An 82-year-old male patient who had a history of ischemic heart disease (IHD) and Debranching Thoracic Endovascular Aortic Repair (TEVAR) (right axillary artery-left axillary artery-left common carotid artery) was admitted to our hospital due to sudden chest pain. The diagnosis revealed acute coronary syndrome: 2-vessel lesions, including the left main trunk (LMT) (right coronary artery (RCA) #2 75%, #3 90%, LMT #5 50%, and left anterior descending (LAD) branch #7 75%). Plain Old Balloon Angioplasty (POBA) was performed on the responsible lesion, RCA (#2-3). Off-pump Coronary Artery Bypass Grafting (OPCAB) was initially planned for the remaining lesion. However, cardiogenic shock occurred, and an emergency OPCAB (SVG-LAD, SVG-#4PD) was performed via partial sternotomy (inverted L-shaped incision on the left side), using intra-aortic balloon pumping (IABP). The patient underwent revascularization using great saphenous vein grafts due to the potential for postoperative pleuroperitoneal communication in patients undergoing peritoneal dialysis, as well as the risk of impaired internal thoracic artery (ITA) flow caused by debranching in future involving internal shunts for dialysis. It is important to consider not only the graft but also the thoracotomy, taking into account the perspectives of early weaning and the prevention of perioperative complications.

BACKGROUND/AIMS: Fecal calprotectin (Fcal) as well as the fecal immunochemical test (FIT) are useful biomarkers for detecting activity and mucosal healing in inflammatory bowel diseases. Here, we report the performance of simultaneous measurements of Fcal and FIT for ulcerative colitis (UC) patients using the newly-developed latex agglutination turbidimetric immunoassay (LATIA) system. METHODS: Fcal and hemoglobin were measured by the LATIA system in 152 UC patients who underwent colonoscopy. Fcal was also quantified with a conventional enzyme-linked immunosorbent assay (ELISA). Fecal markers were evaluated in conjunction with the mucosal status of UC, which was assessed via the Mayo endoscopic subscore (MES) classification. RESULTS: The LATIA system could quantify calprotectin and hemoglobin simultaneously with the same fecal samples within 10 minutes. The values of the Fcal-LATIA closely correlated with those of the Fcal-ELISA (Spearman rank correlation coefficient, r=0.84; P<0.0001). The values of Fcal for each assay and the FIT all significantly correlated with the MESs (Spearman rank correlation coefficient, Fcal-LATIA: r=0.58, Fcal-ELISA: r=0.55, and FIT: r=0.72). The mucosal healing predictability (determined by an MES of 0 alone) of the Fcal-LATIA, Fcal-ELISA, and FIT-LATIA with the cutoffs determined by receiver operating characteristic curve analysis was 0.79, 0.78, and 0.92 for sensitivity, respectively, and 0.78, 0.69, and 0.73 for specificity, respectively. CONCLUSIONS: The performance of the novel Fcal-LATIA was equivalent to that of the conventional Fcal assay. Simultaneous measurements with FITs would promote the clinical relevance of fecal biomarkers in UC.
Agglutination ; Biomarkers ; Classification ; Colitis, Ulcerative ; Colonoscopy ; Enzyme-Linked Immunosorbent Assay ; Feces ; Humans ; Immunoassay ; Inflammatory Bowel Diseases ; Latex ; Leukocyte L1 Antigen Complex ; ROC Curve ; Sensitivity and Specificity

It has been reported that physical fitness of breast cancer patients is relatively lower due to the cancer treatment such as surgery, chemotherapy, or endocrine therapy. Previous studies have revealed that not only cardiorespiratory fitness but also muscle strength is lower among breast cancer patients than no disease women and these symptoms may aggravate the health-related quality of life. However, there is no study which has focused the physical fitness level in Japanese breast cancer survivors. The purpose of this study was to investigate the physical fitness level and the relationship between exercise habituation and physical fitness level in Japanese breast cancer survivors. Fifty breast cancer survivors participated in this study. Participants were assigned to either exercise habituation group (n=25) or non-exercise group (n=25). We evaluated exercise habituation using an original questionnaire and examined various physical fitness level. Body weight, body mass index, and percent body fat were significantly lower in the exercise habituation group than non-exercise group. T-score of cardiorespiratory fitness was significantly higher in the exercise habituation group than average Japanese women. These results suggested that exercise habituation is relative to body weight and cardiorespiratory fitness level in Japanese breast cancer survivors.

