ABSTRACT
The patient is a 39-year-old-man who had rheumatic heart disease and had undergone mitral and aortic valve replacements with mechanical St. Jude prostheses as well as tricuspid valve repair and a MAZE procedure 17 years previously. He was admitted with ventricular tachycardia (VT) and an implantable cardioverter-defibrillator (ICD) was implanted. Four months later, he was admitted again with VT, and attempts to manage the VT with drugs were not successful. We performed electro-anatomical mapping and ablation for VT by re-median sternotomy. His postoperative course was uneventful. At 15 months after surgery, no recurrence of VT was recognized.
ABSTRACT
A 71-year-old female, who had diabetes mellitus and chronic renal failure on dialysis, had undergone mitral valve repair and tricuspid valve annuloplasty. Five months after the operation, she suffered from infectious endocarditis and underwent mitral valve replacement. Postoperatively, a total fluid volume of 300 to 600 ml/day was drained from the pericardial tube, and its appearance became milky after the start of oral intake of food. She was diagnosed with chylomediastinum. Despite fasting and total parenteral nutrition for 2 weeks and subcutaneous octreotide administration, the volume of fluid drainage was not reduced. Therefore, we planned lymphangiography treatment with Lipiodol on postoperative day 37. On operation, under local anesthesia, the left inguinal lymph node was punctured under ultrasound guidance, and Lipiodol was injected at a rate of 12 ml/h for 1h. On the next day, the volume of fluid drainage was reduced, and the pericardial tube could be removed 9 days after lymphangiography.
ABSTRACT
A 52-year old man was referred to our hospital for atrial fibrillation ablation therapy. A multislice computed tomography study demonstrated a giant coronary artery aneurysm situated just proximal to the left anterior descending (LAD), LAD stenosis and coronary-pulmonary artery fistula. The fistula was ligated and the aneurysm was resected under cardiopulmonary bypass. The left internal thoracic artery was used as a bypass graft to the LAD as well as a patch for closure of the LAD orifice to avoid left circumflex artery stenosis. We report a rare case of giant LAD aneurysm with coronary-pulmonary artery fistula.
ABSTRACT
Fifty-two-year-old man who suffered from headache and left neck pain was brought to a nearby hospital by ambulance. Anisocoria and disorder in the field of view of the left eye were observed. Emergency brain MRA showed obstruction of the left internal carotid artery. The patient was transported to our hospital for emergency surgery for suspected acute type A aortic dissection on CT scan. Operative findings revealed a thrombus attached to the ascending aorta continued to left common carotid artery. Thrombectomy for left carotid artery and partial arch replacement were performed. The patient was discharged in good condition on the 16th postoperative day. We encountered a very rare mural thrombus in the ascending aorta.
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Kanehiro Takaki, the founder of The Jikei University School of Medicine suggested that a nutritional factor was important for preventing beri-beri, which was a common disease in the Meiji era in Japan and Southeast Asia. He improved the rations fed to crews of the Imperial Japanese Navy to include wheat and meat. The rations he devised effectively prevented beri-beri. Some 30 years later, vitamin B<sub>1</sub> was discovered, and a deficiency of vitamin B<sub>1</sub> was found to be the cause of beri-beri. Takaki believed that nutrition and exercise were important for keeping our bodies fit. He often gave lectures on how people could keep fit to prevent diseases. Thus, his activities are considered to be the beginning of preventive medicine in Japan. The contributions of Takaki to the physical fitness of the Japanese people have been continued by the graduates of The Jikei University School of Medicine. Some of the graduates became professors of The Jikei University School of Medicine and Tokyo University of Education (now, Tsukuba University). Thus, both universities have the common basis and tradition for research and education in the fields of physical fitness and sports medicine, and have collaborated with each other in these fields. In this article, we provide a brief overview of the history of the development of research regarding physical fitness and sports medicine in Japan. We discuss the contribution of various persons including our graduates, to the health and physical fitness of the Japanese people.
ABSTRACT
A 62-year-old woman was admitted to a regional hospital for acute myocardial infarction. Emergency coronary angiography revealed occlusion of the first diagonal branch, and transesophageal echocardiography showed severe mitral regurgitation due to anterior papillary muscle rupture. She was transferred to our hospital in a state of cardiogenic shock despite the use of high-dose catecholamine and intra-aortic balloon pumping. We immediately performed mitral valve replacement. The patient's postoperative course was uneventful and she was ambulatory when transferred to another hospital on foot on postoperative day 19. Physicians should be aware that fatal anterior papillary muscle rupture may be caused by isolated occlusion of the diagonal branch.
