In an attempt to study the effect of physical training in a hot environment on physiological responses to heat and heat tolerance of men, six male university students were exposed to a combination of muscular exercise and environmental heat for 20 successive days in summer. Muscular exercise was performed on a bicycle ergometer at constant work of about 8 R.M.R.t at the cycling rate of 50 r.p.m. for 2 hrs in the room with a temperature of 30°C and 70%, R.H. Sweat test was performed on the day before the beginning of physical training, on 7th, 14th and 211th days of physical training. Sweating was produced by immersing both legs to just below the knees into stirring water of 42°C for 90 min after staying for 30 min in a climatic chamber of 30CC with 70%, R.H. Sweat volume observed in sweat test increased progressively throughout the period of physical training. Na concentration in sweat at a given sweat rate continued to decrease during the period of physical training and heterogeneity of the local sweat rate and Na concentration in local sweat was reduced by physical training in a hot environment. Rise in rectal temperature induced by a given heat stress decreased significantly during the first week, thereafter showed a trend bo be smaller. The mean value of heat tolerance index I, the magnitude of disturbance induced in the body concerning thermal regulation and water-electrolyte metabolism, decreased considerably during the first week of physical training, thereafter decreased slightly. Thus it might be said that improvement of heat tolerance was induced mostly during the early period (about 1 week) of successive exposure to a combination hard work and environmental heat. This improvement of heat tolerance accompanied by marked reduction of physical strain in terms of temperature regulation might be induced at the cost of increase in disturbance of water-electrolyte metabolism.

Triglyceride contents of liver, heart muscle and skeletal muscles (rectus femoris, tibiaris anterior, soleus, plantaris and extensir digitrum longus) were determined on 1, 3.5, 14, 18 and 21 months-old rats, and especially on 14 and 21 months-old rats composition of triglyceride fatty acids was analyzed and interrelation of these triglyceride contents with aging of rats was studied quantitively and qualitatively. Following results were obtained
1) Changs in liver and muscular triglyceride contents appeared on 14 months-old rats and were significant increase at 21 months-old rats.
2) Liver triglyceride content significantly decreased at 21 months-old rats (p<0.05) .
3) lrriglyceride contents of tibiaris anterior and extensor digitrum longus muscles were mostly unchangeable through the aging of rats.
4) But triglyceride contents of soleus, rectus femoris and plantaris muscles in 21 months-old rats significantly increased (p<0.05) and the individual difference was great.
5) In composition of triglyceride fatty acids, increase of C₁₈, C_18-1, C_18-2 and C_18-3 was observed in epididymal adipose tissue, soleus and rectus femoris muscle on 21 months-old rats, but in extensor digitrum longus and tibiaris anterior muscles.
From these results, changes of tissue triglyceride contents with aging of rats are different in each tissue and increase of triglyceride content is present with qualitative changes in composition of triglyceride fatty acids, increase of long chain and unsaturated fatty acids, and organic specificity, which is related to the functional changes with aging of rats is considered.

Physiological responses to heat and heat tolerance were examined in summer and winter on 13 male athletic university students and male nonathletec university students. After staying for 30 min. in a climatic chamber maintained at 30°C with 70% relative humidity, sweating reaction was examined far 90 min, by immersing both legs up to the knees in a stirring water bath of 42°C.
Both groups showed significantly greater sweat volume, significantly lower Na concentration in sweat and considerably lower rise in rectal temperature and less increase in heart rate in summer than in winter. In both seasons, athletes showed smaller volume of sweat, lower Na concentration in sweat, lower rise in rectal temperature and less increase in heart rate than nonathletes.
It is concluded that heat tolerance of athletes was superior to that of nonathletes when assessed by our heat tolerance indices and this superior heat tolerance of athletes could be explained due to a result of physical training. Heat tolerance index, representing the magnitude of physiological strain in the body induced by heat load, was modified by using relative increase in heart rate in place of salt loss. It can be said that the modified heat tolerance index is useful as a substitute of the original heat tolerance index in field studies.

