There have been an apparent trend in the decline of back-lift strength of young people during recent years. The purpose of this study was to investigate the cause-effect relationship of such a trend using young peoples and university students. In order to examine the characteristics of activities in the lumber back muscles during various physical activities, the surface electromyography (EMG) was obtained from the trapezius, latissimus dorsi, and elector spinae muscles for individuals with poor back-lift strength (5 male children and 4 university male students) and individuals with relatively strong back-lift strength (5 male children and 2 male university students) . The children with poor back-lift strength had significantly less EMG activities in both the trapezius and elector spinae muscles during the measurement of back-lift strength using a dynamometer than the strong back-lift strength children. The former children also had a less EMG activities in elector spinae muscle and a greater EMG activities in trapezius muscle during cycling the bicycle elgometer. Such a trend became more distinct when the load was increased. The university students with poor back-lift strength had a less EMG activity in the elector spinae muscle during the measurement of back-lift strength than those with strong back-lift strength. During running, there was not a distinct difference in the EMG activities of the muscles in the back between the poor and strong strength students. However, as the running speed increased, a greater EMG activity in the trapezius muscle or the latissimus dorsi muscle were observed for the poor back-lift strength students than the stronger back-lift strength students.
These results indicated that the individuals with poor back-lift strength relied more on the upper portion of the back muscle group than the lower portion of the back muscle group during both static and dynamic activities, suggesting that the trend in the decline of back-lift strength of children and students was due to a lack of opportunity to use the lower back muscles in the daily physical activities.

The effects of the surface friction of a grasped object on the regulation of grip force during holding tasks using a precision grip were investigated. Using a force transducer-equipped grip apparatus, the grip force and load force acting on the object were measured continuously while surface materials (silk, wood, suede and sandpaper) and load weights (0.98N, 1.96N, 2.94N, 4.90N and 9.81N) were varied. From the recorded data, the average static grip force, slip force, safety margin force and static friction coefficient were evaluated.
It was found that both the slip force and safety margin force increased as the slipperiness of the object surface increased. Significant interactions between surface type and weight were observed in the slip force and static friction coefficient. The interaction effect resulted from the fact that the frictional relationships with the fingers changed according to both weight and surface conditions. This was considered due to the viscoelastic nature of finger skin. An increase in the safety margin force with surface slipperiness was considered due to psychological reaction, probably fear of dropping the object. Unexpected changes in surface conditions caused a greater safety margin force than trials without a surface change, which might also have been associated with psychological reaction to uncertainty of the new surface condition. A relatively large inter-subject variation was found in the slip force and safety margin force relative to slippery surfaces.

After a general clinical observation period of 3 months, men and women from 66-82 yr. of age with hypertension (n=10) were studied to assess the effects of long-term mild aerobic training and detraining on their blood pressure. Ten patients agreed to take part in aerobic training using a treadmill with the intensity at the lactate threshold (LT) for 30minutes 3-6 times a week for mean 17.1±9.8 months while the time course of changes in the resting blood pressure was monitored.
Following the training period the LT increased significantly by the end of the training period (P<0.001) . After 3months of training both the systolic and diastolic blood pressure decreased significantly (P<0.05, respectively) and both blood pressures stabilized at a significantly lower level throughout the remainder of the study. The mean blood pressure decreased significantly for 9 months (P<0.05) . Finally, the systolic, mean and diastolic blood pressure were found to have decreased significantly, by 9, 5, 11 mmHg, respectively by the end of the training period. (SBP and MBP: P<0.05, DBP: P<0.01, respectively) . One month after the training ended the systolic, mean and diastolic blood pressure all increased significantly (SBP and MBP: P<0.001, DBP: P<0.01, respectively) and approached the initial pre-training levels.
In conclusion, the antihypertensive effect of mild aerobic training at the LT was confirmed for older patients taking antihypertensive medications. However, the cessation of such training resulted in a quick return to pre-training levels.