ABSTRACT
Maximal oxygen uptake (VO<sub>2</sub>max) is an important determinant of health-related physical fitness. In 2006, the Japan Ministry of Health, Labour and Welfare (JMHLW) officially declared a standard reference value and reference interval of VO<sub>2</sub>max. However, these values were established on the basis of a systematic review of reports published in Western countries and were not based on actual VO<sub>2</sub>max data of the Japanese population. Therefore, we conducted a study entitled “The study on a minimum zone of VO<sub>2</sub>max as one of the determinants of health-related physical fitness in Japan” from 2004 to 2006 as a project of the Japanese Society of Physical Fitness and Sports Medicine (JSPFSM). In addition, we collected published VO<sub>2</sub>max data of the Japanese population from the JSPEFM website. In the present study, we attempted to determine the reference interval of VO<sub>2</sub>max with regard to age, gender, and different methods of exercise. Further, we established a cut-off value of VO<sub>2</sub>max for determining metabolic syndrome (MS).1. Reference interval of VO<sub>2</sub>maxFor both men and women, 325 and 364 values for the treadmill exercise, and 1175 and 2178 values for the cycle ergometer exercise, respectively, were collected. This data revealed a balanced distribution of VO<sub>2</sub>max with regard to age. Data that satisfied the VO<sub>2</sub>max criterion were used for the analysis. These data were regressed to age on gender and methods of exercise. The percentage of VO<sub>2</sub>max was calculated using the following equation: %VO<sub>2</sub>max = measured VO<sub>2</sub>max × 100/age-estimated VO<sub>2</sub>max. The iterative truncation method was used to calculate the reference interval of VO<sub>2</sub>max (70%∼130% VO<sub>2</sub>max) from the crude data of %VO<sub>2</sub>max, and then converted to actual VO<sub>2</sub>max. Thus, the reference interval of VO<sub>2</sub>max for healthy Japanese was determined with regard to age, gender, and different methods of exercise.2. Cut-off value of VO<sub>2</sub>max for determining MSUsing the VO<sub>2</sub>max data of subjects with body mass index (BMI) of ≧25kg/m<sup>2</sup> and ≧2 MS risk factors, and the data of subjects with normal BMI without any risk factors, we calculated sensitivity and specificity. The cut-off value was determined using the receiver operating characteristic curve. This cut-off value was defined as the critical value of VO<sub>2</sub>max that should be maintained to avoid MS and remain healthy.
ABSTRACT
The existing adoptive criterion for VO<SUB>2</SUB>max was created for physically fit subjects who were soldiers and/or sportsmen. However, VO<SUB>2</SUB>max is widely used at present as one of the health-related physical fitness determinants from children to aged persons. It might be appropriate to determine the criterion and the critical values for VO<SUB>2</SUB>max in consideration of age and gender.<BR>The present study attempted to determine the reference range and critical values of the criterion for VO<SUB>2</SUB>max using the iterative truncation method. Voluntary VO<SUB>2</SUB>max was measured in 548 healthy volunteers, aged 8 to 82 years, using a treadmill. The % VO<SUB>2</SUB>max was calculated using the equation of %VO<SUB>2</SUB>max=measured VO<SUB>2</SUB>max × 100 gage-estimated VO<SUB>2</SUB>max. Crude data of %VO<SUB>2</SUB>max was applied to the iterative truncation method, and the reference range of %VO<SUB>2</SUB>max (70-130%VO<SUB>2</SUB>max) was determined. Physiological and biochemical parameters, within the values of 70-130%VO<SUB>2</SUB>max, were converted to a percentage using a similar equation of %VO<SUB>2</SUB>max. The value corresponding to 10% of the lower area of the distribution of each parameter was defined as the critical value, which was the minimum level to adopt as the VO<SUB>2</SUB>max. Taking a single or combined application of the critical value of each parameter, the adoptive ratio of VO<SUB>2</SUB>max was investigated.<BR>The present study indicated that there was no difference between VO<SUB>2</SUB>max selected by the iterative truncation method and that obtained by the existing criterion for VO<SUB>2</SUB>max. The combination of the critical value of HRmax and bLAmax was recommended as a criterion of VO<SUB>2</SUB>max. The reference value, critical value of VO<SUB>2</SUB>max and the critical real value of each parameter were shown as a mean of every 5-year interval with the distinction of gender.
