With the recent upgrade of the MRI system, it has become possible to use 3D arterial spin labeling (3D ASL), which is an MR perfusion imaging technique without use of any contrast material. In this paper, we report the effects of imaging conditions on the cerebral blood flow (CBF) level (the amount of cerebral blood flow per unit brain tissue〔ml/min・100g〕) . We also report our clinical experience with 3DASL. In respect of the imaging conditions, changes in CBF values were examined when the arm and the number of excitations (NEX) were variable. The results showed that there were no significant differences in CBF values between different regions in the brain. This was due probably to the fact that the spin of the labeled blood was unaffected although the arm influenced the spatial resolution of images and NEX affected SN ratio.

Studies on the effects of heating as well as the mineral components of hot spring water have been conducted to investigate the effects of balneotherapy. However, few studies have been conducted on the effects of hydrostatic pressure and buoyancy during water immersion. Therefore, we investigated the effect of water immersion up to the neck at thermoneutral temperature on hemostatic activity.
Nine healthy men aged 22 to 34 were immersed up to the neck in the standing position in thermoneutral water (34.0±0.5°C) for two hours. The heart rate decreased immediately after starting water immersion and remained low during the immersion. Hematocrit values (Ht) of the blood samples taken from the ante-cubital vein decreased by 3.4% in average. The decrease in Ht was more prominent in the blood samples taken from the earlobe (4.0%), suggesting that hemodilution due to fluid shift was stronger in the upper part of the body. The time until euglobulin clot lysis shortened immediately after starting the immersion. Although fibrinolytic activity was enhanced, the concentration of tissue plasminogen activator (t-PA) antigen in the blood decreased gradually during the immersion and tended to return to the original level 30 minutes after immersion. A larger decrease in the concentration of plasminogen activator inhibitor-1 (PAI-1) antigen in the blood was observed immediately after starting the immersion, and it remained low for 30 minutes after immersion. An increase in fibrinolytic activity due to the decrease in PAI-1, not in t-PA, was observed during water immersion at thermoneutral temperature and the activation of fibrinolytic system without activation of the coaguration system was also observed.

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.

An 11-year-old boy experienced right flank pain on October 12, 2005. The pain was once alleviated but recurred on the following day, and the patient visited our hospital on October 13, 2005. An imaging study revealed a tumor, sized approximately 12.0 × 7.5 × 8.0 cm, in the right kidney without metastases, for which right nephrectomy was performed. The tumor was solid, although degenerative necrosis and hemorrhage were partially observed inside the tumor. A histopathological study revealed poorly-defined, almost round tumor cells which were strongly stained with vimentin but not with cytokeratin or epithelial membrane antigen (EMA). Based on these findings, a diagnosis of clear cell sarcoma of the kidney in Stage II was made. A review of 10 previous cases reported in Japan during the past 10 years revealed that the affected patients were mostly aged 1 month to 4 years, while our case, occurring in an 11-year-old patient, was uncommon in respect to age.
Neoplasms ; Japan ; Procedures on Kidney ; Cases ; Review of

To investigate the relationship between adolescent sport activity and abnormalities of the lumbar spine on radiography and magnetic resonance imaging (MRI), 237 collegiate athletes (mean age 19.4), representing judo, wrestling, and track, were analyzed from the point of contact or noncontact sports. Radiologic and/or MRI abnormalities of the lumbar spine were found in 68.7% of contact sports athletes (judo and wrestling, n=147), 53.3% of noncontact sports athletes (track, n=90), 69.9% of athletes who have played contact sports over 9 years (C9 athletes, n=83), and 47.1% of atheletes who have done noncontact sports over 9 years (N9 athletes, n=17). Discopathy related abnormalities on radiologic examination were found in 25.3% and 11.8% of C9 and N9 athletes. Disc degeneration on MRI was found in 45.8% and 29.4% of C9 and N9 athletes. Spondylolysis was found in 31.3% of C9, 5.9% of N9, 31.3% of elementary-C (athletes who played contact sports during elementary school, n=96), 32.8% of elementary-L/I (limited contact/impact sports, n=58), and 8.6% of elementary-N athletes (noncontact sports, n=35), respectively. From these results, we concluded that contact sports activity during adolescence induces lumbar spine abnormalities at a higher rate compared to noncontact sports and that spondylolysis is related to contact or limited contact/impact sport activity during elementary school.

