This study was intended to examine the specific nature and an aerobic value of jumping jacks (Fig. 1) which has a greater movement in shoulders and is easy to perform in standing position without specific skill and equipment and in also a narrow place.
Individual's self-selected (free) tempo in jumping jacks was determined for 92 subjects by administering it for 5 minutes.
The optimal tempo was obtained from measuring energy expenditures on two subjects when they performed five minutes of jumping jacks at each tempo of 50, 60 and 70 times/min and also at one's free tempo. Exercise intensity of jumping jacks as a general endurance activity was determined from energy expenditures and % Vo₂2max of 9 subjects who performed 5 minutes of jumping jacks at 60 times/min. Training effect of jumping jacks was examined on the basis of the changes in Vo₂max and heart rate (jumping jacks at 60 times/min for 3 min) before and after one month of training on 7 subjects who participated 180 jumping jacks at free tempo a day, averagely 6.3 times a week. Subjects were all college male students aged between 18 and 22. Followings are the results obtained in this study.
1) Individual's self-selected (free) tempo in jumping jacks was about 60 times/min.
2) The optimal tempo in jumping jacks determined on the basis of energy expenditure was also about 60 times/min.
3) Oxygen requirement and RMR at the optimal tempo (60 times/min) in jumping jacks were 40.9 ml/kg/min and 12.3, respectively. Percent Vo₂max, Oxygen requirement and RMR in jumping jacks was smaller for persons who have greater Vo₂max/body weight.
4) One month of training by jumping jacks demonstrated significant increases in Vo₂max and Vo₂max/body weight, which were 2.59 to 2.751/min (p<0.01) and 43.5 to 46.1 ml/kg/min (p<0.05), respectively. Significant decreases in heart rate were also observed during and recovery after the exercise.
5) From above results, jumping jacks could be used as an effective general endurance exercise, provided that some necessary modifications should be made according to each individual's fitness level.

We investigated the relationship between obesity and lipids in elderly women in a rural area with primary hyperlipidemia after one year of follow-up. Thirty women aged 61 to 89 (mean age, 72.5 years) with primary hyperlipidemia were enrolled in this study. They were all given lipid-lowering dietary by a dietitian (s) and general physicians at the time of entry.
Total serum cholesterol (TCHO), high-density lipoprotein cholesterol (HDL-C), blood pressure and body mass index (BMI) did not change significantly over the past one year however, triglyceride level (TG) significantly decreased during the period. BMI at the time of enrollment was not significantly correlated with the reduction rate of TCHO or HDL-C, but was significantly correlated with the reduction rate of TG.
Thus, BMI may be useful as a predictor of TG change when only dietary therapy is given to eldery suburban women.

A 65-year-old woman suffered from swollen parotid and submandibular glands in July 2005, and sicca of the eyes and oral cavity arose in October 2005. We diagnosed her as having Mikulicz's disease based on magnetic resonance imaging of the head, gallium scintigraphy, and a lip biopsy in June 2006. After prednisolone 10 mg/day was commenced, her salivary glands shrank slightly. Although the amount of prednisolone had been tapered to 7 mg/day by May 2007, her serum IgG rebounded. In January 2008, hachimijiogan extract granules 7.5 g/day were introduced. Swelling of the salivary glands disappeared and her serum IgG level decreased. In May 2008, the amount of prednisolone was tapered successfully to 6 mg/day. Mikulicz's disease is a corticosteroid-sensitive disease, but in this case steroid resistance made treatment difficult. Based on this case, we performed functional assays of P-glycoprotein with calcein-AM, which demonstrated that hachimijiogan can reverse drug resistance.
seconds ; mg/d ; Prednisolone ; Serum ; Effective

In this study, the effect of moderate endurance training on muscle morphological properties of human thigh muscles and isokinetic strength was examined. Five sedentary females carried out a training program of 30 min./day, 3 times a week for a ten-week period. The load requirement was set to 60% of maximal aerobic capacity (Vo₂max) of the subjects. In the determination of muscle cross-sectional areas (CSAs) by MRI, longitudinal sections were first imaged, and ten axial images along the length of femur were taken before and after the endurance training. Muscle CSA and mus-cle volume of knee extensors (KE), flexors (KF), and adductors (AD) were calculated, using the ten axial images. Vo₂max was significantly increased after endurance training (14.6%, p<0.01) . Muscle CSA in KE was significantly increased at the ten levels of femur length. There were also significant increases at seven levels of femur length after endurance training in KF (p<0.05, and 0.01) . Percentage increase of msucle CSA in KE and KF were 10.9 to 16.5% and 7.7 to 15.8%, respectively. Although the muscle volume of KE, KF, and AD was significantly increased, no change in fat volume was observed after endurance training. Isokinetic knee extension and flexion peak torque and peak torque per unit of muscle CSA at three angular velocities (30, 180, and 300 deg/sec) didn't show significant changes. These results suggest that muscle hypertrophy induced by moderate endurance training has no effect on muscle strength.

An investigation on the efficacy of preoperative autologous blood donation in open-heart surgery was made using frozen red blood cells and MAP red blood cells in cooperation with the Red Cross Blood Center. In 109 cases which received the donation, the rate of cases which received no homologous blood transfusion was 93.6% (35.3% in the cases without donation). Even in the cases of redo operation or aortic surgery, in which extensive blood loss is expected, 75% of those given a donation of 1600-2000ml frozen blood required no homologous blood transfusion. The hemoglobin concentration in the cases which received blood donation for more than 4 weeks did not decrease, indicating that safe donation is feasible. The aforementioned frozen and MAP blood preparations can be preserved for a long period so that blood donation can be started even before deciding on the date of operation. Also, its usefulness is not affected by the postponement of the operation. Furthermore, there was no problem in safety with respect to transfer, treatment, and storage of the autologous blood in cooperation with the Red Cross Blood Center, suggesting that this is useful as a preoperative donation method, especially in small- and middle-scale hospitals, which have no separate blood centers. However, there were 2 cases in which aggravated symptoms were noted after blood collection. Therefore, it is important to carefully select cases for autologous blood donation in open-heart surgery and it is desirable to set up appropriate donation schedules.