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Numerous studies on serum enzymes derived from skeletal muscle, such as CH, AST, LDH, are also being reported in the field of sports medicine. In this article, I would like to summarize the findings on “physical exercise and serum enzymes” studied up to the present. Secondly, I will evaluate the usefulness and limits as indicators of condition and muscle fatigue in athletes. The amount of change and time course of Ch, AST, LDH and myoglobin responses were markedly different in 5-km, marathon and triathalon races, and in trained and untrained subjects. Trained subjects showed peaks of these enzymes one day after endurance running, and untrained subjects had a typical biphasic variation after endurance running. The typical change in untrained subjects might reflect a series of different histopathological changes, including muscle damage, repair and regeneration of muscles. In participants of women's marathon races, higher ranking prize winners showed lower levels before and lower increases in Ch activity after the mice than the other participants. higher serum CIA activity above 300 mU/ml accompanied by increases in serum myosin light chain I (MLC I) concentration (above 2.5 ng/ml) without increases in troponin T and CN-MIA were observed during marathon, triathalon, 100-km and 250 km ultra marathon races. The athletes who showed a higher serum CK activity above 500 mU/ml at the pre-race stage felt subjective fatigue and sonic dropped out from the race. Normal persons who had a lower Ch activity below 40.50 mU/ml indi cated lower levels of serum HDL-C and physical fitness (VO<SUB>2</SUB>max) . On the contrary, persons who showed a higher CR level of 100-200 mU/ml or more had higher levels of IIDL-C and VO<SUB>2</SUB>max.<BR>Measurement of serum CK activity might provide useful information for checking health and physical fitness levels in normal persons, and also the physical and subjective conditions of athletes.
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The effects of exercise and dietary therapy on the prevention of diabetic nephropathy (DN) were compared. Thirty-two male OLETF rats were divided into four groups (Ex, Diet, Sed, Pre) . Fourteen LETO rats served as the normal controls. Therapy was conducted for 10 weeks from age 22 to 31 weeks. The Ex group was trained by voluntary exercise, and the Diet group had a restricted food intake resulting in the same BW as that of the Ex group. The Ex developed a significant increase in urinary albumin excretion compared to the Diet group, although significantly less than the Sed group. Blood pressure in the Ex group showed a tendency to be higher during therapy. BW and serum lipids were significantly reduced, and glucose intolerance was improved in both the Ex and Diet groups. There were no differences in the metabolic indices between the Ex and Diet groups. The Ex group showed a significantly heavier kidney weight and a tendency for enlargement of the glomerular area and volume. The protective effect of DN through improvement of the metabolic dis-order by exercise might be offset by exercise-induced renal loads. Control of exercise intensity and blood pressure appear to be important as well as the improvement of glucose intolerance and lipid metabolisms in exercise therapy to prevent an occurrence and development of DN.
ABSTRACT
The purpose of the present study was to investigate a useful exercise protocol and method of evaluation for determining the gas exchange threshold (VO<SUB>2</SUB>GET) and correlation coefficient between VO<SUB>2</SUB>GET and maximal oxygen uptake (VO<SUB>2</SUB>max), which is an index of aerobic capacity. Five healthy male volunteers (age: 25.6 ± 2.0 yrs; height: 172.9±4.0 cm; weight: 69.5±6.6 kg) performed exercise tests 82 times. Each volunteer randomly conducted a RAMP exercise (1 W⋅3 sec<SUP>-1</SUP>), STEP-1 exercise (20W⋅min<SUP>-1</SUP>) and STEP-2 exercise (40W⋅2 min<SUP>-1</SUP>), respectively, at least 4 to 8 rotations. The gas exchange parameters (VE, VO<SUB>2</SUB>and VCO<SUB>2</SUB>) for incremental exhaustive cycle ergometer exercise were measured using a“breath-by-breath”method. Three different methods of evaluation- (VE/VO<SUB>2</SUB>and VE/VCO<SUB>2</SUB>) exchange (M-1), V-slope method (M-2), and M-1 & M-2 (M-3) -were attempted to determine VO<SUB>2</SUB>GET. The VO<SUB>2</SUB>GET values, determined by three different methods (M-1, -2 and -3) of evaluation, were classified as‘easy’ (J-A) and‘difficult’ (J-B) in all tests. Reproducibility of VO<SUB>2</SUB>max and VO<SUB>2</SUB>GET were assessed using the coefficient of variation (CV) and correlation coefficients (r) between VO<SUB>2</SUB>max and VO<SUB>2</SUB>GET.