Search

A 52-year-old woman complained of lower back pain and gluteal pain in April 1997, and was found to have anemia, hypercalcemia and renal disorder. In September of the same year, she was diagnosed as having IgA-lambda myeloma (stage IIIA). VMMD-IFN therapy was started in November, 1997, and this resulted in improvement of the M-protein level, and relief of the pain in the lower back and gluteal region. A second course of VMMD-IFN therapy was also effective. In April 1998, however, the back pain worsened, and in July the patient suffered a fall and fractured her left femur. Upon readmission to our hospital, the level of M-protein was lower, and high fever, hypercalcemia, renal disorder, elevation of the LDH level, anemia and thrombocytopenia were observed. Bone marrow examination revealed 30% atypical large-sized CD19-, CD38+, CD56+ myeloma cells and chromosomal abnormalities. Although the symptoms were improved temporarily after a third course of VMMD therapy, disease aggravation occurred again, and extramedullary masses appeared on the head, face and pelvis. VAD therapy was performed without effect, and the patient died about 2 months after recurrence. This was a comparatively rare case of fulminant multiple myeloma occurring in the terminal stage.

Sleep splint, which is a dental device made of regin, is now widely used for the treatment of obstructive sleep apnea in our country. This device is worn in the mouth at night and makes the upper airway opened during sleep. It enlarges the velopharyngeal space as well as the space at the tongue base and prevents the collapse of the upper airway. This device is a treatment of choice for the patients with mild or moderate types of obstructive sleep apnea who are not treated ordinarily by nasal CPAP. When the patients have nasal obstruction, adenoid hypertrophy, enlarged tonsils, or improper conditions of the teeth, sleep splint is not indicated for those patients. At first, nasal obstruction should be treated, and the adenoids and enlarged tonsils should be removed surgically. The compliance of this treatment is better than that of nasal CPAP, and the major complication of this treatment is almost none.

The relationship between apoptosis and cellular proliferative activity in human non-small cell lung cancer (25 cases) was investigated using the in situ DNA nick-end labeling method and immunohistochemistry for both proliferating cell nuclear antigen (PCNA) and Ki-67 antigen. Comparison of the distribution of Ki-67-positive cells to that of apoptotic cells shows an inverse correlation in semi-serial sections. The PCNA labeling rates were closely correlated with Ki-67 labeling rates in non-small cell lung cancer. It was concluded that the immunostainings of PCNA and Ki-67 were almost equally valuable for assessing the proliferative activity in paraffin-embedded tissue from non-small cell lung cancer and that apoptosis may be related with the cell cycle in this cancer.

For specific transduction of herpes simplex virus thymidine kinase (HSV-tk) into human small-cell lung carcinoma (SCLC) cells, we explored the 5'-flanking region (-1.1 kb) of the gastrin-releasing peptide (GRP) gene as a lung cancer-specific promoter. RT-PCR analysis demonstrated expression of GRP mRNA in the SBC5 human SCLC cell line but not in the RERF human SCLC cell line, the A549 human lung adenocarcinoma cell line or the HeLa human uterine cervix epithelioid carcinoma cell line. A reporting vector containing the GRP promoter (pGL2-GRP) exhibited higher luciferase activity in SBC5 than in the other 3 cell lines. After transfecting an expression vector containing the GRP promoter-bound HSV-tk gene (pGRP-TK) into the cells, we measured their sensitivity to ganciclovir (GCV). In SBC5, pGRP-tk-transfected cells became about 100 times more sensitive to GCV than parental cells in vitro. In nude mice, tumors of pGRP-tk-transfected SBC5 regressed completely after i.p. administration of GCV. GRP promoter might be a good tool for tumor-specific transduction of suicide genes in GRP-expressing SCLC cells., (Copyright 2000 Wiley-Liss, Inc.)

We report a case of drug-induced pneumonitis associated with the herbal medications Sho-saiko-to and Ouren-gedoku-to. A 62-year-old man experienced fever and dry cough after using Ouren-gedoku-to for 2 months. He was admitted to our hospital because a subsequent 5-day course of Sho-saiko-to for suspected bronchitis aggravated these symptoms and caused exertional dyspnea. Chest X-ray films revealed a ground-glass appearance in both lower lung fields. Cessation of these medications improved the patient's clinical and X-ray findings. Bronchoalveolar lavage showed an increase in lymphocytes with a decreased CD 4/CD 8 ratio. While drug-induced lymphocyte stimulation tests gave negative results, challenge tests for Ouren-gedoku-to and Sho-saiko-to were both positive. A diagnosis of drug-induced pneumonitis was made. Our findings suggested the involvement of Ougon, the only common ingredient in the two medications.

