Effects of amrinone and dibutyryl cyclic AMP (DBcAMP) on hemodynamics and myocardial metabolism were studied in 16 patients in the early postoperative period following open-heart surgery. Amrinone was administered continously at 10μg/kg/min for 5 hours and DBcAMP at 12μg/kg/min was infused concomitantly for the last 1 hour. Amrinone increased SVI, and decreased HR, PCWP, arterial systolic blood pressure, double product and central temperature difference significantly. Following concomitant administration of DBcAMP for 1 hour, further increase of CI, O₂ delivery, blood sugar and insulin were observed. Significant decrease of excess lactate from 9.31±3.27 to -1.31±1.83mg/dl (p<0.05) showed that anaerobic metabolism improved in the myocardium after amrinone administration, and the effect improved further to -3.64±1.8mg/dl following concomitant administration of DBcAMP. These data demonstrate that amrinone has beneficial effects on hemodynamics and myocardial metabolism, and following supplementary administration of DBcAMP, further improvement in hemodynamics was observed.

In the present study, we instiuted a long-term mild aerobic training program for older patients with hypertension and investigated its effects on serum lipids and lipoprotein concentrations. The intensity of exercise in mild aerobic training was adjusted to the lactate threshold level (LT), i, e., the level at which the blood lactate concentration began to increase nonlinearly with increasing work intensity. The training group (15 patients, 7 men and 8 women) and control group (15 patients, 7 men and 8 women) were 65-83 year-old patients with mean ages of 75.5±5.6 and 73.7±4.4 (mean±S.D), respectively, who had never exercised regularly up to that time. Treadmill training at the LT was carried out for 30min/day 3-6 times/week and continued for 9 months under the supervision of exercise physiology specialists.
In the training group, LT speed significantly increased from 3.43±0.65 km/h to 3.73±0.67 km/h (9.0%) in men, and from 2.75±0.57 km/h to 3.05±0.61 km/h (11.8%) in women (both P<0.05) . HDL-c was significantly increased 9 months after training both in men (19.2%) and women (20.9%) (both P<0.05) . The TC/HDL-c ratio, an atherogenetic index, was significantly (P<0.05) decreased by training in women but not in men. The other serum lipid and lipoprotein profiles were unchanged in both men and women. In the control group, all serum lipid and lipoprotein profiles were unchanged in both men and women.
The HDL-c level in the training group was higher than in the control group after 9 months in both men and women (both P<0.02) . The TC/HDL-c ratio in the training group was lower only in women (P<0.02) . There were no significant differences in other values between the training group and the control group in either men or women.
These results suggest that mild aerobic training at the LT is an effective method of improving the level of serum HDL-c, the TC/HDL-c ratio and aerobic capacity in the older patients with hypertension.

To investigate the relationship between adolescent sport activity and abnormalities of the lumbar spine on radiography and magnetic resonance imaging (MRI), 237 collegiate athletes (mean age 19.4), representing judo, wrestling, and track, were analyzed from the point of contact or noncontact sports. Radiologic and/or MRI abnormalities of the lumbar spine were found in 68.7% of contact sports athletes (judo and wrestling, n=147), 53.3% of noncontact sports athletes (track, n=90), 69.9% of athletes who have played contact sports over 9 years (C9 athletes, n=83), and 47.1% of atheletes who have done noncontact sports over 9 years (N9 athletes, n=17). Discopathy related abnormalities on radiologic examination were found in 25.3% and 11.8% of C9 and N9 athletes. Disc degeneration on MRI was found in 45.8% and 29.4% of C9 and N9 athletes. Spondylolysis was found in 31.3% of C9, 5.9% of N9, 31.3% of elementary-C (athletes who played contact sports during elementary school, n=96), 32.8% of elementary-L/I (limited contact/impact sports, n=58), and 8.6% of elementary-N athletes (noncontact sports, n=35), respectively. From these results, we concluded that contact sports activity during adolescence induces lumbar spine abnormalities at a higher rate compared to noncontact sports and that spondylolysis is related to contact or limited contact/impact sport activity during elementary school.

