Six healthy boatmen of students were examined their mineral metabolism in urine and serum over three different periods consisting of three successive days in every two weeks, during the training camp of boat race event. The first examination period (I) was 11-14 June as ordinary time while attending school, the second period (II) 25-28 June as relatively light exercise time in training camp while attending school, and the third period (III) in summer vacation 9-12 July as hard physical exercise time. Every two hour urine was collected during the three days of each period and the blood from the cubital vein of the examinees was sampled at noon of the second day in each period.
[A] Urinary excretions per 24 hours in the three different periods.
(1) No definite variation was seen in pH. The value of the Donaggio's reaction was found greater in periods II and III compared to that of period I.
(2) Urine volume did not show any significant variation, but the water metabolism probably rose in periods II and III. Creatinine increased significantly in III.
(3) No significant variation of Na was observed but the total excretion including the sweat was to be much greater in periods II and III increasingly, and the difference of Ca and Mg between I and II was not significant, while total excretion significantly rose in III.
(4) The Na/K ratios fell in periods II and III. The fall seems to be caused by promotion in K excretion and in Na retention relatively, in which the rise of the function of the adrenal cortex is suggested.
[B] Serum contents of Na, K, P, Ca and Mg in the three different periods.
The fall of Na in periods II and III was significantly greater, in which the effect of the sweat excretion is considered, while K rose significantly in the same periods. The increase of P was in II and III. Both Ca and Mg showed a tendency to increase in III.
[C] Diurnal pattern of the urinary excretions in the three different periods.
(1) The increase of the urine excretion was showen with about 2 hours lag after the morning exercise and the increase pattern by the afternoon and evening exercises were also shown. Two peak pattern of creatinine in period II was similar to that of the urine volume.
(2) Increase patterns of Na, K, Ca and Mg excretion in periods II and III were also observed with the physical exercise. In the morning exercise the increase appeared 2 hours after the exercise, though in the afternoon and the evening exercises the increase appeared from the time of exercise. The pattern of Na and K showed that the increase after the morning exercise was greater than that by the afternoon and the evening exercises. The variation pattern of Ca and Mg showed that the time lag in the increase existed in comparison with that of Na and K, in which the greater increase by the afternoon and the evening exercises was observed noticeably compared with that of the morning.
(3) Regarding to P excretion, the decrease during the daytime, and the increase in the sleeping time was common through the three periods. The increase in the evening by the evening exercise in periods II and III was remarkable.

[Objective]It is important for students to learn in school education how to prevent medical accidents caused by deep insertion of a needle. Also, it is essential in safe acupuncture treatment that students are always reminded there are individual variations in subcutaneous structure and to confirm the position of the needle tip in the subcutaneous tissue. To recognize the acupuncture needle tip, muscle twitch induced by electrical stimulation through the acupuncture needle tip was felt with fingers of training students.
[Methods]To prevent accidental pneumothorax, acupuncture training was performed in the upper and lower extremities. After the class, we conducted a questionnaire investigation with the students.
[Result]As the result, students realized that the position of the needle tip which they assumed is different from the real position in subcutaneous tissue.
[Discussion]Without knowing the precise position of the acupuncture needle tip, a desirable effect is not provided, and furthermore, a medical accident may be caused. It is important to confirm the position of the acupuncture needle tip with consideration to individual variation for safe and effective acupuncture treatment.
[Conclusion]We concluded that the skill to prick and insert the acupuncture needle to the correct position is so important in preventing medical accidents that training to learn correct needle tip position should be given in acupuncture education.

Urinary mineral excretions were measured on five healthy 19-years-old female students in domestic sciences course of a woman's college and five healthy 18-19-years-old female students in physical training course, during the training camp of ski events.
The examination for the female students in domestic sciences course was done on 22 December as of ordinary time at school and on 23-25 December 1969 in training camp of ski event at a skiing ground. For the female students in physical training course the examination was done on 9-13 January 1970 in training camp at the same skiing ground and on 3-5 February 1970 in ordinary time at school. Every three hours urine was collected during the examination periods.
(1) Whole urine volume per 24 hours decreased in training camp in comparison with that in ordinary school time, while the excretion increased after the physical exercise and decreased during the sleeping hours.
(2) Creatinine excretion per 24 hours increased in the training camp and diurnally the excretion increased after the physical exercises. The variation of creatinine excretion seemed to be effected by the physical exercise.
(3) Decrease of Na excretion and increase of K excretion were observed in the students of domestic sciences course in training camp. Increase pattern of Na and K excretion with diurnal variation in training camp was observed with physical exercises.
(4) Urinary excretion of Ca and Mg increased by the female students of physical training course in training camp. On the diurnal pattern, the increase of Ca and Mg excretion caused by physical exercise showed some time lag of the peak compared to that of Na and K.
(5) Phosphorus excretion increased both in the students of domestic sciences course and of physical training course in training camp. The decrease of P excretion in the daytime and the increase in the sleeping hours was commonly observed for both groups.
(6) Following up the diurnal variations of urine volume and urinary excretions of Na, K, Ca and Mg in the female students of physical training course through the training camp for five days, difference between the increase of the excretions after, physical exercises and the decrease in sleeping hours got less day by day. Such a change seems to be the physiological adaptation of human body in order to control excess excretions of the important substances.
(7) Although the value of Na f K ratio fell in both student groups during training camp, the decrease was smaller for the physical training course group than for the domestic sciences course group. The fact that more excretions of urine volume and creatinine and less lowering of Na/K ratio than those of the domestic sciences course students were observed in the physical training course students seemed to be the effect of the daily training.

