The purpose of this study was to determine the physiological responses, stroke rate and stroke length of front crawl leg kick and arm stroke of age-group and college swimmers and to elucidate the characteristics of male age-group swimmers, which have not been highlighted adequately. The subjects were ten 11.8-to 12.4-year-old well-trained male elementary school swimmers (group E) and nine 20.1-to 21.1-year-old well-trained male college swimmers (group C) . All the subjects were categorized into similar swimming levels for their ages. All the experiments were performed in a swimming flume (AQUAGYM made by IHI) . The water velocities during leg kicking and arm stroking were 60 and 70%, respectively, of the maximal velocity at maximal oxygen uptake (Vmax) . The oxygen uptake (VO₂), heart rate (HR), pulmonary ventilation (V_E), tidal volume (TV), respiratory rate (RR) and blood lactate (BL) level of each group were significantly higher during leg kicking than arm stroking at both velocities. VO2, V_E; and TV were significantly higher in group C than group E during leg kicking and arm stroking at both velocities, but HR, RR and BL did not differ significantly. The leg kick to arm stroke VO₂ ratio at 70% Vmax was significantly higher in group E than group C. The stroke rate at the same velocity was significantly lower and the stroke length was significantly higher in group C than group E, but the kick rate and length did not differ significantly. VO₂·SR^-1 and VO₂ KR^-1 at both velocities were significantly higher in group C than group E. VO₂ Wt^-1 SR^-1 at 70% Vmax was significantly higher in group C than group E, but VO₂ Wt^-1 KR^-1 at both velocities was significantly lower in group C than group E. These results clarified the differences between group E and group C, which must be considered carefully when designing a training program for age-group swimmers.

A-75-year-old man had refractory late cardiac tamponade after an off-pump coronary artery bypass grafting. He was initially treated by pericardiocentesis with oral nonsteroidal anti-inflammatory drugs, but the treatment failed. Pericardial fenestration was conducted twice for refractory pericardial effusion during his hospitalization. He presented again with recurrence of cardiac tamponade 2 months after the last pericardial fenestration. Therefore, a pleuroperitoneal shunt system was implanted. He recovered well and was discharged without reaccumulation of pericardial effusion.

Effects of hypothermia on corticoidogenesis (CG) were investigated in primary cultured bovine adrenocortical cells. In order to evoke CG, adrenocorticotropic hormone (ACTH), dibutyryl cyclic AMP (db-cAMP), and high K⁺ were used. In the presence of the above mentioned secretagogues, cells were incubated at 37°C, 27°C, and 20°C for 1 hour. Although there was no difference between the ACTH-induced CGs at 37°C and 27°C, CG was significantly lower at 20°C. Both db-cAMP and high K⁺-induced CGs were significantly lower at 27°C, and were not observed at 20°C.
These results indicate that CG is not affected by moderate hypothermia, and is not eliminated even by deep hypothermia. It is also suggested that ACTH influences not only adenylate cyclase and Ca²⁺ channels, but also various processes of glucocorticoid production and could evoke CG at 20°C in bovine adrenocortical cells.

Effects of low temperature on corticoidogenesis (CG) were studied in isolated bovine adrenocortical cells. In the presence of Ca²⁺, cells were incubated with adrenocorticotropic hormone (ACTH) at 27°C and 37°C for 1 hour. After the incubation, the amount of corticoid was measured fluorometrically. After the incubation at 27°C, as compared with that at 37°C, the CGs induced by 10pM and 1nM ACTH decreased, but the CG induced by 10nM ACTH was not affected. Even in the absence of extracellular Ca²⁺, 10nM ACTH could induce the same degree of CGs at 37°C and 27°C, There was no difference in the amount of conversion of 25-hydroxycholesterol to corticoid between the incubations at 37°C and 27°C. The amount of conversion at 20°C, however, was significantly lower.
Our study shows that Ca²⁺ is not an important second messenger for CG at 27°C, and that the enzyme activity beyond side chain cleavage of cholesterol (SCC) does not diminish.
Because cyclic AMP and Ca²⁺ are known as second messengers of ACTH, it is suggested that cyclic AMP plays a more important role than Ca²⁺ in CG during hypothermia and that ACTH not only stimulates SCC but also activates enzyme (s) beyond SCC to evoke CG in the case of deep hypothermia.

