The purpose of this study was to estimate the postoperative growth of untreated segments of the dissected aorta with non-thrombotic communicating false lumen, and also to evaluate the clinical outcome in relation to the aortic enlargement after surgery. Nineteen patients who underwent surgical treatment of aortic dissection were studied with enhanced CT scans and angiograms during the postoperative follow-up period. In Stanford type A patients, mean aortic dilatation rate calculated at the segment showing maximal dilatation was 5.1mm/year during 13-82 months (average, 41 months) after surgery, as a sequela of enlargement of the false lumen. Differences in the aortic dilatation rates between the different segments of the aorta were observed and these were per annum 4.8mm in the ascending aorta, 5.4mm in the transverse aortic arch, 4.3mm in the proximal descending aorta, 2.7mm in the distal descending aorta and 2.4mm in the abdominal aorta. In all patients, major communications were detected at the perianastomotic sites on angiography. In Stanford type B patients, false lumens with small communications were observed to show gradual thrombotic occlusion, but no significant aortic dilatation was detected during the follow-up period (13-70 months, average: 44 months), except three cases of sudden death who had major communications. Nine late events related to dissection, consisting of 4 sudden deaths suspected to be due to aortic rupture, 2 intestinal necroses and 3 cerebral infarctions, occured in 6 patients (32%), among which three patients had undergone arterial fenestration, one of whom had double barrel anastomosis. In the remaining two, major leakages were recognized at distal aortic anastomotic sites on postoperative angiography. The results of this study, we stress the importance of periodic check-ups using enhanced CT scan and if necessary, angiography after surgery of the patients having communicating false lumen. Early detection of progressive aneurysm formation and timely surgical reintervention can yield a good prognosis.

A 60-year-old male patient visited the Oriental Medicine Research Institute of the Kitasato on ***** because of abdominal discomfort. Hangeshashin-to was administered to him and the abdominal discomfort was relieved. He continued to take Hangeshashin-to from June to August 1997. He had chills, high fever, and fatigue from ********. He stopped Hangeshashin-to and took Shosaiko-to for five days because of liver dysfunction. He was admitted to our hospital on ********. Antibiotics and stronger neo-minophagen C were administered to him. A chest roentgenogram revealed a ground-glass shadow on the left upper lung, and Shosaiko-to was discontinued. The patient began to complain of dyspnea and had fine crackles on the chest. A chest roentgenogram and chest CT showed interstitial pneumonitis. Oral predonisolone therapy was started for hypoxemia and the patient improved. A drug lymphocytes stimulation test revealed that lymphocytes were stimulated by Shosaiko-to and its components, Saiko and Ogon. A chest roentgenogram just before ingesting Hangeshashin-to revealed the interstitial change of the lung. Taken all together, this patient suffered from druginduced hepatitis and pneumonitis as a result of ingesting Hangeshashin-to and Shosaiko-to.

A study was carried out to confirm the present states of physical training and nutritional condition in sportsmen on the growing stage. Energy expenditure (EE), caloric intake (CI), food items, body weight, running distance for 12 min and hematological and biochemical parameters of blood and urine were measured in 17 high school boys during intense summer baseball training for seven days. EE was estimated from the records by direct observation of activities during the baseball training (RMR method), and CI was calculated from the dietary record supplied each subject for the seven observation day.
Following results were obtained.
1) The average EE was 55.4±7.5 kcal/kg/day, and the CI corresponded to 87.2% of the EE, although no significant reduction of body weight was observed at the termination of the training session.
2) Running distance for 12 min gradually decreased.
3) Significant decreases in serum TG, TP and Hgb concentrations, and a remarkable increase in CPK activity were observed on the 4 th and final days. Urinary excretion of phosphate, urea nitrogen and catecholamines also increased gradually.
4) The greater the increase in negative energy balance (CI-EE), the greater the decrease in TG, TP and Hgb concentrations, and the greater the increase in serum CPK and urinary excretion of catecholamines.
The present results suggest that greater intake of total energy, protein and fat is recommended for development of endurance capacity, baseball techniques and sound growth in occasion such as the present baseball training program in high school boys.

