Effects of Exercise Intervention on Habitual Physical Activity Above Lactate Threshold Under Free-living Conditions: A Randomized Controlled Trial.

The purpose of the present investigation was to examine the effects of an exercise-based intervention on the daily physical activity (PA) above the lactate threshold under free-living conditions. A total of 81 middle-aged to older males (51±7 years) were randomly assigned into one of 2 groups. The subjects' body weight, visceral fat area, lactate threshold (LT), and PA levels were measured before and after the 8-week lifestyle intervention. The PA levels were assessed using a pedometer with a uni-axial accelerometer (Lifecorder, Kenz, Nagoya). During the intervention, 300 min/week of exercise at LT was targeted in the exercise group. The LT was determined by the log-log transformation method. The subjects in the control group were instructed to maintain their usual lifestyles. In the exercise group, the body weight, visceral fat area and LT significantly improved after the intervention. In contrast, the duration of PA at an intensity of LT, >3 METs and >6 METs did not differ significantly. The present investigation did not find significant changes in the PA at LT under free-living conditions as a result of an 8-week exercise-based intervention, although the participants successfully improved their aerobic capacity and body composition.

Accumulation of short bouts of non-exercise daily physical activity is associated with lower visceral fat in Japanese female adults.

The purpose of the present investigation was to assess the relationship between bouts of very short daily physical activity (PA) lasting <10 min with obesity and abnormal fat distributions. A total of 42 females (age 50±6 years, height 156±5 cm, body weight 54±8 kg, body mass index 22±3 kg/m2) participated in the present investigation. Computed tomography was used to evaluate the area of visceral adipose tissue and subcutaneous adipose tissue (VAT and SAT). All participants wore a pedometer with a one-axial accelerometer (Lifecorder, Kenz, Japan) in order to determine their frequency (bouts/day) of PA and moderate to vigorous intensity PA (MVPA). The total frequency of PA and MVPA, including all bout durations, was not significantly associated with the body fat distribution. The frequency of PA lasting longer than 3 min and 5 min, and MVPA lasting longer than 1 min and 3 min were significantly associated with the area of the VAT (p<0.05). A smaller area of VAT was associated with a higher frequency of PA and MVPA lasting 1-5 min. The present investigation did not find that very short bouts of PA lasting<1 min played a significant role in controlling abdominal fat distribution.

Objectively measured physical activity levels of Venetian adults.

AIM: Venice, Italy, provides a unique environment to study physical activity as there are no automobiles, and walking is the most common means of transportation. The purpose of the present investigation was to objectively assess the physical activity (PA) levels of residents in Venice, Italy, using an accelerometer. METHODS: Twenty-seven Venetians (12 men and 15 women, 48 ± 16 yr, 169.4 ± 6.6 cm, 71.7 ± 11.1 kg) had worn an accelerometer (Lifecorder Ex) for 7 consecutive days in order to determine daily number of steps, time spent in light (LPA), moderate (MPA), or vigorous intensity (VPA) and moderate to vigorous intensity (MVPA) as well as energy expenditure associated with PA (PAEE). The time for all PA and MVPA lasting at least 1 minute, 3 minutes, 5 minutes and 10 minutes were also assessed. RESULTS: The PAEE, number of steps, LPA, MPA, VPA and MVPA averaged over 7 days of week were 1575 ± 524 kJ∙day⁻¹, 11920 ± 3667 steps∙day⁻¹, 77 ± 23 min∙day 43 ± 19 min∙day⁻¹, and 45 ± 21 min∙day⁻¹. The time for MVPA lasting >10 min was 0.3 ± 0.9 min∙day⁻¹. CONCLUSION: The amount and intensity of PA in Venetian adults is substantially higher than in most other populations previously evaluated, particularly American adults. The effects of the highly active Venetian lifestyle on important health outcomes remain unclear, but warrant further investigation.

Comparison of interdevice measurement difference of pedometers in younger and older adults.

OBJECTIVES: In this study, the relationship between inter-instrument differences in regard to the daily number of steps with the intensity distribution of daily physical activity in younger and older adults was examined. METHODS: 17 younger individuals and 28 older individuals wore two pedometers (Lifecorder (LC) and EC-200 (YM)) simultaneously for 7 days, in order to determine the number of steps each took. Furthermore, LC determined the time spent in light, moderate and vigorous physical activity, corresponding to <3 metabolic equivalent (METs), 3 to 6 METs and >6 METs, respectively. RESULTS: The LC detected a significantly larger number of steps than YM (p<0.001), yet there was a strong relationship between the two measurements (r = 0.962, p<0.001). The interdevice difference with the number of steps significantly decreased in inactive older individuals compared with the active older and younger individuals, and it was also significantly negatively correlated with the time spent in light-intensity physical activity (LPA) (r = 0.523, p<0.01). CONCLUSION: This study showed that the interdevice difference with the number of steps significantly increased in older participants due to the greater length of time spent in LPAs.

