[Objective]Daily repetitive exercise is known to be necessary for players in sports. In this study, to further explore the potential functions of acupuncture, we studied whether electroacupuncture (EA) stimulation has efficacy for repetitive exercise-induced oxidative stress.
[Methods]Six healthy male volunteers participated in both the non-treatment control group and the EA group in a crossover design. EA stimulation was applied to both the medial vastus muscles at 2 Hz and optimum intensity for each subject during ten min just before each exercise period. The subject performed ergometer exercise for 20 min with 75%of maximal oxygen uptake each day. This exercise period was performed once a day for three consecutive days. Blood lactate level (BLL) and plasma lipid peroxide (LP) concentration were measured as the markers for metabolism and oxidative stress, respectively. Visual Analogue Scale (VAS) was used to evaluate the individual level of fatigue due to exercise.
[Results]During and just after the exercise period, each value of BLL in the EA group was lower than the same points in the control group. Whereas LP concentrations before the exercise period on the first day in the control group was higher than the values in the same points on the second and third days. LP concentrations before the exercise period in the EA group were almost the same levels for three days. Furthermore, after the exercise period for the three consecutive days, LP concentrations and VAS in the EA group were lower than each value of the same points in the control group, and especially, the alteration of VAS showed a significant difference.
[Conclusion]The increased tendency of LP concentrations before the exercise period for three days in the control group indicated that repetitive exercise induced the accumulation of excess lipid peroxide. It might be suggested that EA stimulation suppressed subjective fatigue by an enhanced energy metabolic rate and decreased production of lipid peroxide. Hence the evidence strongly supported that EA stimulation might be useful for sports conditioning.

No abstract available.
Rectum*

  In Japan, sudden death in the bathroom (‘bath-related death’) occurs particularly in the elderly population in winter. Previously, we showed that bath-related death in Kagoshima Prefecture occurs at similar frequency as that in other prefectures, despite its warm environment. In this study, we performed a retrospective review of the inquest records in Kagoshima from between 2006 and 2013 in order to compare the demographic and circumstantial factors of the following 3 groups classified by the location where the death occurred: home bathroom, spa, and nursing home bathroom. The total number of the deaths was 1533 (759 males and 774 females), which corresponds to a crude mortality rate of 11.3 per 100,000 person-years. Most of the deaths occurred at home (1319; 86.0%), followed by spa (159; 10.4%), nursing home (18; 1.2%), and others (37; 2.4%). In all 3 groups, most of the deceased were over 65 years old and were found sinking in the bathtub. The greatest number of deaths occurred in the winter at home (52.6%) and at a spa (54.7%) compared to other seasons. In contrast, death occurred most frequently in the spring at nursing homes (44.4%), when unexperienced staff begin to work in Japan. There was no significant difference in gender between home and nursing home cases, whereas significant more men died at a spa (p=0.0014). Although most deaths occurred at home between 16:00 and 20:00, a time when the elderly usually take a bath in Japan (49.4%), those at a spa and nursing home occurred earlier (12:00-16:00). The most common past history of illness was hypertension in home and spa cases, and that in nursing home cases was cardiovascular disease. Cardiac events leading to tragic results may occur more frequently in people with these illnesses than in healthy individuals while bathing. A history of drinking alcohol before bathing was observed in minor populations in home and spa cases, although it is also a known risk factor for death. However, the positive rate of spa cases was higher than that of home cases (8.2% vs. 3.3%). In all 3 groups, the most common cause of death indicated on the death certificate was heart disease such as myocardial infarction and arrhythmia (about 50%), followed by drowning. Except for 10 cases in which autopsy was performed, the cause of death in most cases was determined by only external examinations. Instead of autopsy, postmortem computed tomography (PMCT) scanning was performed in 44.9% of cases from 2010 to 2013. Cases that were diagnosed as drowning based on the findings by PMCT imaging have increased in recent years. However, PMCT is inferior to autopsy in detecting intrinsic disease and in elucidating a pathophysiological mechanism leading to drowning. In order to reduce the number of bath-related deaths, it is necessary to accumulate further evidence by increasing the number of cases undergoing autopsy, and to prompt the government and society to develop protective activities not only for known risk factors for death, but also for those peculiar to the bathing location.

Superficial colonic neoplasms sometimes extend into a diverticulum. Conventional endoscopic mucosal resection of these lesions is considered challenging because colonic diverticula do not have a muscularis propria and are deeply inverted. Even if the solution is carefully injected below the mucosa at the bottom of the diverticulum, the mucosa is rarely elevated from the diverticular orifice, and it is usually just narrowed. Although endoscopic submucosal dissection or full-thickness resection with an over-the-scope clip device enables the complete resection of these lesions, it is still challenging, time consuming and expensive. Underwater endoscopic mucosal resection without submucosal injection (UEMR) is an innovative technique enabling en bloc resection of superficial colon lesions. We report three patients with colon adenomas extending into a diverticulum treated with successful UEMR. UEMR enabled rapid and safe en bloc resection of colon lesions extending into a diverticulum.

Superficial colonic neoplasms sometimes extend into a diverticulum. Conventional endoscopic mucosal resection of these lesions is considered challenging because colonic diverticula do not have a muscularis propria and are deeply inverted. Even if the solution is carefully injected below the mucosa at the bottom of the diverticulum, the mucosa is rarely elevated from the diverticular orifice, and it is usually just narrowed. Although endoscopic submucosal dissection or full-thickness resection with an over-the-scope clip device enables the complete resection of these lesions, it is still challenging, time consuming and expensive. Underwater endoscopic mucosal resection without submucosal injection (UEMR) is an innovative technique enabling en bloc resection of superficial colon lesions. We report three patients with colon adenomas extending into a diverticulum treated with successful UEMR. UEMR enabled rapid and safe en bloc resection of colon lesions extending into a diverticulum.

Objective: Caffeine may cause dependence and sleep disturbance, and interact with psychotropic drugs.　Therefore, the caffeine intake of patients with mental disorders should be monitored.　However, in Japan, there is no report on the effects of caffeine in mental disease patients or on their caffeine intake.　Therefore, we conducted a questionnaire survey to clarify the perception of caffeine for psychiatric outpatients.Methods: We conducted an anonymous survey on caffeine recognition for outpatients at 8 medical institutions that advocate psychiatry.Results: We collected questionnaires from 180 people.　The knowledge of foods containing caffeine tended to be high in those who had a positive attitude toward caffeine.　More than 90% of those surveyed knew that coffee contains caffeine, but cocoa and jasmine tea were recognized by less than 25%.　Of those surveyed, 39.4% consumed caffeine‐containing beverages at night.　In addition, the rate of consumption of caffeine‐containing beverages tended to be higher at night because they had a positive attitude toward caffeine.Conclusion: The knowledge and intake situation of caffeine by patients with mental disorders differed depending on their interests and way of thinking about caffeine.　As caffeine intake may influence psychiatric treatment, correct knowledge regarding caffeine is important.