The moisturizing effect of vesicles formed from monoglycerides on human skin was studied by measurement of conductance on and transepidermal waterloss from the skin surface. Although sonication of the monoglycerides in water with Ca2+ gave multilamellar vesicles, the lamellar structure of the vesicles disappeared during their storage without any other additive. With the addition of poly(vinylpyrrolidone) after the sonication, the stability of the vesicles increased and their lamellar structure was maintained for 3 months at 40 degrees C. These vesicles led to a significantly higher water content of the stratum corneum of human skin compared with non-lamellar monoglyceride, and consequently they improved rough human skin.

We encountered a fatal case of mediastinal fibromatosis in a 67-year-old female in whom there was aggressive infiltration into the large vessels, nerves and pericardium. She presented with the superior vena cava syndrome, Horner's syndrome, paralysis of bilateral vocal cords and diaphragm and heart failure. Mediastinoscopical examination revealed an extremely firm tumor adhering to the sternum, trachea and brachiocephalic artery. She died of severe heart failure due to the disturbed dilatation of the heart and ventilatory insufficiency. Although mediastinal fibromatosis is very uncommon and sometimes difficult to diagnose at an early stage, physicians should be aware of this disease for the differential diagnosis of mediastinal tumors.

We report five cases of hypersensitivity pneumonitis among workers cultivating Tricholoma conglobatum (shimeji). After having worked for 5 to 20 years, they began to notice symptoms of cough, sputum, and dyspnea. They were diagnosed as having a hypersensitivity pneumonitis based on clinical features, bronchoalveolar lavage and transbronchial lung biopsy. By the double immunodiffusion test, precipitating lines between shimeji spore antigen and sera were observed in all of the patients. By enzyme-linked immunosorbent assay, the antibody activities against shimeji and three species of fungi (Cladosporium sphaerospermum, Penicillium frequentans, and Scopulariopsis species) were significantly higher in the sera of the patients than in those of normal subjects who were cultivating shimeji. Although it is not clear what causes this disease, these findings may be helpful in determining the specific antigen.

The cDNA and the gene of human aquaporin8 (AQP8) were cloned from human testis cDNA and a genomic library, respectively. The AQP8 cDNA encodes 261 amino acids. The identity of the amino acid sequence to other aquaporins is highest with a plant water channel, gamma-TIP (40.4%), while AQP2 and AQP3 are 28.9 and 29.5% identical to human AQP8, respectively. The human AQP8 is only 74.9% identical to rat AQP8 and 76.0% identical to mouse AQP8. In Northern blot analysis, approximately 1.35-kb human AQP8 mRNA was expressed in pancreas and colon, but not in other tissues. Absence of human AQP8 in testis is noteworthy as rat AQP8 was abundantly expressed in testis. The expression of human AQP8 cRNA in Xenopus oocytes increased osmotic water permeability by 10-fold. AQP8 was not permeable to urea nor to glycerol. The AQP8 gene has five introns, and the locations of exon-intron boundaries were different from those of the other mammalian aquaporins, suggesting its separate phylogenetic origin., (Copyright 1998 Academic Press.)

A 51-year-old man who had been working for 10 years with polyurethane paint containing isocyanate (MDI) was admitted to our hospital with complaints of fever and exertional dyspnea. Fine crackles were heard in both bases, and the patient had clubbed fingers. A chest X-ray film and computed tomograms of the lungs revealed patchy infiltrative shadows in both lung fields and subpleural honeycombing associated with irregular linear areas. Examination of bronchoalveolar lavage fluid showed increased T lymphocytes and a decreased CD 4/8 ratio. Specimens obtained by transbronchial lung biopsy revealed lymphoplasmacytic infiltration into the thickened alveolar walls, macrophage accumulation, and micro-epithelioid cell granulomas in the alveolar sacs. Hypersensitivity pneumonitis was suspected although the causative antigen was not identified because the results of short-term environmental provocation tests were negative in the patient's home and workplace. After discharge, the patient continued working as a paint sprayer. His acute symptoms recurred 1 month after exposure to isocyanate. Similar episodes occurred on two separate occasions. In addition, the patient tested positive for antibody to MDI-HSA in bronchoalveolar fluid. From the above observations, the patient was given a diagnosis of chronic hypersensitivity pneumonitis due to isocyanate (MDI). This condition is extremely rare. Furthermore, it is interesting that acute symptoms recurred 1 month after environmental exposure to the causative antigen.

