Different Influencing Factors for Risk of Falls Between Men and Women while Descending from Mount Fuji.

INTRODUCTION: Annually, approximately 250,000 people climb Mount Fuji in Japan. Nonetheless, only few studies have examined the prevalence of falls and related factors on Mount Fuji. METHODS: We conducted a questionnaire survey of 1061 participants (703 men and 358 women) who had climbed Mount Fuji. The following information was collected: age, height, body weight, luggage weight, experience on Mount Fuji, experience on other mountains, presence or absence of a tour guide, single-day climber or overnight-stay lodger, information on the downhill trail (volcanic gravel, long distance, and the risk of falls), presence or absence of trekking poles, shoe type, shoe sole condition, and fatigue feeling. RESULTS: The fall rate in women (174/358; 49%) was greater than that in men (246/703; 35%). A prediction model using multiple logistic regression (no fall, 0; fall, 1) indicated that the following factors decreased the risk of falls: male sex, younger age, previous experience on Mount Fuji, having information about long-distance downhill trails, wearing hiking shoes or mountaineering boots rather than other types of shoes (eg, running shoes, sneakers) or worn-out shoes, and not feeling fatigued. Additionally, the following factors may decrease the risk of falls in women only: experience hiking on any other mountains, not being part of a guided tour, and using trekking poles. CONCLUSIONS: Women had a higher risk of falls on Mount Fuji than men. Specifically, having less experience on any other mountains, being part of a guided tour, and nonuse of trekking poles may relate to higher risks of falls in women. These results suggest that different precautionary measures for men and women are useful.

An effective strategy to reduce blood pressure after forest walking in middle-aged and aged people.

[Purpose] Forest walking may be effective for human health, but little information is available about effects of energy expenditure on blood pressure responses after forest walking. The aim of this study was to investigate the relationship between the activity energy expenditure and changes in blood pressure in individuals after forest walking. [Subjects] The subjects were 54 middle-aged and elderly people. [Methods] All subjects walked in the forest for approximately 90 min. Blood pressure, salivary amylase, and the Profile of Mood States were evaluated before and after forest walking, and activity energy expenditure was monitored throughout forest walking. Subjects were divided into two groups according to mean arterial pressure changes: a responder group (>5% decreases) and a nonresponder group (<5%). [Results] Forest walking significantly reduced the mean arterial pressure and improved the Profile of Mood States in both groups. Activity energy expenditure was related to changes in mean arterial pressure in the responder group, while this relation was not observed in the nonresponder group. Differential activity energy expenditure did not strongly affect improvement of the Profile of Mood States. [Conclusion] Greater walking-related greater activity energy expenditure might be required to accentuate physiological beneficial effects on in middle-aged and aged people. Furthermore, the forest environment per se can attenuate psychological stress.

[Tuberculous epididymitis after Bacillus Calmette-Guérin intravesical therapy : a case report].

We describe a case of tuberculous epididymitis following Bacillus Calmette-Guérin (BCG) instillation in a 79-year-old man. He had received transuretheral resection of bladder tumor in Sep 2009. Histopathological diagnosis was urothelial carcinoma, high grade, pTa and pTis. To prevent recurrence, he received maintenance therapy for Feb 2010-May 2011 after eight weekly intravesical instillation of BCG. Skin fistula with discharge in the left scrotum occurred in Sep 2011. Treatment with levofloxacin was not effective. Therefore, we performed bilateral orchiectomy (he had hormone therapy of prostate cancer) and left scrotal skin resection. Histopathological examine showed tuberculous epididymitis. He had no signs of recurrence 2 years postoperatively and has not received any anti-tuberculous chemotherapy.

Influence of Smoking and Alcohol Habits on Symptoms of Acute Mountain Sickness on Mount Fuji: A Questionnaire Survey-Based Pilot Study.

