Twenty biochemical components of serum were compared between normal healthy subjects and professionalwrestlers undergoing maximum training daily. Significant difference was found for 13 blood components : creatinine, uric acid, calcium, inorganic phosphorus, LDH, GOT, GPT, γ-GTP, alkaline phosphatase, direct bilirubin, cholesterol, triglyceride and glucose.
Except for direct bilirubin, 12 parameters in wrestlers were higher than in healthy subjects. The higher concentrations of LDH, calcium, inorganic phosphorus, alkaline phos-phatase and creatinine were considered to be related to heavier physical exercise and special diet. The higher concentrations of alkaline phosphatase, calcium and inorganic phosphorus were thought to be mainly related to bone metabolism.

The aim of this study was to investigate quantitatively the power ability of middle and older aged men in the vertical jump.
And, we would try to point out the changes with increasing ages and the influences of the environments factor to the power ability.
Based on the environment point of view, we put an emphasis and consideration on those who did physical exercises and also those who drove a car in a daily life.
Subjects were the health 201 men who visited the sports sauna training center of national stadium for physical exercises.
The power was calcurated from the force and velocity concerning of jumper's C.G. during the take off motion. The force was measured by using a strain gage type tranceducer, and the velocity was calcurated by integrating the equation of motion about of C.G.
Result:
The power ability of middle and older aged men in the vertical jump decreased with increasing ages.
The rate of decrease with every 5 years of age was 0.248 horse power, 2.960×10^-3 horse power in the maximum power and maximum power per body weight.
In comparison with the power ability of 25 years old, the power ability, in terms of maximum power per body weight, of 35 years old, 45 years old, 55 years old were 90.8%, 81.1%, 59.0%, respectively.
There were evidently differences between trained men and untrained men, and then car driver and no car driver in the power ability. The differences of maximum power per body weight were 12.190 × 10^-3 horse power, 9.231×10^-3 horse power, respectively.

Recently, the popular usage of the sauna bath has been greatly increased but this is not necessaeily based upon scientific ground.
This investigation has been made on the most ideal usage time with special emphasis on duration of time in the actual sauna room.
The usage pattern, in view of the times of taking the sauna room and the cold water, has been established.
And then the influences on the body function were measured.
The usage pattern were as follows (Repetition were all 3 times)
(1) 5 minutes stay in the sauna and 1 minute in the water
(2) 7 minutes stay in the sauna and 1 minute in the water
(3) 7 minutes stay in the sauna and 2 minutes in the water
(4) 10 minutes stay in the sauna and 2, 5 minutes in the watar
The result were as follows
1. The usage pattern (1) gave the good result for the function of whole body reaction time, patellar-tendon reflex time, maximum power of vertical jump.
Another usage pattern (2), (3), (4) gave the wrong result for those function.
2. There were no remarkable differences blood pressure, heart rate and skin temperature among the usage pattern (1), (2), (3), (4) .
3. Oxygen intake in the usage pattern (2) gave a large value than the usage pattern (1) .
In the view of the energy expenditure, it was recognized that the usage pattern (2) was the best usage.

Surgery for abdominal aortic aneurysms (AAA, n=240) was reviewed in subgroups of ruptured AAA (RAAA, n=31), non-ruptured AAA with arteriosclerosis obliterans (AAA w/ASO, n=48), and non-ruptured AAA without ASO (AAA w/o ASO, n=161). The average follow-up period was 4.2 years (maximum 15.8 years) and the follow-up rate was 97%. Overall operative mortality rates were 41.9% in RAAA and 2.9% in non-ruptured AAA. Those were 6.3% in AAA w/ASO and 1.9% in AAA w/o ASO. The main causes of death in the long-term follow-up period were heart disease in 32%, malignant neoplasm in 22%, cerebrovascular accidents in 10% and renal failure in 10%, and miscellaneous. Only renal failure was related to operative risk factors. Relative survival rates excluding hospital death following surgery were 79% at 5 years and 0% at 10 years in RAAA; 74% at 5 years and 52% at 10 years in AAA w/o ASO; 95% at 5 years and 78% at 10 years in AAA w/ASO; 90% at 5 years and 70% at 10 years in non-ruptured AAA. These survival rates were lower than those found in the normal population, especially in AAA w/ASO. AAA w/ASO had more surgical risk factors of ischemic heart diseases and diabetes mellitus. Main causes of deaths were heart diseases, and renal failure during the long-term follow-up period was more predominant in AAA. It is important to follow all patients after surgery for AAA with special attention to heart disease and renal failure.

