This study examined peculiarities in both muscle strength and cross-sectional area (CSA) among soccer players in comparison with those of archers as contrasting athletes. Subjects were 15 male soccer players and 9 male archers at N University. Measurement items were height, body weight (BW), isokinetic muscle strength (knee extension, knee flexion, hip extension, hip flexion) and CSA (psoas muscles). Isokinetic muscle strength (30, 120, 240°/sec.) was measured by Cybex6000 (Lumex Co.), and the psoas muscle CSA was determined using magnetic resonance imaging (Hitachi, Japan). Results were as follows : 1. There was no significant difference in isokinetic knee extension and flexion strength/BW at all angular velocities between soccer players and archers. 2. On isokinetic hip flexion strength/BW, the average values of soccer players were significantly higher at all angular velocities than those of archers. However, there was no significant difference in the average values of isokinetic hip extension strength at all angular velocities between the two groups. 3. The average value for the psoas muscle CSA in soccer players was significantly higher than that of archers. In this study, the biggest difference in muscle strength between soccer players and archers was hip flexion strength, and the CSA of the psoas muscle in soccer players, which is the main component of hip flexion, was significantly larger than that of archers. These findings showed the peculiarity of soccer players due to the constant demands of movements involved in ball kicking and running during practice and competition.

In Chinese medicine, Saiko-ka-ryukotsu-borei -to (SRT; Chai-hu-jia-long-gu-mu-li-tang) and Saiko-keishi-kankyo-to (SKT; Chai-hu-gui-zhi-gan-jiang-tang) are frequently used for patients with nervous constitutions who exhibit psychoneurotic symptoms. Specifically, SRT is used for patients of the excessive constitution type (Shi Zheng), and SKT is used for patients of the deficient constitution type (Xu Zheng).
In this study, in order to clarify the action of SRT and SKT on the central nervous system, the effects of these formulas on the monoamines and their metabolism in discrete brain regions in mice were examined.
1) Single-dose administration of SRT and SKT increased the levels of neurotransmitters and stimulated the metabolism in the dopaminergic nervous system of the corpus striatum (including the serotonergic nervous system for SRT).
2) Repeated administration of SRT stimulated the metabolism in the dopaminergic nervous system of the hypothalamus and hippocampus, and inhibited metabolism in the adrenergic nervous system. On the other hand, SKT stimulated dopamine metabolism in the hippocampus and inhibited the metabolism of serotonin.
From these results, it became apparent that single-dose administration of SRT and SKT caused the hyperfunction of the dopaminergic nervous system, and that repeated administration of the agents caused the hyperfunction of the dopaminergic nervous system and the dysfunction of the serotonergic nervous system. This suggests that the actions of SRT and SKT on the central nervous systems may exert an influence on the regulation of psychoneuroic symptoms by stimulating the doperminergic nervous system and inhibiting the serotonergic nervous system.

Background: Operative blood loss during open-heart surgery has been decreasing recently. We have stopped predonated autologous blood transfusions to reduce hospital stay and cost. Material and methods: In 70 consecutive elective open-heart cases, we used intraoperative hemodilutional autologous transfusions and intraoperative autotransfusions to avoid homologous blood transfusion. Predonated autologous blood transfusion was not used. All patients received an infusion of high-dose tranexamic acid prior to and after cardiopulmonary bypass (CPB). Results: Homologous blood transfusion was not required in 77.1% of patients who underwent open-heart surgery. When further classified, 84.5% of patients who underwent primary open-heart surgery, 41.7% of patients who underwent a reoperation, and 33.3% of patients who were preoperatively anemic did not require homologous blood transfusion. In patients who undergo reoperation and who are preoperatively anemic, the rate of homologous blood transfusion is high. Therefore, during the reoperation, intraoperative autologous blood transfusion should be used before starting CPB, and iron should be given to anemic patients prior to reoperation. Conclusion: Our strategy of blood conservation consists of intraoperative hemodilutional autologous transfusion, intraoperative autotransfusion, infusion of high-dose tranexamic acid prior to and after CPB and, avoiding predonated autologous blood transfusion. Based on our experience, predonated autologous blood transfusion is usually unnecessary for cases who undergo surgery for the first time and are not anemic. Predonated autologous blood transfusion should be reserved only for high risk patients with anemia and reoperation cases. For further blood conservation, we need to study the safety limits of non-transfusion in open-heart surgery.

