Two hemodialysis patients underwent coronary artery bypass grafting. Emergency coronary artery bypass grafting was performed in one patient with unstable angina and acute left ventricular failure. The other patient underwent a combined operation of coronary artery bypass grafting and replacement of abdominal aortic aneurysm. In both patients, hemofiltration was used during cardiopulmonary bypass. In the early postoperative periods, peritoneal dialysis and extracorporeal ultrafiltration method (ECUM) were used in Case 1, while Case 2 was treated by hemofiltration and ECUM. Postoperative coronary angiography showed that all grafts of both patients were patent, and both patients weve discharged from hospital without angina.

A 49-year-old man presented in emergency center with complaints of severe lumbago and severe pain of the right lower limb. Symptoms were suggestive of hernia nuclei pulposi and he was referred to orthopedic department of our hospital. His pain was not relieved by analgesics and the right lower leg was cyanotic with a swollen, hard, and tender calf. On palpation a pulsating mass was revealed in the mid-abdomen. He was transferred to the cardiovascular floor. CT and IA-DSA revealed an abdominal aortic aneurysm and no occlusion of the major arteries of the right lower leg. The serum glutamic oxaloacetic, lactic dehydrogenase levels all increased especially the creatinine phosphokinase increased to 46, 460IU/l, and the urine myoglobin level was 4, 200ng/ml. Myonephropathic metabolic syndrome (MNMS) was suspected. Urine volume was maintained with fluid infusion and diuretics. The blood urea nitrogen and potassium levels remained within normal limits throughout the course. The immediate recognition of MNMS and treatment of the condition were successful in preventing serious complications. But all the toes of the right foot became necrotic and they were amputated. Two months after admission, replacement of the abdominal aortic aneurysm was performed successfully. The patient was discharged in good condition one month after the operation.

The electromyographic (EMG) activities of the back and thigh muscles while pedaling a bicycle ergometer at different load levels (300, 450, 600 and 750 kpm/min) and during walking and running at top speed up and down a staircase were investigated in children classified as physically less and more active than average. Each child underwent a battery of physical fitness tests to determine his physical fitness level relative to the national standard. Although the physiques of the inactive and active children did not differ, there were considerable differences between their back-lift, grip and knee-extension strengths, and the maximum anaerobic power, and 50-m dash performances of the two groups. The EMG data for each of the different tasks over selected periods (bicycle pedaling: 5 complete revolutions, staircase task: 5 stepping cycles) under different workload conditions were full-wave rectified and integrated (IEMG) . Under low workload conditions (ergometer tasks at 300 and 450 kpm/min and walking up and down stairs), the mean IEMG values (mIEMG) of all the muscles tested did not differ significantly in the inactive and active children. However, for all the higher workload tasks (pedaling at 600 kpm/min and running up and down stairs), the mIEMG values of the erector spinae muscles in the inactive children were significantly lower than those of the active children, and the difference increased gradually as the workload increased. This trend was even more marked when normalized mIEMG values were used. When the children ran up and down stairs at top speed, the inactive group had lower thigh, gluteus maximus and erector spinae muscle mIEMG values than the active group, and the difference between the normalized mIEMGs of the erector spinae muscles of the two groups showed a particularly strong statistical significance (P<0.01) when running both up and down stairs. As a similar trend was observed when the workload was maintained at a high level for the bicycle pedaling task, we concluded that at least part of the difference between the muscular activities of the two groups of children demonstrated when they carried out the running task was attributable to differences in the development of the muscle fibers and neuronal mechanisms of the erector spinae muscles.

The purpose of this study was to examine the relationship between balancing ability during abrupt acceleration and the habitual physical activity level of elderly females. Thirty-one elderly females, aged 65-75 years, volunteered for this study. Changes in the center of foot pressure (CFP) were measured during postural sway following platform acceleration, and the response time and CFP displacement were evaluated. The scores of their daily physical activities (TS) -consisting of house-hold activities (HS), leisure time activities (LS) and sports activities (SS) -were estimated by the modified Voorrips's questionaire method. Response time and CFP displacement correlated significantly with age (p<0.001) . Response time also correlated significantly with the SS, LS and TS scores (p<0.05) . CFP displacement also correlated significantly with the SS and TS scores (p<0.05) . These results suggest that postural balancing ability during abrupt acceleration correlates signifi-cantly with the habitual physical activity levels, especially sports activities in elderly females.

