Exercise intensity has been identified as a major determinant of the excess post-exercise oxygen consumption (EPOC). However, no studies have compared the prolonged EPOC after supramaximal intermittent exercise and supramaximal continuous exercise. Six young healthy male [age=26±3 (mean±SD) yr ; stature=175.4±5.7 cm ; body weight=66.8±6.7 kg ; maximal oxygen uptake (VO₂max)=44.1±8.5 ml/kg/min] xercised on separate days on a cycle ergometer at two equated total energy expenditures (intermittent exercise : 7×30-second intervals at 150%VO₂max with intervening 15-seconds rest periods ; continuous exercise : 5 min at 105%VO₂max) and then sat quietly in an armchair for 3h. A control trial without any exercise was also performed in a counterbalanced research design. The VO₂, carbon dioxide output (VCO₂), pulmonary ventilation (VE), respiratory exchange ratio (RER), heart rate (HR) and blood lactate concentration (LA) were measured before exercise, during exercise and during the 3-h recovery period. The mean VO₂ after intermittent trial at 150%VO₂max were higher than these of the control trial and the continuous trials at 105%VO₂max for 3-h recovery periods (p<0.05). The 3-h EPOC value for intermittent exercise trial (10.5±2.4L) was significantly greater than that of continuous exercise trial (4.8±2.7L) (p<0.05). The mean RER values for intermittent exercise trial were significantly lower than those of the control trial during 60-180 min post-exercise (p<0.05). We examined the effect of supramaximal exercise intensity on the magnitude of 3-h EPOC after 12-fasting. In the present study, 3-h EPOC was significantly greater for supramaximal intermittent exercise compared with the supramaximal continuous exercise when the amounts of work output performed are same. Therefore, our results indicate that exercise intensity may be a primary factor of 3-h EPOC even in a supramaximal exercise and that one of mechanisms for the 3-h EPOC would be related to the promoted lipid metabolism.

Bub-KAO tablet (50g) consisting of equimolar bicarbonate salt and succinate made it possible to use easily CO₂ bath at home. Since the obtained CO₂ concentration was not so high, we studied the circulatory effects of usual concentration of Bub-KAO bath in normal and hypertensive men.
Seven Bub-KAO tablets (KAO Co., Tokyo, Japan) were put into 350 l of 41°C simple hot spring bath (CO₂ conc. ≈300ppm). Eight normotensive subjects (32.2±4.2yrs) and 13 hypertensive patients (67.8±11.3yrs) took this artificial CO₂ bath for 10min. As a control, 12 normotensives (38.1±8.8yrs) and 12 hypertensives (51.0±8.2yrs) were immersed in 41°C simple hot spring bath for 10min. Hemodynamic functions and blood gas were followed before and after bathing for 30min in the supine position.
In normotensives, blood pressure (BP) was unchanged either by Bub-KAO or simple bath. The increase in heart rate (HR) and cardiac output (CO) and the decrease in total peripheral resistance (TPRi) after Bub-KAO bath were slightly but significantly greater than those of simple bath. In hypertensives, BP was significantly decrased after Bub-KAO bath (-17.2±6.4/-6.8±2.1mmHg) compared to simple bath. Although the increase in HR and CO (+0.55±0.22l/min) after Bub-KAO bath were not so remarkable, decrease in TPRi (-9.3±3.6 unit) was significantly greater than simple bath. Venous blood obtained 10min after Bub-KAO bath became fresh red showing a significant increase in pO₂ and pH (alkalosis) and significant decrease in pCO₂. In arterial blood, although pO₂ was unchanged, slight decrease in pCO₂ and increase in pH were also observed.
These results indicated that artificial CO₂ bath made by usual amounts of Bub-KAO tablets significantly reduced BP of the hypertensives due to vasodilating effect. Vasodilation by CO₂ bath was considered to be derived from the peripheral action of CO₂ as blood pCO₂ was rather reduced. As a basic mechanism of vasodilation by CO₂, we proposed the inhibitory effect on tissue enerqy metabolism of CO₂ as a product inhibtor of TCA cycle and subsequently, the onset of vascular autoregulation mechanism.

