Aerobic dance (AD) is a form of fitness exercise whose program is constructed by a combination of various joint movements. Therefore the exercise is expected to give enough stimulus to not only the cardiorespiratory but also the musculoskeletal system. The purpose of this study was to evaluate the activity level of the leg muscles among the major 22 AD leg movements, or steps (13 low-impact steps and high-impact steps), by electromyography (EMG) analysis. The subjects were two trained AD instructors, who were asked to perform individual steps at a pitch of 144 bpm. EMG data were recorded from the iliopsoas, gluteus maximus, vastus lateralis, biceps femoris, tibialis anterior, and gastrocnemius muscles on the right side by means of surface electrodes. The half-wave of the raw EMG was rectified and integrated over periods of 20 s during the exercise. From the raw EMG data it was observed that the pattern and amplitude of the electrical discharge of each muscle varied in response to the difference in step motion. The integrated EMGs of the iliopsoas, biceps femoris, and gastrocnemius tented to show higher values for high-impact steps in comparison with low-impact steps, but that of the tibialis anterior showed a contrary trend. The mean value and stan-dard deviation of iEMG of each muscle for the 22 steps was calculated for the same subjects, and the muscle activity level was classified into 5 degrees. Making use of this evaluation table, it may be possible to construct an AD program that can activate the leg muscles impartially.

To investigate the relationship between maximal aerobic power (VO₂max) and fatigu-abililty during repeated isokinetic contractions, 39 male speed skaters (mean 20.8 years) served as subjects. They were divided into two groups according to their VO₂max levels ; high VO₂max group (HI, n=19) and low VO₂max group (LO, n=20) . VO₂max was measured in all subjects during incremental exercise on a bicycle ergometer and body composition was determined by densitometry. Cross-sectional area (CSA) of the leg extensor muscles was evaluated using ultrasonic method. Fatiguability was assessed during the fatigue test consisting of 50 repeated isokinetic knee-extensions at an angular velocity of 180 deg⋅sec^-1. Remark-able findings include :
1. There were no significant differences in body composition and thigh composition between the two groups except for high subcutaneous fat in group LO.
2. There were significant differences in VO₂max between group HI (3.93l⋅min^-1, 67.3 ml⋅kg LBM^-1⋅min^-1) and group LO (3.59l⋅min^-1, 59.9 ml⋅kg LBM^-1⋅min^-1) .
3. In the fatigue test, the average initial values did not differ, however, the average final values were higher in group HI. Also, a significant difference was observed in per unit CSA between the two groups.
4. Higher peak forces (kg) in group HI were observed after the initial 30 dymanic contractions per unit CSA and % of peak values (% peak force) .
5. A close relationship was demonstrated between VO₂max per LBM and the fatigue index, i. e., the mean decline in peak force with 50 contractions (r=-0.37, p<0.05) .
Based on the present findings it is suggested that maximal aerobic power (VO₂max) influences the rate of fatigue development even during short-term maximal isokinetic contractions, and that there may be some physiological cross-linkages between cardiopulmonary regulation and the metabolic properties of skeletal muscles. This finding is also in conformity with earlier results indicating the importance of oxygen delivery as a limiting factor for muscle performance.

Computer-based testing (CBT) has been used in Japan since 2002 to assess medical students' basic and clinical medical knowledge, based on the model core-curriculum, before they start clinical clerkships. For effective CBT, multiplechoice questions must accurately assess the knowledge of students. Questions for CBT are submitted by all medical schools in Japan. However, only 40% of questions are chosen for CBT and used at random; the other 60% of questions are rejected because of poor quality. Toimprove the ability of medical staff to devise questions, workshops were held at 30 medical schools. The acceptance rate of questions from schools where workshops were held was significantly increased. The workshops were extremely effbctive for improving the quality of questions.

OBJECTIVE: To assess actual rates of late vaginal stenosis and identify predisposing factors for complications among patients with previously untreated cervical cancer following high-dose-rate brachytherapy. METHODS: We performed longitudinal analyses of 57 patients using the modified Dische score at 6, 12, 18, 24, 36, and 60 months after treatment, which consisted of 15 interstitial brachytherapys and 42 conventional intracavitary brachytherapys, with a median follow-up time of 36 months (range, 6 to 144 months). RESULTS: More than half of the patients developed grade 1 (mild) vaginal stenosis within the first year of follow-up, and grade 2 (97.5%, moderate) to grade 3 (severe) stenosis gradually increased with time. Actual stenosis rates for grade 1, 2, and 3 were 97.5% (95% confidence interval [CI], 92.7 to 97.5), 60.7% (95% CI, 42.2 to 79.3), and 7.4% (95% CI, 0 to 18.4) at 3 years after treatment. Pallor reaction grade 2-3 at 6 months was only a statistically significant predisposing factor for grade 2-3 late vaginal stenosis 3 years or later with a hazard ratio of 3.48 (95% CI, 1.32 to 9.19; p=0.018) by a multivariate Cox proportional hazard model. Patients with grade 0-1 pallor reaction at 6 months showed a grade > or =2 vaginal stenosis rate of 53%, whereas the grade 2-3 pallor reaction group achieved a grade > or =2 vaginal stenosis rate at 3 years at 100% (p=0.001). CONCLUSION: High-dose-rate brachytherapy was associated with high incidence of late vaginal stenosis. Pallor reaction grade 2-3 at 6 months was predictive of late grade 2-3 vaginal stenosis at 3 years after treatment. These findings should prove helpful for patient counseling and preventive intervention.
Adult ; Aged ; Aged, 80 and over ; Brachytherapy/*adverse effects/methods ; Constriction, Pathologic/etiology/pathology ; Female ; Humans ; Iridium Radioisotopes/therapeutic use ; Middle Aged ; *Pallor ; Prognosis ; Prospective Studies ; Radiopharmaceuticals/therapeutic use ; Retrospective Studies ; Uterine Cervical Neoplasms/*radiotherapy ; Vaginal Diseases/*etiology/pathology