A study was conducted to investigate changes in muscle soreness, serum creatine kinase (CK) activity and white blood cell (WBC) count following exercise bouts spaced three weeks apart.
The subjects were six male students (aged 23-25 yr), who had not participated in any training program for over 18 months. They performed muscular exercise of the nondominant arm using elbow flexors. Twenty percent of maximum voluntary contraction was used as the exercise intensity. After three weeks, the subjects repeated the same exercise bout. Perceived muscle soreness, CK activity and WBC count were assessed before, immediately after, 6h after and over 9 days after each exercise bout.
After the first exercise bout (1 st Ex), the subjects experienced muscle sorenss for 3-7 days. Also, a large increase of CK was found in five subjects (266-763%) . When the peak CK efflux was observed (day 3-4 after exercise), soreness had almost disappeared. WBC count was increased immediately and 6 h after exercise, then returned to the resting level. However, a significant increase (p<0.05) in WBC count was observed again on day 7 after exercise when CK had returned to the resting level. After the second exercise (2 nd Ex), a significant decrease of muscle soreness and the CK response was found in comparison with the 1 st Ex (p<0.41) . One interesting feature was that the CK efflux of subjects who had shown a large increase of CK after the 1 st Ex was not increased after the 2 nd Ex.
The initial exercise bout may have induced some damage to the muscle fibers or mem. bran. This damage would induce a process of repair in the damaged tissue, which in turn would adapt the muscle to the next stimulus. However, the subjects who showed a slight increase of CK after the 1 st Ex did not show this adaptation. Therefore an adaptive threshold for fiber or membrane damage may exist.

No abstract available.
Humans ; Hyperglycemia* ; Peritoneal Dialysis*

  An inquiry was made into the health of 10 one-time asbestos workers now living in the southern part of Akita Prefecture who had taken screening tests for asbestosis on a regular basis. The purpose of this study was to provide pertinent information and better health support to these people at high risk of developing asbestos-related diseases. The average number of years they served as asbestos workers was 11.1±2.12 years and 29.8±4.64 years had passed sincefirst exposure. All the subjects were found to have had no idea about guarding against exposure to asbestos while at work. Neither had they been told to protect themselves from this fibrous mineral by their employers. What motivated them to take examinations for asbestosis was news reports provided by newspapers and other mass media about pulmonary disorders caused by earlier contact with asbestos fibers. Half of the subjects did not know anything about qualifications for receiving the health card for retired asbestos workers. They expressed apprehensions about their health. One subject said, “I may be taken ill anytime,” another said, “The psychological burden of always taking meticulous care of my health is overwhelming,” and still another said, “There is no way of knowing whether I am suffering from asbestosis because there is no symptom.” The latest statistics showed that the number of officially acknowledged victims of asbestos-related pulmonary diseases is increasing across the nation together with the incidence of mesothelioma. To allay the anxiety of former asbestos workers about their health, this study suggested that as the responsibilities of the medical profession, we should (1) get acquainted with the relief system and related laws, (2) help the patients maintain their quality of life by following up the their problems over a long period of time, and (3) continue research activities and make the results public so as to contribute to the relief of the patients.

In the previous report, we concluded that chances are very slim for Salithion and Sumithion to concentrate in rabbits as these organophosphorous compounds are excreted quickly. This conclusion was inferentially drawn from the results of measurements of concentration of Salithion and Sumithion residues in the blood after experimental exposures of rabbits to the pesticides.
In the present report, we will discuss the same toxicological problem based on our findings in a series of experiments using rabbits with hepatic disturbances induced by carbon tetrachloride (CCl₄).
Rabbits were divided into three groups. One consists of rabbits having light hepatic disorder. They were subcutaneously injected with 0.1ml/kg of 20% CCl4 olive oil for three days consecutively. Under the second group come rabbits with moderate liver disturbance caused by the injection of 0.3 ml/kg of 20% CCl₄ olive oil. The injection was also made for three days. The remaining group is the control group.
These rabbits were administered orally with 5mg/kg and 20mg/kg of Smithion for three days running.
The examination covered (1) Sumithion residue level in the blood, (2) PNMC level in urine, (3) hepatic function (ChE, GOT, GPT, BSP, Al-P, BUN), (4) urinalysis and (5) histopathological examination of the liver and the kidney. The results of these tests were studied in comparison with those of the control group.
The following is a summary of our conclusion:
1) In the control group, Sumithion residues in the blood disappeared quickly, and could not be detected 72 hours after administration.
2) As far as the disappearance of Sumithion and the excretion of PNMC are concerned, there was no significant difference between the control and the light and moderate liver disturbance groups of rabbits.
3) In the rabbits with CCl₄-induced liver disturbances, it was noted that the administration of Sumithion impeded serum and red-cell ChE activities to a remarkable extent, and delayed the recovery of the liver function.
4) However, the liver disturbance did not deteriorate. The histological observation of the liver and the kidney did not reveal any abnormality due to the administration of Sumithion, either.