Horiuchi, Masahiro, Satomi Mitsui, and Tadashi Uno. Influence of smoking and alcohol habits on symptoms of acute mountain sickness on Mount Fuji: a questionnaire survey-based pilot study. High Alt Med Biol 00:000-000, 2024. Background: Acute cigarette smoking or alcohol intake would cause opposing vasculature effects that may influence acute mountain sickness (AMS). The present study aimed to investigate the effects of smoking and alcohol consumption behaviors, and acute smoking and consuming alcohol during ascent on AMS on Mount Fuji. Methods: This questionnaire survey study included 887 participants who climbed Mount Fuji and obtained information regarding sex, age, and smoking and alcohol habits, including behavior during ascent. Results: AMS prevalence was 45% for all participants. A univariate analysis revealed that younger participants (20-29 years) were associated with increased AMS prevalence (effect size [ES] = 0.102, p = 0.057) and severity (ES = 0.18, p = 0.01). A prediction model using multiple logistic regression indicated that several factors influenced AMS risk: younger age (p = 0.001), daily smoking habits (p = 0.021), no smoking (p = 0.033), or alcohol consumption during ascent (p = 0.096). Alcohol consumption during ascent had no effect on the increased AMS risk in younger participants (20-29 years), while alcohol consumption during ascent increased AMS risk for middle-age participants (50-59 years). Conclusion: Younger individuals are more likely to experience AMS. Smoking habits are associated with an increased AMS risk. It may be recommended that middle-aged climbers should ascend without consuming alcohol.

Influence of short-term hypoxic exposure on spatial learning and memory function and brain-derived neurotrophic factor in rats-A practical implication to human's lost way.

The present study aimed to investigate the effects of a short period of normobaric hypoxic exposure on spatial learning and memory, and brain-derived neurotrophic factor (BDNF) levels in the rat hippocampus. Hypoxic conditions were set at 12.5% O2. We compared all variables between normoxic trials (Norm), after 24 h (Hypo-24 h), and after 72 h of hypoxic exposure (Hypo-72 h). Spatial learning and memory were evaluated by using a water-finding task in an open field. Time to find water drinking fountains was significantly extended in Hypo 24 h (36.2 ± 21.9 s) compared to those in Norm (17.9 ± 12.8 s; P < 0.05), whereas no statistical differences between Norm and Hypo-72 h (22.7 ± 12.3 s). Moreover, hippocampal BDNF level in Hypo-24 h was significantly lower compared to Norm (189.4 ± 28.4 vs. 224.9 ± 47.7 ng/g wet tissue, P < 0.05), whereas no statistically differences in those between Norm and Hypo-72 h (228.1 ± 39.8 ng/g wet tissue). No significant differences in the changes in corticosterone and adrenocorticotropic hormone levels were observed across the three conditions. When data from Hypo-24 h and Hypo-72 h of hypoxia were pooled, there was a marginal negative relationship between the time to find drinking fountains and BDNF (P < 0.1), and was a significant negative relationship between the locomotor activities and BDNF (P < 0.05). These results suggest that acute hypoxic exposure (24 h) may impair spatial learning and memory; however, it recovered after 72 h of hypoxic exposure. These changes in spatial learning and memory may be associated with changes in the hippocampal BDNF levels in rats.

Effects of Simulated Visual Impairment Conditions on Movement and Anxiety during Gap Crossing.

This study investigated the effects of visual conditions associated with progressive eye disease on movement patterns and anxiety levels during gap-crossing tasks. Notably, 15 healthy young adults performed crossover platforms with a 10 cm gap at three different heights, namely equal (0 cm), raised (+15 cm), and lowered (-15 cm) levels, under four vision conditions, namely normal or corrected eyesight, 10° tunnel vision, 5° tunnel vision, and 5° tunnel vision with 0.04 occlusion. Leg movements during gap crossing were analyzed using three-dimensional motion analysis. The results highlighted a distinct motion pattern in the trajectories of participants' legs under the different visual conditions. Specifically, at the point where the gap-crossing movement began (D1), the normal or corrected eyesight conditions resulted in further separation between the steps compared with the other visual conditions. The highest point of the foot during movement (D2) did not differ between the visual conditions, except for the 0 cm step. Furthermore, anxiety levels, as quantified by the State-Trait Anxiety Inventory (STAI-S) questionnaire, were exacerbated under conditions of restricted visual information. In conclusion, visual impairments associated with progressive ocular diseases may perturb complex motor movement patterns, including those involved in gap-crossing tasks, with heightened anxiety potentially amplifying these disturbances.

