A study of the effect of half-day climatotherapy on changes in salivary cortisol levels.

In our previous study setting, climatotherapy programme consisted of six sessions - four in the mid-mountain area and two in a flat park. For all sessions, the subjects underwent climatotherapy in the morning under slightly cool conditions. During each session, the subjects' blood pressure, pulse rate, skin temperature, blood lactate, salivary cortisol and mood profile were recorded, and meteorological data were collected at the sites. We hypothesised that exercise habits, changes in mood profile and effective temperatures during the session, and physical exertion during the climatic terrain cure would affect salivary cortisol levels. Subjects were 30 (spring) and 29 (autumn). Multiple linear regression analyses were performed to examine the determinants of the change in salivary cortisol levels. In the mountain setting, salivary cortisol was elevated, even though the sessions took place in the descending phase of the circadian salivary cortisol variation; however, the post-session cortisol increase was not significant. Increased post-session salivary cortisol was significantly associated with female gender, older age, higher BMI, lower body fat, less daily physical activity, increased blood lactate, increased 'Tension-Anxiety' and 'Depression-Dejection' moods, and decreased 'Anger-Hostility' mood. The increase in cortisol may have been due to older age, a predominance of females, and the increased blood lactate due to the mountainous terrain. In the flat park, the significant decrease in postsession salivary cortisol was related to the descending circadian phase of circadian cortisol variation and the low physical demands of the sessions.

Benefits of an accelerated climatotherapy programme for busy people: comparisons according to area and season.

An accelerated climatotherapy programme was evaluated for use with busy people in mid-mountain and flat lowland areas. A total of 43 urban residents participated in this climatotherapy programme. Participants' blood pressure, pulse rate, peripheral skin temperature and levels of salivary amylase, salivary cortisol and blood lactate were measured, and they completed the Profile of Mood Status questionnaire. In the mid-mountain area, which had a cooler environment and long uphill paths, participants' percentage of maximum pulse rate (70.01%) to estimated maximum heart rate was higher than that (59.67%) of participants in the flat lowland area, suggesting that the mid-mountain area was suitable for endurance training. At both sites, the decrease in peripheral skin temperature during the climatic terrain cure suggested that our programme was properly implemented with a cool body surface in accordance with our purpose. Negative moods improved quickly, suggesting that the forest environment and the fresh-air rest cure may have relaxed participants. In late spring and early autumn, the mood of approximately 25% of participants improved to an Iceberg profile, which is associated with positive mental states and athletic peak performance, after climatotherapy. On the other hand, the weather in early spring and late autumn was more likely to facilitate maintenance of a cool body surface during the climatic terrain cure. With the support of individualized feedback provided after the climatotherapy sessions, three participants developed regular exercise habits, serving as a good example of the effectiveness of our climatotherapy programme to elicit behavioural change.

Biology of the vernix caseosa: A review.

The vernix caseosa is a complex membranous structure comprising 80% water, 10% protein, and 10% lipids including barrier lipids such as ceramides, free fatty acids, phospholipids and cholesterol, synthesized partly by fetal sebaceous glands during the last trimester of pregnancy in an antero-posterior and dorsoventral manner. Because of its lipid content, vernix is hydrophobic and protects the skin from excessive water exposure during the development of the stratum corneum. The vernix caseosa has various functions during fetal transition from an intrauterine to an extrauterine environment, including lubrication of the birth canal during parturition, barrier function to prevent water loss, temperature regulation, for innate immunity and for intestinal development. This review discusses the evidence supporting the prenatal and postnatal functions of vernix caseosa, along with its structure, composition, and physical and biological characteristics. Understanding the biology of the vernix may facilitate improved care of preterm infants immediately post-partum.

Effects of movement music therapy with a percussion instrument on physical and frontal lobe function in older adults with mild cognitive impairment: a randomized controlled trial.

OBJECTIVES: We tested the hypothesis that performing a rhythmic physical task accompanied by a cognitive task, such as multitask movement music therapy (MMT) involving repetitive rhythmic movement with a musical instrument (the Naruko clapper), may improve pre-frontal cortex (PFC) function and cognitive performance. METHOD: Forty-five older adult participants with MCI (74.62 ± 5.05 years) participated in this randomized, controlled, single-blind intervention trial. 35 were assigned to the MMT group and 10 to the control STT group. Before and after the 12-week exercise program, we administered six physical function tests, the Frontal Assessment Battery (FAB), and measured relative oxyhemoglobin concentrations using 45-multichannel functional near-infrared spectroscopy as a reflection of hemodynamic responses in the PFC. RESULTS: We observed significant improvements in FAB scores only in the MMT group. Cerebral blood flow (CBF) in the PFC during the exercise was significantly increased in the MMT group compared with the STT group. The CBF increase was significantly correlated among various channels in the MMT group. CONCLUSIONS: The MMT program appeared to stimulate the PFC and improve cognitive performance in our older adult participants with MCI, suggesting that the repetitive, rhythmic movements of MMT can activate the prefrontal area in older adults. TRIAL REGISTRATION: Clinical Trial Registry Numbers: R000026130, UMIN000022671 (2016/06/08) [(University Hospital Medical Information Network (UMIN) Center] retrospectively registered.

