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1.
J Sports Med Phys Fitness ; 59(10): 1601-1607, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31694361

RESUMO

BACKGROUND: Outdoor exercise often proceeds in rainy conditions. However, there are very few studies reporting the physiological effects of cold with rain or wet-cold exposure on humans during exercise. The purpose of this study was to investigate the effects of rain on physiological responses during running exercise at 80% V̇Omax in the cold. METHODS: Twelve healthy men (age: 21.7±3.3 years; height: 1.760±0.085 m; body weight: 68.8±7.1 kg; maximal oxygen consumption: 67.3±5.00 mL/kg/min) exercised on a treadmill at 80% V̇Omax intensity for 60 minutes with rain (RAIN) or not (CON) at 5 °C. RESULTS: Rectal temperature was significantly lower in RAIN than in CON at 10, 40, 50, and 60 minutes (P<0.05). Mean weighted skin temperature was significantly lower in RAIN than in CON during exercise (P<0.05). Oxygen consumption and rating of perceived exertion were significantly higher in RAIN than in CON at 50 and 60 minutes (P<0.05). Plasma lactate was significantly higher in RAIN than in CON at 10 minutes and from 40 to 60 minutes (P<0.05). Plasma norepinephrine levels were significantly higher in RAIN than in CON at 10 minutes and from 40 to 60 minutes (P<0.05). CONCLUSIONS: These results suggest that rain increased heat loss during the early phase of exercise in the cold, then heat production increased and transiently suppressed cold stress. However, with time, body heat loss intensified due to increasing wet area, and then energy expenditure and plasma lactate increased due to cold stress. Therefore, rain may decrease exercise performance and affect sport safety.


Assuntos
Temperatura Baixa/efeitos adversos , Metabolismo Energético/fisiologia , Chuva , Corrida/fisiologia , Adolescente , Adulto , Regulação da Temperatura Corporal/fisiologia , Estudos de Casos e Controles , Teste de Esforço/métodos , Humanos , Ácido Láctico/sangue , Masculino , Consumo de Oxigênio/fisiologia , Temperatura Cutânea , Adulto Jovem
2.
Int J Clin Oncol ; 24(12): 1574-1581, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31309381

RESUMO

BACKGROUND: The efficacy and safety of nanoparticle albumin-bound paclitaxel (nab-PTX) plus gemcitabine (GEM) in elderly Japanese patients with pancreatic cancer remain unclear. Therefore, we prospectively investigated the tolerability and efficacy of nab-PTX + GEM in Japanese patients aged ≥ 75 years with non-curatively resectable pancreatic cancer. METHODS: We treated eligible patients (n = 27) with nab-PTX + GEM until disease progression, appearance of adverse events, or withdrawal of consent. The primary endpoints included adverse events as well as dosing- and survival-related parameters. RESULTS: The rates of 2-cycle completion were 48.1% for nab-PTX and 55.6% for GEM; the relative dose intensities for the 7th (median) treatment cycle were 65.1% and 74.1%, respectively, whereas the dose-reduction rates were 81.5% and 48.1%, respectively. Grade 3 or higher hemotoxicity was observed in 14 of 27 subjects (51.9%); moreover, 22% experienced grade ≥ 3 peripheral nerve disorder and 1 patient (3.7%) died owing to chemotherapy-related interstitial pneumonia. The disease control rate was 92.6% (25/27), while the median progression-free and overall survival times were 7 and 10.3 months, respectively. CONCLUSION: The nab-PTX + GEM regimen is as efficacious in elderly patients who meet certain criteria as it is in previously reported non-elderly patients. The regimen is feasible with appropriate dose adjustments and attention to adverse events. TRIAL REGISTRATION: Clinical trial registration number: UMIN000018907.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Pancreáticas/tratamento farmacológico , Neoplasias Pancreáticas/mortalidade , Idoso , Idoso de 80 Anos ou mais , Albuminas/administração & dosagem , Desoxicitidina/administração & dosagem , Desoxicitidina/análogos & derivados , Estudos de Viabilidade , Feminino , Doenças Hematológicas/induzido quimicamente , Humanos , Masculino , Paclitaxel/administração & dosagem , Neoplasias Pancreáticas/cirurgia , Doenças do Sistema Nervoso Periférico/induzido quimicamente , Estudos Prospectivos , Resultado do Tratamento
4.
Anal Sci ; 34(9): 1003-1009, 2018 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-29887546