[Emphysematous pyelonephritis and cystitis concurrence; A case report].

We report a case of emphysematous pyelonephritis coexisting with emphysematous cystitis. A 57-year-old woman seen for abdominal pain, diarrhea, and high fever had been referred after computed tomography (CT) elsewhere had shown an air density mass in the left kidney and pelvis. Abdominal CT on admission showed emphysematous change in the left renal parenchyma and intramural bladder. Serum analysis results showed disseminated intravascular coagulation (DIC) and uncontrolled diabetes. Klebsiella pneumoniae was isolated in the blood. She was diagnosed with sepsis based on these findings due to concurrent emphysematous pyelonephritis and cystitis caused by K. pneumoniae. She was treated conservatively with meropenem, intravenous immunoglobulin, and gabexate mesilate and cured. Concurrent emphysematous cystitis and pyelonephritis is rare., with ours only the fourth case reported in Japan.

Does change in barometric pressure per given time at high altitude influence symptoms of acute mountain sickness on Mount Fuji? A pilot study.

BACKGROUND: Acute mountain sickness (AMS) is a common, transient condition characterized primarily by headaches, and it can also be associated with fatigue, dizziness, and nausea with vomiting. The symptoms of AMS are most pronounced after the first night spent at a new altitude. At sea level, changes in barometric pressure per given time have been associated with migraine headaches. We sought to investigate whether changes in barometric pressure, subjective sleep quality index, and other candidates contributed to the risk of developing AMS on Mount Fuji in Japan. METHOD: We surveyed 353 trekkers who stayed overnight at a mountain lodge before summitting Mount Fuji. We collected information regarding sex, age, sleeping altitude at the hut, and perceived sleep quality index including sleep time. AMS was assessed with the Lake Louise Scoring system. Barometric pressure and ambient temperature were collected at the 5th station (2305 m) and at the summit (3776 m). RESULT: The overall prevalence of AMS in our cohort was 41.4% (Lake Louise Score ≥ 3 with headache, n=146). Using logistic regression, three factors were combined to generate a robust model for determining the risk of AMS (with or without AMS). These included (1) Δ barometric pressure during ascent per hour, (2) sleepiness on rising, and (3) sleep refreshment assessed by perceived sleep quality index. CONCLUSION: These results suggest that climbers who stay overnight at the lodge should keep a better physical condition of sleep, and would pay attention to information of barometric pressure condition to decrease their risk of AMS at the summit of Mount Fuji. Our observatory data indicated that an overnight staying in half way up to the summit does not necessarily reduce the AMS risk in both sexes and irrespective of age, at least, until 3776 m elevation.

Combined stimuli of cold, hypoxia, and dehydration status on body temperature in rats: a pilot study with practical implications for humans.

OBJECTIVE: As human thermoregulatory responses to maintain core body temperature (Tcore) under multiple stressors such as cold, hypoxia, and dehydration (e.g., exposure to high-altitude) are varied, the combined effects of cold, hypoxia, and dehydration status on Tcore in rats were investigated. The following environmental conditions were constructed: (1) thermoneutral (24 °C) or cold (10 °C), (2) normoxia (21% O2) or hypoxia (12% O2), and (3) euhydration or dehydration (48 h water deprivation), resulted in eight environmental conditions [2 ambient temperatures (Ta) × 2 oxygen levels × 2 hydration statuses)]. Each condition lasted for 24 h. RESULTS: Normoxic conditions irrespective of hypoxia or dehydration did not strongly decrease the area under the curve (AUC) in Tcore during the 24 period, whereas, hypoxic conditions caused greater decreases in the AUC in Tcore, which was accentuated with cold and dehydration (Ta × O2 × hydration, P = 0.040 by three-way ANOVA). In contrast, multiple stressors (Ta × O2 × hydration or Ta × O2 or O2 × hydration or Ta × hydration) did not affect locomotor activity counts (all P > 0.05), but a significant simple main effect for O2 and Ta was observed (P < 0.001). Heat loss index was not affected by all environmental conditions (all P > 0.05). In conclusion, decreases in Tcore were most affected by multiple environmental stressors such as cold, hypoxia, and dehydration.