We used immunohistochemical staining to examine the expression of the gap junction proteins connexin32 and connexin43 and of the intercellular adhesion molecule, E-cadherin, that is thought to be a prerequisite for gap junctional intercellular communication (GJIC), in 24 specimens of human lung cancer. Connexin32 was not found in cancer tissue and there were significantly fewer spots of connexin43 in the poorly differentiated versus the well differentiated (P = 0.0005) and moderately differentiated (P = 0.0002) adenocarcinomas and in the poorly differentiated versus the well differentiated (P = 0.0182) and moderately differentiated (P = 0.004) squamous cell carcinomas of the lung. E-Cadherin was expressed in all but three cases of poorly differentiated non-small cell lung cancer that showed a heterogeneously decreased expression of E-cadherin. These findings suggest that GJIC is decreased in poorly differentiated non-small cell lung cancer.

A 34-year-old Japanese woman developed acute lung injury soon after inhaling a water-proofing spray which she applied onto her ski suit while smoking a cigarette at the same time. She initially demonstrated arterial hypoxemia (PaO2 = 59 mm Hg) and ground-glass opacities in both lung fields on the CT scan, which both returned to normal without any medication. Several water-proofing sprays, which are easily obtainable in Japan, contain 1,1,1-trichloroethane, liquefied petroleum gas and fluoride resin. Although these components have not been reported to be toxic to the lung yet, high concentrations of these components and/or the pyrolytic products of fluoride resin may have caused acute lung injury in this case.

Although aquaporin 3 (AQP3) is expressed in many tissues in the kidney, gastrointestinal tract, lung, and other organs, its physiological significance in the body still remains to be clarified. To determine whether AQP3 expression is regulated by dexamethasone in human airway epithelium, we studied mRNA expression, protein expression, and water permeability of the cell membrane in a human airway epithelial cell line (A549 cells). Expression of AQP3 mRNA and protein was studied by Northern blot analysis and immunoblot analysis, and osmotic water permeability (Pf) was measured by a stopped-flow light-scattering method. Expression of AQP3 mRNA and protein was detectable in A549 cells and was stimulated by dexamethasone. Pf in A549 cells after incubation with dexamethasone was approximately 2.5-fold greater than that without dexamethasone. Moreover, this dexamethasone-induced increase in Pf was inhibited after treatment with HgCl2. In conclusion, the present study shows that A549 cells express AQP3 and that dexamethasone upregulates the expression of AQP3 and increases the water permeability of the cell membrane. Dexamethasone-regulated AQP3 expression might be important in certain forms of pulmonary diseases accompanied by airway hypersecretion that are treated by corticosteroid administration.

Expression of CD44 isoform that contains variant exons (v1-v10) has been implicated in tumor progression and metastasis. Especially, CD44 isoform containing v6 (CD44v6) and that containing v7 (CD44v7) were shown to confer full metastatic behavior on tumor cells. We examined the expression of CD44v6 and CD44v7 in malignant pleural effusions (13 lung cancers and 4 non-lung cancers) and in benign pleural effusions (7 tuberculosis and 3 pneumonia) with Southern blot analysis of reverse transcription (RT)-polymerase chain reaction (PCR) products. CD44v6 was expressed not only in malignant pleural effusions (12 of 13 lung cancers and 4 of 4 non-lung cancers), but also in benign pleural effusions(9/10). In contrast, although expression of CD44v7 was found in most malignant pleural effusions (12 of 13 lung cancers and 4 of 4 non-lung cancers), it was found in only a few cases of benign pleural effusions. These results suggest that the expression of CD44v7 may be correlated with a tumor-specific event such as metastasis or dissemination in malignant pleural effusion, while no such correlation can be found with CD44v6.

