The purpose of this study was to measure the effectiveness of RPE on exercise intensity for senior citizens. A maximum workload test was administered with the use of a bicycle ergometer on older male and female subjects. The results of our study can be summarized as follows:
1. Two trials were performed on separate days. A high correlation coefficient for the first trial and the second trial was found. The reliability for the male group was r=0.76 (p<0.01) and that for the female group r=0.90 (p<0.01) .
2. A correlation range of r=0.55-0.79 (p (0.01) was found for RPE and physiological exercise intensity (which includes oxygen intake and heart rate) . A higher result was found when the relative value was used in the analysis of the oxygen intake and the heart rate instead of the absolute value.
3. Significant correlation coefficients of r=0.63-0.64 (p<0.01) were found for RPE and the work load in terms of watt units.
4. The majority of the physiological variables were statistically determined ; however, there were no correlations between RPE and systolic blood pressure.
In conclusion, based on our study, we have found that RPE and HR ; RPE and %Vo₂max: RPE and watts grouped individually had a high correlation for effectiveness. The only exception in our study was the RPE and the blood pressure group because no correlation was found overall. Therefore, the overall effectiveness of RPE was proven to be quite sensitive even for senior citizens, and as a result RPE can be utilized when exercise is prescribed for evaluatory measurement in senior citizens.

We report a 59-year-old chronic hemodialysis patient with a thoracoabdominal aortic aneurysm, in whom the entire aortic wall and visceral branches were severely calcified. Using a staged operation approach, the celiac trunk and superior mesenteric artery were first bypassed with a composite graft made from a saphenous vein Y-graft and ePTFE. Next, we inserted a custom-made stent-graft, however, there was poor attachment at both the proximal and distal ends due to the severely calcified aortic wall. As a result, we used additional two stent-grafts. His postoperative course was good, and the CT scan performed one year after operation showed no endoleak.

The purpose of this study was to examine the effects of knee flexion angles during maximum isometric hip extension. Ten healthy men performed maximum isometric hip extension in prone position at 15° and 90° knee flexion. Then, the hip extension torque was measured, and electromyographic (EMG) data were obtained from the biceps femoris long head, semitendinosus, semimembranosus, adductor magnus, and gluteus maximus muscles. The EMG data were full-wave rectified and integrated (IEMG). The IEMG values obtained during the measurement of isometric hip extension were normalized with the values collected at 90° knee flexion (normalized IEMG [NIEMG]). The hip extension torque at 15° knee flexion was significantly greater than that at 90° knee flexion. The NIEMG values from the hamstrings at 15° knee flexion significantly increased compared with those at 90° knee flexion. Meanwhile, the NIEMG values from the gluteus maximus at 90° knee flexion were significantly greater than those at 15° knee flexion. However, the NIEMG values from the adductor magnus did not significantly differ between 15° and 90° knee flexion. These results indicate that the hamstrings effectively generate contracting force during isometric hip extension and at knee extended position because its fiber length was close to the optimal length.

Infective endocarditis with apical abscess is very rare. A 49-year-old man was admitted in a diabetic coma. The next day, he suddenly developed chest pain and headache. Echocardiogram revealed mitral valve vegetations and mitral regurgitation, and brain CT showed multiple cerebral hemorrhage that was thought to be due to cerebral embolism. Surgery was performed on the 10th hospital day for progressive heart failure. During surgery, an abscess was noted at the apex, but the abscess cavity was not connected to the cardiac cavity. The mitral valve was replaced, and the abscess cavity was resected. The defect of the ventricle was repaired with an 8×5cm Goretex sheet. Cultures of blood, vegetation, and the abscess were negative. It was thought that the abscess formation in the apex was caused by infectious coronary embolism, since cerebral embolism and chest pain happened simultaneously, and the abscess cavity was isolated and not in communication with the cardiac cavity.

AIM: To describe a case in which vitrectomy was required for vitreous hemorrhage and fibrovascular proliferation after laser-induced chorioretinal venous anastomosis (LCVA) for non-ischemic central retinal vein occlusion (CRVO).METHODS: Observational case report.RESULTS: A 72-year-old man complained of central scotoma in the left eye, and was diagnosed as suffering from non-ischemic CRVO. LCVA was performed in another hospital. Although favorable visual function was briefly maintained postoperatively,severe vitreous hemorrhage developed in his left eye, necessitating vitrectomy. CONCLUSION: Considering that LCVA carries a risk of serious complications, we must apply this treatment with caution, especially in ethnic groups, such as the Japanese, in whom pigmentation reacts to photocoagulation excessively.

