We studied the effects of the electrolyte composition (K, Ca, Na) and prostaglandin E₁ of the extra-cellular fluid on the tension development of isolated canine coronary arterial strips. In 20mEq/l potassium solution, 4.7mEq/l calcium produced coronary artery contraction. This Ca-induced contraction was partially inhibited dose-dependently (between 10^-15M and 10^-12M) by prostaglandin E₁. Above 10^-11M, intensity of the inhibition did not change. In the presence of 20mEq/l potassium, the reduction of sodium concentration to 12mEq/l increased the tension of coronary artery. Prostaglandin E₁ did not affect this tension development. After 5min perfusion of prostaglandin E₁, Ca-induced contraction was not inhibited. It is concluded that low calcium, high sodium cardioplegic solution may relax the canine coronary artery. Addition of prostaglandin E₁ to cardioplegic solution may reduce the coronary artery contraction partially.

Inflammatory aneurysms of the thoracic aorta are extremely uncommon. We present a 58 year-old man with an inflammatory aneurysm of the aortic arch. He was admitted because of chest pain. Coronary angiographies showed severe stenosis of the left anterior descending artery and computed tomography revealed an aneurysm of the distal aortic arch. We conducted combined graft replacement of the aortic arch and coronary artery bypass grafting. During the operation, the patient was noted to have extensive peri-aneurysmal fibrosis and inflammation with a thick aneurysmal wall. To avoid excessive hemorrhage, distal anastomosis was performed using the graft inclusion technique. He was discharged 35 days after operation without any major complication. Pathological evaluation of the aneurysmal wall revealed destruction of the mural structure and inflammatory cell infiltration in the adventitia.

Off-pump coronary artery bypass (OPCAB) has recently increased in popularity, but the longterm results are still unknown. We evaluated the mid-term results of OPCAB surgery using multi-slice computed tomography (MSCT), which is a non-invasive postoperative evaluation method. Thirty-one consecutive patients who underwent OPCAB surgery at least 2 years prior to the study were selected. The age was 50 to 79 years (66.9±6.5) and the ratio of men to women was 26: 5. Coronary angiography was performed in all patients at 2 weeks postoperatively. The follow-up was complete, and mean follow-up was 30.9 months. There were no hospital deaths and 1 non-cardiac late death. The graft patency rate in coronary angiography was left internal thoracic artery (LITA) 30/30 (100%), right internal thoracic artery (RITA) 2/2 (100%), radial artery (RA) 14/15 (93%), saphenous vein graft (SVG) 15/17 (88%). No graft became occluded on MSCT study and all patients have been angina-free during the follow-up period. We suggest that OPCAB is feasible in most patients with good patency and low mortality. MSCT is an effective follow up method for the morphological findings and noninvasive quantitative evaluation of the bypass grafts.

Many patients who receive general acupuncture treatment have many complaints concerning their autonomic nervous systems. Applying CMI and CMI type classification (Abe method-a variation of CMI) to 100 new patients who came to our clinic last year, we found vegetative dystonia in half of them. Upon this finding, the following examinations were carried out by means of an function test of autonomic nervous system developed by Kageyama et al.: the coefficient of variation (CV) of R-R interval in ECG obtained through the function test is regarded as an expression of vagal function.
(1) Using this test, the participation of the autonomic nervous system in the condition of those patients who visited our clinic was examined.
(2) Effects of acupuncture treatment on the autonomic nervous system were examined.
(3) Acupuncture stimulation was separately applied to S36 (Zusanli), P4 (Ximen) and Liv3 (Taichong) to examine the influence of the acupuncture point location on the CV obtained through the test.
Results:
(1) 15 new patients (25%-comparatively high rate) showed low CV (less than 2%) of R-R interval in ECG.
(2) In some cases, acupuncture treatment caused an increase in CV.
(3) Acupuncture caused pulse infrequens: R-R interval showed a tendency toward prolongation during the in situ needle technique and after withdrawing the needle on each of the three points (S36, P4 and Liv3). CV increased after withdrawing the needle on either S36 or Liv3 and shortly after needle insertion and after withdrawing the needle on P4.
These result suggest that many patients who receive acupuncture treatment have additional disorder in parasympathetic nervous system which can be improved through acupuncture.

A case of progressive systemic sclerosis (PSS) with peripheral circulation disturbance, pulmonary fibrosis and stenosis of esophagus-cardia (E-C) junction, was treated with acupuncture and traditional Chinese medicine. The patient had digital pitting scar due to the peripheral circulation disturbance. Effect of acupuncture was examined using laser Doppler velosimetry (LDV). Acupuncture treatment was operated 3 times a week and laser therapy, once a week. And Chinese medicine was administered. The LDV measurements were done before and after acupuncture. In the total 9 times of measurements, 8 were increased in peripheral blood flow. Two times from the measurements of peripheral blood flow after acupuncture reached in the normal flow level. After the treatment of 2 months, polyarthralgia was reducted, vomiting was disappeard, and the stenosis of the E-C junction was improved. Present data suggest that the acupuncture therapy to the PSS patient is effective.

