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.

A 53-year-old man presented with a painful, non-healing ischemic ulcer of the left fifth toe. The patient was initially treated conservatively for 4 months with local debridement and medication with antiplatelet therapy but his symptoms and the ulcer was refractory. A computed tomography revealed a bulky, irregular, gritty, localized calcification of the infra-renal aorta and was compatible with the so-called “coral reef aorta”. Angiography confirmed the findings of the CT scan, and there was no evidence of occlusive lesions in the distal runoff vessels. A diagnosis of blue toe syndrome secondary to infra-renal coral reef aorta was made. In order to prevent further embolization, the patient underwent aortic excision with PTFE grafting via a retroperitoneal incision. In order to increase the microcirculation of the toe and to aid in the healing of the ulcer, a lumbar sympathectomy was performed simultaneously. The ulcer healed completely on postoperative day 47. The treatment method for coral reef aorta depends on the presence or absence of global ischemia of the lower extremity and embolic complications.

Endovascular treatment is a first-line treatment for renal arteriovenous malformations (AVMs). Endovascular treatment might be effective in patients with aneurysmal-type renal AVMs, which involve one feeding artery and one drainage vein, because control of the feeding artery, rather than the aneurysm itself, could have a therapeutic effect. Herein, we describe two cases of patients with renal AVM with multiple renal artery aneurysms, who were treated by controlling the arterial inflow alone. In Case 1, the patient was a 76-year-old woman with renal AVM discovered during examination for another medical condition. A computed tomography scan revealed four renal aneurysms (φ38/44/24/35 mm) ranging from an intimal defect in the right renal artery to the drainage vein running into the inferior vena cava (IVC). Although we had planned to use a covered stent in the right renal artery to cover the intimal defect without embolization of the aneurysms, a minor artery proximal to the aneurysm was found near the orifice of the right renal artery. Therefore, we used a covered stent in the right renal artery after embolization of the most proximal aneurysm was performed. In Case 2, a 78-year-old man was referred to our facility because a renal AVM was found during examination for lower back pain. The distal posterior branch of the right renal artery attached to the multiple aneurysms and directly drained into the IVC, which was diagnosed as an aneurysmal-type renal AVM. Because there were no arteries arising from the aneurysms in the right renal artery, which fed the renal parenchyma, embolization of only the inflow artery was performed. For both patients, renal blood flow was maintained without any decrease of the renal function. In these patients, although renin-angiotensin system activity was within the normal range, and blood pressure became better controlled postoperatively. In addition, there was significant improvement in the brain natriuretic peptide (BNP) levels postoperatively. Thus, we believe that unstable hypertension and/or high-output heart failure as well as the aneurysmal size should be assessed in the management of renal AVMs.

OBJECTIVE: Electroconvulsive therapy (ECT) is a reasonable option for intractable depression or schizophrenia, but a mechanism of action has not been established. One credible hypothesis is related to neural plasticity. Three genes (Oct4, Sox2, c-Myc) involved in the induction of induced pluripotent stem (iPS) cells are Wnt-target genes, which constitute a key gene group involved in neural plasticity through the TCF family. Klf4 is the other gene among Yamanaka's four transcription factors, and increases in its expression are induced by stimulation of the canonical Wnt pathway. METHODS: We compared the peripheral blood gene expression of the four iPS genes (Oct4, Sox2, c-Myc, and Klf4) before and after modified ECT (specifically ECT with general anesthesia) of patients with intractable depression (n=6) or schizophrenia (n=6). Using Thymatron ten times the total bilateral electrical stimulation was evoked. RESULTS: Both assessments of the symptoms demonstrated significant improvement after mECT stimulation. Expression of all four genes was confirmed to increase after initial stimulation. The gene expression levels after treatment were significantly different from the initial gene expression in all twelve cases at the following treatment stages: at the 3rd mECT for Oct4; at the 6th and 10th mECT for Sox2; and at the 3rd, 6th and 10th mECT for c-Myc. CONCLUSION: These significant differences were not present after correction for multiple testing; however, our data have the potential to explain the molecular mechanisms of mECT from a unique perspective. Further studie should be conducted to clarify the pathophysiological involvement of iPS-inducing genes in ECT.
Depression ; Electric Stimulation ; Electroconvulsive Therapy* ; Gene Expression* ; Humans ; Induced Pluripotent Stem Cells ; Plastics ; Schizophrenia ; Transcription Factors* ; Wnt Signaling Pathway