Competitive gymnasts are confronted with the problem of weight loss before a competition. They intend to decrease body fat, but not muscle. One of the most reasonable method for the purpose is a dieting. Neverthless, a dieting often leads to decrease not only body fat but also lean body weight (LBW) of which 47% is composed of muscle. That is, a dieting has the possibility of decreasing the competitive performance. The well-regulated diet is, therefore, required very much for weight loss of the gymnasts. The body composition (under-water weighing), physical working capacity (submaximal endurance capacity, muscle strength and vertical jump) and blood constituents of seven female gymnasts were measured before and after the 33 day-diet. They, ranging from 18 to 22 years of age, were high ranked athletes in Japan. The diet program was arranged by the dietitian taking gymnasts' favours into consideration. The averaged daily diet evaluated by means of a dietary recall had 1194 kcal with 54.7g of protein, 28.5g of fat and 179.9g of carbohydrate. On the other hand, the usual intakes just before the dieting were 1722 kcal in energy, 43.0g in protein, 57.1g in fat and 269.2g in carbohydrate. All the intakes of vitamins and minerals of the diet were higher than the Japanese recommended dietary allowance (RDA) . They practiced about four hours a day, six days a week, during the diet period. The daily energy expenditures before and at the last stage of the dieting were 2332 kcal and 2551 kcal on the average respectively, which were estimated through motion and time study. After the dieting body weight decreased significantly from 52.11kg to 48.35kg, of which difference was composed of 2.99kg of body fat and 0.77kg of LBW. The decrease of body fat was statistically significant, but LBW was not so. Concerning all the physical working capacities in oxygen uptake and heart rate, muscle strength except trunk extension strength, and vertical jump, there were no significant changes after the dieting. But respiratory exchange ratio (R) decreased significantly at the same work loads. This decrease suggested increased usage of stored body fat as energy during daily practice, and might support the significant decrease of body fat. Most of blood constituents were still in normal ranges in spite of significant changes. Marked change was found in serum FFA which increased three times after the dieting. This change also meant the increased usage of body fat after the dieting. These data indicated that the diet program arranged in this study proved successful and the wellregulated diet was very effective in conditioning the body composition and the physical working capacity of female gymnasts.

The present study examined the effects of having bigger amount of protein than usual in competitive season on lean body weight (LBW), cross-sectional area of thigh and abdomen, muscle strengths, blood constituents and urinary urea nitrogen. Seventeen male varsity throwers (javelin, discus, hammer and shot put) ranging from 19 to 22 years of age, were divided into two groups ; Group A (N=9) with a more protein diet (2.1 g·kg^-1·d^-1), and Group B (N=8) with a usual amount diet (1.5 g·kg^-1·d^-1) . The experimental period was 62 days. During this period, they practiced six days a week. Three days were for throwing practice. Other three days were for weight training. All subjects lived in the same dormitory, and their life styles were similar to each other. The averaged daily diet of Group A evaluated by means of a weighing method had 3824 kcal with 175 g of protein (2.0 g·kg^-1·d^-1), 115 g of fat and 552 g of carbohydrate. The averaged daily diet of Group B had 3441 kcal with 130 g of protein (1.5 g·kg^-1·d^-1), 76 g of fat and 559 g of carbohydrate. All the intakes of vitamins (A, B₁, B₂, C) and minerals (calcium and iron) of the diet of each group were higher than the Japanese recommended dietary allowance. After the period, body weight, %fat, fat and LBW of both groups did not change significantly. Muscle strengths and cross-sectional areas in abdomen and thigh of both groups did not change significantly. Urinary urea nitrogen of both groups did not change significantly. Blood constituents (RBC, Hb, Ht, TP, Alb, BUN) of each group were still in normal ranges in spite of significant changes. No significant changes in body composition and muscle strengths were found in each group. These results, therefore, indicated that the more protein diet (2.0 g·kg^-1·d^-1) was not effective for increasing LBW and muscle strength of varsity throwers in competitive season.

Objective: The present study investigated awareness and knowledge about clinical trials among pharmacists working in the Nagano Hokushin area as well as their contribution to the enlightenment of clinical trial.
Methods: A questionnaire survey of clinical trials was conducted to evaluate levels of interest, impressions, sources of information, and knowledge among hospital and community pharmacists.
Results: We received responses from 77 hospital and 67 community pharmacists.  The levels of interest in clinical trials were not significantly different between hospital and community pharmacists.  About impressions, hospital pharmacists thought that clinical trials were “a new development.”  Contrarily, community pharmacists thought that clinical trials were “a field that they were seldom concerned with.”  About sources of information, hospital pharmacists found that “study meetings” were the most informative.  More community pharmacists than hospital pharmacists chose “general reports, for example, newspapers and televisions” as a source of information, and similarly more community pharmacists indicated that they had “few opportunities for obtaining information about clinical trials.”  About knowledge, the percentage of correct answers about clinical trials between hospital and community pharmacists was not significantly different.  A higher percentage of community pharmacists than hospital pharmacists answered unknown.
Conclusion: Hospital and community pharmacists had different impressions and knowledge about clinical trials probably because of differences in sources of information and its access.  Henceforth, study meetings involving educational material about clinical trials should be held for discussing fundamental knowledge about the methods and structure of clinical trials and for discussing case studies wherein patients consult pharmacists about clinical trials.

