The symptoms of anemia, decreases in the levels of circulating red blood cells (RBC), hemoglobin (Hb) and hematocrit (Ht) lead to decrease endurance performance, and the risk of anemia increases in female endurance athletes. Although Hb is composed of a large amount of amino acids, the relationships between circulating levels of amino acids and RBC, Hb and Ht in female endurance athletes have not been clarified yet. Thus, the purpose of the present study was to investigate the relationship between circulating levels of amino acids and RBC, Hb and Ht in female endurance athletes. Twenty-four female endurance athletes (19.8 ± 0.2 years) participated in this study. We measured circulating levels of RBC, Hb and Ht from blood. Also, we measured circulating levels of amino acids from plasma by use of comprehensive analysis. The levels of circulating RBC, Hb and Ht in all subjects were within the normal range. We found that circulating taurine levels were significantly correlated with RBC (r = 0.48, p < 0.05), Hb (r = 0.44, p < 0.05) and Ht (r = 0.42, p < 0.05) in female endurance athletes. In the present study, we demonstrated that circulating taurine levels were significantly associated with RBC, Hb and Ht in female endurance athletes. These results suggest that circulating taurine levels may be a predictor of anemia and treatment strategy for anemia.

To evaluate training methods for basic clinical skills before bedside learning, we used questionnaires to ask students and instructors their opinions about the fixed-instructor system, in which one instructor teaches the entire course, and the rotation system, in which instructors share responsibilities for teaching according to their specialty. Students had positive impressions of training with both systems. Many students felt that communication with in structors was good inthe fixed-instructor system and that the specialized education provided by multiple instructors was good in the rotation system. However, students expressed dissatisfaction about differences in educational content between the systems. Instructors believed an advantage of the fixed-instructor system was that skills learned could be applied to all medical fields, whereas the rotation system made teaching easier because it was specialized. On the basis of this investigation, we conclude that training should establish good communication between instructors and students and should include the required educational contents. We also found that unifying educational contents is difficult, regardless of the training system. Few reports about educational methods used to teach basic clinical skills have been published in Japan, but studies focusing on this issue are becoming increasingly necessary.

BACKGROUND: In general practice, though patients often stop visiting ambulatory clinics of their own vo-lition despite the need for ongoing medical treatment, there is little reported research on the reasons for nonattendance in Japan. In this study, we investigated whether the patient/doctor relationship influences nonattendance rates in general practice. In addition, we investigated the reasons why patients stopped visiting the hospital.
METHODS: We collected data from 115 patients (58 males, 57 females; age range: 16 to 94 years old, median age: 52 years old) whose initial diagnoses were made in our department from June to July 2000. We classified the patients into five groups based on the level of their complaints concerning the initial consultation (‘A’ representing the highest degree of complaint, ‘E’ representing the lowest) and determined the relationship between the strength of complaints and the non-attendance rate. Furthermore, we investigated the reasons for non-attendance concerning 28 patients who stopped visiting the hospital from April 2000 to November 2001.
RESULTS: The non-attendance rates were 0% (014) for group A, 14.3% (2114) for group B, 5.6% (5189) for group C, 33.3% (216) for group D, and 50% (1/2) for group E. The rate tended to be higher in groups with fewer complaints. The reasons for non-attendance were the following: remission of symptoms (9 patients), request for another hospital or department (6 patients), relief due to consultation at the university hospital (6 patients), and lack of time to come to the particular hospital (5 patients) . In contrast, the most common reason for satisfaction at the time of consultation was ‘enough explanation and listening to complaints well’ in 7 of 11 patients who were satisfied with the consultation.
CONCLUSIONS: The level of patient's complaints at the time of consultation is related to the non-attendance rate. However, sufficient explanation about symptoms and careful listening to complaints are important for establishing a good patient/doctor relationship.

1) We investigated the patients'evaluations of the students, our management of the medical training, and the patients' recognition of our outpatient clinic education. We then requested the patients to give their opinions regarding such interviews.
2) The patients'evaluations of the outpatient clinic and the patients'recognition of our outpatient clinic education were relatively good, but some patients complained about the short duration of medical care and also expressed anxiety over the students'medical interview.
3) Many patients expressed the desire to positively participate in medical education because the patients had high expectations of the medical students.In addition, this interview training fulfilled the patients'desire to be listened to and have their concerns acknowledged.

