A system for making prolonged measurements of oxygen uptake without the use of mask or mouthpiece is described. A subject wears a hood through which air is drawn by a exhaust pump located on the end of hoses. The flow rate of main stream is measured by a pulsed wire flowmeter located between flexible hose and rigid hose. The flow rate is essentially constant during a run. One sample pump bypasses small amount of mixed air from the main stream. The other pump draws the room air. Two sample pumps operate alternatively at 2 min interval. The sample gas is dried by passing through molecular sieve desiccant and is delivered to in-line oxygen analyzer. Both signals of flow rate and oxygen concentrations of room air and mixed air are converted to digital quantities and then stores in memory devices at 5 min interval. All measuring devices were assembled to small package which the subject carries on his back. The weight was about 7 kg. The memory chip is removed from the device after experiment and oxygen uptake is estimated by connecting the memory chip to a microcomputer. This measurement compared favorably with measurement with Douglas bag collection and gas analysis.

A 73-year-old man complained of pain in the right lower abdomen with hypotension. The result of abdominal computed tomography (CT) suggested a rupture of an abdominal aortic aneurysm. Emergency Y graft replacement was performed. During surgery, a perforation of about 1cm in diameter was found in the posterior wall of the abdominal aorta just above the iliac bifurcation. The patient developed postoperative complication of retroperitonitis. The cultures of blood clots collected during surgery grew Bacteroides fragilis, as did postoperative drainage fluid from the retroperitoneum. On the 10th day of illness, axillo-bifemoral bypass was performed and the Y graft was removed. Although continuous lavage of the retroperitoneum was performed, he did not recover from retroperitonitis and died of sepsis 2 months after surgery. Infected abdominal aneurysm is rarely caused by Bacteroides. We discussed the infectious route and treatment of this rare condition with a review of the literature.

[Objective] To examine the effect of moxibustion treatment for reducedpain during activity due to hallux valgus.
[Methods] The subjects were five young females with pain due to hallux valgus. Indirect moxibustion treat-ment was carried out on the region of maximum pain to relieve pain. Moxibustion was performed once per day for 2 weeks, for a total of 14 times. Evaluation used the number of side steps performed and the pain (Numerical Rating Scale) at the time of a side step.
[Results] After moxibustion treatment, pain improvement was observed in all subjects at the time of a side step. At the same time, the number of side steps increased. Repeated measurements before and after moxibustion indicated that there was no significant learning effect.
[Discussion and Conclusion] It became clear that the pain due to hallux valgus is mitigated by moxibustion over a fixed period, while athletic ability with respect to side steps is also improved. These results suggested the pain during activity due to hallux valgus is controllable with moxibustion treatment. By controlling pain, moxibustion treatment also temporarily improves athletic ability.

The purpose of this study was to investigate characteristics of past injuries of female university soccer players in comparison with injuries in male university soccer players.
We investigated past injuries of female players (n=32) and male players (n=24) . A past injury was defined as any injury sustained during soccer that required admission to a team doctor, medical attention or absence from practices or games for more than seven days.
The most frequent injury was Joint Injuries in both female and male players. High occurrence of overuse injuries of lower leg was most apparent in the female players. The 32 female players had experienced 144 injuries, or 4.5 injuries per player, and the 24 male players had suffered 85 injuries, or 3.5 injuries per player. The numbers of injuries per player of female players were 1.3 times higher than the male players. Also, the incidence of injury was 0.64 (injury/player/year) in female players, and 0.27 (injury/player/year) in male players. The incidence of injury of female players was significantly larger than that of male players.
We conclude that the prevention and care of overuse injuries in lower leg is very important for female succor players.

A simple exercise test with vertical jumping was developed for children. The vertical acceleration wave form of back was measured with strain gauge type transducer. After amplification and rectification, the signal of positive acceleration was converted to frequency with voltage-to-frequency converter (VFC) and VFC signals were decoded by a digital counter. The digital output was normalized by gravitational value and defined as physical activity rate. 10 young males and 24 schoolchildren jumped at several frequencies and oxygen uptake, physical activity rate and heart rate were measured. Also 28 children under school age jumped arbitrary and heart rate and physical activity rate were recorded. The results showed that the oxygen uptake per body weight had good correlation to the physical activity rate (r=0.95) . Although heart rate was significantly different with ages, physical activity rate which was defined as an index of exrecise test, was no significant difference with ages and weights (α<0.05) . The results indicated that this jumping test was helpful to make exercise stress test for younger children.

