A study was conducted to examine activity patterns of surface electromyograms (EMGs) in the triceps surae muscles (medial gastrocnemius, MG ; lateral gastrocnemius, LG ; soleus, SOL) during isometric contraction in plantar flexion (60% MVC, 20% MVC) after immersion in water at three different temperatures. Seven healthy male subjects were immersed in water at 2-3°C (ICE), 19-21°C (MID), and 40-42°C (HOT) . The results of the study are summarized as follows :
1) In the MG and LG, there was a slight increase in the rate of integrated electromyograms (IEMGs) in the MG (the main agonist muscle) . However, the rate of increase in the LG, which is the synergistic muscle, was much greater than that in the MG when contraction was sustained at 60% MVC. Therefore, the activity pattern suggests that muscle activity in the LG compensates for that in the MG.
2) The IEMGs of the SQL with sustained contraction, increased significantly after immersion in HOT and MID, but the IEMGs decreased after immersion in ICE. These results suggest that the recruitment threshold in slow-type motor units should increase during sustained isometric contrac-tion in ICE.
As illustrated above, the activity of the LG increased to compensate for that of MG. In the SQL, muscle activity with sustained contraction decreased in ICE. These results suggest that control mechanisms of the central nervous system might play an important role in the associated movement of the triceps surae muscles.

The purpose of this study was to compare changes in oxygenation in the Vastus Lateralis (VL) and Rectus Femoris (RF) muscles during a ramp-loaded bicycle exercise. Twelve healthy males participated in the experiment. The test consisted of a leg arterial occlusion at rest and a ramp-loaded exercise (20 watts/min) using a bicycle ergometer until exhaustion. The changes in deoxygenation in each muscle was measured by near infrared spectrometer (NIRS) . The probes of NIRS were placed on VL and RF approximately 12 cm above the right knee. Oxy-Hb/Mb signals from NIRS were calculated as 100% at rest, with 0 % being the lowest value during the leg arterial occlusion. Pulmonary gas exchanges (VE, VO₂, VCO₂) were measured with an expiratory gas analyzer. In 10 subjects, muscle oxygenation level in VL decreased linearly until the deoxygenation limiting point (DOLP) -the point in exercise at which the deoxygenation rate decreases noticeably. However, in 2 subjects, the DOLP was not detected, and the muscle oxygenation level decreased linearly until exhaustion. The muscle oxygenation level in RF also decreased linearly until 70%VO₂max, although the deoxygenation rate was smaller than that in VL. Thereafter, the muscle oxygenation level in RF continued to decrease until exhaustion. No DOLP was found in any subjects in RF. Compared with the muscle oxygenation level in RF at any points during the exercise, those in VL were lower until 90%VO₂max (P<0.001) . However, the difference in muscle oxygenation levels between VL and RF at exhaustion was not noted. This study indicated that the patterns of deoxygenation in VL and RF during a ramploaded bicycle exercise were different.

A 54-year-old man developed cardiogenic shock after acute myocardial infarction. Urgent coronary angiogram revealed complete occlusion at proximal portion of the right coronary artery and severe stenosis at just proximal site of the left anterior descending branch. Following thrombolytic therapy was not successful and he was sent to the operating room for coronary artery bypass surgery under external cardiac massage after 6hr from the onset. Three aorto-coronary bypasses were made to left anterior descending branch, first diagonal branch and right coronary artery using saphenous vein grafts by aortic cross-clamping of 67min. He fell into severe low cardiac output syndrome and could not be weaned from the cardiopulmonary bypass even by catecholamine infusions and IABP support. Veno-arterial bypass consisted of centrifugal pump and membranous artificial oxygenator was instituted. Venous blood was drained from the right atrium using percutaneous cannula via the right femoral vein and oxygenated blood was returned to the right subclavian artery. Hemodynamics recovered dramatically and after 71hr of this assisted circulation he was weaned from veno-arterial bypass. Activated coagulation time was maintained within 180-200sec. During this period, the centrifugal pump and oxygenator was not necessary to change and no clot was seen in the bypass system. He discharged from our hospital after 2 mo, postoperatively and now he is doing well as NYHA class-II 8 mo. postoperatively.

Objective：The purpose of this study was to determine the reliability and predictive validity of the Judgement checklist for beneficial falls (hereafter called“Judgement checklist”) in stroke patients.Methods：Five raters evaluated the Judgement checklist for 20 fallers with stroke, and two raters reevaluated the same patients. Fleiss' Kappa and Cohen's Kappa for examination of inter-rater and intra-rater reliability were calculated. For predictive validity, beneficial fallers were identified from among 123 fallers with stroke, using the Judgement checklist. We compared the incidence rate of recurrent falls and motor Functional Independence Measure (FIM) in beneficial fallers and other fallers.Results：Fleiss' Kappa for Judgement was 0.838, and Cohen's Kappa was 1.000. Inter-rater and intra-rater reliability for the Judgement checklist was high. The rate of recurrent falls in beneficial fallers was significantly lower than that in other fallers. The motor FIM in beneficial fallers was significantly higher than that in other fallers, and beneficial fallers tended to have above average ability to recover.Conclusion：The reliability and predictive validity of the Judgement checklist were shown to be high. The Judgment checklist was effective in evaluating the quality of falls and was useful for patient instruction after a fall.

Objective：The purpose of this study was to determine the reliability and predictive validity of the Judgement checklist for beneficial falls (hereafter called “Judgement checklist”) in stroke patients.Methods：Five raters evaluated the Judgement checklist for 20 fallers with stroke, and two raters reevaluated the same patients. Fleiss' Kappa and Cohen's Kappa for examination of inter-rater and intra-rater reliability were calculated. For predictive validity, beneficial fallers were identified from among 123 fallers with stroke, using the Judgement checklist. We compared the incidence rate of recurrent falls and motor Functional Independence Measure (FIM) in beneficial fallers and other fallers.Results：Fleiss' Kappa for Judgement was 0.838, and Cohen's Kappa was 1.000. Inter-rater and intra-rater reliability for the Judgement checklist was high. The rate of recurrent falls in beneficial fallers was significantly lower than that in other fallers. The motor FIM in beneficial fallers was significantly higher than that in other fallers, and beneficial fallers tended to have above average ability to recover.Conclusion：The reliability and predictive validity of the Judgement checklist were shown to be high. The Judgment checklist was effective in evaluating the quality of falls and was useful for patient instruction after a fall.