The purpose of this study was to investigate sex differences in the muscle volume (MV) of the iliopsoas, psoas major, and iliacus muscles, normalized by fat free mass (FFM), in the elderly. The subjects were 15 males and 15 females 65 years of age or over. Serial transverse 1.5T magnetic images (10 mm slice) of each subject were taken between the 12^th thoracic vertebrae and the lesser trochanter. FFM was measured with a bioelectrical impedance analyzer. The mean MV of each muscle on the right and left sides were calculated and used for regression analysis of the relationship between MV and FFM.A significant correlation was observed between MV and FFM of the iliacus in both sexes (p<0.01), but not between the MV and FFM of the psoas major. MV normalized by FFM and cross-sectional area (CSA) normalized by FFM^2/3 showed significantly greater values for the psoas major in the males than in the females (p<0.001), but there was no sex difference in the MV or CSA normalized by FFM of the iliacus.These results suggest that elderly males tend to have a greater muscle volume and cross-sectional area of the iliopsoas than elderly females, and that these sex differences are attributable to differences in the psoas major.

Studies on the effects of heating as well as the mineral components of hot spring water have been conducted to investigate the effects of balneotherapy. However, few studies have been conducted on the effects of hydrostatic pressure and buoyancy during water immersion. Therefore, we investigated the effect of water immersion up to the neck at thermoneutral temperature on hemostatic activity.
Nine healthy men aged 22 to 34 were immersed up to the neck in the standing position in thermoneutral water (34.0±0.5°C) for two hours. The heart rate decreased immediately after starting water immersion and remained low during the immersion. Hematocrit values (Ht) of the blood samples taken from the ante-cubital vein decreased by 3.4% in average. The decrease in Ht was more prominent in the blood samples taken from the earlobe (4.0%), suggesting that hemodilution due to fluid shift was stronger in the upper part of the body. The time until euglobulin clot lysis shortened immediately after starting the immersion. Although fibrinolytic activity was enhanced, the concentration of tissue plasminogen activator (t-PA) antigen in the blood decreased gradually during the immersion and tended to return to the original level 30 minutes after immersion. A larger decrease in the concentration of plasminogen activator inhibitor-1 (PAI-1) antigen in the blood was observed immediately after starting the immersion, and it remained low for 30 minutes after immersion. An increase in fibrinolytic activity due to the decrease in PAI-1, not in t-PA, was observed during water immersion at thermoneutral temperature and the activation of fibrinolytic system without activation of the coaguration system was also observed.

To compare the effectiveness of five different muscle training movements on the biceps brachii, latissimus dorsi and trapezius muscles, eight weight-trained men (age, 20.4±0.5 years) were asked to perform three repetitions, at 70% one repetition maximum, of upright rowing (UR) and bent-over rowing (BR) exercises using a barbell ; and seated rowing (SR), front lat pull-down (LPf) and back lat pull-down (LPb) exercises using a Universal Machine. The activities of the biceps brachii, latissimus dorsi, and trapezius during the elbow flexsion and elbow extension phases of each exercise were analyzed using integrated electromyography (EMG) and normalized I-EMG. The results were as follows :1. The mean nrmsEMG values for the biceps brachii were larger during UR and LPf exercises than during BR, SR, and LPb exercises, suggesting that UR and LPf are more effective than the other movements for training the biceps brachii. The mean nrmsEMG values for the latissimus dorsi were larger during SR, LPf, and LPb exercises, followed by BR and UR exercises (in descending order), suggesting that SR, LPf, and LPb exercises are more effective than the other movements for training the latissimus dorsi.2. The mean nrmsEMG values for the upper trapezius were larger during UR and BR exercises than during SR, LPf, and LPb exercises, suggesting that UR and BR exercises are more effective than the other movements for training the upper trapezius. The mean nrmsEMG values for the middle trapezius were larger during BR and SR exercises than during UR, LPf, and LPb exercises, suggesting that BR and SR exercises are more effective than the other movements for training the middle trapezius. The mean nrmsEMG values for the lower trapezius were larger during BR exercise than during other movements, suggesting that BR exercise is more effective than the other movements for training the lower trapezius.3. In all the exercises, each muscle showed a higher nrmsEMG value during the elbow flexsion phase than during the elbow extension phase. This observation suggests that the training method examined in this study should emphasize the elbow flexsion movement.The present results suggest that UR exercise is the most effective movement for training the biceps brachii and upper trapezius, BR is most effective for training the upper trapezius, middle trapezius and lower trapezius, SR is most effective for training the latissimus dorsi and middle trapezius, LPf is most effective for training the biceps brachii and latissimus dorsi, and LPb is most effective for training the latissimus dorsi.

