A questionnaring was conducted on farmers in Akita Prefecture who went in for sports in the intervals of farming. Notably one group of farmers who answered that they took regular exercise showed the following results:
1. The self-consciousness of being healthy and having good physical fitness is by far more intense in this group than in the groups of farmers who took irregular or occasional excercises.
2. The chief reasons why they continued to practice sports were:
a. that they had developed closer friendship among them through sporting activities.
b. that they obtained a good understanding and cooperation from the rest of the family members.
c. that they had leisure time.
3. To find time for sports they saved, above all else, their farming hours, indoor leisure time and homekeeping hours.
4. General endurance, agility and balance were the top three qualities of physical fitness that the greatest number of the farmers referred to as essential to modern farming. Further inquiry will be required into sports which might help to develop these qualities.

In order to study the relative metabolic rate and its relations with the heart rate in Japanese folk-dance “Min-Yo”, nine popular varieties of “Min-Yo” of Akita and Aomori, composed from the recreational point of view, were selected and examined by Douglas Bag method, and at the same time the appearance frequency of the movement of the dances was analyzed from the physiological point of view.
Results obtained were as follows :
1) The degrees of the relative metabolic rate of the dances were middle or heavy, and among them “Akita Ondo” showed the highest valve, 3.95±0.89, and “Hachinohe-Kouta” showed the lowest, 2.39 ± 0.24. Individual variations were noticed even with the same dance, and skillful dancers showed higher values than less skillful ones.
2) As for the changes in heart rate, dances with higher relative metabolic rate show higher heart level in exercise, and those with lower rate showed lower changes. The coefficient of correlation of relative metabolic rate (heart rate in exercise/heart rate at rest × 100) with heart rate index showed a high value, r=0.973 (p<0.01) . The regression line of the latter (y) against the former (x) was, y=0.065x-5.75.
3) Analysis of the movement showed that regardless of the dancing time, dances with high relative metabolic rates involved more intense bodily movement and greater motions, and that those with lower rates involved lighter movement and smaller motions even when the appearance frequency of movement was high.

Recently a deep concern has been shown for the decline of physical fitness of Japanese people. There are many studies on physical fitness of the common people but few on farmers in Japan. The purpose of this study was to take the steps towards establishing the physical fitness norms for Japanese farmers. The statistical analysis was conducted using the records on their physique and motor ability measured on 3, 452 persons aged 20-70, during 1972-1974 years, in the agricultural regions designated by the Ministry of Agriculture and Forestry.
The results obtained were as follows:
1) In stature, the males were nearly equal to that of a standard from Japanese people while the female were slightly inferior. In weight, both males and females were inferior to that of the standard. This tendency is remarkable in the following order: mountain farmers>flatland farmers>suburban farmers. Farmers in Tohoku District were generally short of stature and broad of chest.
2) Farmers were inferior to that of the standard in foot-balance and side steps but were superior in push-ups and endurance walk, the capacities of which lower less with their ages than in the cases of other persons. This tendency is exhibited in the same order as mentioned in 1).
3) Since such tests involving pain as endurance walk have a problem as to their reliability, further investigation should be required.

After our comparative investigation of the farmers' and non-farmers' consciousness of their physical fitness, exercises and health in Aomori Prefecture, the following results were obtained:
(1) As to the cognitive level for their state of health, no marked difference was found between the two groups.
(2) There was also no notable difference between the two as to the cognitive level for their physical fitness. There was, however, a contradiction among the weak farmers, many of whom answered that they were satisfied with their present physical fitness.
(3) As compared with the number of non-farmers, significantly greater number of farmers identified the physical fitness with the endurance of physical labor and the holding ability of the weight. In other words, many farmers simply regarded their physical fitness as their muscular ability.
(4) The number of farmers who really understand the necessity of exercises was significantly smaller than the non-farmer.
(5) In order to strengthen the physical fitness, it is fundamentally necessary for farmers to get more leisure through the improvement of liveng conditions, to be well equipped with facilities for physical culture and to have good physical training leaders properly chosen.

