The purpose of the present investigation was to examine the relationship between the open water swimming (OW) performance and the swimming speed at 2, 3, and 4 mmol/l of blood lactate concentration (SSLA2, SSLA3, and SSLA4) or the critical swimming speed (CSS). Six male collegiate swimmers performed the 10 kilometers of OW, as well as the multi-stage graded swimming test, in order to determine the SSLA2, SSLA3, SSLA4. Furthermore, the CSS was calculated based on the personal best records for 50 to 1500 meters of free-style indoor swimming. As a result, the SSLA2, SSLA3, SSLA4, and CSS corresponded to 102±6%, 106±6%, 110±7%, and 106±5% of the average swimming speed of the OW, respectively. Thereafter, the SSLA2 did not differ significantly in comparison to the average swimming speed of the OW, whereas the SSLA3, SSLA4, and CSS differed significantly with the average swimming speed of the OW (p＜0.05). Furthermore, the average swimming speed during the OW significantly correlated with the SSLA2, SSLA3, SSLA4, and CSS, respectively (p＜0.05). These results suggest that the OW performance significantly correlated with the swimming speed at 2 to 3 mmol/l of the blood lactate concentrations and CSS. Furthermore, regarding these parameters, the SSLA2 may accurately reflect the average swimming speed of OW.

Objective: The use of generic drugs is promoted for the purpose of reductions of medical costs and patient’s copayment.  In general, it is thought that clinical effects of the original brand and the generic drugs are equal if they are bioequivalent.  However, it is necessary to inspect their therapeutic equivalence to use the generic drugs securely.  We, therefore, assessed the therapeutic equivalence and pharmacoeconomics by substitution of an original drug (Amaryl®) with a generic drug (Glimepiride [Tanabe]).
Methods: Therapeutic Equivalence: The total variation was calculated by using the HbA1c levels before it switched from Amaryl® to Glimepiride [Tanabe].  The tolerance limits were set as 1/4 of the total variation.  Pharmacoeconomics: The difference of drug prices and the difference of patient’s copayment were calculated.
Results: As the variation of HbA1c levels was within tolerance limits before and after switching from Amaryl® to Glimepiride [Tanabe], we evaluated that their therapeutic effect was equivalent.  The difference of drug prices after switching from the original to the generic one was 4,582.6 yen/year on average (minimum: 949.0 yen, maximum: 12,045.0 yen); the difference of patient’s copayment was 872.5 yen/year on average (minimum: 0 yen, maximum: 3,613.5 yen).  These data show that the use of the generic drugs is effective to reduce medical costs.
Conclusion: For further promoting the use of the generic drugs, we consider it essential to compare the therapeutic equivalence and the safety of the original and the generic drugs in clinical practice.

Objectives: As the population ages worldwide, including in Japan, there is a growing expectation for older adults to remain active participants in society. The act of sharing one’s experiences and knowledge with younger generations through social engagement not onlyenriches the lives of older individuals, but also holds significant value for our society. In thisstudy, we examined both positive and negative perceptions of older adults and investigated the correlation between these perceptions and generativity among older citizens. Additionally, we evaluated the impact of life satisfaction on these factors. Methods: We conducted a survey of 100 older adults in Japan (mean age, 71.68 years) and utilized multiple regression analyses, using positive and negative perceptions of older adults, life satisfaction, and demographic factors as independent variables. The sub-categories of generativity—namely, generative action, concern, and accomplishment—were used as dependent variables. Results: Participants who held a more positive perception of older adults demonstrated a higher level of generative actions and concerns. Additionally, participants who reported higher levels of life satisfaction also exhibited more generative actions, concerns, and accomplishments. Conversely, those who held a more negative perception of older adults were found to have higher levels of generative actions. Conclusion Enhancing positive perceptions of older adults among them can boost the subcategories of generativity. This study, which was conducted from an exploratory perspective, has several limitations, including a potential sampling bias. A more comprehensive examination of the relationship between perceptions of older adults and generativity is anticipated in future research.

It is well known that eccentric exercise induces muscle damage that is characterized by a prolonged decrease in muscle strength and range of motion, development of delayed onset muscle soreness, and swelling. Therefore, the present study aimed to compare the acute effects of hold-relax stretching (HRS) with those of static stretching (SS) on muscle strength and soreness. The participants comprised 28 male volunteers randomly assigned to either the HRS group (N = 14) or the SS group (N = 14). Initially, the participants of both groups performed 60 maximal eccentric contractions of the knee extensors. Two and four days after this exercise, each group performed either HRS or SS for 60 s at a time and repeated them six times for a total of 360 s. Muscle strength and soreness during stretching and contraction were measured before and immediately after HRS and SS. The results showed that the muscle soreness observed after eccentric contraction significantly decreased immediately after both HRS and SS were performed two and four days later. In addition, there were no significant changes in muscle strength immediately after both HRS and SS were performed two and four days later. The rate of change in muscle soreness after HRS was significantly higher than that after SS two days post eccentric contractions. These results suggest that while both HRS and SS can effectively decrease muscle soreness, the effect of HRS on muscle soreness was larger than the effect of SS.