Laser-Doppler velocimetry was used to evaluate the effects of acupuncture stimulation on peripheral circulation disturbance in patients with collagen disease, progressive systemic sclerosis (PSS) and systemic lupus erythematosus (SLE). The response to acupuncture stimulation to shou-san-li was recorded in 8 patients with PSS and 6 patients with SLE. The digital pitting scars and Raynaud's phenomenon were observed in all the patients. The mean of laser-Doppler flow values in fingertips at room temperature 23°C was 4.83 (V) in normals (n=11), 2.82 (V) in patients (n=14). Patient group showed significantly lower values than normals (p<0.01). Ten minutes after acupuncture stimulation to shou-san-li, the flow values increased in 7, and decreased in 1 out of 13 patients (p<0.05). In normals no significant change was observed after the same stimulation. Present data suggest that the acupuncture therapy to the patients with PSS or SLE who suffered from peripheral circulation disturbance is effective.

Objectives: The aim of this study was to identify characteristic lifestyles in children with obese parents. Methods: 8,030 children (4,072 males and 3,958 females) aged 6 to 7 years were investigated. A questionnaire relating to the lifestyles of children was distributed through elementary schools for completion by parents. The heights and weights of parents were self-reported. A parent with a body mass index (weight in kilograms divided by the square of height in meters) greater than the 90th percentile for gender (26.7 kg/m2 for fathers and 24.3 kg/m2 for mothers) was defined as an obese parent. A chi-square test for each trend was applied to evaluate an increasing trend in the frequency or level of each lifestyle in children with obese parents. Results: Children with obese parents were significantly associated with increasing trends in the proportions categorized by irregular intake of breakfast, faster eating, longer TV watching, and shorter sleeping hours. Conclusions: These lifestyles are considered to be possible risk factors for the development of obesity. These characteristic lifestyles observed in children with obese parents could strengthen the relationship between child and parental body compositions, in addition to the genetic predisposition to obesity in children with obese parents. These findings indicate that education with lifestyle modification for obese parents will be required to prevent further weight gain in children with obese parents.
Child ; Parents ; Life Style ; seconds ; trends

The combined superior transsseptal approach (CSTA) has been used for 12 mitral or left atrial myxoma operations. This approach provided excellent exposure of the mitral valve or myxoma. This approach was compared with the transseptal and left atrial approaches in 1 and 3 cases, respectively. There were no differences in operative time, cardiopulmonary bypass time, anoxic time, bleeding volume, blood transfusion volume and postoperative arrhythmic complications. We use CSTA for cases with tricuspid valve disease, small left atrium, reoperation and left atrial myxomas.

Laser-Doppler velocimetry (LDV) was used to evaluate the effects of low energy laser irradiation on peripheral circulation disturbance in patients with collagen diseases, progressive systemic sclerosis (PSS) and systemic lupus erythematosus (SLE).
Using a commercially available LDV flometer (Periflux, Perimed KB, Sweden), the response to laser irradiation at the acupuncture points of Tian zhu, Feng chi, Jian jing, Shou san li, Jing qu, He gu, Stellate ganglion, was recorded in 4 patients with PSS and 6 with SLE. The digital pitting scars and Raynaud's phenomenon were observed in all the patients. The low energy of 10mW laser was irradiated for 1 minute at each acupuncture points, and LDV flow values ware recorded in fingertips at room temperature 25±0.5°C. Ten minutes after the laser irradiation, the LDV flow values increased significantly (p<0.5).
Present data suggest that the low energy laser irradiation to patients with PSS or SLE who suffered from circulation disturbance is effective.

Objective: Most women with early stage endometrial cancer have a favorable prognosis. However, there is a subset of patients who develop recurrence. In addition to the pathological stage, clinical and therapeutic factors affect the probability of recurrence. Machine learning is a subtype of artificial intelligence that is considered effective for predictive tasks. We tried to predict recurrence in early stage endometrial cancer using machine learning methods based on clinical data. Methods: We enrolled 75 patients with early stage endometrial cancer (International Federation of Gynecology and Obstetrics stage I or II) who had received surgical treatment at our institute. A total of 5 machine learning classifiers were used, including support vector machine (SVM), random forest (RF), decision tree (DT), logistic regression (LR), and boosted tree, to predict the recurrence based on 16 parameters (age, body mass index, gravity/parity, hypertension/diabetic, stage, histological type, grade, surgical content and adjuvant chemotherapy). We analyzed the classification accuracy and the area under the curve (AUC). Results: The highest accuracy was 0.82 for SVM, followed by 0.77 for RF, 0.74 for LR, 0.66 for DT, and 0.66 for boosted trees. The highest AUC was 0.53 for LR, followed by 0.52 for boosted trees, 0.48 for DT, and 0.47 for RF. Therefore, the best predictive model for this analysis was LR. Conclusion The performance of the machine learning classifiers was not optimal owing to the small size of the dataset. The use of a machine learning model made it possible to predict recurrence in early stage endometrial cancer.