The effect of forearm and upper limb muscles vibration during extension and flexion movement of wrist and elbow was studied in 10 normal human subjects. In first experiment, a vibratory stimulation was applied to either the flexor carpi ulnaris (FCU) or the biceps brachii (BB) muscle during simple and simultaneous extension movement about wrist and elbow. In second experiment, vibratory stimulation was applied to either the extensor carpi radialis (ECR) or the triceps brachii (TB) muscle during simple and simultaneous flexion movement about wrist and elbow. The main new findings of the present study are as follows. During simple and simultaneous extension-flexion movements of the elbow, the application of vibration to the FCU or to the ECR produced an undershoot of the target position. However, no undershoot was observed by the application of vibration to the BB or the TB during simultaneous extension-flexion movements of the wrist. From these results, it was revealed that although there are cases where the phenomenon of undershoot resulting from vibration of the wrist and elbow during simple and simultaneous movements corresponds to the type of synaptic connection from muscle spindle group Ia sensory inputs to alpha motor neurons, as identified by Cavallari & Katz (1989) and Cavallari et al. (1992), the manifestation of undershoot is influenced by differences between the movement patterns of the wrist and elbow joints, as well as the differences between simple movement and simultaneous movement.

Object : The purpose of this study was to test the response of the decline in heart rate (HR) induced by compression on the eyeball (eyeball pressure : EP) and voluntary non breath (VNB) after pedaling exercise. Methods : EP ; Nine male subjects performed exercise for 3 min in a supine position using a bicycle ergometer. Immediately after the exercise all subjects received EP for 10 seconds. After that, subjects undertook the same protocol without EP (CON-E). VNB ; Four male and two female subjects performed exercise for 5 minutes using a bicycle ergometer. Immediately after the exercise subjects received VNB for 7 seconds. After that subjects undertook the same protocol without VNB (CON-V). Results : The slope of the decline in HR recovery (HR_DS) after exercise in EP increased significantly more than that in CON-E (p<0.05). However, time constant (HR_TC) in CON-E declined faster than that in EP. Thereby, the relationship between HR_DS in EP and HR_TC in CON-E correlated (r=-0.562). The HR_DS of VNB was greater than that of EP and CON-V. However the relationship between HR_DS in VNB and HR_TC in CON-V did not correlate. Conclusion : We suggest that EP affects vagal nervous activity and VNB affects strength of baroreflex sensitivity. Therefore HR_DS of EP might evaluate vagal nervous activity.

The purpose of this study was to examine the effect of the different visual and vestibular inputs on EMG response of ankle muscles during movement to absorb impact in sliding down a slope. Thereby, our research focused on the relationship between preactivation (PA) in central program and stretch reflex induced by dorsiflexion immediately after impact. The subjects were nine healthy males. Movements were conducted using a special sliding apparatus. Conditions included sliding down a lower 15°slope with eyes open (Low) and with eyes closed (Low-Closed), and a higher 20°slope with eyes open (High) . PA prior to impact indicated the co-contraction of the medial gastrocnemius (MG) and tibialis anterior (TA) . PA levels in those muscles were significantly higher during High than during Low-Closed (p<0.05) . In contrast, PA of the coleus (Sol) was low in all test conditions. After impact, however, the stretch reflex of Sol during Low-Closed was greater than other test conditions. Because muscle stretch velocities and PA levels of Sol among all test conditions remained unchanged, these results suggest that different visual inputs could change the response of stretch reflex by modulations in reflex gain.