We reported a case of left atrial myxoma with renal infarction as an initial clinical symptom. A 65-year-old man had severe right lumbago. A chest CT demonstrated right renal artery embolism. On emergency operation a right renal embolus was removed. Preoperative echocardiography and transesophageal echo showed a tumor in his left atrium which was close to the mitral valve. The tumor was resected one week after the first operation. Embolectomy of the right renal artery could not restore renal function. To the best of our knowledge, this type of cardiac myxoma with renal infarction as an initial clinical symptom is rare.

Background: The pathogeneses of fibromyalgia syndrome (FMS) are related with the living way of a patient, that holds biopsychosocial-existential problems. Especially existential problems are more essential; such patients are sometimes in existential vacuum. It is impossible to care the patients by onlharmacotherapy; that needs psychotherapy and physical therapy. Logotherapy and existential analysis (LTEA) was established by Prof. Viktor Frankl to save such patients, that is one of the experimental psychotherapy. Balneotherapy (BT) is popular all around the world to cure stressful patients. Objective: We have developed Balneo-logotherapy (BLT) for patients with FMS by adding LTEA to the BT, which mainly consists of treatment carried out by taking bathes at a hot spring, a non-ordinary place. We also determined the prognosis one year after the therapy. Method of BLT: After enough motivation and the informed consent, a patient begins BLT program. The mean duration of the therapy was 4.5±1.2 weeks. During the period from the start of the BLT until the time the patient was relieved of Yuatari phenomenon (thermal crisis, bath reaction, YP), the patient was directed to do nothing. Therapist should pay attention to help the patient to overcome YP. After this period, the patient was given free time to do things such as taking a walk. Throughout the period of BLT, patients should write in the simple diary every day and record what they became aware concerning the body and the mind. Subjects and methods: Subjects were 65 patients with FMS (42.0 yrs±11.5, Male: Female = 24:41). Based on pathogenesis, FMS patients were classified into two groups: psychosomatic (PSD) Type (n=30) and PTSD Type (n=35). PSD type was mainly caused by loss of bodily sense (alexithymia) and hyper-adaptation. PTSD Type was mainly caused by trauma such as ill-treatment and war experience. The relationship between having YP or not and the prognosis was also determined. Results: Overall recurrence rate was 30.8%. Recurrence rates for each type were: 23.3% for PSD Type FMS, and 37.1% for PTSD Type. Incidence of YP occurrence was: 80.0% for all cases, 86.7% for PSD Type and 74.3% for PTSD Type. The more severe YP, the better the prognosis (p<0.05). One year after the therapy, cases without recurrence accounted for 69.2% of all the cases. In PSD Type, recurrence was not seen in 73.3%. In PTSD Type, recurrence was not seen in 65.7%. Recurrence rate was lower for the group of patients with development of YP. Discussion: Therapeutic self is most important; to create interpersonal communication to tune in the patient to get aware of intrapersonal communication (according to biopsychosocial-existential model) of the patient. Patient’s psychological movements were; Dependency ⇒ Awareness ⇒ Autonomy ⇒ Reset of the mind (through YP and ASC) ⇒ Intervention by the therapist to make change in behavior through the awareness of his own meaning of life. In this process, occurrence of YP is meaningful. A hot spa is a very suitable place to perform psychotherapy like logotherapy.