No abstract available.
Acetylcysteine* ; Dermatitis, Atopic* ; Healthy Volunteers* ; Humans ; Skin* ; Water Loss, Insensible

Background/Aims: Intestinal Behçet disease is typically associated with ileocecal punched-out ulcers and significant morbidity and mortality. Intestinal ultrasound is a noninvasive imaging technique for disease monitoring. However, no previous reports have compared intestinal ultrasound with endoscopic ulcer activity or histopathological findings for intestinal Behçet disease. We evaluated the usefulness of intestinal ultrasound for assessing the activity of ileocecal ulcers in intestinal Behçet disease. Methods: We retrospectively compared intestinal ultrasound findings with 73 corresponding endoscopic images and 6 resected specimens. The intestinal ultrasound findings were assessed for 7 parameters (bowel wall thickness, vascularity [evaluated using the modified Limberg score with color Doppler], bowel wall stratification, white-plaque sign [strong hyperechogenic lines or spots], mesenteric lymphadenopathy, extramural phlegmons, and fistulas), and endoscopic ulcer activity was classified into active, healing, and scar stages. Histopathological findings were evaluated by consensus among experienced pathologists. Results: Bowel wall thickness (P< 0.001), vascularity (P< 0.001), loss of bowel wall stratification (P= 0.015), and white-plague sign (P= 0.013) were significantly exacerbated in the endoscopic active ulcer stage. Receiver operating characteristic curve analysis revealed that a bowel wall thickness of > 5.5 mm (sensitivity 89.7%, specificity 85.3%) was potentially useful for detecting active lesions. When compared with histopathological findings, an increase in bowel wall thickness reflected the ulcer marginal ridge, and the white-plaque sign reflected the ulcer bottom. Conclusions Intestinal ultrasound is useful for monitoring intestinal ulcer activity in intestinal Behçet disease.

Premenstrual syndrome (PMS) that occur during late luteal phase is a problem for many female athletes. Many studies reported that subjective condition is affected by PMS in female athletes. Moreover, female athletes with PMS have higher stress and/or anxiety levels during luteal phase compared with non-PMS athletes. However, the relationship between PMS and physical performance in female athletes are not clarified yet. The purpose of this study was to investigate the relationship between premenstrual syndrome (PMS) and jump performance in female track and field athletes. Sixteen participants who has natural basal body temperature pattern with the menstrual cycle (observed low-temperature and high-temperature phase), were participated in this study. PMS was assessed by ACOG’s premenstrual syndrome questionnaire. As physical performance, counter movement jump (CMJ) and rebound jump (RJ) were evaluated in low-temperature phase and high-temperature phase. The result of this study, no significant differences were observed in body composition and physical performance between low-temperature phase and high-temperature phase. However, compared with participants who had non-symptom, participants who had a breast tenderness of PMS showed larger decreases in jump height of CMJ (p = 0.038) and RJ index (p = 0.015) in high-temperature phase. Therefore, PMS may have a negative effect on physical performance during high-temperature phase in female athletes.

Arterial stiffness in endurance athletes is low, whereas arterial stiffness in strength athletes is high. The adaptation of the arterial stiffness may be different depending on the training type. On the other hand, there are mixed-trained athletes that can’t be classified as endurance- or strength- trained athletes. The aim of this study was to investigate the arterial stiffness among mixed-trained athletes. The total of 51 young male athletes (15 long-distance runners, 10 handball players and 26 kendo players) and 16 young healthy sedentary individuals (control group) participated in this study. Carotid-femoral pulse wave velocity (cfPWV), carotid-brachial PWV (cbPWV) and femoral-ankle PWV (faPWV), were measured as indices of central and peripheral (upper and lower limbs) arterial stiffness, respectively. cfPWV showed significantly lower in long-distance runners (high endurance capacity) and handball players (strength and high endurance capacities) compared with kendo players (strength and low endurance capacities) and control groups (P < 0.05 for both). cbPWV showed significantly lower in handball players and kendo players compared with the control group (P < 0.05 for both). There was no difference in faPWV among the groups. These data suggest that the competitive characteristics of athletes (i.e., endurance capacity or target muscle groups of sport) influence the adaptation of arterial stiffness. It can be speculated that endurance capacity in mixed-trained athletes can affect central arterial stiffness and similar to endurance trained athletes. In addition, the adaptation in upper limb arterial stiffness will be included in the training effects associated with the sports-specific target muscle groups, while lower limb arterial stiffness may not be unaffected by any type of exercise.