An interactive sports video game as an intervention for rehabilitation of community-living patients with schizophrenia: A controlled, single-blind, crossover study.

Hypofrontality is a state of decreased cerebral blood flow in the prefrontal cortex during executive function performance; it is commonly observed in patients with schizophrenia. Cognitive dysfunction, as well as the psychological symptoms of schizophrenia, influences the ability of patients to reintegrate into society. The current study investigated the effects of an interactive sports video game (IVG; Nintendo Wii™ Sports Resort) on frontal lobe function of patients with schizophrenia. A sample of eight patients (6 male and 2 female; mean age = 46.7 years, standard deviation (SD) = 13.7) engaged in an IVG every week for 3 months in a controlled, single-blind, crossover study. Before and after the intervention we examined frontal lobe blood-flow volume using functional near-infrared spectroscopy (fNIRS), and assessed functional changes using the Frontal Assessment Battery, Health-Related Quality of Life scale, and behaviorally-assessed physical function tests. fNIRS revealed that prefrontal activity during IVG performance significantly increased in the IVG period compared with the control period. Furthermore, significant correlations between cerebral blood flow changes in different channels were observed during IVG performance. In addition, we observed intervention-related improvement in health-related quality of life following IVG. IVG intervention was associated with increased prefrontal cortex activation and improved health-related quality of life performance in patients with schizophrenia. Patients with chronic schizophrenia are characterized by withdrawal and a lack of social responsiveness or interest in others. Interventions using IVG may provide a useful low-cost rehabilitation method for such patients, without the need for specialized equipment.

Climatotherapy in Japan: a pilot study.

Twenty-nine urban inhabitants participated in a half-day climatotherapy programme at the moderate mountain area and lowland area in the northwest part of the main island of Japan. The current study was aimed to investigate physically and mentally the objective and subjective influence of our short programme, which was a prospective pilot study of single intervention. Blood pressure was significantly descended during terrain cure at the uphill mountain path and returned after fresh-air rest cure, while there was no significant change throughout the programme at lowland flat path. Heart rate was significantly ascended and descended at both area, and more clearly changed at the mountain path. Profile of Mood Status brief form Japanese version administered before and after our half-day programme. Age adjusted T score of negative subscales, 'tension-anxiety', 'depression', 'anger-hostility', 'fatigue' and 'confusion' were significantly lower after climatotherapy at both sites. Whereas, there was no significant change concerning 'vigour' score. This short-version climatotherapy programme has been designed for people without enough time for long stay at health resort. It turned out our half-day climatotherapy programme contribute to mood status improvement. In addition, repeated practice of our short-version programme including endurance exercise with cool body shell using uphill path can be expected that blood pressure will go toward the normal range and heart rate will decrease both in usual time and during exercise. Therefore, health benefits can be expected of this climatotherapy programme.

Relationships between estimation errors and falls in healthy aged dwellers.

BACKGROUND: Although fall predictions using motor ability have been well reported in elderly people, there are few reports on physical cognitive ability. OBJECTIVE: To examine the relationship of the results of motor function tests that include physical cognitive ability on the ability to predict falls and to determine which test is the most appropriate. METHODS: We studied 174 community-dwelling elderly adults (mean age 75.7 ± 5.7, 41 males and 133 females), and measured grip strength, one-leg standing time (OLS), timed up and go test (TUG), functional reach test, sit and reach test, and maximal step length (MSL). The estimation error (EE), which was defined as the difference between the predicted and actual values, was calculated in all motor ability tests. Other assessments included the number of falls in the previous year, BMI, frequency of going out, Mini-Mental State Examination score, and Falls Efficacy Scale. In the baseline study, we divided the subjects into a fall group (n = 33) and a nonfall group (n = 141) and compared motor ability and EE for the two groups. During a 1-year follow-up, the nonfall group (baseline study) was assessed for the same measurements by using the same methods. RESULTS: In the baseline study, the fall group had significantly lower values of OLS and MSL. Furthermore, the fall group significantly overestimated their OLS, TUG, and MSL. In logistic regression analysis, EE of TUG (OR = 1.27) and EE of MSL (OR = 1.08) were detected as risk factors for falls. During follow-up, 11 subjects (7.8%) experienced falls. In logistic regression analysis, TUG (OR = 1.89) and EE of MSL (OR = 1.06) were detected as significant risk factors for falls. Since EE of MSL had higher values of both the area under the receiver operating characteristic curve and the sum of sensitivity and specificity than EE of TUG, the nonfall group was divided into two groups with a cutoff value of 2 cm for EE of MSL. A significant distribution disparity in falls between the two groups was found during follow-up and showed a relative risk of 18.78 for EE of MSL. CONCLUSIONS: We suggest that EE of MSL is a potent predictor for falls among healthy elderly adults.

