To investigate the scientific grounds for the effect of raspberry ketone bathing that is claimed to increase energy consumption by stimulating metabolism, a bathing experiment was conducted in 10 normal healthy adults.
As a result, no appreciable difference was detected among tap water, CO₂-enriched water and raspberry water in respect to blood pressure, pulse rate and depth thermometer readings, which suggested that bathing in warm raspberry water was safe, producing no marked load on the cardiovascular system. Changes in the skin surface temperature indicated slow elevation of body temperature, from which bathing in warm raspberry water was considered to produce no marked load on the body even if bathing lasted relatively long as compared with bathing in warm tap water or CO₂-enriched warm water. From the skin tissue blood flow data, it seemed likely that the increase in blood flow caused by bathing in warm raspberry water was produced, not by vasodilatation as in CO₂-enriched warm water bathing, but by such mechanisms as acceleration of metabolism. Data on insulin suggested that bathing in warm raspberry water affected the carbohydrate metabolism as compared with that in warm tap water or CO₂-enriched warm water. Since there was no difference among warm water groups in changes in the adrenocortical hormone “cortisol”, raspberry ketone bathing was considered not to have specific activity. Data on NK cell activity showed that bathing in warm raspberry water produced no appreciable effect on the immune system. It was suggested that measurement of β-endorphin should be performed after adjustment of psychological environments.
The results of expiration air analysis also indicated that, while bathing in CO₂-enriched warm water was related to changes in the cardiovascular system, bathing in warm raspberry ketone water produced no appreciable load on the cardiovascular system but consumed energy through acceleration of metabolic activities.

A total of 1, 000 patients with non-insulin-dependent diabetes mellitus (467 males 533 females) were the subjects of this study designed to clarify the relationships between diabetic neurophathy and obesity. To determine the presence or absence of neuropathy, we interviewed all the subjects and asked them whether or not they had subjective symptoms such as insensitivity of the limbs and conditions associated with autonomic disorder. Furthermore, so long as situations permitted, a battery of tests were given them for the Achilles-tendon reflex and physiological nerve functions. To evaluate the extent of obesity, we used the body mass index (BMI) in accordance with the method proposed by the Japanese Society of Obesity
Results: In obese patients with BMI in excess of 24, subjective symptoms in the limbs, absence of ankle jerks and abnormality in the perception of vibration were observed with higher frequency than in those normal in weight with BMI from 20 to 24. Between these two groups, there was not much difference in the kind of therapy and blood sugara control they received, but the duration of the disease was shorter in the obese group. These findings made us believe that obesity serves as a promoter of neuropathy from the onset.
Even among the slenderly built subjects with BMI below 20, compared with the subjects normal in weight, a large number of them had subjective symptoms of peripheral neuropathy, absence of ankle jerks and abnormal levels of nerve conduction velocity. Between these two groups, there was not much difference in controlled blood sugar level and the duration of the disease, but the percentage of those treated with insulin was higher in the slender groupo than in the noramal-weight group. This fact suggested that severe diabetes might have contributed to the onset of neuropathy.
From the above, we concluded that there is a close link between diabetic neuropathy and obesity, and that proper weight control is a key to the prevention of this type of neuropathy.

A successful surgical correction of an incomplete endocardial cushion defect (ECD) with an ostium primum defect in a 63-year-old man is reported. Incomplete ECD with ostium primum defect often causes severe heart failure in infancy. Reports of its surgical correction in elderly patients are few. The patient had upper abdominal discomfort and grade 1 mitral valve regurgitation. The preoperative diagnosis was complete ECD (Rastelli type A) because we misdiagnosed a leakage from a cleft between the left superior leaflet and the left inferior leaflet for a flow through a ventricular septal defect when we analyzed a preoperative left ventriculography. The importance of not misdiagnosing the leakage and echocardiography in preoperative diagnosis of ECD was therefore realized. The operative procedure involved patch closure of the ostium primum defect and mitral valve annuloplasty by Kay's procedure and the mitral valve regurgitation completely disappeared. The postoperative course was uneventful. The upper abdominal discomfort and cardiomegaly improved. If there is no severe dysfunction of other organs, surgical correction of incomplete ECD should be recommended even for elderly patients.

