A 77-year-old woman with a medical history of myocardial infarction had a medical check-up at a local clinic. She reported sensation of abdominal distension which had appeared 6 months previously. Computed tomography demonstrated a very large ovarian tumor concomitant with an abdominal aortic aneurysm with a maximum diameter of 68 mm, and she was referred to our hospital. We performed a simultaneous extirpation of the ovarian tumor and abdominal aneurysm prosthetic graft replacement. The patient was discharged 13 days postoperatively after an uneventful postoperative course. The histopathological diagnosis of the ovarian tumor was mucinous cystadenoma. We reviewed the surgical procedures for similar cases of concomitant disease, and found that reports of surgical cases of simultaneous huge ovarian tumor extirpation and abdominal aneurysm prosthetic graft replacement are rare.

A study was performed to evaluate the physiological function of elite senior high school soccer players (Kunimi) . Forty-six players were evaluated for cardiorespiratory function (maximum oxygen uptake : Vo₂max, maximum oxygen debt : Max O₂ debt), body composition (underwater weighing) and skinfold thickness, all parameters being measured four times over a two-year period.
The following means were recorded : age, 17.8 yr ; height, 173.0 cm ; weight, 65.8 kg ; percentage body fat (%Fat), 10.0%; lean body mass (LBM kg), 59.2 kg ; LBM/Ht (kg/m), 34.2 ; sum of eight skinfold thicknesses, 63.5 mm ; Vo₂max, 60.0 ml/kg⋅min ; maximum ventilation (V_Emax, BTPS), 136.8l/min ; maximum oxygen debt ; 8.2l, 124.8 ml/kg.
Results for percentage body fat, Vo₂max (ml/kg⋅min) and Max O₂ debt (ml/kg) were compared with values found in other soccer players at various levels.
In summary, one of the most outstanding attributes of the Kunimi senior high school soccer players was a high level of both aerobic power and anaerobic power.

The aim of this study was to examine the changes in natural killer (NK) cell activity, pulse rate, and pain intensity among older adults before and after acupuncture treatment.

To determine whether any difference exists in the skin-temperature responses of the lower limbs to hot-stone application relative to one-site and three-site abdominal application.

A 7-year-old boy suffered from isolated interruption of the aortic arch without any other complications or cardiovascular malformations. Cardiac murmur, which had been apparent since one month of age, had been left untreated because of the absence of any symptoms of heart failure. Isolated interruption of the aortic arch was noted during a routine physical examination at school and the patient was referred to our hospital for a complete medical evaluation. Blood-pressure difference was recognized not only between the right side and the left side of the upper extremities but also between the upper and lower extremities. On the basis of the results obtained via magnetic resonance angiography (MRA) and aortography, a definitive diagnosis of isolated interruption of the aortic arch was made. Reconstruction of the aortic arch by synthetic implant was indicated. The blood-pressure difference disappeared and the postoperative course was satisfactory.

Intestinal ultrasound (IUS) is a promising modality for the management of inflammatory bowel disease (IBD) and has the potential to particularly contribute in monitoring disease activity, an advantage crucial for optimizing the therapeutic strategy. While many IBD physicians appreciate and are interested in the use of IUS for IBD, currently only a limited number of facilities can employ this examination in daily clinical practice. A lack of guidance is one of the major barriers to introducing this procedure. Standardized protocols and assessment criteria are needed such that IUS for IBD can be considered a feasible, reliable examination in clinical practice, and multicenter clinical studies can be conducted for further clinical evidence of the application of IUS in IBD for best patient care. In this article, we provide an overview of how to start IUS for IBD and introduce basic procedures. Furthermore, IUS images from our practice are provided as a color atlas for understanding sonographic findings and scoring systems. We anticipate this “first aid” article will be helpful to promote IUS for IBD in daily practice.

OBJECTIVEThe aim of this study was to examine the changes in natural killer (NK) cell activity, pulse rate, and pain intensity among older adults before and after acupuncture treatment.

METHODSFifty-six individuals (16 males and 40 females), age 60 to 82 years (mean age 72.4 ± 5.0), who were experiencing pain in the shoulder, low back, or knee, participated in the study. NK cell activity, leukocyte differentiation (granulocytes and lymphocytes), pulse rate, and blood pressure values obtained. Pain intensity was used to analyze NK cell activity, leukocytes (granulocyte counts and granulocyte-to-lymphocyte ratio), and the VAS score in accordance with the location of pain complaints before and after acupuncture treatment.

