This study examined peculiarities in both muscle strength and cross-sectional area (CSA) among soccer players in comparison with those of archers as contrasting athletes. Subjects were 15 male soccer players and 9 male archers at N University. Measurement items were height, body weight (BW), isokinetic muscle strength (knee extension, knee flexion, hip extension, hip flexion) and CSA (psoas muscles). Isokinetic muscle strength (30, 120, 240°/sec.) was measured by Cybex6000 (Lumex Co.), and the psoas muscle CSA was determined using magnetic resonance imaging (Hitachi, Japan). Results were as follows : 1. There was no significant difference in isokinetic knee extension and flexion strength/BW at all angular velocities between soccer players and archers. 2. On isokinetic hip flexion strength/BW, the average values of soccer players were significantly higher at all angular velocities than those of archers. However, there was no significant difference in the average values of isokinetic hip extension strength at all angular velocities between the two groups. 3. The average value for the psoas muscle CSA in soccer players was significantly higher than that of archers. In this study, the biggest difference in muscle strength between soccer players and archers was hip flexion strength, and the CSA of the psoas muscle in soccer players, which is the main component of hip flexion, was significantly larger than that of archers. These findings showed the peculiarity of soccer players due to the constant demands of movements involved in ball kicking and running during practice and competition.

In Chinese medicine, Saiko-ka-ryukotsu-borei -to (SRT; Chai-hu-jia-long-gu-mu-li-tang) and Saiko-keishi-kankyo-to (SKT; Chai-hu-gui-zhi-gan-jiang-tang) are frequently used for patients with nervous constitutions who exhibit psychoneurotic symptoms. Specifically, SRT is used for patients of the excessive constitution type (Shi Zheng), and SKT is used for patients of the deficient constitution type (Xu Zheng).
In this study, in order to clarify the action of SRT and SKT on the central nervous system, the effects of these formulas on the monoamines and their metabolism in discrete brain regions in mice were examined.
1) Single-dose administration of SRT and SKT increased the levels of neurotransmitters and stimulated the metabolism in the dopaminergic nervous system of the corpus striatum (including the serotonergic nervous system for SRT).
2) Repeated administration of SRT stimulated the metabolism in the dopaminergic nervous system of the hypothalamus and hippocampus, and inhibited metabolism in the adrenergic nervous system. On the other hand, SKT stimulated dopamine metabolism in the hippocampus and inhibited the metabolism of serotonin.
From these results, it became apparent that single-dose administration of SRT and SKT caused the hyperfunction of the dopaminergic nervous system, and that repeated administration of the agents caused the hyperfunction of the dopaminergic nervous system and the dysfunction of the serotonergic nervous system. This suggests that the actions of SRT and SKT on the central nervous systems may exert an influence on the regulation of psychoneuroic symptoms by stimulating the doperminergic nervous system and inhibiting the serotonergic nervous system.

Background: Operative blood loss during open-heart surgery has been decreasing recently. We have stopped predonated autologous blood transfusions to reduce hospital stay and cost. Material and methods: In 70 consecutive elective open-heart cases, we used intraoperative hemodilutional autologous transfusions and intraoperative autotransfusions to avoid homologous blood transfusion. Predonated autologous blood transfusion was not used. All patients received an infusion of high-dose tranexamic acid prior to and after cardiopulmonary bypass (CPB). Results: Homologous blood transfusion was not required in 77.1% of patients who underwent open-heart surgery. When further classified, 84.5% of patients who underwent primary open-heart surgery, 41.7% of patients who underwent a reoperation, and 33.3% of patients who were preoperatively anemic did not require homologous blood transfusion. In patients who undergo reoperation and who are preoperatively anemic, the rate of homologous blood transfusion is high. Therefore, during the reoperation, intraoperative autologous blood transfusion should be used before starting CPB, and iron should be given to anemic patients prior to reoperation. Conclusion: Our strategy of blood conservation consists of intraoperative hemodilutional autologous transfusion, intraoperative autotransfusion, infusion of high-dose tranexamic acid prior to and after CPB and, avoiding predonated autologous blood transfusion. Based on our experience, predonated autologous blood transfusion is usually unnecessary for cases who undergo surgery for the first time and are not anemic. Predonated autologous blood transfusion should be reserved only for high risk patients with anemia and reoperation cases. For further blood conservation, we need to study the safety limits of non-transfusion in open-heart surgery.

