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We hypothesized that social jetlag would be associated with prolonged sleep duration on weekends and irregularities in wake-up time and/or bedtime on weekdays. In total, 1,200 Japanese male college students were included in this study. Participants completed an eight-day sleep diary in which they recorded their wake-up time, bedtime, and sleep duration every day for a week. Mean wake-up time, bedtime, and sleep duration, standard deviations in wake-up time and bedtime, the coefficient of variation in sleep duration, social jetlag, and chronotype were calculated over seven nights. Multiple regression was used to explore the factors influencing social jetlag. Stepwise selection analysis was performed to analyze the parameters identified on multiple regression analysis. The mean chronotype of the included participants was 5.3 ± 1.5; their mean social jetlag value was 1.1 ± 1.0. The mean wake-up time, bedtime, and sleep duration values were 8.5 ± 1.1, 25.0 ± 1.1, and 7.5 ± 1.1 h, respectively. Multiple regression analysis showed five indicators exerting a statistically significant influence on social jetlag. The standard deviation in wake-up time was adopted as the first factor in the stepwise selection analysis. These results show that social jetlag is associated with not only prolonged sleep duration on weekends but also irregularities in wake-up time during the week.

Background: In recent years, objective quantitative evaluations have become particularly important. Both qualitative and quantitative evaluations are also available for edema. It is thought that the technical problem of quantitative evaluation can be solved by using a simple and reproducible method. Several studies have evaluated various methods for measuring edema. Limitations, such as weaknesses, measurement complexity, and errors, have been identified. Therefore, this study aimed to consider a simple and effective measurement method for the quantitative evaluation of edema. Methods: This study was a prospective, observational study. The subjects were 15 healthy adults (2 male and 13 female). Measurements were performed on the subjects’ right lower leg once in the morning and once in the afternoon, with a minimum interval of 4 hours. Results: The actual volume of the lower leg was correlated with all indices except the ultrasonic echo findings for subcutaneous tissue. The intra-subject and inter-subject reliabilities for the indices using digital images were very high. The lower leg volume was greater significantly in the afternoon from the morning. Conclusion: The leg circumference was measured by utilizing a tape, while the width and volume were measured by utilizing digital imaging suitable for quantitatively evaluating edema. Furthermore, swelling of the lower leg with time can occur in the absence of daily exercise.

Clear cell meningioma is a rare histological variant of meningioma, which often recurs aggressively. This video demonstrates a patient with a petroclival clear cell meningioma, which was resected completely through the anterior transpetrosal approach. The absence of intratumoral spotty signal voids on preoperative susceptibility-weighted imaging (SWI) suggested that the tumor was a meningioma rather than a schwannoma, although typical imaging features of meningioma were not observed. After surgery, the patient’s preoperative hearing disturbance improved from class D to class A, which the authors had sometimes experienced in cerebellopontine angle meningioma surgeries. Careful observation over a 2.5-year period revealed no tumor recurrence, without additional treatment. The video can be found here: https://stream.cadmore.media/r10.3171/2022.1.FOCVID21219

Background During voluntary muscle contraction, sensory information induced by electrostimulation of the nerves supplying the contracting muscle is inhibited and the somatosensory evoked potentials (SEPs) amplitude decreases. This depression of sensory input during voluntary muscle contraction has been demonstrated by many studies using electrophysiological methods. However, the association between the electrophysiological response of the sensory system during sustained muscle contraction and subjective peripheral sensation (SPS) is still unclear. The aim of this study was to investigate changes in spinal excitability, SEPs, and SPS during voluntary muscle contraction. Results The appearance rate of the F-wave was significantly higher during muscle contraction than rest, whereas no significant difference was observed in F-wave latency between muscle contraction and rest. Furthermore, the P25 amplitude of SEPs was significantly lower during muscle contraction than rest, whereas the N20 amplitude of SEPs exhibited no significant differences. The SPS was significantly lower during muscle contraction than rest Conclusions We conclude that sensory gating, which is found in the P25 component of SEPs during muscle contraction, is one of the neurophysiological mechanisms underlying the suppression of SPS.