Papua New Guinea (PNG) is one of the Pacific island countries facing a noncommunicable disease (NCD) crisis. Little has been reported about rehabilitation services for them. This study aimed to describe the characteristics of inpatients with the four major NCDs receiving rehabilitation services in PNG: cardiovascular disease (CVD) (divided into cerebrovascular disease and ischaemic heart disease), diabetes, cancer and respiratory disease. We conducted a subanalysis of our previous study. We reviewed the inpatient records of all inpatients (12,241 records, Total group) and those of inpatients receiving rehabilitation services by physical therapy (PT) (350 records, PT group). After extracting the records of patients with NCDs, we investigated the demographic data, diagnostic data and gait function. We calculated the percentages of inpatients’ characteristics and the ratio of the number of inpatients in the PT group to that in the Total group by diagnosis (PT ratio). The final analysis included 442 records in the Total group and 68 records in the PT group. Diagnoses and percentages in the PT group were cerebrovascular disease (65%), diabetes (22%), cancer (9%), respiratory disease (4%) and ischaemic heart disease (0%). The PT ratio was the highest in cerebrovascular disease (0.88), followed by diabetes (0.16) and other diagnosis (≤0.05). The inpatients with cerebrovascular disease and diabetes were more likely to have poor gait function than those with other NCDs. Our findings suggested that the provision of rehabilitation services for inpatients with the four NCDs was limited and biased for specific conditions. For development of rehabilitation services for patients with NCDs in PNG, scaling up the service provision and expanding its scope would be a possible way forward

Objective: Papua New Guinea (PNG) is the largest of the Pacific Island countries that is facing challenges related to the burden of cerebrovascular disease. There are few reports on rehabilitation services for inpatients with cerebrovascular disease, including stroke. This study aimed to examine the provision of rehabilitation services, physical therapy (PT) and service outcomes in PNG. Methods: A sub analysis of our previous retrospective observational study at a single provincial hospital in PNG was conducted in which patient records of all inpatients (Total group, n = 12,241) and those of inpatients receiving rehabilitation services (PT group, n = 350) were reviewed, and the records of inpatients with cerebrovascular disease were extracted for analysis. For descriptive purposes, demographic data, service provision statistics (length of hospital stay and duration and frequency of PT services provided) and gait function were summarized. Results: The final analysis comprised 50 of 12,241 records in the Total group and 34 of 350 records in the PT group. All of these studied patients suffered a stroke. The dominant age in both groups was ≥40 years. The median length of stay in hospital was 9 days in the Total group. The median frequency and duration of PT services were 4 times and 8.5 days, respectively. Of the 34 inpatients in the PT group, 32 (94%) were discharged with poor gait function defined as ‘dependent or no walking function’. Conclusions: The results implied that stroke patients who were discharged with poor gait function and restarted their life in the community would confront significant barriers and challenges in PNG. This first report, to our knowledge, on rehabilitation services for stroke in PNG may provide a reference point for further clinical research.

Objective: The purpose of this study was to confirm the effect of feeding Okara fermented by Bacillus coagulans on cecum microflora in rat. Method: Three groups of SD rat of 8 weeks old were used in the experiment. The experimental animals were fed control diet, 2% okara diet, 2% fermented okara diet in each group for two weeks. The experimental diet and water were provided ad libitum. Food intake was measured every day. After 24 hours fast, we performed drawing blood with heparin after the experimental period. After drawing blood, several organs were removed for measuring their weight. In addition, we removed cecum after drawing blood about each three groups and studied their microflora. We also measured about plasma albumin, ALT, AST, ALP, LDH, total cholesterol, triacylglycerol, glucose, and cytokine level. Result: Bifidobacteria of cecum and blood IFN-g levels significantly increased in the fermented okara group. The total cholesterol level in blood significantly decreased. Conclusion: Okara fermented by Bacillus coagulans had an influence on not only intestinal microflora but also the immune system in rat, suggesting that the fermented okara can expect development as functional materials.

