In order to re-evaluate the mechanical efficiency during bicycle pedalling the total mechanical work (internal work + external work) and the energy expenditure were determined on four adult males (20-21 years) . The subject worked on a Monark bicycle ergometer with 6 different loads (0-5kp) at a constant pedal frequency of 50rpm. The internal work (W-int) to accelerate the leg itself was determined by a cinematographic procedure used by Fenn (1930) . With the data of external work (W-ext) and energy expended above resting (E_t-E_r), the‘true’efficiency has been calculated as
‘True’efficiency=W-int+W-ext/E_t-E_r×100
The result obtained was as follows : 1) The time course of kinetic energy due to leg movement was similar to those in walking and running reported previously. 2) The W-int at 0kp ranged in about 70-90kgm/min. In the mean values of four subjects the W-int tend to be constant at the loads from 0 to 3kp (about 80kgm/min), but increased appreciably at higher loads of 4-5k p (about 100-110kgm/min) . 3) The ratios of W-int to W-ext were about 20-30% at lkp, 10-20% at 2kp and 5-10% at 3-5kp. 4) The efficiency of leg movement only at Okp resulted in high values of about 40-85%, suggesting energy transfer between leg and inertia wheel. 5) The efficiency values at 1 to 5kp, ranging in 23.5-36.2%, appeared to show a maximum at intermediate work loads. 6) The‘true’efficiency so calculated did not largely differ from the efficiency calculated by conventional way ; 1.5-4% higher than the work efficiency, 2-5% higher than the net efficiency, and 3-5% higher than the apparent efficiency at intermediate loads.

Background : There has been no ideal valve prosthesis for children from the point of view of thromboembolism and size mismatch, and the surgical repair of native mitral valve has always been our first priority in children. However, valve replacement becomes the inevitable surgical option if repair is impossible. The purpose of this study was to assess the long-term results of mitral valvuloplasty (MVP) and mitral valve replacement (MVR) for isolated mitral valve diseases in children under 15 years old. Patients and Methods : From 1981 to 2010, 30 patients underwent a total of MVPs (P group) and 26 consecutive patients underwent a total of MVRs (R group). The median age was 4.6 years (4 months to 16 years) in group P and 6.2 years (4 months to 13.7 years) in group R, and the median body weight was 13.4 kg (6 to 35.5 kg) in group P and 16.4 kg (4.8 to 50.7 kg) in group R. The etiology was congenital in 55 (98%) patients, and due to endocarditis in 1 (2%) patient. Isolated mitral regurgitation was present in 41 (73%) patients (group iMR), and isolated mitral stenosis was present in 15 (27%) patients (group iMS). Mechanical valves (bileaflet disc, n=26) were used in all initial MVR patients. Results : Overall hospital mortality was 0%. The median follow-up time was 9.3±7.8 years (4 months to 27.7 years). There were 6 reoperations in P group and 5 explants due to size mismatch in R group with patient growth, and no explant due to structural valve deterioration. Survival rates at 10 years were 100% in the P group and 88.0% in the R group, and there was a significant difference (p=0.043). Freedom from reoperation at 10 years was 77.6% in P group and 77.0% in R group. Freedom rate from cerebral events at 10 years were 100% in both groups, respectively, and there were no significant differences. Survival rates at 10 years were 100% in the iMR group and 53.3% in the iMS group, respectively, and there was a significant difference between the groups (p<0.001). Freedom rates from reoperation at 10 years were 77.1% in the iMR group and 64.3% in the iMS group, respectively, there being no significant difference. Conclusions : The long-term results of pediatric mitral surgery were acceptable. Mitral valvuloplasty for patients with isolated mitral regurgitation were excellent. Mitral valve replacement can be performed with low initial mortality but should be reserved for medical and reconstruction failure because reoperation and late mortality are high, particularly for patients with isolated mitral stenosis.

Traditionally, the raw moxa material for moxibustion has been sourced from domestic production in Japan.However, imports of Chinese Artemisia princeps Pamp (A. princeps Pamp) have been increasing because of a decrease in domestic A. princeps Pamp for moxa products in recent years. There is a possibility that Japanese sourced moxibustion may become difficult to do because of a shortage of domestic production in the near future. Therefore 15 kinds of A. princeps Pamp were collected in Niigata Pref. known its source of A. princeps Pamp, and these were grown at the Center for Environment, Health and Field Sciences at Chiba Univ. to develop a domestic gardening cultivation system. This report is on investigative results with the first selection, with leaf area as an index.
As a result, when leaf area per1m of stalk length was calculated using the inter-joints length and the leaf area, the largest pieces averaged 3004.6 cm² and the smallest pieces were 1134.4 cm². It is thought that the larger the leaf area per measured stalk length, the more the yield per measured area of the field, since the raw material of moxa is made from dried A. princeps Pamp leaves. Therefore, we believe excellent A. princeps Pamp for moxa has resulted from research.

