Exercise performance may be enhanced by moderate increasing arousal levels before exercise. Although it is known that playing video games increases physiological and psychological arousal levels, the effects of pre-exercise “video game playing” on exercise performance have not been investigated. We examined the influence of playing a racing video games before exercise on sprint cycling performance. Twelve healthy male university students performed one set of 10 s sprint cycling prior to exercise in the no video game (Con), video game with game sound (SV), and video game without game sound (NSV) conditions on separate occasions. The subjective arousal levels were measured before and after the video game using a questionnaire. The subjective arousal levels after playing the video game were higher in SV than in Con and NSV (p < 0.001, p < 0.01), while higher in NSV than in Con (p < 0.01). The maximum power per body weight during sprint cycling was higher in SV and NSV than in Con (p < 0.05, p < 0.05). The mean power per body weight during sprint cycling was higher in SV than in Con (p < 0.05), while tended to be higher in NSV than in Con (p < 0.1), although NSV tended to be lower than in SV (p < 0.1). These results suggest that the subjective arousal levels increase by playing a racing video game with or without game sounds. The results also suggest that playing a racing video game increases the subjective arousal levels and increases the maximum power and the mean power during sprint cycling.

Methadone is a difficult medicine to assess the efficacy at an initial stage because the blood concentration of it varies greatly among individuals and it takes days to reach a steady state and cannot be increased for 7 days. Nevertheless, there are few reports of blood concentration together with effects after administration of methadone about Japanese cancer patients. In this study, we investigated changes in blood concentration and pain score (NRS), and factors that affect blood concentration. Dose per body weight was only correlated with blood concentration of methadone. In the effective cases, NRS decreased chronologically until the 7th day after treatment initiation, and significantly decreased from the 1st day compared to before treatment initiation, but in the ineffective cases, it tended to decrease until the 3rd day, but there was no change thereafter. The blood concentration increased to 110 ng/ml on the 7th day in the effective cases, and in the ineffective cases, it reached the concentration on the 3rd day. Thus there was no correlation between the blood concentration and the drug efficacy. The individual blood concentrations tended to increase slightly or decrease after the 3rd day, but in only one case, it continued to increase. From the above-mentioned, it was shown that the effect could be judged at an early stage, however, since there was a case in which the blood concentration continued to rise until the 7th day, it was considered that the early dose increase within 7 days after initiation should be performed carefully.

Objective: In this study we sought to investigate the clinical factors that affect postprogression survival (PPS) in patients with recurrent or persistent clear cell carcinoma (CCC).We utilized the JGOG3017/Gynecological Cancer InterGroup data to compare paclitaxel plus carboplatin (TC) and irinotecan plus cisplatin (CPT-P) in the treatment of stages I to IV CCC. Methods: We enrolled 166 patients with recurrent or persistent CCC and assessed the impact of variables, including platinum sensitivity, treatment arm, crossover chemotherapy, primary stage, residual tumor at primary surgery, performance status, ethnicity, and tumor reduction surgery at recurrence on the median of PPS in patients with recurrent or persistent CCC. Results: A total of 77 patients received TC, and 89 patients received CPT-P. The median PPS for patients with platinum-resistant disease was 10.9 months, compared with 18.8 months for patients with platinum-sensitive disease (hazard ratio [HR]=1.88; 95% confidence interval [CI]=1.30–2.72; log-rank p<0.001). In the multivariate analysis, the platinum sensitivity (resistant vs. sensitivity; HR=1.60; p=0.027) and primary stage (p=0.009) were identified as independent predictors of prognosis factors for PPS in recurrent or persistent CCC. Conclusions Our findings revealed that platinum sensitivity and primary stage are clinical factors that significantly affect PPS in patients with recurrent or persistent CCC as wellas other histologic subtypes of ovarian cancer. PPS in patients with recurrent CCC should establish the basis for future clinical trials in this population.

STUDY DESIGN: Retrospective and comparative study. PURPOSE: We assessed surgical treatment outcomes in patients with thoracic myelopathy due to ossification of the ligamentum flavum (OLF), and OLF combined with ossification of the posterior longitudinal ligament (OPLL) or vertebral fracture (VF) at the same level. OVERVIEW OF LITERATURE: OLF and OPLL cause severe thoracic myelopathy. Osteoporotic VF commonly occurs at the thoracolumbar junction. There have been no investigations of thoracic myelopathy due to OLF and VF. METHODS: Forty patients were divided among three groups: the OLF group (n=23): myelopathy due to OLF, the OLF+OPLL group (n=12): myelopathy due to OLF and OPLL, and the OLF+VF group (n=5): myelopathy due to OLF and VF. We recorded OLF, OPLL, and VF sites and operative procedures. Each patient’s neurological status, according to the Japanese Orthopaedic Association (JOA) score, and walking ability were evaluated pre- and postoperatively. RESULTS: Patients in the OLF+OPLL group were significantly younger than those in the other two groups. The preoperative JOA score was significantly lower in the OLF+VF than OLF group. The final JOA score was significantly lower in the OLF+VF than OLF and OLF+OPLL groups. The JOA score recovery rate was significantly lower in the OLF+VF than OLF group. Final walking ability was significantly worse in the OLF+OPLL and OLF+VF groups than in the OLF group and significantly worse in the OLF+VF than OLF+OPLL group. CONCLUSIONS: Thoracic myelopathy due to OLF+VF occurs primarily in older females, who also exhibit worse preoperative and postoperative neurological status, and worse walking ability, than patients with thoracic myelopathy due to OLF or OLF+OPLL.

