Single-stage treadmill exercise testing (7° inclination, at 50 m/min for 5 min) was performed in 143 hospitalized patients (aged 32-90 years, mean 64 years ; 78 males and 65 females) who required non-cardiopulmonary operations. Systolic blood pressure was recorded at rest and every 1 min during and immediately after exercise, together with pulse rate and ECG recordings. There was no difference in the systolic blood pressure response to exercise between the male and female patients aged 50 to 69 years, although the increase in pulse rate during exercise was greater in the female patients. Comparing the male patients aged 70 years or more with those aged less than 70 years, the increase in systolic blood pressure during and immediately after exercise was greater in the former than in the latter. Hypertensive patients showed a more exaggerated systolic blood pressure response to exercise than the normotensive patients, although the difference in systolic blood pressure at rest between the two groups was slight on the day of the exercise testing. The incidence of hypertensive episodes after surgery was significantly higher in patients whose systolic blood pressure during exercise had been more than 200mrHg (4/26) than in patients whose systolic blood pressure during exercise had been below 170 mmHg (0/41) . These results indicate that measurement of blood pressure during exercise testing is a useful means of predicting the blood pressure response under stress states in surgical patients.

Male rats of 80 weeks of age were divided into 2 groups, sedentary group (Group I, n-7) and exercise-trained group (Group II, n=8) . Rats in Group II were conditioned by a 4-weeks treadmill running program. These two groups and another group of male sedentary rats of 20 weeks of age (Group III, n-9) were all subjected to a Wiggers type hemorrhagic shock (mean arterial pressure of 30 torr. for 60 min.) . Pulse rate and pulse pressure during the shock experiment, acid-base balance indices and blood gas before and after the shock period, and survival rate within 7 days after the shock experiment were compared between the three groups.
Animals in Group I showed remarkably decreased pulse pressure during the shock period. Metabolic acidosis after the shock period in Group I was remarkable, resulting in a significantly higher mortality compared with Group III. In Group II, pulse pressure during the shock period was higher than in Group I. Metabolic acidosis after the shock period in Group II was less marked than in Group I, and mortality tended to be lowered in Group II.
These results indicated that physical training induced resistance to hemorrhagic shock in aged rats. One of the mediating mechanisms in this cross-adaptation between exercise and hemorrhagic shock may be changes in oxygen transport system.

Eleven hospitalized patients (mean age of 53 years) who suffered from hepatic cirrhosis with esophageal (or gastric) varices were brought to a physical training program. The program consisted of voluntary walking, stair climbing and exercise on a treadmill or on a bicycle ergometer, lasting for 14 days-3 months.
All of the 11 patients acquired general well-being after the training program. Six of them who received an exercise testing showed improved physical fitness after the training program as proved by the reduced pulse rate during exercise or increased tolerance to an exercise load. Some of the patients showed slightly or moderately increased values in hepatic function tests, however, none of them showed physical signs indicating aggravation of the disease. Among 6 patients with so-called hepatogenic diabetes mellitus, amount of insulin required was reduced in 4 patients and glucose output in urine was reduced in all of the 6 patients after the training program, indicating an improved glucose metabolism in those patients. All of the patients, including 6 patients who underwent surgical treatment for varices, were discharged from the hospital in good performance status.
These results indicated that patients with hepatic cirrhosis could safely undergo physical reconditioning which benefits the patients in terms of regaining physical fitness for surgical treatment or for social life.

Five type II diabetic patients (2 males and 3 females, 61-74 years of age) were immersed in cold-spring water (13°C) for 15min, twice or 3 times a day for consecutive 12 days at Kan-no-Jigoku spa in Japan.
In all of the patients, both systolic and diastolic blood pressures rose, and pulse rate increased during the acute cold exposure. This circulatory response to cold-water immersion tended to decrease after 12 days' serial immersions. After each immersion, blood glucose levels are lowered in all of the patients, suggesting the enhanced uptake of glucose by the tissue. After the 12 days' cure, 2 patients with relatively lower severity of diabetes showed improved glucose tolerance estimated by 50g oral glucose tolerance tests. No significant improvement of insulin secretion was observed in 25g intravenous glucose tolerance tests in the present study. Among 3 patients whose urinary output of glucose was measured daily, 2 patients showed gradually decreased urinary glucose and one showed almost no glucosuria throughout the 12 days' cure.
These results indicate that cold-water immersion stimulates the utilization of glucose as seen in exercise and that repeated cold-water immersions, if performed carefully, could be a regimen for diabetic patients.