<BR>The results are summarized as follows:<BR>1) The means of the reproducibility of VO<SUB>2</SUB>max were determined among the 5 subjects by us ing RAMP, 4.8% (n=25), STEP-1, 3.1% (n=28) and STEP-2, 2.9% (n=29) exercise tests; STEP-2 exercise test values (CV) were lower than the others. There was no significant difference in the means of VO<SUB>2</SUB>max among the 5 subjects according to the RAMP and two STEP exercise tests (Two-way ANOVA) .<BR>2) The best reproducibility value of VO<SUB>2</SUB>GET among the 5 subjects was determined using RAMP exercise tests with the V-slope method (M-2) and evaluations were classified as easy (J-A) . The value (CV) was 2.8%. There was no significant difference in the VO<SUB>2</SUB>GET values (M-1 (J-A, -B), M-2 (J-A, -B) and M-3) (Two-way ANOVA) and their means among the 5 subjects concerning RAMP and two STEP exercise tests (Two-way ANOVA) .<BR>3) The best correlation coefficient (r) value between VO<SUB>2</SUB>max and VO<SUB>2</SUB>GET was obtained using RAMP exercise tests with M-2 (J-A) (r=0.976, n=20) .<BR>The present results indicate that the most useful exercise protocol and method of evaluation for determining VO<SUB>2</SUB>GET is the RAMP exercise test with the V-slope method.
ABSTRACT
This study tried to establish both critical and desirable levels of health-related physical fitness (HRPF) including muscle strength (relative grip strength), flexibility and estimated VO<SUB>2</SUB>max. Subjects were 3102 males aged 20 to 59 years. Four batteries of health index score (HIS-A-D) were made based on health examinations and lifestyle habits. Subjects who had 0 to 1 points were defined as healthy individuals, and subjects who had more than 3 or 4 points were defined as unhealthy. Receiver-operating characteristic (ROC) curves were drawn by HRPF test in each battery of HIS. The HIS-B was selected as the most valid battery of HIS. Sensitivity, specificity and the Youden index were calculated using cut-off values which were mean values of each HRPF test measurement in each group who had 0, 1, 2, 3 and>4 points in HIS-B. The critical levels were defined the highest specificity and/or Youden index in each HRPF test. There were seen in groups having > 4 points. The desirable levels were defined as the HRPF test levels in healthy individuals who had 0 to 1 points in HIS-B. The critical and desirable levels of VO<SUB>2</SUB>max were 41.8 and 50.2 at 20y, 40.9 and 46.2 at 30y, 40.0 and 46.2 at 40y, and 37.8 and 45.5 ml/kg/min at 50y, respectively. The levels of other HRPF test were also calculated in the present study. Exercise guidance after health check-ups should be done to attain desirable levels rather than to just maintain critical levels of HRPF.
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The effect of ingestion of a chilled carbohydrate and electrolyte solution on metabolic and hormonal responses and water-electrolyte balance was studied after two 5-km runs in hot outdoor conditions (Temp, 30.6-30.9°C ; humidity, 61.3-62.4%) . Eight healthy females (mean age 21.8 years) participated in : 1) a control experiment (Copt) with no fluid intake, 2) an experiment with 500 ml of tap water (WI), and 3) an experiment with 500 ml of sports beverage (SB) containing carbohydrate and electrolytes each of which were given after the 1st 5-km run, followed by a second 5-km run with an equivalent to 68.7-72.3% of VO<SUB>2</SUB>max. In the Cont, decreases in %ΔPV and blood glucose (BS) and increases in serum osmolality (Sosm), free fatty acid (sFFA) and plasma hormone concentrations related to regulation of the water-electrolyte balance in the body persisted after the 2 nd run. The intake of the sports beverage prevented hypoglycemia and ketoacidosis, as shown by an increase in sFFA and positive results for qualitative analysis of ketone body in the urine, and quick recovery of plasma volume following an endurance run under a hot environment. This study suggests that fluid replacement with a sports beverage containing carbohydrate and electrolytes was superior to plain water or no fluid ingestion in terms of metabolic and hormonal responses and the recovery of plasma volume and elevated rectal temperature following an endurance run under hot conditions.
