This study was to examine the effects of quantity of taking salt diet on the body during exercise. The subjects were made to do endurance exercise on each after intake of the moderate-salt diet, the much-salt diet and a little-salt diet in a fixed duration.
The results were obtained as follows:
1) Under the much-salt diet intake, responce of systolic blood pressure and heart rate showed small increment during the exercise.
2) Under a little-salt diet intake, the CK-MB/CK ratio showed large increment during exercise.
3) Under the much-salt diet intake, serum BUN values were decreased compared with under the other diets. Under a little-salt diet intake, serum BUN, Uric Acid and Triglycerides values were increased, on the contrary serum Glucose values were decreased in resting condition. Especially, under a little-salt diet intake, serum BUN values were increased during the exercise.
4) The value of urinary sodium excretion was varied in response to the intake of salt. The value of urinary potassium excretion showed no change under the much-salt diet intake. But it showed decrease under a little-salt diet intake.
5) Under a little-salt diet intake, the creatinine clearance values were decreaced during and after the exercise.
The above mentioned findings suggested that the change of salt intake itself may become a stressor to the body and it is necessary to pay much attention when we exercise under these condition.

The voluntary exercises consist of different automatized levels and are mostly a combination of the upper limbs and the lower limbs exercises.
This study was to examine the interference of the upper limbs exercise to the periodic lower limbs exercise with different automatized levels. Seven male university students, aged 19 and 20 yrs., served as subjects. The periodic lower limbs exercises were the stepping (walking on the place) and the alternate plantar-flexion of the right and left foot while standing. The frequencies of the lower limbs exercises were 120, 160 and 200 times/min, The stepping, which is similar to the motion of the lower limbs in walking or running, may be performed more frequently in daily life than the plantar-flexion in which only the ankle angle was changed. Therefore, we assume that the stepping is a higly automatized exercise compared with the plantar-flexion. Upper limbs exercise, which was combined with the lower limbs exercise, was the simultaneous tapping of one time by both hand. The interference degree was evaluated by the change of step intervals of the lower limbs exercise. The results were:
1) The fluctuation of step intervals on the plantar-flexion was greater than the fluctuation on the stepping and the smallest in the frequency 120 compared with that in the other frequencies.
2) When the tapping was combined with the lower limbs exercises, one step interval at that time was lengthened and one step interval immediately before the tapping was shortened. This change of step intervals was greater in the plantar-flexion than that in the stepping. The change in the plantar-flexion was the smallest in the frequency 120 compared with that in the other frequencies.
The above mentioned findings suggest that the automatized level of the lower limbs exercise can be clearly evaluated by the interference degree of the upper limbs exercise to the periodic lower limbs exercise.

A study was conducted to investigate the influence of motor learning on functional specialization of the upper and lower limbs by comparing automatized levels in upper and lower limb movements between 17 soccer (S group) and 14 basketball (B group) players at a university. They carried out transitory palmar flexion of both hands while stepping and performing alternate flexion-extension movements of both ankle joints, and transitory plantar flexion of both feet while performing alternate flexion-extension movement of both shoulder joints and both wrist joints. The automatized levels of the upper and lower limb movements were evaluated by the degree of interference between the upper and lower limb movements.
It was shown that automatization of lower limb movements was more advanced than that of upper limb movements in both groups. The automatized levels of stepping in the S and B groups showed no significant difference, and were similar to those of university students in general obtained in our previous study. However, the automatized levels of ankle joint movements in both groups were higher than those for university students in general.
In both groups, the insertion of transitory palmar flexion was restricted to within the phase where the degree of interference was small during the stepping and ankle joint movement. However, this tendency was not clear in the trial where transitory plantar flexion was superimposed on shoulder joint and wrist joint movements.
As for the difference between the groups, the S group showed a higher automatized level of ankle joint movement than the B group. On the other hand, the B group showed higher automatized levels of both upper limb movements than the S group, and this tendency was especially evident for shoulder joint movement.
These results suggest that the change in the automatized level of upper and lower limb movements by specific motor learning is added to the functional specialization of the upper and lower limbs acquired by daily basic motor learning in an upright position.