　　This study was conducted with a view to improving medication management service by reviewing renal excretory drug prescription practices in our hospital for patients with decreased kidney function without intervention of pharmacists. The subjects were the outpatients to whom the doctors had prescribed drugs containing digoxin, cibenzoline, bezafibrate, levofloxacin, valaciclovir or dabigatran. We retrospectively reviewed their serum creatinine levels, sex, age, height, weight and the amount of the drugs prescribed. It was found that there are cases in which medication had been prescribed without serum creatinine testing or prescribed in excess of the amount needed. Furthermore, there were cases in which the renal function had been judged in all probability by age and serum creatinine levels alone. Based on these findings, we concluded that pharmacists should intervene in pharmacotherapy using renal excretory drugs. For the realization of this, it would be necessary to build a system within the Department of Pharmacy to support the pharmacotherapy.

OBJECTIVES: This study aimed to identify factors associated with initiation and adherence of osteoporosis medication from a patient perspective. METHODS: A web-based survey was developed based on health behavior theories. Descriptive analyses were conducted for all survey items. Analyses in a structural equation modeling framework were conducted to identify factors associated with treatment initiation and adherence. RESULTS: Five hundred forty-five women completed the questionnaire. A majority were currently receiving medications for osteoporosis (n = 376, 69.0%) and 25.0% of these patients (n = 94) were considered adherent to their treatment. Knowledge was strongly associated with osteoporosis treatment initiation (standard error [SE], 0.58). Greater knowledge of disease was associated with increased likelihood of initiating medication. Medication complexity (SE, 0.49) and perceived susceptibility to fracture and loss of independence (SE, −0.37) were also associated with initiation. Perceived barriers (SE, −0.85) such as inconvenience, lack of efficacy and financial burden were observed to be the greatest obstacle to adherence. The greater the perceived barriers, the less likely patients were to adhere to medication. Patients' perception of self-efficacy (SE, 0.37) also affected adherence. The greater the patient perception of ability to independently manage their medication, the more likely they were to adhere to the medication. CONCLUSIONS: Different factors were found to be associated with initiation and adherence of osteoporosis medication. Patient knowledge of their disease and the perception of barriers were found to be the most influential. Empowering patients with the knowledge to better understand their disease and decreasing the perception of barriers through education initiatives may be effective in improving patient outcomes.
Education ; Female ; Health Behavior ; Humans ; Japan* ; Osteoporosis* ; Patient-Centered Care

Cardiovascular syphilis and syphilitic aortitis, known as late complications of syphilis, are rarely encountered in clinical practice. However, an increase in the number of syphilis cases has been reported in recent years, during which it has also manifested as a complicating infection in those with HIV. A 66-year-old man, who had no previous laboratory findings of syphilis and no subjective symptoms, presented with a complaint of dyspnea. A diagnosis of cardiovascular syphilis was made based on a positive syphilis serological reaction in the preoperative examination for surgical treatment of a left coronary artery ostium obstruction and aortic regurgitation. Three weeks after treatment with amoxicillin, the patient underwent an aortic valve replacement with a bioprosthetic valve and coronary artery bypass surgery. The aortic wall was yellowish with marked circumferential wall thickening and erosion of the intima. The area where the left coronary artery originates was occluded by intimal thickening and revealed only a dimple-like scar. The aortic valve was tricuspidate with thickening and a shortening of the left coronary leaflet. Pathology showed inflammatory cell infiltration of the aortic tunica media, consistent with syphilitic vasculitis. The postoperative course was uneventful and the patient continues to be treated with antibiotics on an outpatient basis.