Background/Aims: The aim of this study was to evaluate the safety of sedation with propofol as an alternative to benzodiazepine drugs in outpatient endoscopy. Methods: In this prospective study, examinees who underwent outpatient endoscopy under propofol sedation and submitted a nextday questionnaire with providing informed consent were evaluated. Periprocedural acute responses, late adverse events within 24 hours, and examinee satisfaction were evaluated. Results: Among the 4,122 patients who received propofol in the 17,978 outpatient-based endoscopic examinations performed between November 2016 and March 2018, 2,305 eligible examinees (esophagogastroduodenoscopy for 1,340, endoscopic ultrasonography for 945, and total colonoscopy for 20) were enrolled, and their responses to a questionnaire were analyzed. The mean propofol dose was 69.6±24.4 mg (range, 20–200 mg). Diazepam, midazolam, and/or pentazocine in combination with propofol was administered to 146 examinees. Mild oxygen desaturation was observed in 59 examinees (2.6%); and mild bradycardia, in 2 (0.09%). Other severe reactions or late events did not occur. After eliminating 181 invalid responses, 97.7% (2,065/2,124) of the patients desired propofol sedation in future examinations. Conclusions Propofol sedation was found to be safe—without severe adverse events or accidents—for outpatient endoscopy on the basis of the patients’ next-day self-evaluation. Given the high satisfaction level, propofol sedation might be an ideal tool for painless endoscopic screening.

Resistance training is a treatment for muscle weakness and muscle atrophy. Although previous studies reported that muscle strength increased via changes in neural adaptation after low-intensity resistance training with skin cooling (SC), the effects of the training on both muscle strength and muscle thickness were unclear. Therefore, this study investigated the effect of low-intensity training of the triceps brachii with SC on muscle strength and muscle thickness. Volunteers were 12 healthy men, with one arm randomly assigned to SC and the other to control groups. Elbow extension exercises were performed for 8 weeks, and 1 repetition maximum (RM) and muscle thickness of triceps brachii were measured before and after training. Resistance exercise was performed thrice a week using a dumbbell adjusted to 50％ of 1 RM for both the groups. The SC side used an ice bag secured to the triceps brachii during training. There were no significant interaction effects of 1 RM and muscle thickness of triceps brachii；however, both variables significantly increased after training in both the SC and control groups. Muscle strength and muscle thickness increased after the 8-week training program with SC. No significant differences were observed between the groups.

Background/Aims: The aim of this study was to evaluate the safety of sedation with propofol as an alternative to benzodiazepine drugs in outpatient endoscopy. Methods: In this prospective study, examinees who underwent outpatient endoscopy under propofol sedation and submitted a nextday questionnaire with providing informed consent were evaluated. Periprocedural acute responses, late adverse events within 24 hours, and examinee satisfaction were evaluated. Results: Among the 4,122 patients who received propofol in the 17,978 outpatient-based endoscopic examinations performed between November 2016 and March 2018, 2,305 eligible examinees (esophagogastroduodenoscopy for 1,340, endoscopic ultrasonography for 945, and total colonoscopy for 20) were enrolled, and their responses to a questionnaire were analyzed. The mean propofol dose was 69.6±24.4 mg (range, 20–200 mg). Diazepam, midazolam, and/or pentazocine in combination with propofol was administered to 146 examinees. Mild oxygen desaturation was observed in 59 examinees (2.6%); and mild bradycardia, in 2 (0.09%). Other severe reactions or late events did not occur. After eliminating 181 invalid responses, 97.7% (2,065/2,124) of the patients desired propofol sedation in future examinations. Conclusions Propofol sedation was found to be safe—without severe adverse events or accidents—for outpatient endoscopy on the basis of the patients’ next-day self-evaluation. Given the high satisfaction level, propofol sedation might be an ideal tool for painless endoscopic screening.

Resistance training is a treatment for muscle weakness and muscle atrophy. Although previous studies reported that muscle strength increased via changes in neural adaptation after low-intensity resistance training with skin cooling (SC), the effects of the training on both muscle strength and muscle thickness were unclear. Therefore, this study investigated the effect of low-intensity training of the triceps brachii with SC on muscle strength and muscle thickness. Volunteers were 12 healthy men, with one arm randomly assigned to SC and the other to control groups. Elbow extension exercises were performed for 8 weeks, and 1 repetition maximum (RM) and muscle thickness of triceps brachii were measured before and after training. Resistance exercise was performed thrice a week using a dumbbell adjusted to 50％ of 1 RM for both the groups. The SC side used an ice bag secured to the triceps brachii during training. There were no significant interaction effects of 1 RM and muscle thickness of triceps brachii；however, both variables significantly increased after training in both the SC and control groups. Muscle strength and muscle thickness increased after the 8-week training program with SC. No significant differences were observed between the groups.