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[Purpose] The purpose of this study was to investigate the durability of the effect on the dynamic control structure after performance of the Approximation technique (ApT) administered to the lower extremity. Body sway was measured on a stabilometer under two conditions: one without a stimulus, and the other with a disturbance stimulus. [Subjects] The subjects were 38 healthy males, 19 to 27 years of age. [Methods] Participants in the experimental group stood on two scales, and we performed ApT from the iliac crests toward the long axes direction of lower extremities on each leg for one minute in turn and confirmed the approximation with a 10 kg load. Experimental group performed the stabilometer in an unstable environment and we measured the center of gravity sway after the intervention. The control group was measured without performing the maneuver. [Results]Significant differences in Area of Ellipse (AoE) and locus length per unit area (L/A) after ApT for lasted for 70 minutes. [Conclusion] We conclude ApT is a useful improved stability of center of gravity for 70 minutes.

Introduction: Diabetes mellitus is associated with an increased production of reactive oxygen species and a reduction in antioxidant defenses. The aim of this study is to determine the association between the incidence of Type 2 diabetes and gene polymorphisms of glutathione S-transferase (GST), which modulates oxidative stress. Materials & Methods: The associations between the incidence of Type 2 diabetes and the GSTT1 and GSTM1 genotypes were analyzed in 469 Japanese participants in a health-screening program. Results: The clinical characteristics and smoking status were obtained from the health screening record. The incidence of diabetes was 1.5-fold higher in the GSTT1 and GSTM1 null (-) genotype than the GSTT1 and GSTM1 present (+) genotype, respectively. Although the effect of each null genotype was not significant, the combined GSTT1+/GSTM1+ genotypes conferred a significant reduction in risk of diabetes in comparison with the other combinations of genotypes (adjusted odds ratio [OR]: 0.30; 95% confidence interval [CI]: 0.12–0.71). In stratified analyses by smoking status, the incidence of diabetes was significantly higher in never-smokers with the GSTT1- genotype than those with the GSTT1+ genotype (OR: 2.85; 95% CI: 1.17–6.94) and increased significantly in current smokers (OR: 5.91; 95% CI: 1.96–17.88). The effect of the GSTM1- genotype was significant only in current smokers. Conclusion: This study demonstrated that the GSTT1- and GSTT1-/GSTM1- genotypes are independent risk factors for development of Type 2 diabetes regardless of the smoking status of the patient, and that these genotypes and current smoking were interactively associated with the incidence of Type 2 diabetes.

This study tested the hypothesis that the determinants of mild liver injury are prerequisites for more severe idiosyncratic hepatotoxicity. This study verified whether the possible risk factors for rare idiosyncratic valproic acid (VPA)-induced hepatotoxicity, VPA clearance and/or serum carnitine concentrations are common to those for a mild elevation in transaminases in VPA-treated patients. VPA clearance was calculated in 172 Japanese patients with epilepsy, using a non-linear mixed-effects regression program. Carnitine concentrations were determined in a subset of 60 patients. The relationships between VPA clearance, carnitine concentration and levels of transaminases and ammonia were evaluated by Pearson's correlation coefficients. The final model of VPA apparent clearance (CL/F) was as follows: CL/F (L h−1) = 0.012 × (BW/40)0.34 × dose0.55 × 0.90gender × 1.32PHT × 1.11CBZ × 1.12PB, where BW = total body weight (kg); gender = 1 if female, 0 if male; PHT/CBZ/PB = 1 if phenytoin, carbamazepine, or phenobarbital, respectively, is coadministrated, otherwise 0. Either a higher VPA clearance or acyl/free carnitine ratio and a lower total and/or free carnitine concentration, but not VPA concentration, were associated with the mild elevation in transaminases or ammonia. These results support the initial hypothesis, while also helping to clarify the mechanism of severe idiosyncratic hepatotoxicity with VPA.

This retrospective longitudinal study investigated the association between the Q192R polymorphism of the high-density lipoprotein-associated multifunctional antioxidant enzyme, paraoxonase-1 (PON1), and lung function decline, while taking into account smoking history.The demographic, occupational, and respiratory symptom information and lung function variables were obtained from 216 male Saskatchewan grain workers.An interaction between the PON1 genotypes and smoking status was observed. Current smokers with the 192R allele had a lower forced expiratory volume in the first second (FEV(1)) and FEV(1) per forced vital capacity (FVC). The annual decline rate of FEV(1)/FVC in current smokers was greater among 192R allele carriers than noncarriers (0.58+/-0.05 vs. 0.35+/-0.04 %/yr, p0.0001). A similar result was observed with FEV(1) (40.9+/-6.4 vs. -33.0+/-7.0 mL/yr, p=0.10). The annual decline rate of FVC was not influenced by the genotypes.These results strengthened the previous findings of our cross-sectional study, suggesting that the 192R allele may be a novel genetic risk factor for airway injury among current smokers.