Clinical course and outcome of 34 patients with peripheral and visceral artery aneuryms, operated during 1975-1990, were analysed. There were 24 males and 10 females. Ages ranged from 14 to 87, with an average of 55 years. Peripheral aneurysms located most frequently in the lower extremity, and the incidence of various origin of the aneurysms were as follows: 14 in femoral, 5 in popliteal, 4 in internal iliac, 3 in subclavian, 2 in common iliac arteries, and 1 in each of vertebral, radial, splenic, renal and anterior tibial artery. Most common cause of aneurysm was arteriosclerosis. Multiple aneurysms were found in 59% of sclerotic type and in most of these with bilateral aneurysms in the iliac, femoral and popliteal. Ruptured aneurysms were seen in 26% of this series. Most of the aneurysms in the extremities were totally excised without difficulty, while the aneurysms in common iliac and internal iliac were opened with partial excision or obliterated with endoaneurysmorrhaphy. Arterial reconstruction was performed using saphenous vein graft or synthetic vascular graft, excepting that the internal iliac artery itself was not reconstructed. The early operative results were satisfactory, but late results showed two death and three complications of cardiovascular system. Therefore, careful follow up of the postoperative patients was recommended.

During the eleven years from January 1978 to December 1988, we experienced 1, 287 cases of gastric cancer, hospitalized in the surgical department of Tsuchiura Kyodo Hospital which is located in the southern agricultural district of Ibaraki Prefecture.
Among these 1, 287 cases, 1, 233 patients were operated on. Gastric resection was performed in 1, 059 cases including 337 cases of total gastrectomy with the resection rate of 85.9 percent (1, 059/1, 233). In 863 cases, resection gave histologically satisfactory results, and our curative resection rate was 70.0 percent (863/1, 233). Direct mortality rate was 2.35% in all operated cases and 1.32% in resected cases.
The five-year survival rate over the period from 1978 to 1983 was 57.7% in all resected cases and 69.3% in curatively resected cases.
Annual follow up observation showed increases in resection rate, curative resection rate, and five-year survival rate. However, there were no remarkable changes in the rate of total gastrectomy, rate of combined resection of other organs, and degree of lymph nodes dissection.
The main factor contributing to the improvement in the results of surgical treatment of gastric cancer was the increase in the detection rate of cancer in relatively early stages, through gastric mass survey or total check-up in the asymptomatic stage.

Today, rural communities in Japan are on the brink of a ruin, and the rapidly deteriorating social conditions there have exerted a harmful influence on the health of farmers.
During the work for protecting health of the inhabitants in a village of Ehime Prefecture, it was noticed that a considerably low level of community health has reflected on the high frequency of anemia.
It is noteworthy that most of the anemic cases result from overwork and unbalanced nutrition caused by poverty.
In our last investigation on 1389 inhabitants, anemia was found in 28.0% of the male adults, 25.7% of the female adults, 40% of the old people. The mean hemoglobin level was 14.58±1.63 in the male adults, and 12.57±1.51 in the female adults.
It is urgently necessary to take effective measures to correct the situation.
As causal factors, we can enumerate distorted dietary life, overwork, and physiological phenomena peculiar to women, such as pregnancy and delivery, in the case of women; and overwork, a general decline of bone marrow functions, and the secondary anemia caused by other diseases in the case of old people. The establishment of a system of community health control is needed more than anything else.

An examination of anemia has been carried out for 466 pupils of Aiji Elementary School and Aiji Lower Secondary School in Hiromicho, Ehime Prefecture.
The cases of anemia became more and more frequent as the age of the pupils advanced, and this, we think, is closely connected with the distorted dietary life which is forced upon the people in rural areas in Japan by the repid change of living conditions there.
For measures to counter the frequent occurrence of anemia among pupils it is most important to establish a close cooperation between the school health protection and the community health protection and to pursue the community program of health protection.