Three essential factors of the sympathetic nervous functions, sympathetic nervous tone (β-, α-secretion), adrenoceptor sensitivity (β-, α-sensitivity) and adrenergic manifestations, were assessed integratedly by the sequential administration of specific adrenoceptor agonists and blockers. The examination procedures were designed to provide all parameters under the blockade of the autonomic regulation without affecting the basic sympathetic nervous functions.
Decrease in β- and α-secretion associated with the increase in β- and α-sensitivity in patients with diabetic neuropathy, idiopathic orthostatic hypotension and cervical radiation myelopathy were exactly compatible with the autonomic dysfunctions of them and convinced the validity of the methods. Synchronized firings of the sympathetic nerves of the cardiovascular system and harmonized regulation of the adrenoceptor sensitivity were shown by the positive correlations between β- and α-secretion and between β- and α-sensitivity, respectively. Negative correlations between “secretion” and “sensitivity” over wide ranges of these parameters suggested that the concept of denervation hypersensitivity was not specific for patients with organic autonomic neuropathies but was commonly avairable for usual subjects in proportion to the sympathetic nervous tone of the individual subject.

The effects of single bathing of the artificial mineral spring (Basukurin: Tsumura Juntendo Inc. Japan), equivalent mixture of sodium sulfate and sodium bicarbonate, were studied in 13 normal and 22 hypertensive subjects comparing with natural simple hot spring (Kirisima spa).
Blood pressure (BP: automatic sphygmomanometer), heart rate (HR), cardiac output (CO: earpiece type dye-dilution densisometer), total peripheral resistance (TPR: mean BP/cardiac index), forehead deep body temperature (DBT: Core Temp CTM 204) plasma renin activity (PRA: RIA by Habar's method), plasma norepinephrine (NE) and blood gas partial pressure (pO₂ and pCO₂) and pH were measured before and after bathing. Mineral concentration of simple hot spring and Basukurin bath (120g powder/360l simple hot spring) were 0.019% and 0.052%, respectively. The temperature and duration of bathing were both 41°C for 10min.
In normotensives, only systolic BP and TPR were significantly decreased 30min after the simple and Basukurin bathing by the same degree. HR was significantly increased throughout 30min after both bathing. CO was increased only after 10min of Basuku rin bathing. In hypertensives, systolic and diastolic BP and TPR were significantly decreased throughout 30min after simple and Basukurin bathing. The decrement in BP and TPR, however were significantly greater in Basukurin bathing. HR and CO were significantly increased after both bathing. Forehead DBT was significantly elevated after both bathing and gradually decreased throughout 30min of observation. In Basukurin bathing, although the increment in DBT was greater than simple hot spring bathing, the decrease was slower than simple hot spring bathing suggsting the protection from heat radiation by Basukurin bathing. PRA and plasma NE concentration examined in hypertensive subjects after 30min of bathing were significantly elevated only in Basukurin bathing. Although arterial gas concentration and pH were not changed after bathing, venous blood pO₂ and pH were significantly increased and pCO₂ was significantly decreased after 10min of Basukurin bathing.
These data indicates that single Basukurin bathing has more potent hypotensive effect due to vasodilation than simple hot spring. Enhanced vasodilation by Basukurin bathing is probably derived from the protection of heat radiation from the skin by the formtion of thin mineral film on the skin. Increased venous blood pO₂ and pH and decreased pCO₂ represents also the improvement of peripheral circulation assisted by vasodilation and elevated CO.

Chronic disseminated intravascular coagulation (DIC) complicates 5.7% of thoracic aortic aneurysm. DIC with thoracic aortic aneurysm is characterized by hyperfibrinolysis, but usually shows a stable condition in a state of compensated non-overt DIC with limited hemorrhagic symptoms. However, in some cases, hemorrhage caused by external factors may induce uncompensated overt DIC and lead to serious hemorrhagic tendencies. In the present study, we report a patient with a thoracic aortic aneurysm complicated by DIC who exhibited marked hemorrhagic tendencies. DIC remarkably improved following administration of recombinant human soluble thrombomodulin.