A 73-year-old man visited our hospital with complaints of fever, epigastric painand jaundice. Laboratory examinations showed elevation of GOT, GPT, ALP, LAP and amylase. Abdominal ultrasonography revealed gall bladder stones. Endoscopic findings showed parapapillary diverticulum, but the common bile duct stone was not revealed by endoscopic retrograde cholangiography. He was conservatively treated and then discharged. Two months after, the patient was readmitted for cholecystitis and underwent cholecystectomy. After further 2 months, he was again admitted for the same symptoms as those on first admission. We diagnosed this case as Lemmel's syndrome and performed emergency endoscopy. Endoscopic findings revealed the meal rest inside the parapapillary diverticulum. After we removed the meal rest obstructing the orifice of the papilla of Vater using grasping forceps, we performed EST. Purulent bile gushed out from the orifice. Two years have elapsed since them. Cholangitis has not recurred during this period. Therefore, we concluded that EST is effective in treating Lemmel's syndrome.

STUDY DESIGN: Retrospective case-control study. PURPOSE: To evaluate the primary outcomes and radiographic results of percutaneous vertebroplasty (PVP) in patients with singlelevel osteoporotic vertebral fracture (OVF) with intravertebral cleft (IVC) to identify the risk factors for cement loosening after PVP. OVERVIEW OF LITERATURE: PVP is a widely accepted method for managing painful OVF; however, cement loosening occasionally occurs with poor outcomes. METHODS: This retrospective study involved 195 patients treated with PVP for single-level OVF with IVC. Six months thereafter, the primary outcomes were evaluated using the Visual Analog Scale (VAS) for back pain and the modified Oswestry Disability Index. Computed tomography was conducted to detect cement loosening. Possible risk factors, such as age, sex, wedging angle, intravertebral instability, Parkinson’s disease, spinous process fracture, ankylosing spinal hyperostosis, split vertebrae, and adjacent intervertebral vacuum, were assessed. RESULTS: Forty-nine patients (25%) experienced cement loosening 6 months after PVP. The mean VAS scores were significantly higher in patients with cement loosening than in those without (50 vs. 26 mm, respectively; p < 0.01). Cement loosening was closely associated with intravertebral instability (odds ratio [OR], 1.20; 95% confidence interval [CI], 1.04–1.40; p =0.015), Parkinson’s disease (OR, 54.31; 95% CI, 4.47–659.53; p =0.002), spinous process fracture (OR, 7.11; 95% CI, 1.65–30.60; p =0.009), and split vertebrae (OR, 11.59; 95% CI, 1.64–82.02; p =0.014). CONCLUSIONS: Patients with cement loosening experienced worse back pain than those without cement loosening. The important risk factors that influenced cement loosening after PVP were high intravertebral instability, Parkinson’s disease, spinous process fracture, and split vertebrae.
Back Pain ; Case-Control Studies ; Humans ; Hyperostosis ; Methods ; Retrospective Studies ; Risk Factors ; Spine ; Vacuum ; Vertebroplasty ; Visual Analog Scale

No abstract available.
Retrospective Studies ; Risk Factors ; Vertebroplasty

We investigated the effects on medical education of early exposure of undergraduate students to a summer camp for children with asthma. An objective evaluation by the editorial staff found final improvements in the following areas (in descending order of frequency): learning of basic medical behavior (91% of students); cooperative attitude of medical staff in general treatment with the patient and the patient's family (88%); understanding of childhood growth and development (80%); knowledge of childhood asthma (69%); and mastery of basic techniques for therapy and examination (41%). The differences in the ratio of improvement (%) before and after visiting the camp, were (in descending order of frequency): cooperative attitude of medical care staff in general medical treatment with the patient and the patient's family (47%); understanding of childhood growth and development (45%); knowledge of childhood asthma (38%); learning of basic medical manner (34%); and mastery of basic techniques for therapy and examination (25%). These findings suggest that a summer camp is useful for exposing undergraduate medical students to children with asthma and is effective for helping them understand patients and family-oriented pediatric medicine.

