The purpose of the present study was to investigate the relationships of physical fitness, body mass index (BMI), waist-hip ratio (WHR) and sex hormone binding globulin (SHBG) with lipid and glucose metabolism in premenopausal obese women aged 32 to 49 yrs (n=24) . WHR was significantly correlated with HDL-C, HDL₂-C and Apo B, but not correlated with BMI %fat, maximal oxygen uptake (VO₂max), triglyceride (TG), very low density lipoprotein % fat, and Apo A 1. VO₂max/kg was significantly associated with BMI, TG, HDL-C, HDL₂-C, Apo Al, low density lipoprotein (LDL), SHBG, glucose metabolism at rest and during oral glucose tolerance test (OGTT) . The SHBG was strongly correlated with HDL-C, HDL₂-C and Apo A 1. In multiple regression analysis, it was observed that SHBG was one of the independ-ent predictor of HDL-C, HDL₂-C and Apo Al, that VO₂max was good predictor of LDL, Apo B and glucose metabolism at rest and during OGTT, and that BMI was one of the determinat of TG and VLDL. From these results, we concluded that lipid metabolism was independently associated with aerobic work capacity, SHBG, BMI as well as WHR, and that glucose metabolism was independently associated with aerobic work capacity.

Aortitis is an inflammatory arteriopathy that often progresses to obliteration of multiple large arteries. Surgical treatment for obstructive lesions due to aortitis syndrome therefore is difficult in many cases. The patient was a 23-year-old female who at the age of 19 had been diagnosed as aortitis syndrome with cerebral vessel involvement, and she subsequently received steroids. She increasingly experienced syncopal attacks, and was indicated for surgical treatment. Angiography revealed obstruction of the left common carotid and left subclavian arteries, and severe stenosis of the right common carotid and right vertebral arteries. She underwent bilateral ascending aorta-carotid artery bypass operation with 7mm ring-supported EPTFE grafts. After the operation she developed clinical signs of temporary brain damage due to hyperperfusion syndrome, but she now completely recovered and maintains a good clinical condition.

A 51-year-old man underwent arch replacement for a thoracic aortic succular aneurysm in December 1996. The pathological examination indicated aortitis to be the cause of the aneurysm. At that time we did not surgically treat the abdominal aortic aneurysm (AAA) which was only 32mm in diameter. Sixteen months after the first operation, he complained of a pulsatile tumor in his left leg. Angiography revealed an aneurysm of the left superficial femoral artery. The artery distal to the aneurysm was occluded, and the left popliteal artery received collateral blood flow from the deep femoral artery. The size of the AAA increased to 48mm, an indication of repair. Aneurysmectomy of the left superficial femoral artery and replacement of the abdominal aorta were performed simultaneously. The operative findings showed that the aneurysm of the left superficial femoral artery had been ruptured and formed a pseudoaneurysm. The pathological findings demonstrated both aneurysm aortitis. After the second operation, he was given steroid therapy to control the inflammatory reaction and he has been well for one year.