Normoxic hypercapnia may increase high-frequency (HF) power in heart rate variability (HRV) and also increase respiratory sinus arrhythmia (RSA). Low-frequency (LF) power may remain unchanged. In this study, 5-min ECG recordings (N = 10) were analyzed in time and frequency domains while human subjects breathed normoxic 5% CO₂ (5%CO₂) or room air (RA). Tidal volume (V_T), inhalatory (T_I), and exhalatory (T_E) times of breaths in the final minute were measured. ECG time domain measures were unaffected by CO₂ inhalation (P > 0.05). Following natural logarithmic transformation (LN), LF_LN was unaltered (RA: 7.14 ± 0.95 . %CO₂: 7.35 ± 1.12, P > 0.05), and HF_LN increased (RA: 7.65 ± 1.37 . %CO₂: 8.58 ± 1.11, P < 0.05) with CO₂ inhalation. When changes in total power (NU) were corrected, LF_NU decreased (RA: 34.4 ± 22.9 . %CO₂: 23.8 ± 23.1, P < 0.01), and HF_NU increased (RA: 56.5 ± 22.3 . %CO₂: 66.8 ± 22.9, P < 0.01) with CO₂ inhalation. T_I (RA: 2.0 ± 1.0 . %CO₂: 1.9 ± 0.8 s) and T_E (RA: 2.5 ± 1.1 . %CO₂: 2.4 ± 0.9 s) remained unchanged, but V_T increased with CO₂ inhalation (RA: 1.1 ± 0.3 . %CO₂: 2.0 ± 0.8 L, P < 0.001). Heart rates during inhalation (RA: 35.2 ± 4.4, 5%CO₂: 34.5 ± 4.8 beats min⁻¹) were different from heart rates during exhalation (RA: 28.8 ± 4.4, 5%CO₂: 29.1 ± 3.1 beats min⁻¹). Hypercapnia did not increase the clustering of heart beats during inhalation, and we suggest that the HF component may not adequately reflect RSA.

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The present study aimed to determine the effects of the number of players on the playing style of junior high school students in small-sided games (SSG). The participants were 40 young male soccer players (age: 12.73 ± 0.63 years). The number of SSG players was set at 3 vs. 3 + 2 goalkeepers (GKs), 4 vs. 4 + 2 GKs, and 5

. + 2 GKs, and the attacking play was measured using notational analysis. Statistical analysis was performed by unpaired t-test and χ² test. 3 vs. 3 had more passes to the GK than 4 vs. 4. Additionally, the occurrence rate of “dribbling” in the process leading to shooting was higher than 5 . . 4 vs. 4 had a higher occurrence rate of “forward direction” passing than 3 vs. 3. 5 . had a higher number of passes and consecutive passes than 3 vs. 3 and 4 vs. 4. Also, the occurrence rate of “one-touch” in the process of shooting was higher than in 3 vs. 3. These results propose that 3 vs. 3 is characterized by individual goal scoring and GK’s participation in the attack, 4 vs. 4 is characterized by forward passing, and 5 . is characterized by goal scoring with passing as a team.

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Objectives: This study aimed to investigate the relationship between trunk muscle mass index (TMI), appendicular skeletal muscle mass index (ASMI), and walking independence in patients aged 65 years and older undergoing rehabilitation for hip fracture.

Methods: This retrospective, observational study was conducted in a convalescent rehabilitation ward and included 314 patients (aged ≥65 years) with hip fracture. The patients were classified into the independence group [functional independence measure (FIM)-walk score ≥6] or the non-independence group (FIM-walk score ≤5) according to the mobility item score among the motor FIM items at the time of discharge. Age, sex, TMI, ASMI, and Mini Nutritional Assessment-Short Form (MNA-SF) data were also extracted. Between-group and multivariate analyses were performed to evaluate the factors associated with walking independence.