Prevalence of Falls on Mount Fuji and Associated with Risk Factors: A Questionnaire Survey Study.

Since little is known about the detailed situations of falls on Mount Fuji, the aim of this study was to clarify the risk factors of falls on Mount Fuji in Japan. We conducted a questionnaire survey of 556 participants who had climbed Mount Fuji and collected the following information: fall situation, mental status, fatigue feeling, sex, age, climbing experience on Mount Fuji and other mountains, summit success, whether staying at a lodge, use of a tour guide, and symptoms of acute mountain sickness. Among the 556 participants, 167 had a fall (30%). Among 167 participants who had experienced a fall, 30 had fallen more than three times (18%). The main cause (>60%) of fall were slips. The most optimal model using multiple logistic regression (no fall = 0, and fall = 1) found eight significant risk factors, including sex, prior climbing experience on Mount Fuji, staying overnight at a lodge, subjective feeling of relaxation, sleepiness, emotional stability, dullness, and eyestrain. These results suggest that females, people who have no prior climbing experience on Mount Fuji, and people who did not stay at a lodge should pay attention to an increased risk of falls on Mount Fuji.

Impact of Sleeping Altitude on Symptoms of Acute Mountain Sickness on Mt. Fuji.

Horiuchi, Masahiro, Tadashi Uno, Junko Endo, Yoko Handa, and Tatsuya Hasegawa. Impact of sleeping altitude on symptoms of acute mountain sickness on Mt. Fuji. High Alt Med Biol. 19:193-200, 2018. AIMS: We sought to investigate the factors influencing acute mountain sickness (AMS) on Mt. Fuji in Japan, in particular, to assess the effects of sleeping altitude, by means of a questionnaire survey. This study involved 1932 participants who climbed Mt. Fuji, and obtained information regarding sex, age, and whether participants stayed at the mountain lodges. The AMS survey excluded the perceived sleep difficulties assessed with the Lake Louise Scoring (LLS) system for all climbers. RESULTS: The overall prevalence of AMS was 31.6% for all participants (LLS score ≥3 with headache, excluding sleep difficulties). A univariate analysis revealed that overnight stay at Mt. Fuji was associated with an increased prevalence of AMS, but that sex and age were not. For overnight lodgers, the mean sleeping altitude in participants with AMS was slightly higher than that in participants without AMS (p < 0.05). Moreover, participants who stayed above 2870 m were more likely to experience AMS than those who stayed below 2815 m (p < 0.001), but sex and age were not significantly associated with the probability of experiencing AMS. CONCLUSIONS: Staying overnight at a mountain lodge, especially one above 2870 m, may be associated with an increased prevalence of AMS on Mt. Fuji.

Impact of Carbohydrate-Electrolyte Beverage Ingestion on Heart Rate Response While Climbing Mountain Fuji at ~3000 m.

We sought to investigate whether carbohydrate-electrolyte beverage ingestion reduced heart rate (HR) in twenty-three healthy young adults while climbing Mount Fuji at a given exercise intensity. Twenty-three healthy adults were randomly divided into two groups: the tap water (11 males [M] and 1 female [F]) and the carbohydrate-electrolyte group (10 M and 1 F). HR and activity energy expenditure (AEE) were recorded every min. The HRs for the first 30 minutes of climbing were not significantly different between the groups [121 ± 2 beats per min (bpm) in the tap water and 116 ± 3 bpm in the carbohydrate-electrolyte]; however, HR significantly increased with climbing in the tap water group (129 ± 2 bpm) but showed no significant increase in the carbohydrate-electrolyte group (121 ± 3 bpm). In addition, body weight changes throughout two days ascending and descending on Mount Fuji were inversely related to changes in resting HR. Further, individual variation of body weight changes was suppressed by carbohydrate-electrolyte drink. Collectively, carbohydrate-electrolyte beverage intake may attenuate an increase in HR at a given AEE while mountaineering at ~3000 m compared with tap water intake.