A study was conducted to investigate the effects of a sagittal position of the body gravity center (GCP) and manual weight-load on postural control during rapid arm-lifting. The subjects were five males aged 21 to 36 years. They stood on a force plate while maintaining the GCP at 30%, 45% and 60% from the heel, regarding the fool length as 100%, and anteriorly lifted both arms spontaneously as rapidly as possible. These trials were carried out ten times under a 5 kg weight or no weight. EMGs of the biceps femoris muscle (BFM) and anterior deltoid muscle (ADM), the fluctuation of the center of foot pressure (CFP) and body motion were analyzed by focusing on their time sequences.
At 45% and 60% GCP the BFM action started prior to the ADM action, whereas at 30% GCP it tended to lag behind. The lag times under no weight were 13.9±12.75 ms (mean±SD) at 30% GCP, -32.7±18.18 ms at 45% GCP and -46.0±19.40 ms at 60% GCP. Those under 5 kg weight were 15.0±11.40 ms at 30% GCP, -22.0±6.74 ms at 45% GCP and -28.9±7.63 ms at 60% GCP. These results indicate that the anticipatory action of the muscle related to postural control arises only at specific GCPs.
The difference of starting points for BFM action to ADM action showed no significant difference between 45% and 60% GCP for either as 5 kg or no weight. The CFP position moving in a forward direction during arm-lifting showed a marked difference between 45% and 60% GCP. The time for arm-lifting showed a marked difference between 5 kg and no weight. These results suggest that the starting point of anticipatory muscle action related to postural control does not change according to the magnitude and time course of the distance to the body equilibrium as a result of arm-lifting.

Objectives: Waon therapy relieves ischemic symptoms in patients with peripheral arterial disease. Waon therapy increases capillary density and blood flow in ischemic hindlimbs of mice (Circ J 2006;70:463). Moreover, we have shown that Waon therapy increases capillary densities of non-infarcted myocardium of rat with myocardial infarction in association with increases in myocardial expression of eNOS and VEGF mRNA (Am J Physiol Heart Circ Physiol 2011;301:H548). Taken together, Waon therapy may improve myocardial blood flow in patients with severe coronary artery disease. Accordingly, the purpose of the present study was to investigate whether repeated Waon therapy could improve myocardial perfusion in patients with ischemia related to chronic total occlusion (CTO) of coronary arteries. Patients and Methods: Twenty-four patients who had myocardial ischemia in the CTO-related area were examined. The Waon group (n=16) was treated daily for 3 weeks with a 60°C far infrared-ray dry sauna bath for 15 minutes and then kept in a bed covered with blankets for 30 minutes. The severity of ischemia was quantified by thallium-201 myocardial perfusion scintigraphy with adenosine before and after 3-week Waon therapy. Treadmill exercise test, flow-mediated dilation (FMD) of the brachial artery, and the number of circulating CD34-positive bone marrow-derived cells, a putative precursor of endothelial progenitor cells, were determined. The control group (n=8) underwent myocardial perfusion scintigraphy twice with a 3-week interval. Results: In the control group, neither summed stress score (SSS) nor summed difference score (SDS) of myocardial scintigraphy changed. However, Waon therapy improved both SSS (16±7 to 9±6, p<0.01) and SDS (7±4 to 3±2, p<0.01), and the improvement was greater in patients with higher SSS and SDS scores at the baseline. Waon therapy extended treadmill exercise time (430±185 to 511±192 sec, p<0.01) and improved FMD (4.1±1.3 to 5.9±1.8%, p<0.05), but tended to decrease the number of circulating CD34-positive cells. Conclusions: Waon therapy improves CTO-related myocardial ischemia in association with improvement of vascular endothelial function. This therapy could be a complementary and alternative tool in patients with severe coronary lesions not suitable for coronary intervention.

This study aimed to validate the usefulness of parent artery complex coil protection for the treatment of wide-neck, side-branched, and ruptured aneurysms. A microcatheter was first introduced into the aneurysmal sac, and another microcatheter was introduced into the parent artery or near the orifice of the branch artery. A framing coil was deployed partially from the first microcatheter, and a protection coil was deployed from the second microcatheter to prevent protrusion of the first framing coil to the parent artery and side branches. After the first framing coil insertion, the protection coil was withdrawn to confirm the stability of the framing coil and blood flow. The procedures with this technique were successful for 3 patients. Parent artery complex coil protection can be an effective and safe coil embolization technique for the preservation of parent and side branch arteries and an alternative method for emergent ruptured cases.