RESULTSNK cell activity decreased after acupuncture treatment for pain in the shoulder-pain and knee-pain groups. Further, the lymphocyte and granulocyte counts increased after acupuncture treatment for the shoulder-pain group. Pulse rate decreased for the shoulder-pain, low-back-pain, and knee-pain groups after acupuncture treatment. The VAS score decreased after acupuncture treatment for the shoulder-pain, low-back-pain, and knee-pain groups.

CONCLUSIONThis study showed that in older adults, acupuncture treatment decreases pulse rate, relieves pain in the shoulder, low back, and knee, and reduces NK-cell activity.

Acupuncture Therapy ; Aged ; Aged, 80 and over ; Blood Pressure ; Female ; Heart Rate ; Humans ; Killer Cells, Natural ; immunology ; Low Back Pain ; immunology ; physiopathology ; therapy ; Male ; Middle Aged ; Pain Measurement ; Shoulder Pain ; immunology ; physiopathology ; therapy ; Treatment Outcome

The patient was a 57-year-old man who, in 1973, at 19 years of age, had undergone mitral valve replacement for mitral valve stenosis using a Björk-Shiley Delrin (BSD) valve. When the patient visited our hospital, he was living in an assisted-living facility due to paresis of the right side of the body, dysarthria, and other sequelae of cerebral infarction. The patient was referred to and visited our hospital with a chief complaint of chest pain in 2011, 38 years after the BSD valve was implanted. In 2012, mitral valve re-replacement, aortic valve replacement, and tricuspid annuloplasty were performed for congestive heart failure associated with prosthetic valve failure, combined aortic stenosis and insufficiency, and tricuspid insufficiency, which were identified by transesophageal echocardiography. The patient's postoperative course was generally favorable. The disc of the resected prosthetic valve showed a groove and bidirectional cracks caused by wear, and its condition suggested a risk of potential rupture. Transthoracic echocardiography on admission showed mild to moderate prosthetic transvalvular regurgitation, and the symptoms were therefore unlikely to have resulted from the prosthetic valve failure alone at this time. Consequently, it was considered that the heart failure was attributed to the prosthetic transvalvular regurgitation caused by the disc abnormalities in addition to the combined valvular disease by transesophageal echocardiography. In this case, detailed investigation of the heart failure by transesophageal echocardiography led to the discovery of prosthetic valve abnormalities, thus enabling the prevention of a serious cardiac accident due to disc rupture. Detailed examination by transesophageal echocardiography is essential, and early surgical intervention should also be considered if transthoracic echocardiography suggests even a minor prosthetic valve abnormality in a patient who has had this prosthetic valve implanted for such a long time.

OBJECTIVE: Donepezil is used to improve cognitive impairment of dementia with Lewy bodies (DLB). Visuo-spatial dysfunction is a well-known symptom of DLB. Non-verbal Raven’s Colored Progressive Matrices (RCPM) were used to assess both visual perception and reasoning ability in DLB subjects treated with donepezil. METHODS: Twenty-one DLB patients (mean age, 78.7±4.5 years) were enrolled. RCPM assessment was performed at the time of starting donepezil and within one year after starting donepezil. RESULTS: There were significant improvements of RCPM in the total scores between one year donepezil treatment (p=0.013), in both Set A score (p=0.002) and Set AB score (p=0.015), but trend in the Set B score (p=0.083). CONCLUSION: Donepezil is useful for improving visuo-spatial impairment in DLB, but not for problem-solving impairment.
Cholinesterase Inhibitors ; Cognition Disorders ; Dementia* ; Humans ; Lewy Bodies* ; Lewy Body Disease ; Spatial Processing ; Visual Perception

The term, propagated sensation along the channels (PSC) means the peculiar sensation expeerienced by some people along thier meridians when given acupunctural stimulation of acupoints.
In the present study, the incidence of PSC in outpatients who were undergoing acupuncture treatment was investigated.
Low frequency electrical stimulation was performed through press needles at twenty-six points: the twelve terminal points of the twelve regular meridians and the Inner-Zhiyin points of both sides. PSC was assessed on a four-grade basis after the manner carried out in China.
The incidence of PSC was significantly high among the outpatients compared with that among healthy youth. Patients with hypertension or posttraumatic neck syndrome showed higher incidence of PSC than the other patients.