The present investigation was designed to examine the effects of warming-up (W-up) on the blood lactate kinetics during 5 minutes of pedaling exercise. Five healthy male adults were the subjects. The intencity of the criterion task (CT) was about 80% VO₂max, and that of the W-up was a work load corresponding to the anaerobic threshold. Between W-up and CT there were five-minute rest periods on the bicycle ergometer. In order to determine the blood lactate values, blood samples were taken from the antecubital vein at the following times: rest, pre-CT, and 3, 5, 7, and 30-minutes after CT. Expired gas was analysed continuously for the calculation of VO₂, VCO₂, R, VE. The heart rate was recorded every min-ute from ECG.
Blood lactate values increased 3.23±0.91 mmol/l after W-up, a significant increase over the resting values. The peak blood lactate during the W-up experiment (4.62±0.84 mmol/l) was significantly lower than that of the control experiment (6.48±1.69 mmol/l) . Differences in lactate before and after CT (ΔLa) was found to be significantly lower in experiments with W-up (1.39±0.99 mmol/l) as compared with control experiments (5.37±1.62 mmol/l) . In one subject, the blood lactate levels decreased during CT after W-up, while lactate levels increased during CT without W-up. VO₂ during CT were very similar in both experiments. These results indicate that this kind of W-up delays the rate of blood lactate accumulation during CT.

The purpose of this study was to investigate the effects of contraction force and the pooled blood volume in the calf on the pumping action of calf muscle contraction. Calf blood volume was controlled by lower body negative pressure (LBNP) and isometric contraction of calf extensor muscle was performed using a handmade dynamometer in recumbent position. The relative volume changes (ΔV/V%) of calf were determined using rubber straingage, when isometric contractions (5, 10, 20, 40 and 60 kg) of the calf muscle were repeated under LBNP of 0, -20, -40, and -60 mmHg.
During resting condition, Δ V/V was increased by 1.04% under -20 mmHg LBNP, 1.88% under -40 mmHg, and 2.54% under -60 mmHg. These increases of ΔV/V were due to the increased blood pooling in the calf. It was shown that the increased blood volume was almost expelled by several bouts of muscle contractions of proper force. The optimum force of contractions for expelling pooled blood was 20 kg under -20mmHg LBNP, and 40 kg under -40 and -60 mmHg LBNP. And it was apparent that the effectiveness of muscle pump was accumulated with repeating contractions, arriving to a plateau after several bouts.
It was shown that the effect of muscle pump in the given contraction force was more effective under the condition with more amount of blood contained in the calf, but the muscle pumping action by light contraction forces couldn't overcome the effect of severe LBNP.

The purpose of this study was to investigate the effects of contraction force and the pooled blood volume in the calf on the pumping action of calf muscle contraction. Calf blood volume was controlled by lower body negative pressure (LBNP) and isometric contraction of calf extensor muscle was performed using a handmade dynamometer in recumbent position. The relative volume changes (ΔV/V%) of calf were determined using rubber straingage, when isometric contractions (5, 10, 20, 40 and 60 kg) of the calf muscle were repeated under LBNP of 0, -20, -40, and -60 mmHg.
During resting condition, Δ V/V was increased by 1.04% under -20 mmHg LBNP, 1.88% under -40 mmHg, and 2.54% under -60 mmHg. These increases of ΔV/V were due to the increased blood pooling in the calf. It was shown that the increased blood volume was almost expelled by several bouts of muscle contractions of proper force. The optimum force of contractions for expelling pooled blood was 20 kg under -20mmHg LBNP, and 40 kg under -40 and -60 mmHg LBNP. And it was apparent that the effectiveness of muscle pump was accumulated with repeating contractions, arriving to a plateau after several bouts.
It was shown that the effect of muscle pump in the given contraction force was more effective under the condition with more amount of blood contained in the calf, but the muscle pumping action by light contraction forces couldn't overcome the effect of severe LBNP.

The purpose of this study was to elucidate the changes in systolic and diastolic time intervals which accrue along with increase of HR during a prolonged exercise.
Fifteen male collegiate distance runners performed bicycle ergometer exercise of 70% maximal oxygen intake for 60 minutes. Electrocardiogram, phonocardiogram, pulse wave using ear densitogram and its derivative were recorded throughout the exercise, and then HR, STI, DT (diastolic time) and QS₂/DT were caluculated from the tracings.
The results obtained are as follows:
1. At the initial phase of the exercise, DT decreased markedly to result in rapid increase of QS₂/DT. When HR was between 130-150 beats/min, however, the rate of decrease of QS₂ was greater than that of DT, so QS₂/DT showed a tendency to decrease. When HR was more than 150, QS₂ reached a plateau but DT still continued to decrease, and QS₂/DT turned to increase again.
2. LVET decreased slowly throughout the exercise, whereas PEP decreased rapidly within initial two minutes and kept a steady state thereafter. The change in QS₂ after two minutes of exercise seemed to depend on LVET.
3. LVETi and QS₂i showed a similar change as that in QS₂/DT but the change in QS₂i was less obvious than that in LVETi.
4. PEN and PEP/LVET decreased rapidly in the initial two minutes, thereafter they continued to increase more slowly with increase of HR until the end of exercise.
Conclusively, HR continued to increase monotonously during prolonged exercise of a constant intensity, while systolic and diastolic time intervals varied the directions and patterns of their changes during the exercise.