A rare case of secundum type atrial septal defect associated with cleft of the anterior mitral leaflet in 63-year-old man is reported. The electrocardiogram showed right bandle branch block and indeterminate QRS axis. Preoperative cardiac catheterization revealed left to right shunt at the atrial level and moderate mitral regurgitation due to a cleft in the anterior mitral leaflet. Marked tricuspid regurgitation due to a dilated annulus concomitantly existed. The valve deficiencies were repaired and the atrial septal defect was closed at operation. Forty cases of secundum type atrial septal defect associated with cleft mitral valve were discussed about their electrocardiograms and operative indications.

Objective: To examine the potent of water as a solvent agent in the preparation of traditional herbal medicine.
Methods: Water extracts of 18 plants were prepared through reflux and examined (25 mg/mL) to evaluate their possibility for inhibiting protein tyrosine phosphatase 1B (PTP1B). The determination of IC50 values was performed for the samples possessing more than 80% inhibition. Meanwhile, those exhibiting IC50 values more than 7.0 mg/mL were further profiled for their chemical constituents through nuclear magnetic resonance (NMR) measurement.
Results: About 44% (8) of the examined samples showed more than 80% inhibition against PTP1B. The water extracts of Elephantopus scaber, Helicteres isora aerial parts, Elaeocarpus grandiflorus (E. grandiflorus) fruits, Melaleuca leucadendron leaves, and Quercus infectoria gum had IC50 values ranging from 2.05 to 6.90 mg/mL. Meanwhile, Andropogon nardus and Centella asiatica were at the area of d 3.0–4.0 ppm. Further, the 13C NMR observation of samples possessing the most intensive signals in their proton NMR Cinnamomum burmannii and E. grandiflorus showed the peaks at the area of d 60–90 ppm as the supportive evidence for sugar group signals. Intriguingly, a disaccharide from E. grandiflorus could be an active inhibitor towards PTB1B.
Conclusions: In contrast to the mainstream solvents currently used in modern herbal manufactures especially Jamu medicine in Indonesia, pure-water-extracted materials should be reconsidered and could be reemerged for future studies and for the manufacture of herbal medicines. In addition, the activity of Jamu components should be confirmed that their antidiabetes and antiobesity activities could be through the inhibition of PTP1B.

We report a case of a caseous calcification lesion originating from a calcified anterior mitral annulus. A 59-year-old woman on chronic hemodialysis was referred to our hospital due to an elevated brain natriuretic peptide value. Transthoracic echocardiography demonstrated moderate aortic valve stenosis with regurgitation and a pendulous mass in the left ventricular outflow tract, and therefore we perfomed. The patient underwent resection of the mass with aortic valve replacement. Pathological examination of the mass revealed interstitial calcium deposits but without tumors or inflammatory cells. We speculated that the cardiac mass was caseous calcification which originated from a severely calcified mitral annulus based on its echocardiographic and pathological features.

Objective : To evaluate the reliability and the validity of the Japanese version of the Spinal Cord Independence Measure (SCIM) in patients with cervical spinal cord injury. Design : Cross-sectional, observational study. Setting : Rehabilitation ward for spinal cord injury in Japan. Patients and Methods : 26 inpatients with traumatic and non-traumatic cervical spinal cord injury, with an average age of 60.3, were included to examine the internal consistency of the subscales (subscores in each domain) and the whole scale, and to determine concurrent validity of the SCIM and the Functional Independence Measure (FIM) motor subscores. To examine interrater reliability, 12 of these patients were assessed by 2 physiatrists independently and intraclass correlation coefficients (ICC) for total scores and weighted kappas for individual item scores were calculated. Results : The ICC for total SCIM score was 0.99, and the weighted kappas for individual item scores showed moderate to strong agreement (kappa=0.54-1.00). The Cronbach's alpha coefficients for domain subscores and total score were above 0.71, demonstrating appropriate internal consistency of the SCIM. The total SCIM scores significantly correlated with the FIM motor subscores (Spearman's rho=0.95), however, there were some variations with the SCIM scores in patients who were rated as 6 (modified independence) with the FIM in such items as bladder management and indoor mobility. Conclusion : The results supported the internal consistency, interrater reliability and concurrent validity of the SCIM in patients with cervical spinal cord injury. The SCIM may be a potential measure to evaluate certain functional aspects that cannot be assessed by the FIM alone.