Survey on the incidence and management of pseudomyxoma peritonei in Japan.

PURPOSE: Pseudomyxoma peritonei(PMP)is a rare condition characterized by massive ascites accumulation due to mucinous tumor dissemination in the peritoneal cavity. More recently, Sugarbaker has defined radical cytoreductive surgery and intraperitoneal chemotherapy as standardized therapy for PMP. The objective of this study was to investigate the incidence of PMP and the recent therapeutic approaches for this condition in Japan. METHODS: Questionnaires answered by PMP patients between 2006 and 2010 were evaluated in this study. The study included 1, 084 gastroenterological surgery and gynecology institutions in Japan. RESULTS: Data from 379 institutions were analyzed(response rate: 35. 0%). The mean number of diffuse PMP cases at a single institution in 5 years was 0. 78. Of 266 diffuse cases, surgery was performed in 232 cases(87. 2%)and chemotherapy was administered in 138 cases(51. 9%). However, complete cytoreduction was achieved in only 31 of 232 operated cases(13. 4%)and intraperitoneal chemotherapy was administered to only 45 of 138 patients receiving chemotherapy( 32. 6%). CONCLUSION: Despite the limited data, our results suggest that PMP occurs rarely in Japan, similar to the trend reported in Western countries. Further, the Sugarbaker procedure was not widely used in Japanese institutions.

Effects of movement music therapy with the Naruko clapper on psychological, physical and physiological indices among elderly females: a randomized controlled trial.

BACKGROUND: Recent interventional studies have indicated that some exercise programs have beneficial physical and immunological effects for older people. Some evidence suggests that exercise programs involving music and/or a rhythmic movement component may be particularly beneficial. OBJECTIVE: To assess the effects of a new type of movement music therapy (MMT) on physical, immunological, hormonal and psychosocial health parameters among older adults. METHODS: 112 elderly female subjects (average age 73.62 ± 5.50 years) who performed little habitual exercise participated in this randomized, controlled, single-blinded intervention trial. The subjects were divided into two groups which participated in different exercise programs (experimental group: MMT; control group: simple exercise program). We assessed a comprehensive range of indices before and after the interventions, which lasted a total of 8 weeks. These indices included (1) the Philadelphia Geriatric Center morale scale, (2) self-rated health status, (3) physical function tests (e.g. blood pressure, pulmonary function, body balance, gait ability, muscle endurance, muscle-strength, and functional mobility), and (4) saliva analysis for physiological function indices (e.g. secretory immunoglobulin A (SIgA), chromogranin A, cortisol, and total protein). RESULTS: In comparisons between the MMT and control interventions in younger elderly subjects (≤74 years old), systolic blood pressure decreased (p = 0.02), pulmonary function improved (p = 0.05) and body balance improved (p = 0.04) in the MMT group, but not in the control group. The SIgA secretion rate of the experimental group remained significantly elevated (p = 0.02) 15 min after exercise compared with before exercise. There were no significant differences between interventions in psychosocial indices. In contrast, no significant differences were detected between interventions in any measures in the older elderly group (≥75 years old). CONCLUSION: These results indicate that the MMT, even with a short (8-week) intervention period, improves physical and physiological functions to a significantly greater extent in younger elderly individuals compared with a control intervention without music.

Work-related allergy in medical doctors: atopy, exposure to domestic animals, eczema induced by common chemicals and membership of the surgical profession as potential risk factors.

PURPOSE: To investigate the risk factors associated with work-related allergy-like symptoms in medical doctors. METHODS: Self-administered questionnaire survey and CAP test were conducted among medical school students in the 4th grade of their 6-year medical course in 1993-1996 and 1999-2001. Follow-up questionnaires were sent in 2004 to the graduates. These questionnaires enquired into personal and family history of allergic diseases, lifestyle, history of allergy-like symptoms including work-relatedness and occupational history as medical doctors. Relationships between allergy-like symptoms and relevant factors were evaluated by multivariate logistic regression analysis. RESULTS: Of 261 respondents at the follow-up survey, 139 (53.3%) and 54 (20.7%) had a history of any allergy-like symptoms and any work-related allergy-like symptoms, respectively. Female gender and family history of allergic diseases were significantly associated with any allergy-like symptoms. Personal history of allergic disease, exposure to domestic animals, eczema caused by rubber gloves, metallic accessories, or cosmetics during schooling days, and membership of the surgical profession were significant risk factors for work-related allergy-like symptoms. On the contrary, to work-related allergy-like symptoms, gender, age, and smoking status were not significantly related, and consumption of prepared foods was inversely related. CONCLUSIONS: Personal history of atopy and eczema induced by common goods and the history of keeping domestic animals may be predictors of work-related allergy-like symptoms in doctors. After graduation from medical school, physicians start with exposure to various allergens and irritants at work, which relate to work-related allergy-like symptoms, especially for surgeons.

