This study was designed to evaluate nutritional status of older endurance runners (age ; 62.5±2.5 yr., weight ; 53.8±4.2 kg, %fat ; 12.0±2.1%, mean±SD) by comparing with agematched sedentary individuals (63.6±3.5 yr., 58.4±9.1 kg, 15.6±4.0%) and middle-aged long distance runners (35.2±3.1 yr., 61.2±5.6 kg, 11.8±1.9%) . Average training distance of the older runners was a half of that of the middle-aged runners (44 vs. 85 km/week) . Maximal oxygen uptake in the older runners was significantly higher than in the older sedentary controls, but lower than in the middle-aged runners (50.4±4.1 vs. 30.6±3.5 vs. 64.0±2.2 ml/kg/min, respectively) . No differences were observed in the concentrations of serum albumin, serum iron and blood hemoglobin among the three groups. Intake levels of the three groups with regard to the major nutrients were sufficient as compared with the recommended dietary allowance appropriate for age, sex and physical activity level. Total caloric intake in the older runners was not remarkably higher than in the older controls in terms of kcal/day (2, 430 vs. 2, 230), but was significantly higher in terms of kcal/kg wt/day (45.5 vs. 38.9) . Percents to the total caloric intake of protein (15.2%), fat (25.4%) and carbohydrate (52.6%) in the older runners were almost identical to the other two groups. Ratios of animal to total in protein and fat were not significantly different among the groups. The intakes of calcium, iron, and vitamins A, B1, B2 and niacin were higher, but statistically not significant, in the older runners than in the older controls. These results suggest that nutritional status of older endurance runners is adequate for maintaining their health in a good state while keeping their active lifestyle.

Endovascular treatment is a first-line treatment for renal arteriovenous malformations (AVMs). Endovascular treatment might be effective in patients with aneurysmal-type renal AVMs, which involve one feeding artery and one drainage vein, because control of the feeding artery, rather than the aneurysm itself, could have a therapeutic effect. Herein, we describe two cases of patients with renal AVM with multiple renal artery aneurysms, who were treated by controlling the arterial inflow alone. In Case 1, the patient was a 76-year-old woman with renal AVM discovered during examination for another medical condition. A computed tomography scan revealed four renal aneurysms (φ38/44/24/35 mm) ranging from an intimal defect in the right renal artery to the drainage vein running into the inferior vena cava (IVC). Although we had planned to use a covered stent in the right renal artery to cover the intimal defect without embolization of the aneurysms, a minor artery proximal to the aneurysm was found near the orifice of the right renal artery. Therefore, we used a covered stent in the right renal artery after embolization of the most proximal aneurysm was performed. In Case 2, a 78-year-old man was referred to our facility because a renal AVM was found during examination for lower back pain. The distal posterior branch of the right renal artery attached to the multiple aneurysms and directly drained into the IVC, which was diagnosed as an aneurysmal-type renal AVM. Because there were no arteries arising from the aneurysms in the right renal artery, which fed the renal parenchyma, embolization of only the inflow artery was performed. For both patients, renal blood flow was maintained without any decrease of the renal function. In these patients, although renin-angiotensin system activity was within the normal range, and blood pressure became better controlled postoperatively. In addition, there was significant improvement in the brain natriuretic peptide (BNP) levels postoperatively. Thus, we believe that unstable hypertension and/or high-output heart failure as well as the aneurysmal size should be assessed in the management of renal AVMs.

BACKGROUND: Port wine stains (PWSs) are commonly treated with pulsed dye laser (PDL) as a standard therapy. However, it is not easy to predict the minimal effective dose in the first treatment session. OBJECTIVE: The aim of this study was to assess whether dermoscopic findings before and after laser irradiation corresponded with the clinical improvement of PWS in patients undergoing PDL therapy. METHODS: Seven untreated PWSs in 6 patients (a male and 5 females), who presented to our hospital between May 2008 to January 2010, were assessed in this study. The mean age was 36.3 years, ranging from 14 to 57 years. A PDL with a wavelength of 585 nm and a spot size of 7 mm was used. Before and after test irradiation, patients underwent dermoscopy and clinical photography, and we assessed whether the dermoscopic findings corresponded with clinical improvement after 3 months. RESULTS: There were no obvious differences observed in the clinical photographs between each test level immediately after irradiation. However, dermoscopic photographs showed differences as the irradiated energy increased. These changes corresponded to the clinical improvement after 3 months. CONCLUSION: Our study indicates that the minimal effective fluence can be predicted by observing dermoscopic change immediately after irradiation. We think that examining the dermoscopic findings immediately after irradiation allows the laser surgeon to predict the minimal effective fluence and this prevents adverse effects of the skin.
Dermoscopy ; Humans ; Lasers, Dye ; Male ; Photography ; Port-Wine Stain ; Skin