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We examined the relationship between serum magnesium (sMg) change and urinary Mg (uMg) excretion, lipid metabolism and hormonal responses induced by prolonged physical exercise. Six recreational runners voluntary participated in the study, and their sMg, uMg, serum lipid and circulatory levels of plasma hormones (ACTH, cortisol, ADH, aldosterone) were determined during a 1-week recovery period after a full-marathon race. Immediately after the race, fall of sMg was significant, but recovered to the pre-race level in the next day. Urinary Mg excretion decreased significantly after the race and the tubular reabsorption rate (%TRMg) was elevated for one week. The negative correlation between sMg and %TRMg suggested that a decreased level of sMg enhanced tubular reabsorption of Mg. On the other hand, no correlation was observed between the plasma hormone levels and %TRMg, thus hormonal responses induced by prolonged exercise had less effect on the tubular reabsorption of Mg. Therefore, fall of sMg after the full marathon race may not be a reflection of Mg depletion, but seems to be the result of a Mg shift to other regions (muscle, erythrocytes and adipose cells) from the serum. Increased level of serum FFA after the race suggested enhanced lipolysis, which might be a cause of sMg reduction.
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A cross-sectional study was carried out to investigate the effect of physical exercise in daily lives of healthy women on the aging process in terms of maximal aerobic capacity (VO<SUB>2</SUB>max), body fat tissue mass (FTM), lean tissue mass (LTM), bone mineral density (BMD), serum triglyceride (TG), total cholesterol (TC), HDL-C and LDL-C concentrations, and systolic (SBP) and diastolic blood pressure (DBP) . These parameters are considered as risk factors of cerebrovascular disease and/or osteoporosis, which are the main causes of becoming bedridden and demented in middle-aged and older women. One hundred sixty-five healthy female volunteers aged 20 to 76 years participated in the study, 82 of whom were postmenopausal with a mean age at menopause of 49.7±3.1 years. Eighty-two of the subjects had been exercising regularly by jogging, swimming, aerobic dancing, or playing tennis more than twice a week for 2 years (Ex group), whereas 83 individuals had not been engaging in regular exercise (Cont group) . Serum lipid concentrations, SBP and DBP measurements at rest and treadmill VO<SUB>2</SUB>max and HRmax measurements were determined in the morning after an overnight fast. Whole-body BMD (TBMD), head, lumbar, arm and leg BMD, FTM and LTM were measured by dual-energy X-ray absorptiometry one to two hours after a light lunch. The mean and SD of each measurement were calculated for five-year age groups between 40 and 60 years and one group each under 40 and over 60 years.<BR>The results were as follows:<BR>1, VO<SUB>2</SUB>max (r=-0.590) and HRmax (r=-0.632) decreased significantly with age. The VO<SUB>2</SUB>max of the Ex group was significantly higher than that of the Cont group in all each age groups. However, no differences in the aging process in terms of HRmax were found between the two groups.<BR>2, Resting SBP (r=-0.391) and DBP (r=0.315) increased significantly with age. However, no hypertensive individuals (160/95 mmHg-) were found among the 165 subjects.<BR>3. Only serum TC (r=0.346) and LDL-C (r=0.339) among the blood constituents measured changed with age. No changes in serum HDL-C were detected with age. Lower TC (189.2±23.3 mg/dl) and higher HDL-C (72.2±10.9 mg/dl) were observed in eleven runners (49.7±7.7 years) among the subjects who participated frequently in official races than in subjects of the same ages in the Cont group. The highest serum HDL-C (75.8±15.8 mg/dl) and HDLC/TC ratios (0.362) were noticed among the subjects (n=26) who both regularly exercised and consumed alcoholic beverages.