The purpose of this study was to clarify the effects of different frequencies of skipping rope on the elastic components of muscle and tendon in human triceps surae. Six male subjects performed ten rounds of skipping rope. Skipping tempos were with in a range of 100-170 skips per minute (SPM) . The vertical ground reaction force and the surface EMG of triceps surae muscles were recorded during each skipping round. Elastic components of muscle and tendon were estimated by Residual Time (RT : lag time difference between the vanishing point of muscle discharge and disappearance of EMG, and the end of the ground reaction force wave) and RTintegrate (integration of ground reaction force while RT still appears) . RT and RTintegrate at 100 SPM were the smallest values for all jump frequencies. On the other hand, integrated EMG (iEMG) at 100 SPM was the largest value for all jump frequencies. Although RT and RT_integrateprogressively increased as SPM was increased, iEMG correspondingly decreased. Rate in utilization of elastic components of muscle and tendon assessed by RT_integrateat 170 SPM corresponds to 150% at 100 SPM. These results suggest that the rate in utilization of the elastic components of muscle and tendon while skipping rope, depend on jump frequency.

Infants with complete atrioventricular canal (CAVC) and severe congestive heart failure, not responding to medical managements, presents a difficult management problem. Between December, 1980, and August, 1987, 16 infants with CAVC presenting severe congestive heart failure underwent pulmonary artery banding. Average age at operation was 1.7 months (0.5 to 4) and average weight was 3.5kg (2.5∼4.9). Only four patients were older than 3 months of age at operation. Pre-operative cardiac catheterization and echocardiogram demonstrated that seven patients had mild to severe left atrioventricular valve regurgitation. Hospital death occurred in one patient (6%) due to rupture of the pulmonary artery. Of three late deaths, one patient had congestive heart failure, and one patient complicated with partial obstruction of right pulmonary artery died suddenly of an upper respiratory infection 11 months after rebanding. Survivors have been followed 18 to 94 months and all patients are growing at an increased rate postoperatively. In five patients of 12 long-term survivors who have undergone cardiac catheterization 37 to 83 months after the operation, pulmonary/systemic systolic pressure ratio (PP/PS) were 0.2∼0.42 (average 0.28). It is concluded that the pulmonary artery banding in infants with CAVC can be performed with low operative and late mortality and can provide good relief of symptoms and allow normal growth and development. It should be emphasized that early surgical palliation is mandatory to prevent the development of pulmonary hypertension and pulmonary emphysematous change.

OBJECTIVES: The number of patients with bilateral cochlear implant (CI) has gradually increased as patients and/or parents recognize its effectiveness. The purpose of this report is to evaluate the efficacy of 29 bilateral CI out of 169 pediatric CI users, who received auditory-verbal/oral habilitation at our hearing center. METHODS: We evaluated the audiological abilities 29 Japanese children with bilateral CIs including wearing threshold, word recognition score, speech discrimination score at 1 m from front speaker (SP), 1 m from second CI side SP, speech discrimination score under the noise (S/N ratio=80 dB sound pressure level [SPL]/70 dB SPL, 10 dB) at 1 m from front SP, word recognition score under the noise (S/N ratio=80 dB SPL/70 dB SPL, 10 dB) at 1 m from front SP. RESULTS: Binaural hearing using bilateral CI is better than first CI in all speech understanding tests. Especially, there were significant differences between the results of first CI and bilateral CI on SDS at 70 dB SPL (P=0.02), SDS at 1 m from second CI side SP at 60 dB SPL (P=0.02), word recognition score (WRS) at 1 m from second CI side SP at 60 dB SPL (P=0.02), speech discrimination score (SDS) at 1 m from front SP under the noise (S/N=80/70; P=0.01) and WRS at 1 m from front SP under the noise (S/N=80/70; P=0.002). At every age, a second CI is very effective. However, the results of under 9 years old were better than of over 9 years old on the mean SDS under the noise (S/N=80/70) on second CI (P=0.04). About use of a hearing aid (HA) in their opposite side of first CI, on the WRS and SDS under the noise, there were significant differences between the group of over 3 years and the group of under 10 months of HA non user before second CI. CONCLUSION: These results may show important binaural effectiveness such as binaural summation and head shadow effect. Bilateral CI is very useful medical intervention for many children with severe-to-profound hearing loss in Japan as well as elsewhere.
Asian Continental Ancestry Group ; Child ; Cochlear Implantation ; Cochlear Implants ; Head ; Hearing ; Hearing Aids ; Hearing Loss ; Humans ; Japan ; Noise ; Parents ; Speech Perception