Ischemic mitral regurgitation (IMR) is a serious and increasingly common clinical disorder, but at present, the relationship between left ventricular shape and IMR is not completely understood. Thirty patients with moderate or severe IMR who underwent mitral valve surgery combined with coronary artery bypass grafting were studied retrospectively. Left ventricular shape, left ventricular regional wall motion, hemodynamic index, condition of the coronary artery, severity of IMR and long term results were assessed using ventriculography and angiography. Left ventricular shape at end diastole and end systole were quantified based upon the ratio of the major-to-minor axis and the sphericity index. Hospital mortality rate was 13.3%, 5 years survival rates were 10.5%, and 5-year rate of freedom from congestive heart failure (CHF) were 7.8%. Significant difference between cardiac deaths (n=11) and survivors (n=19) included requiring intensive care admission, requiring intra-aortic balloon pumping, recurrent myocardial infarction, the ratio of the major-minor axis at end diastole, the sphericity index at diastole, and the sphericity index at end systole. Multivariable regression analyses were performed with the Cox proportional hazards model. Significant determinants of survival were the sphericity index at end systole and LV regional wall motion at the site of the anterobasal segment or apex. These findings indicate that the shape of the LV and LV regional wall motion in IMR may be important determinants of prognosis and suggest that surgical attention to shape may be helpful for mitral valve surgery.

BACKGROUND AND PURPOSE: Plasma D-dimer levels are elevated during the acute phase of cerebral infarction (CI). We investigated whether the D-dimer level on admission and other clinical characteristics could be used to predict the poor outcome of patients with acute CI. METHODS: The clinical characteristics and plasma D-dimer levels measured within 3 days of onset were compared according to outcome among patients with acute CI. RESULTS: In total, 359 consecutive patients (mean age, 71.8 years) were examined, of which 174 had a poor outcome [score on the modified Rankin scale (mRS) > or =3] at 30 days after hospitalization. The mean mRS score was higher and a poor outcome was observed more frequently among women than among men (p<0.001 for each). The proportions of women, cardioembolism, atrial fibrillation, advanced age (> or =75 years), prior history of CI or transient ischemic attack, and elevated D-dimer level (> or =1.0 microg/mL) were significantly higher among patients with a poor outcome than among those with a good outcome. A multivariate analysis showed that elevated D-dimer level [> or =1.0 microg/mL; odds ratio (OR), 2.45; 95% confidence interval (95% CI), 1.52-3.89; p<0.01], advanced age (OR, 1.93; 95% CI, 1.21-3.07; p<0.01), and female gender (OR, 1.75; 95% CI, 1.08-2.83; p=0.02) were independent predictors of a poor outcome. CONCLUSIONS: Certain clinical characteristics (gender and advanced age) and an elevated D-dimer level upon admission can be used to predict the outcome of patients with acute CI at 30 days after hospitalization.
Atrial Fibrillation ; Cerebral Infarction ; Female ; Fibrin Fibrinogen Degradation Products ; Hospitalization ; Humans ; Ischemic Attack, Transient ; Male ; Multivariate Analysis ; Odds Ratio ; Plasma ; Stroke

Endoscopic papillectomy (EP) for ampullary adenomas achieves cure rates ranging from 76% to 90%, and recurrence rates are as high as 33%. If remnant or recurrent lesions after prior EP are endoscopically visible and are not suspected of intraductal extension into the biliary or pancreatic duct, repeated snaring and cutting can be performed until all visible lesions are completely resected. However, endoscopic ablative therapies, particularly argon plasma coagulation, can be attempted for tiny or uncertain remnant and recurrent lesions. In addition, intraductal radiofrequency ablation has recently been attempted for residual intraductal lesions after EP at several institutions. Although still under investigation, it has shown some promise. It might be offered as an alternative to surgery, particularly in patients who are unfit for surgery or those who refuse to undergo surgery.

Because the corona disaster made group medical training difficult, we conducted resuscitation training for new students and basic medical skills training for fourth-year students without face-to-face instruction using video learning, assessment, and ICT. In the resuscitation training, the students were allowed to take a mannequin home and film themselves performing the resuscitation while learning by video. Later, group and peer assessment were conducted via Zoom, and a significant increase in self-assessment was observed. In the basic medical skills training, the students filmed their own implementation at their own pace while learning by video, and the teachers later conducted video assessment and feedback. The lack of face-to-face instruction made it possible to implement the limb spine training, which had not been possible in previous years. It is necessary to adjust the timing of the video registration by the students and the video assessment by the teachers, and to make further improvements to the system.