Anthropometrical measurement were obtained on 178 male nonathletic university students and 168 male athletic university students (Swimming, Handball, Soccer, Rugby, Running, Thrower, Judo and Gymnastics) aged 18-22 years.
The results obtained were as follows
The mean values of height and body weight for nonathletes were 170.2cm and 59.7kg respectively. The mean values of height and body weight for athletes except gymnastics and long distance runner were larger than those for nonathletes. Athletes showed larger mean values of girth of chest than nonathletes (86.1cm) . The mean values of girth of upper arm and girth of thigh for nonathletes were 26.9cm and 50.6cm respectively. The mean values of girth of upper arm for athletes except basketball, long distance runner and jumper were considerably larger than that for nonathletes. Athletes except long distance runner, jumper and gymnastics showed larger mean values of thigh than nonathletes. The mean values of skinfold thickness for athletes except heavy weight class of judo were thinner than that for nonathletes and the percentage of body fat calculated by using the prediction formura from mean skinfold thickness, body surface area and body weight for athletes was smaller than that for nonathletes
Plotting of body weight and body fat content in standard measure against height in standard measure with family of iso-deviation line was used to compare the body composition and body shape of athletes with those of nonathletes. In this plotting, physical characteristics could be expressed as the difference (R) between the points representing the mean value of athletes on the origin, (the mean values of nonathletes) and ratio of deviation (r) from standard line representing correlation of body weight or body fat content to height for nonathletes. Plotting R against r with family of lines of the same height was proposed to differentiate physical characteristics of athletes participating in different kinds of sports and to evaluate the effect of training on physical characteristics. Plotting of girth of upper arm and girth of thigh in standard measure against girth of chest was used for the evaluation of difference in body shape of athletes.

A 60-year-old man was admitted to our institution with abnormal ECG findings. Coronary CT and angiography showed coronary aneurysms from the left main trunk to the bifurcation of the left anterior descending artery, and the left circumflex artery, with severe stenosis and complete obstruction of the proximal right coronary artery. Morphological evaluation findings strongly suggested that the coronary aneurysms were highly related to childhood Kawasaki disease. We successfully performed triple vessel coronary artery bypass grafting. Here, we report a very rare case of coronary aneurysms presumed to be due to childhood Kawasaki disease in an elderly man.

A 43-year-old male patient with C5 giant cell tumor (GCT) underwent tumor resection and anterior bone fusion of C4-C6. The tumor recurred locally 9 months after surgery with the patient complaining of neck and shoulder pain similar to his preoperative symptoms. Denosumab was administered and his pain disappeared after a two-month administration, with a sclerotic rim formation seen at the tumor site on computed tomography. He has been followed for 18 months with no evidence of tumor recurrence. Complete resection is generally recommended, but is not easy for many patients with cervical GCT because of the existence of neurovascular structures. Some patients suffer from recurrence and treatment becomes more difficult. As such, denosumab may be an efficacious option for treatment of recurrent GCT of the cervical spine, although long-term follow-up is required to monitor for presence or absence of recurrence.
Adult ; Cervical Vertebrae ; Denosumab* ; Female ; Follow-Up Studies ; Giant Cell Tumor of Bone ; Giant Cell Tumors ; Humans ; Male ; Neck ; Recurrence ; Shoulder Pain ; Spine

Inflammasomes are cytosolic multiprotein complexes that sense microbial motifs or cellular stress and stimulate caspase-1-dependent cytokine secretion and cell death. Recently, it has become increasingly evident that both DNA and RNA viruses activate inflammasomes, which control innate and adaptive immune responses against viral infections. In addition, recent studies suggest that certain microbiota induce inflammasomes-dependent adaptive immunity against influenza virus infections. Here, we review recent advances in research into the role of inflammasomes in antiviral immunity.
Adaptive Immunity ; Cell Death ; Cytosol ; Dendritic Cells ; DNA ; Inflammasomes* ; Influenza Vaccines* ; Influenza, Human* ; Metagenome ; Microbiota ; Multiprotein Complexes ; Orthomyxoviridae ; RNA Viruses