Introduction. The principal therapy for gallstones was open cholecystectomy. Recently, however, with remarkable advances in laparoscopic surgery on the biliary tract in particular, laparoscopic cholecystectomy has become preferred treatment for symptomatic cholelithiasis. To assess our experience in surgical treatment for gallstones and determine the best method to reduce postoperative discomfort, cases of cholecystectomy performed in our institution were reviewed.
Patients.-During the past 14 years, 524 patients were treated for cholelithiasis (cholecystolithiasisin 412, choledocho-cholecystolithiasis in 75, choledocholithiasis in 36, intrahepatic stones in 1). The ratio of men to women was 1: 1.7 and the average age was 61 years. Results.-Only cholecystectomy was performed on 86% of the patients with cholecystolithiasis and 91% had accompaning open surgery with laparoscopic cholecystectomy in latest years. Open cholecystectomy by inserting a T tube was done on 61% of choledochocholecystolithiasis cases. In some cases papilloplasty and/or choledochoduodeno or choledochojejunostomy followed. Almost all patients with choledocholithiasis had open cholecystectomy with T-tube insertion and additional procedures to remove stones in thebiliary tract in earlier years. In these years, no more addidional procedures except for choledochotomy with T-tube insertion had been performed in any cholelithiasis cases.
Conclusions.-Laparoscopic cholencystetomy is a safe and effective procedure and should be preferred for symptomatic cholelithiasis except for cases with acute cholecystitis, common bile duct stones, gallbladder cancer and other severe complications.

The purpose of this study was to investigate the relation between alterations of salivary secretory immunoglobulin A (SIgA) and the occurrence of upper respiratory tract infections (URTI) in rugby football players.We examined the relationship between the onset of URTI and the daily alterations of SIgA levels in 32 male collegiate rugby football players (20.5±1.3 years) during summer training camp for 36 days.Total of 6 in 32 subjects had the appearance of URTI symptoms (18 %). SIgA secretion rate decreased significantly in the middle of training camp compared to the baseline (P＜0.05). Furthermore, SIgA secretion rate during the appearance of URTI (13.7±1.1μg/min) were significantly lower than that without symptoms (19.2±1.4 μg/min, P＜0.01). These results suggest that serial monitoring of SIgA may be useful to assess the risk status of URTI affection in athletes.

A 75-year-old woman underwent endovascular stent-grafting for a descending thoracic aortic aneurysm, followed by video-assisted thoracoscopic right upper lobectomy for concomitant lung cancer in a later procedure. Two custom-made endovascular spiral Z stents covered with woven Dacron (DuPont Co., Wilmington, DE, USA) were delivered via the femoral artery under local anesthesia using pull-through technique. Intraoperative angiograms showed successful exclusion of the aneurysm without any endoleakage. Conventional surgical treatments for both diseases in this patient would have required bilateral thoracotomy either in a simultaneous or staged fashion and entail risks of postoperative pulmonary dysfunction and progression of the cancer. Endovascular stent-grafting offered potential superior operative results and quality of postoperative life in this patient with concomitant descending thoracic aortic aneurysm and cancer of the right lung.

Between 1996 to 2000, 12 patients with arteriosclerotic thoracic aortic aneurysm underwent surgery with cardiopulmonary bypass using the right axillary artery as an arterial inflow. All patients received total arch replacement with selective cerebral perfusion and deep hypothermic circulatory arrest. One patient with occlusion of the left carotid artery died of postoperative stroke. There were no postoperative complications or deaths related to axillary artery perfusion except for cerebrovascular accidents. Perfusion through the axillary artery, providing antegrade aortic flow, is a safe and effective procedure to avoid stroke owing to retrograde arterial perfusion. We believe that the axillary artery could be an alternative to conventional femoral artery cannulation in the setting of aortic arch operations.

The purpose of this study was to investigate the effects of Lactobacillus gasseri OLL2809 (MG2809) intake on salivary secretory immunoglobulin A (SIgA) secretion and incidence of upper-respiratory tract infection (URTI) symptoms among college rugby athletes. Sixty-seven subjects were assigned to a MG2809 group (n = 33) or a placebo group (n = 34) using a double-blind procedure. Each subject took MG2809 or placebo tablets for 9 weeks. Resting saliva samples were collected before (0 week) and after 2, 4, 6, 8, and 9 weeks of the MG2809 intakes. A log of URTI symptoms was kept every day during the study period. Our results showed that salivary SIgA level was significantly increased at 6 weeks in the MG2809 group (p < 0.05), although the placebo group did not show significant change. The duration of URTI symptoms episode in the MG2809 group was significantly shorter than that in the placebo (p < 0.05). These results suggest that regular intake of MG2809 may enhance oral immune function mediated by SIgA and reduce the risk of URTI in athletes.

The case involved a 73-year-old woman who underwent surgical resection for right renal cell carcinoma extending to the inferior vena cava. During surgery the tumor thrombus disappeared from the inferior vena cava. We performed transesophageal echocardiography and detected the tumor thrombus in the right ventricle. Therefore, we immediately tried to remove the thrombus using cardiopulmonary bypass. However, we could not find the tumor thrombus in the right ventricle or in the main pulmonary artery. We used angioscopy of the pulmonary artery and detected the tumor thrombus at the orifice of the inferior pulmonary artery. The tumor thrombus was removed under direct visualization. In the event of an intraoperative pulmonary embolism, simple and safe techniques for exact and rapid diagnosis are needed. Intraoperative angioscopy allows direct visualization of the pulmonary arterial branches and appears to be very useful for detection of tumor thrombi even in emergency cases.