Interactions between monthly training volume, frequency and running distance per workout on marathon time.

PURPOSE: This study attempted to clarify the relationships between marathon time and monthly training volume, training frequency and the longest (LRD) or average running distance per workout (ARD), as well as their interactions. METHODS: Male recreational runners (n = 587) participating in the Hokkaido Marathon 2017 completed a questionnaire before the race; of these, 494 finished the race. We assessed age, running career, body height, body weight, body mass index (BMI), monthly training volume, training frequency, the LRD and the ARD. These indicators were each divided into 4 or 5 homogeneous subgroups to determine whether the other indicators in each subgroup predicted marathon time. RESULTS: In the training frequency subgroups, there were significant correlations between monthly training volume, the LRD or the ARD and marathon time, except for the subgroup that trained 2 times per week or less; in this subgroup, the relationship between the ARD and marathon time was not significant. In all monthly training volume subgroups, there were no significant relationships between training frequency, the LRD or the ARD and marathon time. In the ≥ 21 km LRD and ≥ 10 km ARD subgroups, there were significant correlations between monthly training volume and marathon time (all P < 0.01); these correlations were not significant in the 1-20 km LRD and < 10 km ARD subgroups. CONCLUSION: These results indicate that monthly training volume is the most important factor in predicting marathon time and that the influence of monthly training volume is only significant if the running distance per workout exceeded a certain level.

The Effects of Enteral Nutrition on the Intestinal Environment in Patients in a Persistent Vegetative State.

Enteral nutrition (EN) is a rational approach to providing nutritional intake via the intestines in patients who are unable to tolerate parenteral nutrition. We conducted a preliminary study to investigate the effects of EN on the intestinal environment in 10 patients in a persistent vegetative state (PVS) (n = 5 each in the EN and EN with probiotics; Clostridium butyricum MIYAIRI 588) groups compared with 10 healthy controls. The results of 16S amplicon sequencing of the intestinal microbiota showed that EN led to dysbiosis with a decrease in α-diversity and an obvious change in ß-diversity. A particularly significant decrease was seen in useful intestinal bacteria such as Bifidobacterium and butyrate-producing bacteria. Analysis of intestinal metabolites also supported these results, showing significant decreases in butyric and pyruvic acid after EN. Although C. butyricumMIYAIRI 588 improved some intestinal metabolites that were decreased after EN, it did not improve the dysbiosis of the intestinal microbiota. These findings indicate that EN causes dysbiosis of the intestinal microbiota and an imbalance in some intestinal metabolites in patients in a PVS. Moreover, although C. butyricumMIYAIRI 588 improved the imbalance of some intestinal metabolites after EN, it did not prevent dysbiosis of the intestinal microbiota.

Recovery of Cognitive and Behavioural Function During Long-term Inpatient Rehabilitation in Patients with Moderate-To-Severe Traumatic Brain Injury: Evaluation of a Retrospective Case Series.

OBJECTIVE: To elucidate the characteristics of recovery progression during long-term rehabilitation after moderate-to-severe traumatic brain injury. METHODS: Longitudinal changes in consciousness, swallowing disorders, activities of daily living, and psychological and behavioural status were studied in 7 patients with moderateto-severe traumatic brain injury, using scores of the National Agency for Automotive Safety & Victim's Aid (NASVA score), Glasgow Coma Scale (GCS), Dysphagia Severity Scale (DSS), Eating Status Scale (ESS), Functional Independence Measure (FIM), Cognitive-related Behavioural Assessment (CBA), and Neuropsychiatric Inventory (NPI). Scores were collected every month until discharge (median 359 days after injury), or until the study end date for those patients who remained hospitalized (432 days). RESULTS: Patients were qualitatively classified into those who improved well in the early phase, in terms of consciousness, swallowing, and activities of daily living, and those with less or delayed improvement. Psychological and behavioural difficulties appeared to remain less improved than the other functions for longer periods in many patients. Statistical comparisons that included all 7 patients revealed a significant improvement in NASVA score, GCS, DSS, and ESS, but not in FIM, CBA, and NPI at discharge/at the last measurement compared with scores at admission. CONCLUSION: Swallowing function is more responsive to long-term rehabilitation in patients with moderate-to-severe traumatic brain injury, while neuropsychiatric and behavioural difficulties tend to persist for longer periods.

Clinical outcomes of end-flexible-rigidscopic transoral surgery (E-TOS) in patients with T1-selected T3 pharyngeal and supraglottic cancers.

