Physiological responses to heat and heat tolerance were examined in summer and winter on 13 male athletic university students and male nonathletec university students. After staying for 30 min. in a climatic chamber maintained at 30°C with 70% relative humidity, sweating reaction was examined far 90 min, by immersing both legs up to the knees in a stirring water bath of 42°C.
Both groups showed significantly greater sweat volume, significantly lower Na concentration in sweat and considerably lower rise in rectal temperature and less increase in heart rate in summer than in winter. In both seasons, athletes showed smaller volume of sweat, lower Na concentration in sweat, lower rise in rectal temperature and less increase in heart rate than nonathletes.
It is concluded that heat tolerance of athletes was superior to that of nonathletes when assessed by our heat tolerance indices and this superior heat tolerance of athletes could be explained due to a result of physical training. Heat tolerance index, representing the magnitude of physiological strain in the body induced by heat load, was modified by using relative increase in heart rate in place of salt loss. It can be said that the modified heat tolerance index is useful as a substitute of the original heat tolerance index in field studies.

Clinical training programs play an extremely important role in the new postgraduate clinical training system introduced in 2004 because facilities for clinical training now include various health-related institutions in addition to the university hospitals and special hospitals for clinical training used in the previous system. Although educational goals have been established by the Ministry of Health, Labour and Welfare, trainees may have difficulty achieving these goals, even under the guidance of staff at the various facilities. There are differences in the function and quality of health-related institutions in the community. For the practical and convenient application of educational goals, we have attempted develop a “model program” to supplement the objectives indicated by the learning goals with more specific objectives. These supplementary objectives can be modified by individual institutions. We hope that this “model program” contributes to the development of objectives for each institution and helps improve the quality of the postgraduate training system in Japan.

OBJECTIVETo evaluate the potential benefit of carbon ion radiotherapy (C-ion RT) through comparison with photon intensity-modulated radiotherapy (IMRT) in dose distribution for prostatic adenocarcinoma.

METHODSIn randomly selected 5 patients, treatment planning of C-ion RT (4 coplanar beams) and IMRT (7 coplanar fields) were worked out by computer working station. In order to make a meaningful comparison, it was defined that the 95% isodose surface had to cover 100% of the PTV in each plan; all dose was given as normalized dose with the definition of the minimum dose of the PTV being equal to 95% of prescribed dose. Dose-volume histograms (DVHs) of the tumor and organ-at-risks (OARs) were calculated. Volume irradiated more than or equal to some specified doses, conformity index ( CI) , and inhomogeneity coefficient (IC) of each treatment plan was compared, respectively.

RESULTSWith C-ion RT, the mean irradiated volumes (in %) of the rectum were significantly smaller than that with IMRT except for 95% dose level, and C-ion RT could provide complete protection to the posterior rectal wall. In addition, C-ion RT could also remarkably reduce the dose to the bladder, femoral heads and non-target normal tissues at each dose level. Dose conformation and homogeneity in the target volume of C-ion RT were better than that in IMRT (mean CI50%, 3.36 vs. 5.04, mean CI95%, 1.20 vs. 1.46, mean IC, 0.03 vs. 0.12).

CONCLUSIONCompared with IMRT, C-ion RT can obtain better dose distribution, and may reduce tumor recurrence and radiation-induced complications in prostatic adenocarcinoma.

Adenocarcinoma ; pathology ; radiotherapy ; Aged ; Carbon Radioisotopes ; therapeutic use ; Femur Head ; radiation effects ; Humans ; Male ; Prostatic Neoplasms ; pathology ; radiotherapy ; Radiotherapy Dosage ; Radiotherapy, Intensity-Modulated ; methods ; Rectum ; radiation effects ; Urinary Bladder ; radiation effects

The patient was an 81-year-old male. During treatment of a refractory subcutaneous abscess, he was diagnosed with an infection of an infrarenal aortic aneurysm caused by unknown bacteria. Antibiotic administration was initiated, but the infection persisted and there was no improvement of the aortic infection focus or aneurysm morphology. In order to control the infection and avoid rupture of the aortic aneurysm, excision of the infectious abdominal aortic aneurysm, omental plombage, and debridement of the surrounding infected tissue were performed. According to histopathological examination of the extracted sample, findings were consistent with an infection of the aortic aneurysm. Although administration of antibiotics continued, the infection continued to worsen during the postoperative course and an enlarged subcutaneous abscess and miliary tuberculosis were indicated by computed tomography. Therefore, an acid-fast bacteria culture test of the subcutaneous abscess, sputum, and urine and Tuberculous (Tb)-real time polymerase chain reaction (PCR) tests were carried out. According to Tb-PCR test of the subcutaneous abscess, mycobacterium tuberculosis was detected. In the re-evaluation of the extracted sample, granulomatous inflammation with spindle-shaped cell fenestration around the necrotic tissue and the appearance of epithelial cells and multinucleated giant cells were observed. Findings were consistent with a tubercular infection of the aortic aneurysm. Anti-tuberculosis treatment was initiated, and significant improvement of the inflammation and subcutaneous pus in the right chest were observed. On Day 39 after surgery, the patient was discharged from the hospital and walked home with no help. We experienced a successful case of tubercular infection of an infrarenal aortic aneurysm requiring surgery. Infection was controlled and rupture of the aortic aneurysm was avoided with surgical treatment and antituberculosis therapy. (Surgical treatment by excision of infectious abdominal aortic aneurysm, omental plombage, and debridement of the surrounding infected tissue, and antituberculosis therapy were carried out.)