The purpose of this study is to examine the validity of muscle fatigue evaluation using maximum voluntary torque (MVT), and to identify the dependence of individual's tolerance for fatigue on the capacity to exert MVT. In 14 young male subjects (10 regular exercisers and 4 sedentary), MVT was measured during isometric knee extension, and voluntary activation (VA), which reflects motor unit activation, was evaluated using the twitch interpolation technique. In addition, the maximum endurance time (ET) was measured, and behavior of the mean power frequency (MPF) and the average rectified value (ARV) of surface EMGs from the vastus lateralis muscle were analyzed during constant force isometric contractions of 60% MVT (short-duration fatigue task; SDF task) and 20% MVT (long-duration fatigue task; LDF task) . Correlations were examined among these five variables.
The results were as follows:
1) Subjects were divided into a high voluntary activation group (HVA group) and a low voluntary activation group (LVA group) . Four sedentary subjects were included in the latter group.
2) MVT was significantly larger in the HVA group than in the LVA group (p<0.01) . A significant positive correlation (r=0.72) was found between MVT and VA (p<0.01) .
3) A significant negative correlation (r=-0.71) was found between MVT and endurance time (ET) for the LDF task (p<0.01) . The ET was significantly longer in the LVA group than in the HVA group (p<0.01) .
4) The MPF of voluntary EMG decreased consistently, as ARV increased during isometric contraction in both tasks (p<0.01), indicating the development of fatigue in the muscle. The final change of MPF relative to the initial value was significantly greater in the SDF task than in the LDF task (p<0.05) .
5) A significant correlation (r=-0.83) was seen between the relative change in MPF and ARV in the SDF task (p<0.01) .
6) For the SDF task, the final change of MPF and ARV relative to the initial value was significantly greater in the LVA group than in the HVA group (p<0.05) .
These results indicate that tolerance for local muscle fatigue usually evaluated as maximum endurance time, may depend on individual differences in VA, the VA, in turn, depending on adapta-tion to exercise, and that there appears to exist a corresponding adaptative strategy of the neuromuscular system during fatiguing contractions. Usefulness of our procedure using the twitch interpolation technique in evaluating muscle fatigue was also suggested.

Objective : By extracting and modeling the component factors that community pharmacists have for “YARIGAI”—a Japanese colloquial expression commonly defined as “something worthwhile doing”—and by re-defining “YARIGAI,” we sought to help improve the quality of work lives of community pharmacists. Methods : All of 139 employee pharmacists participated in a workshop of the COMPASS Project (May 2011) were surveyed using a self-administered questionnaire. Responses were collected on the scene. The seventeen, 6-point-scale questions focused on the “patient-pharmacist relationship,” which may be related to “YARIGAI.” Then “YARIGAI” factors were extracted using factor analysis, and modeled using covariance structure analysis. IBM SPSS (ver. 20) and Amos 5.0J were used for the analyses. Results : To the item “I feel ‘YARIGAI’ with pharmacy work,” 12.2% of the 139 respondents said, “Strongly agree”, followed by “Agree” (41.0%) and “Somewhat agree” (33.8%). A factor analysis extracted three factors related to “YARIGAI” (knowledge, patient counseling management, and sense of personal growth). After modeling (AGFI : 0.903, RMSEA : 0.048) with these factors as latent variables and items in them as observable variables, a positive correlation was indicated for all the following factor pairs : “knowledge” and “patient counseling management”, “knowledge” and “sense of personal growth”, and “sense of personal growth” and “patient counseling management” (standardized points of estimate : 0.71, 0.55, and 0.42, respectively). Standardized coefficients for all latent and observable variables were 0.7 or higher, showing a good fit. Conclusion : “YARIGAI” of pharmacists employed by community pharmacies can consist of “knowledge,” “patient counseling management,” and “sense of personal growth”. Our results suggest that the improvement of communication skills and knowledge can lead to improvement of “YARIGAI” of pharmacists working for community pharmacies.