To investigate a relationship between gender differences in recovery from skeletal muscle fatigue and muscle oxygenation, we examined whether there is a difference in oxygen supply and consumption of the working muscles after intermittent handgrip exercise between young males and females using near-infrared spectroscopy (NIRS). Healthy young subjects (25.8±3.9 years ; males, n=10 ; females, n=10) repeated static maximal voluntary contractions (MVC) with a handgrip for 5 seconds followed by 5 seconds rest for a period of 4 minutes in Study 1. The MVC force was measured before, each minute during the handgrip exercise, and 2, 5, and 10 minutes following the exercise. In Study 2, the selected 10 subjects (males, n=5 ; females, n=5) performed the same exercise and their total- and deoxy- hemoglobin/myoglobin level was measured using the venous occlusion NIRS method; and O₂ supply index (OSI) and O₂ consumption index (OCI) calculated before and after the exercise. In Study 1, females exhibited higher %MVC force at the end of the exercise and during the recovery period than males (p<0.05). In Study 2, the %OSI was significantly lower in females than in males at 5 and 10 minutes in the recovery period (p<0.05), but no significant differences were detected in %OCI. Furthermore, %MVC of the recovery period correlated with %OCI of the recovery period in females (r=0.724, p=0.015), but not in males. These findings suggest that female working muscles can convert consumed oxygen more effectively after an intermittent handgrip exercise, and therefore, be able to recover muscle force faster.

We evaluated the effects of SCP bathing on the body by compared with those of a-EG, one of major component of SCP, bathing and the control bathing with tap water alone. Healthy adults were used as the subjects. The effects of bathing on blood pressure and pulse rate were not significantly different among the three bathings, indicating that effects of SCP and α-EG bathing on the lung and heart were similar to those of an ordinary bathing. The surface skin temperature at the forehead decreased more slowly in the subjects after taking a SCP bathing than the other two, suggesting that SCP has temperature holding effects. Also, the results of deep body temperature suggested that α-EG might be related to the heat absorbing effects of SCP bathing, which were significantly marked than those of the other two bathings. The present results regarding the changes in blood flow and deep body temperature during bathing suggest that SCP might produce an environment that allows more rapid heat transfer from bath water to the body and less releasing it from the body. Therefore, we concluded that some component other than α-ethylglucoside would be involved in the heat transfer and moisturizing during SCP bathing. Measurement of skin water content indicated that a region directly contacting with hot water was moisturized in a short time, but this condition quickly returned to the pre-bath condition. Whereas, for regions not contacting with bath water, the skin was much more moisturized by taking SCP bath than the other two bathings. Therefore, it was concluded that SCP is effective for enhancement of skin moisturizing.

PURPOSE: Ticlopidine hydrochloride, an antiplatelet agent, is believed to have saved life years in many patients with ischemic cerebral vascular diseases in Japan. But severe adverse events have also been reported. The current investigation aimed to compare two hypothetical cohorts treated with and without ticlopidine in terms of risks and benefits of ticlopidine treatment using Markov model.
METHODS: We conducted Markov decision analysis to estimate the number of lives saved and the increase in quality-adjusted life years (QALYs) over the past 20 years by ticlopidine in Japan. Two cohorts of 60-year-old male patients with previous histories of cerebral infarction, one of which treated with ticlopidine and the other not treated with ticlopidine, were compared with respect to the number of deaths and quality of life (QOL) . Data incorporated were the probabilities of the recurrence of cerebral infarction and the associated mortality, adverse events of the drug, and the utility of health status treated with ticlopidine.
RESULTS: Approximately 1, 630, 000 patients were estimated to be on ticlopidine for variable periods of time during the past 20 years in Japan. With treatment, 17, 130 lives were saved, while 1, 338 patients died because of cerebral bleeding, agranulocytosis, severe hepatic dysfunction, or thrombotic thrombocytic purpura, resulting in a net benefit of 15, 792 lives saved by ticlopidine over the past 20 years. In terms of QOL, there was a total increase of 382, 191 QALYs. Sensitivity analyses showed that the older the patients when ticlopidine therapy was started, the smaller the benefits that were gained by treatment.
CONCLUSIONS: Ticlopidine is considered to have made a great contribution in savingmany lives and improving QALYs in the past 20 years in Japan. This kind of analysis based on Markov model can be employed to demonstrate effectiveness of drugs and medical technologies in terms of population health outcomes.