BACKGROUND: Pedicled flaps are useful for reconstructive surgery. Previously, we often used vascularized supraclavicular flaps, especially for head and neck reconstruction, but then shifted to using thoracic branch of the supraclavicular artery (TBSA) flaps. However, limited research exists on the anatomy of TBSA flaps and on the use of indocyanine green (ICG) fluorescence videoangiography for supraclavicular artery flaps. We utilized ICG fluorescence videoangiography to harvest reliable flaps in reconstructive operations, and describe the results herein. METHODS: Data were retrospectively reviewed from six patients (five men and one woman: average age, 54 years; range, 48–60 years) for whom ICG videoangiography was performed to observe the skin perfusion of a supraclavicular flap after it was raised. Areas where the flap showed good enhancement were considered to be favorable for flap survival. The observation of ICG dye indicated good skin perfusion, which is predictive of flap survival; therefore, we trimmed any areas without dye filling and used the remaining viable part of the flap. RESULTS: The flaps ranged in size from 13×5.5 cm to 17×6.5 cm. One patient received a conventional supraclavicular flap, four patients received a TBSA flap, and one patient received a flap that was considered to be intermediate between a supraclavicular flap and a TBSA flap. The flaps completely survived in all cases, and no flap necrosis was observed. CONCLUSIONS: The TBSA flap is very useful in reconstructive surgery, and reliable flaps could be obtained by using ICG fluorescence videoangiography intraoperatively.
Arteries ; Female ; Fluorescence ; Head ; Humans ; Indocyanine Green ; Male ; Neck ; Necrosis ; Perfusion ; Reconstructive Surgical Procedures ; Retrospective Studies ; Skin ; Surgical Flaps

BACKGROUND/AIMS: Changes in lipid profiles in patients infected with hepatitis C virus (HCV) during direct-acting antiviral therapy have been reported in recent years. However, the clinical aspects of disturbed lipid metabolism in chronic HCV infection have not been fully elucidated. METHODS: Dynamic changes in serum total, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) cholesterol and apolipoprotein levels in patients infected with HCV genotype 1b were examined during combination therapy with daclatasvir (DCV) and asunaprevir (ASV). RESULTS: Total, LDL−, and HDL-cholesterol levels increased rapidly and persistently after week 4. Apolipoprotein (apo) A-I, apo B, apo C-II, and apo C-III levels were significantly higher at week 4 than at week 0. In contrast, apo A-II and apo E levels were significantly lower. The differences in LDL− and HDL-cholesterol levels were positively correlated with those of apo B and apo A-I, respectively. Interestingly, in patients with non-sustained virological response, these cholesterol levels decreased rapidly after viral breakthrough or viral relapse. Furthermore, similar changes were observed for apo A-I, apo B and apo C-III levels. CONCLUSIONS: Clearance of HCV using combination therapy with DCV and ASV results in rapid changes in serum lipid profiles, suggesting an influence of HCV infection on disturbed lipid metabolism.
Apolipoprotein A-I ; Apolipoprotein A-II ; Apolipoprotein C-II ; Apolipoprotein C-III ; Apolipoproteins ; Apolipoproteins B ; Apolipoproteins E ; Cholesterol ; Genotype ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Humans ; Lipid Metabolism ; Lipoproteins ; Recurrence

PURPOSE: Sacroiliac fixation using iliac screws for highly unstable lumbar spine has been reported with an improved fusion rate and clinical results. On the other hand, there is a potential for clinical problems related to iliac fixation, including late sacroiliac joint arthritis and pain. MATERIALS AND METHODS: Twenty patients were evaluated. Degenerative scoliosis was diagnosed in 7 patients, failed back syndrome in 6 patients, destructive spondyloarthropathy in 4 patients, and Charcot spine in 3 patients. All patients underwent posterolateral fusion surgery incorporating lumbar, S1 and iliac screws. We evaluated the pain scores, bone union, and degeneration of sacroiliac joints by X-ray imaging and computed tomography before and 3 years after surgery. For evaluation of low back and buttock pain from sacroiliac joints 3 years after surgery, lidocaine was administered in order to examine pain relief thereafter. RESULTS: Pain scores significantly improved after surgery. All patients showed bone union at final follow-up. Degeneration of sacroiliac joints was not seen in the 20 patients 3 years after surgery. Patients showed slight low back and buttock pain 3 years after surgery. However, not all patients showed relief of the low back and buttock pain after injection of lidocaine into the sacroiliac joint, indicating that their pain did not originate from sacroiliac joints. CONCLUSION: The fusion rate and clinical results were excellent. Also, degeneration and pain from sacroiliac joints were not seen within 3 years after surgery. We recommend sacroiliac fixation using iliac screws for highly unstable lumbar spine.
Aged ; Arthritis/*surgery ; Bone Screws ; Female ; Humans ; Low Back Pain/diagnosis/epidemiology ; Lumbar Vertebrae/*surgery ; Male ; Middle Aged ; Pain/diagnosis/*epidemiology ; Sacroiliac Joint/*immunology/*pathology