Preoperatively, hypertrophic non-obstructive cardiomyopathy with asymmetrical septal hypertrophy was found in a 66-year-old man with a chief complain of effort angina whose CAG showed stenosis of 70% in LCA (seg 5) and 100% in RCA (seg 1) with collaterals from LAD. Although graft flows, 240ml to LAD and 28ml/min to RCA, were obtained, it was necessary to place the patient on the assisted circulation and catecholamines when the weaning from CPB was being tried due to “stone heart” despite patient had been on IABP during surgery and short anoxic arrest time of 44min. Postoperative hemodynamic recovery was slow with low cardiac output improved lately by the continuous use of IABP and DBcAMP. Catecholamines and vasodilators often cause disturbance of hemodynamics in hypertrophic obstructive type but seem to be effective in non-obstructive type. Importance of myocardial protection, use of IABP, careful administration of β-stimulants and DBcAMP are discussed in surgery of patients with cardiomyopathy.

A case of isolated left coronary artery ostial stenosis treated successfully by the saphenous vein patch plasty is reported. A 49-year-old woman was referred for surgery because of unstable angina with subendcardial infarction on ECG. Coronary angiogram showed isolated severe stenosis of left coronary artery ostium without stenotic lesion in the periphery and right coronary artery. At surgery, the aorta was incised obliquely downward to the left coronary ostium and this incision was further extended 8mm distally in the main trunk. Atheromatous left coronary ostium was enlarged with the saphenous vein patch. Postoperatively, angina disappeared and aortic root angioram revealed a well dilated ostium. At 1 year follow-up, the patient remains asymptomatic.

After a general clinical observation period of 3 months, men and women from 66-82 yr. of age with hypertension (n=10) were studied to assess the effects of long-term mild aerobic training and detraining on their blood pressure. Ten patients agreed to take part in aerobic training using a treadmill with the intensity at the lactate threshold (LT) for 30minutes 3-6 times a week for mean 17.1±9.8 months while the time course of changes in the resting blood pressure was monitored.
Following the training period the LT increased significantly by the end of the training period (P<0.001) . After 3months of training both the systolic and diastolic blood pressure decreased significantly (P<0.05, respectively) and both blood pressures stabilized at a significantly lower level throughout the remainder of the study. The mean blood pressure decreased significantly for 9 months (P<0.05) . Finally, the systolic, mean and diastolic blood pressure were found to have decreased significantly, by 9, 5, 11 mmHg, respectively by the end of the training period. (SBP and MBP: P<0.05, DBP: P<0.01, respectively) . One month after the training ended the systolic, mean and diastolic blood pressure all increased significantly (SBP and MBP: P<0.001, DBP: P<0.01, respectively) and approached the initial pre-training levels.
In conclusion, the antihypertensive effect of mild aerobic training at the LT was confirmed for older patients taking antihypertensive medications. However, the cessation of such training resulted in a quick return to pre-training levels.

The effects of long-term low intensity aerobic training and detraining on serum lipid and lipoprotein concentrations were examined in 10 older patients suffering from hypertension and coronary heart disease. Training was carried out for 30 minutes 3-6 times a week for a mean of 17.1 months using a treadmill with the intensity level set at the blood lactate threshold (LT) .
Following this training both LT and the serum HDL-c increased significantly (P<0.001, P<0.01, respectively) after 6 months while the TC/HDL-c ratio decreased singificantly (P<0.001) only after 1 month and stabilized at a steady favorable value throughout the remainder of the study. The serum TC, TG and LDL-c did not change significantly by the end of the training period. There was a significant negative correlation between the initial TC/ HDL-c level and the change in the TC/HDL-c level at 1 month after training (r=-0.71, P< 0.02) . Only 1 month after the detraining the HDL-c decreased significantly while the TC/HDL-c increased in comparison with the final training value (P<0.001, P<0.05, respectively) and then returned to the pre-training levels.
In conclusion, these results suggest that long-term low intensity aerobic training could improve the profile of the serum lipid and lipoprotein concentrations in older patients. However, these results might depend on such factors as a low HDL-c level, a high TG level, the length of the exercise period, or the frequency per week and the age of the patient, while the cessation of such training quickly returned the profile to that of pre-training levels.