The effects of long-term low intensity aerobic training and detraining on serum lipid and lipoprotein concentrations were examined in 10 older patients suffering from hypertension and coronary heart disease. Training was carried out for 30 minutes 3-6 times a week for a mean of 17.1 months using a treadmill with the intensity level set at the blood lactate threshold (LT) .
Following this training both LT and the serum HDL-c increased significantly (P<0.001, P<0.01, respectively) after 6 months while the TC/HDL-c ratio decreased singificantly (P<0.001) only after 1 month and stabilized at a steady favorable value throughout the remainder of the study. The serum TC, TG and LDL-c did not change significantly by the end of the training period. There was a significant negative correlation between the initial TC/ HDL-c level and the change in the TC/HDL-c level at 1 month after training (r=-0.71, P< 0.02) . Only 1 month after the detraining the HDL-c decreased significantly while the TC/HDL-c increased in comparison with the final training value (P<0.001, P<0.05, respectively) and then returned to the pre-training levels.
In conclusion, these results suggest that long-term low intensity aerobic training could improve the profile of the serum lipid and lipoprotein concentrations in older patients. However, these results might depend on such factors as a low HDL-c level, a high TG level, the length of the exercise period, or the frequency per week and the age of the patient, while the cessation of such training quickly returned the profile to that of pre-training levels.

The effects of aging on adaptive force control of precision grip while manipulating a small object were compared between older (84.2±8.9 yrs, n=33) and young adults (19.1±0.24 yrs, n=18) from the following perspectives: (1) adaptation to an unfamiliar object with uncertain physical properties during 16 consecutive lifts ; (2) adaptation to an object with a non-slippery (sandpaper) surface during 12 consecutive lifts, followed by 12 consecutive lifts with a slippery (silk) surface ; and (3) adaptation to objects with different weights (0.49, 0.98, 1.96 and 2.94 N) during 24 lifts (6 consecutive lifts for each weight) .During each trial, grip and load forces were monitored. Safety margin force and slip force were evaluated from the data obtained.
The majority of older adults employed a considerably greater safety margin for an unfamiliar object in the initial trials than did young adults, while the minority of the older adults were able to adapt their safety margin force with a few trials, like the young adults. The older adults who overestimated the safety margin force, however, successfully adjusted their grip force to more optimal levels with repeated lifts, suggesting that the adaptive capability of grip force remained even at 90 years of age. The adaptation of older adults, however, was found to be slower (i. e., required more trials) than that of young adults. Upon encountering surface friction change, the safety margin forces in older adults were more strongly affected by the previous surface condition than those in the young adults. In addition, adaptation to a non-slippery surface seemed more difficult than that to a slippery surface with aging. Upon encountering weight change, older adults showed more difficulties in scaling their safety margin forces according to object weights.
Slower adaptation and difficulty in adaptation to the friction or weight change in older adults may reflect the agerelated decline of tactile sensitivity which impaired the signaling of frictional conditions and various discrete events in the hand. In addition, the lift repetition for force adaptation may possibly reflect the age-related deficit or slowing of central processing capacities related to grip force production.

A 48-year-old man with Buerger disease and intractable finger ulcers underwent successful transplantation of autologous peripheral blood-derived mononuclear cells pretreated with erythropoietin and blood donation to activate bone marrow function. Clinical symptoms on his finger ulcers improved significantly within 1 month after mononuclear cell transplantation, however, one of the intractable ulcers reappeared 2 months later. In total three transplantations were performed. Every cell transplantation revealed similar effectiveness 1 month later, and the interval of the subsequent disappearance of finger ulcers ranged from 3–6 months. There were no adverse effects based on this new therapy. These findings suggest that autologous peripheral mononuclear cell transplantation pretreated with erythropoietin and blood donation might be a non-invasive and safe alternatives for patients with Buerger disease and intractable finger ulcers.

