1) Because some students cannot find target lesions with a microscope during the traditional histopathology class, they become anxious and frustrated. 2) Histopathology class, in which medical students learn with digital microscopic images on a computer display without a microscope, was supported by 75.8% of the students.3) Histopathology class with digital microscopic images should be adopted as a strategy to decrease the nervousness and frustration of medical students.

A 70-year-old woman, who had a history of a percutaneous transvenous mitral commissurotomy for rheumatic heart disease 34 years previously, was admitted with progressive right heart failure. Massive calcification of the left wall was observed on multidetector CT. She underwent a mitral valve replacement, tricuspid annuloplasty and permanent pacemaker implantation. Massive calcification of the left atrial wall is a rare condition, and constitutes a major complication and risk to mitral valve surgery because of the difficulty in entering the left atrium, potential embolization, and impaired hemostasis.

Allergological characteristics were studied on 36 patients with respiratory diseases (30 cases of bronchial asthma, 3 cases of diffuse panbronchiolitis, 3 cases of allergic granulomatous angitis, and 1 case of bronchiectasia) who received spa therapy at Misasa Branch Hospital.
1. The results obtained in patients with bronchial asthma were as follows:
Serum IgE levels were generally low, and many cases with less than 301IU/ml were observed (185±184/ml in female patients and 469±532IU/ml in male patients). The rate of positive skin reactions to various allergens was low in these asthma cases. A rather low rate of positive skin reaction to house dust, in particular, was characteristic. In regard to the rate of releasing chemical mediators such as bistamine and leukotrienes from leukocytes stimulated by Ca ionophore A 23187, a wide variety of cases were observed (histamine, 3.4-51.1%; LT B₄ 9.8-119.8ng/10⁶ cell; LT C₄, 3.5-43.8ng/10⁶ cells). By analyzing cell components in bronchoalveolar lavage fluids (BALF), notable increase in the number of eosinophils were observed especially in male patients, although no other significant differences were shown between the two groups.
2. In those patients with respiratory diseases other than asthma, a remarkable increase in the number of neutrophils in BALF was seen in diffuse panbronchiolitis cases and a remarkable increase in the number of eosinophils in BALF was seen in the cases of allergic granulomatous angities. Serum IgE levels were low in both of these cases.

The purpose of this study was to clarify some of the characteristics of race-walking, especially the relationship between walking speed and oxygen requirement, and stride in race-walking and normal walking, and to examine whether race-walking is effective for the maintenance and promotion of health.
The subjects were five male race-walkers (race-walker group) and five male college students (control group) .
The results obtained were as follows:
1. Under race-walk conditions, the highest speeds attained in the race-walker and control groups were 200-220 m/min and 160 m/min, respectively. Under normal walking conditions, however, the values were 140 m/min in both groups.
2. A lower oxygen requirement was observed at slower speed during normal walking and at a higher speed (over 130 m/min) during race-walking.
3. Oxygen requirement (ml/kg/100 m) in the race-walker group was minimal at 60-80 m/min during race-walking and at 60 m/min during normal walking. Values in the control group were minimal at 60 m/min under both walking conditions.
4. The oxygen requirement in the race-walker group was less than that of the control group under both walking conditions.
5. Under normal walking conditions, as the speed increased, both step-length and step frequency gradually increased, until step-length reached a limit of 80 cm. Thereafter, walking was maintained only by an increase in step frequency. However, in the race-walkes group, the subjects were capable of increasing their step-length further, and maintaining a higher speed (up to 220 m/min) .
6. It was suggested that race-walking is one of the most efficient exercises for maintaining and improving health.

