History of Physical Fitness and Sports Medicine in Japan / 体力科学

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 B₁ was discovered, and a deficiency of vitamin B₁ 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.

EFFECTS OF BICYCLE ERGOMETER EXERCISE AND PGE₁ INJECTION FOR PATIENTS WITH INTERMITTENT CLAUDICATION / 体力科学

The purpose of this study was to clarify the effects of bicycle ergometer training and prostaglandin E₁ (PGE₁) for patients with intermittent claudication. Subjects were divided into four groups : the medication group (M), the PGE₁ group (P), the exercise group (E) and the PGE₁ and exercise group (PE). The P group was injected with 10<i>μ</i>g of PGE₁, the E group performed bicycle ergometer exercise 3 times a week for 6 weeks, and the PE group was injected with PGE₁ and performed exercises. The maximal walking distance (MWD) was evaluated by a treadmill test. Muscle oxygenation level was measured by near-infrared spectroscopy and recovery half time (T_1/2) was calculated. MWD was significantly improved for P (142%), E (216%) and PE (240%) groups. T_1/2 was significantly improved in the E and PE groups. This study indicates that improvement of MWD was a result of development of muscle perfusion in lower limbs and PGE₁ injection may support exercise therapy.

CHARACTERISTICS OF INTRAMYOCELLULAR LIPID CONTENT IN SKELETAL MUSCLES OF OVERWEIGHT MEN AND ENDURANCE-TRAINED ATHLETES / 体力科学

This study used proton magnetic resonance spectroscopy (¹H-MRS) to investigate differences in muscle group specific intramyocellular lipid (IMCL) storage characteristics associated with elevated muscle lipid storage, and to determine whether IMCL content is associated with maximal aerobic capacity. Seven healthy men [untrained (UT)], four overweight (OW) and six endurance-trained (T) subjects volunteered for this study. Data were acquired, using ¹H-MRS, from the tibialis anterior (TA), medial gastrocnemius (MG) and soleus (SOL) muscles. The IMCL content in TA was approximately twice as high in T subjects than in UT and OW subjects. In MG, IMCL was higher in OW and T subjects compared with UT subjects. A linear relationship existed between the VO₂max and IMCL in TA and a curve of second-degree relationship between the VO₂max and IMCL in MG. These results suggest that elevated IMCL deposits in TA might reflect enhancement of aerobic capacity, whereas the IMCL accretion in MG might reflect not only aerobic capacity but also overweight and obese conditions in men.

1H-MRS STUDY ON GENDER DIFFERENCES IN INTRAMUSCULAR TRIGLYCERIDES IN HUMAN SKELETAL MUSCLE AND THEIR RELATION TO BODY FAT AND ENDURANCE CAPACITY / 体力科学

Gender differences were measured in the amount of intramyocellular triglyceride (IMCL) and extramyocellular triglyceride (EMCL) in skeletal muscles using<SUP>1</SUP>H-MR spectroscopy and their relation to body fat and peak VO<SUB>2</SUB>was studied. Fourteen apparently healthy subjects were separated into groups by gender. Both the male and female group subjects were selected according to similar ages and BMI (male: n=7, BMI=20.5±0.6 kg/m<SUP>2</SUP>, age=21.1±0.7 years, female: n=7, BMI=20.6±0.5 kg/m<SUP>2</SUP>, age=18.7±0.3 years) . We found a significant correlation between IMCL and EMCL in the soleus (SQL: p<0.01) and medial gastrocnemius (MG: p<0.01) muscles. IMCL values in SQL were significantly higher than IMCL values in MG and tibialis anterior muscle (TA) in both males and females in the order of SQL>MG>TA (p<0.01) .<BR>IMCL and EMCL values in MG and SQL among females were significantly higher (p<0.01) than their corresponding values in males. However, a gender difference in IMCL and EMCL values for TA was not found. There was no correlation between IMCL and EMCL values for each muscle and BMI ; but IMCL (r=0.63 in SQL) and EMCL (r=0.88 and r=0.73 in SQL, and MG, respectively; p< 0.01) values correlated significantly with percent FAT. There was no correlation between IMCL values for each muscle and peak VO<SUB>2</SUB>; but the EMCL values of SQL correlated quite negatively with peak VO<SUB>2</SUB> (r=-0.63, p<0.05) . These results suggest that there are gender differences in intramyocellular and extramyocellular triglyceride contents. Lipids were positively related to percent body fat in SQL and MG; EMCL values may have a negative effect on endurance capacity.