This paper reports the results of clinical research on spring pollen disease based upon the Oriental medical diagnoses. Sixty-nine patients (twenty-four males and forty-five females) who were afflicted with the spring pollen disease were categorized into groups according to the types of Oriental herbal medicine that they responded to. Then, the authors compared the respective periods when the disease first developed in the patients of each group. A comparison was also made based on the differences between their objective signs and subjective symptoms.
As a result of the research, the types of spring pollen disease observed have been classified into the following three groups, with one exceptional type (see Example 4). The first is a group for which “a treatment for superficies-syndrome” (Kai-hyo) was effective using “the drugs of acrid taste and warm nature” (Shin-on) (see Example 23). The patients of this type first manifested their symptoms in the period between the end of January and mid-February. It was found that most of them exhibited a predisposition to a “hypofunctioning condition” (Kyo-sho), and were diagnosed as having pollen disease with the “wind-cold symptom” (Fu-kan-sho). The second is a group for which “a treatment for superficies-syndrome” was effective using “acrid and coldnatured drugs” (Sin-ryo) (see Example 22). Most of the patients of this type first manifested their symptoms after mid-February. It was found that they exhibited the symptom of “cold in the superficies” (Gai-kan) and “the pathogenic factor blending wind-evil and heat-evil” (Fu-netsu), and that most of them manifested “a hyper-functioning condition” (Jitsu-sho). They were diagnosed as having pollen disease with the “wind-warm symptom” (Fu-on-sho) of a “warm disease” (On-byo) with a strong “wind-evil” (Fu-ja) and weak “warm-evil” (On-ja). The third is a group with the mixture of “the treatment for superficies-syndrome” with “the drugs of acrid taste and warm nature” and those of “acrid and cold nature” (see Example 20). It was found that the patients of this group carried little predisposition to “a hypofunctioning condition, ” and that they exhibited a mixed condition of coldness and heat, carrying both characteristics of the first and second groups. They were diagnosed as having the pollen disease with “auxiliary symptoms” (Ken-sho), “the wind-warm symptom” of “a warm disease” combined with “cold-evil” (Kan ja).

The Ministry of Health and Welfare of Japan is planning a pooling system for multiple-choice questions (MCQs) for the national examination for medical practitioners. To clarify possible problems of such a system, a field study was performed by 10 medical schools in Japan using 90 MCQs from previous examinations. Nine hundred twenty-four 6th-year students participated in the field test. For each MCQ, the correct-response rates at the originating school and those obtained in the field test were significantly correlated. Thus, the correct-response rates to questions on the field test could be predicted from the rates at the originating schools. However, for each question the correct-response rate was significantly higher for students of the originating school than for students of other schools. In the national examination, care should be taken to prevent differences in scores on the basis of question sources.

The results obtained from a survey of balneal treatment and medical researches made at Hanezawa Spa in Yamagata Prefecture are summarized as follows.
1) Visitors to this spa vary in age, include both sexes in equal number and are, by far, farmers.
2) Visitors are mostly from the local area and surrounding villages and towns, 70% of whom come to the spa for recreation and 20% for therapeutic treatment and recuperation. The figures mentioned here greatly depend upon the time this survey was made, and it is quite probable that the number of visitors for balneal treatment should always be much larger.
3) In this survey, short-time visitors are largest in number, coming to the spa for recreation. Long-time visitors come there for balneal treatment. Visitors are mostly those with diseases of the digestive organs and those with the skin diseases.
4) The larger number of visitors bathe four to five times a day and about 40% of them drink hot-spring waters. Because of the presence of a large number of short-time visitors, the effect of balneal treatment and bathing reaction could not be made clear.
5) Only 4.4% of visitors came there under doctor's directions.
6) Observation of the effect of drinking hot-spring waters on the excretion of gastric juice revealed that it has power to neutralize acid in the stomach and to control the excretion of gastic juice. Such should naturally be the case because this spa is of alkaline muriated spring.
7) With a view to find the effect of drinking hot-spring waters at this spa, examinations were made of renal function. The results obtained from the dilution tests show that the urinary excretion has been delayed and the power of dilution has declined. It is advisable, therefore, that visitors should see whether they are afflicted with the diseases of kidney or circulatory system before they resort to drinking hot-spring waters at this spa.

Our overall surveys of medical consultations for balneal therapy and of balneal curation at the Namekawa Spa, Yamagata Prefecture may be summarized as follows.
1) The Namekawa Spa is one in the Iegatayama Spa family located in the border of Fukushima and Yamagata Prefecture, which is saline hydrogen sulphide spring in character.
There is only one hot-spring inn in this resort (Fukushimaya Inn). It is rich in natural scenery, without the atmosphere of an amusements center and isolated from the wordly things. It is purely a spa for balneal treatment.
2) The larger number of visitors to this spa are from within the prefecture, especially from the towns and villages around the spa, but, because of its nearness to Fukushima Prefecture, quite a number of visitors are from this prefecture.
The visitors are mostly farmers, especially those of advanced age.
Half the visitors have been at the spa before and many of them are in the habit of revisiting the spa year after year.
3) A majority of visitors come to the spa for therapy of diseases and for recuperation, which shows that this spa has the character of balneal therapy.

To reduce surgical invasion, we recently used a limited incision through a retroperitoneal approach in the abdominal aortic surgery. Between May 2001 and March 2002, 18 patients who had infrarenal aortic aneurysm, iliac aneurysm, or aortoiliac occlusive disease were surgically treated using a new approach at Dokkyo University Koshigaya Hospital. Although 1 patient with a short aortic neck had to be converted to conventional surgical incision, the remaining 17 patients were successfully treated with the limited incision (range, 6-10cm). Operative time and intraoperative blood loss were 275.2±62.9min and 968.5±473.8ml, respectively. None of these patients required homologous blood transfusion in the perioperative period. All patients were extubated in the operation room. Oral feeding and mobilization started on day 1.6±0.5 and 1.4±0.9, respectively. Furthermore, all patients were discharged home without serious complications such as postoperative ileus and perioperative death. These results show that the limited incision through a retroperitoneal approach is safe and effective in the abdominal aortic surgery. This technique maintains quality outcome while reducing surgical invasion.