The purpose of this study was to clarify some of the characteristics of race-walking, especially the relationship between walking speed and oxygen requirement, and stride in race-walking and normal walking, and to examine whether race-walking is effective for the maintenance and promotion of health.
The subjects were five male race-walkers (race-walker group) and five male college students (control group) .
The results obtained were as follows:
1. Under race-walk conditions, the highest speeds attained in the race-walker and control groups were 200-220 m/min and 160 m/min, respectively. Under normal walking conditions, however, the values were 140 m/min in both groups.
2. A lower oxygen requirement was observed at slower speed during normal walking and at a higher speed (over 130 m/min) during race-walking.
3. Oxygen requirement (ml/kg/100 m) in the race-walker group was minimal at 60-80 m/min during race-walking and at 60 m/min during normal walking. Values in the control group were minimal at 60 m/min under both walking conditions.
4. The oxygen requirement in the race-walker group was less than that of the control group under both walking conditions.
5. Under normal walking conditions, as the speed increased, both step-length and step frequency gradually increased, until step-length reached a limit of 80 cm. Thereafter, walking was maintained only by an increase in step frequency. However, in the race-walkes group, the subjects were capable of increasing their step-length further, and maintaining a higher speed (up to 220 m/min) .
6. It was suggested that race-walking is one of the most efficient exercises for maintaining and improving health.

Introduction
 During the course of primary health care activities in Khammouane province of Lao PDR by non- profit organization, international support and partnership for health, an exceedingly high infant mortality rate was recognized in some villages. As thiamine deficiency was strongly suspected for the main cause of the high mortality, the household survey with an emphasis on nutritional aspect and the measurement of thiamine level in the blood of mothers as well as their breast-milk were carried out for the confirmation.
Methods
 The survey was conducted at Sibounhouane sub-district (Group 1) with the highest infant mortality and Hatkhamhieng sub-district (Group 2) with the lowest mortality. Fifty families of the two groups, each consisting of randomly selected 25 families with less than one year old infant(s) were interviewed by using prepared questionnaire. The body weight of both mother and infant was measured and blood and milk were taken from the mother.
Results
 The ethnic minorities of the group 1 consisted of Lao Lum (44%) and Lao Theung (56%), whereas only Lao Lum in the group 2. The economical indicators and the mother's educational level in the group 1 were inferior to those in the group 2. There was no significant difference in the methods of preparing staple glutinous rice, likely to flux thiamine and intake of thiaminases between the two groups. High infant mortality rate was documented in the group 1 whose clinical symptoms were mostly consistent with those of infantile beriberi. The concentration of thiamine in the blood and milk of mothers in both groups were considerably lower and significant reduction of thiamine level was observed in the group 1 than the group 2. Nevertheless, both groups of those infants tended to be inadequately fed with the foods except for breast-milk during their early infantile phase.
Conclusions
 The low concentration of thiamine in the blood and milk of mothers was strongly suggestive that infantile beriberi due to thiamine deficiency was the principal cause of the infant mortality in the study region. We hereby surmise that thiamine deficiency could be extensively prevalent in Lao PDR than the currently studied areas because of their traditional preparing methods of staple dietary rice, postpartum food taboos and intake of thiaminases. For the prevention of infant death due to severe thiamine deficiency, necessary measures including the exchange of information among the institutions concerned, adequate thiamine supplementation and nutritional counseling have to be urgently adopted.

Annual changes in age, age at onset, incidence of cases with steroiddependent intractable asthma, clinical asthma types and clinical efficacy rate were examined in 256 patients with chronic respiratory diseases, especially in 203 cases with bronchial asthma, admitted to Misasa Branch Hospital from 1982 to 1989.
1. A number of patients with respiratory diseases as well as asthmatics admitted each year, having spa therapy, increased from early year (1982) to later year (1989).
2. A number in cases with 40 year or over of age (also with 60 year or over of age) and cases with 40 year or over of age at onset showed a tendency to increase in later three years (1987-1989). A decreased frequency of cases with steroid-dependent asthma and of cases with type II (bronchiolar obstruction type) was observed in the later three years.
3. The clinical efficacy of spa therapy for bronchial asthma was Niger in the later three years than in early three years (1982-1984).