Cat-scratch disease occurs after a scratch from a cat infected with Bartonella henselae. We report a 64-year-old man with cat-scratch disease who had swollen lymph nodes. Consequently, metastasis of a malignant tumor was suspected as the most likely cause in the differential diagnosis. Therefore, the diagnosis was delayed and several diagnostic examinations were performed. Although diagnosis was difficult in this case, an accurate diagnosis was achieved by taking a detailed medical history, including questioning about pet ownership, and by carefully examining the lower limbs including the femoral region. These steps are important to diagnose cat-scratch disease.

[Objective]Using cotton to cover needle shafts when removing acupuncture needles is recommended in order to prevent blood contamination. However, the effect of risk reduction has not been confirmed by experimental studies. We, therefore, observed spreads of fluorescent agent, assumed as blood, with or without alcohol cotton to avoid direct contact between fingers and needle shaft.
[Methods]Subjects were two blind acupuncturists and two acupuncture students. We asked them to insert acupuncture needles to people who played a role of a patient. Of the five acupoints needled, we put the fluorescent agent to one point, and asked the subjects to remove the needles. After all the needles were removed, we took photographs of all points needled and the subjects'hands in order to assess the spread of the fluorescent agent. 'We performed two sessions. In Session A, the subjects used alcohol cotton to cover a needle shaft so that their fingers did not contact the needles directly. In Session B, they did not use alcohol cotton. The subjects were not told that we used the fluorescent agent.
[Results](1) In the forearm of those who were needled, adhesion of the fluorescent agent was not seen in three out of four subjects, in Session A. (2) In two of the four subjects who inserted the needles, the adhesion area of the fluorescent agent in the needle-supporting hands was smaller in Session A compared with Session B. (3) In three of the four subjects who inserted the needles, the adhesion area of the fluorescent agent in the needle-stimulating hands was smaller in Session A compared with Session B.
[Conclusion]It is suggested that covering needle shaft with alcohol cotton during needle withdrawal suppresses the spread of blood contamination.

We investigated the effects of milrinone administered during cardiopulmonary bypass (CPB) for open heart surgery. Ten patients (group M) received milrinone after aortic declamping during CPB. Ten other patients served as controls with no administration (group C). Soon after the bolus infusion of milrinone, the perfusion pressure dropped significantly in the M group, however, after CPB and at the end of operation, aortic pressure showed no difference between the two groups. There were no differences in heart rate, pulmonary artery pressure and pulmonary capillary wedge pressure. After CPB, cardiac index was high and systemic vascular resistance index was low in the M group. The need for cathecholamine and time for rewarming showed also no significant differences. No adverse reaction was recognized. During CPB, a single administration of milrinone was useful for peri- and post-operative management of patients undergoing open heart surgery.

The aim of this study was to investigate quantitatively the power ability of middle and older aged men in the vertical jump.
And, we would try to point out the changes with increasing ages and the influences of the environments factor to the power ability.
Based on the environment point of view, we put an emphasis and consideration on those who did physical exercises and also those who drove a car in a daily life.
Subjects were the health 201 men who visited the sports sauna training center of national stadium for physical exercises.
The power was calcurated from the force and velocity concerning of jumper's C.G. during the take off motion. The force was measured by using a strain gage type tranceducer, and the velocity was calcurated by integrating the equation of motion about of C.G.
Result:
The power ability of middle and older aged men in the vertical jump decreased with increasing ages.
The rate of decrease with every 5 years of age was 0.248 horse power, 2.960×10^-3 horse power in the maximum power and maximum power per body weight.
In comparison with the power ability of 25 years old, the power ability, in terms of maximum power per body weight, of 35 years old, 45 years old, 55 years old were 90.8%, 81.1%, 59.0%, respectively.
There were evidently differences between trained men and untrained men, and then car driver and no car driver in the power ability. The differences of maximum power per body weight were 12.190 × 10^-3 horse power, 9.231×10^-3 horse power, respectively.

Recently, the popular usage of the sauna bath has been greatly increased but this is not necessaeily based upon scientific ground.
This investigation has been made on the most ideal usage time with special emphasis on duration of time in the actual sauna room.
The usage pattern, in view of the times of taking the sauna room and the cold water, has been established.
And then the influences on the body function were measured.
The usage pattern were as follows (Repetition were all 3 times)
(1) 5 minutes stay in the sauna and 1 minute in the water
(2) 7 minutes stay in the sauna and 1 minute in the water
(3) 7 minutes stay in the sauna and 2 minutes in the water
(4) 10 minutes stay in the sauna and 2, 5 minutes in the watar
The result were as follows
1. The usage pattern (1) gave the good result for the function of whole body reaction time, patellar-tendon reflex time, maximum power of vertical jump.
Another usage pattern (2), (3), (4) gave the wrong result for those function.
2. There were no remarkable differences blood pressure, heart rate and skin temperature among the usage pattern (1), (2), (3), (4) .
3. Oxygen intake in the usage pattern (2) gave a large value than the usage pattern (1) .
In the view of the energy expenditure, it was recognized that the usage pattern (2) was the best usage.