The purpose of this study is to investigate the prevalence of and to classify the types of silicosis patients who were working at that time as migrant workers in the eastern part of Toyama Prefecture. Migrant workers are known in Japanese as “dekasegi” This term refers to workers who migrate seasonally from their home towns to areas where work is more available.
Questionnaires were sent to all male inhabitants aged 30 or over in the selected five areas. Eighty-seven percent of the questionnaires were answered and returned. Based on the results, 482 inhabitants were selected as migrant workers with experience in jobs where they were exposed to large amount of dust. Chest roentgenography and subjective symptoms were examined in these subjects.
The results obtained were follows;
(1) Eight hundred and eighty-five of the respondents (41%) had worked as migrant workers.Of these, 580 men (66%) had worked in jobs with exposure to dust.
(2) Of the 482 migrant workers whose jobs exposed them to dust, 424 silicosis cases (88%) were found by chest roentgenographic examination. Silicosis is classified into four types according to the national Pneumoconiosis Law on the basis of chest roentgenographic findings. These patients included 195 cases of type 1, 123 cases of type 2, 59 cases of type 3 and 47 cases of type 4 silicosis.
(3) The prevalence of disease symptoms in the silicosis patients included ; cough 39%, phlegm 40%, shortness of breath 41%, palpitations 17% and wheezing in 20% of the cases. The silicosis patients showed a higher frequency of respiratory disease symptoms than those dust-exposed workers who did not evidence signs of silicosis.
(4) The silicosis patients were found in 98% of the migrant workers whose exposure to dust lasted a period of more than 20 years, 89% in men whose work was between 10 and 19 years and 76 % in men who had worked less than 10 years.
(5) The silicosis in 297 cases (70% of the total number of disease patients) was first detected during the examinations in the course of this research.

Although maximal oxygen uptake (VO₂max) or oxygen uptake corresponding to lactate threshold (VO₂@LT) is considered the single best determinant of one's cardio-respiratory endurance or aerobic capacity, the direct measurement of these attributes requires elaborate equipment, trained personnel, special knowledge, and/or a maximal effort on the part of the subject who is tested. In addition, the measurement is time consuming. The current investigation was designed to examine the validity of aerobic capacity estimated from submaximal cycling exercise and field performance tests in the elderly. The subjects tested were 18 sedentary men and women aged 63 to 75 years (69.7±3.4) . Indirect VO₂max tests were selected from those proposed by Astrand and Ryhming, Siconolfi et al., and Margaria et al. (step test), and YMCA. The VO₂max values estimated by these methods, with the exception of the Siconolfi method, were found to have large errors when compared to the errors obtained in previous studies for younger subjects. There were no significant correlations between step test scores and VO₂max and VO₂@LT in the elderly. Correlations of 12-min distance walk with VO₂max (r=.711) and VO₂@LT (r=.714) were significant. Our findings suggest that 12min distance walk be a better aerobic capacity test than other indirect VO₂max tests including Astrand and Ryhming test.

A 62-year-old woman was admitted to our hospital because of dextrocardia on her chest X-ray film. She had been in good health though the X-ray abnormality had been pointed out from her childhood. Echocardiogram, magnetic resonance imaging, and cardiac catheterization revealed situs inversus, congenitally corrected transposition of the great arteries, and severe tricuspid valve (systemic atrioventricular valve) regurgitation with mild systemic ventricular dysfunction. The surgeon stood on the patient's left side during the operation. On cardiopulmonary bypass, the tricuspid valve, facing almost dorsally, was exposed through a superior transseptal approach. Tricuspid valve replacement with a mechanical valve was performed with leaflet preservation. Systemic ventricular function is preserved at one year after operation.

In 31 asthmatic children, we investigated the change of the structure on the time of living, an amount of exercise by pedmeter and measured pulmonary ventilatory function during 28 weeks swimming training.
The result showed 58.07% of contribution factor to the structure on the time of living on children with asthma and dynamic play time after school were significantly shorter in asthmatic than non-asthmatic children (p<0.05) . After 28 weeks, we could not find any significantly differences of dynamic play time between asthmatic and nonasthmatic children.
An amount of exercise in daily life from the point of view of walking step number by pedmeter were significantly less in aged 6-9 years boys and girls, and aged 10-12 years boys than non-asthmatic children (respectively, p<0.05, p<0.01) . However, after 28 weeks, we could not find any differences between asthmatic and non-asthmatic children.
Forced vital capacity (FVC) and rate of forced expiratory volume on one second (% FEV_1.0) were increased after 28 weeks than the begining of swimming, and we found the strength of their breathing muscles.
On according to perform the great swimming distances (averages 220m in boys, 325m in girls), all asthmatic children became very lively and actively.

A 52-years-old female farmer has suffered from bronchial asthma during the last 10 years during the lettuce growing season (NOV.-May). Laboratory test findings showed that her sumptoms were due to type I allergy. Namely, she showed eosinophilia, an increased level of Ig E and an immediate positive reaction to intracutaneous lettuce allergen. But, she gave negative reactions in RAST and immediate skin reaction test to 23 common allergens. By provocation tests she showed positive reactions to both the environment (FEV_1.0-26.8%) and allergen inhalation (FEV_1.0-30.0%), and had amoderate attack 15 minutes after inhalation of undiluted lettuce juice. The allergen was extracted from fresh lettuce juice by Coca's method. The protein concentration of the allergen was 8.74 mg/ml and its concentration in crude juice was 0.874 mg/ml.
Inhalation of lettuce juice during the harvest time was concluded to be the cause of this allergy.
A survey of farmers cultivating lettuce by a questionnaire and by mass physical examination revealed dermatitis as the most frequent complaint, with a similar incidence (7.1%) of respiratory symptoms including rhlnitis. However, further detailed questioning showed that the cause of most respiratory symptoms was not allergic, and the intracutaneous reaction of the farmers to the allergen was similar to that of control subjects who were not farm workers. The positive rate of the skin patch test was significantly higher in farmers growing lettuce than in control who were not farm workers.
Allergic disease caused by lettuce might be generated as allergic dermatitis of type IV. Type I allergy caused by lettuce is rare, but here we reported one case of this rare type.