1) Children's data (10-18 years old) of back strength, height, grip strength and running long jump from data book of Japan Education Ministry (1964-1981) were analyzed. Back strength was mainly studied and was compared with other data (grip strength etc.) . The groups with high average values for back strength at 10-14 years old did not necessarily show high values for back strength at 17 years old, or vice versa. Values for back strength at 10-14 years old were not significantly correlated with those at 17 years old.
2) Using the data from data book mentioned above, tension of deep back muscle (FMUS) was calculated based on kinetic models (FMUS. I, II, III) . Calculated FMUS values were 3-5 times larger than measured back strength values at each age.
3) Relative change of back strength and FMUS in 1964-1981 were compared. All values for back strength were lower than those for FMUS except in 1967. During the late 1960th and the 1970th, average back strength values gradully decreased, but the decrease of FMUS was less obvious than that of back strength.
4) Based on the data of 422 children (7-12 years old, male and femele), values of diaphragm area were approximated with some assumptions, and then FMUS values were calculated. FMUS values calculated by approximate diaphragm area were significantly larger than those calculated by constant diaphragm area (465 cm2) .
The figure for getting FMUS values easily was offered to avoid troublesome calculation. This consists of two graphs, and one can read FMUS values with reasonable precision. Parameters needed for getting FMUS values are sexuality, height, body weight and back strength.

34 male rats (13 weeks old) were used in this experiment. 11 rats were at rest and 23 rats were loaded to run on a treadmill with 2 degree slope at a speed of 25m/min. Relation between quantities of blood substances (plasma glycerol, blood lactate and plasma free fatty acids ; FFA) and lipolytic activity of epididymal adipose tissue was studied to clarify a mechanism of lipolysis of the adipose tissue in the exercise.
1) Plasma FFA and glycerol began to increase in parallel at 30 min after the run, but at exhaustion only plasma glycerol enhanced.
2) Blood lactate increased at 10 min after the run and more at exhaustion.
3) Basal lipolytic activity of epididymal adipose tissue in vitro was not influenced by the run, while norepinephrine induced lipolysis of the adipose tissue decreased with lapse of running time. Relation between plasma FFA and lipolytic activity of epididymal adipose tissue was inverse during the run.
4) There was also inverse relation between blood lactate and lipolytic activity of adipose tissue induced with norepinephrine. From these results, it is assumed that the increase of plasma FFA during the exercise was not resulted from the increase of lipolytic activity of the adipose tissue stimulated with only norepinephrine and effects of other hormones (ACTH, Glucagon, Growth hormone and etc.) and their interactions on the lipolysis might be considered.

An 80-year-old male patient had complained of left abdominal pain since 1990, and an abdominal aortic aneurysm (AAA) 5.3cm in diameter was diagnosed by computed tomography (CT). The patient was NYHA class III with complaints of chest pain during exercise. Coronary arteriography showed that he had three-vessel disease. At that time, aneurysmectomy was not anticipated due to his age and because the AAA showed no tendency to enlarge. However, in October 1993, CT showed that the AAA rapidly enlarged to 6.8cm in diameter. Due to the greater risk of rupture of the AAA, aneurysmectomy was considered necessary. The operative mortality associated with aneurysmectomy in patients with coronary artery disease (CAD) is higher than that in patients without CAD. Therefore, coronary artery bypass grafting (CABG) was indicated prior to aneurysmectomy. The patient underwent CABG (two vessels) in December 1993, and aneurysmectomy was successfully performed in February 1994. He was discharged uneventfully 17 days after the operation.

Six (1.2%) of 501 patients sustained phrenic nerve injury during operation for congenital heart disease at our institutions between 1992 and 1998. The diagnosis was confirmed by percutaneous stimulation of the phrenic nerve. All but 1 patient were less than 9 months old, and the average weight was 3.6kg. All 6 patients underwent diaphragmatic plication and were extubated by 7 days after operation. Percutaneous stimulation of the phrenic nerve allowed direct assessment of phrenic nerve function which was difficult to detect by clinical and radiological evidence. This method can be non-invasively used at the bedside to facilitate early and accurate diagnosis of phrenic nerve palsy.