A selective and sensitive competitive enzyme-linked immunosorbent assay (ELISA) method was developed and validated for the quantification of erlotinib in 50μL of samples of human serum. Anti-erlotinib serum was obtained by immunizing mice with an antigen conjugated with bovine serum albumin and 3,4-bis(2-methoxyethoxy)benzoic acid using the N-succinimidyl ester method. Enzyme labeling of erlotinib with horseradish peroxidase was similarly performed using 3,4-bis(2-methoxyethoxy)benzoic acid. A simple competitive ELISA for erlotinib was developed using the principle of direct competition between erlotinib and the enzyme marker for anti-erlotinib antibody, which had been immobilized on the plastic surface of a microtiter plate. Serum erlotinib concentrations lower than 40 ng/mL were reproducibly measurable using the ELISA. This ELISA was specific to erlotinib and showed very slight cross-reactivity (6.7％) with a major metabolite, O-desmethyl erlotinib. Using this assay, drug levels were easily measured in the blood of mice after oral administration of erlotinib at a single dose of 30 mg/kg. ELISA should be used as a valuable tool for therapeutic drug monitoring and in pharmacokinetic studies of erlotinib.

An 81-year-old patient, who had a postinfarction left ventricular aneurysm with thrombus underwent left ventricular aneurysmectomy with right coronary artery bypass grafting (CABG). Preoperative examination showed 99% stenosis of the left coronary artery (#7) and 90% stenosis of the right coronary artery (#3). The operation was performed because angina was not improved and formation of thrombus was suspected on the wall of the aneurysm. The operation was performed under cardiopulmonary bypass and by antegrade and continuous retrograde cardioplegia. The aneurysm was resected and a relatively fresh thrombus which was detected on the endocardium of the aneurysm was extracted. The left ventricle was closed by direct linear suture with felt reinforcement. Because the area of resection included part of the left anterior descending artery, only right CABG (#3) with a saphenous vein was done. Weaning from bypass was very easy and the postoperative course was uneventful.

Using the DDG-2001 pulse dye densitometer, cardiac output (CO) and circulating blood volume (BV) were determined before and after the operation, and its accuracy and the significance of postoperative management were studied. Referring to 14 cases undergoing open heart surgery, CO and BV were determined using the DDG-2001 before application of the cardiopulmonary bypass and immediately, 4h and 12h after the operation. The level of CO was compared with that determined by the thermodilution method, and the level of BV with that calculated from hemoglobin levels determined before and after the cardiopulmonary bypass application and the priming volume in the circuit. Further, body fluid balance after the operation was calculated, and its relation to BV was studied. As to the correlation coefficient and inclination of the regression line, they were 0.77 and 0.849 with CO, and 0.821 and 0.844 with BV, respectively. Upon completion of the operation BV decreased, but increased again 4h and 12h later, although the body fluid balance was negative. CO and BV determined by the pulse dye densitometry favorably correlated with those determined by other methods. Immediately after the operation BV decreased, but then increased in the course of time, although the body fluid balance was negative.

There is disagreement regarding the indications of surgery for cases of severe aortic stenosis (AS) with a decrease in left ventricular ejection fraction (EF) and a low aortic pressure gradient (PG), since there is a high perioperative risk associated with this condition. Hence, we investigated the surgical outcome of AS cases with impaired left ventricular function. Our department performed 144 aortic valve replacements (AVRs) for cases of AS and AS-dominant mild regurgitation (ASr) between January 2000 and September 2005. Among these cases, 9 patients had an EF under 35%, and these patients were selected as subjects and compared with a control group with an EF of more than 35%. Patients with accompanying coronary artery diseases that required treatment were excluded to avoid confounding effects on cardiac function. The mean age of the 9 subjects (4 men and 5 women) was 67.8±10.8 years old, with a range from 53 to 80 years old, and the subjects had the following mean background data: EF, 34.4±0.5%; left ventricular end-diastolic dimension (LVDd), 57.3±5.8mm; left ventricular end-systolic dimension (LVDs), 49.3±5.7mm; interventricular septum thickness (IVSth), 11.9±1.9mm; and left ventricular posterior wall thickness (LVPWth), 11.1±2.6mm. Characteristics such as left ventricular dilatation and thinning of the left ventricle myocardium were noted in these data. The cases were classified as severe AS because the mean aortic valve area (AVA) was 0.58±0.2cm², but the peak aortic pressure gradient (peak PG) (65.2±32.7mmHg) in the 9 subjects was lower than that of the control group (97.0±65.2mmHg). All 9 subjects underwent aortic valve replacements (AVRs), with simultaneous mitral annuloplasty (MAP) in 3 cases, mitral valve replacement (MVR) in 1 case and performance of a Maze procedure in 1 case. No deaths occurred while the patients were in hospital. Postoperative complications included 2 cases of transient atrial fibrillation and 1 case of postoperative bleeding requiring rethoracotomy for hemostasis. The EF in the late postoperative period showed improvement in 8 cases and was unchanged in the remaining case; the mean postoperative EF was 56.9% for the 9 subjects. All cases were rated as improved based on the NYHA classification of cardiac performance, and the significant improvement in EF in 8 of the 9 cases suggests that surgery is safe and can improve prognosis for patients with advanced AS with myocardium thinning and decreased EF.