A 44-year-old woman was found to have an abnormally high concentration of CA19-9 in serum. Five years later, she underwent a right upper lobectomy for an abnormal shadow on a chest roentgenogram, because it was thought to indicate a malignant tumor. A chest CT scan revealed a cyst with fluid in the right upper lobe. During the 5 years before the lobectomy, the serum CA19-9 concentration rose when the cyst fluid volume increased, and fell when the cyst fluid volume decreased. Before the operation, the serum CA19-9 concentration was very high and the cyst was swollen. The cyst wall was found to be lined with ciliated columnar epithelial cells and to contain hyaline cartilage and smooth muscle, which led to the diagnosis of bronchial cyst. The surface epithelium and cyst fluid were positively stained by a monoclonal antibody against CA19-9. The serum CA19-9 concentration decreased and was within the normal range 3 months after the operation.

We studied the short-term effects and complications of the use of a dental device (prosthetic mandibular advancement: PMA) in 72 patients with obstructive sleep apnea syndrome (OSAS), and the compliance of these patients with this treatment. In 61 (84.5%) of the 72 patients, the apnea index decreased by more than 50%. The lowest SaO2 and symptom scores also improved significantly. The severity of OSAS was not related to the percent reduction in apnea index. Complications of PMA use were observed in 22 patients (30.6%), but no severe adverse effects were observed. Sixty-two of the 72 patients continued using the PMA throughout the entire study period (overall compliance rate, 86.1%). In addition, the long-term compliance rate (more than 5 years) was 61.5%. We conclude that the effects of PMA in patients with OSAS are clinically significant, that there are no severe complications, and that compliance with treatment is good.

A ramp exercise test was thought to be adequate especially for evaluation of patients with respiratory system diseases. First, we told about the significances, the methods and apparatus, the arrangements for workload and the matters that demand special attentions of this exercise test. Next, various indices which were obtained during ramp exercise and the estimations of them were explained. Furthermore, we referred to the exercise-limiting factors for patients with COPD and pulmonary fibrosis as symmetrical respiratory system diseases.

Human aquaporin 3 (AQP3) gene was isolated, and its structural organization was characterized. The gene appeared to exist as a single copy in the human genome and to comprise six exons distributing over 7 kilobases. The sizes of the exons are 171, 127, 138, 119, 218, and 1035 base pairs, and those of introns are approximately 3530, 300, 350, 330, and 90 base pairs, respectively. The initiation site of transcription was identified to locate 64 base pairs upstream of the first ATG codon by primer extension analysis and ribonuclease protection assay. The 5'-flanking region has a TATA box, two Sp1 sequences, and some consensus sequences including AP2 sites. With luciferase assay, the 5'-flanking region was demonstrated to have a promoter activity, which is up-regulated 4-fold by phorbol ester. These findings about the genomic clone of human AQP3 will contribute to elucidate the molecular mechanism of transcriptional regulation of AQP3.

A 34-year-old housewife presented to a hospital because of dry cough. Her chest radiograph showed bilateral multiple nodular lesions. Smaller but similar lesions had been seen on the chest radiograph 2 years earlier. Because the tissue taken during a trans bronchial biopsy was non-diagnostic, open lung biopsy was done and the diagnosis was pulmonary metastasis of alveolar soft part sarcoma. The primary tumor was found in her left calf by MRI. Malignant tumors are important for differential diagnosis of slow-growing multiple pulmonary nodules, and in some cases MRI is useful for finding the primary site.

A 31-year-old man, asymptomatic but with an abnormal shadow adjacent to the right tracheobronchial angle on chest roentogenogram, presented to our hospital. CT and MRI of the chest revealed this shadow to be a dilated azygos arch. The inferior vena cava was interrupted, at the intrahepatic portion, by the azygos continuation. There was also an abnormality of tracheobronchial branching. The right middle lobe bronchus gave rise to the upper lobe bronchus. The right B7 was absent though the left BX7 was present. The pulmonary arteries passed over the main bronchi bilaterally. Interruption of the inferior vena cava is often associated with significant cardiovascular and abdominal anomalies but only rarely with anomalies of tracheobronchial branching.

To assess the clinical utility of a ramp exercise test in patients with pulmonary diseases, the gas exchange variables from normal volunteers and patients with pulmonary diseases during ramp exercise were compared to those during steady-state exercise. Measurements during ramp exercise could titrate the extent of the patients' maximal exercise as well as the adequate performance of parameters in gas exchange coupling. There were no significant differences in the four variables achieved between the two exercises. These gas exchange variables during ramp exercise made it possible to predict the exercise-limiting factors for patients with COPD and pulmonary fibrosis. Furthermore, a ramp exercise test could be performed safely even in patients with severe lung diseases and required a shorter period than a steady state exercise test. Thus, a ramp exercise test is thought to be useful in the evaluation of patients with pulmonary diseases.