We report a case of vascular parkinsonism mainly treated at the patients' home with thyrotropin-releasing hormone (TRH). The patient was a 77-year-old male who had an attack of cerebral bleeding in the left posterior lobe in 1990. Thereafter, dysarthria, dysphagia and gait disturbance gradually developed. He had rigidity in the neck, and upper and lower extremities, but no tremor, and walked with short strides (marche a petit pas). We diagnosed the case as vascular parkinsonism, by his history and those symptomes.
We treated him mainly at his home since 1994. At first, we used combinations of levodopa, bromocriptine, amantadin, and anti-chorinergic drugs, but symptomes and signs of vascular parkinsonism did not disappear.
Finally, we used TRH 0.5 mg by an intravenous or intramuscular injection for 10-14 days a month. Thereafter, he became able to eat, speak and walk a little more, and we continued this therapy for about one year. He died in 1996 of asphyxia at a meal. We think TRH was effective for chronic stage of vascular parkinsonism even if treated at home.

Long term physical training is known to cause a change of cardiac functions and this effect is observed at various levels of the heart (from whole heart to subcellular level), although its mechanism is not fully understood. It is reported that cardiac hypertrophy and decreased heart rate can be observed as effects of long term physical training, but change of the catecholamine content in heart tissue induced by training is controversial.
In the present experiment, long schedule of short daily swimming episodes was employed to observe the effect of mild physical training on cardiac functions of rats in the growing stage. We measured body weight, heart weight, heart rate under light anesthesia, variation of R-R-interval of electrocardiogram, and catecholamine contents in cardiac muscle.
1) Wister rats were divided into 2 groups 3 weeks after birth. One group rats was kept sedentary in cages, and the other group was required to free swim in a tank containing water at 30°C. At the beginning of the programme, swimming time was 10 min. Swimming was applied 5 days a week for up to 14 weeks, and swimming time was gradually increased to 30 min.
2) Body weight of rats in the trained group was significantly less than that of the controls, and the heart weight to body weight ratio in the trained rats was significantly higher than in the controls.
3) In the exercised rats, the R-R interval of the ECG was longer than that of the controls, and there was a tendency for the variation of R-R interval in the trained group to be larger than that of the controls.
4) At 10 and 17 weeks, rats from each group were sacrificed after or without a 30 min test swim for measurement of catecholamine content of the ventricular muscle. One time swimming for 30 min increased dopamine content, but did not change norepinephrine content except for the trained group at 10 weeks. There was no significant difference in cardiac catecholamine contents in the rested state of the control and trained groups at 10 and 17 weeks.
5) Results were interpreted as follows: One time swimming for 30 min influences the activity of the autonomic nervous system innervating the heart, and catecholamine metabolism at nerve terminals of the sympathetic nervous system. Long term mild swimming does not cause permanent change of catecholamine contents, and the low heart rate in the trained group cannot be soley explained by the decreased activity of the sympathetic nervous system.

Background/Aims: Adalimumab has been shown to induce and maintain clinical remission in patients with moderate to severe ulcerative colitis (UC). However, no large-scale population-based studies have been performed in Japan. This study was conducted to evaluate the safety and effectiveness of adalimumab in clinical practice in Japanese patients with UC. Methods: In this 52-week, prospective, multicenter, single-cohort, noninterventional, observational, postmarketing surveillance study, patients with moderate to severe UC received an initial subcutaneous injection of adalimumab 160 mg, followed by 80 mg at 2 weeks, and then 40 mg every other week. Safety assessments were the incidence of adverse drug reactions (ADRs) and serious ADRs. Effectiveness assessments were clinical remission, corticosteroid-free remission, mucosal healing, and change in C-reactive protein (CRP) levels from baseline. Results: Of 1,593 registered patients, 1,523 (male, 57.6%; mean age, 41.8 years) and 1,241 patients were included in the safety and effectiveness populations, respectively. ADRs were reported in 18.1% and serious ADRs in 4.9% of patients. Clinical remission was achieved in 49.7% of patients at week 4, increasing to 74.4% at week 52. Corticosteroid-free remission rates increased over time, from 10.4% at week 4 to 53.1% at week 52. More than 60% of patients demonstrated mucosal healing at weeks 24 and 52. Mean CRP levels (mg/dL) decreased from 1.2 at baseline to 0.6 at week 4 and 0.3 at week 52. Conclusions This large real-world study confirmed the safety and effectiveness of adalimumab in patients with UC in Japan. No new safety concerns were identified.