Introduction : To grasp what kind of problems exists in order to solve the shortage of pathologists, we conducted a survey with special focus on the condition of facilities with single pathologists. We also considered whether the use of virtual slide technology is a viable option in mitigating the shortage of pathologists.
Methods : The survey was conducted at the 58th Autumn Annual Meeting of the Japanese Society of Pathology using questionnaires. Interviews were also obtained with pathologists who use virtual slides
Results : The percentage of facilities with single pathologists was approximately 30%, and these facilities had the highest rates of using virtual slides for remote pathology consultations. Regardless of the number of pathologist at a facility, outside consultation was often obtained with difficult cases. Although pathologists working alone expressed anxiety over diagnosing cancer, consulting other facilities appeared to be difficult.
Conclusion : In order to reduce the anxiety of pathologists working alone and to raise the accuracy of cancer diagnoses, a mechanism by which pathologists can consult each other is required. Developing a network for pathologists for such consultations using virtual slides is felt to be important in primary care.

Using near-infrared spectroscopy, we monitored changes of oxygenated hemoglobin and myoglobin contents [oxy (Hb+Mb) ], deoxygenated hemoglobin and myoglobin contents [deoxy (Hb+Mb) ], and total hemoglobin and myoglobin contents [total (Hb+Mb) ] of the thigh muscle at rest and during incremental bicycle exercise and recovery in 10 healthy male volnuteers. Gas exchange parameters were also measured in breath-by-breath mode.
The following results were obtained :
1) During low-intensity exercise (216 kpm/min), oxy (Hb+Mb) increased, while deoxy (Hb+Mb) and total (Hb+Mb) decreased. These changes are thought to reflect an increase in arterial blood flow to the exercising muscle and an increase in venous return.
2) During high-intensity exercise (above 972 kpm/min), oxy (Hb+Mb) decreased, while deoxy (Hb+Mb) increased. These findings probably reflect increased O₂extraction.
3) Upon cessation of exercise, oxy (Hb+Mb) and total (Hb+Mb) increased, and deoxy (Hb+Mb) decreased abruptly. These changes probably reflect post-exercise hyperemia with decreased O₂extraction.
4) Oxy (Hb+Mb) level at ventilatory threshold (VT) was the same as or higher than that of resting condition, indicating that VT occurs when the level of O₂in the vessels of the thigh muscle is relatively high.
5) Spontaneous fluctuation of oxy (Hb+Mb) with frequency of 7-10 cycles/min was observed. This fluctuation was more marked during exercise than during rest or recovery.
These findings suggest that the influence of increased blood flow and venous return on oxy (Hb+Mb), deoxy (Hb+Mb) and total (Hb+Mb) are greater than that of O₂extraction during low intensity exercise, whereas the influence of O₂extraction increases with exercise intensity.
Near-infrared spectroscopy provides valuable information with regard to O₂transport and O₂extraction in the exercising muscle.