This study aimed to investigate the differences in the development of muscle thickness (MT) in the lower limbs with specific sports-event training. Furthermore, the relationship between MT of the lower limbs for weightlifters and sprinters and their competition performances (total weight lifted and 100m sprint times) was examined. Subjects were 64 males divided into 3 groups: weightlifters (n=20), sprinters (n=20), and untrained subjects as controls (n=24). The MT{relative to (body weight)^1/3}of knee extensors (KE), knee flexors (KF), plantar flexors (PF) and dorsi flexors (DF) was measured at 21 sites (proximal, middle and distal) along the length of the upper and lower leg by B-mode ultrasound. The MT of KE for weightlifters was significantly greater than that for sprinters and controls, while the MT of KF and PF for sprinters was significantly greater than that for weightlifters and controls. The MT of rectus femoris (RF), vastus intermedius (VI), vastus lateralis (VL) and vastus medialis (VM) for weightlifters was significantly greater than that for sprinters and controls, while the MT of RF and VM for sprinters was greater than that of controls. On the other hand, the MT of KE for weightlifters and sprinters (especially VM) correlated significantly with competition performances. These results indicated that squatting affected the MT of KE except for RF while sprinting affected the MT of KF and PF. It was also concluded that the MT of KE for weightlifters and sprinters (particularly VM) was related to their competition performances.

Exercise therapy as well as diet therapy, is fundamental in the treatment of diabetes mellitus, however, its methods and effects of long term physical exercise therapy has not yet been clarified.
The present study has been designed to evaluate the effects of physical exercise therapy in diabetic patients with fasting hyperglycemia. Ten non-insulin dependent diabetic patients participated in a 6-month physical exercise program consisting of 30 min, of jogging performed 3 times per week (Exercise group) . The exercise intensity represented 40% of estimated Vo₂max.
The following results were obtained:
1. More significant improvement of glucose tolerance and plasma insulin response to glucose load was observed in exercise group as compared with the patients treated with mild caloric restriction alone (Diet group, N=15) .
2. The significant increase in plasma HDL-cholesterol and HDL-cholesterol/total cholesterol ratio was observed only in exercise group.
3. The reduction of body weight in exercise group was significantly greater than that in diet group.
4. The physical exercise also resulted in an improvement of cardiovascular adaptaion to exercise.
5. Improvement of symptoms in daily life activity was also found after physical exercise therapy. However, some medical troubles such as hypoglycemia, muscle pain and arthralgia were found during observation period.
In conclusion, physical exercise therapy is useful as an adjunct to diet to improve metabolic control in patients with diabetes mellitus. And for effective exercise therapy, exercise program must be individualized, and motivation is stimulated by team including physician, trainer, nurse and dietitian.

Effects of 38°C 30-minute bathing on hemostatic function and autonomic nervous function were studied in 15 48-to-72-year-old patients with cerebral infarction. Blood samples were collected three times: immediately before the bathing, at the end of 30 minutes of bathing, and 30 minutes after the bathing. Hematocrit values and fibrinogen concentrations decreased during bathing and returned to the pre-bathing levels 30 minutes after bathing. This indicates that bathing caused hemodilution due to the fluid shift. During bathing, noradrenaline decreased at a rate significantly higher than that of hemodilution while the sympathetic nervous function, which was evaluated by spectral analysis of sequential variation in arterial blood pressure, was not suppressed. The autonomic nervous system seemed to be inactive in these patients. Coagulation time (PT and APTT) and platelet factor (β-TG and PF4) showed few changes. In the fibrinolytic system, however, tissue plasminogen activator (t-PA) antigen levels increased and plasminogen activator inhibitor type-1 (PAI-1) levels decreased after 30 minutes of bathing. This suggests that fibrinolytic activity was enhanced by 38°C bathing for 30 minutes. Thus, subthermal bathing with comfort may be useful in preventing cerebral infarction.

