The present study was performed to investigate heart rate responses and occurrence of arrhythmias caused by various diving maneuvers and swimming in infants. Forty four healthy infants (mean age 2.5±1.1, mean ±SD) served on this study. Condition of telemetry electrocardiograph recording was 1) rest on the land and in the water, 2) diving, 3) swimming and 4) “pass in water (PW) ”. Moreover, diving styles was classified for five patterns by presence of body movement or expiration (Apneic not move diving, Expiratory not move diving, Apneic kick diving. Expiratory kick diving and Underwater swimming) . “Diving bradycardia” was observed during diving and PW, and the magnitude of heart rate reduction was grater in diving without body movement than diving combined with body movement. Presence of expiration did not influence on the level of bradycardia during diving. Any kinds of arrythmias was observed 13 out of 44 subjects. In premature contractions, supraventricular premature contraction (SVPC, 7 subjects) was observed more often than ventricu-lar premature contraction (PVC, 3 subjects) . Another arrhythmias observed was atrioventricular junctional rhythm (AVJR, 1 subject), atrioventricular junctional escaped beat (AVJEB, 3 subjects) and wandering pacemaker (1 subject) . The danger arrhythmias which is necessary to restrict on exercise or swimming was not observed in this study.

Ten athletic women (5 normal ovulatory cycles, 5 short luteal phases) and 6 non-athletic women with normal ovulatory cycles were subjected to an investigation of episodic gonadotropin secretion. In the middle follicular phase, blood samples were obtained via an indwelling venous catheter every 15 minutes for 4 hours.
Mean levels of gonadotropins in both athletic groups were lower (p<0.001) than in the control group. LH pulse frequencies in the short luteal group were significantly lower than in the control group (p<0.001) . LH pulse amplitudes were similar in all groups. FSH dynamics were the same as those for LH.
In athletic women, low mean levels and infrequent episodic secretion of gonadotropins were obvious. These data suggest that strenuous athletic activity may cause hypothalamic-pituitary insufficiency, especially that of hypothalamic origin.

Athletic women often exhibit menstrual disorders such as luteal insufficiency, oligomenorrhea and amenorrhea are often seen. It has been suggested that such disorders are related to prolactin release caused by physical activity. To investigate the mechanism by which the disorders are promoted, prolactin secretion was studied in 10 athletic women (5 with normal ovulatory periods, and 5 with short luteal periods) and 6 non-athletic controls. Blood samples were obtained during the early follicular phase of the menstrual cycle through an indwelling venous catheter at 15-minute intervals for 4 hours. The concentration of prolactin was measured by radioimmunoassay.
The mean prolactin concentration in the athletic group was lower than that in the control group (p<0.001), and pulse frequency in the athletic group was higher than that of the control group (p<0.01) . Pulse amplitude in the athletic women with short luteal periods was higher than that of those with normal ovulation. Pulse duration in the athletic women with short luteal periods was significantly longer than that of those with normal ovulation (p<0.01) .
These findings suggest that prolactin is one of the most important factors in menstrual disorders in athletic women.

We evaluated the therapeutic results of cancers in the bile duct, the pancreas head region and the liver and cirrhosis.
The former two types were examined in a total of 49 cases: 10 cholecystocarcinomas, 18 cholangiocarcinomas, 6 papillocarcinomas, and 15 pancreas head cancers. Radical surgery was performed in only 9 cases: 1 cholecystocarcinoma, 1 cholangiocarcinoma, 5 papillocarcinomas and 2 pancreas head cancers. The surgical success rate was satisfactory 83%(5/6) for papillocarcinoma, yet showed 18.4% overall.
Liver cancer and cirrhosis were examined in 102 cases: 78 cirrhoses and 24 livercancers. Of the former, 15% were viral cirrhosis, 44% alcoholic, 1% specific and 40% unknown. Ofthe latter, 29% were viral liver cancer, 29% alcoholic and 42% unknown.
Treatment of these cancers, with the exception of one type, was unfavorable. To increase the surgical success rate, cancers will have to be discovered earlier using such recent, highly-advanced technological means as endoscopy, ultrasonography, angiography and computerized tomography. At the same time, radical surgery should be actively applied in a broader range of cases.
In cirrhosis, bleeding in the upper digestive tract and complicating liver cancer are increasing in frequency due to prolonged life expectancy. How to manage this increase remains subject for further study in the future.