Lentinula edodes mycelia extract has been reported to maintain and improve immune function and QOL in cancer patients. In this study, the effects of Lentinula edodes mycelia extract on immune function were investigated in 10 healthy volunteers. Ten subjects were administrated Lentinula edodes mycelia extract orally for 20 weeks on average (846 mg / day ), and the immunological function (IFNγ production amount, IL-10 production amount, lymphocyte subset)was evaluated before and after ingestion at Fukuoka Tenjin Southern Clinic. Immune function following ingestion of Lentinula edodes mycelia extract showed a tendency of IFNγ production to increase, IL - 10 to decrease, and IFNγ / IL - 10 production ratio to be improved remarkably. No significant change was observed in lymphocyte subsets such as regulatory T cells before and after ingestion. Adverse events during the intake period were not observed. It was suggested that oral intake of Lentinula edodes mycelia extract has an action to improve the immune function of healthy adults.

Background/Aims: Crohn’s disease is a chronic disorder; therefore, it is essential to investigate long-term safety and efficacy of treatments. This study assessed the safety and effectiveness of adalimumab for up to 3 years in Japanese patients with Crohn’s disease in real-world settings. Methods: This was a multicenter, single-cohort, observational study of patients with Crohn’s disease. Safety assessments included incidence of adverse drug reactions. Effectiveness assessments included clinical remission, mucosal healing, and Work Productivity and Activity Impairment (WPAI). Results: The safety and effectiveness analysis populations comprised 389 and 310 patients, respectively. Mean (standard deviation) exposure to adalimumab in the safety analysis population was 793.4 (402.8) days, with a 58.1% retention rate. A total of 105 patients (27.0%) and 43 patients (11.1%) experienced adverse drug reactions and serious adverse drug reactions, respectively, with no patient reporting tuberculosis or hepatitis B. Infections and serious infections were reported in 37 patients (9.5%) and 17 patients (4.4%), respectively. Malignancy was reported as an adverse drug reaction in 2 patients (0.5%). Remission rate increased from 37.8% (98/259) at baseline to 73.9% (167/226) at week 4 and remained > 70% over 3 years. Proportion of patients without mucosal ulcerations increased from 2.7% (2/73) at baseline to 42.3% (11/26) between years > 2 to ≤ 3. WPAI improvement started at 4 weeks, with the overall work impairment score improving from 42.7 (n = 102) at baseline to 26.9 (n = 84) at 4 weeks. Conclusions Results from this study confirm the long-term safety and effectiveness of adalimumab treatment in Japanese patients with Crohn’s disease in the real-world setting.

BACKGROUND/AIMS: Decreased trough levels of infliximab (TLI) and antibodies to infliximab (ATI) are associated with loss of response (LOR) in Crohn's disease. Two prospective studies were conducted to determine whether TLI or ATI better correlates with LOR (Study 1), and whether TLI could become a predictor of mucosal healing (MH) (Study 2). METHODS: Study 1 was conducted in 108 patients, including those with LOR and remission to compare ATI and TLI in discriminating the 2 conditions based on receiver operating characteristic (ROC) curve analyses. Study 2 involved 35 patients who were evaluated endoscopically. RESULTS: In Study 1, there were no differences between the 2 assays in ROC curve analyses; the TLI cutoff value for LOR was 2.6 µg/mL (sensitivity, 70.9%; specificity, 79.2%), and the ATI cutoff value was 4.9 µg/mL (sensitivity, 65.5%; specificity, 67.9%). The AUROC (area under the ROC curve) of TLI was greater than that of ATI. AUROC was useful for discriminating between the 2 conditions. In Study 2, the TLI was significantly higher in the colonic MH group than in the non-MH group (2.7 µg/mL vs. 0.5 µg/mL, P=0.032). CONCLUSIONS: TLI is better than ATI for clinically diagnosing LOR, and a correlation was observed between TLI and colonic MH.
Antibodies ; Cohort Studies* ; Colon ; Crohn Disease* ; Humans ; Infliximab* ; Prospective Studies* ; ROC Curve ; Sensitivity and Specificity