Observations on the digital vascular hunting reaction to cold air exposure and measurements of physical characteristics were made among male university students: 88 non-athletic; 18 tall, lean non-athletic; 26 volleyball players. Experiments were carried out at about 3 p, m. in winter. The subjects sat at rest on a chair for 30 min in a room at 22°C and inserted their left hands up to the wrist with the palm downwards into a chamber at -10°C for 30 min. The skin temperature on the center of the dorsal surface of the distal phalanx of the left middle finger was recorded continuously starting at 5 min before the cold exposure. The physical status of volleyball players was characterized by large stature, a low body fat and long fingers, while that of tall and lean non-athletic subjects was characterized by light body weight, a low body fat, and long and slender fingers. In each group, the higher the temperature before cold exposure, the higher were the skin temperature at the first temperature rise during cold exposure and the mean skin temperature during cold exposure. The mean value of the finger skin temperature during cold exposure for volleyball players at a given value of skin temperature before cold exposure tended to be lower than those for non-athletes. The mean value of the finger skin temperature during cold exposure for volleyball players was lower than that for non-athletes. Among the non-athletes, tall and lean subjects showed a lower mean skin temperature during cold exposure. The skin temperature during cold exposure tended to be lower when the length of the finger was longer and the ratio of finger girth to length was smaller. The lower mean skin temperature during cold exposure for volleyball players might result from injuries and shocks to the finger received during volleyball training.

In an attempt to study the effect of a moderate work load on the concentration of serum erythropoietin and hemoglobin in young women, 8 female university students with a high hemoglobin content (group H), 7 female university students with a low hemoglobin content (group L) and 7 female university students with a tendency to be anemic (group A) were subjected to moderate work for 7 successive days in summer.
Each subject pedalled at a constant work load of 1.25kp at a cycling rate of 50rpm for 60min every day. Blood samples were drawn from the cubital vein under basal conditions on the day before training, the fourth day of training and the day after the training period. The results obtained were as follows; Group H showed a significantly higher erythropoietin concentration before training than groups L and A. The concentration of erythropoietin in group H decreased slightly during the training period, whereas those in groups L and A increased, although the differences were not statistically significant.
The concentration of serum iron in group H was significantly higher than that in group L before training. The former decreased significantly during the training period, whereas the latter was maintained at a lower level. The differences in blood constituents found among the three groups before training lessened after one week's moderate exercise.
The increase in Hb concentration in the subjects in groups L and A after training might have been induced by the augmented secretion of erythropoietin due to training for 7 successive days.

In an attempt to study the effect of physical training in a hot environment on physiological responses to heat and heat tolerance of men, six male university students were exposed to a combination of muscular exercise and environmental heat for 20 successive days in summer. Muscular exercise was performed on a bicycle ergometer at constant work of about 8 R.M.R.t at the cycling rate of 50 r.p.m. for 2 hrs in the room with a temperature of 30°C and 70%, R.H. Sweat test was performed on the day before the beginning of physical training, on 7th, 14th and 211th days of physical training. Sweating was produced by immersing both legs to just below the knees into stirring water of 42°C for 90 min after staying for 30 min in a climatic chamber of 30CC with 70%, R.H. Sweat volume observed in sweat test increased progressively throughout the period of physical training. Na concentration in sweat at a given sweat rate continued to decrease during the period of physical training and heterogeneity of the local sweat rate and Na concentration in local sweat was reduced by physical training in a hot environment. Rise in rectal temperature induced by a given heat stress decreased significantly during the first week, thereafter showed a trend bo be smaller. The mean value of heat tolerance index I, the magnitude of disturbance induced in the body concerning thermal regulation and water-electrolyte metabolism, decreased considerably during the first week of physical training, thereafter decreased slightly. Thus it might be said that improvement of heat tolerance was induced mostly during the early period (about 1 week) of successive exposure to a combination hard work and environmental heat. This improvement of heat tolerance accompanied by marked reduction of physical strain in terms of temperature regulation might be induced at the cost of increase in disturbance of water-electrolyte metabolism.

Anthropometric measurements were obtained on 126 male nonathletic first year university students (N-1), 178 male nonathletic third year university students (N-3) and 114 male athletic third year university students (A) . The mean values of height and body weight for group A were significantly larger than those for groups N-1 and N-3. Group A showed significant larger mean values of girth of chest, abdomen, thigh and upper arm than groups N-1 and N-3. Physical status of group N-1 was a little shorter and slender than that of group N-3. Group A showed significantly greater mean values of Rohrer's index and Brugsch's index than groups N-1 and N-3. The mean values of skinfold thickness and body fat (%) caluculated by using prediction formula from mean skinfold thickness for group A were significantly smaller than those for group N-3 and were essentially the same as those for group N-1. Bigger physique and smaller body fat content of athletes could be explained as due to a result of physical training and might be considered as the cause of superior physical fitness of athletes.
The following prediction equations for standard body weight (W) from height (H) using mean values of body weight and height (W and H) and their standard deviations (cW and aH) are proposed for the evaluation of overweight and underweight.
W=3W/HH-2W
and W=σW/σHH-σW/σHH+W
Plotting of body weight and body fat content in standard measure against height in standard measure was used to compare physical characteristics of athletes with those of nonathletes.