Various crude drugs were examined for their tyrosinase inhibitory activity. Marked activity was observed in Chouji and Yakuchi extracts and the active substances in these extracts were identified as eugenol and yakuchinone A, respectively. Other vanillyl compounds such as ferulic acid, curcumin and yakuchinone B also had higher activities than eugenol or yakuchinone A and inhibited the enzyme competitively. The presence of the hydroxyl group at the 4 position of the aromatic ring of the cinnamoyl moiety and the alpha,beta-unsaturated carbonyl conjugated with an aromatic ring in these substances may play important roles in the competitive inhibition of tyrosinase.

We previously demonstrated disruptions of the pulmonary capillary endothelium and alveolar epithelium at transmural pressures (Ptm) of 52.5 cmH2O in rabbit by electron microscopy. In the present study, we determined the characteristics of the alveolar edema fluid in this condition by carrying out bronchoalveolar lavage after blood perfusion for 10 min at Ptm of 12.5 (low), 32.5 (intermediate), and 52.5 cmH2O (high). At low Ptm, where our previous studies showed no ultrastructural changes, the volume of alveolar fluid obtained by urea dilution was very small, and the concentrations of proteins, cells, and leukotriene B4 (LTB4) in the bronchoalveolar lavage fluid (BALF) were low. However, at high Ptm the volume of alveolar fluid and the concentrations of total protein and cells in the BALF were greatly increased. The amount of LTB4 in the BALF also increased substantially from 6.0 to 49.5 micrograms (P < 0.001). Intermediate changes were seen at intermediate Ptm. We concluded that exposing pulmonary capillaries to high Ptm results in a high-permeability form of edema. In addition, the presence of LTB4 suggests that chemical mediators are released, possibly as the result of exposure of the reactive capillary endothelial basement membrane, as demonstrated by electron microscopy.

To examine whether alteration of 7S collagen in the alveolar basement membrane is related to the condition and prognosis of diffuse interstitial lung diseases (idiopathic interstitial pneumonia: IIP, collagen vascular diseases, sarcoidosis, and hypersensitivity pneumonitis), we measured serum 7S collagen levels in 123 patients with diffuse interstitial lung disease and other lung diseases. Patients with diffuse lung diseases (diffuse interstitial lung disease, pulmonary emphysema, and diffuse panbronchiolitis: DPB) showed significantly higher serum levels of 7S collagen than healthy normal controls. Serum 7S collagen levels in IIP and collagen vascular diseases were significantly higher than those in pulmonary emphysema and DPB. In cases of IIP, serum 7S collagen levels in the active stage were significantly higher than those in the inactive stage. Furthermore, the prognosis of patients with higher serum 7S collagen levels was significantly poorer than those of patients with lower serum 7S collagen levels. In infectious pulmonary diseases, serum 7S collagen levels of patients with adult respiratory distress syndrome (ARDS) were significantly higher than those of patients without ARDS. Autopsy specimens obtained from patients with positive serum 7S collagen showed diffuse alveolar damage and/or diffuse pulmonary hemorrhage in the alveolar areas. Immunohistochemical staining for 7S collagen showed disruption and/or loss of the alveolar basement membrane. The authors conclude that serum level of 7S collagen is useful for estimating the activity of diffuse interstitial lung diseases as an index of the destruction of alveolar structure.

A 38-year-old male with pulmonary emphysema due to severely reduced serum alpha-1-antitrypsin (AAT) level (14.5 mg/dl) was found to have an inherited new AAT deficient variant Siiyama. Chest roentgenogram and CT scanning revealed advanced emphysema, and severe obstructive ventilatory impairment was observed. During the 4-year follow-up period, the annual rate of decline of FEV 1.0 showed approximately 10-fold greater than the normal decline in FEV 1.0 (-380 ml/yr). Treatment with tamoxifen in order to raise the serum AAT level only resulted in an insufficient increase. Augmentation therapy of human AAT should be considered in the future.