Objective: Aerobic exercise on land decreases arterial stiffness, however, the effect of exercise in water on arterial stiffness has not been clear. This study investigated the effect of a 15-min cycling exercise on land and that in water on pulse wave velocity (PWV) as an index of arterial stiffness. Methods: Nine healthy young men were randomly performed exercise on land and exercise in water equivalent to 50% of each maximum oxygen uptake on separate days. The PWV from carotid to femoral artery (aortic PWV) and femoral to posterior tibial artery (leg PWV) were measured at baseline and 15, 30, 60 min after exercise. Results: The heart rate in water was significantly lower during exercise than that on land. In addition, the carbon dioxide output and respiratory exchange ratio during exercise were significantly greater in water. Body temperature increased after the exercise on land but decreased after the exercise in water. Although the aortic PWV and leg PWV decreased concomitantly with decrease in SBP and DBP after the exercise on land, there were no significant changes after the exercise in water. Conclusion: Although acute exercise on land decreased arterial stiffness after exercise, acute exercise in water of the same exercise load did not. The differences in body temperature and blood pressure after exercise may result in diverse arterial stiffness after exercise.

Investigation was made into the health care conditions in a rural district in Akita Prefecture. Topographically, the district is divided into two parts-one characterized by mountain and the other by flat terrain.
1. In remote, depopulated villages, per capita cost of public health is on the increase.
2. The number of health personell, particularly public health nurses, is not enough to carry on various health programs.
3. With the prospect of greater numbers of the aged in society, there is an urgent need for increased medical services along with the consolidation of primary health care. In order to meet the need, it is necessary to establish a regional community health system comprised of a hospital as a nucleus and neighborhood medical instituions such as clinics and health centers.

OBJECTIVES: To investigate the link between cigarette smoking and muscle strength in Japanese men. METHODS: We used data on 4249 Japanese men, aged 43.3+/-13.9 years, in this cross-sectional investigation study. Grip strength and leg strength were measured as indicators of overall muscle strength. Meanwhile, subjects' cigarette smoking habits were recorded by trained medical staff. The effect of cigarette smoking on muscle strength was evaluated. RESULTS: A total of 1618 men (38.1%) were smokers and 1481 men (34.9%) exercised regularly. Significant differences in muscle strength were noted between men with and without a Brinkman index of 400 or greater, after adjusting for age. After adjusting for age, height, body weight and exercise habits, associations between the Brinkman index and leg strength and the ratio of leg strength to body weight were attenuated. CONCLUSIONS: Cigarette smoking might be negatively associated with muscle strength, especially grip strength in Japanese men.
Adult ; Body Weight ; Exercise ; Hand Strength/physiology ; Humans ; Japan ; Male ; Middle Aged ; Muscle Strength/*physiology ; *Smoking

Due to the widespread acceptance of gastric and esophageal endoscopic submucosal dissections (ESDs), the number of medical facilities that perform colorectal ESDs has grown and the effectiveness of colorectal ESD has been increasingly reported in recent years. The clinical indications for colorectal ESD at the National Cancer Center Hospital, Tokyo, Japan include laterally spreading tumor (LST) nongranular type lesions >20 mm and LST granular type lesions >30 mm. In addition, 0-IIc lesions >20 mm, intramucosal tumors with nonlifting signs and large sessile lesions, all of which are difficult to resect en bloc by conventional endoscopic mucosal resection (EMR), represent potential candidates for colorectal ESD. Rectal carcinoid tumors less than 1 cm in diameter can be treated simply, safely, and effectively by endoscopic submucosal resection using a ligation device and are therefore not indications for ESD. The en bloc resection rate was 90%, and the curative resection rate was 87% for 806 ESDs. The median procedure time was 60 minutes, and the mean size for resected specimens was 40 mm (range, 15 to 150 mm). Perforations occurred in 23 (2.8%) cases, and postoperative bleeding occurred in 15 (1.9%) cases, but only two perforation cases required emergency surgery (0.25%). ESD was an effective procedure for treating colorectal tumors that are difficult to resect en bloc by conventional EMR. ESD resulted in a higher en bloc resection rate as well as decreased invasiveness in comparison to surgery. Based on the excellent clinical results of colorectal ESDs in Japan, the Japanese healthcare insurance system has approved colorectal ESD for coverage.
Asian Continental Ancestry Group ; Carcinoid Tumor ; Colorectal Neoplasms ; Delivery of Health Care ; Emergencies ; Hemorrhage ; Humans ; Insurance ; Japan ; Ligation ; Tokyo