Physical function is weakly associated with angiotensin-converting enzyme gene I/D polymorphism in elderly Japanese subjects.

BACKGROUND: The turning point in the deterioration of physical function seems to occur between the ages of 70 and 80 years. In particular, muscle strength may decline even more in subjects older than 75. A recent study found that the angiotensin-converting enzyme (ACE) genotype also affects physiological left ventricular hypertrophy. A very limited number of papers have examined genetic differences in resistance and endurance forms of a single sporting discipline. OBJECTIVE: The purpose of this study was to evaluate the relationship between ACE genotype and physical function by controlling the known confounding factors including dental status. METHODS: We selected 431 subjects who were aged 76 years and did not require special care for their daily activities. We conducted a medical examination, followed by 5 physical function tests, as follows: (1) maximum hand grip strength, (2) maximal isometric knee extensor strength, (3) maximal stepping rate for 10 s, (4) one-leg standing time with eyes open and (5) 10-meter maximum walking speed. Subjects were genotyped for the ACE intron 16 Alu insertion. In addition, serum concentrations of total cholesterol, total protein, IgA and IgG were measured at a commercial laboratory. The Eichner index was used as an indicator of occlusal condition. Multiple linear regression analysis was performed to evaluate the relationship between the ACE gene insertion/deletion (I/D) polymorphism and physical function considering confounding factors. RESULTS: The ACE gene I/D polymorphism was positively associated with hand grip strength and 10-meter maximum walking speed. Betas of hand grip strength were 0.09 for I/D (p = 0.022) and 0.12 for insertion/insertion (I/I; p = 0.004). Betas of 10-meter walking speed were -0.11 for I/D (p = 0.093) and -0.14 for I/I (p = 0.039). Dental status such as Eichner index class C was significantly associated with one-leg standing time with eyes open (beta -0.11; p = 0.028). CONCLUSION: This study suggests that there is a significant relationship between ACE genotype and physical function. In particular, subjects with the ACE deletion/deletion genotype were associated with upper extremities.

Differentiation of herpes simplex virus 1 and 2 in cerebrospinal fluid of patients with HSV encephalitis and meningitis by stringent hybridization of PCR-amplified DNAs.

Differentiation of herpes simplex virus (HSV) types 1 and 2 in cerebrospinal fluid of 17 patients with serologically diagnosed HSV encephalitis and meningitis or acute limbic encephalitis was determined by stringent hybridization of polymerase chain reaction--amplified DNAs. Ten of 17 patients were positive; six with HSV 1 isolates and four with HSV 2 isolates. We detected HSV type 1 in two cases of meningitis, although meningitis is generally thought to be caused by type 2. Additionally, HSV type 2 was found in one case of acute adult encephalitis, which is generally due to HSV type 1. HSV DNAs could be detected for over 1 month after onset, although our patients included several prolonged and recurrent cases. HSV DNA genomes were not detected in three cases of acute limbic encephalitis. Our study indicates that this method can be used for type differentiation in HSV CNS infections.

Therapeutic effect and mechanism of repetitive transcranial magnetic stimulation in Parkinson's disease.

The therapeutic effect of repetitive transcranial magnetic stimulation (rTMS) on clinical performance was assessed by a double-blind study in 9 patients with Parkinson's disease (PD). Nine other patients underwent sham stimulation as controls. The modified Hoehn and Yahr (H&Y) staging scale, the Schwab and England Activities of Daily Living (ADL) scale, and the Unified Parkinson's disease rating scale (UPDRS) were used to assess changes of clinical performance. Patients were assessed prior to and following 2 months of rTMS. In addition, the mechanism of rTMS was investigated by dopamine and homovanillic acid (HVA) in the lumbar cerebrospinal fluid (CSF) of 17 patients before and after therapeutic rTMS for three or four months. rTMS was applied manually to the frontal areas 60 times per session, i. e., 30 times per side using a large circular coil, a pulse intensity of 700 V, and a frequency of 0.2 Hz. Sessions were continued once a week for 2 months. The 9 control patients showed no changes of symptoms between the initial evaluation and that after 2 months of sham rTMS. In contrast, all 9 patients receiving rTMS showed a significant decrease of the modified H&Y and UPDRS scores after 2 months, while the Schwab and England ADL Scale scores increased significantly. In the second CSF sample from patients receiving rTMS, HVA showed a significant decrease These results suggest that rTMS is beneficial for the symptoms of Parkinson's disease and that it may act via inhibition of dopaminergic systems.

