Although there are a number of reported cases of increased cerebral blood flow during exercise, there are no reports on the relation between changes of blood flow during exercise and attentional function. The purpose of this study is to clarify the relation between changes of blood flow during exercise with AT intensity and attentional function, using near-infrared spectral analysis. The subjects were 10 healthy males. The research protocol was to conduct steady load exercise. We randomly conducted two invention trials: 1) an exercise/task trial in which a trail making test (TMT) was performed as an attentional assignment during steady load exercise, and 2) a rest/task trial in which TMT was performed during rest as a control. As a result, we observed the following: increase of oxy-Hb in the prefrontal cortex during AT exercise, the significant shortening of TMT during exercise from 69.1±10.2 seconds to63.2±7.2seconds, and, with further control, that the more oxy-Hb rises, the more TMT time is shortened. From these results, it is suggested that 10 minutes of exercise would improve attentional function, and furthermore, there is a possibility that increased cerebral blood flow may be involved with the improvement of attentional function.

The purpose of this study was to investigate the effect of constant endurance cycling exercise below Ventilatory Threshold (VT), under different pedal rate/torque regulations (PTR), on muscle oxygenation, as well as cardio-respiratory function and energy metabolism. Eight healthy male adults participated in the study for three tests. The first test was to examine the maximum oxygen uptake (VO₂max) using a ramp loading measurement of 60 rpm, 20 watt/min ; and an individual 80%VT load was obtained. The second and third tests (random) were to measure heart rate (HR), blood pressure (MAP), expired gas and NIRS data before, during and after 30 min 80%VT constant cycling exercise with low pedal rate/high torque (LPHT : 32 rpm, 23.3±6.0Nm) or high pedal rate/low torque (HPLT : 79rpm, 9.4±2.4Nm). As a result, HPLT showed higher values in HR (p<0.001), MAP (p<0.001), VO₂ (p<0.001), VCO₂ (p<0.001) and RER (p<0.05), than LPHT ; but LPHT showed a higher fat consumption rate than HPLT (p<0.05). Significant PTR effect were recognized for the parameters of the tissue hemoglobin index (THI) (p<0.001) and oxygenation hemoglobin (ΔO₂Hb) (p<0.01) ; and both indicated higher values for HPLT than LPHT ; but LPHT showed insignificantly (p=0.066) higher de-oxygenation hemoglobin (ΔHHb) than HPLT. Moreover, the significant time effects of THI and ΔO₂Hb were also recognized. In conclusion, this study indicated that during constant cycling exercise below VT, HPLT might result in greater muscle blood volume, higher muscle oxygenation concentration and higher HR and VO₂ compared with LPHT. These results suggest that, HPLT might be effective in alleviating the working load on lower limbs, as well as promoting muscle oxygenation, cardiorespiratory function (systemic oxygen supply) and energy metabolism. Therefore, HPLT constant cycling exercise below VT could be used in a rehabilitation program as a beneficial exercise for elderly people with decreasing muscle strength in their lower limbs.

The decrease of balance capacity is considered as a high risk factor of fall accident, so it is important for the middle-aged and elderly people to keep balance capacity on a high level. In this study, we investigated the effects of aqua exercise on dynamic and static balance function. Thirty-two middle-aged women (56.6±8.1 years) participated a 60-min aqua exercise program three times per week for eight weeks. After exercise intervention, body weight, body mass index, grip strength, side step, shuttle stamina walking test were significantly improved (p<0.05-0.001). Functional reach (p<0.001) and total length of centroid shake with eye close condition (p<0.05) was significantly improved, but with eye open condition was not changed. However, when we evaluate the total length of centroid shake by T-score, static balance performance with eye open and close condition was significantly (p<0.05) improved in the below average groups. In addition, measurement value of functional reach was also improved in these groups. These results indicate that aqua exercise benefits not only physical muscle strength and endurance capacity, but also balance function in middle-aged women. Particularly aqua exercise is more effective for the subjects with lower static balance function before intervention.

The aim of the present study was to examine whether amount of oral cortisol, immunoglobulin A (IgA), chromogranin A (CgA) and inflammatory cytokines, might be affected by prolonged strenuous exercise. Ten young male volunteers either exercised on recumbent ergometer at 75 % VO₂ max for 60 min (exercise session) or sat quietly (resting session). Saliva samples were obtained at 60 min intervals during sessions for measurements of salivary stress markers (cortisol, IgA and CgA), salivary inflammatory cytokines, such as interleukin-1β (IL-1β), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) and osmolality. Saliva flow rate was decreased and saliva osmolality was increased during the 60-min exercise. Saliva cortisol and CgA concentrations and secretion rates were increased during and after the exercise, whereas saliva IgA concentration and secretion rates were decreased after the exercise. Salivary inflammatory cytokines was increased during and after the exercise. The present findings suggested a single bout of prolonged strenuous exercise caused a transient increase in the salivary cortisol, CgA and inflammatory cytokines levels, whereas salivary IgA concentration and secretion rates were decreased after the exercise. Further studies, however, are needed to delineate whether or not salivary stress markers and inflammatory cytokines may be used as biological markers to determine the host responses to acute prolonged strenuous exercise.