RESUMO

The determination of urinary tetrahydroglucocorticoid (THGC) glucuronides might prove helpful in the diagnosis, pathophysiological analysis and assessment of the therapeutic efficacy of the diseases caused by abnormal cortisol secretion. We developed and validated a method for the determination of the THGC glucuronides in human urine using liquid chromatography/electrospray ionization (ESI)-tandem mass spectrometry not requiring enzymatic hydrolysis. The method employed a derivatization using an ESI-enhancing reagent for carboxylic acids, 1-[(4-dimethylaminophenyl)carbonyl]piperazine (DAPPZ), and its isotopologue, 2H4-DAPPZ. The deproteinized urine samples were derivatized with DAPPZ. The 2H4-DAPPZ-derivatized standards of known amounts were then added to the DAPPZ-derivatized urine samples and served as the internal standards. The DAPPZ-derivatization enhanced the assay sensitivity and reduced the sample volume, and the use of 2H4-DAPPZ significantly improved the assay accuracy. The developed method enabled the separate quantification and profiling of the urinary THGC glucuronides and had a satisfactory application for the real sample analysis.


Assuntos
Cromatografia Líquida/métodos , Glucocorticoides/urina , Espectrometria de Massas em Tandem/métodos , Urinálise/métodos , Calibragem , Glucocorticoides/química , Humanos , Isótopos/química , Limite de Detecção , Reprodutibilidade dos Testes
6.
Dig Dis Sci ; 63(6): 1641-1646, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29557076

RESUMO

BACKGROUND: Long-term studies evaluating self-expandable metal stents in patients who have unresectable malignant hilar biliary obstruction (UMHBO) after surgical reconstruction of the intestine remain inadequate. We developed a side-by-side (SBS) technique using a two-channel endoscope to place self-expandable metal stents in patients with UMHBO occurring after Billroth II reconstruction. AIMS: We validated the long-term outcomes obtained with this technique. METHODS: The study group comprised seven patients with UMHBO in whom we attempted to place metal stents by the SBS technique using a two-channel scope. The procedure was validated retrospectively. RESULTS: The technical success rate was 86% and functional success rate was 100%. The median time to recurrent biliary obstruction (RBO) was 222 days (95% CI 4.9-439.1). Besides RBO, there were no other complications. CONCLUSIONS: The SBS procedure performed using a two-channel scope is a safe and useful new technique for the treatment of UMHBO occurring after Billroth II reconstruction.


Assuntos
Colestase/terapia , Neoplasias do Sistema Digestório/cirurgia , Endoscópios , Endoscopia do Sistema Digestório/instrumentação , Gastroenterostomia/efeitos adversos , Stents Metálicos Autoexpansíveis , Idoso , Idoso de 80 Anos ou mais , Colestase/diagnóstico por imagem , Colestase/etiologia , Neoplasias do Sistema Digestório/complicações , Neoplasias do Sistema Digestório/patologia , Endoscopia do Sistema Digestório/efeitos adversos , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Desenho de Prótese , Recidiva , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento
7.
J Sports Med Phys Fitness ; 58(9): 1197-1203, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28409513

RESUMO

BACKGROUND: Individuals who exercise outdoors in winter expose themselves to cold conditions, which have detrimental effects on physiological responses and exercise performance. Many runners wear arm warmers to protect against cold. However, the effects of these warmers remain unclear. This study aimed to determine the effect of arm insulation on physiological responses during running in a cold environment. METHODS: Twelve healthy men (mean±SD age, 22.4±3.9 years; height, 1.71±0.07 m; mass, 66.9±8.1 kg; maximal oxygen consumption, 52.3±4.79 mL/kg/min) ran on a treadmill at an intensity of 70% maximal oxygen consumption for 30 minutes in a climatic chamber at 5 °C wearing (ARM) or not wearing (CON) a tight-fitting polyester sleeve on the forearm. RESULTS: During the first 10 minutes of exercise, esophageal temperature was significantly higher (P<0.05) in ARM than in CON. Weighted mean skin temperature was significantly higher (P<0.05) in ARM than in CON. Thermal sensation was significantly higher (P<0.05) in ARM than in CON during rest and during the first 10 minutes of exercise. Plasma lactate concentration was significantly lower (P<0.05) in ARM than in CON at 10 minutes, and plasma norepinephrine concentration was significantly lower (P<0.05) in ARM than in CON at 10 and 20 minutes. CONCLUSIONS: Higher esophageal temperature and thermal sensation and lower plasma norepinephrine concentration indicate that arm insulation suppressed cold stress and attenuated the production of plasma lactate in the early stages of exercise.


