Background and Objective: The cesarean section is preformed commonly in modern society, where safety is regarded as of utmost importance and maternal age at childbirth is on the rise. While the risk of pulmonary embolism is high and getting out of sickbed early is recommended after a cesarean delivery, a woman in labor suffers wound pain and uterine contraction pain. We reviewed several reports that spinal anesthesia with opioids offered a good analgesic effect and inquired the validity and safety of this procedure.
Methods: Subjects were 88 full-term pregnant women ronging in age from 19 to 41 years. They recieved a cesarean section without complications and nonreassuring fetal status. The subjects were divided into 2 groups: Group A underwent spinal anesthesia with 0.5% high-density bupivacaine (n＝51) and Group B is received bupivacaine with 0.1mg morphine and 0.01mg fentanyl added (n＝37). Comparison was made between the two groups with respect to the amount of intravenous ephedrine for hypotention, revelation of nausea, the frequency of use of a postoperative painkiller, NRS (Numerical Rating Scale) and Apgar score of newborns.
Results: In Group B, the quantity of ephedrine used was significantly less than in Group A to assure anesthesia. The significant difference was observed in the occurrence of nausea. (p＝0.002). The times in Group B. the painkiller was used could be reduced. The pain was reduced by half or over from the average value of NRS. There was no difference in Apgar score.
Conclusions:In the rural area which is short of medical workers, high-quality care during the perioperative period can be obtained performed only by spinal anesthesia with the addition of opioids.

 By using a simplified model for cardiovascular system which consists of the cardiac resistance R_h, the artery C_a, the vein C_b and the peripheral vessel R_s, the ratio of the arteriovenous pressure difference Δp to the maximum arteriovenous pressure difference Δp_M was defined as the circulatory ratio θ ≡Δp ⁄ Δp_M. It was shown that the circulatory ratio θ was θ=1 ⁄ 2 regardless of the exercise. It was revealed that this regulation is done by keeping R_h ⁄ R_s constant and the ratio is equal to the arterial compliance fraction k_a.

OBJECTIVES: Sarcopenia, decreased muscle volume and muscle weakness in the elderly is a serious risk of various adverse outcomes. Current diagnostic procedure for sarcopenia includes gait speed, grip strength, and percentage of skeletal muscle volume. However, lower leg muscle strength decreases much faster than grasp power, and we have evaluated the usefulness of its measurement using a recently developed instrument (Locomoscan). METHODS: Forty-three institutionalized elderly subjects were evaluated for their anthropometrical parameters, body composition, grasp and lower leg muscle strength, and gait speed. They were categorized into 2 groups; gait speed equal to or higher than 0.8 m/s and that below 0.8 m/s. RESULTS: Leg muscle strength per body weight was significantly greater in those with their gait speed equal to or higher than 0.8 m/s, whereas there was no significant difference in other parameters. Receiver operator characteristics analysis has shown that leg muscle alone significantly predicted the greater gait speed. CONCLUSIONS: Lower leg muscle strength can be useful for predicting gait speed.
Aged* ; Body Composition ; Body Weight ; Gait* ; Hand Strength* ; Humans ; Leg* ; Muscle Strength* ; Muscle Weakness ; Muscle, Skeletal ; Sarcopenia