We investigated the relationship between body weight reduction and intensity of daily physical activities assessed with 3-dimensional accelerometer during a 3-month exercise program. Twenty-six middle-aged women (58.1±7.4 yrs.) participated in this study. Participants underwent a 90-min endurance exercise intervention once a week, and a 3-dimensionsal accelerometer was attached through the program. Body weight (BW), body mass index, fat mass and percent body fat were reduced significantly (p<0.001), while diastolic blood pressure (p<0.01) and shuttle stamina walking test (p<0.05) improved significantly after the exercise intervention. Moreover, a significant negative correlation was observed between the changes in BW and total activity time (TAT) per day of more than 3METs (TAT≥3METs)(r=−0.580, p<0.01) and TAT≥4METs (r=−0.627, p<0.001). To the contrary, the daily steps and the TAT≥2METs were not related to the changes in BW. After adjusting daily steps, TAT≥3METs (β=−0.630, p<0.01) and TAT≥4METs (β=−0.659, p<0.01) were still significantly related to the changes in BW. These results indicate that weight reduction has a much closer relationship with exercise intensity than daily steps. It is important to keep both quantity and intensity of exercise in the unsupervised exercise program aimed at weight reduction.

The purpose of this study was to examine the effects of aquatic exercise training on the trunk muscles function and activities of daily living in abdominal obese women. Nineteen abdominal obese (abdominal circumference: 90 cm or more) and fifteen age-matched non-obese women were recruited as participants in this study. The aquatic exercise training (60 min/day, three days/week for 8 weeks) based on abdominal twists for activating the trunk muscle function. Physical parameters, biochemical characteristics, arteriosclerotic parameters and activities of daily living scores were assessed before and after the training period. In both groups showed abdominal circumference, percent of body fat, blood pressure and lower extremity muscle strength increased significantly after aquatic exercising training. In particular, endurance capacity of abdominal and back muscles increased significantly and activities of daily living scores were significantly improved in the obese group. Moreover, the improvement in the strength of lower extremities and improvement in the activities of daily living scores, such as climbing and descending stairs, in the obese group tended to be higher than non-obese women. Additionally, in abdominal obese group, the amount of the reduction of abdominal circumference was significantly associated with that of the increase in the strength of lower extremities. Taken together, these findings suggest the possibilities that the present aquatic exercise training based on trunk muscle exercise improving the function of trunk and lower extremity muscles with reduction in the abdominal obesity, contributing to improve activities of daily living in abdominal obese women.

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.

A 73-year-old woman presented at our hospital with dyspnea. Echocardiography showed severe aortic stenosis and a coronary angiography revealed right coronary artery disease. Therefore, we performed aortic valve replacement (AVR) and coronary artery bypass grafting (CABG) surgery. Proximal anastomosis was initially attempted to the ascending aorta. However, the ascending aorta was thin and weak, we decided to anastomose to the side of the aortic arch. Proximal anastomosis was performed with an anastomotic device. Postoperative coronary computed tomography (CT) showed that the graft was patent.

Objective: This study intended to clarify whether healthcare professionals provide palliative care and the factors associated with such care. Methods: An anonymous self-administered questionnaire survey was conducted of healthcare professionals in in an acute care hospital in order to investigate their practice and understanding of palliative care as well as their personal attributes. A multivariate logistic regression analysis was conducted to identify factors associated with their palliative care practice. Results: 605 of 955 respondents (response rate: 63%) answered. Twenty-three percent of all respondents answered that they were involved in palliative care practice. A multivariate logistic regression analysis revealed understanding the concept and practical components of palliative care, including the functions of palliative care, differences between primary and specialized palliative care, and advance care planning, were factors associated with palliative care practice. Conclusion: Palliative care specialists should provide the educational support for healthcare professionals to enable them to deepen their understanding of palliative care. Such support from the palliative care specialist may promote the health care professionals’ awareness of their own roles in palliative care.

A 67-year-old man with dyspnea at rest was diagnosed with acute heart failure and admitted to our hospital. Echocardiogram showed severe AR, and CT implied an ascending aortic aneurysm and abnormal space in the aortic root. The patient underwent emergent surgery for suspected acute aortic dissection. Intraoperative findings showed the dehiscence of commissure of the aortic valve, and more, the abnormal space in the aortic root was not due to acute aortic dissection but an aortic subannular left ventricular aneurysm. The aneurysm was sutured and closed, and after that, aortic valve replacement and ascending aortic replacement were performed. Although subannular left ventricular aneurysm is a rare disease, it is important to carry out the preoperative evaluation considering the existence of such diseases.