The purpose of this study was to investigate the kinetics of Vco₂during incremental exercise. The subjects were 7 males, age 21-28 years, exercised at two steady state work loads (540 kpm/min, 810 kpm/min) and incremental work load which was increased stepwise by every 1 min from 180 kpm/min to exhaustion. The Vo₂and Vco₂during steady state exercise (4 to 5 min) were determined by the Douglas bag method and arterialized blood samples were taken for lactate (LA) analysis and blood gas analysis. The Vo₂, Vco₂, and blood lactate were also determined throughout the incremental exercise. At exhaustion, mixed venous Pco₂ (PVco₂) was determined by the CO₂rebreathing method.
1) The Vco₂values at rest and during steady state exercise were linearly related to the Vo₂values. When the regression line was compared with Vco₂during the incremental exercise on the same Vo₂, the Vco₂during the incremental exercise below the anaerobic threshold showed lower values.
2) The total sum of the difference in Vco₂between steady state and incremental exercise was defined as CO₂store. The calculated CO₂store and CO₂store per body weight were significantly related to PVco₂at exhaustion in incremental exercise, respectively (r=0.954, r=0.954) .
3) At work load below the anaerobic threshold, Vco₂was linearly related to Vo₂. If the Vco₂above the anaerobic threshold is estimated from Vo₂using the regression line obtained at work load below the anaerobic threshold, the estimated Vco₂will be lower than the measured Vco₂. The total sum of the difference in the Vco₂was defined as CO₂excess. The CO₂excess and the CO₂excess per body weight were significantly related to ΔLAmax (the difference between LA at 3rd min after exhastion and LA at exercise below the anaerobic threshold), respectively (r=0.870, r=0.930) .
4) HCO₃^-calculated from blood gases (pH and Pco₂) was significantly related to LA (r=-0.902) . The increase of 1 mM/1 in LA was corresponding to the decrease of 0.843 mEq/l in HCO₃^-.
5) From these results, it appeared that the expired Vco₂during the incremental exercise consisted of the stored Vco₂, the exceeded Vco₂, and the produced Vco₂ (Vco₂metabolically produced from Vo₂) .

Allergic bronchopulmonary mycosis (ABPM) develops mainly in patients with asthma or cystic fibrosis via types I and III hypersensitivity reactions to filamentous fungi. Aspergillus spp., especially Aspergillus fumigatus, is the major causative fungus because of its small conidia, thermophilic hyphae, and ability to secrete serine proteases. The cardinal histological feature of ABPM is allergic (eosinophilic) mucin-harboring hyphae in the bronchi, for which the formation of extracellular DNA trap cell death (ETosis) of eosinophils induced by viable fungi is essential. Clinically, ABPM is characterized by peripheral blood eosinophilia, increased IgE levels in the serum, IgE and IgG antibodies specific for fungi, and characteristic radiographic findings; however, there are substantial differences in the clinical features of this disease between East and South Asian populations. Systemic corticosteroids and/or antifungal drugs effectively control acute diseases, but recurrences are quite common, and development of novel treatments are warranted to avoid adverse effects and emergence of drug-resistance due to prolonged treatment with corticosteroids and/or antifungal drugs.
Acute Disease ; Adrenal Cortex Hormones ; Antibodies ; Asian Continental Ancestry Group ; Aspergillus ; Aspergillus fumigatus ; Asthma ; Bronchi ; Cell Death ; Cystic Fibrosis ; Diagnosis ; Eosinophilia ; Eosinophils ; Extracellular Traps ; Fungi ; Humans ; Hypersensitivity ; Hyphae ; Immunoglobulin E ; Immunoglobulin G ; Invasive Pulmonary Aspergillosis ; Recurrence ; Serine Proteases ; Spores, Fungal

The purpose of this study was to investigate the changes of blood components of middle and old aged runners in marathon running. The results were as follows.
1) Mean running time of marathon was 250 min. Some of subjects did last spurt.
2) Change of body weight was -4.8%. RBC, Hct, and Hb were changed by -4.8%, -4.4%, and -4.7% respectively. The decrease of plasma volume was 7.8% according to Dill's method.
3) Blood glucose was 112 mg/dl at rest and decreased to 70 mg/dl after running. The glucose level of five subjects was in range from 59 to 50 mg/dl.
4) The increase of L.A. was 52%. The L.A. after running tended to correlate to the running speed at last spurt.
5) T.G. significantly decreased after running. On the contrast, FFA increased by 323%. This increment of FFA correlated to mean running speed (r=0.681, P<0.05) .
6) The increments of GOT, GPT, and LDH were 71%, 62%, and 61% respectively, The decreases of LDH-1, 2 and increases of LDH-4, 5 were found after running. Furthermore, AGOT and 4GPT correlated to the running speed at last spurt or L.A. after running.

