A 51-year-old man with osteogenesis imperfecta and who had aortic regurgitation was admitted to our hospital for aortic valve replacement. His height was 146cm and his weight was 49kg. The patient had suffered from bone fractures several times since childhood. Bone deformity, blue sclera and his status were clinically indicative of osteogenesis imperfecta. Aortic valve replacement with a 25mm SJM^® prosthetic valve was successfully performed for aortic valve insufficiency and slight annulo-aortic ectasia. Soft tissues and the sternum were fragile. Pathological examination (Elastica-Masson stain) of the aortic valve and left ventricular wall revealed a loss of fibrous tissues and remarkable thickening due to elastic fibers. The patient was discharged 31 days after surgery. Osteogenesis imperfecta is one of the collagen diseases caused by gene abnormality, in which fragile bones are easily fractured. Cardiovascular disease is rarely associated with it and the surgery-related mortality rate is reported to be approximately 30%, due to bleeding.

1) Tension development during rapidly grip strength exertion of athletes and nonathletes was by Natori's method analyzed.
2) Subjects of athletes were 71 healthy men of 17-26 ages and of non-athletes were 54 healthy men of 17-30 ages. Athletes were 26 high school students of 17-19 ages, 22 physical education college students of 19-21 ages and 23 general adult men of 20-26 ages. High school students were 3 Sumo-men, 4 Judo-men, 6 Kendo-men and 13 Baseball-men. Physical education college students were 6 Handball-men, 9 Rugby-men and 7 Gymnasticsmen. General adult men were 11 Judo-men and 12 Kendo-men. Non athletes were 20 high school students of 17-18 ages, 6 university students of 19-21 ages and 28 general adult men of 21-30 ages.
3) Isometric grip strength manometer were used a new device, to improvement on Smedley's manometer straingauge added.
Tension development were amplifired and recorded by portable Visigraph (Sanei-Sokki Ltd.) with paper-speed of 10cm/sec.
4) In the each case was 3 portions of a whole curve of time course of tension and Pmax.P₁, P₂; log t₁, log t₂; tan θ, tan ψ estimated according Natori's method.
5) Except general adults of 26-30 ages of non-athletes were Pmax. of athletes greater than non-athletes.
Pmax, of a Judo-man of general adult was greatest 68.5kg, and Pmax. of a high school student of 17 age of non-athlete smallest 35.8kg.
6) Tan θ and tan ψ of athletes were greater than non-athletes.
Tan θ of a Sumo-man of high school student was greatest 0.3628 and tan θ of a Judoman of general adult was greater 0.3500, but tan θ of a high school student of non-athletes was smallest 0.1624.
Tan ψ of a Kendo-man of general adult was greatest 1.6308 and tan ψ of a Sumoman of high school student was greater 1.5769, but tan ψ of a high school student of non-athlete was smallest 0.5278.
7) Muscle strength of non-athletes may well increased to be about 25 age, so that Pmax. of general adults of non-athletes were greater and of high school students of nonathletes smaller.
But athletes exercised usually for athletic sports, so that Pmax, and tan θ, tan ψ independent of age was greater than non-athletes, these were an each event varied. Pmax. of Judo-men of general adults were relative greater and tan θ, tan ψ were greatest. Pmax. of Handboll-men were greatest but tan θ, tan ψ were relative smaller. Pmax. of Gymnas-tics-men were relative greater but tan θ, tan ψ were smallest. So that were varied pattern of time course of tension development of hand grip exertion an each event of athletics.

A 75-year-old male visited Fuchu general hospital on foot because of possible acute mushroom poisoning. He had no symptom on admission. He twice ate some toxic mushrooms for lunch and for dinner on the previous day with his wife, who was found dead in her bed on the morning of his admission. A legally ordered autopsy was held on his wife, and a-amanitin was detected in her liver, brain and blood samples. Detection of a-amanitin in blood samples has never been reported in the literature. His liver and kidney failure rapidly progressed. He died on the 10th hospital day despite intensive treatment including hemodialysis and plasma exchange. On histological examination, his necropsy liver specimen revealed massive liver necrosis and new growth of pseudocholangioles, which apparently bore testimony to acute toxic mushroom poisoning.

