Phagocytic cells, polymorphonuclear leucocytes and macrophage, play an important role in a non-specific cellular immunity which is first defense line for infectious disease. The purpose of this paper is to clarify combined effects of stressful exercise and sleep disturbance on rat non-specific cellular immunity represented by yields of cells from bronchoalveolar lavage and superoxide generating capacity of alveolar macrophage.
Male Wistar rats ( 5 weeks old) were divided into following 4 groups. 1) Training group; exercised on a treadmill at a belt speed of 35 m/min for 45 min/day, 2) Jet Lag group; noninvasive sleep disturbance by the shifted day/night time every 2 week interval, 3) Training + Jet Lag (T+ J) group ; exercised on a treadmill with sleep disturbance, that we assumed one of chronic fatigue model in this paper, and 4) Control group ; set sedentary condition.
After 6 weeks of the experiment, 2 groups were newly selected from T + J group for the examination of rest effects on the chronic fatigue model rats. And to examine the combined effects of stressful exercise and sleep disturbance on matured rats (11 weeks old), Acute Training + Jet Lag (AT+J) group was selected from the Control group.
Rats were sacrificed at 11 and 17 weeks old. T + J group seemed to be able to adapt first 6 weeks but negative effects were found out at 17 weeks old. Same phenomena were also recognized in AT + J group. These results suggest that the chronic fatigue model rats may easily catch the infectious disease and there are possibility that both stress, stressful exercise and sleep disturbance, negatively affects the non-specific cellular immunity, especially after maturation.

The principal objective of this paper is basic research on the development of an easy and rapid method to estimate physical fatigue levels. The focus of the research is to determine chronically fatigued conditions at an early stage for the prevention of chronic fatigue. Special attention was given to overtraining as one form of chronic fatigue in this paper. Long-distance runners representatives of a university in Tokyo nominated for Hakone-Ekiden were recruited as subjects. Examinations with informed consent were carried out on a once a month basis during 8 months and included the following; 1) physical characteristics ; body weight and body fat weight, 2) serum-biochemical test ; 6 parameters by the dry-chemistry method and the traditional method, 3) subjective fatigue levels ; the questionnaire of subjective symptom authorized by the Japan association of industrial health and the profile of mood state (POMS) . In this paper, data obtained from 19 male runners attending all 8 examinations were statistically analyzed.
Serum parameters obtained by the dry-chemistry method, an easy and rapid method which provides clinical values on site, showed significant correlations with the traditional method.
No correlation was observed between subjective fatigue scores and serum enzyme activity levels which were used as markers for estimation of physical fatigue levels in this study, however, monthly changes of enzyme levels and fatigue scores from July to August seemed to correlate in almost subjects. In contrast, using data obtained in the entire exprimental period, there was no relationship between the monthly changes of enzyme levels and fatigue scores. The results may indicate that some subjects exhibit gaps between physical fatigue and feelings of fatigue.
The above mentioned results suggest that measurements of serum enzyme activity levels using the dry-chemistry method are a useful indicator for the prevention of overtraining.

Phagocytic cells, polymorphonuclear leucocytes and macrophages, play an important role in non-specific cellular immunity, which is the first line of defense against infectious diseases. The purposes of this study were to clarify the combined effects of forced exercise and sleep disturbance on non-specific cellular immunity in mature rats, and to compare the effects between forced and voluntary exercise. Non-specific cellular immunity represented by the yield of cells from bronchoalveolar lavage and the superoxide-generating capacity of alveolar macrophages was investigated using mature rats.
Male Wistar rats (11 weeks old) were divided into 5 groups:
1) Training group ; exercised on a treadmill at a belt speed of 35 m/min for 15 min/day,
2) Jet Lag group ; disturbance of the sleep cycle by day/night time shifts at 2-week intervals,
3) Training+ Jet Lag (T + J) group ; exercised on a treadmill with sleep disturbance, a model identified by our research group to simulate chronic fatigue, 4) Voluntary group ; housed with running wheels, and 5) Control group ; housed under sedentary conditions.
Body weight and food consumption measured during the experimental period showed coincidental changes. After 6 weeks of the experiment, the rats were sacrificed at the age of 17 weeks. Negative effects on non-specific cellular immunity were observed in the training group, and the rats were also slightly affected by sleep disturbance (Jet Lag group) . These negative effects seemed to be cumulative in the T+J group. In contrast, significant positive effects were observed in the voluntary group.
These results suggest that stress, forced exercise and sleep disturbance negatively affect non-specific cellular immunity, and that voluntary exercise is able to enhance immunity even if it is started after maturation.

OBJECTIVETo identify the ankyrin-B gene mutations that cause long QT syndrome (LQTS) and determine the prevalence of such mutations in Japanese patients with LQTS.