The purpose of this clinical investigation is to analyse the growth of the ventricular volumes and the changes of indices of cardiac performance during infancy and childhood. The materials were composed of 129 healthy infants and children (4 months to 13 years of age), who had a history of Kawasaki disease and without any evidence of coronary artery lesion. All the cases underwent cardiac catheterization and cineangiography under sedation. Volumes of the left and right ventricles were calculated by integration methods in tow frames for end-diastole and end-systole from biplane cineangiograms. Left ventricular mass was calculated in 120 infants and children by Rackley's method.
All the volumes and masses were deviled by body surface area in order to normalize the crude values for infants and children of different size. The mean values of left ventricular end-diastolic volume index (LVEDVI), right ventricular end-diastolic volume index (RVEDVI) and stroke index (SI) for each age were less in the younger children than those in the older children, and abrupt stepwise increase was observed at 1 year, 6 years and 10-11 years of age in the values of LVEDVI, RVEDVI and SI.
The infants and chidren were divided into four groups according to age (under 1 year, 1 to 5 years, 6 to 10 years and more than 11 years) . The values of LVEDVI, RVEDVI, SI and LVmass index were less in the younger age groups than those in the older age groups, and the difference of each age groups was statistically significant. The value of left ventricular ejection fraction (LVEF) was less in the youngest group (under 1 year) than those in the another groups (p<0.01) . The value for right ventricular ejection fraction (RVEF) was not significantly different in the age groups. End-systolic pressure-volume ratio was normalized with left ventricular mass (LVESP/ (LVESV/LVmass) ) . This normalized ratio was the lowest in the youngest group (under 1 year) and the highest in the oldest group (more than 11 years) .
As mentioned before, abrupt stepwise increase was observed in the“normal”values of LVEDVI, RVEDVI and SI in infancts and children. The explanation of this fact may be difficult at present. By the evidence of the normalized end-systolic pressure-volume ratio, it can be said that the contractility of the left ventricle in“healthy”infants and children was increased according to age. The reason why the value of LVEF was less in the youngest group than those in the another groups can be attributed to the lower contrac-tility in the youngest group. A possible factor that the value of RVEF was not significantly different between the youngest group and the another groups is; because the right ventricle works under higher pressure during fetal and neonatal period, then the right ventricular performance developed already in infancy.

A 53-year-old man who had angina pectoris and juxtarenal aortic abdominal aneurysm was referred to our department. Because the coronary angiography showed severe triple vessel disease, coronary bypass grafting was performed prior to aneurysmectomy. Contrast enhanced computed tomography revealed a retroaortic left renal vein located behind the posterior wall of the aneurysm. The postoperative course was uneventful. Because of its complicated embryological development, the anatomy of the renal veins shows extensive variability. The incidence of retroaortic left renal vein was 2%. Large lumbar and retroperitoneal veins often joined it to form a complex retroaortic venous system. These veins are particularly vulnerable to injury during circumferential dissection of the proximal parts of the aorta. Unawareness of this anomaly and vigorous attempts at encircling the aorta with clamps can result in laceration of the vein. Subsequent catastrophic hemorrhage may lead to unfavorable results, nephrectomy or death. Therefore, preoperative evaluation by a contrast enhanced CT scan and adequate intraoperative management based on a understanding of the potential anatomical variations are imperative. We recommend crossclamp of the aorta proximally with a vertical clamp to avoid circumferential dissection with possible injury to a retroaortic left renal vein. Injury may necessitate division of the aorta to obtain exposure for venous repair. In addition, this anomaly may be related to aorto-left renal vein fistula syndrome and left renal vein entrapment syndrome.

A 41-year-old woman was given a diagnosis of Behçet's disease at age 25. When she was 31, a large aortic pseudoaneurysm developed near the left renal artery. Isolation of the aneurysm and anatomical grafting and ancillary bypass were performed. Ten years later, a graft duodenal fistula developed. Extra-anatomical reconstruction was done after complete resection of the original graft and the infectious lesion. It was found that the intra-abdominal organs were receiving blood supply only from the inferiol mesenteric artery. Moreover, severe ischemia of the intra-abdominal organs was a concern during surgery. Therefore, hepatic vein oxygen saturation was monitored continuously with a Swan-Ganz catheter for ischemia of the intra-abdominal organs. It proved to be a very effective indicator and we could perform this operation safely. Reoperation of grafting is often inevitable in patients with Behçet's disease. Also, two stumps of abdominal aorta were left in this patient because of the extra-anatomical reconstruction. Pseudoaneurysm may later occur at the site of the stumps, thus necessitating careful follow-up observations.

A 52-year-old man was referred to our institution because of a solitary aneurysm of the left common iliac artery. The presence of the aneurysm was demonstrated by CT and angiography. The aneurysm had a diameter of about 30mm. The walls of the bilateral external iliac arteries were irregular, like a string of beads. The aneurysm was resected and replaced with a vascular prosthesis. Histological examination of the aneurysm and a part of the left external iliac artery indicated a diagnosis compatible with fibromuscular dysplasia (FMD: medial fibroplasia). A solitary iliac aneurysm is rare, and is usually due to atherosclerosis. However, the aneurysm in this case was related to FMD. To the best of our knowledge, only one other case of a solitary common iliac aneurysm caused by FMD has so far been described.

Intravenous leiomyomatosis (IVL) is defined as the extension into the venous channels of histologically benign smooth muscle tumors originating either from a uterine myoma or from the walls of a uterine vessel. We report a case of IVL extending to the right atrium and right ventricle through the right internal iliac vein and the inferior vena cava. The patient was a 43-year-old woman. The tumor was extirpated by simultaneous median sternotomy and laparotomy with the use of cardiopulmonary bypass. It was necessary to use cardiopulmonary bypass in order to open the right atrium. However, it proved difficult to insert the venous cannulae into the inferior vena cava due to the presence of the tumors. In order to perform the cannulation, a trans-right atrial excision of this tumor was necessary. Nevertheless, hemodynamic deterioration tended to occur during the procedure because of unexpected bleeding. We believe that to safely carry out this operation, it would be better to ensure circulatory arrest before trans-right atrial excision of the tumor. We have been continuing preventive antiestrogen therapy because recurrence would be very likely if any tumorous tissue remained after surgery. Fortunately, no intravenous infiltration of the tumor has been detected by either pelvic computed tomography or ultrasonography during the 26-month follow-up period. Surgical excision of the tumors and postoperative medication are now believed to have been effective.