Recently, there has been an increase in reports of allergic reactions to Kampo medicines. In order to elucidate the mechanisms of these so-called Kampo allergies, suitable methods are necessary to detect allergens in crude drugs and allergenspecific antibodies in sensitized individuals. In this study, methodology and sensitivity were studied using enzyme-linked immunosorbent assay and Western blot analysis. The antigens used were haptenized baicalin and high-molecular-weight components of Ginseng Radix, both derived from Shosaiko-to extract.
Attempts were also made to further identify antigens from Shosaiko-to and detect antigenspecific antibodies in immunized rabbits.

In search of reasons for regional differences in the death rate from stroke, an extensive factfinding project was carried out in Yamagata Prefecture. Out of the total 44 municipalities in the prefecture, we picked out four townships; two are noted for their high standard mortality rate from cerebrovascular disease and the other two have a low mortality from the disease. In these four townships, a thorough investigation was conducted on the incidence of stroke, along with health examination for cardiovascular disease. The findings are as follows;
1. Despite the fact that Yamagata Prefecture has a high rate of stroke, blood pressure levels stood on a par with, or even lower than, the national average.
2. There were no correlations between the standard mortality rates and blood pressure levels, ECG readings, funduscopic observations, and total serum cholesterol levels.
3. By occupation, white-collar workers showed higher values than blue-collar workers and farmers in diastolic blood pressure, obesity, and cholesterol levels in the blood serum. The occupational difference was observed in each and every one of the four townships.
4. The standard mortality rate and other fatality indices were not correlated with the incidence rate of stroke among the middle-aged and the rate of detection in the health examination for the conditions that might lead to stroke. Interesting to note is the fact that the incidence rate among the middle-aged was parallel with the detection rate. This finding suggests that further study of the incidence rate and the prevalence rate in necessary.

The purpose of the present study was to determine the change in total excess volume of CO₂output (CO₂excess) due to bicarbonate buffering of lactic acid produced during exercise and change in swimming performance following resistance training for 8 weeks in competitive swimmers. Ten healthy university competitive swimmers were assigned to either a resistance training and swimming training group (COMBINE: N=5) or a swimming training only group (SWIM: N=5) . Muscle mass was measured using magnetic resonance imaging (MRI) . CO₂excess and blood lactate concentration were measured during incremental exercise on a cycle ergometer and swimming performance was measured during competition. COMBINE showed a significantly higher percentage change in muscle mass (11.1±4.5%) than SWIM (3.5±2.5%) . The percentage change in CO₂excess, CO₂excess per body weight (CO₂excess/BW) and CO₂excess/BW per blood lactate accumulation (CO₂excess/BW/ΔLa) during exercise was significantly higher in COMBINE (107.3±60.1, 102.6±56.8, 59.1±37.7%, respectively) than in SWIM (42.5±10.0, 42.9±10.4, 13.4±22.4%, respectively) . The percentage change in swimming performance was significantly higher in COMBINE (2.2±1.8%) than in SWIM (-2.0±3.6%) . A negative correlation between percentage change of muscle mass and percentage change of CO₂excess/BW/ ΔLa (SWIM: r=-0.993, P<0.01, COMBINE: r=-0.744, P>0.05) was found. It was suggested that combined swim and resistance training resulted in greater increases in the bicarbonate buffering system (CO₂excess/BW/ΔLa) . However, increases in muscle mass may have subsequently caused a relative decrease in the contribution of the bicarbonate buffering system.