Differentiation of Herpes simplex virus types 1 and 2 in sera of patients with HSV central nervous system infections by type-specific enzyme-linked immunosorbent assay.

OBJECTIVE: To differentiate by enzyme-linked immunosorbent assay (ELISA) using type-specific glycoprotein G herpes simplex virus (HSV) type 1 and type 2 in serum collected from patients with HSV central nervous system (CNS)infections. METHODS: HSV 1 and 2 typing in convalescent sera of 17 patients with HSV acute encephalitis, myelitis, or meningitis was determined by the type-specific IgG ELISA kit (Gull Laboratory, Inc.). HSV CNS infections were diagnosed by polymerase chain reaction (PCR) or conventional serologic tests from acute to convalescent stages. RESULTS: In 13 of 17 patients, HSV type 1 and HSV type 2 antibodies were positive; 11 patients with HSV type 1 and 2 patients with HSV type 2 were found. All 10 patients with encephalitis showed equivocal or positive results for HSVtype 1. In two of three cases of myelitis, HSV type 1 was demonstrated. Each case of myelitis and meningitis reacted to both types 1 and 2. CONCLUSION: These data suggest that the kit is useful for type differentiation of HSV CNS infections from convalescent sera, and can play a supplementary role in HSV typing by PCR or previous serologic tests.

Establishment of a novel tissue culture method, stem-disc culture, and its practical application to micropropagation of garlic (Allium sativum L.).

A restricted part of the undeveloped stem of the garlic clove, called the "stem disc", which is just under the basement of the immature foliage leaves, proved to be a very potent explant for the micropropagation of garlic. Twenty to thirty tissue-cultured shoots consistently were differentiated from a single clove during 1 month of culture on phytohormone-free Linsmaier and Skoog medium. In addition, more than 90% of the shoots formed bulblets in vitro during an additional 1 month of culture. Pretreatment of the garlic bulbs at 4 °C for approximately 8 weeks before preparing the stem discs enhanced both shoot development and bulblet formation. This novel method for culturing garlic was designated the stem-disc culture method. Shoot development in this type of in vitro culture apparently is divided into four stages: expansion of tissue zones surrounded by the basal parts of the immature foliage leaves, formation of dome-shaped structures, bud differentiation directly from each dome, and development into shoots and bulblets. The dome-shaped structures appeared within 5 days of the onset of culture and had developed independently into shoots approximately 1 cm high 3 weeks later. Histological observations showed that both the internal cell organization and formation process of the dome-shaped structures were similar to those in the meristem. In addition, events leading to the formation of these dome-shaped structures appeared to be initiated by vigorous cell division in the epidermis of concentric tissue zones surrounded by the basements of immature foliage leaves. The results of several field trials showed that the stem-disc culture method is useful for the production of garlic seed plants, including virus-free plantlets. Furthermore, it is a novel field cultivation system for garlic in that the seedlings produced by in vitro-induced bulblets are used as seed instead of the usual cloves.

Neurosyphilis showing transient global amnesia-like attacks and magnetic resonance imaging abnormalities mainly in the limbic system.

We report a case of neurosyphilis with transient global amnesia (TGA)-like attacks on the first presentation. MRI abnormalities in bilateral limbic systems, including a few lesions in the basal ganglia and thalamus, were identified. Depression and dementia became apparent, accompanied by a high treponemal antibody titer and mild cortical atrophy. Antisyphilitic therapy brought about mild improvement, and the MRI abnormalities decreased.

Peripheral neuropathy in allergic granulomatous angiitis.

A 61-year-old woman began to suffer bronchial asthma in 1985. She then developed low back pain and numbness along the lower extremities, eventually leading to bilateral drop foot in 1990. At that time, she was diagnosed as having lumbar disc hernia, and extirpation of the discs at the L3-4 and L4-5 was performed. However, her clinical condition showed little improvement. Six months later, she was emaciated and bedridden with distal dominant muscular atrophy in all four limbs, purpura in the left leg and hypereosinophils. Motor conduction velocity (MCV) was not detected in the peroneal nerves. The toes gradually became cyanotic, and a skin biopsy from the cyanotic region revealed necrosis in the vessels surrounded by infiltration of a large number of neutrocytes and lymphocytes. She was diagnosed as having mononeuritis multiplex due to allergic granulomatous angiitis (AGA), which is characterized by bronchial asthma, hypereosinophilia and necrotizing vasculitis. Thirty mg/day prednisolone was then administered. However, the toes and calcaneal areas gradually became necrosed. Finally, amputation of both feet was necessary. We concluded that an early diagnosis of this syndrome is most important, and corticosteroids should be administered early.