Effects of Short-Term Acclimatization at the Summit of Mt. Fuji (3776 m) on Sleep Efficacy, Cardiovascular Responses, and Ventilatory Responses.

Horiuchi, Masahiro, Shiro Oda, Tadashi Uno, Junko Endo, Yoko Handa, and Yoshiyuki Fukuoka. Effects of short-term acclimatization at the summit of Mt. Fuji (3776 m) on sleep efficacy, cardiovascular responses, and ventilatory responses. High Alt Med Biol. 18:171-178, 2017.-We investigated the effects of a short period of acclimatization, at 3776 m on Mt. Fuji, on sleep parameters and related physiological responses. Physiological responses were assessed in seven healthy lowlander men during both daytime and sleep while at sea level (SL), as well as for three consecutive nights at high altitude (HA; 3776 m, day 1 [D1], D2, D3, and morning only of D4). Blood pressure variables, heart rate (HR), pulmonary ventilation (VE), and breathing frequency (Bf) progressively increased each day, with significant differences between SL and HA (p < 0.05, respectively). In contrast, end-tidal PCO2 (PETCO2) progressively decreased each day with statistical differences between SL and D3 at HA (p < 0.05). During sleep at HA, mean arterial pressure (MAP) was stable, whereas it decreased during sleep at SL. Sleep efficacy, which was assessed by actigraphy, was linearly impaired with statistical differences between SL and D3 (p < 0.05). These impairments in sleep efficacy at HA were associated with higher MAP and HR, as well as lower Bf and PETCO2 during the daytime (pooled data, p < 0.05, respectively). These results suggest that hypoxia-induced cardiovascular and ventilatory responses may be crucial contributors to changes in sleep efficacy at HA.

Prevalence of acute mountain sickness on Mount Fuji: A pilot study.

BACKGROUND: Few studies have investigated climbing-related acute mountain sickness (AMS) on Mt Fuji. Although several studies of AMS have been conducted elsewhere, Mt Fuji is unique because there are many mountain lodges between the fifth station (a common starting point for climbers at an altitude of 2305 m) and the summit (3776 m), and many climbers commonly sleep overnight at mountain lodges during their ascents. This study surveyed the prevalence of AMS among climbers on Mt Fuji to determine which factors, if any, were related to the risk of developing AMS. METHODS: This study collected data from 345 participants who climbed Mt Fuji in August 2013, including information regarding age, sex, climbing experience and whether the climber stayed at a mountain lodge (n = 239). AMS was surveyed using the Lake Louise Score (LLS) questionnaire. The item on perceived sleep quality was excluded for those who did not stay at a mountain lodge (n = 106). RESULTS: The overall prevalence of AMS was 29.5% (≥ 3 LLS with headache). According to a univariate analysis, AMS was not associated with sex (male vs female), age group (20-29, 30-39, 40-49 or >50 years) or stay at a mountain lodge (single day vs overnight stay). Conversely, prior experience climbing Mt Fuji (no prior attempts vs one or more prior attempts) was related to the risk of AMS. In addition, there was a significant deviation in the number of participants reporting poor sleep, and total sleep time was significantly shorter in participants with AMS. CONCLUSIONS: These preliminary findings suggest that no single factor can explain the risk for developing AMS while climbing Mt Fuji. In addition, impaired perceived sleep quality was associated with the severity of AMS in climbers who stayed overnight at a mountain lodge.

Influence of the hypothalamus on the midbrain tonic inhibitory mechanism on metabolic heat production in rats.

