1) Children's data (10-18 years old) of back strength, height, grip strength and running long jump from data book of Japan Education Ministry (1964-1981) were analyzed. Back strength was mainly studied and was compared with other data (grip strength etc.) . The groups with high average values for back strength at 10-14 years old did not necessarily show high values for back strength at 17 years old, or vice versa. Values for back strength at 10-14 years old were not significantly correlated with those at 17 years old.
2) Using the data from data book mentioned above, tension of deep back muscle (FMUS) was calculated based on kinetic models (FMUS. I, II, III) . Calculated FMUS values were 3-5 times larger than measured back strength values at each age.
3) Relative change of back strength and FMUS in 1964-1981 were compared. All values for back strength were lower than those for FMUS except in 1967. During the late 1960th and the 1970th, average back strength values gradully decreased, but the decrease of FMUS was less obvious than that of back strength.
4) Based on the data of 422 children (7-12 years old, male and femele), values of diaphragm area were approximated with some assumptions, and then FMUS values were calculated. FMUS values calculated by approximate diaphragm area were significantly larger than those calculated by constant diaphragm area (465 cm2) .
The figure for getting FMUS values easily was offered to avoid troublesome calculation. This consists of two graphs, and one can read FMUS values with reasonable precision. Parameters needed for getting FMUS values are sexuality, height, body weight and back strength.

The purpose of this study was to examine sex differences in subjective symptoms of fatigue (SSF) in high school and college students by considering the relationship between subjective feeling of fatigue and life habits.
A questionnaire on SSF (54 items), dealing with subjective feeling of fatigue and life habits (frequency of exercise, going to sleep, waking in the morning and physical condition) was administered to 5622 healthy students aged 15-20 yr, and data of 5335 properly completed questionnaires was analyzed.
The following was determined :
1) Sex differences were confirmed in most SSF items. SSF complaints for females was generally higher than that of males.
2) The relationship between SSF and the age was low in both sexes.
3) Subjective feeling of fatigue is somewhat related to SSF.
4) The going to sleep last night influence on SSF was different in both sexes and related largely to the next day SSF in males.
5) Waking this morning and today's physical condition are related to SSF in both sexes.
6) In males, the influence of exercise habits on SSF regarding drowsiness is relatively large.

This study aimed to examine the effect of linear polarized near-infrared light (PL) irradiation on the recovery of isokinetic muscle exertion and subjective fatigue sensation in muscles after strenuous exercise. Eighteen healthy college students participated in the experiment for all conditions of meridian point irradiation (MPI), femurs muscles irradiation (FMI), and no irradiation (NI) . They all took isokinetic knee extension and flexion tests (IK test) before and after strenuous exercise up to exhaustion. Each subject was irradiated at the meridian point or in femurs muscles after the second IK test. The third IK test was carried out after ten-minutes rest.
The effects of PL irradiation were confirmed on the recovery rate of muscle fatigue in knee extension motion with high load intensity (PT 60 d/s and TW 60 d/s : MPI, FMI> NI, p<0.05 16.2%, 13.4%>8.5%, and 16.1%, 14.1%>8.3%, respectively) . Also, in flexion motion, significant differences in the recovery-degree for each condition were found, and the effect of PL irradiation was suggested. There was no difference between the effect of MPI and FMI. In addition, subjective fatigue sensation in muscles after rest decreased significantly in MPI as compared with NI (MPI: 52.1%>NI : 36.6%, p<0.05) . From the above, it was suggested that PL irradiation is effective on recovery in muscle fatigue after strenuous exercise regardless of irradiation conditions, MPI or FMI.

  We describe a prototype seminar, inspired by the problem-based learning tutorial system, on pediatric emergency practice for young physicians working in 7 pediatric emergency centers in Yokohama. The seminar was received favorably by the participants, especially as an opportunity for individual learning. We expect that the seminar will contribute to the standardization of emergency practice in these pediatric centers and the establishment of an interhospital network.

  After 1985, the decrease in domestic nursing power progressed gradually. The care for the elderly shifted from domestic private nursing to public nursing-care services when the long-term nursing-care insurance law was enacted in 2000. Because many of the elderly receiving nursing care suffer from chronic ailments of hypertension or the consequences of cerebrovascular disease, etc., cooperation between hospitals and nursing homes is necessary and indispensable. We began exchanging information by E-mail on a trial basis with a special elderly nursing home in April 2009. We aimed to integrate medical care and nursing by sharing medical and nursing information. We concluded that the use of E-mail could serve our purpose. The reason why we reached this conclusion is as follows:The mechanism of the information transmission by E-mail, that also relates to semiotics and narratology, is related to the essence of the description. This mechanism functions as a tool for mutual understanding among hospitals, nursing homes, and families. This also functions as a device to make the medical and nursing experience join. As a result, this mechanism enables the elderly to escape death as dying of sickness in the hospital and to die a natural death in the course of nursing. It is an easy method that can be introduced at a low cost for the purpose of establishing cooperation in medical and nursing care among hospitals, clinics, nursing homes, and nursing support centers, etc. especially in medically underserved remote areas.