<BR>4. A tendency for FTM to increase and LTM to decrease with age were observed in both groups, and a lower %FTM (percentage of FTM to body weight) and higher %LTM were evident in the Ex group. Differences in %FTM and %LTM between the Ex and Cont groups at 40-45 years were significant.<BR>5. Partial and whole BMDs decreased significantly with age (TBMD-Age ; r=- 0.527) . Significantly higher leg BMDs in both the 20-39-year and 40-45-year groups, and spine and TBMD in the 20-39 years in the Ex group, who were premenopausal women, were shown. No significant differences in BMDs between the two groups were observed in postmenopausal women, but the Ex group tended to have higher partial and whole BMDs. The postmenopausal official race runners (n=5.52.6-1.5years) also had higher TBMD and leg BMD values than subjects of the same ages in the Cont group.<BR>6. Investigation of correlations between VO<SUB>2</SUB>max, LTM, FTM, BMDs and serum lipid concentrations, yielded a significantly higher correlation (r=0.669) between LTM (kg) and absolute VO<SUB>2</SUB>max (1/mm) . Although VO<SUB>2</SUB>max per LTM (VO<SUB>2</SUB>max/LTM) decreased with age (r=-0.595), VO<SUB>2</SUB>max/LTM in the Ex group was significantly higher than in the Cont group in each age group. The VO<SUB>2</SUB>max per body weight (ml/kg/min) was negatively correlated with %FTM (r=-0.442) and positively correlated with
ABSTRACT
The present study was conducted to investigate the effect of acid-base disturbance on blood lactate concentration (bLA) and OBLA (Onset of Blood Lactate Accumulation) during an incremental bicycle test.<BR>Nine healthy male subjects underwent the incremental test at 60 min after the oral administration of NH<SUB>4</SUB>Cl (acidotic-treatment ; Acid), NaHCO<SUB>3</SUB> (alkalotic-treatment ; Alk) and NaCI (control ; Cont) at 1.87 mM⋅kg<SUP>-1</SUP>body weight. Exercise was started at a load of 80W, which was subsequently increased by 10W every minute until exhaustion. During exercise, O<SUP>2</SUP>intake (VO<SUP>2</SUP>), ventilatory volume (VE) and heart rate (HR) were monitored continuously. Venous blood samples were obtained before administration and every 2 min during exercise.<BR>No change could be detected in resting VO<SUB>2</SUB>, VE and HR following oral administration of NH<SUB>4</SUB>Cl, NaHCO<SUB>3</SUB>and/or NaCl. At 60 min after oral administration venous blood pH (<SUB>v</SUB>pH) and bicarbonate ion concentration (<SUB>v</SUB> [HCO<SUB>3</SUB><SUP>-</SUP>] ) were significantly lower in Acid (7.265±0.033; p <0.001, 23.6±1.8 mM⋅1<SUP>-1</SUP>; p<0.01) ; and significantly higher in Alk (7.370±0.045 ; p<0.01, 29.7±1.6 mM⋅1<SUP>-1</SUP>; p<0.01) compared to Cont (7.318±0.041, 26.6±2.1 mM⋅1<SUP>-1</SUP>) . Changes in VO<SUB>2</SUB>, VE and HR during exercise were essentially the same in all cases. No differences were observed in exercise time. During exercise, vpH and<SUB>v</SUB> [HCO<SUB>3</SUB><SUP>-</SUP>] gradually decreased, but remained significantly lower in Acid and higher in Alk compared to Cont. Blood lactate concentration (bLA) increased during exercise. Peak values were observed at exhaustion, but it was lower in Acid (8.03±1.18mM⋅1<SUP>-1</SUP>) and higher in Alk (10.73±1.48) compared to Cont (9.49±1.79) in all subjects. The Onset of Blood Lactate Accumulation (OBLA) was determined for each subject. OBLA was significantly higher in Acid (71.9±9.1%VO<SUB>2</SUB>max) than Cont (62.5±9.9%VO<SUB>2</SUB>max) and Alk (62.2±8.0%VO<SUB>2</SUB>max) .<BR>Changes in acid-base balance were found to cause differences in bLA responses to the same exercise load and possibly change OBLA. Care must be taken when using OBLA or LT as an index of aerobic capacity in some patients with acid-bace disorders; hemodialitic, obese or diabetic patient.