We report a case of ulcerative colitis (UC) after mitral valve replacement (MVR) surgery due to infective endocarditis (IE). A 59-year-old woman underwent MVR for mitral regurgitation due to IE. Six days after the surgery, melena was observed suddenly, and she received a blood transfusion. Ulcer and erosion were observed in the rectum 5 to 10 cm from the anal ring by endoscopy. We changed her antibiotic treatment and stopped warfarin potassium. Heparin sodium was started 2 days after melena. We diagnosed ulcerative colitis from the finding of the rectal lesion and biopsy. We gave mesalazine and betamethasone as treatment for UC. The patient's condition improved and her general condition stabilized. She was discharged 36 days after surgery.

A 50-year-old man was diagnosed as having aortic valve insufficiency, complete occlusion of the right coronary artery and 75% stenosis of the left main trunk due to syphilitic aortitis. Aortic valve replacement and coronary artery bypass grafting to three vessels were successfully performed. The selection of surgical procedures for the coronary lesion with syphilitic aortitis should be made carefully, since the progression of aortic root inflammation in the acute phase and the development of atherosclerotic changes are not preventable in the future. It is most important to select effective and safe surgical interventions, especially for patients with such a low cardiac function as our patient.

A 68-year-old woman complained of hemoptic shock and recovered with conservative treatment. Ruptured descending aorta into the left lung was diagnosed. Graft replacement of the descending aorta was successfully performed. We speculated that spontaneous rupture of the descending aorta into the left lung might have occurred due to high blood pressure affecting the weak aortic wall with sclerotic change, causing hemoptysis. The ruptured descending aorta was successfully replaced without dissection between the ruptured aorta and the left lung. The postoperative course was uneventful with neither pulmonary nor infectious complications.

A 45-year-old woman who was a Jehovah's Witness was admitted to our hospital with a complaint of palpitation and sort on-effort. A ruptured aneurysm of the sinus of Valsalva (RASV) associated with stenosis of the right ventricular outflow was diagnosed. Operative findings revealed a RASV with a double chambered right ventricle (DCRV) and a ventricular septal defect (VSD). RASV, DCRV and VSD were successfully repaired with extracorporeal circulation without use of homologous blood. We reported this case because congenital combination of RASV, DCRV and VSD is very rare.

A 69-year-old man complained of abdominal pain with inflammatory reaction. Abdominal aortic aneurysm (AAA) with a left main trunk lesion was diagnosed and he successfully underwent Y-graft replacement of the abdominal aorta and coronary artery bypass grafting. Finally AAA was classified as “inflammatory” by histopathological findings. We present this case of “inflammatory AAA” associated with coronary artery disease, and discuss it with a review of literatures.

During the 18-month period from January 1, 1981 to June 30, 1082, we encountered a total of 11 cases of child peptic ulcer-three gastric ulcer and eight duodenal ulcer casen.
There is every indication that the incidence of child peptic ulcer will increase in a rural area like Yuri, which is situated in Japan's northeastern prefecture of Akita.
To be noted is the fact that 10 cases out of 11 of peptic ulcer were found in three-year lower secondary schoolchildren and the remaining one was found in a sixth grader of six-year elementary school. The incidence as well as the number of visits to our clinics went up as the age advances and reached a peak in third graders of lower secondary school.
The reason why third graders of lower secondary school were attacked most by peptic ulcer is probably that they, at puberty, are under psychic or psychogenic stress with anxiety over high school entrance examinations, mental strain from forced attendance at a cramming school, trouble in getting along with friends, and dissatisfaction with parents.
Therefore, child peptic ulcer should not be treated as a disease of the digestive organ alone but as a disorder in the autonomic nervous system with an aid of psychosomatic medicine and psychiatry. For the prevention of the disease, it would also be necessary to take account of socio-cultural factors.

Surgical interventions for aorto-iliac obstructive diseases were studied through the operative results. Eighteen patients underwent aorto-femeral bypass (AOF) and 23 who were over 70 years of age or who had serious preoperative complications had axillofemoral bypass (AXF). No perioperative death occurred in AOF patients, while the mortality rate of AXF patients was 8%. Postoperative ankle pressure indexes were significantly higher in AOF patients than in AXF patients. Follow-up graft patency rate was 100% in AOF patients at 54 months (mean), and 85% in AXF patients at 44 months respectively. AOF should be the first choice for patients with aorto-iliac obstructive disease, and AXF is suitable only for high-risk patients.