Results: The independence group had higher TMI (males: 6.6±0.9

. .6±1.0 kg/m², P <0.001; females: 6.1±0.8 . .7±1.0 kg/m², P <0.001), ASMI (males: 6.7±1.1 . .9±1.3 kg/m², P=0.004; females: 5.3±0.9 vs. 4.7±0.8 kg/m², P <0.001), MMSE-J (21.5±4.9 vs. 16.4±4.5 points, P <0.001), and MNA-SF [median (interquartile range): 8 (6–9) vs. 7 (5–8) points, P <0.001] than the non-independence group. Multivariate analysis showed that TMI at admission was significantly associated with walking independence (odds ratio: 1.86, 95% confidence interval: 1.28–2.72, P <0.001).

Conclusions: This study suggests that a higher TMI at admission was important for acquiring walking independence in patients with hip fracture and shows the importance of early evaluation of TMI during hospitalization of patients with hip fracture.

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Clinical aspects of laparoscopy combined total colectomy (LTC)(n=10) and open total colectomy (OTC)(n=29) with ileorectal anastomosis for familial adenomatous polyposis and ulcerative colitis are compared in a retrospective study. The mean operative time was 282 (range, 169 to 420) minutes in the LTC group and 274 (range, 139 to 570) minutes in the OTC group. The mean volume of operative blood loss was 321 (range, 52 to 728) ml and 471 (range, 48 to 1040) ml for the LTC and OTC groups, respectively. Nasogastoric tube could be removed after POD 1.2 . .8 (p<0.05), the mean time to passage of stool was 1.9 (range, 1 to 3) . .2 (range, 3 to 7) days (p<0.01), and in the LTC group watery stool was soon made solidification after POD 23.4 vs. 84.1 (p<0.01). Laparoscopy combined total colectomy may prove to have one-stage restorative total colectomy without a temporary ileostomy due to early solidification of watery stool and more benefits than conventional open surgery.

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Nafamostat is a serine protease inhibitor and is known to cause hyperkalemia in clinical practice. Its mechanisms have been thought to inhibit sodium channels.The study aimed to develop nafamostat-induced hyperkalemia model to investigate mechanisms of the serine proteases for hyperkalemia. Nine-week-old Wistar-Imamichi male rats were used. Catheters were placed in the femoral vein, bladder, and jugular vein under sevoflurane anesthesia. Urine and blood were collected every 15 min by 8 times. (1) Nafamostat (1.2 mg/kg/h, c.i.)

% Glucose groups. (2) Combination (Nafamostat 0.9, 1.8 or 3.6, c.i. and Amiloride 18.0 μg/kg, i.v. after 54.0 μg/kg/h, c.i.) % Glucose and Amiloride (18.0, i.v. after 54.0, c.i.) groups. Serum and urinary potassium were measured by the ion electrode method. (1) Changes in serum potassium level and urinary potassium excretion did not increase with nafamostat alone. (2) In the combination group, serum potassium level increased from 30 min to 90 min after administration compared with amiloride alone. Urinary potassium excretion showed a downward trend. A hyperkalemia rat model with decreased renal excretion was developed by nafamostat in combination with amiloride, which mechanism might be appearance of a potential inhibitory action of serine proteases to amiloride-sensitive sodium channels.

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A symptomatic relief by hyaluronic acid (HA, MW: 3.5 × 10⁶), which is synthesized by Streptococcus spp, was investigated in experimental ovine osteoarthrosis. Bilateral osteoarthrosis (OA) of the temporo-mandibular joints (TMJs) was induced by perforating discs and by scrapping subchondral condylar surface. HA was intra-articularly injected into the left joints of 6 sheep on 7, 10, 14, 17 and 21 days after the operation and physiological saline as the control was injected into the contralateral (right) joints on the same day. Three sheep were killed at 1 month post-operation (MPO) and the remaining three sheep were killed at 3 MPO. Various responses such as proliferation of fibrous tissue, denudation, erosion, osteophyte formation, subcortical cyst formation and ankylosis were observed radiographically and histopathologically. The treatment of HA ameliorated the degenerative changes and lowered the osteoarthrotic score in the left joints at 1 MPO (9.96 .81) and 3 MPO (10.86 .29) compared to the right joints. These results indicate that a repeated intra-articular injection of HA inhibits the progression of OA in ovine TMJs by inducing the development of articular cartilage and by reducing the proliferation of fibrotic tissue.