OBJECTIVESThe purpose of this study was to quantitatively and qualitatively examine a gender difference of subjective symptoms of fatigue (SSF) in healthy students.

METHODSThe subjective fatigue scale for young adults (SFS-Y) consisted of the following 6 subscales: concentration thinking difficulty, languor, reduced activation, reduced motivation, drowsiness and feeling of physical disintegration. The SFS-Y was administered to 5,435 students aged 15 to 20 yr. Student's t test was used to examine quantitative gender differences for items and factor scores. The qualitative gender difference was examined by comparing factor structures obtained from confirmatory factor analysis. A similarity in the factor structure was evaluated from: 1) interpreted factor names, 2) factor loadings, 3) degree of fit, and 4) congruence coefficient.

RESULTSA complaint of SSF shows gender differences, but the difference is not remarkable. The factor structure of SSF in males and females is suggested to be the same, because six factors with the same name were interpreted in both groups and the similarity of factor structure was very high.

CONCLUSIONThere are some qualitative gender differences in SFS, but no qualitative gender differences in factor structure.

Methods: Among 399 patients who underwent ASD surgery, 62 (≥5 levels fused, >2-year follow-up) underwent fusion from T9–10 to L5 (group L, n=21) or to S2–alar–iliac (group S, n=41). Spinal alignments, Scoliosis Research Society (SRS)-22 scores, performance of activities (clipping toenail, wiping buttock, and wearing socks), proximal and distal junctional failure (PJF+DJF), rod fractures (RFs), and overall revision rates (RRs) were compared between the groups. Results: Group L included younger patients and had longer follow-ups when compared with group S. Although the preoperative pelvic incidence and SRS sagittal modifiers were better in group L, postoperative spinal restorations were nonpathological in both groups. Both groups showed similar deformity progression at the 2-year follow-up; however, group L had lower SRS-22 pain scores. Although “wiping buttocks” did not differ between the groups, the performance of “clipping toenails” and “wearing socks” was poorer in group S at 2 years (possible, group S; 40% vs. group L; 85%–90%). The RRs did not differ between the groups; however, the PJF+DJF rate was higher in group L. DJF was not observed in group S, but occurrence of RFs was noted. Conclusions Although poorer SRS-22 pain scores might be related to lumbosacral mobility, sufficient restoration, equivalent deformity progression, and similar RRs with better activity imply that lumbosacral preservation should be considered in younger patients with moderate deformities.

No abstract available.
Gastroenterostomy* ; Stents*

  We examined how difficult it would be for the elderly living in mountainous areas to go to the nearest hospital using a Voronoi tessellation representing the mathematical concept of neighborhood. We defined the index of the nursing-care capacity for the elderly as the ratio of the number of caregivers to the number of the elderly receiving nursing-care.
  The mean age of those who drive to the hospital by themselves worked out at 70±9.8 years. Meanwhile, that of those who go to the hospital by bus or taken to hospital in a car driven by a family member came to 80±7.0years. The latter was significantly older than the former.
  The areas of the Voronoi tessellation generated by patients' places of residence were divided into three groups according to the size. The plots of these three groups of the the places of residence on the map had a three-layer and doughnut-like structure, i. e., inner-, middle-, and outer-layer.
  The index of the nursing-care capacity in 2008 was less than 1.0 for the patients under 80 years of age. This means that when those who were at the age of 50 in 2008 become old and need nursing-care, access to the hospital will become harder to them than at present. For those who are over 80 years of age and live in the outer layer that is far away from arterial road, it will be almost impossible.
  These findings suggest that outpatient care with transportation assistance by a family member at present should be reconsidered because of the future lack of care personnel. It would also be necessary to consider the welfare of older people from the geographical point of view in order to manage the problems concerning the various physical and sociological difficulties of the elderly.

A 14-year-old women who had a history of aortic root replacement at 7 years old admitted our hospital due to dilatation of aortic arch aneurysm. Loeys-Dietz syndrome was diagnosed when she was 10 years old. Computed tomography showed 70 mm proximal arch aneurysm. Operative findings revealed brachiocephalic artery and left common carotid artery branched from aneurysm. Partial arch replacement was performed and distal anastomosis was made between left common carotid artery and left subclavian artery. Close observation by CT regularly is necessary and undergo aortic repair not to miss the timing of surgery.