In order to give more effective instruction for running in sports medicine, the mechanical stresses in the knee joint during running at various speeds and step lengths were investigated.
The subjects were five male sprinters. Running conditions were as follows : 1) running at four speeds (2.5 m/s, 4.5 m/s, 6.5 m/s and maximum running speed) with natural step lengths, 2) run-ning with three different step lengths (1.0 m, 1.5m and preferred step length) at 4.5 m/s running speed, and 3) running at maximum speed using four different step lengths (1.0 m, 1.5m 2.5m and preferred step length) . Running movements were recorded using a high speed video camera. And ground reaction forces were also measured by a force platform. The compressive force and shear force in the tibiofemoral joint were computed from the results of two dimensional motion analysis. That is, the external force caused by ground reaction forces, the internal force produced by the mus-cle to develop joint torque and total force (external+internal force) were computed for both com-pressive and shear forces.
The total compressive force that affects the meniscus and articular cartilage in the tibiofemoral joint depended on the magnitude of internal force. The total compressive force increased with running speed and step length. Therefore, caution should be employed in changing running speed and step length for regulating the magnitude of total compressive force on the tibiofemoral joint. On the other hand, the total shear force that caused traction stress in the posterior cruciate ligament depended on the magnitude of external force. The posterior shear force was generated during the foot contact period, and increased with step length. As for total shear force in the tibiofemoral joint, care must be taken to regulate step length.

We performed the thromboexclusion procedure with reconstruction by an axillo-bifemoral bypass for unresectable abdominal aortic aneurysm combined with chronic renal faliure, and obtained satisfactory postoperative result. The patient was a 68-year-old male who suffered from a huge abdominal aortic aneurysm (AAA) and had a history of hypertension and chronic renal failure. The AAA was accompanied with a saccular portion 10cm in diameter which compressed and eroded the vertebral body. Aortic cross-clamping above the bilateral renal arteries was inevitable for resection in spite of the renal dysfunction. We decided that direct manipulation of the aneurysm was impossible despite it being on the verge of rupture, considering the high operative mortality. We employed the exclusion-bypass method to stabilize the aneurysm, that is, we constructed axillo-bifemoral bypass using a knitted Dacron T-graft 8mm in diameter and then intercepted the bilateral common iliac arteries by suture closure. Postoperative intraaneurysmal thrombosis progressed rapidly from the distal side, then it halted just below the bilateral renal arteries on the 12th postoperative day. Renal arterial flow was maintained and renal function improved. Bleeding from the operative wound occurred suddenly on the 5th postoperative day. Although this appeared to be disseminated intravascular coagulation initially, it had resulted from augmentation of fibrinolysis due do acceleration of coagulation. The markers of fibrinolysis for example α₂ plasmin inhibitor (α₂PI) and plasmin-α₂ plasmin inhibitor complex (PIC) were useful for diagnosis, and tranexam acid and aprotinin were effective for therapy. Although the exclusion-bypass method is technically less invasive and useful for high-risk AAA, the postoperative management is not easy because of the acceleration of the coagulation-fibrinolysis system.

Objective: Glycemic control varies based on lifestyle factors and stress coping mechanisms, which are influenced by personality. The psychological factors associated with glycemic control have not yet been established in patients with type 2 diabetes mellitus (T2DM). The relationship between a 5-factor model of personality and glycemic control was evaluated in individuals with T2DM. Methods: The subjects were 503 Japanese outpatients with T2DM. Glycated hemoglobin A1c (HbA1c) levels, depressive status, insomnia and personality traits were assessed. Lifestyle factors of the patients, such as habitual alcohol consumption and smoking, were also included in the analyses. Results: Because the influence of insulin therapy on HbA1c is so strong, we stratified the patients according to insulin use. Simple regression analysis showed a significant correlation between HbA1c and neuroticism in patients who did not use insulin. After adjustment for confounders, multiple regression analyses revealed that none of the personality factors, including neuroticism, were found to be associated with HbA1c. Conclusion These findings suggest that personality traits do not have a large impact on glycemic control. Further studies are required to confirm the relationships between psychological factors and glycemic control using a longitudinal study design.