A study was conducted to clarify the exercise intensity and metabolic condition during a free routine of synchronized swimming with respect to heart rate (HR), blood lactate concentration (La) and the rate of perceived exertion (RPE) . Six well trained female synchronized swimmers participated as subjects. HR during the free routine was measured continuously. La and RPE during the free routine were measured intermittently from the start to end of each stage. Maximum heart rate (swimmingHRmax : S-HRmax) was determined by measurement of maximum oxygen uptake using a swimming flume. Peak blood lactate concentration (Peak La) was measured after the maximum front crawl stroke of 100 m. The average values and S. D. of S-HRmax and Peak La were 180.0±3.8 beats · min^-1 and 9.6 ± 1.0 mmol · 1^-1, respectively. Average values, S. D. and ranges of HR and %S-HRmax during the free routine were 137.6±25.5 (60-180) beats · min^-1 and 76.5± 14.3 (34.5-96.8) %, respectively. HR during the free routine showed a decrease in the breath-holding phase. Average values and S. D. of La, %Peak La and RPE at the fourth stage were 5.4±1.2mmol·1^-1, 57.0±17.2% and 17.7±0.8, respectively. La, %Peak La and RPE at the fourth stage were significantly higher than those at the other stages, and La, %Peak La and RPE at the third stage were significantly higher than those at the second stage. These results suggested that the overall intensity of the free routine was moderate, but that part of the free routine included high-intensity activity and the percentage of anaerobic metabolism during the free routine increased in the final stages

BACKGROUND: The existence of a gap between research evidence and clinical practice has been described recently. Several drugs are effective in preventing secondary events after acute myocardial infarction (AMI), but it is not certain whether this evidence is employed in daily practice. We investigated the drugs currently employed for patients with a history of AMI in Japan.
METHODS: Medical records of patients who developed AMI during the calendar year of 1999 were retrospectively identified at three teaching hospitals in Japan. We collected data on drugs prescribed at three time points (upon admission for AMI, at the time of discharge, and one year after discharge) for each patient.
RESULTS: Data were available for 149 patients with AM!. Drugs prescribed at the time of discharge were aspirin (77.5%), nitrates (68.3%), and angiotensin converting enzyme inhibitors (52.8%) . β-blockers were prescribed for only 12.0% of patients. The drugs used one year after discharge were to a large extent similar to those at the time of discharge. There were no significant correlations between the use of these drugs and comorbidity.
CONCLUSION: Despite established evidence that β-blockers offer benefits to patients with a history of AMI, they have not been prescribed frequently, for reasons that remain unclear. To improve the quality of clinical care, further systematic effort is needed to bridge this evidence to practice gap.

This paper reports on issues relating to the optimal use of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid magnetic resonance imaging (Gd-EOB-DTPA MR imaging) together with the generation of consensus statements from a working group meeting, which was held in Seoul, Korea (2010). Gd-EOB-DTPA has been shown to improve the detection and characterization of liver lesions, and the information provided by the hepatobiliary phase is proving particularly useful in differential diagnoses and in the characterization of small lesions (around 1-1.5 cm). Discussion also focused on advances in the role of organic anion-transporting polypeptide 8 (OATP8) transporters. Gd-EOB-DTPA is also emerging as a promising tool for functional analysis, enabling the calculation of post-surgical liver function in the remaining segments. Updates to current algorithms were also discussed.
Algorithms ; Contrast Media/*diagnostic use/metabolism ; Diagnosis, Differential ; Gadolinium DTPA/*diagnostic use/metabolism ; Humans ; Liver Diseases/*diagnosis/metabolism/surgery ; Liver Function Tests ; *Magnetic Resonance Imaging ; Organic Anion Transporters, Sodium-Independent/metabolism ; Postoperative Complications/diagnosis ; Practice Guidelines as Topic

Clinical training programs play an extremely important role in the new postgraduate clinical training system introduced in 2004 because facilities for clinical training now include various health-related institutions in addition to the university hospitals and special hospitals for clinical training used in the previous system. Although educational goals have been established by the Ministry of Health, Labour and Welfare, trainees may have difficulty achieving these goals, even under the guidance of staff at the various facilities. There are differences in the function and quality of health-related institutions in the community. For the practical and convenient application of educational goals, we have attempted develop a “model program” to supplement the objectives indicated by the learning goals with more specific objectives. These supplementary objectives can be modified by individual institutions. We hope that this “model program” contributes to the development of objectives for each institution and helps improve the quality of the postgraduate training system in Japan.

Aged ; Aged, 80 and over ; Carotid Artery Diseases ; physiopathology ; surgery ; Cerebrovascular Circulation ; physiology ; Female ; Humans ; Iofetamine ; Male ; Perioperative Period ; Radiopharmaceuticals ; Stents ; Tomography, Emission-Computed, Single-Photon ; methods