The present study was carried out to investigate differences in hormonal and metabolic responses to moderate exercise in the post-absorptive state and during a 33-hour fast. Secretory factors and the roles of regulatory hormones of carbohydrate and lipid metabolism during moderate exercise were assessed baesed on these data. Energy substrates in the blood (glucose, BG; lactate, LA; triglyceride, TG; free fatty acids, FFA; free glycerol, FG) and plasma hormones (ACTH; GH; Cortisol, Corti; glucagon, IRG; insulin, IRI) concentrations were measured from 12 h to 33 h during the fasting period (12: 00, 24: 00, 06: 00, 09: 00), and 3min, 10 min and 30min after moderate treadmill exercise (estimated 70-80% of VO₂max) for 20 min under fasting conditions between 09: 00 and 11: 00. These results (in the fasting experiment, Fast) were compared to the results on a normal diet (N-D) .
The results were as follows:
1. No differences in mean VO₂ and respiratory exchange ratio (RER) during exercise were observed between the Fast and N-D experiments. Mean heart rate during exercise in Fast was higher by 3.3±2.2 bpm (p<0.05) .
2. Serum FFA and FG concentrations were significantly higher as a results of 24-hour fasting than the values measured at the same time in N-D. No significant change in serum TG concentrations were observed in Fast. While BG and LA concentrations remained low, and in small changes occurred in then both during Fast.
3. Slightly higher levels of plasma ACTH, GH and IRG were found in Fast, but they were not significantly different from N-D. Plasma Corti concentrations gradually increased after 24 hours of fasting, and were 1.9 times higher at 09: 00 after 33 hours of fasting than on N-D. Plasma IRI levels, however, remained low, and the molecular ratio of IRG to IRI (IRG/IRI) was higher throughout Fast (1.8 to 10.6 times higher than on N-D ) .
4. Plasma ACTH, GH and Corti concentrations increased markedly after exercise, and remained high until 30 min on Fast. No significant change in IRG and depression of insulin secretion were demonstrated after exercise on both treatment.
5. Significant correlation between changes in plasma ACTH and Corti concentrations were observed throughout the experiments (Fast, r=0.562; N-D, r=0.528) .
6. All of the energy substrates except blood TG increased after exercise, and the net increases in LA and FG (Δ) on Fast were significantly higher than on N-D. Significant correlations between the changes in the concentrations of FFA and FG (Fast, r=0.745; N-D, r= 0, 696), LA and BG (Fast, r=0.689; N-D, r=0.623), and FFA and LA (Fast, r=0.579; N-D, r= 0.479) were detected throughout both experiments.
7. The coefficients of correlation between changes in plasma ACTH and FFA, and between BG and LA concentrations were higher on Fast than N-D. However, changes in plasma IRI and IRG concentrations were not directly correlated with any other changes in energy substrates in the blood in either treatment.
The results indicated that moderate exercise for 20 min after a 33-hour fast causes marked responses in ACTH, Corti and GH secretions. It appeared that Corti secretion de-pended on ACTH, and that Corti facilitated fatty metabolism during exercise on Fast. However, secretion factors and the role of GH during exercise remain a matter of conjecture.

Methadone oral tablets initially became available on the Japanese market in MAR－2013. Methadone, which has different pharmacological properties from other opioids including morphine, can cause serious adverse drug reactions such as respiratory depression and QT prolongation. One of the causes of these reactions is its extremely complex pharmacokinetics. Methadone is mostly metabolized in the liver, with a variety of metabolic enzymes, including cytochrome P450 (CYP) 3A4, CYP2B6, and CYP2D6, being involved. The characteristics of methadone include self-induction of metabolism, delayed excretion due to alkaline urine, and an extremely long half-life requiring a long time to achieve a steady state. Without a full understanding of its complex pharmacokinetics, the blood concentration of methadone is not maintained at a constant level, and serious adverse events could happen due to an unexpected increase in its blood concentration. Herein, for safe clinical use by physicians and pharmacists, we summarize the pharmacokinetics of methadone.

