Healthy male adults (22-58 years old) and female adults (21-49 years old) were tested on the influence by the long distance walking and running.
6 males walked 50 km in 8 hours, 3 males walked 40 km in 7 hours, 2 females walked 50 km in 8 hours and a half hour, 4 females walked 35 km in 7 hours, and 5 females walked 20 km in 5 hours
All participants were tested on their bloods, urines and blood pressures at the starting time, 5 min after the goal in, and one hour after the goal in. The results were as follows.
1) Decrement tendency of the systolic and diastolic blood pressure were observed by the long distance walking.
2) Degree of concentrations of the blood was not correlate with the distance of walking.
3) Neutal white blood cells were increased in all groups, but 20 km walking female group. Lynphcytes were intensively decreased in all groups.
4) Degree of increase of blood lactate, blood sugar and FFA did not relate the distance of walking.
5) Increasing tendency of CPK and LDH were related to the walking distance, and that of CPK was more strictly.
6) The increase of LDH isoenzyme 5 in all groups except 20 km female group may be caused by impressive muscle work. But it was noticed that the significant increase of LDH isoenzyme 1 were observed in the groups of female walked above 35 km and 50 km wilked male group.
Further more 3 males were tested with 20 km walk, 13 and 20 km run. Above mentioned results we would like to propose that walking more than 20 km in female and 40 km in male and running more than 13 km in male should not be recommended imprudently.

We investigated the degree of fatigue among medical students during the second trial of the Common Achievement Tests, which use a computer-based testing (CBT) method. A revised questionnaire for subjective fatigue symptoms proposed by the Industrial Fatigue Research meeting of the Japan Society for Occupational Health was used to examine the degree of fatigue. The CBT examinee group (n=41) sat for the examination for 6 hours using video display terminals. Significant changes were seen in 19 of the 25 items for subjective symptoms. At the end of the test period, significant differences between the CBT examinee group and the lecture participant group (n=50) were found for 15 of the items for subjective symptoms. Subjective symptoms were classified into 5 categories: sleepiness, instability, displeasure, feeling languid, and blurred vision. In the CBT examinee group, rates of symptoms increased significantly in all 5 categories. The increase in the rate of “blurred vision” was especially marked.

Seven long distance runner aged from 51 to 75 were tested on the view point of physical fitness and results as follows.
1) Mean values of maximum VO₂ml/kg/min, maximum heart rate and maximum respiratory rate during all out running were 43.7, 170 and 56.4 respectively.
2) The maximum heart rate, maximum respiratory rate and oxygen intake during 5 minutes walking with the speed of 120 meter/min. were 80 percent, 64 percent and 77 percent of the former respectively.
3) A case that was able to run one hour under the condition the heart rate continued about 200 beats was found.
4) The systolic blood pressures were rised during walking and running but were decreased below the level of starting time in 5 to 10 min. after the stop of them.
5) It was presumed that the speed of initial stage of long distance running should be held relatively slow for the aged to perform their ability reasonavely.
6) The girth of lower leg became large by the long distance running on the case of man, but not on the case of woman.
7) The skinf old of them were reduced of all.
8) Vital capacity ratio one second/max and side step test were high level, but the grip strength, vertical jump, backward flexibility, forward flexibility and static endurance of leg were not always high compared with ordinary level of same aged.
9) The size of heart shade of them were almost appeared in the normal range.
10) Anemia caused by hard training was found in all cases.

The aged above 40 to 76 years old ran 25 kirometers. We measured the systolic and diastolic blood pressure all of them before start and immediately after goal. The urine had been tested too. The results were as follows.
1) The systolic and diastolic blood pressures measured at the point of immediately after goal were lower than that of before running in all aged groups markedly.
Beside decreasing tendency of blood pressure, especially of systolic phase, due to running was higher in older people than younger.
2) The excretion of albumin in urine was increased by the running in all age groups, but the degree of it was larger in younger group than older people.
3) The number of people whose urine pH moved to acidity caused by running was much in the youngest group, and no one had been found in the oldest group.

