The aims of this study were to demonstrate the trend of overall mortality rate and premature mortality rate for select types of cancer in Japan and to assess the utility as a target indicator. The age-adjusted mortality rate for the total population (overall mortality rate) and that for persons under 65 years of age (under 65 mortality rate) for stomach cancer, liver cancer and lung cancer from 1950 to 1997 in Japan were calculated. Moreover, the turning point year of the mortality trend was estimated using a regression model of the rate of annual increase in each mortality rate. As the results show, a decline in the under 65 mortality rate preceding a decline in the overall mortality rate was observed in stomach cancer and male liver cancer. Also, the under 65 mortality rate due to lung cancer seemed to begin to decline in recent years for males, while the overall mortality rate has been increasing. This study suggests that the premature mortality rate is a more sensitive indicator of the effectiveness of cancer prevention. Hence, because of not only the larger burden of premature deaths but also the sensitivity, premature mortality is considered to be suitable as a target indicator for cancer prevention strategies.
Mortality Vital Statistics ; Malignant Neoplasms ; trends ; Japan ; Prevention

Blood lactate kinetics is an important physiological determinant of endurance exercise performance. Recently, some studies reported that the blood glucose transition point can also be observed (blood glucose threshold; GT) and the GT is consistent with the lactate threshold (LT). However, we have recently reported that blood glucose kinetics and blood lactate kinetics were different during two sets of incremental running tests in the same day. This result suggested that influence of low glycogen storage on GT and LT are different. This study was intended to clarify the effect of low glycogen storage on the blood glucose and the blood lactate kinetics during incremental running test performed two successive days. Eight male endurance runners participated in incremental running test performed two successive days. The main finding was that the blood glucose was significantly lower in the second day than the first day during incremental test, although blood glucose was not different at rest in both days. However, blood lactate was not different form rest to fifth stages in both days, significantly lower only at the final stage in the second day than the first day. Respiratory exchange ration were lower in the second day compared to the first day. GT was significantly higher in the second day than the first day, but LT was not different in both days. We concluded that low glycogen storage effected blood glucose kinetics more than blood lactate kinetics, and resulted in only the change of GT.

Two patients of chronic mediastinitis after cardiac surgery were treated by omental transfer. Their previous cardiac operations were open mitral commissurotomy and aortic valve replacement. They underwent radical surgical therapy for mediastinitis 8 to 9 years after the first cardiac surgery. In both cases, the infection resulted from Dacron felt on the ascending aorta. Under the cardiopulmonary bypass, the Dacron felt and infected tissue were resected. And omental transfer was done to prevent recurrent infection. The patients have been follwed up for 10 to 14 months. And they have no symptoms of their mediastinitis during these periods. From these experience, we consider that omental transfer is very helpful to treat infectious complications after cardiac surgery.

Relationship between SGOT/SGPT ratio and energy intake were investigated in 1030 subjects (373 males, 657 females). These figures were taken from epidemiological survey of the Tokushima prefecture from 1975 to 1980.
The results of the survey were as follows.
1) Energy intakes in reversal group (SGOT/SGPT <1) was higher than that in nromal group (SGOT/SGPT >1).
2) Body weight in reversal group was higher than that in normal group except young woman (18-39 years).
3) Incidence of reversal of SGOT/SGPT ratio showed increasing values as energy intakes levels increased.
It is possible to conclude from the results that SGOT/SGPT ratio was affected by energy intakes.

The present study was conducted to obtain basic information about blood glucose fluctuation and relation with race performance during 100 km marathon. Subcutaneous glucose of one well-trained runner was measured by continuous glucose monitoring system (CGMS) at 5 min interval and blood samples for biochemical analysis were drawn at pre, middle and post of the race. Energy balance during one week prior to the 100 km race was recorded, and the whole energy and fluid intake during the race was analyzed. Blood glucose fluctuated reflecting duration of exercise and energy supply during the race. During the latter part of the race (65–70 km), abrupt declines in blood glucose level, which reflected insufficient carbohydrate intake before the race (119 g), were accompanied by decrease in running speed. The present report suggests that continuous glucose monitoring supplemented with standard nutritional and physiological measurement provides precise and valuable information on runner’s energy state during the ultra-endurance race, and that athletes need to reassess their preparation for the race and planning of energy intake during the race.

The present study was conducted to obtain basic information about blood glucose fluctuation and relation with race performance during 100 km marathon. Subcutaneous glucose of one well-trained runner was measured by continuous glucose monitoring system (CGMS) at 5 min interval and blood samples for biochemical analysis were drawn at pre, middle and post of the race. Energy balance during one week prior to the 100 km race was recorded, and the whole energy and fluid intake during the race was analyzed. Blood glucose fluctuated reflecting duration of exercise and energy supply during the race. During the latter part of the race (65–70 km), abrupt declines in blood glucose level, which reflected insufficient carbohydrate intake before the race (119 g), were accompanied by decrease in running speed. The present report suggests that continuous glucose monitoring supplemented with standard nutritional and physiological measurement provides precise and valuable information on runner’s energy state during the ultra-endurance race, and that athletes need to reassess their preparation for the race and planning of energy intake during the race.

