After studying the Step Test (hereinafter referred to as ST), one of the method of measuring the endurance of whole part of body, another method of measuring the endurance against the load of upper limbs is considered necessary for those physically handicapped person and or those who reqires a consideration for local development, as in the ST the loaded parts of the movement is limitted only to lower limbs.
Following the method of ST, a method of measuring the endurance of upper limbs is worked out as shown belows;
A method of measuring the endurance of upper limbs;
Arm Test (hereinafter referred to as AT) (A tentative idea)
Kinetic load method;
for male: floor push-up type.
To bend and stretch successively for 30 times with two seconds each. (When stretching arms from bended position, to give a word every one second to prevent from using reactive power.)
To make him sit and count his pulse at following three different times;
P₁: 30 sec.-45 sec. after
P₂: 1 mm. -1 min. 15 sec. after
P₃: 1 min. 30 sec. -1 min. 45 sec. after
(However, the time to start measuring is quickened as well as measuring time is shortened because of quick recovery of pulse after the excersise.)
Exponential Equation:
AT=60 (loaded times/sec.) /P₁+P₂+P₃×100
(ST method is applied also in this case, but calculated based on basic calculation formula, as the marks obtained was one half of that of ST.)
The auther applied this test together with ST to several groups to find out that the sum of the marks of AT and ST as well as ratio differs in each group. In other word, the sum of the endurance of both upper and lower limbs is taked for as the endurance of the whole body and the ratio of these as the difference of the endurance between the upper and lower limbs.
We will study further on as to the appropriateness of this measuring method and calculation formula of the marks to find out method of measuring the endurance of upper limbs, and at the same time will study the method of evaluating the endurance of whole body.

The patient was a 70-year-old woman with severe aortic stenosis and familial hyperlipidemia which was diagnosed in 1994. The patient was admitted as an emergency case due to syncope in 2002. According to ultrasound cardiography (UCG), the pressure gradient of the aortic valve was 120.7mmHg, and the diameter of the aortic valve annulus was 16.7mm. Computed tomography showed porcelain aorta from the annulus of aortic valve to the ascending aorta. On cardiac catheterization, the pressure gradient was 96mmHg, AVA was 0.4cm², and the ejection fraction was 38.7%. Since these findings suggested that conventional AVR was difficult, thoracotomy was performed at the left 5th intercostal level, and apicoaortic valved conduit (valved graft: SJM19HP, Intergard 22mm+Medtronic apical LV connector) was implanted. Postoperative cine MRI showed that most of the cardiac output (87%, 3.29l/min) flowed through the conduit, with the flow via the aortic valve accounting for 13%, 0.51l/min. This surgical procedure can be an effective alternative when conventional AVR is difficult.

In Akita Prefecture, there are nine hospitals established by the Akita Prefectural Federation of Agricultural Cooperatives for Health and Welfare (Koseiren). Half of the stroke patients in the prefecture were treated in these Koseiren hospitals, and half of the mass screening projects for the prevention of cardio vascular diseases were undertaken by these hospitals. A retrospective cohort study was done using mass-screening data (age, sex, past history of diabetes mellitus, blood pressure, body mass index, smoking and drinking habits) of 175,033 cases stored at these hospitals from 1988 to 1999, and the prefecture-wide stroke data of 2,520 initial stroke events registered from 1988 to 2003. The number of stroke cases was broken down into 1,428 cases of cerebral infarction (57%, CI), 693 cases of cerebral hemorrhage (27%, CH) and 399 cases of subarachnoid hemorrhage (16%, SAH). The subjects were also divided into five age groups:30-49, 50-59, 60-69, 70-79 and 80-89. Blood pressure (BP) was classified into six categories according to the JNC 6 criteria. Risk factors were determined using the Cox analysis. The hazard ratio for CI and CH was increasing with advancing age. CI showed a higher hazard ratio in men than women (hazard ratio for men was 1.8). The hazard ratio was increasing as BP became higher in any of three stroke subtypes, and especially CH showed the strongest correlation with BP. Uncontrollable risk factors were very closely associated with the attack of CI. On the other hand, BP (controllable risk) was closely linked with the attack of CH. Our results showed the prevention of CI was not easy. Controlling BP may be the most effective strategy for preventing hemorrhagic stroke (CH and SAH).
Cerebrovascular accident ; Cephalic index ; Blood pressure determination ; hazard ; Risk Factors