Comparison between natural and immunized anti-GM1 antibodies analyzed by marker releasing rate assay with liposome.

Naturally occurring rabbit anti-GM1 was compared with immunized induced anti-GM1 antibody in the same individual rabbits by the characterization of immune potency determined by complement-dependent damage to liposomes containing GM1 as antigen. Antigen-antibody reaction was the rate determining step in this assay. The maximum rate was measured by the first derivative conversion monitoring in spectrophotometry and the maximum level of marker released was measured by the conventional method described previously. When the concentration of sera required to get fifty percent of maximum values in each assay were compared, the ratios (rate assay/conventional assay) were 5.7 to 10.0 in natural antibodies and 3.2 to 2.3 in immunized induced antibodies, respectively. Furthermore, the maximum rate of marker release from liposome was not correlated with the maximum level of marker released depended on the sources of antibodies. These results suggest that natural antibody, even the titer was high in conventional liposome assay, has different characteristics compared with the immunized induced antibody.

[Non-herpetic acute limbic encephalitis].

We reported four cases of acute encephalitis, in which MRI abnormalities localized in the limbic system. In the four cases, fever and consciousness disturbance were commonly found and convulsive seizures appeared in three. Within 10 days, their consciousness level became clear, but severe amnestic syndrome remained as sequela. Cerebrospinal fluid (CSF) at the acute stage revealed mild lymphocytic pleocytosis and elevated protein. MRI revealed abnormal signal intensities in both hippocampi and amygdaloid bodies, although CT scans were normal. Herpes simplex encephalitis selectively affects one or both temporal lobes and the limbic system, But our cases spared the temporal lobes. Additionally, serum and CSF antibody titers by CF and ELISA for herpes simplex virus (HSV) were within normal range from the acute to convalescent stages. Neither HSV type 1 and 2 DNA genomes by sensitive PCR-hybridization method were detected in CSF taken from the acute stage of all four cases. On the other hand, paraneoplastic limbic encephalitis is known as a subacute encephalitis predominantly involving the limbic system. MRI shows high signal intensities on T2-weighted in both medial temporal lobes. In our cases, this type of limbic encephalitis was excluded because of the acute onset and lack of malignancy. Accordingly, our four cases are regarded as non-herpetic acute limbic encephalitis. Several Japanese similar cases have been reported. Further etiological studies should be performed.

[Binswanger's type encephalopathy without alopecia and lumbago in young hypotensive patients].

Binswanger's type encephalopathy is characterized by progressive dementia and diffuse subcortical ischemic lesions associated with arteriosclerosis. Hypertension is believed to be a major pathogenic factor in causing this encephalopathy but there are some cases of the encephalopathy not suffering from hypertension. In 1985, Yamamura et al. and Fukutake et al. reported familial cases of normotensive juvenile Binswanger's type encephalopathy with alopecia and lumbago, and considered it to be possibly a new clinical syndrome. We reported three cases of relatively young-onset (under the age of 40) Binswanger's type encephalopathy with persistent hypotension. All three patients suffered from neither alopecia nor lumbago. Patient (male aged 40) had repeated episodes of ischemic stroke and had progressive dementia. Patients 2 (male aged 41) and 3 (male aged 34) were not in a state of dementia, but had a history of transient ischemic attacks, and at present are completely symptom-free. Though there were no risk factors for cerebrovascular disease in these cases, the repeated episodes of ischemic stroke and the existence of small multiple lacunes in the basal ganglia on CT and MRI suggest that the white matter damage was principally due to a vascular disorder. In these cases, persistent hypotension was characteristic and might be a factor for the induction and exacerbation of this encephalopathy. These three cases are different from the classic form of Binswanger's type encephalopathy based on hypertension. Normotensive cases have been described before, but our cases do not seem to fall into this category because the blood pressure constantly remained hypotensive.(ABSTRACT TRUNCATED AT 250 WORDS)

[Hepatitis B virus antibody positive spastic paraparesis].