Background/Aims: The frequency and details of nonalcoholic fatty liver disease (NAFLD) complications in patients with inflammatory bowel disease (IBD) remain unclear. This study aimed to clarify characteristics of NAFLD in patients with IBD. Methods: We retrospectively identified and enrolled patients with IBD diagnosed with or without NAFLD by undergoing abdominal computed tomography (CT) at our institution between 2005 and 2020. The primary endpoint was the complication rate of NAFLD in patients with IBD. Secondary endpoints were the clinical characteristics of nonobese patients with IBD and comorbid NAFLD and their association with nutritional and inflammatory parameters. Results: Twenty-one (21.9%) of 96 eligible patients with IBD also had NAFLD. In nonobese patients (defined as patients with a body mass index <25 kg/m2), C-reactive protein (CRP; P<0.001) and alanine aminotransferase (P=0.018) levels were higher and the albumin level (P=0.005) and prognostic nutritional index (PNI; P=0.002) values were lower in patients with NAFLD than in those without NAFLD. The PNI value was positively correlated (P<0.001) and the CRP level was negatively correlated (P=0.001) with the hepatosplenic ratio. However, in the NAFLD combined group, PNI (P<0.05) and CRP values (P<0.001) were improved over time after CT imaging by continuing IBD treatment. Conclusions Worsening nutritional and inflammatory status in IBD patients is associated with complications of NAFLD. Diagnosis of NAFLD in IBD patients using CT imaging might be useful not only for early detection of NAFLD but also in assessing the need for therapeutic intervention for IBD.

BACKGROUND/AIMS: Recent developments in analytical techniques including next-generation sequencing have clarified the correlation between intestinal microbiota and inflammatory bowel disease. Fecal microbiota transplantation (FMT) for patients with ulcerative colitis (UC) is proposed as a potential approach to resolving their dysbiosis; however, its safety and efficacy have not been confirmed. This single-arm, open-label, non-randomized study aimed to evaluate the safety and efficacy of FMT for Japanese patients with UC as the first registered clinical trial in Japan. METHODS: We enrolled 10 patients with active UC despite medical therapy. The donors were the patients' relatives and were carefully screened for infectious diseases. Fecal material was administered via colonoscopy, and the primary endpoint was the presence or absence of serious adverse events related to FMT. The secondary endpoint was a change in partial Mayo score at 12 weeks post-FMT. Scores ≤2 were considered a clinical response. Fecal samples were collected to follow changes in gut microbiota, while extracted complementary DNA were analyzed by a next-generation sequencer. We obtained written informed consent from all patients and donors. This study was approved by our Institutional Review Board and is registered in the University hospital Medical Information Network (UMIN) Clinical Trials Registry (UMIN 000012814). RESULTS: Five patients with moderate disease and five with severe disease were enrolled. No severe adverse effects were observed. One patient achieved clinical response; however, none of the patients' microbiota diversity recovered to the donor levels. CONCLUSIONS: The use of single FMT for UC was safe; however, we failed to show its clinical efficacy and potential to change the intestinal microbiota.
Asian Continental Ancestry Group* ; Colitis, Ulcerative* ; Colonoscopy ; Communicable Diseases ; DNA, Complementary ; Dysbiosis ; Ethics Committees, Research ; Fecal Microbiota Transplantation* ; Gastrointestinal Microbiome* ; Humans ; Inflammatory Bowel Diseases ; Information Services ; Informed Consent ; Japan ; Microbiota ; Tissue Donors ; Treatment Outcome ; Ulcer*

Fecal microbiota transplantation (FMT) has been reported as a safe and effective therapy in patients with refractory and recurrent Clostridium difficile infection (CDI). FMT has also been reported as a promising therapy in patients with ulcerative colitis (UC). Both, CDI and UC, are believed to be caused by dysbiosis, such as altered compositions or decreased diversity of the intestinal microbiota. This report describes a patient with UC in remission with a second recurrent episode of CDI, who was treated with FMT. A single FMT performed via colonoscopy completely resolved the patient's diarrhea and eradicated C. difficile bacteriologically without any severe complications. Molecular biological analysis of the patient's fecal microbiota showed that FMT could dramatically change the altered composition of intestinal microbiota and restore its diversity. Despite the restoration of the intestinal microbiota, FMT could not prevent a relapse of UC in this patient. However, it improved the intestinal symptoms of CDI and could prevent further recurrences of CDI.
Clostridium difficile ; Clostridium ; Colitis, Ulcerative ; Colonoscopy ; Diarrhea ; Dysbiosis ; Fecal Microbiota Transplantation ; Gastrointestinal Microbiome ; Humans ; Microbiota ; Recurrence ; Ulcer