The purpose of this investigation was to determine the effects of daily walking on aerobic work capacity, vital age and other fitness components in middle-aged and elderly walkers. The subjects were thirty-six walkers (average 65.0±8.0 yr, 51-80 yr), whose training period averaged 13.5±9.0 yr. The walkers were significantly greater in maximal oxygen uptake (VO₂max), and oxygen uptake at the lactate threshold (VO₂LT), and were 6.5 yr younger in vital age (VA) than sedentary middle-aged and elderly. These findings suggest that middle-aged and elderly walkers have more favorable profile of aerobic work capacity and of health status when compared to sedentary persons.

1)We visited the Duke–NUS Graduate Medical School Singapore to learn the administration and management of, and the theory behind, team–based learning (TBL), a candidate educational method to replace the problem–based learning tutorial.
2)TBL motivates students to prepare for and engage in discussion. The grading of performance in TBL, certain characteristics of assignments, and the use of peer evaluation all promote individual and group accountability for learning.
3)To obtain the maximum overall benefit from TBL and to exploit group dynamics for effective learning, well–designed assignments are the key.

The procedure of cross clamping and declamping of the infra-renal abdominal aorta is common in the reconstructive abdominal aortic surgery. However, little is known to the oxygen free radical formations during the surgery. To evaluate the oxygen radical production, the malondialdehyde (MDA) levels in venous blood were measured prior to, during and after the operation with other metabolites such as C3, C3a, granulocytes, CPK, amylase, BUN, creatinine, beta-2-microglobulin, total protein (TP), hematocrit (Ht), GOT, GPT, LDH, lactate, potassium, and myoglobulin in ten patients of the infra-renal aortic aneurysm. The average of the aortic occlusion time was 63±18min in the patients. The levels of MDA (from 3.2±0.7nmol/ml to 2.3±0.5nmol/ml), C3, TP and Ht were decreased during the operation and there were significant correlations between the levels of MDA (r=0.486, p<0.01), C3 (r=0.59, p<0.01) and TP. It is, therefore, likely that the reduction of MDA and C3 levels is due to the blood dilution by the bleeding, fluid infusion and blood transfusion during the operation. The levels of C3a did not increase during and after the operation. The levels of CPK (from 73±40U/l to 920±705U/l) and amylase (from 183±87U/l to 444±420U/l) were temporary increased on the first day after the operation. The level of lactate was increased during the occlusion of the aorta (from 9.0±3.0mg/dl to 20.2±5.8mg/dl) and until the just after the operation (23.2±18.6mg/dl). The other metabolites such as GOT, GPT, BUN, creatinine and beta-2 microglobulin did not change throughout the investigation period. There was a substantial ischemia of lower extremities during the aortic occlusion resulted in significant increase of lactate level. These results suggest that the temporary occlusion of the infra-renal aorta during the common reconstructive abdominal aortic surgry does not produce the oxygen free radical formation which increases the lipidperoxidation level in the systemic circulation.

Eight patients with aneurysms in the ascending aorta and the aortic arch underwent reconstructive surgery under deep hypothermia and circulatory arrest between Jan., 1988 and Jun., 1991. The patients consisted of 3 males and 5 females, ranging in age from 45 to 73 years (62.0±11.8, mean ±S.D.). Four patients were operated on in emergency. The lesions in 7 of 8 patients were Stanford type A dissecting aneurysms and the remaining one was a true aneurysm in the ascending aorta and the proximal aortic arch. The operation time, extracorporeal circulation time, and circulatory arrest time were 432.6±147.3, 191.9±66.1, and 31.0±10.8 (16 to 47) min, respectively. In all cases, the ascending aorta and the proximal aortic arch were replaced by an artificial graft through the median sternotomy approach. The brachiocephalic artery was reconstructed in 2 cases. The intraoperative blood loss was 4, 685±2, 943ml and the blood transfusion was 4, 659±2, 779ml. All patients awoke from 2 to 19hr after surgery and no complication in the central nervous system was observed. The postoperative complications which were detected in 3 patients consisted of drug induced renal dysfunction in 1 case, sinus arrhythmia in another, and mild hepatic dysfunction in the last case. There were neither operative deaths nor late deaths during the follow up period which ranged from 1 month to 42 months. Deep hypothermia and circulatory arrest should be regarded as a good circulatory support technique in reconstrutive surgery of the ascending aorta and the proximal aortic arch.

A 67-year-old woman underwent simultaneous surgical treatment of aneurysms in the descending thoracic and abdominal aorta. The aneurysm in the descending thoracic aorta was 5.0cm in diameter. The abdominal lesion which was accompanied by closed partial dissection was located below the renal arteries and its diameter was 7.8cm. First, the patient was positioned in right decubitus position and left thoracotomy was made. The descending thoracic aorta was replaced with an artificial graft under partial cardiopulmonary bypass through the left femoral vein and artery. Thoracotomy was closed after removal of cardiopulmonary bypass and neutralization of heparin with protamine sulfate. The patient's position was then changed to supine, and following median laparotomy, her abdominal aorta was replaced with an artificial graft. Her postoperative course was entirely uneventful except for slight hoarseness and transient urine disorder. Although simultaneous operation for multiple aneurysms may give more surgical stress to patients, it can reduce the risk of rupture of the remaining aneurysm as compared with surgical treatment in two stages. The order in which aneurysms are operated on should be considered well in simultaneous operation. It was considered in this case that the thoracic lesion should be treated first because crossclamping of the abdominal aorta may increase cardiac afterloads and result in rise of intraluminal pressure and rupture of the thoracic aortic aneurysm.

1) The faculty development at each medical school from 2003 through 2005 was analysed.
2) The major themes in faculty development were problem based learning, tutorial, computer based testing, and clinical training.
3) Faculty development is considered an effective way to enhance the contributions of faculty members to medical education.