This study was intended to clarify 1) the difference of the exercise intensity at blood lactate threshold (LT) and blood glucose threshold (GT), 2) the effect of exercise duration on the LT and GT during two sets of incremental running test. Ten male runners (age 25.0±3.2 yr, height 171.2±5.5 cm, body mass 57.9±4.0 kg, VO_2max 64.6±3.0 ml/kg/min) completed two sets of incremental running test (each set was set to run ten stages at 60-90% VO_2max). Second set was repeated after 8 min recovery. LT and GT speed were investigated at the first set. Lactate minimum (LM) and glucose minimum (GM) speed were selected where the blood lactate and glucose concentration were at the lowest during the second set. Using the indirect calorimetry (VO₂, VCO₂), fat and carbohydrate oxidation rates were calculated. GT was observed in all runners. VO₂ and energy expenditure were similar between the two incremental running tests, however, fat oxidation was significantly higher and carbohydrate oxidation was significantly lower during the first half of the second set. This change was regarded as the influence of the exercise duration in the first set. Furthermore, GM speed was significantly lower than GT speed, but LM speed and LT speed were not different. It was considered that the shift of GT was affected by the substrate utilization change during prolonged exercise.

From January, 1975 to December, 1989, 231 Björk-Shiley prostheses have been implanted in our hospital. During this period, we have experienced thrombosed valves in 0.69%/pt-yr for the aortic and 1.2%/pt-yr for the mitral position. Ten patients, four in the aortic and six in the mitral, have had thrombotic obstruction of a prosthetic valve. Seven cases of them had insufficient warfarin control. Clinical signs of thrombosed valves were dyspnea, thromboembolism and abnormal cardiac sound. Cineradiography was the most useful diagnostic method. Two cases underwent thrombolytic therapy, but one case died of cerebral complication and another needed an emergency cardiac operation 24 hours after the onset. Six survived among the eight surgical cases. We concluded that thrombosed valves mainly resulted from an insufficient anticoagulant therapy and an urgent surgical intervention would better be performed.

In this report, we describe our surgical experience with seven cases of acute type A aortic dissection which resulted from retrograde propagation from tears in the proximal descending arota. As an emergency procedure, we used a ringed intraluminal prosthesis in six patients and five of these survived. All survivors underwent follow up CT scanning during a period ranging from 4 months to 5.6 years after surgery, especially to evaluate the fate of the false lumen on the residual aorta. In four patients, the arch dissection has been completely occluded by thrombosis, however, it remained patent in one patient 2.3 years postoperatively in whom reentry was found in the arch vessel at the time of operation. Enlargement of the false lumen beyond the descending aorta was found in two patients. On the other hand, the results have been excellent in the most recent patient who underwent complete graft replacement of both the ascending aorta and aortic arch including the primary tear. The authors believe, therefore, that the complete graft replacement of the ascending aorta to the aortic arch should be considered as the procedure of choice in these particular patients. Only such procedures enable the complete healing of both the ascending and arch dissection, and reoperation can be confined to the area distal to the descending aorta, if necessary.

Objective To investigate the characteristics and prognosis of acute and chronic pancreatic pseudocysts and to identify the predictive factors of interventional treatment of pancreatic pseudocysts. Methods From January 1995 to December 2004, 36 patients with pancreatic pseudocysts at Nippon Medical School were studied retrospectively. Group 1 included 9 patients with acute pancreatitis associated pseudocysts which resolved spontaneously. Group 2 included 9 patients with acute pancreatitis associated pseudocysts and symptoms persisted or with complications which requiring interventional treatment. Group 3 included 9 patients with chronic pancreatitis associated pseudocysts which resolved spontaneously. Group 4 included 9 patients with chronic pancreatitis associated pseudocysts with symptoms persisted or with complications which requiring interventional treatment. Results Among the 36 patients, there were 13 women and 23 men. The etiology of pancreatitis due to alcohol was 18(50.0%) cases, biliary tract disease 8(22.2%)cases, others 10(27.8%) cases. The average duration of follow up was (24. 2 ± 18.5) months. The majority of pseudocysts (32/36, 88.9%) were not communicated with the main pancreatic duct;the number and location of the 4 groups of pseudocysts were not significantly different;the biggest diameter of pancreatic pseudocysts in group 3 was the smallest, all below 4 cm, which was significantly less than those in other 3 groups (P < 0.05) ;the majority of volume of pancreatic pseudocysts in group 1 and 3 was not increased, while it was increased in group 2 and 4.