The purpose of this study was to measure the effectiveness of RPE on exercise intensity for senior citizens. A maximum workload test was administered with the use of a bicycle ergometer on older male and female subjects. The results of our study can be summarized as follows:
1. Two trials were performed on separate days. A high correlation coefficient for the first trial and the second trial was found. The reliability for the male group was r=0.76 (p<0.01) and that for the female group r=0.90 (p<0.01) .
2. A correlation range of r=0.55-0.79 (p (0.01) was found for RPE and physiological exercise intensity (which includes oxygen intake and heart rate) . A higher result was found when the relative value was used in the analysis of the oxygen intake and the heart rate instead of the absolute value.
3. Significant correlation coefficients of r=0.63-0.64 (p<0.01) were found for RPE and the work load in terms of watt units.
4. The majority of the physiological variables were statistically determined ; however, there were no correlations between RPE and systolic blood pressure.
In conclusion, based on our study, we have found that RPE and HR ; RPE and %Vo₂max: RPE and watts grouped individually had a high correlation for effectiveness. The only exception in our study was the RPE and the blood pressure group because no correlation was found overall. Therefore, the overall effectiveness of RPE was proven to be quite sensitive even for senior citizens, and as a result RPE can be utilized when exercise is prescribed for evaluatory measurement in senior citizens.

[Objective]We performed a questionnaire for the purpose of investigating the present conditions of infection control education in Japanese acupuncture schools and to discuss the problems.
[Methods]We conducted a postal survey by sending out questionnaires to 153acupuncture schools in Japan from December 2008 to March 2009.
[Results]Replies were obtained from 69.9%of the schools (107 out of 153schools). In their responses, 65%of the schools taught hand-washing with soap and alcohol-based hand rub as methods of hand hygiene. Moreover 58%of the schools used only single use needles (SUNs), 40%used both reusable and single use needles, and 2%used only reusable needles. However, single use was observed only at 25%of the schools that introduced SUNs.
Furthermore, we inquired whether the students were taught to use sterilized gloves and finger cots. The results illustrated that a proportion of schools provided the instruction;the proportion of constant instruction was 17%, that of the instructor's option was 35%, that of no requisite was 48%.
[Conclusion]From the above-mentioned results, it became clear that the direction for use of SUNs was not instructed adequately. In addition, this aseptic technique for puncture is not yet standardized in the school's education. It is necessary to realize the measures based on evidence and to employ them in educational programs at acupuncture schools.

1) To become physicians who care for patients as human beings, medical students must know about child welfare. A serious problem in the fields of medicine and welfare is child abuse. Collaboration is needed to support children and families, but many challenges exist.
2) The goal of our Multidisciplinary Team Workshop, which started in 2006 and targets students in a wide range of fields, is to educate future practitioners about the necessity of multidisciplinary collaboration.
3) More than 80% of the participating students felt the workshop was useful, and the participation of medical students increased the significance of the workshop for students from other disciplines.

Three patients, who received infrarenal aorto-iliac bifurcation grafts, complained of flaccid and insensible feeling on lower extremities immediatedly after surgery. These symptoms were supposed due, in two cases, to spinal cord ischemia or, in remaining one case, to ischemic change of the peripheral nerve, In former cases, spinal cord hypoxia might be caused by interrupted blood supply through spinal artery as it was intercepted temporarily but for about three and a half hours during surgical procedures. In the latter case, cramping of the left iliac artery lasted for five and a half hours, which might result in anoxic damage of the peripheral nerve. Hyperbaric oxygenation (HBO) at two atmospheric absolute (ATA) pressure for 75min and 3 ATA for 90min were repeated everyday for them. In all cases, almost complete sensorimotor recovery was obtained after 15 to 30 instances of HBO, which was combined with physical therapy. HBO seemed to have improved early hypoxic and edematous damages of the spinal cord or peripheral nerve. As an unfavorable complication of abdominal aortic surgery, incidence of sensorimotor disturbance of the extremities is infrequent and/or unpredictable, however, once it occurs, no effective therapeutic maneuvers were developed yet. Through these clinical data, HBO should be introduced more actively for such disorders. One of the key issues to enhance the effect of HBO is that, HBO should be introduced as soon as possible once postoperative nuerologic disorders were diagnosed.

