A study was designed to examine the effects of exercise intensity on renal clearance parameters. Five healthy male subjects underwent exercise tests on an bicycle ergometer at 4 different work loads for 15 min. The indicators of exercise intensity employed were the percentage of maximal oxygen uptake (%VO₂max), heart rate (HR) and blood lactate level (La) . As parameters of renal clearance, para-aminohippurate clearance (CPAH), thiosulfate clearance (C_thio) and creatinine clearance (C_cr) were measured by the continuous infusion technique during the exercise.
1) The renal clearance parameters during exercise decreased linearly as the exercise intensity increased. The percentage of maximal oxygen uptake at the onset of the decreases in %C_PAH, %C_chiu and %C_cr were 36, 45 and 47%VO₂max, respectively.
2) Among the indicators of exercise intensity, the decrease in La showed the closest correlation with renal clearance during the exercise.
3) The renal plasma flow, which was measured as C_PAH, began to decrease linearly at a significantly lower exercise intensity than the glomerular filtration rate, which was measured as both C_thio and C_cr.
The above results suggest that renal clearance parameters begin to decrease at the threshold as exercise intensity increases.

We report the case of a 51-year-old woman whose body weight was increased after bariatric surgery. She has been obese from a young age. When she was 30 years old, she developed type 2 diabetes mellitus. She was hospitalized for diabetic ketoacidosis at 45 years of age. She was diagnosed bulimic at 48 years of age, and body weight reduction with diet and exercise therapy became difficult because she was bulimic. Then, she underwent bariatric surgery and her body weight had reduced by 11 kg, 6 months after the surgery. However, her body weight began to increase again 7 months post surgery. At this time, her mental status had become unstable and she ate constantly in the afternoons. We administered yokukansan 5 g/day to treat her unstable mental status. Her body weight then decreased in accord with decreasing energy intake after the administration of yokukansan. She also became aware that her mental status was improving. Furthermore, her HbA1c (JDS) decreased from 8.7% to 7.1% after yokukansan treatment. In this case, it is possible that yokukansan suppressed the overeating by stabilizing her mental status, with the parallel decreases in body weight and HbA1c.

Objective: We report two cases of atypical femoral fracture (AFF) in patients with cancer.Patients: Two patients, a 53-year-old woman with breast cancer and a 77-year-old man with prostate cancer, could not walk after being injured in a fall. They used bone-modifying agents (BMA) for the prevention of bone metastasis for three and four years, respectively.Results: Intramedullary nails were placed to fix the femoral fractures in each patient. Neither of them had pathological metastatic femoral fractures based on fracture site specimens; however, severe suppression of bone turnover at the fracture site was suspected. Both patients could ambulate with a T-cane and were free of hip pain after surgery. Radiographs showed no callus formation at the fracture site.Conclusion: Based on the two cases of AFF in patients with cancer related to BMA use, we should consider that the incidence of AFF may be associated with long-term BMA use.