METHODSWe conducted a search for ankyrin-B gene mutation in 78 unrelated patients with LQTS (28 males and 50 females, aged 2 to 89 years). With informed consent from all the subjects and/or their parents, genomic DNA was purified from the white blood cells of the patients and amplified using polymerase chain reaction (PCR). Single-strand conformational polymorphism (SSCP) analysis of the amplified DNA was performed to screen for mutations and aberrant SSCP products were isolated and sequenced by dye terminator cycle sequencing method using an automated fluorescent sequencer. PCR and restriction fragment length polymorphism (PCR-RFLP) analysis was carried out to further confirm the missense mutations by comparison with samples from 150 normal healthy individuals.

RESULTSWe identified a T to A transition mutation at position 4,603 in exon 40, resulting in the substitution of arginine for a tryptophan at amino acid residue 1,535 (W1535R) in the regulatory domain of 220-kD ankyrin-B, which is a highly conserved domain shared by different species.

CONCLUSIONThis novel missense mutation in the ankyrin-B gene may be a cause of type 4 LQTS. Ankyrin-B gene mutation might not play the major role in LQTS in Japanese.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Amino Acid Substitution ; Ankyrins ; genetics ; Base Sequence ; Child ; Child, Preschool ; Exons ; Female ; Humans ; Long QT Syndrome ; genetics ; Male ; Middle Aged ; Molecular Sequence Data ; Mutation, Missense ; Point Mutation

BACKGROUND/AIMS: The effects of Histamine-2 receptor antagonists and proton pump inhibitors on the gastrointestinal motility have not yet been sufficiently investigated. The aim of this study was to determine the effects of intravenous bolus administration of famotidine and omeprazole on the rate of gastric emptying using the continuous 13C breath test (BreathID system, Exalenz Bioscience Ltd, Israel). METHODS: Twelve healthy male volunteers participated in this randomized, 3-way crossover study. After fasting overnight, the subjects were randomly assigned to receive 20 mg of famotidine, 20 mg of omeprazole or 20 mL of saline alone by intravenous bolus injection before a test meal (200 kcal per 200 mL, containing 100 mg of 13C-acetate). Gastric emptying was monitored for 4 hours after the ingestion of test meal by the 13C-acetic acid breath test performed using the BreathID system. RESULTS: No significant differences in the calculated parameters, namely, the T1/2, Tlag, GEC, beta and kappa, were observed among the 3 test conditions. CONCLUSIONS: The study revealed that intravenous administration of gastric acid suppressant drugs had no significant influence on the rate of gastric emptying in comparison with that of saline alone as a placebo. Our results indicating the absence of any effect of either famotidine or omeprazole on accelerating the rate of gastric emptying suggest that both medications can be administered safely to patients suffering from hemorrhagic peptic ulcers who need to be kept nil by mouth from the viewpoint of possible acceleration of gastrointestinal motility in the clinical setting.
Acceleration ; Administration, Intravenous ; Breath Tests ; Cross-Over Studies ; Eating ; Famotidine ; Fasting ; Gastric Acid ; Gastric Emptying ; Gastrointestinal Motility ; Humans ; Male ; Meals ; Mouth ; Omeprazole ; Peptic Ulcer ; Proton Pump Inhibitors ; Proton Pumps ; Protons ; Stress, Psychological

BACKGROUND/AIMS: There are few reports on the correlation between chewing gum and the gastrointestinal functions. But previous report showed use of chewing gum to be an effective method for controlling gastrointestinal symptoms. The aim of this study was to determine the correlation between chewing gum and gastric emptying using the continuous real time 13C breath test (BreathID system). METHODS: Ten healthy male volunteers participated in this randomized, 2-way crossover study. The subjects fasted overnight and were randomly assigned to chewing gum (Xylish, 2-3/1 tablet) for an hour following intake of a test meal (200 kcal/200 mL) or intake of the test meal alone. Gastric emptying was monitored for 4 hours after administration of the test meal by the 13C-acetic acid breath test performed continually using the BreathID system. RESULTS: No significant differences in the calculated parameters, namely, T1/2 (median, 111.82 vs 109.26 minutes; P = 0.575), Tlag (median, 53.28 vs 56.53 minutes; P = 0.333), gastric emptying coefficient (median, 3.58 vs 3.65; P = 0.285), regression-estimated constant beta (median, 1.85 vs 1.80; P = 0.575) and regression-estimated constant kappa (median, 0.61 vs 0.62; P = 0.959) were observed between the test meal alone group and the test meal and chewing gum group. CONCLUSIONS: This study showed that chewing gum had no effect on the rate of gastric emptying. Therefore, since chewing gum did not enhance the speed of gastric emptying, it may ameliorate gastrointestinal symptoms through other mechanisms, such as saliva and autonomic nervous system.
Autonomic Nervous System ; Breath Tests ; Chewing Gum ; Cross-Over Studies ; Gastric Emptying ; Humans ; Male ; Mastication ; Meals ; Saliva