BACKGROUND: Endoscopic laryngo-pharyngeal surgery (ELPS), which is a transoral minimally invasive surgery using a gastrointestinal endoscope and a curved laryngopharyngeal retractor, is effective to treat primary lesions of superficial laryngopharyngeal cancers. To extend concepts of ELPS to invasive laryngopharyngeal cancers, we developed end-flexible-rigidscopic transoral surgery (E-TOS) from ELPS by changing a gastrointestinal endoscope to a flexible-tip rigid endoscope. AIMS/OBJECTIVES: To retrospectively evaluate oncological outcomes and laryngopharyngeal functional preservation of E-TOS in patients with T1-selected T3 laryngopharyngeal cancers. MATERIAL AND METHODS: In 47 patients T1-selected T3 pharyngeal and supraglottic cancers were resected by E-TOS using the flexible-tip rigid endoscope and curved instruments. Negative resection margin was histopathologically evaluated. The survival, preservation of larynx, and disease control rates were estimated using Kaplan-Meier method. RESULTS: Curative resection was achieved in 94% of patients. No patient complained prolonged swallowing dysfunction or hoarseness after E-TOS. Postoperative bleeding, stenosis of the pharynx and esophageal entrance, and local recurrence was observed each in one patient. The 3-year overall survival, disease-specific survival, laryngeal preservation, local control, and locoregional control rates were, 86%, 93%, 100%, 98%, and 79%, respectively. CONCLUSION: E-TOS is an effective minimally invasive surgery for T1-selected T3 pharyngeal and supraglottic cancers with preserving laryngeal function.

Expression of specific IGFBPs is associated with those of the proliferating and differentiating markers in regenerating rat plantaris muscle.

To examine the relationship between specific insulin-like growth factor (IGF)-binding proteins (IGFBPs) and myogenesis during muscle regeneration in vivo, we measured mRNA expression of IGFBPs and myogenic markers in rat plantaris muscle after bupivacaine administration. IGF-I Ea, MGF, IGFBPs and myogenic marker mRNAs were analyzed 12, 24, 48 and 72 h after bupivacaine injection. IGFBP-1, -2, -3 and -4 proteins were immunostained after the treatment. MGF, IGF-I Ea and IGFBP-4 mRNAs started to increase 12 or 24 h after bupivacaine injection and increased further after that. IGFBP-1, -2, -3 and -4 proteins were strongly stained in the immature muscle fiber nuclei and the extracellular matrix after bupivacaine injection. PCNA, MyoD, IGFBP-2 and IGFBP-3 mRNAs increased at 12 or 24 h and did not show further increases after that. Myogenin, p21, IGFBP-1 and IGFBP-5 mRNAs sharply increased after 72 h. These results suggest that specific IGFBPs are individually expressed and differently associated with the expression of myogenic markers in regenerating muscles.

Dorsal column stimulation in persistent vegetative state.

Objectives. The problem of treating patients in a vegetative state remains grossly unresolved, and spinal cord stimulation (SCS) had seemed promising in some studies, suggesting, to us, further study. Materials and Methods. A prospective uncontrolled and nonrandomized observational study for 20 consecutive years (1986-2005) was performed on the effect of SCS in 214 patients in persistent vegetative state (PVS) that resulted from global anoxia and/or, stroke and/or head injury. After confirming the condition of PVS, a spinal cord stimulator, at the C2-C4 level, was implanted, stimulating according to a protocol of 15-min on/15-min off during daytime only. The results were evaluated using an efficacy scale designed by us for our study, detecting signs of awareness of self and surrounding. Results. Excellent and positive results were obtained in 109 of 201 patients (54%), but better in those patients below the age of 35, those of PVS of traumatic origin and those patients with regional cerebral blood flow over 20 mL/100 g/min. Conclusions. These findings, though inconclusive of actual benefit of SCS for PVS, indicate to us that further evidence-based, randomized controlled trials are needed to confirm efficacy of the treatment and define those who are going to benefit from this treatment method.

Muscle IGF-I Ea, MGF, and myostatin mRNA expressions after compensatory overload in hypophysectomized rats.