Introduction: Paraoxonase-1 (PON1) is a high-density, lipoprotein-associated, multifunctional antioxidant enzyme that is detected in nonciliated bronchiolar epithelial cells, although its role in the lung has not yet been clarified. We therefore investigated the association between the PON1 Q192R polymorphism and lung function. Patients & Methods: A total of 216 male Saskatchewan grain handlers provided demographic, occupational and respiratory-symptom information by means of questionnaires, and thereafter underwent PON1 Q192R genotyping and lung-function testing. Results: Mean lung-function values did not differ among the Q192R genotypes. However, current smokers with the Q/Q genotype had a higher mean percent predicted forced expiratory volume in the first second (FEV1), and absolute and percent predicted FEV1 per forced vital capacity (FVC) compared with current smokers with at least one 192R allele (100.9 ± 11.2% vs 92.0 ± 15.1%, p = 0.01; 78.0 ± 5.9% vs 74.1 ± 6.8%, p = 0.03; and 96.8 ± 7.1% vs 92.1 ± 8.3%, p = 0.03; respectively). The incidence of subjects with FEV1/FVC less than 70% was significantly higher in current smokers with at least one 192R allele than in nonsmokers with the Q/Q genotype (odds ratio: 5.0; 95% confidence interval: 1.5–17.4). The protective effect of the Q/Q genotype was not found in nonsmokers. The FVC was not influenced by either PON1 genotype or smoking status. Conclusion: The results obtained from grain handlers suggest that PON1 may play some role in the protection of the airways against the toxicity of cigarette smoke, and the 192R allele may be a novel genetic risk factor for airway injury.

Complementary and alternative medicine (CAM) may provide patients with an alternative to traditional medicine, but an assessment of its efficacy is required. One CAM method, electroacupuncture (EA) treatment, is a maneuver that utilizes stimulation of acupuncture needles with a low-frequency microcurrent. To study the effect of short-term EA, we evaluated the differential expression of genes induced by EA in mouse skeletal muscle for up to 24 h. We then used RT-PCR to confirm the expression patterns of six differentially expressed genes. Bioinformatics analysis of their transcription control regions showed that EA-inducible genes have numerous common binding motifs that are related to cell differentiation, cell proliferation, muscle repair, and hyperplasia. These results suggested that EA treatment may induce cell proliferation in skeletal muscle. To verify this possibility, we used EA to stimulate mouse skeletal muscle daily for up to 1 mo and examined the long-term effects. Immunohistochemical analysis showed that nuclei of muscle cells treated with EA for 1 mo, especially nuclei of satellite cells, reacted with anti-human PCNA. Also, expression of the gene encoding myostatin, which is a growth repressor in muscle satellite cells, was suppressed by daily EA treatment for 1 wk; EA treatment for 1 mo resulted in more marked suppression of the gene. These molecular findings constitute strong evidence that EA treatment suppresses myostatin expression, which leads to a satellite cell-related proliferative reaction and repair in skeletal muscle.

Introduction Tympanoplasty consists of a series of operative procedures, which not only eliminate chronic infections of the middle ear completely but also improve hearing. The purposes of tympanoplastic procedures are the elimination of inflammatory processes and postinflammatory changes in the middle ear in order to diminish ear discharge and to obtain dry ear and the reconstruction of the damaged sound-conduction mechanism in order to facilitate sound conduction to the inner ear and restore the hearing. In our experience there are cases where tympanoplasty failed to eliminate the inflammatory processes or to restore hearing in chronic otitis media. I have, therefore, clinically observed these cases of failure in order to clarify manipulation of the labyrinth windows and their surroundings and assure accomplishment of both aims of tympanoplasty. Material I examined 242 tympanoplasty cases operated on by us for chronic middle ear suppuration from October, 1957, to November, 1958. The cases included

Disophrol Chronotab, an oral constrictive agent of mucous membrane of upper respiratory tract was given to 23 patients. The results suggest that Disophrol Chronotab is a very valuable drug for treating allergic, hypertrophic rhinitis.Side effects were noted in 38% of patients, but there was no severe condition.

Of the patients in whom operative construction of the middle ear (tympanoplasty) was carried out with the objective of eradication of infection and restoration of hearing during 1954, the findings were recorded in detail in 125 cases of chronic otitis media and 22 cases of postradical mastoidectomy. The results of examination of the state of the stapes in these cases are presented here. The state of the stapes is not only closely related to the restoration of hearing, but treatment of this part is also an extremely important problem from the standpoint of elimination of inflammation and restoration of hearing. Mobility of the stapes also determines the necessity or unnecessity for fenestration, and the presence or absence of the stapes is important from the standpoint of method of treatment. The basis for operative procedures in chronic otitis media to eradicate inflammation, prior to determination of whether to carry out secondary

I. INTRODUCTION TO INDICATE the hearing acuity by audiometer, the lowest pattern of threshold is generally used. No questions regarding this method have so far been raised. Hearing acuity, however, is important for speech on the one hand, and hearing above threshold is practically important on the other. The threshold alone, therefore, does not perfectly indicate practical hearing. In other words, the threshold value indicates the hearing acuity only when the intensity of the presented tone is parallel with the loudness or perceived tone. Fowler (1928), however, found a phenomenon in which the loudness rapidly increases in correspondence to small increases in intensity, and he called this phenomenon "recruitment" of tonal loudness. From this fact we cannot say in cases in which this phenomenon exists that the threshold pattern indicates actual hearing. Fowler1 (1936) published the balance test of loudness with the binaural loudness comparison and emphasized the possibility of

The author has been performing tympanoplastic surgery for chronic suppurative otitis media since 1952, and the surgical procedures have again and again been improved.

The author pursued the causes of failure in tympanoplasty by performing revision operations in 65 failed cases of tympanoplasty, and on these an attempt was made to clarify the operative controls necessary to avoid the failure in tympanoplasty. Thus, he suggests that the following controls be adopted as standards in all cases of tympanoplastic surgery: 1. The antrum and mastoid control, 2. The perilabyrinth control, 3. The ossicular chain control, 4. The epitympanum control, 5. The oval window control, 6. The round window control, 7. The tympanic sinus control, 8. The meso-tympanum control, 9. The hypotympanum control, 10. The tube control, 11. The drum membrane control. By adopting these 11 controls of the middle ear we can perform tympanoplasty with the object of satisfying both elimination of infection in the middle ear and restoration of hearing.