Background/Aims: Several studies have assessed the effect of cool temperature on colonic peristalsis. Transient receptor potential melastatin 8 (TRPM8) is a temperature-sensitive ion channel activated by mild cooling expressed in the colon. We examined the antispasmodic effect of cool temperature on colonic peristalsis in a prospective, randomized, single-blind trial and based on the video imaging and intraluminal pressure of the proximal colon in rats and TRPM8-deficient mice. Methods: In the clinical trial, we randomly assigned a total of 94 patients scheduled to undergo colonoscopy to 2 groups: the mildly cool water (n = 47) and control (n = 47) groups. We used 20 mL of 15°C water for the mildly cool water. The primary outcome was the proportion of subjects with improved peristalsis after treatment. In the rodent proximal colon, we evaluated the intraluminal pressure and performed video imaging of the rodent proximal colon with cool water administration into the colonic lumen. Clinical trial registry website (Trial No. UMIN-CTR; UMIN000030725). Results: In the randomized controlled trial, after treatment, the proportion of subjects with no peristalsis with cool water was significantly higher than that in the placebo group (44.7% vs 23.4%; P < 0.05). In the rodent colon model, cool temperature water was associated with a significant decrease in colonic peristalsis through its suppression of the ratio of peak frequency (P < 0.05). Cool temperaturetreated TRPM8-deficient mice did not show a reduction in colonic peristalsis compared with wild-type mice. Conclusion For the first time, this study demonstrates that cool temperature-dependent suppression of colonic peristalsis may be associated with TRPM8 activation.

Anti-inflammatory therapy is generally considered to be prior to surgery for Takayasu disease to achieve better outcomes. We report two Takayasu arteritis patients with thoracic aneurysm. Case 1 was a 19-year-old woman who presented acute trachyphonia for one month. CT revealed aortic arch aneurysm of which maximal diameter was 64 mm with partial cystic protrusion. We performed urgent total arch replacement before anti-inflammation therapy was induced. Postoperative course was uneventful and the patient discharged on steroid therapy. Case 2 was a 35-year-old woman who complained chest pain for two weeks. CT revealed a Valsalva aneurysm with maximal diameter 54 mm and the aortic wall of the arch including its branches was surrounded by thick low density area. As the FDG-PET confirmed inflammatory arteritis, initial steroid therapy was planned. However, one day before admission, the patient presented acute aortic dissection and did not respond to any resuscitation. We conclude that the right time of surgery or the initial induction of anti-inflammatory therapy for anuerysmal dilation by Takayasu arteritis is to be determined based not only on the inflammation level but also on aneurysmal size and the patient's severity of complaints.

Today, syphilitic aortic aneurysm is rarely diagnosed due to widespread use of penicillin for early syphilis. Large aneurysms can be symptomatic by compressing on adjacent organs. We report a case of a huge syphilitic aneurysm of the thoracic aorta complicated with airway obstruction and superior vena cava syndrome. A 62-year-old man presented with acute severe dyspnea and distention of superficial veins. Contrast-enhanced computed tomography revealed an aneurysm of the ascending aorta extending to the transverse arch the diameter of which was 90 mm. The aneurysm compressed the bilateral main bronchi and superior vena cava. We performed an emergency operation because respiratory failure persisted despite the support of a ventilator. Since the aneurysm eroded the sternum, median sternotomy was performed under hypothermic circulatory arrest. Dissecting the aneurysm was complicated due to dense adhesion. Ascending aorta and partial arch replacement with reconstruction of the brachiocephalic trunk was successfully performed with antegrade cerebral perfusion. Postoperative computed tomography demonstrated that compression of the bilateral main bronchi was released. The result of preoperative syphilitic serologic test was strongly positive, and pathological findings of the aneurysm wall specimen was compatible with syphilitic aneurysm. Following treatment with benzyl penicillin for 14 days, the patient was discharged on the 19th postoperative day without specific complications.

Surgical stress is closely associated with the activity of the thyroid hormone. Although many patients undergoing cardiac surgery revealed markedly low triiodothyronine (T3), few patients showed symptomatic hypothyroidism. This condition is generally recognized as “non thyroidal illness (NTI) ” which is characterized by a low T3 level, despite the normal function of hypothalamus-pituitary-thyroid system. NTI is generally considered as one of the biological defense mechanisms rather than a pathological condition, eliminating the requirement of medical intervention. Even if low T3 is observed in blood biochemical examination after open heart surgery, a cautious interpretation is required. We report an elderly case presenting severe fatigue and mild disorientation accompanied by significantly low thyroid hormone after aortic valve replacement. The morbidity was remarkably improved with medical treatment, suggesting hypothyroidism after cardiac surgery.