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To test the hypothesis that the hyperthermia-induced ventilatory response relates to aerobic power and/or the cutaneous vasodilatory response during exercise, we asked 18 subjects to perform 3 kinds of exercise: an incremental exercise to determine peak oxygen consumption (V(O)(2peak)), a steady state exercise at 50% of V(O)(2peak) to determine the ventilatory response to increasing body temperature, and a steady state exercise at 60% of V(O)(2peak) to determine the cutaneous vasodilatory response to increasing body temperature. The ventilatory and cutaneous vasodilatory responses were evaluated by plotting the increase in minute ventilation or in forearm vascular conductance against the increase in oesophageal temperature. Regression analysis revealed that: (1) there was a negative relationship between the hyperthermic ventilatory response and cutaneous vasodilatory response, (2) there was a negative relationship between the hyperthermic ventilatory response and V(O)(2peak), and (3) there was a positive relationship between the cutaneous vasodilatory response and V(O)(2peak). These results support our hypothesis and suggest that exercise training suppresses the hyperthermic ventilatory response and improves the thermoregulatory response.

The aim of this study was to retrospectively evaluate the long-term results of transcatheter arterial chemoembolization (TACE) for the treatment of local recurrence of hepatocellular carcinoma (HCC) after the first TACE. Between September 1992 and October 2004, 85 recurrent HCC nodules of 35 patients were treated by TACE. During the median follow-up period of 15.5 months (range 1.9-58.6 months), 58 of the 85 treated tumors developed local recurrence again after the second TACE. The overall 6-, 12-, and 36-month recurrence-free rates of these tumors after the second TACE were 47.0%, 36.2%, and 25.8%, respectively. Local recurrence of HCC after the first TACE was treated by a second TACE with equivalent efficacy as that of the initial TACE, if segmental chemoembolization was achieved. We regard TACE as the treatment of choice for the management of local recurrence of HCC.

Purpose: To establish the protective efficacy against late complications of electron therapy using customized lead eye shields in cases with orbital and periorbital lesions., Methods: Between 1982 and 2006, 16 patients with 22 orbital and periorbital lesions were treated by electron therapy. Customized lead eye shields were prepared and placed in the respective patients' eyes during each fraction of electron therapy. The toxicity and local control rates were analyzed., Results: The preparation period for the customized lead eye shields was 2 days. The shields could be used throughout the treatment period in all the patients. No evidence of radiation cataract was observed in 15 of the 16 patients. None of the patients developed corneal ulceration or evidence of lead poisoning., Conclusion: Customized lead eye shields could be made relatively quickly, and electron therapy for orbital and periorbital lesions could be undertaken safely without any late complication., (2008 S. Karger AG, Basel.)

Purpose: The authors analyzed the correlation between radiotherapy doses at reference points on the uterine edge and the rectal wall and both pelvic control and late rectal complications of cervical cancer therapy., Methods and Materials: Between 1997 and 2005, 57 patients with Stages IB-IVA cancer of uterine cervix were treated with a combination of external beam radiotherapy and high-dose-rate intracavitary brachytherapy. Their high-dose-rate intracavitary brachytherapy was planned by dose-point optimization at six dose points located on the edge of uterus by computed tomography. A rectal reference point located on the anterior wall of the rectum by computed tomography was also used. The pelvic control rate and the rate of late rectal complications were calculated according to the biologically effective dose (BED) at each point and several clinical parameters., Results: The overall 3-year pelvic control rate was 69.4%. The patients with a BED >80 Gy10 at the point on the edge of the uterine cervix had better pelvic control (78.4% at 3 years) than the patients with a BED < or =80 Gy10 (54.4% at 3 years), and the difference was significant. The difference in the BED (Gy3) at the rectal reference point between the patients with Grade 0-1 late rectal complications (median, 114 Gy) and the patients who developed Grade > or =2 late rectal complications (median, 178 Gy) was significant. Chemotherapy was a borderline significant parameter in regard to correlation with pelvic control and late rectal complications, but there were no correlations with other dosimetric or clinical parameters., Conclusions: The radiotherapy dose at the reference point on the edge of the cervix affected pelvic control more than the clinical parameters, and the dose at the rectal reference point was more strongly correlated with the occurrence of late rectal complications.