<SUP>1</SUP>H-MRS STUDY ON GENDER DIFFERENCES IN INTRAMUSCULAR TRIGLYCERIDES IN HUMAN SKELETAL MUSCLE AND THEIR RELATION TO BODY FAT AND ENDURANCE CAPACITY / 体力科学

Gender differences were measured in the amount of intramyocellular triglyceride (IMCL) and extramyocellular triglyceride (EMCL) in skeletal muscles using<SUP>1</SUP>H-MR spectroscopy and their relation to body fat and peak VO<SUB>2</SUB>was studied. Fourteen apparently healthy subjects were separated into groups by gender. Both the male and female group subjects were selected according to similar ages and BMI (male: n=7, BMI=20.5±0.6 kg/m<SUP>2</SUP>, age=21.1±0.7 years, female: n=7, BMI=20.6±0.5 kg/m<SUP>2</SUP>, age=18.7±0.3 years) . We found a significant correlation between IMCL and EMCL in the soleus (SQL: p<0.01) and medial gastrocnemius (MG: p<0.01) muscles. IMCL values in SQL were significantly higher than IMCL values in MG and tibialis anterior muscle (TA) in both males and females in the order of SQL>MG>TA (p<0.01) .<BR>IMCL and EMCL values in MG and SQL among females were significantly higher (p<0.01) than their corresponding values in males. However, a gender difference in IMCL and EMCL values for TA was not found. There was no correlation between IMCL and EMCL values for each muscle and BMI ; but IMCL (r=0.63 in SQL) and EMCL (r=0.88 and r=0.73 in SQL, and MG, respectively; p< 0.01) values correlated significantly with percent FAT. There was no correlation between IMCL values for each muscle and peak VO<SUB>2</SUB>; but the EMCL values of SQL correlated quite negatively with peak VO<SUB>2</SUB> (r=-0.63, p<0.05) . These results suggest that there are gender differences in intramyocellular and extramyocellular triglyceride contents. Lipids were positively related to percent body fat in SQL and MG; EMCL values may have a negative effect on endurance capacity.

Immunosuppressive Effects of Prostaglandin E1 during and after Cardiopulmonary Bypass Operation in Patients with Ischemic Heart Diseases / 日本心臓血管外科学会雑誌

The Immunosuppressive effects of prostaglandin E₁ (PGE₁) used in cardiopulmonary bypass (CPB) operation were studied. We examined 30 patients, with ischemic heart diseases. The patients were divided into 3 groups: 11 patients given PGE₁ in group PG (G-PG), 10 patients given amurinon, a phosphodiesterase inhibiter, in group A (G-A), and 9 patients not given either of those drugs in the control group (G-C). Immunologically, lymphocyte subpopulations, and adhesion molecule expression on cell membrane and phagocytosis of neutrophils were analyzed before, at the time of, and after the operation until POD 7. The prominent effects of PGE₁ were observed on neutrophils. The expression of CD 62L, an adhesion molecule designated as L-selectin, on the cell surface membrane of neutrophils significantly increased during and after CPB in G-A and G-C, but it remained unchanged in G-PG during the observation period. Moreover, CPB caused an enhancement of the phagocytic activity of neutrophils in all groups, but its degree was much less in G-PG than in the other two groups. Among lymphocyte subpopulations, the number of CD 3⁺T-cells in G-PG rather than that of CD 20⁺B-cells reduced more greatly than those values observed in G-A and G-C. The decrease of T-cell number, throughout the observation period, in G-PG seemed to be mainly due to the decrease of the number of CD 4⁺T-cells designated as helper T-cells, although the number of CD 8⁺T-cells esignated as killer/suppressor T-cells slightly decreased on PODs 3 and 7. Amurinon, as a whole, did not exert any significant effect either on lymphocytes or on neutrophils in our experiments. Taken together, these results show that the treatment of patients with PGE₁ during CPB causes suppressive effects on immunorelevant cells. It may mitigate the activity of neutrophils, which are suspected as a possible culprit causing reperfusion injury. However, these suppressive effects, including the lowered numbers of CD 4⁺T-cells, may render the patients more vulnerable to infection. Much more intensive cares is required in these patients after operations.

A Study on Long-Term Administration of Seishin-Renshi-In to Patients of Non-Insulin-Dependent Diabetes Mellitus / 日本東洋医学雑誌

Seishin-Renshi-In (TJ-111) (Qing-Xin-Lian-Zi-Yin) was administered to seven patients with non-insulin-dependent diabetes mellitus (NIDDM). Five years treatment with TJ-111 was three male patients, three years was one female patient, and two years was two female patients. All of them received 7.5g of TJ-111 per day, 30 minutes before every meal. Body weight and HbA₁ were examined and recorded at intervals during the whole period of administration.<br>Patients whose HbA₁ was increased by more than 8% transiently showed the increases of body weight. It was proved that it is important to keep the calorie intake at an appropriate level and to exercise every day for adjusting body weight even in the treatment of Kampo medicine. The patients who decreased body weight by daily training were considered to be “Kyo-Sho”, and it is suggested to administer Seishin-Renshi-In for the treatment of NIDDM in the concept of Kampo medicine. No side effects were recognized in any cases of treatment with Seishin-Renshi-In.