We present here thirteen patients (5 men and 8 women, aged 31 to 73, mean 55 years) with spastic paraparesis who showed clinical features similar to those of HTLV-1 associated myelopathy without HTLV-1 antibody, but with positive antibody to hepatitis B virus (HBV). All of these patients showed slowly progressive difficulty in walking. Five patients had previous histories of blood transfusion, of these one with history of B hepatitis. Neurologically, muscle weakness, spasticity and exaggerated deep tendon reflexes in the lower extremities were common to all the patients. Seven patients showed Babinski's reflex. Disturbance of micturition was noted in 3 patients. None showed organic changes of the spine on magnetic resonance image (MRI). None was serologically positive for syphilis and had cryoglobulin and hypergammaglobulinemia. Elevated levels of the liver enzymes were noted in two patients. All patients were positive for hepatitis B surface antibody (HBs-Ab) (EIA) but negative for hepatitis B surface antigen (HBs-Ag) (EIA). Five patients were seropositive for hepatitis C virus (HCV) (PHA). In 3 of them, reverse transcriptase polymerase chain reaction was performed but failed to detect HCV-RNA. All patients underwent spinal tap, and showed normal cell count and protein concentration in their cerebrospinal fluid (CSF). Atypical cells were not observed in all the patients. The CSFs from three patients were tested for HBs-Ag and HBs-Ab. HBs-Ag was negative in all three patients, but HBs-Ab was positive in two patients.(ABSTRACT TRUNCATED AT 250 WORDS)

[Clinical characteristics and muscle histopathology in polymyositis positive anti-hepatitis with C virus antibody].

In 14 patients with polymyositis (PM), 5 patients (2 males and 3 females) were positive for anti-hepatitis C virus (HCV) antibody measured by a second generation assay. We analysed the clinical characteristics and histopathological findings of the biopsied muscles from those 5 patients. They aged from 42 to 65 years averaging 53.6 years. Two asymptomatic patients visited our hospital due to elevated muscle enzyme levels, who had slight weakness in their orbicularis oculi and neck muscles on physical examination. The other 3 patients had moderate weakness of the proximal muscles. Anti-nuclear antibody was positive in 2 of the 5 patients and anti-Jo 1 antibody was negative in all patients. The serum enzymes elevated were creatine kinase (215-2, 207 (IU/l)) and glutamate oxaloacetate transaminase (40-119 (KU)). HCV-RNA was positive in the sera of 4 patients examined. All muscle biopsy specimens revealed variation in fiber size with inflammatory cellular infiltration and observed degenerating and regenerating fibers. The scant infiltration type was observed in 2 asymptomatic patients in whom the infiltrated cells were CD4 positive. The endomysial infiltration type was observed in 3 symptomatic patients; CD8 positive cells were found focally to diffusely in 2 patients examined. The expression of class 1 molecules from the major histocompatibility complex was detected mainly in infiltrated fibers to variable degrees. All of the patients showed a good response to the initial steroid therapy. The present study suggests that autoimmune reaction related to HCV infection causes myositis, therefore anti-HCV antibody should be checked in cases of PM.

[Clinical and immunological findings of hepatitis B virus associated spastic paraparesis--a comparison with HAM].

We investigated clinical features and immunological parameters in 40 patients with slowly progressive spastic paraparesis including 13 cases (4 men and 9 women, aged 43 to 71, mean 61 years) with positive antibody to hepatitis B virus (HBV), 13 (6 men and 7 women, aged 39 to 75, mean 63 years) with positive antibody to HBV and HTLV-I, and 14 (3 men and 11 women, aged 33 to 71, mean 55 years) with positive antibody to HTLV-I (HAM). None showed obviously organic changes of the spine on magnetic resonance image. Patients with positive antibody to HBV (hepatitis B virus associated myelopathy, HBM) were significantly lower in disability grade and had a fewer incidence of micturition than in the HAM. Furthermore, natural killer (NK) activities were in normal range and peripheral blood lymphocytes did not show autologous proliferation response (APR). Patients with positive antibody to both HBV and HTLV-I showed APR similar to HAM, but in most patients NK activities were within normal range. These results suggest that the mechanism of myelopathy in HBM may be different from that in HAM, and HBV infection may play a role as a cofactor in HAM.

[A case of Prader-Willi syndrome with bilateral middle cerebral artery occlusion and moyamoya phenomenon].

We report a case of Prader-Willi syndrome (PWS) complicated with juvenile stroke. The patient is a 19-year-old man with right hemiplegia, who has had a history of non-insulin-dependent diabetes mellitus (NIDDM) for ten years. The diagnosis of PWS was confirmed genetically by the method of fluorescence in situ hybridization which showed the deletion of chromosome 15. His brain MRI revealed abnormal signal intensities in the left basal ganglia and around the right trigone of the lateral ventricle. Angiographic examination showed occlusions of bilateral proximal middle cerebral arteries with basal moyamoya vessels. The left vertebral artery was also occluded at its origin. Only a few cases of PWS complicated with stroke have been reported before and, to date, there has been no case with arterial occlusion similar to our case. Though the cause of these arterial occlusions is unknown, it may be related to arteriosclerosis following NIDDM.