Tirabrutinib (TIR), a Burton’s tyrosine kinase inhibitory drug, has been approved in Japan for treating relapsed/refractory primary central nervous system lymphoma (PCNSL). The authors recently encountered three patients with newly diagnosed refractory PCNSL using TIR. Three patients, 48, 78 and 88 years-old males, diagnosed with PCNSL by histologically verification were firstly treated with high dose Methotrexate based chemotherapy (HD-MTX) and/or radiotherapy, however these cases were refractory for these standard treatments, demonstrated early cerebrospinal fluid dissemination or accompanied with severe adverse event. The authors decided to administrate TIR to these patients with a full informed consent. TIR demonstrated dramatic reduction of the volume of tumor on MRI within one month after administration of TIR, and improved the patient’s performance status. However, one case demonstrated liver dysfunction and multiple brain abscess due to aspergillus infection, and one case demonstrated early progression of the tumor 49 days after starting TIR. Administration of TIR for the patients with newly diagnosed refractory PCNSL demonstrated a rapid and dramatic clinical response, and presented with several clinical implications for this complicated condition.

Background and Aims Colorectal neoplasms with submucosal fibrosis are the most challenging targets of endoscopic resection. Water pressure endoscopic submucosal dissection (WP-ESD) is a recently introduced procedure that has several advantages over conventional endoscopic submucosal dissection (C-ESD). This study aimed to assess the efficacy and safety of WP-ESD for fibrotic colorectal neoplasms. Methods This retrospective observational study investigated 133 colorectal neoplasms expected to have submucosal fibrosis that were resected by WP-ESD or C-ESD between April 2012 and April 2020. Eighty-seven lesions after endoscopic or surgical treatment, 18 with biopsy scar with fold convergence and 28 in patients with ulcerative colitis, were included. The differences in treatment outcomes, including procedure time and adverse event proportions, between the WP-ESD and C-ESD groups were analyzed. The clinical course after perforation using WP-ESD was also evaluated, including postprocedural multidetector CT findings obtained immediately after WP-ESD. Results Severe submucosal fibrosis was observed in 96 lesions (72.2%). The median procedure time was significantly shorter in the WP-ESD group than in the C-ESD group (43.5 minutes [interquartile range {IQR}, 32.8-73] vs 72 minutes [IQR, 45-105]; P = .0041). The multivariate analysis revealed WP-ESD as an independent factor for a short procedure time (odds ratio, 2.90; 95% confidence interval, 1.28-6.55). The proportions of post-ESD electrocoagulation syndrome (11.6% vs 13.1%) and perforation (20.4% vs 22.8%) were similar between the groups. Four of 11 patients with perforation who underwent WP-ESD showed fluid collection on postprocedural multidetector CT images. Conclusions WP-ESD can shorten procedure time for treating fibrotic colorectal neoplasms.

The purpose of this study was to clarify the effect one-sided skeletal muscle contraction has on the circulatory system, spinal α-motoneuron excitability, and somatosensory-system-evoked potential. Nine healthy males maintained tension at 10, 20, and 30% of maximal voluntary contraction in static gripping in right hand. Heart rate, ln high frequency (HF), blood pressure (BP), F-wave, and somatosensory-evoked potential (SEP) were recorded during gripping task. BP, F-wave and SEP were recorded from left hand (contralateral side from contracting side). There were significant main effects of contractions strength on heart rate (0%: 68.2 ± 6.8 bpm, 10%: 67.6 ± 7.4 bpm, 20%: 69.7 ± 8.5 bpm, 30%: 73.7 ± 9.3 bpm, F3.24=9.18, P

In the present study, a tandem-bicycle ergometer was developed, because it is believed that such an ergometer can be used to eliminate differences in signaling between single- and tandem-exercise in cardiorespiratory responses, and is able to quantify interdependence in one load. It is necessary to verify whether cardiorespiratory responses to submaximal exercise are the same between single and tandem-bicycle ergometers. Accordingly, we compared cardiorespiratory variables during exercise in three conditions: 1) with a general bicycle single saddle using a general bicycle ergometer, 2) with a tandem bicycle front saddle using a tandem ergometer, and 3) with a tandem bicycle rear saddle using a tandem ergometer. Eleven healthy males participated in this study. The subjects exercised for 15 min at three intensities (1.5, 2.0 and 2.5 kp) in each condition. The pedaling rate was constantly kept at 60 rpm. Heart rate (HR), oxygen uptake (VO2), and the rating of perceived exertion (RPE) were measured during the last minute of each intensity. There were no significant differences in the variables HR, VO2, and RPE at each load among the three conditions. The ranges of coefficient of variation (CV) values were 3.0 - 4.8%: HR and 4.2 - 5.1%: VO2. It was reported that between-day CV for HR and VO2 during treadmill running was 1.0 - 10.7% and 1.9 - 11.6%. Given these CV values of present and previous studies, it can be seen that physiological response is stable during developed tandem-bicycle ergometer exercise. These results suggest that cardiorespiratory responses to exercise are at comparable levels between a normal bicycle ergometer and the newly developed tandem-bicycle ergometer.