Investigation on Improvement of Peripheral Circulation by Continuous Use of Prostaglandin E1 during Open Heart Surgery. Evaluation with Peripheral Blood Flow by Laser Doppler Flowmeter and Temperature Difference between the Periphery and Core / 日本心臓血管外科学会雑誌

Prostaglandin E₁ (PGE₁) was used continuously in adults from immediately after induction of anesthesia, during extracorporeal circulation, to the acute phase after open heart surgery. Using blood flow in the toe determined by laser Doppler flowmeter and the temperature difference between periphery and core as indices, the effects of afterload reduction and improvement of peripheral circulation were investigated. Subjects were 17 adults who underwent open heart surgery. PGE₁ was used in 7 patients and not used in 10. In the group using PGE₁, continuous injection of 0.015μg/kg/min of PGE₁ was started immediately after induction of anesthesia and was maintained during extracorporeal circulation until the acute phase after surgery. During extracorporeal circulation, perfusion pressure was kept at 50∼60mmHg and PGE₁ injection was controlled within the range of 0.015∼0.030μg/kg/min. At completion of extracorporeal circulation, the dose was fixed at 0.015μg/kg/min again. The degree of improvement of peripheral circulation was evaluated on the basis of hemodynamics, blood flow in the toe determined by laser Doppler flowmeter and the temperature difference between periphery and core, at induction of anesthesia (before using PGE₁) on completion of extracorporeal circulation, and in the acute phase after surgery. The value of blood flow in the toe determined by laser Doppler flowmeter was significantly higher in the PGE₁ group than in the non-PGE₁ group, from completion of extracorporeal circulation to the acute phase after surgery. Moreover, peripheral temperature was significantly higher in the PGE₁ group than in the non-PGE₁ group at completion of the extracorporeal circulation as well as immediately after surgery, and the temperature difference between periphery and core was significantly smaller. Continuous injection of PGE₁ enabled smooth control of perfusion pressure during extracorporeal circulation. Although there was no significant difference in peripheral vascular and total pulmonary resistance, the coefficients tended to be lower in the PGE₁ group. The use of PGE₁ during open heart surgery seems to be an effective method to improve peripheral circulation.

Usefulness of Treadmill Test for Determination of Degree of Intermittent Claudication / 日本心臓血管外科学会雑誌

The degree of intermittent claudication is difficult to evaluate objectively; therefore, the therapeutic efficiency of a drug is difficult to test in patients suffering from intermittent claudication. The purpose of this paper is to know whether treadmill test is useful to evaluate objectively the degree of intermittent claudication. 20 patients suffering from a peripheral arterial occlusive disease with intermittent claudication (Stage II) were investigated. PGE₁ incorporated in lipid microspheres (Lipo PGE₁) was infused (10μg/day) with one shot on 7 consecutive days into the forearm vein of patients. Painfree walking distance and maximum walking distance were measured on treadmill (3.0km/h, 5% incline). Brachial systolic pressure and ankle pressures were measured before and after exercise, and ankle/arm pressure ratio and ankle pressure difference between the pre-exercise and post-exercise values were calculated. All measurements were performed before and 7 days after beginning of treatment. Painfree walking distance was prolonged from 72.5±41.4m before treatment to 92.0±53.7m after treatment, with significant difference (<i>p</i><0.01). However, no significant changes of ankle/arm pressure ratio, ankle pressure difference and maximum walking distance were observed. It is concluded that measurement of painfree walking distance on treadmill was useful to evaluate objectively the degree of intermittent claudication.

Relationship between serum .GAMMA.-glutamyl transpeptidase fraction pattern and the pattern of food intake / 日本農村医学会雑誌

The effects of the food intake pattern on the activity and fraction pattern of serum γ-glutamyl transpeptidase (γ-GTP) were examined in 257 healthy Japanese men.<BR>Applying the technique of factor analysis to the food intake data, the following three factors were extracted. The first factor (F1): meats, eggs, and vegetables had a highly positive factor loading. The second factor (F2): wheat had a highly positive factor loading, while rice had a highly negative factor loading. This factor was considered to be a “wheat versus rice factor”. The third factor (F3) could not be explained simply in terms of its factor. The scores of the first two factors for the 257 subjects were calculated.<BR>Significantly negative correlations were observed between the percentage of GT<SUB>1</SUB> fraction and the factor score of F1 (r=-0.230, p<0.01), between the percentage of GT<SUB>1</SUB> fraction and the factor score of F2 (r=-0.187, p<0.01). The total serum γ-GTP activity was not correlated with the factor score. These results suggested that the percentage of GT<SUB>1</SUB> fraction is influenced by the pattern of food intake.