The purpose of this study was to examine effects of moderate-intensity endurance exercise on reactive oxygen species production and leukocyte activation markers in young and middle-aged persons. Blood samples were collected before and after the jogging of 10 km. Although cytokines recruiting and priming neutrophils and monocytes were released into the circulation and functional after the jogging of 10 km, reactive oxygen metabolites-derived compounds (d-ROMs) were not significantly increased. It was indicated that chemokines and leukocyte activation markers at rest were increased with aging, and that might be accompanied by the higher level of d-ROMs in the elderly.

The present study was done to elucidate the medical problems and physical fitness of under-weight elementary schoolboys. Eighty nine volunteers, ranging in age from 9 to 12 yrs, were divided into five groups based on the grade of obesity, expressed as % of the standard, taking into account height, age and sex.
The mean grade of obesity for under-weight boys was -12 %, and this group was defined as the experimental group (group I; n=15) . The group III, which contained 23 boys of grade 0 %, and the group V made of 13 boys of grade +33.5 % was defined as the normal control and obese control, respectively.
The measurement of blood pressure, EKG recording, and blood sampling were done in the state of fasting before and after exercise. The exercise was a step test of 5 min duration with a temp of 1 step per 2 seconds, jumping over a bench 25 cm high for 9 years old boys, and 33 cm high for boys of 10 to 12 years. The step test score (PFI) and recovery rate of heart rate (RR (HR) ) were calculated from the EKG. The test battery of physical fitness performance was also done on another experimental day.
The serum levels of total cholesterol (TC), triglyceride (TG), total protein (TP) and hemoglobin (Hgb) were lower in experimental group (EG) than in control groups (CG) . The cholesterol-HDL/TC ratio was conversely higher in EG than in CG. There were no significant differences in the other biochemical measurements between the five groups.
Any abnormal EKG was not recorded before and after exercise throughout the subjects. The frequency of hypertension (above the 135/80 mmHg) was 10.2 % at pre-exercise time. But, none of the boys in EG was found to be hypertensive.
The PFI and physical fitness performance test score showed no differences between EG and group III, however, the score of group V was inferior to that of EG and/or group III. The RR (HR) in EG and over-weight group was lower compared to that for the average-weight boys.
Almost all components in blood measured were elevated after exercise in all the groups. The finding of the highest interest of the exercise-induced elevations of blood constituent levels was an increase in WBC measured as an indicator of stress. The magnitude of increase in WBC (ΔWBC) was higher in EG and the over-weight group than in the average-weight group. In normal subjects, ΔWBC was generally proportional to the work intensity, which, in the present exercise, depended upon the stature and body weight, because the height of bench, tempo and duration of exercise were same for all groups. The work intensity in EG was presumed milder, becasue the mean stature was slightly taller and bodyweight was less heavy compared to those in control groups. But, the greater increase of WBC in EG was observed in spite of a lighter work intensity. According to the Selye's literature, the particular WBC reaction to exercise in the under-weight boys was interpreted as a over-reaction to stress in the state of malnutrition.
From some biochemical parametors, the leaner subjects were assumed to be in a slight malnutrition. And also a later recovery of HR and over-reaction to exercise stress were shown in the under-weight boys group.
It is emphasized that the malnutrition resulting from excessive effort for preventing obesity was unfavourable for children in the growing stage for their healthy growth and development.

Water Jet flow was projected at normal human aortic walls and human chronic obstructive iliac arteries in the air or in the ordinary saline solution. Ordinary saline solution was used for the jet, which was projected at a pressure of 10kg·f/cm² through a nozzle 0.10mm in diameter. When the Water Jet was projected at the normal aortic intima, damage to the wall was more severe with duration of fluid projection, and projection for ten sec ruprured the elastic fiber of the media. But when the fluid jet projected ordinary saline, damage to the aortic wall was slight and projection for 30sec only dissected the surface of the intima. Water Jet projection in air showed slight effect on thrombi of the chronic obstructive iliac arteries, and projection for 60sec only made small irregular holes in the thrombi. When the Water Jet was projected in ordinary saline solution, however, destructive effects on thrombi were stronger and the projection for 40sec could remove almost all the thrombi for a distance of 2cm, while damage to the initima was very slight. This study demonstrated that fluid jet projection using ordinary saline solution could remove thrombi in chronically obstructive artery safely and effectively and suggested the possibility of the Water Jet angioplasty.