Work form affects maximum oxygen uptake for one year in workers.

Our previous study suggested that the work form is related to the maximum oxygen uptake (VO(2)max). Therefore, we test the hypothesis by a longitudinal study that, besides these lifestyle-related factors, the work form increases VO(2)max among workers. Seven hundred and ninety nine males aged 37.1 ± 10.6 and 395 females aged 37.7 ± 10.5 (range: 20 to 59 yr old), who participated in The Total Health Promotion Plan (THP) at their respective workplaces twice in one year from 1997 to 1998, were selected. Data on VO(2)max were analyzed for age, systolic blood pressure (SBP), body mass index (BMI), work form (sedentary, standing, and ambulatory), exercise, and smoking. Age and the baseline variables for BMI and for VO(2)max showed significant negative relationships with a change in VO(2)max in males and females. Further, a change in the BMI showed a significant negative relationship with a change of VO(2)max in males. However, exercise habit and an ambulatory work form showed significant positive relationships with a change of VO(2)max in males. It was suggested that after adjusting for other factors in males, an ambulatory work form may be associated with an increase in VO(2)max in one year.

Air-induced anti-Markovnikov addition of secondary phosphine oxides and H-phosphinates to alkenes.

[reaction: see text] Air (oxygen) induces the addition of secondary phosphine oxides and H-phosphinates to alkenes to selectively produce the corresponding anti-Markovnikov adducts in good to high yields. Mechanistic studies show that the addition probably proceeds via a radical chain mechanism.

Palladium-catalyzed insertion of isocyanides into P(O)-H bonds: selective formation of phosphinoyl imines and bisphosphinoylaminomethanes.

Palladium and rhodium catalyzed the addition of H-phosphine oxides to isocyanides to selectively generate alpha-iminophosphine oxides and bisphosphinoylaminomethanes, respectively.

Physical work load affects the maximum oxygen uptake.

PURPOSE: Maximum oxygen uptake (VO2max) is known to be influenced by life-style factors, such as exercise and smoking. We aimed to further test the hypothesis that, besides these, work form also contributes to increase VO2max among workers. METHOD: Three thousand six hundred and forty eight male workers with age 38.3 +/- 12.1 and 1,575 female workers with age 35.6 +/- 11.1, ranging from 20-year old to 69-year old, who participated in Total Health Promotion Plan at workplaces in Fukui Prefecture in 1998 were selected. Data on VO2max were analyzed for age, systolic blood pressure (SBP), body mass index (BMI), work form (sedentary, standing or ambulatory), exercise, and smoking. RESULTS: Multiple regression analysis showed that work form ("standing", "ambulatory"), and exercise habits might increase VO2max while BMI, age, and SBP might decrease VO2max in male participants. Exercise habits were suggested to increase VO2max while BMI, SBP, and age might decrease VO2max in females. In females smoking, was suggested to increase VO2max. CONCLUSION: After adjusting for age, BMI, SBP, exercise, and smoking, it was suggested that the physical work load, represented by the work form, may contribute to increases in VO2max in males. Implications of smoking among females with respect to VO2max is discussed.

The Pt-catalyzed carboselenation of alkynes by selenoesters.

[reaction: see text] The Pt-catalyzed carboselenation of terminal alkynes with selenoesters provided vinylselenides regio- and stereoselectively in moderate yields.

Cyclopropanation of vinylidenecyclopropanes. Synthesis of 1-(dihalomethylene)spiropentanes.

Synthesis of 1-(dihalomethylene)spiropentanes via cyclopropylidenecyclopropanes generated by cyclopropanation of vinylidenecyclopropanes by dihalocarbenes is described. Reaction of diarylvinylidenecyclopropanes with dibromocarbene and dichlorocarbene exclusively gave 1-(dihalomethylene)spiropentanes in high yields. Reaction of monoarylvinylidenecyclopropanes with dihalocarbenes afforded cyclopropylidenecyclopropanes as the major product with the formation of a small amount of 1-(dihalomethylene)spiropentanes. The efficiency of the thermal rearrangement from the cyclopropylidenecyclopropanes to the 1-(dihalomethylene)spiropentane derivatives depended on the substituents and the reaction temperature. Reaction of diarylvinylidenecyclopropanes with diphenylcarbene and phenylthiocarbene gave the corresponding spiropentane derivatives. This type of thermal rearrangement was applicable to the cyclopropanation of 1,1-diarylallenes.