A number of investigators have been concerned with the anthropometric as well as physical characteristics of sumo wrestlers during the past several decades. However, none have attempted to determine body density and percent body fat by the most accurate technique of hydrostatic or underwater weighings. Thus, a precise quantification of body density and percent body fat for the wrestlers has not yet been obtained. Ogawa et al. (1972) have predicted the body composition of sumo wrestlers from a formula which added the triceps and subscapular skinfold thicknesses. As the regression equation used in this instance was based on samples of normal young men, it may not have great predictive accuracy when used on the exceptional population of very stout athletes.
The purposes of this study were : (1) to assess the validity of percent body fat estimation by skinfold thickness measurement when compared to the hydrostatic weighing criterion method ; (2) to determine the interrelationships between anthropometric variables for use in the clear assessment of the physical characteristics of ‘Shindeshi’ sumo wrestlers ; and (3) to thereby develop a formula that would reliably predict percent body fat using skinfold thicknesses and/or anthropometric measurements in this exceptional population. The interrelationships between anthropometric and body composition variables were investigated using 35 Shindeshi sumo wrestlers, aged 15-20 years (X=16.5±1.5) .
The results of the present study can be summarized as follows.
1. The Shindeshi in the present study possessed physiques more developed than those tested in the past, as evidenced by Rohrer's and Ponderal Indices which were approximately 180 and 26.2, respectively. The development of body weight was particularly notable (i.e., over 100kg) .
2. Percent body fat for the Shindeshi was remarkably higher than that of a normal population of the same age, with approximately seventy percent of the Shindeshi possessing more than 20% body fat and less than 1.05000 body density.
3. Body density and height correlated negatively and insignificantly with almost all the variables. In contrast, correlations of body weight, circumferences, and all other variables were, in most cases, high and positive, with body weight correlating least with height. The skinfold measurement correlating best with % body fat was that taken at the thigh site (r=0.898) . The circumference measurements correlating best with % body fat were obtained at the thigh (r=0.888 and 0.831) and the abdomen (r=0 885) parts.
4. Of the six formulae for estimating % body fat, Sloan's correlated best with % body fat as determined by densitometry, and best approximated the mean value of 24.5%. However, all of the equations underestimated the measured % body fat of the Shindeshi.
5. When an exceptional population is being investigated, estimation of % body fat should be done with a population specific equation to ensure predictive accuracy. The following multiple regression equation (r=0.963) should, therefore, be utilized for estimation of % body fat in sumo wrestlers.
Y=0.2488x₁+0.6172x₂-14.3962 where x₁ and x₂ are abdomen circumference and skinfold thickness at thigh, respectively.

This study aimed to estimate the cost-effectiveness of pregabalin treatment for neuropathic pain.
Design:Long-term simulations based on state transition models.
Methods:We examined the cost-effectiveness of pregabalin for treatment of three common peripheral neuropathic pains, postherpetic neuralgia(PHN), painful diabetic peripheral neuropathy(DPN), and radiculopathy, using the incremental cost-effectiveness ratio(ICER). We used quality-adjusted life years(QALYs)as an index of effectiveness, and also estimated medical costs. For PHN and DPN, we constructed state transition models comprising two states, with and without pregabalin treatment, and performed 52-week simulations. The pain scores reported in Japanese phaseIII studies were used to set patients' weekly pain scores. The results of utility surveys conducted overseas were used as utility scores, while values randomly sampled from probability distributions were used to set weekly pain scores and drop-out rates. In base-case analyses, we performed 1000 1st-order Monte Carlo simulations using 1000 values randomly sampled from probability distributions, and calculated QALYs and medical costs for 52 weeks for each group. For radiculopathy, the ICER was calculated from changes in QALYs for 12 weeks reported overseas and medical costs estimated separately for the identical period.
Results:The ICERs for PHN, DPN, and radiculopathy were 1,116,886 Yen/QALY, 1,100,420 Yen/QALY, and 1,095,943 Yen/QALY, respectively, which were well below the upper limits of ICER ranges for treatments considered cost-effective. There were no cases in which ICERs obtained from scenario and sensitivity analyses differed significantly.
Conclusion:Pregabalin was shown to be cost-effective treatment for neuropathic pain.