Water exercise is particularly important for lifestyle disease prevention and long-term care prevention, and is prevalent among the middle-aged and elderly population. During water immersion, buoyancy acts on the immersed body and the influence of gravity is reduced. In addition, cardiovascular responses, caused by blood shifts from the abdomen and legs to the thoracic region, occur due to water pressure, unlike in the case of land exercise. Resting water immersion at thermoneutral conditions (about 34°C water temperature) induces an increase in stroke volume, a reduction in heart rate, an increase in cardiac output, and a reduction of total peripheral vascular resistance, unlike resting on land. During water exercise and the recovery phase of water exercise, there are similar cardiovascular responses due to changes in blood flow. The water temperature and water level cause changes in these basic responses. It has been confirmed that water exercise does not lead to excessive responses in blood pressure, and is effective in cardiovascular rehabilitation. In addition, water immersion during the recovery phase after exercise has attracted attention as a rehabilitative exercise modality. Previous studies have suggested that the effects of immersion on cardiovascular response in the rest, exercise, and recovery phases provide benefits to the immersed person, but further studies are needed to confirm the effective application of the methods.

Objectives: There are several recommendations on the prevention of hypothermia during snow shoveling. However, there seemed to be insufficient evidence supporting these recommendations because they are not based on data from actual snow shoveling research. The purpose of this study was to investigate changes in brain temperature (tympanic temperature) and visceral temperature (rectal temperature) during snow shoveling among healthy young males. Methods: Eight healthy young males (age, 23.6 ± 2.4 years; weight, 69.7 ± 6.1 kg; height, 172.8 ± 7.3 cm) performed snow shoveling with an ordinary-size shovel for 15 min at their own pace in a rural snowfall area in December, 2009. Rectal temperature (Tre) and tympanic temperature (Tty) were measured 5 times (at rest, 5th (Ex5), 10th (Ex10), and 15th (Ex15) minute of snow shoveling; and 5th (Rec5) minute of recovery phase). The room temperature was 18.6 ± 0.7°C and the atmospheric temperature was 3.8 ± 2.6°C. Results: Tre continued to increase from at rest to Ex15. Tre at Ex15 (37.7 ± 0.3°C) was significantly higher (p < 0.05) than that at rest (37.2 ± 0.3°C). Tty at rest (36.7 ± 0.2°C) and Tty at Ex5 (36.6 ± 0.3°C) decreased significantly (p < 0.05) at Ex10 (36.2 ± 0.6°C). A significant negative correlation between changes in Tre and Tty were observed during snow shoveling (r = -0.49, p < 0.05). Conclusion: Discrepancy between changes in brain temperature (tympanic temperature) and visceral temperature (rectal temperature) should be taken into consideration in the prevention of disease development during snow shoveling in a cold environment.

The present study was performed to test the hypothesis that the blood pressure (BP) response to resistance exercise in middle-aged men with stiffening arteries is greater than that in young men with compliant arteries. The BP responses to acute dynamic resistance exercise (leg press) at individual relative (low, moderate and high) and absolute intensities were investigated in both young and middle-aged men. A total of 21 sedentary healthy normotensive men, 21-25 years of age (young) and 41-59 years of age (middle-aged), were included in the study. At rest, the arterial compliance (simultaneous ultrasound and applanation tonometry) and muscle strength (leg press) were lower, and indices of arterial stiffness and BP were higher in the middle-aged men than in the young men (p < 0.05). There were no significant differences in height, body mass, or heart rate between the two groups. During exercise, the systolic BP of the middle-aged men at 80% one-repetition maximum (1RM) was significantly lower than that of the young men for the last half of the exercise period (p < 0.05). The amounts of change in systolic and diastolic BP from baseline to the end of resistance exercise were lower in the middle-aged men than in the young men at individual relative intensities (p < 0.05) and at individual absolute intensity. In contrast to our hypothesis, these findings indicated that the BP response during dynamic resistance exercise using large muscle groups may be attenuated in middle-aged men relative to young men.