Objectives: Increasing activity levels in older people is important for maintaining quality of life and ameliorating the risks of morbidity related to falls, depression, and dementia. This study aimed to clarify the seasonal variation effects on total energy expenditure, number of steps, time spent in low- and moderate- or high-intensity physical activities, and daily activities performed.Patients and Methods: This was a cross-sectional study of 22 community-dwelling older individuals (3 men, 19 women; mean age, 75.1 ± 7.3 years) living in three districts of Gero, Gifu, who participated in the Gero Salon Project hosted by the Social Welfare Councils. Evaluations were conducted in each season from September 2016 to August 2017. We used a uniaxial accelerometer, the Lifecorder device, which measures physical activity, and the Physical Activity Scale for the Elderly to evaluate activities of daily living. Data were analyzed using the multiple comparisons (Bonferroni correction) method.Results: Total energy expenditure and time spent in moderate- or high-intensity activities did not show seasonal variations. However, the lowest number of steps was taken during the winter, and the number of steps increased significantly from winter to spring. The time spent in low-intensity physical activities was significantly longer in the spring and summer than in the winter. There was no significant seasonal difference in total Physical Activity Scale for the Elderly score, leisure activities, domestic activities, or work-related activities. However, there was a significant difference between the summer and winter scores in “outdoor gardening,” with the lowest score observed during the winter.Conclusions: With climate changes in the winter months, “outdoor gardening” becomes difficult, thus decreasing the number of steps taken. Therefore, it is necessary to identify other ways for older people to maintain physical activity during the winter season.

No abstract available.
Aortic Valve Insufficiency* ; Aortic Valve* ; Echocardiography, Transesophageal ; Vena Cava, Inferior*

Centrocestus armatus is an intestinal parasite belonging to the family Heterophyidae. We developed an apparatus for recovering cercariae and clarified the infection dynamics of this parasite. To clarify the circadian rhythm of cercarial shedding in the summer season, we filtrated 30 l of river water every 2 h for 24 h. Cercariae were first detected between 06:00 and 08:00 h, increased over time to reach peak at 16:00 h and decreased thereafter, thus showing a single-peak pattern. In a survey of seasonal change, approximately 200 cercariae were contained in 1 l of river water during the summer season, while none were found during the winter. This cercarial shedding pattern appeared to be related to sunrise/sunset and water/atmosphere temperature. Therefore, we examined whether cercarial shedding was affected by light or temperature changes under laboratory conditions, and confirmed that both light and temperature were important factors for cercarial shedding. Light was a stronger factor than water temperature. Cercarial shedding of C. armatus occurred in response to temperature and light. The change in the number of juvenile metacercariae detected in fish brain corresponded with monthly detection rates of cercariae; however, the incidence of new infections decreased in August. This suggests that Nipponocypris temminkii contains a defense mechanism against new infections that may have hindered the increase in parasite infectivity. These results clarified the smooth infection from the first to the second intermediate host of C. armatus in the endemic river. Throughout the study period, fecal samples were collected from 19 kites, 114 herons, and three unidentified species. However, our results using C. armatus showed a low value of 1% in herons and 5% in kites. The infection dynamics of final host to first intermediate host need to be further investigated.

　　This study was conducted to clarify the benefits of using cervical cytological examinations and human papilloma virus (HPV) testing in our cervical cancer screening program, which was carried out during the period from April 2012 through March 2013 in the Yuri-Honjo district of Akita Prefecture. A total of 772 women underwent this screening. About 11.3% (87/772) of the examinees tested positive for HPV, and of these 87 women, 64 were also positive for HPV DNA in the examinations subsequently conducted in the outpatient clinic. Of the HPV DNA-positive women who showed no sign of abnormalities in cytology, 67.6% had lesions cervical intraepithelial neoplasia (CIN) 1 and above, and five women had l CIN 2/3. Compared with the conventional cytology which detected nine women with CIN 2/3, our screening method with a combination of cytology and HPV testing found 14 women with CIN 2 or 3. To upgrade the cervical cancer screening, we recommend HPV testing should be used in combination with cervical cytology.

　　This study was conducted to document a correlation between the age distribution of patients with cervical cancers and their genotype patterns of human papilloma virus (HPV). Retrospective analysis was performed on 53 patients in the clinical stage of CIN 3 and above. The patients were treated in our hospital during the period between January 2008 and May 2011. The age distribution showed that the patients in their twenties accounted for 28.0%, those in their thirties 34.0%, those in their forties 24.0%, those in their fifties 4.0%, and those in their sixties and older 10.0%, the average of the subjects was 39.5 years. This distribution pattern also indicated that the women aged 49 and younger are prone to cervical cancer. The overall detection rate of positive HPV in the high risk group was 97.1%. The detection rates varied according to the HPV genotypes, being 41.2% in HPV16, 17.6% in HPV52, 13.2% in HPV58, and 5.9% in HPV18. The average ages of patients at the stage of CIN3 and above who demonstrated the positive and negative results for HPV16/18 were 35.4 years and 44.7 years, respectively. During the follow-up period of 40 months, 27 of 179 patients with positive HPV of the high risk group showed development of grades from below CIN2 to those CIN3 and above. Of the patients positive for HPV16/18, 30.9% demonstrated a further development of the lesions, whereas there were only 8.1% in the patients negative for HPV16/18. These studies suggested a significant connection between the viral infection of HPV16/18 and the development of cervical cancer in young women.