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[Purpose] The aim of the study was to establish whether pulsating electrostatic field application, shown to increase blood flow and metabolic activity and to function as an ion pump, is able to reduce muscle pain after exercise-induced muscle damage. [Subjects and Methods] Seven participants (4 males, 3 females) performed two sessions of downhill running separated by at least 4 weeks. After the running sessions, participants were either treated for 45 min with a pulsating electrostatic field (field intensity, 9000 V; current, <9 mA; frequency, 50 Hz) or a sham treatment. The order of the intervention was random, and the condition was blinded for the participants. Muscle soreness score, creatine kinase, and jump ability were assessed before and up to 48 hours after running. [Results] Twenty-four and 48 hours after the downhill running, the muscle soreness score tended to be less increased after pulsating electrostatic field administration when compared with the sham setting (changes in muscle soreness score: 3.7±1.6 . .7±2.2 after 24 h and 3.1±2.0 . .4±3.2 after 48 h, respectively). No further differences were detected. [Conclusion] The outcomes show that a pulsating electrostatic field might be a promising treatment to reduce muscle soreness after exercise-induced muscle damage. However, further studies are needed to confirm the present outcomes and to establish the mechanism by which a pulsating electrostatic field may reduce muscle pain.

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Epicardial adipose tissue (EAT), localized beneath the visceral pericardium, is a metabolically active endocrine and paracrine organ with possible interactions within the heart. Recent studies identified possible roles of uric acid (UA)-induced oxidative stress and increased inflammatory status in the pathogenesis of ascending aortic dilatation. The aim of this study was to investigate whether EAT is an independent factor for ascending aortic dilatation. The patients were evaluated by a complete transthoracic echocardiographic examination including measurements of EAT and aortic dimensions. Serum levels of UA and C-reactive protein and EAT thicknesses were compared in 38 patients with dilated ascending aorta (DAA) (the diameter ≥ 37 mm) vs. 107 subjects with normal aortic diameter (AD) of < 37 mm. EAT thickness was significantly higher in DAA group compared to normal AD group (8.3 ± 2.7 . .4 ± 2.2 mm, p < 0.001) as well as age (53 ± 10 vs. 48 ± 9 years, p = 0.004), the presence of hypertension (54% vs. 30%, p = 0.009) and UA levels (6.0 ± 1.4 . .2 ± 1.1 mg/dL, p < 0.001). There was a strong correlation between EAT thickness and ascending aortic diameter (r = 0.521, p < 0.001). In multiple logistic regression analysis, EAT thickness (OR: 1.429, p = 0.006), body mass index (OR: 1.169, p = 0.014) and UA levels (OR: 1.727, p = 0.023) were independently correlated to ascending aortic dilatation. We therefore propose that increased EAT thickness is an independent predictor of ascending aortic dilation.

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Epicardial fat tissue has unique endocrine and paracrine functions that affect the cardiac autonomic system. Epicardial fat thickness (EFT) and blunted heart rate recovery (HRR) are newly identified cardiovascular risk factors in patients with metabolic syndrome (MS). The objective of this study is to evaluate the association between EFT and HRR in patients with MS. Forty patients with MS and 36 healthy controls were included in the study. Echocardiographic EFT and HRR at 1min after exercise termination (HRR-1) are measured and compared between the two groups. HRR-1 equal to or lower than 18 beats is considered as blunted HRR. EFT was increased (7.2 ± 2 . .6 ± 1.8 mm; p = 0.001) and HRR-1 was significantly reduced in patients with MS compared to control group (21 ± 8 vs. 26 ± 9; p = 0.006). Among the MS patients, subjects with blunted HRR had increased EFT compared to patients without blunted HRR (8.5 ± 2.0 . .9 ± 1.1 mm, p < 0.001). In multivariate analysis, EFT was the only independent predictor of blunted HRR in patients with MS (95% confidence interval = 1.42-3.87, OR = 2.34, p = 0.001). Furthermore, EFT of equal to or thicker than 5.5 mm was associated with the blunted HRR with 84% sensitivity and 52% specificity (ROC area under curve: 0.84, 95% confidence interval = 0.70-0.96, p < 0.001). In conclusion, EFT is an independent predictor of blunted HRR, a novel cardiovascular risk factor, in patients with MS.