It is known that lactic anions and hydrogen ions (H⁺) produced during intense exercise are partly transported or diffused from muscle to blood resulting in the production of non-metabolic CO₂ through the bicarbonate buffering system. The purpose of the present study was to examine the reliability of the estimation of non-metabolic CO₂ output using respiratory gas analysis during incremental exercise. Six healthy subjects underwent an incremental pedaling exercise test accompanied by respiratory gas and arterial blood sampling. The rate of non-metabolic CO₂ output (VCO₂-NM) was calculated by subtracting projected metabolic VCO₂ from actual VCO₂ after CO₂ threshold (CT) . CT was determined using a modified V-Slope method. Bicarbonate (HCO₃^-), pH, CO₂ partial pressure and lactate concentration were measured from arterial blood samples using automatic analyzers. The kinetics of VCO₂-NM and HCO₂^- were compared throughout the exercise test. VCO₂-NM was significantly correlated with HCO₃^-decrease after CT (r=0.976, p<0.001) and the kinetics of VCO₂-NM and HCO₃^- decrease were similar during exercise. Furthermore, the amount of non-metabolic CO₂ output (NM-CO₂) calculated integrating VCO₂-NM above CT was significantly correlated with the difference in HCO₃^-between CT and exhaustion (r=0.929, p<0.01) and with the difference in arterial blood pH between rest and exhaustion (r=0.863, p<0.05) . However, NM-CO₂ was not significantly related to maximum ventilation (r=0.111, ns) . These results suggest that the estimation of non-metabolic CO₂ output during incremental exercise proposed in the present study is reliable. It was also suggested that the primary factor which influenced nonmetabolic CO₂ output during incremental exercise was the addition of H⁺ into blood and not hyperventilation.

The present study examined the effect of the long-term intake of chicken breast extract (CBEX), which contains carnosine and anserine, on carnosine content in skeletal muscles of humans and on short-period exercise performance with high intensity.
Before and after CBEX was orally given to 13 healthy male subjects for 30 days, pieces of their muscle (M. vastus lateralis) were excised and carnosine concentration in the muscle was measured. Before and after the test period, the subjects exercise performance (mean and peak power body weight) was determined by pedaling for 30 sec. On the basis of baseline concentrations of carnosine, the subjects were classified into two groups: low (n=8) and high (n=5) carnosine-baseline groups. In the former group, intake of CBEX increased carnosine concentration in the muscle (p<0.05), resulting in significant correlation between increased rate of carnosine concentration and mean power. These results suggest that exercise performance depends on carnosine concentration in the muscle, and that taking carnosine-containing foods may improve exercise performance.

A survey through general questionnaires was performed on those who visited the Hijiori, Yutagawa and Akakura hot springs in Yamagata Prefecture for thermalisme.
A total of 548 replies were obtained and they were analyzed in comparison with the survey results reported by Sugiyama et al. about 30 years ago.
Most of visitors were regular customers living in Yamagata Prefecture. Further, most of them, both men and women, were of age 60 or over. This fact was remarkably different from the investigation results of 30 years ago.
The degree of satisfaction among visitors as to the effectiveness of thermalisme was high among most of those who visited there to relieve pain but not so high among those who visited there for their health or for resting.

A study was conducted to evaluate the chronic effects of regular physical activity on nonspecific and specific immune responses. Male Fischer rats (SPF) exercised voluntarily on running wheels for 4 months, and were then injected intraperitoneally with sheep red blood cells (SRBC), followed by measurement of the host defense functions at -2 d, 3h, 24h and 4 d of antigen stimulation. The following results were obtained:
1) The ability of circulating neutrophils to produce superoxide measured by the spontaneous NBT test showed an earlier and higher (p<0.05) rise after SRBC injection in the exercise group, suggesting that neutrophils were activated in vivo more promptly against foreign-body invasion. This might reflect a priming response of neutrophils at the early phase of SRBC-induced host defense reactions modulated by the previous regular exercise.
2) The ability of neutrophils to produce superoxide in response to in vitro stimulation with Staphylococcus aureus 209 P was markedly reduced during inflammatory response in the sedentary group, whereas that in the exercise group was maintained at a constant level. The value at 4 d after SRBC injection in the sedentary group was decreased to more than 20% below the baseline (p<0.02) . In addition, a significantly (p<0.02) lower value than that in the exercise group was shown, although phagocytic activity was similar in the two groups. This suggested that neutrophil bactericidal activity was decreased in the sedentary group.
3) Plasma IgG levels in the exercise group were consistently and significantly (p<0.0001) higher by about 30% than those in the sedentary group, regardless of SRBC injection. This suggested an enhanced host defense status by regular exercise.
4) The specific humoral immune response to SRBC injection was assessed in terms of hemagglutination and plasma IgM levels, but no significant differences were shown between the groups.

