The present study was intended to determine max. Vo₂ and its relation to body weight of Japanese athletes. The subjects in this study were 151 male and female athletes who were Japanese excellent or good runners and swimmers.
Max. Vo₂2 was determined during the maximum running on the treadmill. Treadmill test was made with a constant slope of 8.6%. During the first 2 minutes, the treadmill was set in motion at a certain speed (180 or 200 m/min for male and 160 m/ min for female), and then the speed was increased by 10 m/min every succeeding minute until exhaustion. Expired air during running was collected in Douglas bag every 1 minute upto exhaustion. The sampling gas was analyzed by means of a Beckman oxygen and carbon dioxide analyzer.
The results obtained in this study were as follows ;
1) The regression equations were calculated between max. Vo₂ and body weight in relation to sex and sports (Table 1) .
2) Max. Vo₂ per body weight of the male swimmers ranges from 50 to 70 and that of the male runners is 70 ml/kg/min. For the female swimmers max. Vo₂ is between 40 and 60 and the female runners approximately 60 ml/kg/min.
3) The regression equation was calculated between the mean speed of 5000 m running as performance (Y) and max. Vo₂ per body weight as physical resources (X) for the runners.
Y=0. 0431X+2.50±0.232

The purpose of the present study was to obtain the insights about the roles of specialized home care clinics and the “Doctor net” in community palliative care by investigating changes in the home death rates of cancer patients in a city where both specialized home care clinics and the Doctor net are available. A region palliative care intervention study was conducted, and data on the rate of cancer patients who died at home between 2007 and 2010 in the region were collected. The rate of cancer patients who died at home increased from 7.0% in 2007 to 13.0% in 2010. In 2007, 49% of the total number of people who died at home were patients of specialized home care clinics, and the rate increased to 13.0% in 2010. However, the number of cancer patients of other clinics who died at home did not decrease, from 63 in 2007 to 98 in 2009 and 77 in 2010. The functions of specialized home care clinics and the Doctor net adopted in general clinics were not exclusive to each other, and specialized home care clinics may improve palliative care implemented for cancer patients at home by participating in the Doctor net to provide general clinics with support.

Aberrant right subclavian artery is a common congenital anomaly of the aortic arch, with a reported prevalence of approximately 0.5%. However aneurysms of this aberrant vessel are very rare. A 71-year-old man was admitted with cerebral hemorrhage. Chest X-ray revealed an abnormal upper mediastinal shadow. Angiography, computed tomography (CT) scan, and magnetic resonance (MR) imaging revealed an aberrant origin of the right subclavian artery arising as the fourth branch of the aortic arch and crossing the mediastinum from left to right indenting the esophagus posteriorly. The origin of the right subclavian artery was aneurysmal (maximum diameter was 5cm), and this aneurysm did not compress the esophagus. The patient was treated by Dacron patch graft aortoplasty and right subclavian artery reconstruction with the aid of cardiopulmonary bypass and hypothermic selective cerebral perfusion. The postoperative course was uneventful and there were no major complications. The surgical technique is detailed as well as a review of all the cases in the literature.

A total of 56 patients undergoing coronary artery bypass grafting were allocated to two groups: the Cold group (28 patients) with cold (4°C) crystalloid cardioplegia and topical ice slush, and the Tepid group (28 patients) with tepid (32°C) blood cardioplegia delivered intermittently antegrade. The two groups were comparable in terms of preoperative New York Heart Association classification, age, gender, and number of grafts. Intraoperatively, tepid blood cardioplegia was associated with a significantly shorter cardiopulmonary bypass time and nearly uniform return of normal sinus rhythm. Cardiac output after bypass was significantly higher than before bypass only in the Tepid group. The absolute peak levels in the myocardial-specific isoenzyme of creatine kinase were higher in the Cold group (70±8IU/l) than in the Tepid group (31±5IU/l). There was a trend toward reduced incidence of perioperative myocardial infarction (0% versus 7.1%) and need for intraaortic balloon pump support (0% versus 3.6%) associated with the use of tepid blood cardioplegia. Our results suggest that intermittent tepid blood cardioplegia is a safe and effective technique for coronary artery bypass grafting.