This paper reports the results of clinical research on spring pollen disease based upon the Oriental medical diagnoses. Sixty-nine patients (twenty-four males and forty-five females) who were afflicted with the spring pollen disease were categorized into groups according to the types of Oriental herbal medicine that they responded to. Then, the authors compared the respective periods when the disease first developed in the patients of each group. A comparison was also made based on the differences between their objective signs and subjective symptoms.
As a result of the research, the types of spring pollen disease observed have been classified into the following three groups, with one exceptional type (see Example 4). The first is a group for which “a treatment for superficies-syndrome” (Kai-hyo) was effective using “the drugs of acrid taste and warm nature” (Shin-on) (see Example 23). The patients of this type first manifested their symptoms in the period between the end of January and mid-February. It was found that most of them exhibited a predisposition to a “hypofunctioning condition” (Kyo-sho), and were diagnosed as having pollen disease with the “wind-cold symptom” (Fu-kan-sho). The second is a group for which “a treatment for superficies-syndrome” was effective using “acrid and coldnatured drugs” (Sin-ryo) (see Example 22). Most of the patients of this type first manifested their symptoms after mid-February. It was found that they exhibited the symptom of “cold in the superficies” (Gai-kan) and “the pathogenic factor blending wind-evil and heat-evil” (Fu-netsu), and that most of them manifested “a hyper-functioning condition” (Jitsu-sho). They were diagnosed as having pollen disease with the “wind-warm symptom” (Fu-on-sho) of a “warm disease” (On-byo) with a strong “wind-evil” (Fu-ja) and weak “warm-evil” (On-ja). The third is a group with the mixture of “the treatment for superficies-syndrome” with “the drugs of acrid taste and warm nature” and those of “acrid and cold nature” (see Example 20). It was found that the patients of this group carried little predisposition to “a hypofunctioning condition, ” and that they exhibited a mixed condition of coldness and heat, carrying both characteristics of the first and second groups. They were diagnosed as having the pollen disease with “auxiliary symptoms” (Ken-sho), “the wind-warm symptom” of “a warm disease” combined with “cold-evil” (Kan ja).

The Ministry of Health and Welfare of Japan is planning a pooling system for multiple-choice questions (MCQs) for the national examination for medical practitioners. To clarify possible problems of such a system, a field study was performed by 10 medical schools in Japan using 90 MCQs from previous examinations. Nine hundred twenty-four 6th-year students participated in the field test. For each MCQ, the correct-response rates at the originating school and those obtained in the field test were significantly correlated. Thus, the correct-response rates to questions on the field test could be predicted from the rates at the originating schools. However, for each question the correct-response rate was significantly higher for students of the originating school than for students of other schools. In the national examination, care should be taken to prevent differences in scores on the basis of question sources.

In order to examine the personal space perception, measurements were conducted on both elbows in 14 men and 46 women. Each subject, with his (or her) eyes closed and with his upper arm fixed horizontally, was instructed to stop the vertical and horizontal swing motion of his lower arm at the point he considered to be the middle of the range of possible motion on the front and side of plane at his shoulder, and this was repeated ten times. In various conditions, similar measurements were also done to study factors affecting the personal space perception in 14 men.
Mean values of bisected angles in percentage against range of motion were deviated from the middle points in the direction of the elbow extension, although there were large differences between the individuals. The deviation was smallest in the vertical. side of plane, and was larger in the horizontal plane than that in the vertical plane. The deviation was not so much affected by the various conditions.
It was suggested that the gain of the personal space perception is higher in the elbow extension than in the elbow flexion and its difference is larger in the horizontal plane than in vertical plane of the human elbow joint.

A 46-year-old man who developed fever and general fatigue was referred to our hospital with suspicion of infective endocarditis. A ventricular septal defect had been previously diagnosed. Transthoracic echocardiography revealed vegetation on the aortic, mitral, and pulmonary valves, and each valve had significant regurgitation. An emergency operation was performed because of congestive heart failure. The aortic and mitral valves were replaced with mechanical valves. The pulmonary valve was repaired ; the anterior leaflet was resected and replaced by glutaraldehyde-treated autologous pericardium. The patient's postoperative course was uneventful. Recurrence of infection was not observed for 3 years after the operation. Triple-valve endocarditis, especially that involving a combination of the aortic, mitral, and pulmonary valves, is rare. Involvement of multiple valves on both sides of the heart may be attributed to a congenital intracardiac shunt. Early surgical intervention may be useful to control infection and heart failure, as in the present case.

The purpose of this study was to compare the effect between cyclists and noncyclists of pedal rates on ankle, knee, and hip joint torque during pedaling exercises. Six male cyclists (CY) and seven male noncyclists (NC) pedaled at 40, 60, 90 and 120 rpm with a power output of 200 W. The lower limb was modeled as three rigid segment links constrained to plane motion. Based on the Newton-Euler method, the equation for each segment was constructed and solved on a computer using pedal force, pedal, crank, and lower limb position data to calculate torque at the ankle, knee, and hip joints. The average planter flexor torque decreased with increasing pedal rates in both groups. The average knee extensor torque for CY decreased up to 90 rpm, and then leveled off at 120 rpm. These results were similar to NC. The average knee flexor torque in both groups remained steady over all pedal rates. The average hip extensor torque for CY decreased significantly up to 90 rpm where it showed the lowest value, but increased at 120 rpm. For NC, the average hip extensor torque did not decrease at 90 rpm compared with 60 rpm, and was significantly higher than CY at 120 rpm (CY : 28.1 ± 9.0 Nm, NC : 38.6 ± 6.7 Nm, p<0.05) . The average hip flexsor torque for NC at 120 rpm increased significanly from 90 rpm, and was significantly higher than CY (CY : 11.6±2.9 Nm, NC : 22.6±11.8 Nm, p<0.05) . These results suggest that it would be better for cyclists to select a pedal rate of between 90 to 110 rpm to minimize joint torque, and, as a result, reduce peripheral muscle fatigue.