BACKGROUND: Human T cell leukemia virus type-1 (HTLV-1) stimulates inflammation activity. Our previous study revealed a positive association between asymptomatic HTLV-1 infection and advanced periodontitis among elderly Japanese individuals with low levels of hematopoietic activity (reflected by reticulocyte levels). Since low hematopoietic activity has been correlated with low-grade inflammation and low-grade inflammation is associated with atherosclerosis, the status of atherosclerosis could, in turn, determine the nature of this association. METHODS: To this end, a cross-sectional study of 907 elderly Japanese individuals (aged 60-99 years), who had participated in dental health check-up during the period 2016-2018, was conducted. Advanced periodontitis was defined as periodontal pocket ≥ 6.0 mm. RESULTS: Among the study population, 295 (32.5%) were found to have atherosclerosis defined as a carotid intima-media thickness (CIMT) of ≥ 1.1 mm. HTLV-1 infection was positively associated with advanced periodontitis in participants with atherosclerosis, but no significant associations were observed among the participants without atherosclerosis. The known risk factors' (including reticulocyte and CIMT) adjusted odds ratio (OR) and 95% confidence interval (CI) of advanced periodontitis were OR 2.01 and 95% CI 1.06-3.81 for participants with atherosclerosis and OR 0.61 and 95% CI 0.34-1.12 for participants without atherosclerosis. CONCLUSION This study found a significant association between HTLV-1 infection and advanced periodontitis among elderly Japanese with atherosclerosis. However, this association is absent in individuals without atherosclerosis, suggesting that atherosclerosis might act as a determinant in the association between HTLV-1 infection and advanced periodontitis among elderly Japanese.

BACKGROUND: We reported that human T cell leukemia virus 1 (HTLV-1) infection is positively associated with atherosclerosis. Recent evidence has revealed a close association of periodontitis with atherosclerosis, endothelial dysfunction, and disruption of the microcirculation. However, the association between HTLV-1 and advanced periodontitis has not been investigated to date. Since hematopoietic activity is closely linked to endothelial maintenance activity and is known to decline with age, we hypothesized that the state of hematopoietic activity influenced the association between HTLV-1 and advanced periodontitis in elderly participants. METHODS: A cross-sectional study was performed including 822 elderly participants aged 60-99 years who participated in a dental health check-up. Advanced periodontitis was defined as a periodontal pocket ≥ 6.0 mm. Participants were classified as having low or high hematopoietic activity according to the median values of reticulocytes. RESULTS: HTLV-1 infection was positively related to advanced periodontitis among participants with lower hematopoietic activity (lower reticulocyte count), but not among participants with higher hematopoietic activity (higher reticulocyte count). The adjusted odds ratio (95% confidence interval) considering potential confounding factors was 1.92 (1.05-3.49) for participants with a lower reticulocyte count and 0.69 (0.35-1.36) for participants with a higher reticulocyte count. CONCLUSIONS Among elderly participants, the association between HTLV-1 infection and advanced periodontitis is influenced by hematopoietic activity. Since hematopoietic activity is associated with endothelial maintenance, these findings provide an efficient tool for clarifying the underlying mechanism of the progression of periodontitis among elderly participants.
Aged ; Aged, 80 and over ; Cross-Sectional Studies ; Female ; HTLV-I Infections ; physiopathology ; Hematopoiesis ; physiology ; Human T-lymphotropic virus 1 ; physiology ; Humans ; Japan ; epidemiology ; Male ; Middle Aged ; Odds Ratio ; Periodontitis ; epidemiology ; virology ; Prevalence ; Risk Factors