A 69-year-old woman had syncope and aphasia. Magnetic resonance imaging showed multiple cerebral infarctions in both hemispheres. Cardiogenic embolisms were suspected, but no arrhythmic causes were shown. Transesophageal echocardiography revealed a highly calcified mitral annulus (MAC) with a rough intraluminal surface and mild mitral regurgitation, but no thrombus or tumor in the left heart system. However, recurrent multiple cerebral embolisms occurred in spite of strict anticoagulation therapy. We speculated that spontaneous rupture of the MAC was the cause of the scattered cerebral embolisms, and we therefore planned to remove the MAC as safely as possible and to endothelialize the deficit of MAC with autologous pericardium. Operative findings revealed that the MAC in P2-P3 had ruptured longitudinally and the ostium of the left atrium was connected to the ostium of the left ventricle as an inter-atrioventricular tunnel beneath the posterior mitral annulus with a fragile calcified wall. The finding suggested that calcified particles that had peeled away from the MAC by normal heart beating resulted in the cerebral infarctions. Therefore, she underwent resection of the MAC and mitral valve replacement with reinforcement of the decalcified posterior mitral annulus between the posterior left ventricular wall and the left atrial wall using autologous pericardium, which enabled both appropriate insertion of a mechanical prosthetic valve and endothelial continuity covering the surface of the residual MAC. No systemic embolism has occurred for two and a half years after surgery. This is the first case report of cerebral embolism caused by a spontaneously ruptured MAC.

A 44-year-old man who received left ventricular assist device (LVAD) implantation for end-stage heart failure due to dilated cardiomyopathy suffered from mediastinitis. Computed tomography confirmed mediastinitis. His mediastinum was reopened and irrigated. Negative pressure wound therapy (NPWT) was applied to the wound without closing the chest. This system enabled the patient to receive early physical rehabilitation. One year after LVAD implantation, under NPWT, the patient could walk in the general ward, and was waiting for cardiac transplantation. We used some useful materials for NPWT including a coatable non-alcoholic film, flexible sealing sheet, soft exudate absorber, in order to control wound clean, keep air-tight, prevent damage to the skin and to reduce mediastinal instability. LVAD implantation is usually performed as a bridge to transplantation or recovery. One of the most critical complications is intractable mediastinitis. We described a successful infection control of LVAD related mediastinitis with the NPWT.

There is little or no information about the distribution of elastic fibers in the human fetal head. We examined this issue in 15 late-stage fetuses (crown-rump length, 220-320 mm) using aldehyde-fuchsin and elastica-Masson staining, and we used the arterial wall elastic laminae and external ear cartilages as positive staining controls. The posterior pharyngeal wall, as well as the ligaments connecting the laryngeal cartilages, contained abundant elastic fibers. In contrast with the sphenomandibular ligament and the temporomandibular joint disk, in which elastic fibers were partly present, the discomalleolar ligament and the fascial structures around the pterygoid muscles did not have any elastic fibers. In addition, the posterior marginal fascia of the prestyloid space did contain such fibers. Notably, in the middle ear, elastic fibers accumulated along the tendons of the tensor tympani and stapedius muscles and in the joint capsules of the ear ossicle articulations. Elastic fibers were not seen in any other muscle tendons or vertebral facet capsules in the head and neck. Despite being composed of smooth muscle, the orbitalis muscle did not contain any elastic fibers. The elastic fibers in the sphenomandibular ligament seemed to correspond to an intermediate step of development between Meckel's cartilage and the final ligament. Overall, there seemed to be a mini-version of elastic fiber distribution compared to that in adults and a different specific developmental pattern of connective tissues. The latter morphology might be a result of an adaptation to hypoxic conditions during development.
Adult ; Capsules ; Cartilage ; Connective Tissue ; Ear Cartilage ; Ear Ossicles ; Ear, Middle ; Elastic Tissue ; Fascia ; Fetus ; Head ; Humans ; Joint Capsule ; Laryngeal Cartilages ; Ligaments ; Muscle, Smooth ; Muscles ; Neck ; Pterygoid Muscles ; Stapedius ; Temporomandibular Joint Disc ; Tendons ; Tensor Tympani