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An elevated white blood cell (WBC) count is associated with nonalcoholic fatty liver disease (NAFLD); however, a leukocyte subtype that is involved in the pathogenesis of NAFLD is not known. This study was conducted to investigate the association between NAFLD and WBC subtype fractions (%) among healthy elderly Koreans. A total of 794 subjects who underwent a health check-up were investigated. After excluding excessive alcohol intake and other liver diseases, NAFLD was diagnosed based on sonographic findings: hyperechogenecity of liver tissue, difference of echogenicity between liver and kidney, and visibility of vascular structures. The prevalence of NAFLD among entire cohort was 39.0% (310/794). The presence of NAFLD was significantly associated with higher blood WBC counts (5,485 ± 1073 . ,230 ± 995 per mm³, p = 0.001) and monocyte fraction (6.08 ± 2.40% . .12 ± 1.31%, p < 0.001). The multiple logistic regression analysis, after controlling confounders, including age, gender, body mass index, systolic and diastolic blood pressure, fasting blood glucose, alanine aminotransferase, triglyceride, and high-density lipoprotein cholesterol, showed that the prevalence risk of NAFLD was increased significantly according to the monocyte fraction quartiles: odds ratios (ORs) and 95% confidence intervals (CIs) for NAFLD were 1.00, 2.75 (1.63-4.62), 2.84 (1.67-4.84) and 5.17 (3.03-8.83), respectively. There were no significant associations between NAFLD and the total WBC count quartiles in this model. These results indicate that the elevated peripheral blood monocyte fraction is associated with NAFLD. The monocyte fraction might be a useful marker for NAFLD.

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Background: It is controversial whether angiotensin-converting enzyme inhibitors (ACEI)/angiotensin receptor blockers (ARB) provide significant survival benefits in patients with coronary artery disease (CAD) but without myocardial infarction (MI). This study investigated whether the association of ACEI/ARB therapy with clinical outcome in patients undergoing percutaneous coronary intervention (PCI) was affected by history of MI. Methods and Results: A total of 11,590 patients undergoing first PCI were divided into 2 groups: those with MI and those without MI. All-cause and cardiovascular mortality were compared between the patients with and without ACEI/ARB at discharge in each group. In patients with MI, significantly lower 3-year all-cause/cardiovascular mortality for patients with ACEI/ARB relative to those without ACEI/ARB was noted in the total patients (all-cause: 6.6% vs. 11.7%, P<0.0001; cardiovascular: 3.8% vs. 6.9%, P<0.0001) and in the 1,007 propensity score-matched pairs (all-cause: 8.2% vs. 11.3%, P=0.018; cardiovascular: 3.7% . .7%, P=0.014). In patients without MI, however, all-cause (5.2% . .6%, P=0.56) and cardiovascular (3.2% vs. 3.0%, P=0.23) mortality were similar regardless of whether ACEI/ARB were used or not; and similarly in the 2,061 propensity score-matched pairs (all-cause: 4.1% . .4%, P=0.33; cardiovascular: 1.4% vs. 2.1%, P=0.30). Conclusions: Use of ACEI/ARB at hospital discharge was associated with lower all-cause/cardiovascular mortality in revascularized CAD patients with MI, but not in those without MI.  (Circ J 2013; 77: 1242–1252)

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As the number of women who postpone their first pregnancy until their late 30s or early 40s is increasing, adenomyosis is more frequently encountered by obstetricians. Some studies have reported on the relationship between adenomyosis and pregnancy complications. We aimed to investigate the effect of adenomyosis on pregnancy complications and outcomes and associations between adenomyosis type and pregnancy outcomes. This multicenter retrospective 1:4 case-control study included 61 women with singleton pregnancies diagnosed with adenomyosis. The control group included women with singleton pregnancies without adenomyosis; these women were matched to those with adenomyosis using propensity scores. The incidence of obstetric complications, delivery, and neonatal outcomes were compared. The adenomyosis group (n = 61) had significantly higher incidence of preterm delivery (21.3% vs. 9.4%), hypertensive disorders of pregnancy (13.1%