Today, many villages in Japan are rapidly declining as a result of the policy of the Japanese government aiming at the growth of monopoly capital.
Shimo-Ono is one of such villages, with 184 houses and 731 inhabitants. We would report the progress of the regional examinations carried out in this village for these nine years and discuss about the necessity of the communal system of health protection, the actual state of health destruction and the countermeasures to be taken against this, and the problems imposed upon future regional examinations.

Background: Laparoscopy-assisted gastrectomy requires a lot of disposable products. So we compared the cost between laparoscopy-assisted gastrectomy and open surgery.Patients and methods: For comparison we used five cases each of open distal gastrectomy (ODG), laparoscopy-assisted distal gastrectomy (LADG), open total gastrectomy (OTG) and laparoscopy assisted total gastrectomy (LATG). In this study, we defined the profit of gastrectomy as below and we used the list price for all products. Profit of gastrectomy=Fee for gastrectomy-(Costs of all single use products-Demandable fee for single-use products)Results: Mean profits of ODG and LADG were 278,756.2 yen and 190,292.8 yen. The difference was 88,463.4 yen. Mean profits of OTG and LATG were 395,922.6 yen and 330,653.6 yen. The difference was 65,269 yen. Mean hospital charges, mean length of hospital stay, mean hospital charges per day of ODG, LADG, OTG and LATG were 1,390,464 yen, 21.4 days, 65,140.0 yen and 1,484,254.0 yen, 18.8 days, 80,805.4 yen and 1,956,664.0 yen, 24.4 days, 82,397.1 yen and 1,686,936.0 yen, 18.4 days, 91,894.8 yen, respectively.Conclusion: The turnover of laparoscopic gastrectomy was higher than open gastrectomy, but, the profit was lower because of high costs of disposable products. Hospital charges were not higher but the charge per day was higher because of a shorter hospital stay.
Gastrectomy ; Laparoscopy ; Hospitals ; Mean ; Financial cost

1) To examine the significance and problems of medical interview training, self-administered questionnaires were completed by 90 students who took part in medical interview training with simulated patients in clinical training after objective structured clinical examinations.2) Most students thought that medical interview training was meaningful and thanked the simulated patients for their useful comments. On the other hand, some students felt that to improve their interviewing skills stricter feedback from simulated patients and instructors might be needed.3) Our results suggest that repeated training in medical interviewing in clinical training after objective structured clinical examinations is an effective method for teaching communication skills. However, in the future the scenarios should be improved and the frequency of medical interview training should be increased.

Effects of 38°C 30-minute bathing on hemostatic function and autonomic nervous function were studied in 15 48-to-72-year-old patients with cerebral infarction. Blood samples were collected three times: immediately before the bathing, at the end of 30 minutes of bathing, and 30 minutes after the bathing. Hematocrit values and fibrinogen concentrations decreased during bathing and returned to the pre-bathing levels 30 minutes after bathing. This indicates that bathing caused hemodilution due to the fluid shift. During bathing, noradrenaline decreased at a rate significantly higher than that of hemodilution while the sympathetic nervous function, which was evaluated by spectral analysis of sequential variation in arterial blood pressure, was not suppressed. The autonomic nervous system seemed to be inactive in these patients. Coagulation time (PT and APTT) and platelet factor (β-TG and PF4) showed few changes. In the fibrinolytic system, however, tissue plasminogen activator (t-PA) antigen levels increased and plasminogen activator inhibitor type-1 (PAI-1) levels decreased after 30 minutes of bathing. This suggests that fibrinolytic activity was enhanced by 38°C bathing for 30 minutes. Thus, subthermal bathing with comfort may be useful in preventing cerebral infarction.