Influence of the hypothalamus on increased body temperature was examined in male rats. Body temperature was increased by removing the midbrain tonic inhibitory mechanism (TIM) on heat production from brown adipose tissue (BAT) by microinjections of a local anesthetic, procaine, into the midbrain. Procaine microinjections in unanesthetized rats increased rectal temperature that was followed by a strong tail skin temperature rise. Procaine microinjections in unanesthetized and decerebrated rats also increased rectal temperature but without skin temperature rise. These decerebrated animals fatally developed hyperthermia. In anesthetized rats, procaine microinjections increased temperature of the interscapular BAT (IBAT) higher with shorter onset for temperature rise than rectal temperature. Increased IBAT temperature by procaine microinjections in anesthetized rats was attenuated during hypothalamic warming, and enhanced during hypothalamic cooling when compared with that observed during thermoneutral hypothalamic temperature. These results suggest that the midbrain TIM is able to function in unanesthetized conscious rats, and that the integrity of the midbrain mechanism to tonically inhibit metabolic heat production does not require the presence of intact hypothalamus. These results also suggest that the hypothalamus modulates directly or indirectly IBAT heat production that was induced by removal of the midbrain TIM.

Deodorization of soybean proteins by enzymatic and physicochemical treatments.

To utilize soy protein isolate (SPI) more widely, a convenient and effective method for deodorizing it is required. This paper reports a new deodorizing method using various types of solid adsorbents made of polystyrene, polymethacrylate, and zeolite, as well as charcoal. Treatment of the SPI solution with them decreased the hexanal content in the solution, whereas the content of linoleic acid was not much decreased. A brominated polystyrene adsorbent (SEPABEADS SP207) and a zeolite adsorbent (HSZ-360HUD) removed hexanal most effectively, although 30-40% of the total hexanal remained. A model experiment showed that their hexanal adsorption capacity was much higher than the hexanal content in the SPI solution and that an excess amount of hexanal added to the SPI solution was mostly removed by them. These results suggest that hexanal in the SPI solution can be classified into two types. Hexanal of type I may be free or bound weakly on the surface of proteins and is removable by the adsorbents, whereas hexanal of type II may be bound tightly inside proteins and is unremovable by the adsorbents. Despite the considerable amount of hexanal remaining in the SPI solution even in the most successful cases, the SPI solution was well deodorized as shown by the sensory test. Accordingly, type I hexanal may be closely related to the soybean odor. Removal of hexanal by the adsorbents was not much improved by alpha-chymotryptic digestion of SPI. Type II hexanal might be in similar states even in the chymotryptic digests.

Transiently enhanced LPS-induced fever following hyperthermic stress in rabbits.

Hyperthermia has been shown to induce an enhanced febrile response to the bacterial-derived endotoxin lipopolysaccharide (LPS). The aim of the present study was to test the hypothesis that the enhanced LPS-induced fever seen in heat stressed (HS) animals is caused by leakage of intestinal bacterial LPS into the circulation. Male rabbits were rendered transiently hyperthermic (a maximum rectal temperature of 43 degrees C) and divided into three groups. They were then allowed to recover in a room at 24 degrees C for 1, 2 or 3 days post-HS. One day after injection with LPS, the post-HS rabbits exhibited significantly higher fevers than the controls, though this was not seen in rabbits at either 2 or 3 days post-HS. The plasma levels of endogenous LPS were significantly increased during the HS as compared to those seen in normothermic rabbits prior to HS. LPS fevers were not induced in these animals. One day post-HS, rabbits that had been pretreated with oral antibiotics exhibited significantly attenuated LPS levels. When challenged with human recombinant interleukin-1beta instead of LPS, the 1-day post-HS rabbits did not respond with enhanced fevers. The plasma levels of TNFalpha increased similarly during LPS-induced fevers in both the control and 1-day post-HS rabbits, while the plasma levels of corticosterone and the osmolality of the 1-day post-HS rabbits showed no significant differences to those seen prior to the HS. These results suggest that the enhanced fever in the 1-day post-HS rabbits is LPS specific, and may be caused by increased leakage of intestinal endotoxin into blood circulation.