Patients with obstructive sleep apnea (OSA) syndrome are known to exhibit nocturnal natriuresis/diuresis. We studied plasma and urinary levels of atrial natriuretic peptide (ANP), a potent natriuretic hormone released from the heart, and plasma antidiuretic hormone (ADH) levels in patients with OSA during awake and sleeping periods, to compare with those of normal subjects. Seven patients with OSA and 6 normal subjects were studied. Arterial blood samples were drawn during the awake and the sleeping period, while in patients with OSA, blood samples were obtained during the apneic period. Urine samples were collected over two 12-hour periods (9 a.m.-9 p.m. and 9 p.m.-9 a.m.) In patients with OSA, plasma ANP as well as urinary ANP excretion increased during the apneic period compared with the awake period. There was a significant negative correlation between plasma levels of ANP and ADH in patients with OSA. On the other hand, normal subjects had no apparent differences in plasma and urinary ANP levels between the two periods. It is suggested that nocturnal increase in ANP and decrease in ADH are responsible for the nocturnal diuresis and natriuresis associated with OSA.

To clarify the precise of cellular immunity mechanism in pulmonary tuberculosis, we investigated the amount of IL-2 in patients with untreated active pulmonary tuberculosis. When serum adenosine deaminase (ADA) activity was examined using enzyme assay, an abnormally high level was observed in all patients (29.0 + 11.6 IU/ml, mean + SD; 4.5-17.8, normal range). Likewise, the level of serum-soluble interleukin-2 receptor (IL-2R) measured by ELISA showed abnormal high level in all patients (844.3 + 584.8 IU/ml; 80-300, normal range). When stimulated using PHA, the peripheral lymphocyte's ability to produce IL-2 revealed no difference between control subjects and patients. It was, however, noted that the lymphocytes of the patients significantly suppressed IL-2 responsiveness when compared to the control subjects (P less than 0.05). The serum IL-2 concentration measured using RIA could not be detected in any of the patients as was the same for control subject. All of the above mentioned results suggest that T-cell activation which caused increment in serum ADA activity and soluble IL-2R occurred in active pulmonary tuberculosis. The suppressed IL-2 responsiveness in the peripheral lymphocytes of patients proposes the possibility of soluble IL-2R reduction by the negative feedback mechanism in IL-2-sensitive lymphocytes.

Diffuse panbronchiolitis in two brothers is reported. The elder brother aged 46, was admitted in May 1983 due to severe dyspnea and productive cough, which had gradually worsened over several years. He had severe hypoxemia and hypercapnia. He died at age 47 of respiratory failure due to pseudomonas infection despite antibiotic therapy. The younger brother, at age 41, was admitted in March 1983 due to fever, productive cough, and abnormal shadows on chest X-ray films. He showed mild hypoxemia and his symptoms improved with antibiotic treatment. Since then he has been followed as an outpatient for over 7 years while taking 400 mg of Erythromycin per day, and he has had no exacerbation. These two cases had different clinical courses despite the facts that both had similar conditions of chronic sinusitis and appeared to be exposed to no special environmental or occupational hazards. These facts suggest that not only intrinsic factors, such as defenselessness of airways, but extrinsic factors such as viral, mycoplasmal, or bacterial infection may act together on the mechanisms of the onset and progression of diffuse panbronchiolitis.

A 56-year-old man was admitted with hemiparesis and shortness of breath. He was positive to human immunodeficiency virus (HIV) antibody and was diagnosed as acquired immunodeficiency syndrome (AIDS) with Kaposi's sarcoma and pneumocystis carinii pneumonia. He developed chronic photosensitivity and vitiligo preceding the onset of the AIDS-related complex (ARC). Association of the two skin lesions with HIV infection is very rare. Although the role of HIV infection in these skin lesions is not significant, the immunological responses in the early course of HIV infection may have contributed to the development of both of these skin lesions.

The purpose of this study was to evaluate the usefulness of ratings of perceived exertion (RPE) as an indicator of exercise intensity in patients with chronic obstructive pulmonary disease (COPD). The subjects were ten male patients with COPD, whose mean forced expiratory volume in 1 s was 1.09 1, SD 0.41, and ten healthy middle-aged men. Ramp incremental exercise on a cycle-ergometer was performed and RPE was determined by the Borg 15-point scale. The absolute oxygen uptake at each RPE was significantly greater in the healthy subjects than in the patients with COPD. However, oxygen uptake calculated as a percentage of maximal at any RPE did not differ significantly between the two groups. Arterial blood lactate concentration at points 15 to 19 on the RPE scale was increased in healthy subjects (P less than 0.05-P less than 0.001), while the dyspnoea index at points 11 to 19 on the RPE scale was higher in patients with COPD (P less than 0.05-P less than 0.001). The main complaints on stopping exercise were dyspnoea in the patients with COPD and fatigue in the healthy subjects. Although the nature of RPE may have been different in the two groups, RPE could be a possible indicator of exercise intensity when physicians prescribe exercise to patients with COPD.