Assuntos
Regulação da Temperatura Corporal/fisiologia , Temperatura Corporal/fisiologia , Temperatura Baixa/efeitos adversos , Ácido Láctico/sangue , Norepinefrina/sangue , Corrida/fisiologia , Teste de Esforço , Humanos , Masculino , Consumo de Oxigênio , Descanso/fisiologia , Temperatura Cutânea/fisiologia , Adulto Jovem
8.
J Sports Sci ; 36(4): 393-397, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28368213

RESUMO

Recent studies have shown the contribution of genetic determinants to athletes' physical ability. However, despite the fact that cognitive abilities like self-control and stress-tolerance influence athletes' competitive performance, few studies to date have investigated the association between genetic polymorphism, which is linked to cognitive ability and athletic performance. The present study investigated the link between single-nucleotide polymorphisms (SNPs), which are known to exert influences on dopaminergic neural function and competitive performance of swimmers. The results have revealed superior competitive performance in competitive swimmers with Met allele of catechol-O-methyltransferase Val158Met polymorphism than those with Val/Val genotype. The investigated SNPs of DRD2 and DRD3 were not associated with swimmer's competitive performance. This finding indicates that genetic polymorphism linked to cognitive ability influences the athletes' performance.


Assuntos
Catecol O-Metiltransferase/genética , Comportamento Competitivo/fisiologia , Polimorfismo de Nucleotídeo Único , Natação/fisiologia , Genótipo , Humanos , Masculino , Adulto Jovem
9.
Surg Endosc ; 32(1): 498-506, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-28733743

RESUMO

BACKGROUND: Peroral cholangioscopic lithotripsy is a useful procedure in patients with a normal gastrointestinal anatomy who have difficult-to-treat stones. We evaluated the usefulness of peroral direct cholangioscopy (PDCS) using single-balloon enteroscope (SBE) in patients with difficult-to-treat stones who had undergone Roux-en-Y reconstruction. METHODS: Among 118 patients (169 sessions) who underwent SBE-assisted endoscopic retrograde cholangiopancreatography to treat biliary stones after Roux-en-Y reconstruction, patients in whom it was difficult to remove biliary stones via a transpapillary or transanastomotic approach and difficult to switch to ultra-slim endoscope, were retrospectively enrolled. The biliary insertion success rate, procedure success rate, procedure time, and procedural complications were assessed. The SBE was inserted into the bile-duct, first using a free-hand technique, second using a guide wire, and third using the large balloon anchoring and deflation (LBAD) technique. RESULTS: A total of 11 patients (14 sessions) were enrolled in this study. The biliary insertion success rate was 100%. Bile-duct insertion was performed using a free-hand technique in 4 sessions, a guide wire in 3 sessions (rendezvous technique, 2 sessions), and the LBAD technique in 7 sessions. The procedure success rate was 86% in first session, and 100% in second session. The median procedure time was 81 min (range 49-137). The median procedure time in the bile-duct was 21.5 min (range 6-60). Mild pancreatitis occurred as a complication in one patient. The median follow-up was 528 days (range 282-764). No patient had stone recurrence. CONCLUSIONS: PDCS using SBE is a useful procedure in patients with Roux-en-Y reconstruction. The LBAD technique is an useful technique of inserting SBE into the bile-duct.


Assuntos
Colangiopancreatografia Retrógrada Endoscópica/instrumentação , Colelitíase/cirurgia , Endoscópios Gastrointestinais , Idoso , Idoso de 80 Anos ou mais , Anastomose em-Y de Roux , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Estudos Retrospectivos
15.
J Phys Ther Sci ; 28(6): 1676-80, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27390393

RESUMO

[Purpose] The purpose of this study was to evaluate the relationship between malalignment and lower-extremity injury and to determine the optimal dynamic alignment of the lower extremity with wall squats. [Subjects and Methods] Healthy individuals from one therapy school were enrolled and assigned to a wall squat normal or abnormal group based on their forms during wall squats. The abnormal group was found to be more prone to lower-extremity injury on three-dimensional motion analysis. Eight students from each group were randomly chosen for the study. The effects of single-leg landing movements were assessed using three-dimensional motion analysis. [Results] In the sagittal plane, significant flexion of the hip and knee joints occurred 0.02 and 0.04 seconds after initial foot contact with the ground in the normal and abnormal groups, respectively. In the frontal plane, significant adduction of the hip joint occurred at 0.07 seconds in the abnormal group. [Conclusion] The abnormal group tended to display later flexion of the hip and knee joints and narrower hip, knee, and ankle range of motion than the normal group, suggesting that dynamic alignment of the lower extremity in the abnormal group likely made them susceptible to injury.