Using several electrophoretic techniques, this study examined the effects of 3 weeks hindlimb suspension on the patterns of isomyosins, myosin heavy chain (HC) isoforms and myosin light chain (LC) isoforms in the soleus muscle of the rat. The suspended soleus showed a shift in the HC isoform distribution with a marked increase in fast HC isoforms and a commensurate decrease in HCI. In addition, the change in the fast HC isoforms consisted of the expression of HCIId and HC IIb absent in the normal soleus. In contrast to HC isoforms, suspension did not lead to appreciable changes in LC isoform distribution. Analyses of electrophoresis under nondenaturing conditions demonstrated that the normal soleus expressing HCI and HCIIa isoforms contained two isomyooins. Although, of the two isomyosins observed in the normal soleus, the faster migrating band most likely represented the HCIIa-based one (FMas), its mobility was not identical with that of the HCIIa-based isomyosin (FMaf) found in fast-twitch muscles, migrating in the order FMaf>FMas. FMas was designated as intermediate isomyosin (IM) . Some of the suspended soleus contained slow isomyosin (SM) and IM whereas the others comprised FM 3 and/or FM 2 as well as SM and IM. In spite of the expression of HCIIb and HCIId in the suspended soleus, FM 3 and FM 2 observed in these muscles exhibited distinct mobilities from either HCIId-based or HCIIb-based isomyosins comprised in fast-twitch muscles. These results suggest that some of newly expressed HCIId and/or HCIIb isoforms in the suspended soleus are associated with not only fast but also slow LC isoforms and function as a constitutive element of the myosin molecule.

In a 63-year-old male patient Jehovah's witness, IABP was introduced due to acute myocardial infarction and cardiogenic shock, and PCI (BMS) was carried out to CAG #7 100%. Stent placement was carried out and his hemodynamics stabilized. A left-to-right shunt was observed upon carrying out LVG, so the patient was referred to our hospital for surgery purposes due to a diagnosis of ventricular septal perforation (VSP). Upon transferring the patient to hospital, his PA pressure elevated to 53 mmHg although the blood pressure was maintained, and no findings of right heart failure were observed. His respiratory condition was stable. Emergency surgery was considered, but the patient was taking Clopidogrel following PCI, and so VSP repair (extended endocardial repair) was carried out following 4 days discontinuation of Clopidogrel. Preoperative anemia was not observed ; however, postoperative hemorrhagic anemia improved due to iron preparation administration, and the patient was discharged from hospital 22 days following surgery without blood transfusion.

We report a rare case of primary cardiac angiosarcoma in the right atrium. A 47-year-old man was admitted to our hospital with cardiac tamponade. Echocardiography and computed tomography revealed a tumor in the right atrial cavity. We performed tumor resection to confirm the histological diagnosis, to prevent tumor embolism, and to increase the possibility of improving the prognosis. The tumor was resected with the right atrial wall and right pericardium. The right atrium was then reconstructed with a bovine pericardial patch. The pathological diagnosis was angiosarcoma. The patient survived only about 6 months after surgical resection, but there was no local recurrence. This report presents a very rare case of cardiac angiosarcoma associated with cardiac tamponade.

A 76-year-old woman with a sudden onset of chest and back pain was admitted to our hospital. Computed tomography (CT) showed a giant thoracoabdominal aortic aneurysm. Therefore, the patient underwent emergency operation. Under a left anterolateral thoracotomy and pararectal laparotomy with left heart bypass, we performed graft replacement of the thoracoabdominal aorta and reconstruction of the celiac artery, superior mesenteric artery and renal arteries. The left lung was tightly adhered to the aneurysm because of the contained rupture. Copious pulmonary bleeding and air leakage occurred due to thrombectomy of the aneurysm. During the operation, critical air leakage was repaired using the remaining aneurysmal wall. The postoperative course was uneventful. The patient was discharged 16 days after surgery. Copious air leakage due to lung injury was a potentially life-threating condition in the postoperative course of this case of thoracoabdominal aortic aneurysm. Surgical treatment of critical air leakage due to lung injury is very important in thoracic surgery.

Congenital quadricuspid aortic valve is a very rare malformation. We report two cases with severe aortic regurgitation due to isolated quadricuspid aortic valve. It consisted of three equal cusps and one smaller cusp, which was identified at the time of valve replacement surgery for severe aortic regurgitation.

The main purpose of basic clinical training for housestaff is to acquire the ability to be a primary physician who can properly manage acute medical problems, develop intimate bonds with patients, and provide them with continuous care. We emphasize the importance of training in the office, clinic, or patients' homes. Although residents have so far spent most of their clinical rotations in an inpatient setting, a training program that devotes substantial time to ambulatory care is indispensable to improve basic clinical training in primary care medicine.