The purpose of this study is to develop the non-invesive method for three dimensional analysis of knee extensor and knee flexor muscle groups of the thigh part in human subjects. Our system consisted of magnetic resonance imaging (MRI) to get cross-sectional images of muscle and a computer graphics system which reconstructs three dimensional image of each muscle. The subjects chosen for this study were four healthy male adults, aged from 21 to 30 years. MRI scan was carried out from head of the femur to the upper border of the patella along thigh. Three dimensional (3D) muscular image was reconstructed based on the data from MRI. Referring to the anatomic feature, contour information of knee extensor muscles (KEM) and knee flexor muscles (KFM) was identified on MRI and those muscles were reconstructed to 3 D images using the computer graphics system. This system also provided information on the quantitative volume and cross-sectional area (CSA) of each muscle.
The structure of each muscle of KEM and KFM was displayed by a wireframe model or a surface model on the CRT. It was revealed that 3D muscular images of the surface model using coloring and shadowing were highly effective to understand their shapes and relative location of muscles. CSA and volume of KEM were 86.84±8.38cm²and 2044.25±168.28cm³ and those of KFM were 38.48±5.90cm² and 751.95±50.56cm³ respectively.
These results indicate that not only the anatomical information but also the volume and maximum CSAs of KEM and KFM can be measured quantitatively by this method using three dimensional analysis.

Using three-dimensional (3 D) imaging, we investigated the morphological characteristics of the M, latissiums dorsi (LD) and M, erector spinae (ES) of the dorsal trunk in judo athletes employing a computer graphics system on magnetic resonance imaging (MRI) . The subjects were five healthy untrained women (HUW) without lower back pain syndrome, and five Japanese female elite judo athletes (EJA) . There was no significant difference in height or weight between the HUW and EJA. Three-dimensional imaging of the LD and ES was reconstructed visually, based on MRI consecutive slice data taken from the first thoracic vertebra to the symphysis pubis along the trunk. Then the volume of the LD and ES was determined using a surface reconstruction algorithm.
The morphological characteristics of the LD in the EJA appeared to indicate enlargment compared with those in the HUW, whereas the characteristics of the ES in both groups were similar. The volume of the LD was significantly different between the HUW (226.6±33.18 ml) and EJA (438.1±107.8 ml), whereas that of the ES showed no difference (HUW; 257.4±78.8 ml, EJA ; 284.0±74.82 ml) . In the EJA, but not in the HUW, there was a significant positive correlation between the volume of the LD and weight, and differences were noted between the two regression slopes. There was also a positive correlation between the volume of the ES and weight in both the HUW and EJA, which showed the same simple linear regression slope. These results suggest that the muscle hypertrophy evident in the LD, but not in the ES, is related to the effects of Judo training.

Recently, basophil activation test (BAT) has been applied to the diagnosis of drug allergy. We performed BAT for various Kampo medicines taken by 12 cooperators to evaluate the concentration which arouse nonspecific reaction during incubation in BAT. When whole blood of each was incubated for 24 hours with each Kampo medicine, false positive results were frequently observed. After 1-hour incubation with Kampo medicine at high concentration (1/312.5), false positive results were sometimes observed. These results suggest that in the diagnosis of Kampo-medicine adverse reactions, BAT should be performed in the condition of 1-hour incubation with lower concentration (1/1250 or lower).

A 47-year-old woman visited our clinic, and thereafter she had taken various Kampo medicines until she turned 58 years old. She took each medicine, containing 1-3.5 g/day of glycyrrhiza, for one or two months. Hypertension or edema was not observed in those days. From the age of 60, she took 7.5 g of tokishigyakukagoshuyushokyoto, containing 2 g of glycyrrhiza, day after day. Hypertension or edema was not observed for 35 months. However, when she was 63 years old, pseudoaldosteronism with headache, hypertension, edema,and hypopotassemia was observed for the first time. This case suggests that administration period or patient's age influences the development of pseudoaldosteronism.

Incidence of glycyrrhiza-induced pseudoaldosteronism is not well understood. We examined relationships between pseudoaldosteronism incidence and daily glycyrrhiza dose in previous clinical studies. The incidence in patients administered glycyrrhiza 1 g/day was 1.0% (mean). The incidence with 2 g/day, 4 g/day and 6 g/day were 1.7% (mean), 3.3% and 11.1% (mean), respectively. Thus a dose-dependent trend toward pseudoaldosteronism incidence was suggested by previous literature.

