We report a 78-year-old man who had an impending ruptured atherosclerotic arch aneurysm combined with chronic dissecting ascending aortic aneurysm. The patient underwent a graft replacement of the ascending aorta and aortic arch using the elephant trunk method with the aid of profound hypothermia and continuous retrograde cerebral perfusion. Cerebral blood velocity was measured with transcranial Doppler (TCD) during operation. The TCD flow pattern after weaning of cardiopulmonary bypass indicated a state of brain edema. Therefore it is important in extensive retrograde cerebral perfusion to control the perfusion pressure and prevent destruction of the blood brain barrier aggressively. Pharmacological intervention could improve the safety of retrograde cerebral perfusion. Postoperative diagnostic images showed that the part of the distal anastomosis around the elephant trunk was not surrounded with thrombus. At this stage, it is not necessary to perform next extensive aortic replacement. It is important to consider the occurrence of complication, who using elephant trunk method, including paraplegia, thromboembolism, kinking of prothesis.

The purpose of the present study is to investigate protein metabolism during rapid weight reduction. Six male boxing players put on a restricted diet of their own accord for two weeks. Body weight changes were observed and a biochemical analysis was made of their urine and blood. The initial body weight of 66.1±3.0kg (mean±SE) decreased to 63.6±3.2 kg after two weeks (P<0.01) . The changes in lean body mass (LBM) by weight reduction were not significant, but the LBM tended to decrease after two weeks. The mean caloric intake was 2, 791±728 kcal before the study and 1, 643±548 kcal after two weeks. The reduction of carbohydrate consumption is much more than that of fat and protein consumption. The 3-Me/Cr in urine increased significantly after two weeks (348.1 ± 37.0 μol/g to 508.1 f 45.6 μmol/g, P<0.01) and the increase of Urea-N/Cr in urine (8.4±0.5mg/mg creatinine to 13.7±1.3mg/mg creatinine, P<0.01) was also significant after two weeks. Urine volume decreased significantly after two weeks (P<0.01) . There was no significant difference in the blood components during the weight reduction period. These results might suggest that rapid weight reduction and massive decrease of carbohydrate intake accelerate protein catabolism.

This study was carried out to determine the relationship between health status and physical fitness, and the contribution of each element of physical fitness to the health status of middle-aged and elderly men and women. The subjects were 889 males and females aged 30 to 69 years. Physical fitness tests and medical check ups were performed. According to health status, the subjects were divided into two groups ; the healthy group (HG, n=348) and the unhealthy group (UG, n=207) . Multiple discriminant analysis was applied to the multivariate data. Correct discriminant probabilities of multiple discriminant functions to discriminate the HG and UG were 70.2% and 68.2% for men and women, respectively. These results suggested that there was a relatively strong relationship between health status and the level of physical fitness in both men and women. The contribution of each element of physical fitness to health status was evaluated by correlation coefficients between the discriminant score representing health status, and performance on each element of the physical fitness test and age. Age and muscle endurance contributed significantly to health status in both men and women. In addition, close relationship was seen between health status and elements of cardiorespiratory endurance, balance, and muscle strength in men, while change in physique correlated with health status in women. From these findings, it was concluded that exercise programs for health promotion in middle-aged and elderly people should be provided separately with consideration of the degree to which these specific elements contribute to health status.