Sources of research funding: We gratefully acknowledge the support of the 17th Congress of the Japanese Society for Emergency Medicine support of this program.
Ethical considerations: The program was conducted after receiving approval from the Institutional Animal Experiment Committee of the Jichi Medical University, and in accordance with the Institutional Regulation for Animal Experiments and Fundamental Guideline for Proper Conduction of Animal Experiment and Related Activities in Academic Research Institutions under the jurisdiction of the Ministry of Education, Culture, Sports, Science and Technology of Japan. It was approved on April 9th, 2014. The approval number is 14-225.
Disclosure of conflicts of interests: We gratefully acknowledge the contributions of personnel from Panasonic Corp. who enabled the interactive communication system.
Abstract
Introduction: Live surgery demonstrations have been widely used in surgical education. However, they cannot be used to demonstrate trauma surgery due to the emergency situation and lack of informed consent. The aim of this study was to conduct a live demonstration of trauma surgery with a porcine model to increase educational opportunities in trauma surgery.
Methods: Live demonstration was conducted at the Center for Development of Advanced Medical Technology (CDAMtec) , Jichi Medical University, Japan. An experienced trauma surgeon instructed three trainees during a live demonstration using pre-planned injuries in a porcine model. A six-point Likert Scale was used on a written survey to determine the value of the program to the viewers. Free-form written comments were also obtained from the participants. Live images of the surgical field were transmitted to a lecture room by a closed wireless LAN with interactive bidirectional audio capability.
Results: Eighty-three participants viewed this live demonstration and completed the questionnaire. Participants were highly satisfied with the live demonstration (mean survey scores: 4.6-5.1/6) , and gave very positive feedback concerning the educational value of this program. Nine free-form comments were submitted, which revealed that the participants felt they could acquire concrete skills for trauma surgery.
Discussion: Live demonstrations for trauma surgery using a porcine model are a feasible and effective educational tool to demonstrate technical procedures and non-technical skills, with possible added advantages regarding the ethical considerations of performing a live surgery demonstration.

Background/Aims: Hybrid endoscopic submucosal dissection (ESD), in which an incision is made around a lesion and snaring is performed after submucosal dissection, has some advantages in colorectal surgery, including shorter procedure time and preventing perforation. However, its value for rescue resection in difficult colorectal ESD cases remains unclear. This study evaluated the utility of rescue hybrid ESD (RH-ESD). Methods: We divided 364 colorectal ESD procedures into the conventional ESD group (C-ESD, n=260), scheduled hybrid ESD group (SH-ESD, n=69), and RH-ESD group (n=35) and compared their clinical outcomes. Results: Resection time was significantly shorter in the following order: RH-ESD (149 [90–197] minutes) >C-ESD (90 [60–140] minutes) >SH-ESD (52 [29–80] minutes). The en bloc resection rate increased significantly in the following order: RH-ESD (48.6%), SH-ESD (78.3%), and C-ESD (97.7%). An analysis of factors related to piecemeal resection of RH-ESD revealed that the submucosal dissection rate was significantly lower in the piecemeal resection group (25% [20%–30%]) than in the en bloc resection group (40% [20%–60%]). Conclusions RH-ESD was ineffective in terms of curative resection because of the low en bloc resection rate, but was useful for avoiding surgery.

OBJECTIVEWe investigated relationship between job stress and self-rated health among Japanese nese full-time occupational physicians (OPs).

METHODSIn 2000, we mailed self-administrated questionnaires to 716 OPs. Of these OPs, 349 (49%) returned sufficiently completed questionnaires for analyses. oblique-rotated principal factor analysis of the job stress questionnaire extracted three components; low understanding of occupational health services in companies (low understanding), conflicts between occupational physicians and their coworkers (conflicts), and discrepancies between occupational physicians' routine work and occupational health services (discrepancies).

RESULTSThe model, in which low understanding contributed to self-rated health through job satisfaction and self-rated health was influenced by job satisfaction and discrepancies, provided a good fit to the data.

CONCLUSIONSWe found that a potential relationship between job stress and self-rated health among Japanese full-time OPs. The present results implied that among full-time OPs, low understanding contributed negatively to self-rated health through job satisfaction, and that self-rated health was influenced positively by job satisfaction and negatively by discrepancies.

OBJECTIVEThe present study investigated the relationship between coping skills and job satisfaction among Japanese full-time occupational physicians (OPs).

METHODSIn 2000 we mailed self-administered questionnaires to 716 full-time OPs who were members of "Sanyu-kai", the only Japanese association of full-time OPs. The questionnaires included age, gender, marital status, main type of company's work, the number of full-time OPs, the number of employees, working years as an OP, tenure in the present company, job stress, and coping skills question. The coping skills questions consisted of 11 items which were decided after discussion among several experienced full-time OPs. In total, 351 (49%) of the OPs returned suitable questionnaires for analyses.

RESULTSConsidering age, gender, marital status, and coping skills, multiple regression analysis (stepwise method) found that age, simplification of work, obvious roles for staff, consultations, and communication in the community and company were factors which contributed significantly to job satisfaction. Structural equation modeling showed that age and coping skills such as work system improvements, consultations, and communication in the community and company influenced job satisfaction.

DISCUSSIONOur results indicated that the age and coping skills influenced job satisfaction among full-time OPs. Our results are also considered to support the training of OPs in the future.