A total of 478 resected gastric cancer cases were studied. The male-female ratio was 1.6, -294 males and 184 females. The patients were divided into two groups, namely, the elderly group (patients aged 70 and over) and the non-elderly group (patients aged 69 and below). In the elderly group males were predominant over females. The number of elderly patients accounted for 34.1% of the total number of stomach cancer cases. This percentage is higher than the national average. In the elderly group, cases detected by stomach health screening or health diagnosis tests were a few, but many cases were in stage IV. The number of inoperable cases was somewhat high, radical gastrectomy was performed on a few of the patients, and the resection rate was somewhat low. A tendency was observed for multiple cancer focuses ; in regard to the regions of occupation or spreading and tissue type, the upper region was less likely and the lower region was more likely to be affected, the anterior wall and the circle were likely to be affected. A tendency was observed for the localization of highly differentiated tissue in the patients. Although no difference was observed in the direct surgical mortality rate, the 5 year survival rate was unfavorable, suggesting the patients might have died due to other diseases. In the elderly group, those who suffered from diseases and preoperative complications comprised 92% of the total, and abnormalities during preoperative examinations were detected in 96% of these patients. Postoperative complications developed in 42%. Postoperatively, psychological problems must be taken into consideration. In elderly patients who are operable, although it is desirable to actively perform surgery aiming at radical operations, it is thought necessary to cope carefully with resection of the stomach. If a radical operation is performed after carefully evaluating preoperative risks and with adequate preparations, it is thought possible for elderly patients to achieve favorable therapeutic results and improvement in their QOL differing little from non-elderly patients.

Study was made on total of 304 cases of cancer of the large intestine resected during the period of 12 years from 1978 to 1989.
Colon cancer accounted for 56.8% of the total and rectal cancer 43.2%. There were no sexual differences. Those people aged 50 and older represented 86.0% of the total number of the cases. By age group, those in their 60s topped the list with 27.3%, followed by those in 70s with 24.4%. Almost all the cases (95.1%) were of the patients who had visited the hospital, having noticed symptoms themselves. A very few cases were detected among the people without subjective symptoms when they received group medical Checkups.
By region, 39.4% of the colon cancer cases were found in S, followed by A. In the cases of rectum cancer, Rb accounted for 50.7%. Of the total caces, 74.5% had cancer on the left side of the large intestine.
Resection rate was 91.5%. The rate of resection leading to cure was 71.8%. Broken down by histological staging, stage I came to 11.7%; stage II, 30.9%; stage III, 21.8%; stage IV, 11.7%; stage V, 23.8%.
The 5-year-survival rete averaged 57.1%. In pre-surgery tests, the positive rate of CEA was as low as 46.6%. The positive rate for early cancer was extremely low. Measurement of CEA levels as an auxiliary diagnosis, therefore, did not prove itself to be useful in searching for cancer.

A clinical study was made on a total of 478 stomach cancer cases that had been subjected to surgery during the 12-year period from 1978 to 1989. Of the total, 34.1% were accounted for by the patients aged 70 years and above. Those old patients were divided into the two groups-those in their 70s and those in their 80s and above. The clinical cases of the two aged groups were studied in comparison with the cases of the patients aged 69 and below (65.9%). The number of early stomach cancer cases was smallest in the 70s age group. However, in this age group, advanced cancer was largest in number, metastases to lymph nodes, peritonea, and the liver were observed in many cases, and the curative resection rate was low. In the age group of 80 and above, either early cancer or advanced cancer was large in number. Apparently moderation was exercised in performing surgerical operations on the persons of advanced age. It was found that R2 lymph node dissection had been confined to 68.4% of the patients aged 80 and above, but that the curative resection rate was highest with 84.2% probably because limited lymph node metastasis. In this age group, a majority of cancers occurred at the antral region. A tendency was observed that cancer occurs less at the lesser curvature and on the posterior wall of the stomach and much more freqently at the greater curvature and on the anterior wall. Histologically, the tumor cells were mostly of a highly differentiated, localized type. Although high risk is involved in surgery in the elderly patients, many cases of stomach cancer are operable. So, it would be worth physicians' intention to risk operations while taking precautions against postoperative complications, with a view to improving the cure rate and helping the patients to upgrade the quality of life in their remining years.

BACKGROUND/AIMS: To compare the diagnostic yield of 20-gauge forward-bevel core biopsy needle (CBN) and 22-gauge needle for endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) of solid pancreatic masses. METHODS: The use of 20-gauge CBN was prospectively evaluated for 50 patients who underwent EUS-FNA from June 2016 to December 2016. Data were compared with those obtained by a retrospective study of 50 consecutive patients who underwent EUS-FNA using standard 22-gauge needles between December 2016 and April 2017. At least two punctures were performed for each patient; the sample from the first pass was used for cytology with or without histology and that from the second pass was used for histology. Sample quantity was evaluated using the sample obtained from the second pass. RESULTS: There was no significant difference in the diagnostic accuracy rate between the first and second passes (20-gauge CBN: 96% [48/50]; standard 22-gauge needle: 88% [44/50]). Samples >10× power fields in length were obtained from 90% (43/48) and 60% (30/50) of patients using the 20-gauge CBN and standard 22-gauge needle, respectively (p=0.01). Technical failure occurred for two patients with the 20-gauge CBN. CONCLUSIONS: Diagnostic accuracy of the 20-gauge CBN was comparable to that of the 22-gauge needle. However, two passes with the 20-gauge CBN yielded a correct diagnosis for 100% of patients when technically feasible. Moreover, the 20-gauge CBN yielded core tissue for 90% patients, which was a performance superior to that of the 22-gauge needle.
Biopsy ; Biopsy, Fine-Needle ; Diagnosis ; Endoscopic Ultrasound-Guided Fine Needle Aspiration ; Humans ; Needles ; Pancreas ; Prospective Studies ; Punctures ; Retrospective Studies ; Ultrasonography