We analyzed the career options of students who had graduated from Kyoto University School of Medicine from 2002 through 2009. The percentage of graduates who chose to train as junior residents in the Kyoto University Hospital group, including Kyoto University Hospital and its related hospitals, did not differ between before and after the new clinical training system was enforced; however, after the start of the new system, the percentage of graduates choosing to train at Kyoto University Hospital significantly decreased, and the career options of graduates at hospitals related to the Kyoto University Hospital became diversified. An analysis of physicians who had trained at the Kyoto University Hospital group as junior residents from 2004 through 2008 showed no significant difference in the percentage of senior residents at the Kyoto University Hospital or its related hospitals who had graduated from Kyoto University or any other universities.

This study was designed to determine prediction equations of body density (BD) for athletes using anthropometric variables and to examine validity of the prediction equations. The subjects were 211 male and 198 female athletes aged 18 to 22 years. The subjects were measured for standing height, body weight, skinfold thickness, girth as well as body composition. Body composition was estimated from densitometry using underwater weighing method and pulmonary residual volume measurement. Skinfold thickness was measured at 9 sites on the right side of the body with an Eiken-type ski nfold caliper and 7 measures of girth were taken using a cloth tape. All measurements were done three times from April to October : pre-, mid- and post-competitive season, in order to find out a suitable site reflecting body composition change. Using multiple regression analysis, equations to estimate BD were obtained from standing height, body weight, skinfold thicknesses and girths. The effective prediction equations for BD were as follows : For Males
ED=1.11104-0.00053 (sum of chest, abdomen and quadriceps skinfold thicknesses in mm) -0.00027 (waist girth in cm) .
R=0.851, SEE=0.0051.
For Females
BD=1.11861-0.00054 (sum of abdomen, triceps and subscapula skinfold thicknesses in mm) -0.00054 (waist girth in cm) .
R=0.826, SEE=0.0062.
A cross-validation analysis of these prediction equations for BD correlated highly with hydrodensitometrically determined BD (r=0.832, SEE=0.0053 for males and r=0.812, SEE= 0.0062 for females) . Thus the prediction equations developed in the present study will be applicable to athletes.

This study examined cytokine responses to cold exposure together with the effects of exercise and thermal adaptation. Ten male short-track skaters who had adapted to a cold environment, and ten male inline skaters who had not, were each assigned to two experimental conditions. For the cold condition, subjects sat for 60 min at 5–8°C, then exercised on a cycle ergometer for 60 min at 65% maximal oxygen uptake (at 5–8°C), and finally sat again for 120 min at room temperature (20–25°C). In the control condition, subjects participated in the same protocol as the above but at room temperature (20–25°C). Blood samples were collected at pre-cold exposure, post-cold exposure (pre-exercise), post-exercise, post-30 min, post-60 min, and post-120 min, and analyzed for plasma concentrations of interleukin (IL)-1 receptor antagonist (IL-1ra), IL-8, IL-10, IL-12p40, soluble tumor necrosis factor receptor I (sTNFR-I), cortisol, and myoglobin by using enzyme-linked immunosorbent assay (ELISA). 60-min cycle ergometer exercise induced significant increases in plasma IL-1ra, IL-10 and IL-12p40 at room temperature in short-track skaters adapted to the cold, but significant decreases in these cytokines were observed with exposure to cold. These results indicate that acute cold exposure has a suppressive effect on cytokine response during exercise, suggesting the possibility of preventive effects on immunosuppression, heat stroke and allergy induced by exercise.

　　Hyperbaric oxygen (HBO) therapy for acute carbon monoxide (CO) poisoning is performed after oxygen therapy and breathing therapy. The usefulness of HBO therapy in emergency treatment has been reported. In this study, we examined the effectiveness of HBO for CO poisoning that was performed at our hospital over the past 5 years. Subjects were 23 patients who had HBO therapy for CO poisoning in the period January 2008-November 2013. The male to female ratio of the cases was 14:9 and the mean age was 54.6±20.8 years. The cause was suicide in 39.1% of cases and accident in 60.9%. The mean number of treatments was 5.4±6.8. The atmosphere absolute was 2ATA:2.8ATA=12:11. The ratio of direct conveyance of the patient to our hospital to indirect conveyance of the patient from another hospital was 15:8. The effectiveness of HBO therapy at the time of discharge was 73.9%. However, delayed neuropsychiatric sequelae (DNS) was detected in 3 of the 23 cases of CO poisoning. No correlations were found between elapsed time after CO inhalation and various blood parameters. However, time to start of therapy is important for DNS, and our results suggest that early treatment at a hospital with a hyperbaric chamber is necessary.

