A study was conducted to clarify the influence of water immersion at different levels on pulmonary response. The subjects, ten healthy men (mean age, 26.2±7.9 years), subjected to measurement of static lung volumes and maximum expiratory flow-volume curves while sitting immersed in water at the level of both the neck and diaphragm. TLC, VC, ERV and FRC for water immersion at the diaphragm level were significantly decreased in comparison with those measured in air. These lung volumes were further decreased upon water immersion to neck level. However, RV did not change significantly upon immersion at either water level. Significant decreases of FEV_1⋅0, FEV_1⋅0%, V₅₀ and V₂₅ were observed upon water immersion at the diaphragm level as compared with those obtained in air. Water immersion to neck level produced further decreases in pulmonary functional parameters. Although peak flow and V₇₅ did not change significantly upon water immersion at either level, V₅₀ and V₂₅ were decreased markedly in comparison with the values obtained in air. A tendency for a marked decrease in pulmonary function parameters was observed upon water immersion to neck level. The changes observed upon water immersion to diaphragm level may have resulted from compression of small airways induced by both an increase of blood volume in the thorax and hydrostatic pressure against the abdomen. The changes induced by water immersion to neck level may have been exacerbated by the two mechanisms described above, in addition to hydrostatic pressure on the chest wall. The present results suggest that the significant reduction of pulmonary functional parameters caused by water immersion may be due to compression of small airways induced by an increase of blood volume in the thorax and hydrostatic pressure on the chest wall and abdomen.

A study was performed to clarify the relationships between oxygen uptake (VO₂) kinetics on recovery from incremental maximal exercise and blood lactate, glucose and alanine metabolism. Eight healthy males aged 21.6±3.3 years were studied. The incremental exercise test was performed using a modified version of Bruce's protocol until 30 min after exhaustion. The VO₂ responses on recovery were fitted by a two-component exponential model. Blood lactate concentration in the recovery phase was fitted by a bi-exponential time function to assess the velocity constant of the slowly decreasing component (γ2) expressing the rate of blood lactate removal. Both blood lactate and plasma alanine concentration were significantly increased from rest to maximal exercise, and were significantly decreased thereafter, but remained above resting values for 30 min after the maximal stage. Blood glucose concentration was significantly decreased following maximal exercise and returned to the pre-exercise value by 30 min after the maximal stage. Concentrations of plasma branched-chain amino acids (valine, leucine and isoleucine) were significantly decreased from the maximal stage until 30 min after exhaustion. The time constant of the slow component on recovery VO₂ [τVO₂ (s) ] was correlated with neither γ2 nor the degree of change in blood lactate from the maximal stage until 30 min after exhaustion (Δlactate) . However, τVO₂ (s) was significantly correlated with both Δ blood glucose and Δ alanine. In addition, Δ alanine was significantly correlated with Δ blood glucose. From these results, we conclude that oxygen uptake kinetics after exhaustive maximal exercise is related to glucose resynthesis through alanine metabolism, as compared with that from lactate metabolism.

A study was performed to clarify the effects of endurance training above the anaerobic threshold (AT) on the isocapnic buffering phase during incremental exercise in athletes. Eight middle-distance runners aged 19.6±1.2 years performed incremental exercise testing with a modified version of Bruce's protocol. After a 6-month high-intensity interval and paced running training at levels above AT, maximal oxygen uptake (VO₂max) (ml⋅ kg^-1⋅min^-1) was significantly increased from 60.1±5.7 to 64.7±5.5 (p<0.05) . AT (m⋅lkg^-1⋅min^-1) was slightly but significantly increased from 28.2±3.5 to 29.6±4.3 (p<0.05) . The respiratory compensation point (RC) (ml⋅ kg^-1⋅min^-1) was markedly increased from 53.0±8.3 to 57.7±8.2 (p<0.05) . Although neither the slope of the first regression line below AT (S1) nor that of the second line above AT (S2) calculated by V-slope analysis was altered, the range of isocapnic buffering (ml⋅kg^-1⋅min^-1) from AT to RC was significantly extended from 24.8±5.9 to 28.1±6.0 after the 6-months of training (p<0.05) . In addition, the amount of change in VO₂max after the 6-month of training period (ΔVO₂max) was correlated with Δisocapnic buffering (R=0.72, p<0.05) . We conclude that the degree of increased respiratory compensation point is larger than that of AT after high-intensity endurance training at levels above AT, and that the range of isocapnic buffering may be an important factor in relation to the increase in the maximal aerobic capacity of athletes.

