Habitual exercise is important for improving or maintaining the arterial function with age. However, the role of functional fitness on arterial stiffness in the elderly is unclear. This study was conducted to examine the relationships between functional fitness and arterial stiffness in elderly woman. Four hundred and seventy-nine elderly woman participated in the present investigation. The systolic/diastolic blood pressure and brachial to ankle pulse wave velocity were obtained in the supine position using an automatic pulse wave form analyzer. Four items of functional fitness (standing/sitting, walking, hand working, and self-care working) were assessed. The measurement variables were calculated for five chronological classifications (60~64, 65~69, 70~74, 75~79 and 80 yrs or over). The four items of functional fitness and brachial to ankle pulse wave velocity increased linearly with age. A multiple stepwise regression analysis revealed that systolic blood pressure (β= 0.366), age (β= 0.225), heart rate (β= 0.188), body mass index (β= -0.102), and standing/sitting (β= 0.098) were independent contributors to brachial to ankle pulse wave velocity, accounting for 29.6% of the variability. The physical function, especially standing/sitting, influences the arterial function in elderly women.

Yearly changes in serum electrolytes, especially calcium (Ca), and Ca intake which may influence such changes were studied for 2 years from 1979 to 1980 in the same inhabitants of a rural area with a tendency to low Ca intake, and the following results were obtained.
1) Among different components of electrolytes, yearly changes in Ca were greater than in magnesium and inorganic phosphorus.
2) Yearly changes in serum Ca level from 9 mg/dl or lower level to higher level or vice versa were more frequent in men than in women and the number of women with not more than 9 mg/dl showed a tendency to decrease.
3) Yearly changes in serum Ca were closely correlated with Ca intake. It was supposed that serum Ca level in those who took about 400 mg/day of Ca was fluctuating above or below 9 mg/dl level in proportion to amount of intake.

High-intensity interval exercise (IE) leads to greater improvements in the arterial function than continuous exercise at moderate intensity (CE). However, few studies have been performed on the effects of the repetition exercise (RE) on the vascular endothelial function. The purpose of this study was to compare the effects of CE vs. IE vs. RE during aerobic exercise on the vascular endothelial function determined by flow-mediated vasodilation (FMD). Ten healthy male subjects randomly performed 3 trials as follows: CE (20-min cycling at 50%W_max), IE (10 × 1-min intervals cycling at 75%W_max interspersed with 1-min intervals cycling at 25%W_max), and RE (30 × 20-sec intervals cycling at 100%W_max interspersed with 20-sec intervals at rest). FMD was assessed at rest and 30 and 60 min after each exercise, and then the normalized FMD (nFMD) was calculated from the peak shear rate. The nFMD (a.u.) significant increased 30 min after IE (1.2 ± 0.2 to 3.0 ± 1.0, p<0.05) and increased 30 min after CE (1.0 ± 0.2 to 1.4 ± 0.2, n.s.) and returned to baseline at 60 min after both exercises, while the nFMD decreased 30 min after RE (1.3 ± 0.2 to 1.2 ± 0.1, n.s.) and was sustained at 60 min. The nFMD value at 30 min after IE was significantly greater than that at 30 min after RE (3.0 ± 1.0 versus 1.2 ± 0.1, p<0.05). These results suggest that RE may lead to a less improvement in the vascular endothelial function than CE and IE.

Surgical interventions for aorto-iliac obstructive diseases were studied through the operative results. Eighteen patients underwent aorto-femeral bypass (AOF) and 23 who were over 70 years of age or who had serious preoperative complications had axillofemoral bypass (AXF). No perioperative death occurred in AOF patients, while the mortality rate of AXF patients was 8%. Postoperative ankle pressure indexes were significantly higher in AOF patients than in AXF patients. Follow-up graft patency rate was 100% in AOF patients at 54 months (mean), and 85% in AXF patients at 44 months respectively. AOF should be the first choice for patients with aorto-iliac obstructive disease, and AXF is suitable only for high-risk patients.

In a consecutive series of abdominal aortic aneurysm repairs, a non-washing autotransfusion unit system was used in 47 patients, and was not used in 25. In the 47 patients treated with the autotransfusion unit, the average amount of autotransfused blood was 1, 109±131ml in elective cases. The amount of banked blood transfusion was significantly smaller in autotransfused patients (mean; 712ml), compared to non-autotransfused patients (mean; 1, 405ml). Postoperative levels of serum bilirubin were higher in patients with greater autotransfused blood volumes than those with smaller volumes. The combination of preoperative autologous blood donation (2-3 units) and intraoperative autotransfusion is necessary to perform abdominal aortic aneurysm repair without homologous blood transfusion.

We reviewed our experience with 4 cases of chronic dissecting aortic aneurysm (DeBakey IIIb) with the false lumen extending into the abdominal aorta and major branches being perfused from the false lumen. In such cases, resection of the intrathoracic portion of the aneurysm and closing of the distral false lumen may exclude visceral perfusion from the false lumen. In order to ensure continued perfusion of true and false lumens after repair, we performed “double barrel” anastomosis for distal anastomosis in graft replacement of the descending aorta. Follow-up periods ranged from 8 to 21 months, 17 months on average. Postoperatively, neither apparent expansion of the false lumen nor compression of the true lumen was found in these cases. The advantage of this procedure is the effective restoration of visceral perfusion. We emphasize that this procedure is one of the choices of procedures, as a two-staged approach for chronic aortic dissection presenting with visceral perfusion from the false lumen and without an enlarged abdominal aorta, though more patients and longer follow-up are required to fully evaluate this procedure.

A non-anastomotic false aneurysm occurred in a 77-year-old male 11 years after bypass grafting between the left external iliac artery and the right femoral artery using a Cooley double velour knitted Dacron graft. The false aneurysm was caused by rupture of an artificial graft. A partial resection of the graft and its replacement using a Hemashield^® graft were successfully performed. It was speculated that the mechanical stress by the inguinal band degenerated graft fibers and developed aneurysmal formation.

Incomplete development and severe malformation of the heart result in miscarriage of embryos because of its malfunction as a pump for circulation. During cardiogenesis, development of the heart is precisely coordinated by the genetically-primed program that is revealed by the sequential expression of transcription factors. It is important to investigate how spatial allocation of the heart containing cardiomyocytes and other mesoderm-derived cells is determined. In addition, the molecular mechanism underlying cardiomyocyte differentiation still remains elusive. The location of ectoderm-, mesoderm-, and endoderm-derived organs is determined by their initial allocation and subsequent mutual cell-cell interactions or paracrine-based regulation. In the present work, we provide an overview of cardiac development controlled by the germ layers and discuss the points that should be uncovered in future for understanding cardiogenesis.
Abortion, Spontaneous ; Cilia ; Embryonic Development* ; Embryonic Structures ; Female ; Germ Layers ; Heart ; Humans ; Myocytes, Cardiac* ; Pregnancy ; Transcription Factors ; Zebrafish*