Exercise has been well known to a fundamental treatment of diabetes mellitus, as well as diet therapy. Nevertheless, its therapeutic use and clinical effects are still unknown in details. The aim of this study is the establishment of practical exercise therapy for the patients with diabetes mellitus. The present study shows the acute exercise effects on blood metabolites and the effects of long term physical training in diabetics.
The following results were obtained.
1) Although no significant change of blood glucose level was observed in normals, the decrease of blood glucose and triglyceride levels were observed in diabetics in acute exercise. Moreover marked elevation of FFA level was also observed after acute exercise in diabetics.
2) Significant decrease of blood glucose and increase of HDL-cholesterol levels were found in diabetics by long term regular physical training.
3) Body weight reduction without loss of lean body mass and the improvement of physiological response to exercise test were achieved after long term physical training.
These results suggest that the regular physical training leads to the better control of diabetes mellitus and keeps good condition in patients with diabetes mellitus, and that it may have a important role of the prevention for the diabetic vascular complication.

BACKGROUND: Although non-thyroidal illness syndrome (NTIS) is considered a negative prognostic factor, the alterations in free triiodothyronine (fT3) levels in trauma patients requiring massive transfusion have not been reported. METHODS: A prospective observational study comparing 2 groups of trauma patients was conducted. Group M comprised trauma patients requiring massive transfusions (>10 units of packed red blood cells) within 24 hours of emergency admission. Group C comprised patients with an injury severity score >9 but not requiring massive transfusions. Levels of fT3, free thyroxine (fT4), and thyroid-stimulating hormone (TSH) were evaluated on admission and on days 1, 2, and 7 after admission. The clinical backgrounds and variables measured including total transfusion amounts were compared and the inter-group prognosis was evaluated. Results are presented as mean±standard deviation. RESULTS: Nineteen patients were enrolled in each group. In both groups, 32 were men, and the mean age was 50±24 years. In group C one patient died from respiratory failure. The initial fT3 levels in group M (1.95±0.37 pg/mL) were significantly lower than those in group C (2.49±0.72 pg/mL;P<0.01) and remained low until 1 week after admission. Initial inter-group fT4 and TSH levels were not significantly different. TSH levels at 1 week (1.99±1.64 μIU/mL) were higher than at admission (1.48±0.5 μIU/mL) in group C (P<0.05). CONCLUSION: Typical NTIS was observed in trauma patients requiring massive transfusions. When initial resuscitation achieved circulatory stabilization, prognosis was not strongly associated with NTIS.

Purpose: To focus on the effects of the presence of mesiodens on adjacent teeth and to investigate the timing of its safe removal. Materials and Methods: Cone-beam computed tomography examinations, obtained at Okayama University Hospital over a three-year period, were inspected. Data were recorded including the number of mesiodens; associated abnormalities; and the relationship with neighboring structures. Depending on multiple factors, the risk of developing complications due to early extraction of a mesiodens was divided into three categories: high, medium, and low risk. Results: A total of 5,958 cone-beam computed tomography exams were obtained, 460 patients aged 3-85 years were diagnosed with a total of 568 mesiodens, 382 (67.3%) of which were discovered in young patients (age <10 years), and 333 (87.2%) of these were associated with abnormalities. Regarding the risk categories, 11 (1.9%) were considered to be in the high-risk, five (0.9%) in the medium-risk and 552 (97.2%) in the low-risk categories. Moreover, eight out of 11 high-risk mesiodens were extracted and no post-operative complications have been seen. Conclusion As the results showed that no postoperative complications were seen in all the extracted cases of high-risk mesiodens, this indicates the possibility of safe extraction at an early age which could reduce related future complications.

Since students who would like to study Kampo medicine more have no opportunity to communicate each other in Northern Japanese Universities, we newly started joint study conferences held by medical students in 2013. The objectives of this paper are to report on these annually held student-based Kampo study conferences in the Hokkaido and Tohoku areas, and the ways each university studies Kampo medicine. In the conference, the students reported on their club activities. Then they studied the history of Kampo medicine and simulation of abdominal diagnosis, and performed group work on case reports together. The number of student participants in these conferences has tripled over 3 years from 18 to 58 (for a total of 111 participants). All members were satisfied with the content. And this reflects medical students' need for a wider perception of Kampo medicine, rather than a limited one gained in their university club activities. We hope this conference will play a major role in other nationwide student-based Kampo study conferences in the years to come.