The peak (dPower/dt), the maximum value of dPower/dt calculated by differentiation of ventricular power with respect to time, is verified from the physiological studies to be quite useful index indicating the ventricular contractility independent of the pre- and afterloads. However, the index has the disadvantage in the clinical application that it can not be measured by a non-invasive method. In the present study, peak (dPower/dt) could successfully be determined in a non-invasive manner as the product of aortic flow as measured with an ultrasonic pulsed Doppler flowmeter and brachial blood pressure as measured with cuff in the new apparatus. Involved in this study were 21 children, 52 adults with normal cardiac performance and 11 adult patients with coronary artery disease. The measurement of the index was successfully carried out in 28 of 61 adults and especially 16 of 21 children. The results of the study are summarized as follows:
1. Power waveform is similar to blood flow waveform and is little influenced by blood pressure waveform.
2, Peak (dPower/dt) can be determined as product of peak rate of change of aortic flow (peak (dF/dt) ) and mean brachial blood pressure without resorting to measurement of blood pressure waveform.
3. Peak (dPower/dt) was found significantly lower in cases having an ejection fraction less than 50% (93.5 J/sec²) than in those showing an ejection fraction of above 50% (145.3 J/sec²) (p<0.001) .
4. Peak (dPower/dt) normalized with body surface area was not significantly different from 8 years old children (80.2 J/sec²/m²) and 21-34 years old adults (88.0 J/sec²/m²) . According to this index, the cardiac contractility of 8 yearus old children seemed to reach the adult level.
From these findings it is concluded that the non-invasive method of determining a cardiologic parameter, peak (dPower/dt), as an index of cardiac contractility provides a means of salient clinical value.

OBJECTIVETo explore the diagnostic feasibility of noninvasive assessment of coronary atherosclerotic plaques with MSCT in comparison with IVUS.

METHODSContrast-enhanced MSCT angiography (Sensation 64, Siemens Medical Solutions) was performed before percutaneous coronary intervention (PCI), and three-vessel IVUS (Boston Scientific, Natick, MA) was performed during procedure in 12 patients with stable angina pectoris. Complete investigation was digitally stored, and assessed offline with EchoPlaque (Indec Systems, Mountain View, CA). The comparison of MSCT with IVUS was performed based on segment at plaque site (American Heart Association 15-segment model).

RESULTSA total of 88 segments in 31 vessels (left anterior descending: 12, left circumflex: 10, and right coronary artery: 9) were investigated by both IVUS and MSCT. Among 68 assessable segments (54 proximal-middle segments and 14 distal segments) by MSCT (20 segments were excluded for poor image quality: 16 for severe calcification, 2 for motion artifact, 2 for poor opacification), MSCT correctly detected 47 of the 51 segments with plaques (sensitivity: 92%), and correctly evaluated 16 of 17 segments without plaques (specificity: 94%). Concerning plaque quantification, MSCT correlated well with IVUS in grading whether the vessel obstruction was less or more than 50% (simple kappa: 0.63, 95% CI: from 0.47 to 0.78). Plaque area by MSCT also correlated with that by IVUS (r = 0.53, P < 0.01), but overestimated plaque area [(9.09 +/- 3.89) mm(2) vs. (6.80 +/- 2.81) mm(2), P < 0.01]. In addition, 30 of 43 hypoechoic compositions were detected as low-density compositions by MSCT with average CT number as 67.39 HU.

CONCLUSIONSIn segments without severe calcification, contrast-enhanced 64-slice CT angiography could detect plaques in coronary artery with high accuracy. Plaque area quantification by MSCT correlated with that of IVUS though with limited accuracy.

Coronary Angiography ; Coronary Artery Disease ; diagnostic imaging ; Humans ; Tomography, X-Ray Computed ; methods ; Ultrasonography, Interventional