To identify the factors affecting the high mortality rates associated with ruptured abdominal aortic aneurysm (rAAA), a review was made of the records of 35 consecutive patients (33 males, 2 females, mean age 69.9yr.) treated surgically between 1988 and 1997. Preoperatively profound shock (systolic pressure less than 70mmHg) was seen in 19 patients and loss of consciousness in 9. Maximum diameter of the AAA was 79±20mm and the preoperative hemoglobin level was 9.1±2.4g/dl. Proximal aortic clamp was performed at the intrathoracic aorta in 3 cases, the suprarenal aorta in 6, balloon occlusion in 4, and the infrarenal aorta in 22. Since 1994, diltiazem and nitroglycerin have been routinely given for latent myocardial ischemia and early induction of continuous hemodialysis for renal failure was attempted postoperatively. The overall hospital mortality rate was 20%. Multisystem failure was the most frequent cause of hospital death (57.1%), followed by pneumonia with sepsis in 28.6%, and intraoperative cardiac arrest (14.3%). By univariate analysis of various factors associated with the mortality rate, loss of consciousness, abnormality on electrocarciogram (ECG) and duration of shock for more than five hours were statistically significant. Multivariate analysis with stepwise logistic regression demonstrated that an ECG abnormality and duration of shock more than five hours were associated with high mortality, but not at statistically significant levels. These findings suggest that factors that are predictive of death (loss of consciousness and ECG abnormality) may be a reflection of shock in this patient population.

An 81-year-old patient, who had a postinfarction left ventricular aneurysm with thrombus underwent left ventricular aneurysmectomy with right coronary artery bypass grafting (CABG). Preoperative examination showed 99% stenosis of the left coronary artery (#7) and 90% stenosis of the right coronary artery (#3). The operation was performed because angina was not improved and formation of thrombus was suspected on the wall of the aneurysm. The operation was performed under cardiopulmonary bypass and by antegrade and continuous retrograde cardioplegia. The aneurysm was resected and a relatively fresh thrombus which was detected on the endocardium of the aneurysm was extracted. The left ventricle was closed by direct linear suture with felt reinforcement. Because the area of resection included part of the left anterior descending artery, only right CABG (#3) with a saphenous vein was done. Weaning from bypass was very easy and the postoperative course was uneventful.

Using the DDG-2001 pulse dye densitometer, cardiac output (CO) and circulating blood volume (BV) were determined before and after the operation, and its accuracy and the significance of postoperative management were studied. Referring to 14 cases undergoing open heart surgery, CO and BV were determined using the DDG-2001 before application of the cardiopulmonary bypass and immediately, 4h and 12h after the operation. The level of CO was compared with that determined by the thermodilution method, and the level of BV with that calculated from hemoglobin levels determined before and after the cardiopulmonary bypass application and the priming volume in the circuit. Further, body fluid balance after the operation was calculated, and its relation to BV was studied. As to the correlation coefficient and inclination of the regression line, they were 0.77 and 0.849 with CO, and 0.821 and 0.844 with BV, respectively. Upon completion of the operation BV decreased, but increased again 4h and 12h later, although the body fluid balance was negative. CO and BV determined by the pulse dye densitometry favorably correlated with those determined by other methods. Immediately after the operation BV decreased, but then increased in the course of time, although the body fluid balance was negative.

In this study, the effect of moderate endurance training on muscle morphological properties of human thigh muscles and isokinetic strength was examined. Five sedentary females carried out a training program of 30 min./day, 3 times a week for a ten-week period. The load requirement was set to 60% of maximal aerobic capacity (Vo₂max) of the subjects. In the determination of muscle cross-sectional areas (CSAs) by MRI, longitudinal sections were first imaged, and ten axial images along the length of femur were taken before and after the endurance training. Muscle CSA and mus-cle volume of knee extensors (KE), flexors (KF), and adductors (AD) were calculated, using the ten axial images. Vo₂max was significantly increased after endurance training (14.6%, p<0.01) . Muscle CSA in KE was significantly increased at the ten levels of femur length. There were also significant increases at seven levels of femur length after endurance training in KF (p<0.05, and 0.01) . Percentage increase of msucle CSA in KE and KF were 10.9 to 16.5% and 7.7 to 15.8%, respectively. Although the muscle volume of KE, KF, and AD was significantly increased, no change in fat volume was observed after endurance training. Isokinetic knee extension and flexion peak torque and peak torque per unit of muscle CSA at three angular velocities (30, 180, and 300 deg/sec) didn't show significant changes. These results suggest that muscle hypertrophy induced by moderate endurance training has no effect on muscle strength.

To determine the relationships among silent brain infarction (SBI), bone mineral density and milk consumption in elderly women, we studied 26 senile female outpatients with SBI in comparison with 18 age-matched controls.
There was a significant difference between the two groups in diastolic blood pressure (p<0.05), and a significantly larger number of individuals in the SBI group had a history of hypertension than in the control group (p<0.005). Bone mineral density at the ultradistal end of the radius tended to be lower in the SBI group than in the control group (0.05These finding indicated a close correlation between SBI and milk consumption habits in elderly women.