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The present study was carried out to investigate differences in hormonal and metabolic responses to moderate exercise in the post-absorptive state and during a 33-hour fast. Secretory factors and the roles of regulatory hormones of carbohydrate and lipid metabolism during moderate exercise were assessed baesed on these data. Energy substrates in the blood (glucose, BG; lactate, LA; triglyceride, TG; free fatty acids, FFA; free glycerol, FG) and plasma hormones (ACTH; GH; Cortisol, Corti; glucagon, IRG; insulin, IRI) concentrations were measured from 12 h to 33 h during the fasting period (12: 00, 24: 00, 06: 00, 09: 00), and 3min, 10 min and 30min after moderate treadmill exercise (estimated 70-80% of VO<SUB>2</SUB>max) for 20 min under fasting conditions between 09: 00 and 11: 00. These results (in the fasting experiment, Fast) were compared to the results on a normal diet (N-D) .<BR>The results were as follows:<BR>1. No differences in mean VO<SUB>2</SUB> and respiratory exchange ratio (RER) during exercise were observed between the Fast and N-D experiments. Mean heart rate during exercise in Fast was higher by 3.3±2.2 bpm (p<0.05) .<BR>2. Serum FFA and FG concentrations were significantly higher as a results of 24-hour fasting than the values measured at the same time in N-D. No significant change in serum TG concentrations were observed in Fast. While BG and LA concentrations remained low, and in small changes occurred in then both during Fast.<BR>3. Slightly higher levels of plasma ACTH, GH and IRG were found in Fast, but they were not significantly different from N-D. Plasma Corti concentrations gradually increased after 24 hours of fasting, and were 1.9 times higher at 09: 00 after 33 hours of fasting than on N-D. Plasma IRI levels, however, remained low, and the molecular ratio of IRG to IRI (IRG/IRI) was higher throughout Fast (1.8 to 10.6 times higher than on N-D ) .<BR>4. Plasma ACTH, GH and Corti concentrations increased markedly after exercise, and remained high until 30 min on Fast. No significant change in IRG and depression of insulin secretion were demonstrated after exercise on both treatment.<BR>5. Significant correlation between changes in plasma ACTH and Corti concentrations were observed throughout the experiments (Fast, r=0.562; N-D, r=0.528) .<BR>6. All of the energy substrates except blood TG increased after exercise, and the net increases in LA and FG (Δ) on Fast were significantly higher than on N-D. Significant correlations between the changes in the concentrations of FFA and FG (Fast, r=0.745; N-D, r= 0, 696), LA and BG (Fast, r=0.689; N-D, r=0.623), and FFA and LA (Fast, r=0.579; N-D, r= 0.479) were detected throughout both experiments.<BR>7. The coefficients of correlation between changes in plasma ACTH and FFA, and between BG and LA concentrations were higher on Fast than N-D. However, changes in plasma IRI and IRG concentrations were not directly correlated with any other changes in energy substrates in the blood in either treatment.<BR>The results indicated that moderate exercise for 20 min after a 33-hour fast causes marked responses in ACTH, Corti and GH secretions. It appeared that Corti secretion de-pended on ACTH, and that Corti facilitated fatty metabolism during exercise on Fast. However, secretion factors and the role of GH during exercise remain a matter of conjecture.
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A study was carried out to confirm the present states of physical training and nutritional condition in sportsmen on the growing stage. Energy expenditure (EE), caloric intake (CI), food items, body weight, running distance for 12 min and hematological and biochemical parameters of blood and urine were measured in 17 high school boys during intense summer baseball training for seven days. EE was estimated from the records by direct observation of activities during the baseball training (RMR method), and CI was calculated from the dietary record supplied each subject for the seven observation day.<BR>Following results were obtained.<BR>1) The average EE was 55.4±7.5 kcal/kg/day, and the CI corresponded to 87.2% of the EE, although no significant reduction of body weight was observed at the termination of the training session.<BR>2) Running distance for 12 min gradually decreased.<BR>3) Significant decreases in serum TG, TP and Hgb concentrations, and a remarkable increase in CPK activity were observed on the 4 th and final days. Urinary excretion of phosphate, urea nitrogen and catecholamines also increased gradually.<BR>4) The greater the increase in negative energy balance (CI-EE), the greater the decrease in TG, TP and Hgb concentrations, and the greater the increase in serum CPK and urinary excretion of catecholamines.<BR>The present results suggest that greater intake of total energy, protein and fat is recommended for development of endurance capacity, baseball techniques and sound growth in occasion such as the present baseball training program in high school boys.