The relationship of ventilation response (VE) to arterial potassium concentration (K+) during ramp incremental exercise was assessed in nine patients with chronic obstructive pulmonary disease (COPD), and in 10 healthy subjects. For COPD patients the maximum oxygen uptake (VOmax) was 19.6 +/- 3.8 ml kg-1 min-1 (+/- SD), and percentage of forced expired volume at 1 s (% FEV1) was 47.8 +/- 10.4%. In healthy subjects, VO2max was 44.4 +/- 7.0 ml kg-1 min-1 and FEV1 was 89.7 +/- 7.4%. Breath-by-breath determinations for VE, oxygen uptake (VO2) and carbon dioxide output (VCO2), as well as determinations for K+, partial pressure of oxygen (PO2), partial pressure of carbon dioxide (PCO2), pH and lactate in arterial blood were performed during a workout on an exercise bicycle at a ramp function work rate of 20 W min-1, preceded by a 40 min warm-up period. The major findings in the present study are: (1) that there is a linear relation between ventilation and arterial K+ concentration during ramp exercise in both healthy subjects and COPD patients; (2) that the slope of the VE-K+ relationship is significantly lower in COPD patients (16.2 +/- 7.3 l min-1 mM-1) than in normal subjects (37.4 +/- 6.9 l min-1 mM-1, P less than 0.01); and, (3) that the slope of the VE-K+ relationship is significantly related to the ability to ventilate during maximal exercise in both healthy subjects and COPD patients (P less than 0.05). It is thought that the significantly reduced slope of the VE-K+ relationship in the COPD patients could be interpreted as a reduced sensitivity to the stimulus and/or as a mechanical impairment of the ventilation.

The present study was designed to evaluate the specificity of physiological adaptation to extra endurance training in five female competitive walkers and six female distance runners. The mean velocity (v) during training, corresponding to 4 mM blood lactate [onset of blood lactate accumulation (OBLA)] during treadmill incremental exercise (training v was 2.86 m.s-1, SD 0.21 in walkers and 4.02 m.s-1, SD 0.11 in runners) was added to their normal training programme and was performed for 20 min, 6 days a week for 8 weeks, and was called extra training. An additional six female distance runners performed only their normal training programme every day for about 120 min at an exercise intensity equivalent to their lactate threshold (LT) (i.e. a running v of about 3.33 m.s-1). After the extra training, there were statistically significant increases in blood lactate variables (i.e. oxygen uptake (VO2) at LT, v at LT, VO2 at OBLA, v at OBLA; P less than 0.05), and running v for 3,000 m (P less than 0.01) in the running training group. In the walking training group, there were significant increases in blood lactate variables (i.e., v at LT, v at OBLA; P less than 0.05), and walking economy. In contrast, there were no significant changes in lactate variables, running v and economy in the group of runners which carried out only the normal training programme. It is suggested that the changes in blood lactate variables such as LT and OBLA played a role in improving v of both the distance runners and the competitive walkers.(ABSTRACT TRUNCATED AT 250 WORDS)

To assess the most important determinant for successful distance running (800 m, 1500 m and 3000 m events) in female athletes, measurements of several anaerobic indices were made (peak power, mean power) using the Wingate anaerobic test (WAnT), and aerobic indices such as oxygen uptake (VO2) or running velocity (v) at lactate threshold (LT), VO2 or v at onset of blood lactate accumulation (OBLA), running economy (RE), and maximal oxygen uptake were determined using the incremental treadmill test. The RE was represented by a VO2 value measured at 240 m.min-1 of a standard treadmill velocity. A stepwise multiple regression analysis (SAS stepwise procedure) combined the best features of forward inclusion and backward elimination to determine the most important factors in predicting the performance of running these distances as dependent variables. The stepwise procedure showed that the blood lactate variables such as LT and/or OBLA are highly correlated with, and contributed to predicting performance running 800 m-3000 m, whereas the anaerobic component was related only to running 800 m. In conclusion, blood lactate variables account for a large part of the variation in distance running performance in female as in male runners. The component of the anaerobic system which can be measured by the WAnT was shown to contribute to performance in running 800 m, but not in longer distances.

