curve was constructed using the Kaplan-Meier analysis and stratified into an increase or no-increase of the FIM score. Multivariable logistic regression analysis was used to determine factors associated with the effects of rehabilitation. Discriminative sensitivity of FIM cognitive items for an increase in total FIM was estimated using the area under the receiver operating characteristic (AuROC) curve. Results : The average total FIM score increased from 64.2±3.6 to 75.8±3.0, and the increase in FIM motor and cognitive items was 11.0±1.3 and 0.5±0.6, respectively. The cumulative survival rate within 2.5 years was significantly higher in the FIM increase group than that in the FIM no-increase group. FIM cognitive items and anemia were significantly associated with rehabilitation effects, and AuROC showed that a cutoff of 34 points in cognitive FIM had moderate discriminative sensitivity for a total FIM increase (AuC, 0.719 ; p<0.0008). Conclusions : Rehabilitating hemodialysis patients improved their FIM score (particularly the motor items), and a higher FIM score resulted in a better prognosis. The effectiveness of rehabilitation depends on maintaining a perfect FIM cognitive score.

OBJECTIVEPhytoestrogen isoflavones (IFs) are considered to suppress estrogen-related cancers through their antiestrogenic activity. The antioxidant effect of IFs, however, has not been confirmed in anin vivo system, so suppression of hydroperoxide formation and resultant DNA adduct formation were studied.

METHODSThe antioxidant effects of the soya-hypocotyl tea (SHT), which contained daidzein (14+/-1.5 mg/l) and genistein (3+/-0.5 mg/l), were examined in Wistar rats fed the AIN-76 control diet or iron deficient diet (FeD) for 4 weeks. The intake amount of the diet and IFs were measured daily. Urinary excretion of IFs was measured for 3 days before sacrifice. In addition to the serum lipid analyses, phosphatidylcholine hydroperoxide (PCOOH), and phosphatidylethanolamine hydroperoxide (PEOOH) production in red blood cells and the liver were measured as a biomarker of oxidants. Production of DNA adducts by oxidative stress was measured by the amount of 8-hydroxy-2'-deoxyguanosine (oh(8)dG) in the liver and kidney, and urine. Histological changes were checked by H&E staining and immunohistochemistry for oh(8)dG.

RESULTSFeD rats showed anemia, growth retardation, hyperlipidemia. IFs only lowered the triacylglycerol level and did not change the cholesterol level. Rats fed the normal diet did not show suppression of PCOOH and PEOOH production in either red blood cells or the liver, while groups administered SHT showed suppressed production of PCOOH and PEOOH in the liver. The cumulative intake of daidzein, genistein and the total amount of IFs showed significant inverse associations with urinary excretion of oh(8)dG. oh(8)dG in the kidney showed an inverse association with the amount of oh(8)dG in the urine. Enzymehistochemically, a strong localization of oh(8)dG was found in the epithelial cells of the bile canaliculi and proximal tubules of the kidney.

CONCLUSIONIFs and SHT showed antioxidant effects at physiological concentrations in anin vivo system. The antioxidant effects of IFs decreased oxidation stress to the nuclear DNA, which was shown by the decreased oh(8)dG production. It is suggested that to prevent various cancers, in addition to the known antiestrogenie, antityrosin kinase, and other effects. IFs appeared to promote excretion of oh(8)dG.

OBJECTIVEWe conducted a study to develop an assessment sheet for fall prediction in stroke inpatients that is handy and reliable to help ward staff to devise a fall prevention strategy for each inpatient immediately upon admission.

METHODSThe study consisted of three steps: (1) developing a data sampling form to record variables related to risk of falls in stroke inpatients and conducting a follow-up survey for stroke inpatients from their admission to discharge by using the form; (2) carrying out analyses of characteristics of the present subjects and selecting variables showing a high hazard ratio (HR) for falls using the Cox regression analysis; (3) developing an assessment sheet for fall prediction involving variables giving the integral coefficient for each variable in accordance with the HR determined in the second step.

RESULTS AND DISCUSSION(1) Subjects of the present survey were 704 inpatients from 17 hospitals including 270 fallers. (2) We selected seven variables as predictors of the first fall: central paralysis, history of previous falls, use of psychotropic medicines, visual impairment, urinary incontinence, mode of locomotion and cognitive impairment. (3) We made 960 trial models in combination with possible coefficients for each variable, and among them we finally selected the most suitable model giving coefficient number 1 to each variable except mode of locomotion, which was given 1 or 2. The area under the ROC curve of the selected model was 0.73, and sensitivity and specificity were 0.70 and 0.69, respectively (4/5 at the cut-off point). Scores calculated from the assessment sheets of the present subjects by adding coefficients of each variable showed normal distribution and a significantly higher mean score in fallers (4.94 +/- 1.29) than in non-fallers (3.65 +/- 1.58) (P = 0.001). The value of the Barthel Index as the index of ADL of each subject was indicated to be in proportion to the assessment score of each subject.

CONCLUSIONWe developed an assessment sheet for fall prediction in stroke inpatients that was shown to be available and valid to screen inpatients with risk of falls immediately upon admission.

Methods: A total of 14 patients with unilateral radicular symptoms and five healthy subjects were subjected to simultaneous apparent T2 mapping and neurography with nerve-sheath signal increased with inked rest-tissue rapid acquisition of relaxation enhancement signaling (SHINKEI-Quant) using a 3-Tesla magnetic resonance imaging. The Visual Analog Scale (VAS) score for neck pain and upper arm pain was used to evaluate clinical symptoms. T2 relaxation times of the cervical dorsal root ganglia of the brachial plexus were measured bilaterally from C4 to C8 in patients with radicular symptoms and from C5 to C8 in healthy controls. The T2 ratio was calculated as the affected side to unaffected side. Results: When comparing nerve roots bilaterally at each spinal level, no significant differences in T2 relaxation times were found between patients and healthy subjects. However, T2 relaxation times of nerve roots in the patients with unilateral radicular symptoms were significantly prolonged on the involved side compared with the uninvolved side (p<0.05). The VAS score for upper arm pain was not significantly correlated with the T2 relaxation times, but was positively correlated with the T2 ratio. Conclusions In patients with cervical radiculopathy, the SHINKEI-Quant technique can be used to quantitatively evaluate the compressed cervical nerve roots. The VAS score for upper arm pain was positively correlated with the T2 ratio. This suggests that the SHINKEI-Quant is a potential tool for the diagnosis of cervical nerve entrapment.