To determine whether IGF-I Ea, MGF, and myostatin mRNAs are related to GH-independent overload-induced muscle growth, we examined the expressions of IGF-I Ea and MGF mRNAs in the plantaris muscle after compensatory overload in hypophysectomized rats. The muscles were divided into four groups: normal-control, normal-overloaded, hypophysectomized-control, and hypophysectomized-overloaded. The weights of the plantaris muscle in the normal-overloaded were significantly higher than those of the normal-control. The weights of the hypophysectomized-overloaded were also significantly higher than those of the hypophysectomized-control. IGF-I Ea and MGF mRNAs in normal-overloaded and hypophysectomized-overloaded 3 days after overload were significantly higher than those of normal-control and hypophysectomized-control, respectively. Myostatin mRNAs in normal-overloaded and hypophysectomized-overloaded 3 days after the overload were significantly lower than those of normal-control and hypophysectomized-control, respectively. Thus, it was shown that IGF-I Ea, MGF, and myostatin mRNAs were expressed in association with muscle enlargement after compensatory overload independently of pituitary state. These observations suggest that the expression of IGF-I Ea, MGF, and myostatin mRNAs due to compensatory overload would be associated in a growth-hormone-independent manner.

mRNA expression of fibroblast growth factors and hepatocyte growth factor in rat plantaris muscle following denervation and compensatory overload.

We addressed the question of whether hypertrophy induced by compensatory overload differs according to innervation status, and how fibroblast growth factors (FGF) and hepatocyte growth factor (HGF) mRNAs are expressed in the rat plantaris muscle during overload (OL) and/or denervation. Male Wistar rats were divided into four groups (Normal-Cont, Normal-OL, Denervated-Cont, and Denervated-OL). according to the plantaris denervation and/or overload. Three weeks later, plantaris weight in Denervated-Cont and Denervated-OL was significantly lower than in the Normal-Cont. The muscle weights in the Normal-OL were higher than in the Normal-Cont. The muscle weights in the Denervated-OL were higher than in the Denervated-Cont. Three days after the treatment, FGF-2, FGF-6, FGF-7 and HGF mRNAs in the Normal-OL were significantly higher than those in the Normal-Cont. FGF-2, FGF-6, FGF-7 and HGF mRNAs in the Denervated-OL were also significantly higher after 3 days than those in the Denervated-Cont. After 7 days, FGF-2, FGF-5, FGF-6, FGF-7 and HGF mRNAs were significantly higher in the Normal-OL than those in the Normal-Cont. At 21 days, FGF-1, FGF-6 and HGF mRNA levels were significantly increased. In the Denervated-OL, FGF-2, FGF-7 and HGF mRNAs at 7 days, and FGF-2 mRNA at 21 days were significantly higher than those in the Denervated-Cont. FGF-2 and FGF-6 mRNA levels decreased significantly following denervation; however, FGF-1, FGF-5, FGF-7 and HGF mRNA levels increased and maintained this increase for the 21-days treatment period. Muscle hypertrophy was thus induced by compensatory overload irrespective of innervation status, possibly in association with certain FGFs and HGF. The differential mRNA expression patterns of FGFs and HGF observed following compensatory overload and/or denervation suggest distinct roles for individual FGFs and HGF in muscle hypertrophy and/or atrophy.

Local changes of IGF-I mRNA, GH receptor mRNA, and fiber size in rat plantaris muscle following compensatory overload.

We investigated whether local insulin-like growth factor-I (IGF-I) mRNA and growth hormone (GH) receptor mRNA expressions in plantaris muscle were related to the region-specific hypertrophy following compensatory overload. Adult male normal or hypophysectomized rats were subjected to unilateral distal-half removals of the gastrocnemius and soleus muscles. The contralateral hindlimb was used as the control. Two weeks later, fiber areas in the distal and proximal parts of the plantaris muscle were measured. All the fiber areas measured in the distal part of the plantaris muscle in normal and hypophysectomized rats were significantly increased following the compensatory overload. In the proximal part, fiber areas of type I, IIA, and IIC were significantly increased, but fiber area of type IIB did not change. IGF-I mRNA expressions in the distal and proximal parts were increased 3 d after the compensatory overload in normal and hypophysectomized rats. The increase of IGF-I mRNA expression in the distal part 3 d after compensatory overload was greater than those in the proximal part. IGF-I mRNA expressions in the distal and proximal parts were increased 14 d after the compensatory overload in hypophysectomized rats, but not in normal rats. GH receptor mRNA expressions were decreased following compensatory overload, and almost disappeared 14 d after the compensatory overload in hypophysectomized rats. Thus muscle fiber hypertrophy following compensatory overload was different among the parts in a muscle and IGF-I mRNA was expressed in concert with the region-specific hypertrophy, but not GH receptor mRNA.