This study examined the effects of low-intensity morning exercise (ME) on physiological response during unsteady workload evening exercise. Nine healthy men participated in the following 2 experimental conditions: 15 minutes of bicycle exercise at 40% maximum oxygen consumption (V[Combining Dot Above]O2max) in the morning (the ME condition) and rest (control [C] condition). Heart rate (HR), blood pressure (BP), temperature, oxygen uptake, and natural logarithm of high frequency, an index of cardiac parasympathetic modulation, were measured before evening exercises, which were performed for 32 minutes in 2 parts: The steady-state exercise test included three 4-min bouts of exercise at 20, 60, and 40% V[Combining Dot Above]O2max. The unsteady exercise test consisted of 4-min bouts of exercise with gradual increases and decreases in workload at 20 and 60% V[Combining Dot Above]O2max. Heart rate, BP, and oxygen uptake were measured in both experiments. Maximal and minimal values, amplitude, and phase lags were measured with each cycle of unsteady workload exercise. With steady-state exercise, HR and systolic BP at 60 and 40% V[Combining Dot Above]O2max were significantly lower in the ME condition than in the C condition. However, oxygen uptake was not significantly different between the 2 conditions. With unsteady exercise, the HR and oxygen uptake phase lags were significantly shorter and the amplitude of oxygen intake was significantly larger in the ME condition than in the C condition. There were no significant differences in physiological parameters between the conditions at rest or during recovery. The physiological response during evening exercise is enhanced by low-intensity ME, which might be an effective conditioning method on a sporting event day.

The importance of physical activity in the development and maintenance of bone mineral density (BMD) is widely accepted. However, the effects on cortical BMD have not been clarified in detail. The present study examined bilateral asymmetries in cortical BMD of the tibia using peripheral quantitative computed tomography. Subjects comprised 37 young male athletes and 57 controls (age range, 18-28 years). BMD and geometrical indices were determined in bilateral tibiae. Cortical and trabecular BMD were calculated at the diaphysis and distal metaphysis, respectively. Cortical width, periosteal cross-sectional area, and cross-sectional moment of inertia were calculated using tomographic data of the tibial diaphysis. In athletes, the non-dominant leg showed greater cortical BMD than the dominant leg (mean difference, 5.42%; P < 0.0001). Cortical width and moment of inertia were also greater in the non-dominant leg. Periosteal area displayed no significant difference between legs. The control group exhibited similar results except for cortical BMD. No differences in trabecular BMD were noted between legs in either athletes or controls. These results implies the existence of mechanisms for the mechanical adaptation of cortical BMD. Dominant leg is used for mobility or manipulation whereas the non-dominant leg contributes to support the actions of the dominant leg. Loading differences in bilateral legs in young athletes might affect the remodeling rate leading to the side-to-side differences in cortical BMD.

Aim: Fluctuations in autonomic nervous functions throughout the menstrual cycle and the underlying mechanism concerning them are not well known. This study was designed to test the hypothesis that fluctuations in cardiovagal baroreflex sensitivity (BRS) throughout the menstrual cycles of young women are due to fluctuations in carotid arterial distensibility. Methods: In eight eumenorrhoeic healthy young women (18–24 years), we determined the variations in the carotid arterial distensibility coefficient (DC; via simultaneous ultrasonography and applanation tonometry), cardiovagal BRS (phase IV of the Valsalva manoeuvre and the sequence method; up- or down-sequence spontaneous BRS), and serum oestradiol and progesterone concentrations at five points in the menstrual cycle (menstrual = M, follicular = F, ovulatory = O, early luteal = EL, and late luteal = LL). Results: Serum oestradiol and progesterone levels were consistent with the predicted cycle phases. Carotid arterial DC fluctuated cyclically, increasing significantly from the M (52.4 ± 4.9 × 10−3 kPa−1, mean ± SE) and F (52.7 ± 4.4) phases to the O (57.6 ± 4.4) phase and declining sharply in the EL (46.0 ± 4.0) and LL (45.1 ± 3.0) phases (F = 6.37, P