Glutathione S-transferases (GSTs), superoxide dismutase 2 (SOD2) and NAD(P)H:quinone oxidoreductase 1 (NQO1) are anti-oxidant enzyme genes. Polymorphisms of GSTs, SOD2 and NQO1 have been reported to influence individual susceptibility to various diseases. In an earlier study, we obtained preliminary findings that a subset of glutathione S-transferase T1 (GSTT1)-wt patients with varicocele may exhibit good response to varicocelectomy. In this study, we extended the earlier study to determine the distribution of genotype of each gene in the infertile population and to evaluate whether polymorphism of these genes affects the results of surgical treatment of varicocele. We analyzed 72 infertile varicocele patients, 202 infertile patients without varicocele and 101 male controls. Genotypes of GSTs were determined by polymerase chain reaction (PCR). Genotyping of SOD2 and NQO1 was performed using the PCR-restriction fragment length polymorphism (PCR-RFLP) method. A significantly better response to varicocelectomy was found in patients with the GSTT1-wt genotype (63.2%) and NQO1-Ser/Ser genotype (80.0%) than in those with GSTT1-null genotype (35.3%) and NQO1-Pro/Pro or NQO1-Pro/Ser genotype (45.2%), respectively. The frequencies of glutathione S-transferase M1/T1, SOD2 and NQO1 genotypes did not differ significantly among the varicocele patients, idiopathic infertile patients and male controls. GSTT1 genotype is associated with improvement of semen parameters after varicocelectomy. As the number of patients with NQO1-Ser/Ser genotype was not sufficient to reach definite conclusions, the association of NQO1 genotype with varicocelectomy requires further investigation.
Adult ; Genotype ; Glutathione Transferase ; genetics ; Humans ; Infertility, Male ; etiology ; genetics ; surgery ; Male ; NAD(P)H Dehydrogenase (Quinone) ; genetics ; Polymorphism, Genetic ; Predictive Value of Tests ; Superoxide Dismutase ; genetics ; Treatment Outcome ; Varicocele ; complications ; genetics ; surgery

Purpose: Total or proximal gastrectomy of the upper-third early gastric cancer (u-EGC) often causes severe post-gastrectomy syndrome, suggesting that these procedures are extremely invasive for patients without pathologically positive lymph node (LN) metastasis. This study aimed to evaluate the clinical applicability of a stomach function-preserving surgery, local resection (LR), with prophylactic left gastric artery (LGA)-basin dissection (LGA-BD). Materials and Methods: The data of patients with u-EGC (pathologically diagnosed as T1) were retrospectively analyzed. Total gastrectomy was performed in 30 patients, proximal gastrectomy in 45, and subtotal gastrectomy in 6; the LN status was evaluated assuming that the patients had already underwent LR + LGA-BD. This procedure was considered feasible in patients without LN metastases or in patients with cancer in the LGA basin. The reproducibility of the results was also evaluated using an external validation dataset. Results: Of the 82 eligible patients, 79 (96.3%) were cured after undergoing LR + LGA-BD, 74 (90.2%) were pathologically negative for LN metastases, and 5 (6.1%) had LN metastases, but these findings were only observed in the LGA basin. Similarly, of the 406 eligible tumors in the validation dataset, 396 (97.5%) were potentially curative. Tumors in the lesser curvature, post-endoscopic resection status, and small tumors (<20 mm) were considered to be stronger indicators of LR + LGA-BD as all subpopulation cases met our feasibility criteria. Conclusions More than 95% of the patients with u-EGC might be eligible for LR + LGA-BD.This function-preserving procedure may contribute to the development of u-EGC without pathological LN metastases, especially for tumors located at the lesser curvature.

This case report describes our first experience performing percutaneous epicardial catheter ablation for Burugada syndrome in our hospital. We describe the good results achieved in this case. The patient was a man in his 30s with no remarkable medical history. However, his family history was notable for the sudden death of his grandfather at age 37 years and his father at age 27 years. While asleep, the patient experienced convulsions and lost consciousness. During emergency transportation, defibrillation was performed 7 times by the ambulance crew. When the patient arrived at our hospital, sinus rhythm was observed on ECG. During resuscitation, Burugada syndrome was diagnosed based on ECG findings. On hospital day 6, an internal cardioverter defibrillator was implanted. After discharge, the defibrillator operated 10 times, so we opted for ablation treatment. Fractionated potential of over 150 ms was confirmed in the right ventricular outflow tract. A low voltage zone of <1 mV could be mapped, and the same site was cauterized a total of 46 times. As a result, ST segment amplitude decreased significantly in lead V1 on ECG. Percutaneous epicardial catheter ablation performed with reference to Nademanee’s report achieved good results in this case of Burugada syndrome.