A 62-year-old woman was admitted to a regional hospital for acute myocardial infarction. Emergency coronary angiography revealed occlusion of the first diagonal branch, and transesophageal echocardiography showed severe mitral regurgitation due to anterior papillary muscle rupture. She was transferred to our hospital in a state of cardiogenic shock despite the use of high-dose catecholamine and intra-aortic balloon pumping. We immediately performed mitral valve replacement. The patient's postoperative course was uneventful and she was ambulatory when transferred to another hospital on foot on postoperative day 19. Physicians should be aware that fatal anterior papillary muscle rupture may be caused by isolated occlusion of the diagonal branch.

In recent years, physical inactivity among children or adolescents has been a major public health concern. Although a number of studies have examined the effect of physical inactivity on depressive symptoms in adults, only few studies have examined this effect on children. Therefore, the purpose of this study was to examine the effect of physical activity on the development of depressive symptoms in children by using longitudinal data. The study participants were students in grades 4 to 8 in the Koshu City. Their physical activity and depressive symptoms were examined in 2008 by a questionnaire. One year later, their depressive symptoms were examined again. Students who had depressive symptoms at the baseline were excluded. Physical activity at the baseline was categorized into 3 groups as independent variables. The development of depressive symptoms was used as the dependent variable. Multivariate logistic regression analyses were performed to examine the relationship. At the baseline, 1532 students completed the questionnaire. Of them, 1379 students (727 boys and 652 girls) did not have depressive symptoms. One year later, 1319 students (95.6%) completed the questionnaires on depressive symptoms. Of them, 41 (6.0%) boys and 68 (10.6%) girls had developed depressive symptoms during the study period. High physical activity was significantly associated with decreased incidence of depressive symptoms compared to low physical activity only in boys (odds ratio: 0.37, 95% confidence interval: 0.12-0.95). Our results suggest that high physical activity significantly affects the depressive symptoms in boys.

Electromyographic muscle activities of the shoulder muscles during shoulder external rotation with reference to load magnitude were studied in 8 healthy male subjects without history of shoulder injuries. In addition, we discussed the relationship between rotator cuff muscles and superficial muscles. The subjects performed shoulder external rotation from 60°internal rotation to 45° external rotation at 20° of shoulder abduction and 20° of flexion. A Cybex dynamometer used to prescribe angle and velocity of the shoulder movement. At the same time, intramuscular wire electrodes were inserted into the supraspinous, infraspinous and teres minor muscles, and then surface electrodes were placed over the posterior deltoid and middle trapezius muscles. The load magnitude ranged 2-18 Nm and the angle velocity was set at 15 deg/sec. The rotator cuff muscles became significantly to be activated from 2 Nm (the supraspinous and infraspinous m.) and from 4-5 Nm (the teres minor m.) compared with the muscle activity during non-load. The superficial muscles became significantly to be activated from 4-7 Nm (the posterior deltoid m.) and from 3-6 Nm (the middle trapezius m.) compared with the muscle activity during non-load. Within the load range (18 Nm 46.8% MVC), %iEMG of the rotator cuff muscles was always larger than that of the superficial muscles. Therefore, we concluded that the contribution of the rotator cuff muscles was larger than that of the superficial muscles up to 3-4 Nm, and activities of the superficial muscles increased gradually from 3-4 Nm during shoulder external rotation.

[Objective] The aim of this investigation was to evaluate bone metabolism responses to acute resistance exercise during the menstrual cycle. [Methods] Subjects were young healthy sedentary women (n=7) with regular menstrual cycles. The subjects performed acute resistance exercise in each phase (follicular and luteal) of the menstrual cycle. Bone metabolism markers (bone formation marker BAP and bone resorption marker ICTP), bone metabolism related hormones (parathyroid hormone, calcitonin, calcium and inorganic phosphorus) and lactate were determined. Blood samples were collected before (Pre) and immediately following the exercise (Post), 1 hour (P1h) and 24 hours (P24h) after the exercise. [Results] BAP significantly increased at Post compared with Pre both in the follicular and luteal phases (p<0.05), but significantly decreased at P1h and P24h in the luteal phase. ICTP significantly increased at Post in the follicular phase (p<0.05) and significantly decreased at P1h and P24h in the luteal phase. The bone metabolism responses in the luteal phase moved to low-bone turnover at P1h and P24h. [Conclusion] The bone metabolism response to acute resistance exercise was different between menstrual phases. These results suggest that bone metabolism is influenced by the menstrual cycle.