PURPOSE: The purpose of this study was to investigate the clinical and hormonal features of patients with incidentally discovered adrenal adenomas in relation to corticotropin releasing hormone (CRH) testing and the clinical outcome of adrenalectomy. MATERIALS AND METHODS: Twenty-three consecutive patients with incidentally detected adrenal adenomas were included in this retrospective study. All the patients underwent abdominal computed tomography scans and hormonal assays, including assessment of circadian rhythms of plasma cortisol and corticotropin (adrenocorticotropic hormone, ACTH), a corticotropin stimulation test, and low-dose and high-dose dexamethasone tests. The patients were reevaluated at regular intervals (6, 12, and 24 months) for a median period of 24 months. Subclinical Cushing's syndrome (SCS) was diagnosed in patients with subtle hypercortisolism who did not present clinical signs of Cushing's syndrome. RESULTS: We calculated the responsive index (peak value of ACTH in CRH test/baseline value of ACTH in CRH test). Of 23 patients, 6 had Cushing's syndrome, 8 had SCS, and 9 had a non-functioning tumor. All patients underwent laparoscopic adrenalectomy. Several patients (5 of 6 with Cushing's syndrome and 2 of 8 with SCS) required cortisol replacement therapy after surgery. The remaining patients required no hormonal replacement after surgery. Those who required hormone replacement had a responsive index of less than 1.2. Those who did not need hormone replacement therapy had a responsive index of more than 2.0. CONCLUSIONS: In our limited experience, the responsive index of the CRH test might be a valuable tool for predicting the need for cortisol replacement after surgery in patients with SCS.
Adenoma ; Adrenalectomy ; Adrenocorticotropic Hormone ; Circadian Rhythm ; Corticotropin-Releasing Hormone ; Cushing Syndrome ; Dexamethasone ; Hormone Replacement Therapy ; Humans ; Hydrocortisone ; Plasma ; Retrospective Studies

Purpose: Tsukioka Onsen is the prominent hot spring which contains the largest amounts of sulfur in Japan. The purpose of this study is to clarify the benefits of bathing in Tsukioka Onsen by comparison between the bathing in Tsukioka hot spring and with natural water. Methods: Subjects were 20 females aged from 30 to 60 y.o. On 21th of November, we applied them to bathe in Tsukioka hot spring for 10 minutes (42 celcius) and to bathe in natural water for 10 minutes (42 celcius) using cross-over methods. The interval of the two way bathing was 2 hours. We conducted a questionnaire survey using visual analog scale in which participants answered their subjective health and the sensory evaluation of skin with hot water. Statistical analysis was performed using paired t-test. This research was approved by ethical committee of the Japan health & research institute. Results: Warming effect of full body, blood circulation, stiff shoulder and back pain were all improved after bathing either with hot spring and natural water. The effects were particularly stronger with hot spring than natural water. Recovery from fatigue, sense of relaxation, sense of refresh, most feeling of skin, refreshing touch of skin were improved only after bathing with hot spring.   Regarding to sensory evaluation of skin, smooth feeling and moist feeling of skin were significantly notified predominantly with hot spring not with natural water. Conclusion: This study showed that bathing in Tsukioka Onsen may cause thermal, cleaning, and moisture effects more than the one with natural water. We think that the alkalinity and the rich containing of chloride in hot water in Tukioka Onsen may contribute to these effects. We also suggested that one reason for these effects is that the large amounts of containing sulfur in Tukioka hot spring penetrated through skin may cause particular dilation of blood vessels in addition to the thermal effect of hot water.

Purpose: Our previous study compared the characteristics of middle-aged persons who regularly take hot bathtub baths with those who do not and found taking hot bathtub baths helped to have good sleep and increase self-rated health. However, few studies have focused on this habit among young people. This study therefore compared the characteristics of young persons who regularly take hot bathtub baths with those who do not and clarify the potential effects of habitual bathtub bathing on their health. Methods: In this cross-sectional study, a self-reported questionnaire on bathtub bathing habits and general health and lifestyle was distributed to 483 university students between May and June 2013. Respondents were divided into two groups: those who took 3 or more bathtub baths per week (high-frequency group) and those who took 2 or fewer bathtub baths per week (low-frequency group). Differences between the groups were determined for sex, age, living with or apart from one’s family, quality of sleep, sense of fatigue, and self-rated health. Prior to conducting the study, the study protocol was approved by the Institutional Review Board of Daito Bunka University. Results: We obtained 394 responses (response rate: 81.6%) and analyzed 376 valid responses. Those who answered the question on bathtub bathing habits were divided into a high-frequency group (176 persons, 47%) and a low-frequency group (200 persons, 53%). The high-frequency group (52% men, 43% women, 5% sex was unknown) had a slightly greater proportion of men than in the low-frequency group (p=0.07). The two bathing frequency groups did not significantly differ by age group(p=0.43), and the age distribution in the high-frequency group age was 51% among 18 year olds, 45% among 19 year olds, 39% among 20 year olds, 48% among 21 year olds, and 61% among 22 year olds and older. Significantly more of the high-frequency group lived with their family (70% versus 23% living alone) than the low-frequency group (p<0.001). In terms of quality of sleep, 62% of the high-frequency group and 60% of the low-frequency group reported having good sleep (p=0.72). For sense of fatigue, 27% of the high-frequency group and 23% of the low-frequency group reported they did not experience fatigue (p=0.36), and for self-rated health, 81% of the high frequency group and 76% of the low-frequency group reported they were healthy (p=0.30). While there were no significant differences between the two groups, the findings suggest that those in the high-frequency group experienced good health. Results of logistic regression analysis adjusted for living with or apart from family showed the following odds ratios (95% confidence intervals) in the high-frequency group: good quality of sleep 1.02 (0.63-1.66), no fatigue 1.37 (0.76-2.46), and self-rated health 1.61 (0.90-2.89). Conclusion: Among university students in this study, men and persons living with their families were highly likely to take hot bathtub baths regularly. While there were no significant differences between the high and low frequency bathers, taking hot bathtub baths may marginally help to reduce fatigue and increase self-rated health. Competing interests: The authors declare no conflicts of interest.