As well known, the adreno-sympathetic hormone - catecholamine - plays an important role in maintaining the stability of “milieu interieur”. Accordingly, a marked change may occur in catecholamine secretion in case of prolonged strenuous exercise such as marathon race where is required remarkable augmentation of cardiovascular functions. The authors had an opportunity of examining the physiological functions of all the participants in the First Tokyo International Women Marathon Race held on November 18, 1979, and collected urine samples from them before and after the race to evaluate the physiological load of the race in each woman participant by changes in urinary excretions of catecholamine metabolite (VMA) and some other substances.
As for the subjects of examinations, 19 foreign runners were 31.1 years of age on the average (ranging from 20 to 48 years) and their average Rohrer's Index was 119.0, while 33 Japanese runners were 27.8 years of age on the average (ranging from 18 to 42 years) and their average Rohrer's Index was 125.8. The urine samples at rest were collected at 8 a.m. on the day before the race after more than 10 hours fasting, and the samples after running were collected in 30 minutes after finishing the race. Just after the collections, the authors made determinations of the urine volume and pH and qualitative tests for sugar, protein, occult blood, Keton bodies and bilirubin. Then the determinations of VMA were made by Pisano's method. The resulte obtained were compared among six groups classified by the performance, viz., the order of the arrival. The classification was made as follows : 1) 1-5, 2) 6-10, 3) 11-15, 4) 16-20, 5) 21-25 and 6) 26-46. The comparison was also made between the foreigners and the Japanese.
Results:
Although there could be no significant correlation between the performance and the age or physique, the Rohrer's Index was smallest in Group 1) and largest in Group 6) .
The qualitative urine tests disclosed no marked change due to the running but protein less than 300 mg/dl was detected in the urine after running in 31 out of 40 runners. This fact seems to suggest that their physiological loads were considerably heavy. The urine volume on the average showed a decrease from 41.5 ml/hr at rest to 16.3 ml/hr after running, viz., 60.7 % decrement. The decrement was 53.2 % in the foreigners while it was 65.3 % in the Japanese. The urine volume was rather larger in Groups 5) and 6) than in the others. The urine pH on the average showed a decrease from 6.4 at rest to 5.6 after running, viz., 12.5 % decrement, and the decrement was 6.9 % in the foreigners while it was 14.9 % in the Japanese. Regarding the relation between the performance and the urine pH, there could be noted a tendency, the upper the ranking of the group, the smaller the change in pH.
The urinary excretion of VMA on the average of all the runners showed a striking increase from 155.8 mg/hr at rest to 383.1 mg/hr after the running. The increase due to running was 121.4 % in the foreigners while it was 144.1 % in the Japanese. Regarding the relation between the performance and the VMA excretion, Group 1) showed no increase in the excretion on the average, while the other groups generally showed 100 % - 200 % increase in the excretion.
On the basis of the above-mentioned findings, it was presumed that the physiological load of the marathon race was heavier in the Japanese runners than in the foreign runners, and in the lower ranking groups than in the upper ranking groups of the performance. In other words, the foreigners who showed excellent performance seemed to be highly adapted to the prolonged strenuous exercise by training and to have a regulatory mechanism of metabolism so efficient as to cope with heavy physiological load by small increase in catecholamine secretion.

　　Mature cystic teratoma with malignant transformation is a rare disease with an incidence of about 1% among ovarian tumors. Here, we describe how we were able to diagnose pathological tissue preoperatively using colonoscopy. The patient was a 68-year-old woman (gravida 4). She presented with abdominal pain. Her general condition was poor. On examination, we found perforation of an ovarian tumor into the sigmoid colon. Lower gastrointestinal endoscopy was performed and some tissue was retrieved. Pathological analysis of the tissue revealed a diagnosis of squamous cell carcinoma.

The purpose of this study was to investigate the changes of blood components of middle and old aged runners in marathon running. The results were as follows.
1) Mean running time of marathon was 250 min. Some of subjects did last spurt.
2) Change of body weight was -4.8%. RBC, Hct, and Hb were changed by -4.8%, -4.4%, and -4.7% respectively. The decrease of plasma volume was 7.8% according to Dill's method.
3) Blood glucose was 112 mg/dl at rest and decreased to 70 mg/dl after running. The glucose level of five subjects was in range from 59 to 50 mg/dl.
4) The increase of L.A. was 52%. The L.A. after running tended to correlate to the running speed at last spurt.
5) T.G. significantly decreased after running. On the contrast, FFA increased by 323%. This increment of FFA correlated to mean running speed (r=0.681, P<0.05) .
6) The increments of GOT, GPT, and LDH were 71%, 62%, and 61% respectively, The decreases of LDH-1, 2 and increases of LDH-4, 5 were found after running. Furthermore, AGOT and 4GPT correlated to the running speed at last spurt or L.A. after running.

The aim of the present study is to clarify the improvement of peripheral muscle oxygen consumption after successful renal transplantation. We investigated change of forearm (brachioradial muscle) muscular oxygen consumption in chronic renal failure children before and after renal transplantation. by using near-infrared spectroscopy.Oxygen consumption of brachioradial muscle was increased significantly after succesful renal transplantation. And half recovery time of brachioradial muscle oxygenation in arterial occlusion and exercise were decreased after renal transplantation.These results suggest that increased muscular blood flow and increased oxidative generation of ATP might contribute to the increased oxygen turn over after renal transplantation.

STUDY DESIGN: Retrospective case series. PURPOSE: To investigate the oncological outcomes, including distant relapse, after en bloc spondylectomy (EBS) for spinal metastases in patients with a minimum of 2-year follow-up. OVERVIEW OF LITERATURE: Although EBS has been reported to be locally curative and extend survival in select patients with spinal metastases, detailed reports regarding the control of distant relapse after EBS are lacking. METHODS: We conducted a retrospective review of 18 consecutive patients (median age at EBS, 62 years; range, 40–77 years) who underwent EBS for spinal metastases between 1991 and 2015. The primary cancer sites included the kidney (n=7), thyroid (n=4), liver (n=3), and other locations (n=4). Survival rates were estimated using the Kaplan–Meier method, and groups were compared using the log-rank method. RESULTS: The median operative time and intraoperative blood loss were 767.5 minutes and 2,375 g, respectively. Twelve patients (66.7%) experienced perioperative complications. Five patients (27.8%) experienced local recurrence of the tumor at a median of 12.5 months after EBS, four of which had a positive resection margin status. Thirteen patients (72.2%) experienced distant relapse at a median of 21 months after EBS. The estimated median survival period after distant relapse was 20 months (95% confidence interval, 0.71–39.29 months). No association was found between resection margin status and distant relapse. Overall, the 2-year, 5-year, and 10-year survival rates after EBS were 72.2%, 48.8%, and 27.1%, respectively. Importantly, the era in which EBS was performed did not impact the oncological outcomes. CONCLUSIONS: Our results suggest that EBS by itself, even if margin-free, cannot prevent further dissemination, which occurred in >70% of patients at a median of 21 months after EBS. These results should be considered and conveyed to patients for clinical decision-making.
Clinical Decision-Making ; Follow-Up Studies ; Humans ; Kidney ; Liver ; Methods ; Neoplasm Metastasis ; Operative Time ; Recurrence ; Retrospective Studies ; Spine ; Survival Rate ; Thyroid Gland