Purpose: To elucidate the local therapeutic results of computed tomography (CT)-guided transcatheter arterial chemoembolization (TACE) as initial treatment for hepatocellular carcinoma (HCC), and to verify factors which affect local therapeutic results., Methods: From 1992 to 2002, 265 tumors of 79 HCC patients were treated by 139 sessions of CT-guided TACE as initial treatment. Among these 265 tumors, 182 constituted multiple new lesions, and the remaining 83 tumors were single new lesions. Local recurrence was retrospectively ascertained on follow-up CT images obtained after TACE., Results: The overall local recurrence-free rates (LR-FRs) after a single TACE session at 6, 12, and 36 months were 67%, 49%, and 28%; those of the single new lesions were 80%, 66%, and 32%; and those of tumors with complete lipiodol accumulation were 82%, 68%, and 41%, respectively. LR-FRs of tumors of the single new lesions, and those of tumors with complete lipiodol accumulation, were significantly higher than the LR-FRs of multiple new lesions and tumors with incomplete lipiodol accumulation, respectively. For single new lesions < or =4 cm and the tumors that were one of multiple new lesions, there were no significant differences in the LR-FRs regarding the number of TACE sessions on the basis of patient, tumor location, or tumor size., Conclusion: Local therapeutic results of single new lesions were better than those of multiple new lesions, and the local therapeutic effect of TACE was not affected by the number of treatments on the basis of patient, tumor location, or tumor size.

We compared the growth rate of locally recurrent hepatocellular carcinoma (HCC) with that of primary HCC. After the first treatment by transcatheter arterial chemoembolization (TACE), 60 locally recurrent HCC nodules were reviewed. The tumor volume doubling time (DT) of locally recurrent HCC was significantly shorter than that of primary HCC. The 95% lower threshold value was 17.7 days. The 6-, 12-, and 36-month recurrence-free rates of the tumors having DTs more than 70 days after the second TACE (77.7%, 53.8%, and 40.4%) were significantly higher than those of the tumors having DTs less than 70 days (26.7%, 26.7%, and 17.8%). Locally recurrent HCCs cannot double in diameter in less than 53 days. In the case that an equivocal lesion smaller than the section collimation depicted during a contrast-enhanced computed tomography (CECT) screening cannot be ruled out as local recurrence, the next CECT screening should be performed 2 months later.

The purpose of this study was to determine whether the metabolic response and running performance during intermittent graded sprint running were affected by moderate hypobaric hypoxia (H; 2,500 m above sea level) in competitive middle-distance runners. Nine male runners performed intermittent graded sprint running until exhaustion, to evaluate the metabolic response and running performance in H and normobaric normoxia (N). The test constructed of incremental (25 m min(-1)) 20 s running bouts (4 degrees inclination) interspaced with 100 s recovery periods. Maximal running speed was not different between conditions [453 (7) m min(-1) vs. 458 (4) m min(-1) in N vs. H]. V(O2) at each speed was lower in H than N (ANOVA; P < 0.05). Although, oxygen deficit (D(O2)) at each speed was not different between N and H (ANOVA; P = 0.1), total accumulated D(O2) in all bouts was significantly higher in H than N [165 (10) ml kg(-1) in N and 173 (10) ml kg(-1) in H]. The ratio of D(O2).V(O2)(-1) was similar in all bouts, but higher in H than N. These results suggest that intermittent graded sprint running performance is not affected by moderate hypobaria despite a reduction in the energy supplied by aerobic metabolism due to a compensatory increase in the energy supplied by the anaerobic metabolism in competitive middle-distance runners.

We investigated the effects of brief leg cooling after moderate exercise on the cardiorespiratory responses to subsequent exercise in the heat. Following 40 min of ergometer cycling [65% peak oxygen uptake (VO(2peak))] at 35 degrees C (Ex. 1), seven male subjects [21.9 (1.1) years of age; 170.9 (1.9) cm height; 66.0 (2.0) kg body mass; 46.7 (2.0) ml kg(-1) min(-1) VO(2peak)] immersed their legs in 35 degrees C (control condition, CONT) or 20 degrees C (cooling condition, COOL) water for 5 min and then repeated the cycling (as before, but for 10 min) (Ex. 2). Just before Ex. 2, esophageal temperature ( T(es)) was lower in COOL than in CONT [36.9 (0.2) vs 37.5 (0.1) degrees C] ( P<0.01), as also were both mean skin temperature [33.9 (0.2) vs 35.2 (0.2) degrees C] ( P<0.01), and heart rate (HR) [93.2 (6.0) vs 102.7 (4.9) beats min(-1)] ( P<0.05). During Ex. 2, no differences between CONT and COOL were observed in oxygen uptake, arterial blood pressure, blood lactate concentration, or ratings of perceived exertion; however, T(es), skin temperature, and HR were lower in COOL than in CONT. Further, during the first 5 min of Ex. 2, minute ventilation was significantly lower in COOL than in CONT [50.3 (2.0) vs 53.4 (2.6) l min(-1)] ( P<0.01). These results suggest that brief leg cooling during the recovery period may be effective at reducing thermal and cardiorespiratory strain during subsequent exercise in the heat.