Background/Aims: Colorectal polyp detection during colonoscopy is influenced by the lesion location, size, morphology, and histology. However, no studies have systematically assessed the difficulty of detection along the short axis of the intestinal lumen. This study aimed to evaluate the colorectal polyp detection rates on this axis during colonoscopy. Methods: This retrospective study analyzed 1,169 polyps in 513 patients who underwent colonoscopy at Showa University Hospital between November 2022 and February 2023. The short-axis lumen was divided into: upper right, lower right, lower left, and upper left. Each polyp detected was assigned to a quadrant. Detection rates were compared across quadrants and analyzed for associations with clinicopathological factors including lesion size, location, macroscopic type, and examiner experience. Results: The lesion detection rates varied significantly by quadrant. The upper left quadrant had the lowest detection rate (17.5%) compared with the expected 25.0% per quadrant. Subgroup analyses consistently confirmed the lower detection rates in this quadrant across most lesion types and patient groups, except for lesions in the cecum and rectum. Conclusions The lower detection rate in the upper left quadrant suggests that this orientation poses a challenge and may increase the number of missed lesions. Enhanced examination of this area may improve detection; however, further prospective studies are required.

A 72-year-old female received surgical aortic valve replacement for severe aortic stenosis in our hospital. During surgery, black pigmentation was observed in the aortic valve, aorta intima and mitral valve anterior leaflet collocated with calcification. We suspected Alkaptonuria (AKU) as a possible diagnosis for those surgical findings, past medical history and physical findings. A urine test for organic acids showed homogentisic, confirming the diagnosis of AKU. AKU is very rare genetic metabolic abnormality that occurs in about 1 in 25,000 to 100,000 people. AKU involves deficiency in the gene coding for HGA-1,2-dioxygenase, which metabolizes homogentisic acid to maleylacetoacetic acid in the tyrosine metabolic pathway. HGA accumulates in the body, causing black pigmentation in places including the aorta intima and mitral valve.

Herein, we present a case of aortic root replacement 42 years after aortic valve replacement (AVR) with the Björk-Shiley Spherical (BSS) valve in a patient with an aortic root aneurysm. The patient was a 67-year-old man who had undergone AVR with BSS and aortic root enlargement for the treatment of infective endocarditis and aortic insufficiency at 25 years of age. He underwent aortic root replacement for an enlarged aortic root (73 mm). Under general anesthesia, median re-sternotomy was performed, and the BSS valve was removed. The valve functioned well with no pannus or thrombus. We performed an aortic root replacement using a composite graft consisting of a 24-mm mechanical valve and 30-mm artificial graft. We experienced a rare case of long-term durability of the BSS valve, which functioned well for 42 years.

Purpose of this study was to examine the recovery process of delayed onset muscle soreness, jump performance, force to contact with the ground and lower limbs movement after intensive jump exercise (IJE), and the relationships between muscle soreness, changes of jump performance and lower limbs movement. Nine males who have experience in special jump exercise participated in this study voluntarily. For the measurement, subjective investigation of the muscle soreness, drop jump performance using a 30 cm high box [jump height, contact time and drop jump index (jump height / contact time)], ground reaction force and movements of lower limbs. This measurement was carried out before IJE (Pre), and at 4 hours (P4), 24 hours (P24) and 72 hours (P72) after IJE. Main results are as follows ; at the time of P24 when intense muscle soreness appeared, significant jump height decreases and contact time increases were shown, and the jump index decreased markedly. This decrease of performance correlated to the change of knee and ankle joint movements during the eccentric phase. At P4, for a subject who felt strong muscle soreness, the decrease of jump height and jump index were considerable. At P72, most subjects recovered to the levels of jump height and contact time to the Pre level. The findings reveal that the jump performances are related to the degree of delayed onset muscle soreness.

The purpose of this study was to investigate the influence of physiological factors which effect oxygen kinetics and energy system contribution on the power of Wingate test (WT), with focusing on the difference of aerobic capacity. Twenty three male track and field athletes (sprinters, long distance runners and decathletes) performed the WT on electromagnetic-braked cycle ergometer. The applied resistance was 7.5% of body weight, and the duration was 60 seconds. Moreover, aerobic capacity (maximal oxygen uptake [VO₂max]) was determined by an incremental test, and anaerobic capacity (maximal accumulated oxygen deficit [MAOD]) was determined by a supramaximal constant load test. The oxygen uptake during each test was recorded by a breath-by-breath method. The participants were divided into two group which was high VO₂max group (High group; n = 11) and low VO₂max group (Low group; n = 12). In the results, although the VO₂max was significantly higher in the High group, the MAOD was not significantly different between two groups. The oxygen uptake during WT was significantly higher in the High group, and the accumulated oxygen deficit during WT was significantly higher in the Low group. The aerobic contribution was significantly higher in the High group than in the Low group. In contrast, the anaerobic contribution was significantly higher in the Low group than in the High group. These results suggest that by the difference of aerobic capacity, aerobic and anaerobic energy supply contribution was different in WT.

Patient compliance with presciibed drug regimens may be improved by finding out incom-pliant patients and exhorting them to take their medicines, but it's not an easy task. We telephoned those who had not shown up at the pharmacy within 7 days after the preparation of their drugs to come and receive the dispensed drugs. When the dispensed drugs had to be disposed of after a long misplacement, we prepared a “patient compliance report” to inform the attending physicians about noncompliance by attaching it to the patient's visit history. Further, of when they visited the hospital again we gave guidance about drug compliance at the window to those whose dispensed drugs had been disposed.
We contacted 63 patients by telephone during the 3-month period from January to March 1995 of the patients who left their drugs at the pharmacy, and found 30.6% of them had some compliance problems. Telephone calls were effective for reducing the proportion of the patients whose dispensed drugs were disposed of to 0.03% from 0.11%, the percentage worked our during the 5-month period from August to December 1994 during which no telephone call was made. We reported 19 drug disposal cases to the physicians by means of the “patient compliance report”. All the physicians appreciated it as they were brought to a realizatopn of the drug compliance rate of their patients.
As there were some patients who did not know that their drugs were prescribed, we considered how to cope with the left dispensed drugs would not be a question of the pharmacy alone. It should be handled as a problem of the whole hospital from the stage ofconsultation to payment.