. .3%), cesarean delivery (46.0% vs. 20.9%), and postpartum hemorrhage (57.3% vs. 36.8%) than the control group (n = 244). Subgroup analysis by the adenomyosis type revealed that the diffuse adenomyosis group (n = 41) was significantly more likely to experience preterm labor (29.3% vs. 7.3%), hypertensive disorders of pregnancy (17.0% . .5%), severe hypertensive disorders of pregnancy (12.2% vs. 1.8%), preterm premature rupture of membranes (12.2% vs. 2.4%), cesarean delivery (61.3% vs. 18.9%), and postpartum hemorrhage (70.7% vs. 44.5%) than the control group (n = 164). The focal adenomyosis (n = 20) group was not statistically different from the control group (n = 80) with respect to obstetric complications. Women with diffuse adenomyosis require more careful perinatal management than previously thought.

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The relationship between subarachnoid hemorrhage (SAH) and chronic renal failure (CRF) remains unknown. We retrospectively reviewed 302 cases of SAH. Of these, 6 cases were diagnosed as CRF who needed hemodialysis. In the cases with hemodialysis, SAH of unknown origin was more frequent than in ordinary SAH cases (80.0% . .5%, P＜0.0001). No SAH occurred during hemodialysis. The frequency of SAH in the patients with hemodialysis seemed to have no relationship with the duration of hemodialysis. These results suggest that further investigation is needed to clarify the effect of hemodialysis on cerebral vessels, which may frequently lead to SAH of unknown origin.

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The hypothesis of the present study is that active immunization of cows against inhibin would neutralize endogenous inhibin, increase circulating levels of follicle stimulating hormone, and subsequently affect follicular dynamics and the ovulation rate during the estrous cycle. Thirteen cows were immunized against inhibin α-subunit and, 6 cows were immunized with a placebo. Both groups were given 4 booster immunizations 7, 14, 21, and 34 weeks after the primary injection. Ovaries were examined daily after the 2nd, 3rd, and 4th booster immunizations by transrectal ultrasonography for 25 days. After the 4th booster immunization, blood samples were collected daily for one complete estrous cycle to measure FSH and LH. The results showed that the immunized cows generated antibodies against inhibin, and that they had higher FSH levels compared with the controls. The number of follicular waves during the estrous cycle was higher in the immunized cows (3 or 4 waves) than in the controls (2 or 3 waves). Moreover, the immunized cows had a greater number of follicles during the estrous cycle compared with the control cows. The maximum number of follicles was 14.8 ± 1.7 .4 ± 0.2 in inhibin-immunized and control cows, respectively, during the first follicular wave and 13.9 ± 1.9 .6 ± 0.7, respectively, during the ovulatory wave. Multiple ovulations were increased in the immunized cows. However, the ovulation rate varied greatly in the immunized animals. In conclusion, immunization against inhibin increased FSH secretions during the estrous cycle in the cows. Moreover, the immunized cows had a greater number of follicular waves during the estrous cycle and a greater number of follicles, and this could be used as a potential source of oocytes for use in IVF/embryo transfer programs.

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Occupational asthma is characterised by airway inflammation, variable airflow limitation and airway hyperresponsiveness related causally to work. The aim of the study was to ascertain whether in patients with occupational asthma findings persist after withdrawal from occupational allergen exposure. A group of 37 patients with occupational asthma and a control group of 19 persons were examined. Results in asthmatics obtained during the first visit when occupational asthma was acknowledged, were compared with recent results about 6.5 yr on average after elimination of occupational allergen exposure. Recent findings in occupational asthma patients were compared with the control group. In patients with occupational asthma, no significant differences were found between results obtained at the first and recent visit. Symptoms of asthma persisted in as much as 86.5% of patients. During recent examination there were more positive results in asthmatic patients comparing with the control group in histamine challenge (61.3 . .3%, p<0.01), eosinophile cationic protein (41.7 . .3%, p<0.05), prick tests (45.9 vs. 10.5%, p<0.05). Positive results of the present histamine challenge test and elevated eosinophils in sputum were more frequent (p<0.05) in patients with occupational asthma due to high molecular weight allergens than to low molecular weight allergens.

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