This study aimed to evaluate dynamic balance capability, bathyesthesia, and the composite compensation of bathyesthesia and visual sense for dynamic balance assessed by use of force plates and to examine their correlation to age in a cross-sectorial manner. Participants of this study were 147 healthy people (55 men, 92 women). To evaluate dynamic balance capability, we evaluated the index of postural stability (IPS), which is the logarithmic value of the ratio of the area of stability limits to the area of postural sway, with participants standing on a hard surface with eyes opened. To measure bathyesthesia, we evaluated the modified index of postural stability (MIPS), i.e., the IPS with participants standing on a soft surface with eyes closed. As for the composite compensation index of bathyesthesia and visual sense for dynamic balance, we calculated the rubber IPS Romberg ratio (MIPS/IPS). The correlation coefficients (Spearman’s rho) of IPS, MIPS and MIPS/IPS to age were −0.666 (p < 0.001), −0.697 (p < 0.001) and −0.600 (p < 0.001), respectively. These results suggest that dynamic balance capability and bathyesthesia decline with advancing age, and the composite compensation of bathyesthesia and visual sense for dynamic balance strengthens with advancing age.

In the presence of Leriche syndrome, the lower extremities are perfused by collateral flow from internal mammary arteries. If an internal mammary artery graft is used in coronary artery surgery, an acute ischemic limb will develop postoperatively. A 52-year-old man was admitted to our department with bilateral claudication. Multidetector row computed tomography with contrast showed total occlusion of the infrarenal abdominal aorta and rich collateral flow to the lower extremities from internal mammary arteries. Cardiac angiography revealed three-vessel disease. Simultaneous coronary artery bypass grafting and an ascending aorto-bifemoral bypass were performed without cardiopulmonary bypass. Postoperative computed tomography angiography showed that grafts to the coronary and bifemoral arteries were patent. This combined procedure is useful for patients with coronary artery disease and aortoiliac occlusive disease. This procedure without cardiopulmonary bypass has not previously been reported.

Spinal cord injury is a dreaded and serious complication of operative procedures on the descending aorta. To avoid this serious complication, 53 patients underwent somatosensory evoked potential (SEP) monitoring during operations on the aorta which required cross-clamping of the descending aorta. 38 patients whose SEPs were kept normal during and after operations did not develop spinal cord injury. Among the 14 patients who developed both abnormal decrease in amplitude and elongation of peak latency, 13 lost their SEPs during aortic cross-clamping. Peripheral nerve ischemia seemed to be the cause of those abnormalities in 8 to whom cross-clamping was given to the abdominal aorta. Inadequate perfusion of the distal aorta was suspected in 6 to whom cross-clamping was given to the descending thoracic aorta. In these cases, however, SEP monitoring was not specific in differentiating spinal cord ischemia from peripheral nerve ischemia. Spinal cord injury was noted in only one of the 6 patients. The remaining one patient developed complete loss of SEP and spinal cord injury on the first postoperative day despite the well preserved SEP during the operation. Since this patient underwent flow reversal and thromboexclusion method for the dissecting aneurysm, gradual thrombotic occlusion of the important radicular arteries draining to spinal cord might have resulted delayed appearance of the spinal cord injury. In conclusion, SEP monitoring is the reliable method to detect the spinal cord ischemia which might be developed during cross-clamping of the descending aorta. However, this method bears limitation in its clinical application due to the following reasons. First, intraoperative SEP monitoring cannot predict delayed occurence of spinal cord injury. Secondly, this method cannot detect the qualitative extent of ischemia of spinal cord and the safe range of the cross-clamp time.