BACKGROUND/AIMS: Gastrointestinal stromal tumor (GIST) is one of the most common types of submucosal tumors (SMTs). Because of GIST's malignant potential, it is crucial to differentiate it from other SMTs. The present study aimed to identify characteristic endoscopic findings of GISTs in the small intestine. METHODS: We reviewed the clinicopathological and endoscopic findings of 38 patients with endoscopically or surgically resected SMTs in the small intestine. SMTs were classified into GIST and non-GIST groups, and clinicopathological and endoscopic findings were compared between the 2 groups. RESULTS: Fifteen patients had GIST and 23 patients had other types of SMTs in the small intestine. Comparison of the endoscopic findings between the 2 groups revealed that dilated vessels in the surrounding mucosa were significantly more in number in the GIST group than in the non-GIST group (P<0.05). However, there were no other differences in endoscopic findings between the 2 groups. Among patients with GISTs, the presence of dilated vessels in the surrounding mucosa was not associated with bleeding risk, tumor size, or metastasis rate at diagnosis. CONCLUSIONS: Dilated vessels in the surrounding mucosa, identified during balloon-assisted endoscopy, may be a diagnostic indicator for GIST in the small intestine. However, its clinical significance should be further analyzed.
Diagnosis ; Endoscopy ; Gastrointestinal Stromal Tumors ; Hemorrhage ; Humans ; Intestine, Small ; Mucous Membrane ; Neoplasm Metastasis

Gastric cancer involving the placenta during pregnancy is rare; however, we present 1 such case in this report. A 31-year-old Japanese woman was referred at 26 weeks of gestation for the evaluation of a swollen left supraclavicular lymph node. Biopsy revealed poorly differentiated adenocarcinoma, and esophagogastroduodenoscopy with biopsy of the stomach confirmed the diagnosis of gastric cancer. Her epigastric and back pain became more pronounced and her general status worsened, and we performed a cesarean delivery at 29 weeks. Microscopic examination of the placental specimen revealed poorly differentiated adenocarcinoma cells diffused into the intervillous space. Postpartum chemotherapy consisted of S-1 plus oxaliplatin. Unfortunately, this treatment was ineffective, and the patient died 3 months after delivery. The infant did well, without clinical or laboratory manifestations of metastasis. In patients with advanced gastric cancer during pregnancy, it is important to perform a microscopic examination of the placenta to evaluate for metastatic involvement.
Adenocarcinoma ; Adult ; Asian Continental Ancestry Group ; Back Pain ; Biopsy ; Diagnosis ; Drug Therapy ; Endoscopy, Digestive System ; Female ; Humans ; Infant ; Lymph Nodes ; Neoplasm Metastasis ; Placenta ; Postpartum Period ; Pregnancy ; Stomach ; Stomach Neoplasms

OBJECTIVES: We conducted multi-directional language development tests as a part of the Research on Sensory and Communicative Disorders (RSVD) in Japan. This report discusses findings as well as factors that led to better results in children with severe-profound hearing loss. METHODS: We evaluated multiple language development tests in 33 Japanese children with cochlear implants (32 patients) and hearing aid (1 patient), including 1) Test for question and answer interaction development, 2) Word fluency test, 3) Japanese version of the Peabody picture vocabulary test-revised, 4) The standardized comprehension test of abstract words, 5) The screening test of reading and writing for Japanese primary school children, 6) The syntactic processing test of aphasia, 7) Criterion-referenced testing (CRT) for Japanese language and mathematics, 8) Pervasive development disorders ASJ rating scales, and 9) Raven's colored progressive matrices. Furthermore, we investigated the factors believed to account for the better performances in these tests. The first group, group A, consisted of 14 children with higher scores in all tests than the national average for children with hearing difficulty. The second group, group B, included 19 children that scored below the national average in any of the tests. RESULTS: Overall, the results show that 76.2% of the scores obtained by the children in these tests exceeded the national average scores of children with hearing difficulty. The children who finished above average on all tests had undergone a longer period of regular habilitation in our rehabilitation center, had their implants earlier in life, were exposed to more auditory verbal/oral communication in their education at affiliated institutions, and were more likely to have been integrated in a regular kindergarten before moving on to elementary school. CONCLUSION: In this study, we suggest that taking the above four factors into consideration will have an affect on the language development of children with severe-profound hearing loss.
Aphasia ; Asian Continental Ancestry Group ; Child ; Child Development Disorders, Pervasive ; Cochlear Implants ; Communication Disorders ; Comprehension ; Hearing ; Hearing Aids ; Hearing Loss ; Humans ; Japan ; Language Development ; Mass Screening ; Mathematics ; Rehabilitation Centers ; Vocabulary ; Weights and Measures ; Writing