ABSTRACT
The purpose of the present study was to assess the effect of commercial sports beverage intake after a thermal exposure on water-electrolytes balance.<BR>Nine healthy male volunteers with a mean age of 26.4 years, not heat acclimated, participated in a control experiment where no fluid was given (C experiment) . Five of them were given 500ml isotonic sports beverage containing Na<SUP>+</SUP>, K<SUP>+</SUP>, Cl<SUP>-</SUP>and glucose (S. B experiment) and/or 500 ml tap water (Wa experiment) immediately after sauna exposure. The nude subjects were exposed to a sauna with 65 to 70°C (r. h. 50 to 60%) for 30 min.<BR>Serum protein, electrolytes (Na<SUP>+</SUP>, K<SUP>+</SUP>, Cl<SUP>-</SUP>), creatinine, plasma aldosterone (Ald), and catecholamines concentrations and excretions of electrolytes and aldosterone into urine were measured before, and 3, 30, 60, and 120 min after the sauna. Serum and urinary osmolalities, blood pressure, rectal temperature (Tr), heart rate, oxygen consumption and weight loss were also measured.<BR>Body weight loss ranged from 50 to 750g. Serum protein, electrolytes and Ald concentrations increased significantly after the sauna. The enhanced levels of these variables and the depression of urine volume, urinary Na<SUP>+</SUP>excretion were maintained throughout the 2h recovery period in C experiment. Hydration associated with a reduced concentration of serum protein and electrolytes was observed at 30 min in S. B, at 60 min in Wa, and a dehydration occured again at 120 min both in S. B and Wa. A peak of urine volume was observed at 60 min in S. B and at 120 min in Wa during recovery. Free water clearance (C<SUB>H2O</SUB>) was -0.98 ml/min/100 ml GFR (Ccr) prior to the exposure. With no fluid administration after the sauna, an excess in negative water balance remained throughout the 2 h recovery. But C<SUB>H2O</SUB>changed from negative to positive at 60 and 120 min after sports beverage and/or water loadings.<BR>A significant elevation of % TRNa (0.33 to 1.14%) was maintained after the sauna in both C and Wa experiment. Plasma Aid concentration and excretion of Aid in urine after the exposure were higher in both C and Wa than in S. B experiment. The increased Tr did not return to the initial level throughout the recovery. No significant differences were observed among the three experiments in heart rate and blood pressure as well as Tr.<BR>The data indicate that salt deficit due to the sauna exposure was attenuated, but not prevented, by sports beverage intake, although the Aid secretion was alleviated. It is suggested that an over loading of sports beverage or water (i. e. 500 ml VS 50 to 750 g weight loss) leads to a marked and prompt water-diuresis, and to another dehydration. The increase of Tr as well as a partly salt deficit can be related to the rises in Ald secretion still observed at 2 h recovery.
ABSTRACT
The present study was done to elucidate the medical problems and physical fitness of under-weight elementary schoolboys. Eighty nine volunteers, ranging in age from 9 to 12 yrs, were divided into five groups based on the grade of obesity, expressed as % of the standard, taking into account height, age and sex.<BR>The mean grade of obesity for under-weight boys was -12 %, and this group was defined as the experimental group (group I; n=15) . The group III, which contained 23 boys of grade 0 %, and the group V made of 13 boys of grade +33.5 % was defined as the normal control and obese control, respectively.<BR>The measurement of blood pressure, EKG recording, and blood sampling were done in the state of fasting before and after exercise. The exercise was a step test of 5 min duration with a temp of 1 step per 2 seconds, jumping over a bench 25 cm high for 9 years old boys, and 33 cm high for boys of 10 to 12 years. The step test score (PFI) and recovery rate of heart rate (RR (HR) ) were calculated from the EKG. The test battery of physical fitness performance was also done on another experimental day.<BR>The serum levels of total cholesterol (TC), triglyceride (TG), total protein (TP) and hemoglobin (Hgb) were lower in experimental group (EG) than in control groups (CG) . The cholesterol-HDL/TC ratio was conversely higher in EG than in CG. There were no significant differences in the other biochemical measurements between the five groups.<BR>Any abnormal EKG was not recorded before and after exercise throughout the subjects. The frequency of hypertension (above the 135/80 mmHg) was 10.2 % at pre-exercise time. But, none of the boys in EG was found to be hypertensive.<BR>The PFI and physical fitness performance test score showed no differences between EG and group III, however, the score of group V was inferior to that of EG and/or group III. The RR (HR) in EG and over-weight group was lower compared to that for the average-weight boys.<BR>Almost all components in blood measured were elevated after exercise in all the groups. The finding of the highest interest of the exercise-induced elevations of blood constituent levels was an increase in WBC measured as an indicator of stress. The magnitude of increase in WBC (ΔWBC) was higher in EG and the over-weight group than in the average-weight group. In normal subjects, ΔWBC was generally proportional to the work intensity, which, in the present exercise, depended upon the stature and body weight, because the height of bench, tempo and duration of exercise were same for all groups. The work intensity in EG was presumed milder, becasue the mean stature was slightly taller and bodyweight was less heavy compared to those in control groups. But, the greater increase of WBC in EG was observed in spite of a lighter work intensity. According to the Selye's literature, the particular WBC reaction to exercise in the under-weight boys was interpreted as a over-reaction to stress in the state of malnutrition.<BR>From some biochemical parametors, the leaner subjects were assumed to be in a slight malnutrition. And also a later recovery of HR and over-reaction to exercise stress were shown in the under-weight boys group.<BR>It is emphasized that the malnutrition resulting from excessive effort for preventing obesity was unfavourable for children in the growing stage for their healthy growth and development.