BACKGROUND/OBJECTIVES: Osteoarthritis (OA) is a major public health issue in Japan and other countries, and foods that prevent or treat OA are in strong demand. Proteins and peptides in chicken meat and bones are known for being rich in functional and nutritional ingredients for the improvement of osteoporosis. We speculated that chicken legs, a food consumed in many regions of the world, may also contain such ingredients. In this study, we aim to (i) evaluate the effect of chicken leg extract (CLE) on the promotion of cartilage matrix production and (ii) identify the active ingredient in CLE that contributes to this function. MATERIALS/METHODS: Artificial CLE digest was prepared, and the acid mucopolysaccharide production-promoting activity of the CLE digest was evaluated by alcian blue staining of ATDC5 cells. CLE was orally administered to rabbits with burr holes in the knee joint of the femur, and the degree of regeneration of cartilage matrix was evaluated. Furthermore, we investigated orally administered CLE-derived peptides in human plasma using LC-MS. From measuring the acid mucopolysaccharide production-promotion activity of these peptides, a molecule considered to be an active ingredient in the CLE digest was identified. RESULTS: CLE digest promoted acid mucopolysaccharide production and facilitated regeneration of cartilage matrix in in vitro and in vivo experiments. Four peptides including phenylalanyl-hydroxyproline (Phe-Hyp) were detected as CLE-derived peptides in human plasma. The effect of CLE was inferred to be due to Phe-Hyp, which was confirmed to be present in the CLE digest. CONCLUSIONS: It was shown that CLE stimulated the production of articular cartilage matrix both in vitro and in vivo, and that CLE could be an effective food for preventing or treating OA. Furthermore, only Phe-Hyp was confirmed as the active compound in the CLE digest, suggesting that the activity of CLE was due to Phe-Hyp.
Alcian Blue ; Cartilage ; Cartilage, Articular ; Chickens ; Femur ; Humans ; In Vitro Techniques ; Japan ; Knee Joint ; Leg ; Meat ; Osteoarthritis ; Osteoporosis ; Peptides ; Plasma ; Public Health ; Rabbits ; Regeneration

Methods: Patients with degenerative lumbar diseases, whose MRIs detected BME, were enrolled. On a T2-weighted fat-saturated MRI, BME appeared as a high-intensity region adjacent to the vertebral endplate. We calculated the contrast ratios (CRs) of BME and normal bone marrow using the signal intensities of BME, normal bone marrow, and the spinal cord. On computed tomography, we calculated Hounsfield unit (HU) values in the same area as BME, the sclerotic endplate, and normal bone marrow to assess bone density. Results: There were 16 men and 14 women, with an average age of 73.5 years. The mean CRs of BME and normal bone marrow were −0.015±0.056 and −0.407±0.023, respectively. BME’s CR was significantly higher than that of normal bone marrow (p<0.01). The HU values in the same area as BME, the sclerotic endplate, and normal bone marrow were 251.9±24.6, 828.3±35.6, and 98.1±9.3, respectively; these values were significantly different from each other (p<0.01). Conclusions The CR on MRI is a useful quantitative assessment tool for BME in patients with degenerative lumbar diseases.

BACKGROUND: Predictive factors for the efficacy of dipeptidyl peptidase-4 (DPP-4) inhibitors for lowering glycosylated hemoglobin (HbA1c) remain unclear in patients with type 2 diabetes mellitus. The aim of this study is therefore to clarify predictive factors of the efficacy of DPP-4 inhibitors for lowering HbA1c after 12 months of treatment. METHODS: A total of 191 consecutive type 2 diabetic patients (male sex 55%, mean age, 68.3+/-35.8 years), who had been treated with DPP-4 inhibitors for 12 months, were enrolled in this study and evaluated retrospectively. RESULTS: After 12 months of DPP-4 inhibitor treatment, random blood glucose level, and HbA1c level, decreased from 167+/-63 to 151+/-49 mg/dL (P<0.01), and from 7.5%+/-1.3% to 6.9%+/-0.9% (P<0.01) respectively, without severe side effects. Multiple regression analysis showed that predictors of DPP-4 inhibitor treatment efficacy in lowering HbA1c level after 12 months were a decrease in HbA1c level after 3 months of treatment, a high baseline HbA1c level, a low baseline body mass index, and the absence of coronary artery disease. CONCLUSION: Most suitable candidates for treatment with DPP-4 inhibitors are diabetics who are not obese and do not have coronary artery disease. In addition, long-term efficacy of DPP-4 inhibitors can be predicted by decrement of HbA1c after 3 months of treatment.
Blood Glucose ; Body Mass Index ; Coronary Artery Disease ; Diabetes Mellitus ; Diabetes Mellitus, Type 2* ; Dipeptidyl-Peptidase IV Inhibitors ; Hemoglobin A, Glycosylated ; Humans ; Retrospective Studies ; Treatment Outcome