The purpose of this study was to determine the effects of water temperature on rectal temperature and oxygen uptake during supine floating. Eight healthy males volunteered for this study. This study was performed in a supine position at rest on land and in three water conditions (25, 30 and 35 degrees Celsius). All experiments were performed for 35 minutes. Water conditions of immersion at 25 degrees Celsius resulted in a decrease in rectal temperature and an increase in oxygen uptake. The changes in rectal temperature differed among individuals. A significant correlation was observed between changes in rectal temperature and % body fat. However, the changes in rectal temperature were affected by other factors. These data suggest that the changes in rectal temperature during immersion at 25 degrees Celsius could be affected by other factors elaborated in this paper.

The cross-sectional area (CSA) of large-conductance arteries increases in response to endurance training in humans. To determine whether training-induced changes in arterial structure are systemic in nature or, rather, are confined to the arteries supplying exercising muscles, we studied 10 young men who performed one-legged cycle training [80% of one-legged peak O2 uptake (V˙o 2 peak), 40 min/day, 4 days/wk] for 6 wk and detraining for another 6 wk. There were no significant differences in baseline one-leggedV˙o 2 peak and CSA of the common femoral artery and vein (via B-mode ultrasound) between experimental and control legs. In the experimental leg, one-leggedV˙o 2 peak increased 16% [from 3.0 ± 0.1 to 3.4 ± 0.1 (SE) l/min], arterial CSA increased 16% (from 84 ± 3 to 97 ± 5 mm2), and venous CSA increased 46% (from 56 ± 5 to 82 ± 5 mm2) after endurance training. These changes returned to baseline during detraining. There were no changes in one-leggedV˙o 2 peak and arterial CSA in the control leg, whereas femoral venous CSA in the control leg significantly increased 24% (from 54 ± 5 to 67 ± 4 mm2) during training. Changes in femoral arterial and venous CSA in the experimental leg were positively and significantly related to corresponding changes in one-leggedV˙o 2 peak ( r = 0.86 and 0.76, respectively), whereas there were no such relations in the control leg ( r = 0.10 and 0.17). When stepwise regression analysis was performed, a primary determinant of change inV˙o 2 peak was change in femoral arterial CSA, explaining ∼70% of the variability. These results support the hypothesis that the regional increase in blood flow, rather than systemic factors, is associated with the training-induced arterial expansion. Femoral arterial expansion may contribute, at least in part, to improvement in efficiency of blood transport from the heart to exercising muscles and may facilitate achievement of aerobic work capacity.

There are several recommendations on the prevention of hypothermia during snow shoveling. However, there seemed to be insufficient evidence supporting these recommendations because they are not based on data from actual snow shoveling research. The purpose of this study was to investigate changes in brain temperature (tympanic temperature) and visceral temperature (rectal temperature) during snow shoveling among healthy young males.Eight healthy young males (age, 23.6 ± 2.4 years; weight, 69.7 ± 6.1 kg; height, 172.8 ± 7.3 cm) performed snow shoveling with an ordinary-size shovel for 15 min at their own pace in a rural snowfall area in December, 2009. Rectal temperature (Tre) and tympanic temperature (Tty) were measured 5 times (at rest, 5th (Ex5), 10th (Ex10), and 15th (Ex15) minute of snow shoveling; and 5th (Rec5) minute of recovery phase). The room temperature was 18.6 ± 0.7°C and the atmospheric temperature was 3.8 ± 2.6°C.Tre continued to increase from at rest to Ex15. Tre at Ex15 (37.7 ± 0.3°C) was significantly higher (p0.05) than that at rest (37.2 ± 0.3°C). Tty at rest (36.7 ± 0.2°C) and Tty at Ex5 (36.6 ± 0.3°C) decreased significantly (p0.05) at Ex10 (36.2 ± 0.6°C). A significant negative correlation between changes in Tre and Tty were observed during snow shoveling (r = -0.49, p0.05).Discrepancy between changes in brain temperature (tympanic temperature) and visceral temperature (rectal temperature) should be taken into consideration in the prevention of disease development during snow shoveling in a cold environment.