This study evaluated factors influencing residual aortic regurgitation (AR) after valve re-suspension surgery for acute type A aortic dissection. From January 1996 through December 2002, 63 patients were treated for acute type A dissection at our institution. Among these 63 patients, pre-and postoperative echocardiograms were available in 38 patients who underwent surgery combined with native aortic valve re-suspension. These 38 patients were divided into 2 groups according to the postoperative AR grade, i. e.: AR group: AR grade≥II (n=6), no-AR group: AR grade≤I (n=32). The severity of pre and postoperative AR was assessed by transthoracic or transesophageal echocardiography. The preoperative diameters of mid ascending aorta and sinotubular junction, and the percentage of the circumference of the dissection at the sinotubular junction level was measured by enhanced CT scan. Preoperative patient backgrounds were similar in both groups. The preoperative AR grade in the AR group was significantly greater than that of the no-AR group (2.25±1.17: 0.69±0.91, p<0.001). The tear was more frequently located in the ascending aorta in the AR group than in the no-AR group (66.7%: 37.5%, p<0.05). The percentage of circumference of the dissection at the sinotubular junction level did not affect the preoperative AR grade, but it did show a tendency to influence the severity of postoperative AR, though the difference was not significant. Three patients (7.9%) had AR grade III at the time of discharge, but did not clinically require further surgical intervention. Preoperative significant AR and the location of the tear in the ascending aorta are associated with postoperative residual AR after aortic valve re-suspension. The percentage of circumference of the dissection at the sinotubular junction level might influence the severity of postoperative AR.

　　Chronic kidney disease (CKD) has recently been reported to be an independent risk factor for stroke. However, a detailed analysis was yet to be conducted according to stroke subtype. We attempted to determine the risk factors for stroke using data from the “specific health checkup” for metabolic syndrome conducted by the 9 hospitals affiliated with the Akita Prefectural Federation of Agricultural Cooperatives, and evaluate and determine the risk factors for stroke. There were 401 patients who had undergone metabolic syndrome checkups from 2007 and 2010 and suffered from stroke afterwards within 3 years after the screening. The controls were all 69,407 subjects who were screened during the same period. The predictors examined were sex, age, blood pressure, BMI, cholesterol values (HDL・LDL), history of diabetes mellitus, presence of atrial fibrillation, CKD, and drinking and smoking habits. Analysis was conducted using logistic regression. The risk factors for stroke as a whole were male sex, age, blood pressure, diabetes, atrial fibrillation, CKD, and smoking history. For cerebral infarction, the risk factors were male sex, age, blood pressure, diabetes, atrial fibrillation, CKD, and smoking habit. The risk factors for cerebral hemorrhage were age, blood pressure, and CKD. For subarachnoid hemorrhage, the risk factors were female sex, age, blood pressure, low HDLemia, and CKD. In conclusion, CKD is an independent risk factor for the 3 subtypes of stroke, and in particular plays an important role as a higher risk factor for cerebral hemorrhage. Smoking cessation and controls of blood pressure, diabetes and atrial fibrillation are the important measures for stroke prevention. In addition, the further intervention should also be targeted to those with the result of CKD revealed by specific health checkups.