17.
J Hepatobiliary Pancreat Sci ; 23(5): 289-97, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26946214

RESUMO

BACKGROUND: Very few studies have examined effectiveness of duodenal stent placement (DSP) for duodenal obstruction (DO) caused specifically by pancreatobiliary cancer. We compared two types of stents with different axial forces (AF) for DO with pancreatobiliary cancer. METHODS: The patients were randomly assigned to two stent groups with different AF (high AF stent, WallFlex™: W-group or low AF stent, Niti-S™: N-group). The primary endpoint was improvement in the Gastric Outlet Obstruction Scoring System (GOOSS) score. This study was registered at UMIN000009061. RESULTS: The GOOSS scores significantly improved in both W-group (0.9 before vs. 2.7 after; P = 0.002) and N-group (1.0 before vs. 2.5 after; P = 0.001). The change in the GOOSS score after DSP did not differ significantly between the groups (P = 0.482). The median time to recurrent DO (RDO) was significantly shorter in W-group than in N-group (89 days vs. 421 days; P = 0.025). The incidence of RDO was significantly higher in W-group than in N-group (64% vs. 24%; P = 0.027). Stent kinking occurred only in W-group. CONCLUSIONS: The GOOSS scores significantly improved after DSP, but effectiveness did not differ significantly between groups. The use of stents with high AF was related to short-term stent patency, but did not influence survival time.


Assuntos
Neoplasias dos Ductos Biliares/complicações , Colangiopancreatografia Retrógrada Endoscópica/métodos , Obstrução Duodenal/cirurgia , Endoscopia Gastrointestinal/métodos , Cuidados Paliativos/métodos , Neoplasias Pancreáticas/complicações , Stents , Idoso , Neoplasias dos Ductos Biliares/cirurgia , Obstrução Duodenal/etiologia , Feminino , Seguimentos , Humanos , Masculino , Neoplasias Pancreáticas/cirurgia , Estudos Prospectivos , Desenho de Prótese , Fatores de Tempo , Resultado do Tratamento
18.
J Med Case Rep ; 9: 194, 2015 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-26362063

RESUMO

INTRODUCTION: In the World Health Organization histological classification of the liver tumor, peliosis hepatis is defined as a tumor-like lesion. The entity is characterized by the appearance of multiple cyst-like, blood-filled spaces within the liver parenchyma. CASE PRESENTATION: A 77-year-old Japanese man with prostate cancer was referred to our department because he was diagnosed as having two hepatic tumors. The tumors were confirmed to be peliosis hepatis by repeated needle biopsies and because of their atypical images by enhanced computed tomography and enhanced magnetic resonance imaging. Later these tumors grew rapidly, increased in number, and disseminated throughout his whole liver. We are now treating the patient conservatively due to his age and his existing medical conditions. CONCLUSION: Peliosis hepatis is a rare hepatic benign tumor that should be considered in the differential diagnosis of multiple unknown liver tumors that are revealed by atypical radiological images.


Assuntos
Fígado/diagnóstico por imagem , Fígado/patologia , Peliose Hepática/complicações , Peliose Hepática/diagnóstico , Neoplasias da Próstata/complicações , Idoso , Diagnóstico Diferencial , Humanos , Imagem por Ressonância Magnética , Masculino , Tomografia Computadorizada por Raios X
19.
Intern Med ; 54(16): 2007-12, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26278292

RESUMO

Castleman's disease of the pancreas is extremely rare. To the best of our knowledge, Castleman's disease arising around the main pancreatic duct has not been previously reported. The patient was a 74-year-old man. Abdominal ultrasonography performed at a health check-up revealed a dilated main pancreatic duct. Pancreatic cancer was strongly suspected on various imaging studies. However, the results of a cytological examination of the pancreatic juice were negative for malignancy. The patient did not want to undergo a histological diagnosis by endoscopic ultrasound-guided fine-needle aspiration, thus pylorus-preserving pancreatoduodenectomy was performed. Pancreatic Castleman's disease arising around the main pancreatic was diagnosed by the histopathological examination.


Assuntos
Hiperplasia do Linfonodo Gigante/diagnóstico , Ductos Pancreáticos/patologia , Pancreaticoduodenectomia , Idoso , Hiperplasia do Linfonodo Gigante/patologia , Diagnóstico Diferencial , Humanos , Masculino , Neoplasias Pancreáticas/diagnóstico , Pancreaticoduodenectomia/métodos
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