PURPOSE: To prevent low bone mineral density (BMD), that is, osteoporosis, in postmenopausal women, it is essential to diagnose osteoporosis more precisely. This study presented an automatic approach utilizing a histogram-based automatic clustering (HAC) algorithm with a support vector machine (SVM) to analyse dental panoramic radiographs (DPRs) and thus improve diagnostic accuracy by identifying postmenopausal women with low BMD or osteoporosis. MATERIALS AND METHODS: We integrated our newly-proposed histogram-based automatic clustering (HAC) algorithm with our previously-designed computer-aided diagnosis system. The extracted moment-based features (mean, variance, skewness, and kurtosis) of the mandibular cortical width for the radial basis function (RBF) SVM classifier were employed. We also compared the diagnostic efficacy of the SVM model with the back propagation (BP) neural network model. In this study, DPRs and BMD measurements of 100 postmenopausal women patients (aged >50 years), with no previous record of osteoporosis, were randomly selected for inclusion. RESULTS: The accuracy, sensitivity, and specificity of the BMD measurements using our HAC-SVM model to identify women with low BMD were 93.0% (88.0%-98.0%), 95.8% (91.9%-99.7%) and 86.6% (79.9%-93.3%), respectively, at the lumbar spine; and 89.0% (82.9%-95.1%), 96.0% (92.2%-99.8%) and 84.0% (76.8%-91.2%), respectively, at the femoral neck. CONCLUSION: Our experimental results predict that the proposed HAC-SVM model combination applied on DPRs could be useful to assist dentists in early diagnosis and help to reduce the morbidity and mortality associated with low BMD and osteoporosis.
Bone Density ; Dentists ; Diagnosis, Computer-Assisted ; Early Diagnosis ; Female ; Humans ; Mandible ; Neural Networks (Computer) ; Osteoporosis ; Radiography, Panoramic ; Sensitivity and Specificity ; Support Vector Machine

High-dose methotrexate-based chemotherapy has extended survival in patients with primary central nervous system lymphoma (PCNSL). However, although salvage treatment is necessary in recurrent and refractory PCNSL, this has not been standardized. We herein describe the efficacy of a combination of rituximab and temozolomide (TMZ) in two consecutive patients with recurrent and refractory PCNSL. Based on the immunohistochemical study, case 1 had a non-germinal center B-cell-like (non-GCB) subtype, was positive for bcl-2 and negative for O6-methylguanine-DNA methyltransferase (MGMT). Case 2 was GCB subtype, bcl-2-, and MGMT+. Because of the positive expression of MGMT, interferon-beta was additionally given in case 2. Complete responses and partial responses were obtained after the third and fourth cycles of combination therapy, respectively. This was maintained for 12 months, with acceptable toxicity. The combination of rituximab and TMZ was effective in tumors with different immunohistochemical profiles. This combination therapy warrants further study in a larger population.
Aged ; Antibodies, Monoclonal, Murine-Derived/*therapeutic use ; Antineoplastic Agents/*therapeutic use ; Central Nervous System Neoplasms/*drug therapy ; Dacarbazine/*analogs & derivatives/therapeutic use ; Drug Therapy, Combination/*methods ; Humans ; Lymphoma/*drug therapy ; Male ; Middle Aged ; Neoplasm Recurrence, Local/drug therapy

Objectives: This review aims to introduce preoperative scoring systems to predict lymph node metastasis (LNM) and ongoing clinical trials to investigate the therapeutic role of lymphadenectomy for endometrial cancer. Methods: We summarized previous reports on the preoperative prediction models for LNM and evaluated their validity to omit lymphadenectomy in our recent cohorts. Next, we compared characteristics of two ongoing lymphadenectomy trials (JCOG1412, ECLAT) to examine the survival benefit of lymphadenectomy in endometrial cancer, and described the details of JCOG1412. Results: Lymphadenectomy has been omitted for 64 endometrial cancer patients who met lowrisk criteria to omit lymphadenectomy using our scoring system (LNM score) and no lymphatic failure has been observed. Other two models also produced comparable results. Two randomized phase III trials to evaluate survival benefit of lymphadenectomy are ongoing for endometrial cancer. JCOG1412 compares pelvic lymphadenectomy alone with pelvic and para-aortic lymphadenectomy to evaluate the therapeutic role of para-aortic lymphadenectomy for patients at risk of LNM. For quality assurance of lymphadenectomy, we defined several regulations, including lower limit of the number of resected nodes, and submission of photos of dissected area to evaluate thoroughness of lymphadenectomy in the protocol. The latest monitoring report showed that the quality of lymphadenectomy has been well-controlled in JCOG1412. Conclusion Our strategy seems reasonable to omit lymphadenectomy and could be generalized in clinical practice. JCOG1412 is a high-quality lymphadenectomy trial in terms of the quality of surgical procedures, which would draw the bona-fide conclusions regarding the therapeutic role of lymphadenectomy for endometrial cancer.