Amplitude and phase response of ventilation (V_E), carbon dioxide output (VCO₂) and oxygen uptake (VO₂) during sinusoidally varying work load for periods (T) of 1-16 min were studied in six healthy men. The relationships between these parameters and aerobic capacity (VO₂max, ATVO₂) were also examined. The results and conclusions obtained were as follows:
(1) The relationship between the period (T) of exercise and amplitude response of VO₂, VCO₂ and V_E was well described by first-order exponential models. However, the relationship between the period of exercise and the phase shift (phase responses of VO₂, VCO₂, and V_E) was better described by complex models comprising a first-order exponential function and a linear equation. This can be explained by Karpman's threshold theory.
(2) High negative correlations were observed between the steady-state amplitude (A) of phase response or the time constants (r) of amplitude response and VO₂max, and ATVO₂. Significantly high negative correlations for all gas exchange parameters may be more rapid in individuals with greater aerobic capacity.
(3) A close relationship between the response of VCO₂ and V_E was demonstrated by a higher correlation coefficient than that between VO₂ and VCO₂ or between VO₂ and V_E. This can be partly, but not completely, explained by the cardiodynamic theory.

Objectives: The aim of this study was to explore the first-year medical students’ perception of their learning from a lecture about sexual minorities.
Methods: In September 2012, a physician and a gynecologist first lectured about sex differences, reproductive medicine, and sexually transmitted infections. Next, the representative of a support group for a sexual minority talked about the prejudice and discrimination toward sexual minorities. He showed a video about a high school student who had publicity revealed his sexual orientation. We analyzed the students’ reports by the qualitative data analysis method Step Coding and Theorization. The students’ descriptions were extracted, coded by contents, and then grouped into several categories.
Results: Many students were surprised at the percentage of persons belonging to a sexual minority. By watching the DVD they came to realize that homosexuals are just like other persons in most ways. They mentioned the need for correct knowledge about sexual minorities.
Conclusion: We believe that the educational session about sexual minorities is meaningful for and valued by medical students, and medical care for sexual minorities should be taught to medical students.

We report two cases of numbness and pain of neuropathy due to ANCA (antineutrophil cytoplasmic antibody)-associated vasculitis successfully treated with Ogikeishigomotsuto. The first case was a 57-year-old female who complained of high fever, painful skin eruptions of the lower limbs, and proteinuria. Although the severe pain was reduced with steroid therapy, neuropathy-related numbness and pain remained widespread in her lower limbs. After we prescribed Ogikeishigomotsuto, most of her pain disappeared while her degree of numbness diminished by almost half in two weeks. In addition, her steroid therapy could be tapered off without adverse effect. The second case was an 82-year-old female with fever and myalgia. Although myalgia of the upper arm disappeared with steroid treatment, walking became difficult due to numbness from the lower legs, to the soles of her feet. With Ogikeishigomotsuto administration, she became better able to walk because her legs had warmed up, and the range of her numbness had decreased. These cases suggest that Ogikeishigomotsuto may be effective against numbness and neuropathic pain due to ANCA-associated vasculitis.
Numbness ; Pain ; Peripheral neuropathy ; Antineutrophil cytoplasmic antibody measurement ; Vasculitis

Pure autonomic failure (PAF) is a degenerative disorder with diverse autonomic nervous symptoms, but without somatic nervous symptoms. We encountered a patient with PAF who was successfully treated with keishikashakuyakuto. A 61-year-old man complained of diarrhea, abdominal pain, dysuria and orthostatic hypotension. PAF was strongly suspected, based on a low level of plasma noradrenalin at rest and a finding of severe diffuse sympathetic nerve injury on ¹²³I MIBG myocardial scintigraphy. Various Kampo formulas were not effective, or could not be administered continually. Urinary retention was treated with self-catheterization. After the extract of keishikashakuyakuto was administered, his complaints of diarrhea and abdominal pain gradually decreased, and he was able to eat various kinds of food. His daily living activities improved.Moreover, he could urinate by himself, so the self-catheterization was stopped. Five years later, the diagnosis of PAF was clinically confirmed, but his daily living activities did not deteriorate. This suggests that keishikashakuyakuto can be effective for diseases with diverse autonomic nervous symptoms, such as the present case.

A 59-year-old man was admitted to our hospital with severe mitral incompetence. Mitral valve repair, tricuspid annuloplasty and the Maze procedure were performed. After weaning from cardiopulmonary bypass, his systolic blood pressure (SBP) dropped to 40 mmHg. Immediate administration of catecholamines markedly increased SBP but his continuing low blood pressure required additional treatment with vasopressin and hydrocortisone. On postoperative day 12 in the general ward, he suddenly lapsed into an intractable hypoglycemic coma. Endocrine function tests revealed adrenocorticotropic hormone deficiency. Since the time of writing has been doing well with 20 mg of hydrocortisone.

To investigate the effectiveness of Maobushisaishin-to (traditional Japanese herbal medicine; Tsumura TJ-127) in treating the common cold, a clinical comparison between Maobushisaishin-to and a general common cold drug was conducted using the sealed envelope method. The study involved 83 patients in the TJ-127 group and 88 patients in the general cold drug group. No differences in age, gender or the period from the onset of the disease to the beginning of treatment were observed between the two groups.
The results indicated greater than moderate improvement in 81.9% of the TJ-127 group, compared with 60.3% of the compound cold drug group (p<0.01). Further analysis of symptom diaries kept by the patients indicated that TJ-127 provided more rapid relief for symptoms such as fever, feeling feverish, coughing and phlegm than did the general cold drug. No side effects were observed for the TJ-127. These results suggest that TJ-127 is effective in the treatment of the common cold.