The purpose of this study was to compare the relationship of ventilation (VE) with pH, arterial concentrations of potassium [( K+]a), bicarbonate [( HCO3-]a), lactate [( la]a), and acid-base parameters which would affect hyperpnoea during exercise and recovery. To assess this relationship, ten healthy male subjects exercised with intensity increasing as a ramp function of 20 W.min-1 until voluntary exhaustion and they were then allowed a 5-min recovery period. Breath-by-breath gas exchange data, [HCO3-]a, pH, [la]a, [K+]a and blood gases were determined during both exercise and recovery. Using a linear regression method, the VE/[K+]a relationship was analysed during both exercise and recovery. Several interesting results were obtained: a significant relationship between [K+]a and VE was observed during recovery as well as during exercise; the VE at any given values of [K+]a was significantly higher during recovery than during exercise and out of those factors affecting exercise hyperpnoea, only [K+]a had a similar time-course to VE during recovery. Changes in [K+]a during recovery were shown to occur significantly faster than VE with an [K+]a time constant of 70.0 s, SD 16.2 as opposed to 105.5 s, SD 10.0 for VE (P less than 0.01). These results provided further evidence that [K+]a might play an important role as a substance which can stimulate exercise hyperpnoea as has been suggested by other workers. The present study also showed that during recovery [K+]a contributed significantly to the control of VE.

The relationships among four descriptors of lactate increase: lactate threshold (LT) (the VO2 at which blood lactate concentration begins to increase above the resting level during an incremental exercise test), LT1 (the VO2 at which blood lactate increases 1 mM above the resting level), LT2 (the VO2 at which blood lactate concentration reaches a fixed value of 2 mM), onset of blood lactate accumulation (OBLA; the VO2 at which blood lactate reaches a concentration of 4 mM), were compared with aerobic capacity (VO2max) and 12 min running performance in 19 untrained female students. The VO2 (+/- SD) of LT, LT1, LT2, OBLA, and VO2max were 14.5 +/- 3.7 ml X kg-1 X min-1, 22.5 +/- 4.3 ml X kg-1 X min-1, 22.2 +/- 4.5 ml X kg-1 X min-1, 30.3 +/- 5.2 ml X kg-1 X min-1 and 36.0 +/- 5.1 ml X kg-1 X min-1, respectively. The mean (+/- SD) distance covered in the 12 min running was 2356 +/- 160 m. The results were as follows: 1) the lactate parameters (i.e. LT, LT1, LT2, and OBLA) were highly correlated with each other. 2) all the lactate parameters were related to VO2max and endurance running performance with a high correlation coefficient. Of the four descriptors of lactate change with exercise, LT correlated best with VO2max and endurance running performance compared to LT1, LT2 and OBLA. It is concluded that lactate threshold is the best index for aerobic capacity and endurance running performance.

Relations between intensities of electrical noxious stimulus applied to the tooth pulp and magnitudes of evoked responses at various relay stations of tooth pulp afferents were investigated with lightly anesthetized rats. The stimulus-response function in each relay station and the cerebral cortex follows the power function only in the range of lower, but noxious, stimulus intensities; however, it deviates from it in the range of higher ones, the exponent of the function becoming smaller. The higher the relay station locates, the smaller the exponent value is.

The effects of electroacupuncture (EA) on the rat jaw-opening reflex elicited by tooth pulp stimulation were studied to decide the effective stimulus conditions for electroacupuncture stimulation (EAS). The present study revealed that one of the most important factors for producing a strong EA effect was the stimulus pulse-frequency and that the stimulus pulse-duration was not an essential factor for this effect. In the rat, the following stimulus conditions were very useful for the quantitative study of the EA effect. (1) Stimulation time is 15 min. (2) Stimulus pulse-frequency is 30 to 150 Hz. (3) Stimulus pulse-duration is 0.1 to 5 ms. When the EAS was applied to the Ho-Ku point under these conditions, the degree of the suppression of the jaw-opening reflex was about 50% of the control.