We performed echocardiography on 19 hemodialysis patients before and after dialysis session. The patients were divided into three groups (normal pressure group; N=9, pre-dialysis hypertension group; N=6, pre-and post-dialysis hypertension group; N=4). The findings of echocardiography (Left ventricular end-diastolic dimension; LVDd, Left ventricular ejection fraction; EF, Left atrial dimension; LAD, Interventricular septal thickness; IVT) were compared in the three groups. There was no significant difference in LVDd and LAD between three groups. The mean value of EF was significantly (P=0.03) higher in the pre-dialysis hypertention group (68±9.4%) than in the normal pressure group (65±9.6%). The mean value of IVT was significantly (P=0.01, 0.01) higher in the pre-dialysis hypertention group (11±0.9 mm), pre-and post-dialysis hypertention group (11±0.6 mm) than in the normal pressure group (10±1.7 mm). These findings suggested thet hypertension may affect cardiac function. Therefore, we concluded that to keep normal blood pressure is important in hemodialysis patients.

 As globalization also influences medical education, Chiba University has provided extensive study abroad programs. This paper reports a medical student's methods to prepare for using such programs and improve his English level, and outlines his actual experience of studying abroad during a 6-year period. It also discusses the significance of medical study abroad, focusing on the following 3 points: meeting medical leaders in other countries; establishing friendships with international medical students of similar age groups, while comparing Japanese students' abilities with international standards; and taking full advantage of being a student, as one is allowed to flexibly develop global perspectives only in his/her school days before starting a long career as a medical professional, to provide guidance for medical students toward such experience and career development based on it.

We reexamined the cases of renal disease found in urinalyses which had been performed as part of the mass screening, to ascertain its efficacy. During 1990, a total of 94, 913 people underwent physical checkups made by the Naganoken Kouseiren Health Screening Center. The mean positive rates of proteinuria, occult blood in urine and both were 2.4%, 6.2% and 0.5%. Of the total number of examinees, 59, 803 had undergone the previous year's checkup. The mean positive rates of proteinuria, occult blood in urine and both for two consecutive years were 0.8%, 3.4% and 0.1%. The mean positive rates of proteinuria and occult blood increased with age. The mean positive rate of proteinuria was 1.7 times higher in males than in females. On the other hand, the mean positive rate of occult blood was 2.7 times higher in females than in males. However, there was no difference what so ever between men and women in the mean positive rate of both proteinuria and occult blood.
In the mean time, we reviewed the 85 cases in which renal biopsy was performed at the Saku Central Hospital from 1985 through 1990. Among them, 35 (41.2%) were the cases which had been suspected to have kidney disorder in the urinalysis conducted as part of a mass screening, and IgA nephropathy accounted for about 60% of them. The reports from medical institutions which made follow up examinations using the results of the health screening showed that the rate of renal disease was highest in the proteinuria positive cases; that of urological diseases, in the occult blood positive cases; that of chronic glomerulonephritis and urological diseases, in the proteinureal occult blood positive cases. We concluded that urinalysis included in a battery of tests at the time of the mass health screening is an effective procedure for detecting chronic glomerulonephritis and urological diseases.

Objective : Serum albumin is important marker in all aspects of stroke care including rehabilitation. We examined the serum albumin level of stroke patients, and investigated the relation between their serum albumin level and their prognosis. Methods : The serum albumin levels of 295 patients enrolled from 2008 to 2014 were sequentially checked in our hospital and in subsequent rehabilitation hospitals. Functional outcome was measured by functional independence measure (FIM) at the time of discharge from the rehabilitation hospital. Results : In all types (cerebral infarction, cerebral hemorrhage and subarachnoid hemorrhage (SAH)) of apoplexy, serum albumin levels were the highest at the time of admission, temporarily declined after admission, and almost recovered at the time of discharge. In SAH, the serum albumin levels deteriorated at a greater rate than in other types of stroke. In cerebral infarction and cerebral hemorrhage, the lowest serum albumin level was positively correlated with FIM at the time of discharge from the rehabilitation hospital (p<0.001). But, in SAH, there was no significant correlation between the lowest serum albumin level and FIM at the time of discharge (p=0.844). Conclusion : Our data suggest that serum albumin level is associated with the outcome of stroke patients, except for SAH patients. Serum albumin level should be one of the prognostic factors used in stroke patients, but we should consider that SAH patients are exceptional because of other neurological complications.

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.