This study developed an animal model of surgically wounded submandibular glands (SMGs) and investigated the effects of collagen gel with basic fibroblast growth factor (bFGF) on tissue regeneration of surgically wounded SMGs in vivo. The animal model was produced by creating a surgical wound using a 3-mm diameter biopsy punch in SMGs. The wound was filled with collagen gel with bFGF (bFGF group) or without bFGF (control group). In the animal model of surgically wounded SMGs, salivary glands without scar tissue around the wound area were observed with smaller areas of collagen gel. Small round and spindle-shape cells invaded the collagen gel in both groups after operation day (AOD) 5, and this invasion dramatically increased at AOD 7. Host tissue completely replaced the collagen gel at AOD 21. The invading immune cells in the group treated with collagen gel with bFGF were positive for vimentin, a-smooth muscle actin (aSMA), CD49f, c-kit and AQP5 at AOD 7. Similarly, the mRNA expression of vimentin, aSMA, CD49f, keratin19 and AQP5 was also increased. This study suggests that the use of collagen gels with bFGF improves salivary gland regeneration.

A 56-year-old man felt something abnormal in his right upper leg and 2 weeks later, sudden severe pain occurred. He was admitted to our department, on the suspicion of peripheral artery aneurysm. Arteriography showed a right deep femoral artery aneurysm. We successfully treated him with transcatheter embolization. Selective angiography of the deep femoral artery after the embolization disclosed complete occlusion of the aneurysm. We concluded that this minimally invasive treatment by transcatheter embolization for aneurysm of the deep femoral artery may be the first treatment of choice rather than operative resection.

Staged arterial switch operation without homologous blood transfusion was successfully performed in 5 patients weighing 4.1-11.0kg (double outlet right ventricle: 2 cases, transposition of great arteries: 3 cases). The postoperative hemodynamics and respiratory status were uneventful in all patients (initial central venous pressure after ICU admission: 9.0-14.5cmH₂O, mean 12.5cmH₂O, duration of intubation: 3.5-18.0h, mean 7.8h). Autologous blood donation immediately after induction of anesthesia and minimization of bypass circuit were effective methods for open heart surgery without homologous blood transfusion, particularly in staged arterial switch operation requiring prolonged cardiopulmonary bypass.

Although maximal oxygen uptake (VO₂max) or oxygen uptake corresponding to lactate threshold (VO₂@LT) is considered the single best determinant of one's cardio-respiratory endurance or aerobic capacity, the direct measurement of these attributes requires elaborate equipment, trained personnel, special knowledge, and/or a maximal effort on the part of the subject who is tested. In addition, the measurement is time consuming. The current investigation was designed to examine the validity of aerobic capacity estimated from submaximal cycling exercise and field performance tests in the elderly. The subjects tested were 18 sedentary men and women aged 63 to 75 years (69.7±3.4) . Indirect VO₂max tests were selected from those proposed by Astrand and Ryhming, Siconolfi et al., and Margaria et al. (step test), and YMCA. The VO₂max values estimated by these methods, with the exception of the Siconolfi method, were found to have large errors when compared to the errors obtained in previous studies for younger subjects. There were no significant correlations between step test scores and VO₂max and VO₂@LT in the elderly. Correlations of 12-min distance walk with VO₂max (r=.711) and VO₂@LT (r=.714) were significant. Our findings suggest that 12min distance walk be a better aerobic capacity test than other indirect VO₂max tests including Astrand and Ryhming test.

This paper describes a clinical review of cases of gastric cancer treated surgically at the Department of Surgery of the Shirakawa Kosei General Hospital, the core medical institution in the southern part of Fukushima Prefecture.
During the period of 20 years from January 1981 through December 2000, a total of 1, 132 cases were operated on for gastric carcinoma. Surgical resection cases totaled 1, 023 (resection ratio: 90.4%); curative resection cases, 894 (curative resection ratio: 79.0%); 5-year survival rate for resection cases, 68.3%; and 5-year survival rate for curative resection cases, 75.6%. When the cases were divided into those treated during the first half of the 20 years nad those treated during the latter half of the 20 years, the number or resection cases was smaller during the latter than during the first half but the resection ratio was larger. The early stomach cancer cases in terms of the degree of progress, histological classification, depth and metastasis to lymph nodes have been increasing and the 5-year survival rate has been on the rise.

　　We experienced five cases of male breast cancer for during the past 10 years from 2002 through 2011, and performed the clinicopathologic study. Male breast cancer accounts for as low as 1.59% of all breast cancers, and the average age at occurrence is 70.4 years. In every case of ours the tumor was located around the nipple with its nodular diameter not exceeding 2.0 cm. By histological types, our case consisted of two papillotubular carcinoma, two solid-tubular carcinoma and one scirrhous carcinoma. Pathological findings showed that all cancers had infiltrated into the surrounding fat tissues of the mammary gland and four of them into the overlying skin. One case of papillotubular carcinoma was diagnosed as neuroendocrine carcinoma. Four cancers examined for ER and PgR were all positive, but all cases for HER2 was negative. There was a tendency for the age and clinical history of breast cancer to be older and longer in men than in women. Information about male breast cancer should be disseminated more widely and more effects toward early detection should be made.