Many epidemiological studies revealed strong association of obesity with risk factors for cardiovascular disease such as high blood pressure, dyslipidemia, glucose intolerance. Many clinical trials have shown that weight reduction by means of calory intake restriction with or without physical exercises significantly improves risk profiles. In adition, it was recently reported that visceral adeposity is more pathogenetic than hypodermal adiposity and this visceral obesity is closely related to insulin resisitance syndrome.
We dicussed the importance of obesity in pathogenesis and management of cardiovasclar diseases. Because obesity is a modifiable risk factor, we must help overweight patients to control their body weight.

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To improve the total safety for the biplane cerebral angiographic examination, we have developed a new 3D display system. By applying this system, shortening the examination time and reducing the risk of infection and embolization were achieved.
We added just one graphic-workstation for 3 D reconstruction to an ordinary biplane digitalcine-angiography system. This system can process the images of angiogram extempore and display the run of arterial vessels to the examiner.
Biplane images were taken from the digital-cine-angiography system into the workstation through a video display. Three dimensional positions were calculated and displayed on a CRT monitor. It took from 15 to 45 seconds for the calculation. This system could display instantly the run of arterial vessels from any angle by using the computer mouse.
Our system doesn't disturb the examination, but helps us to understand the run of the arterial vessels. This system was useful in cases where the arteries wound their way around or overlapped each other.

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We could control the time to pick up oocytes by use of GnRH analogue, and treated 15 cycles by administration of GnRH analogue and FSH. We had 13 cycles IVF and 12 cycles of ET. Mean dose of FSH was 75 IU×19.5. Mean number of aspirated follicles was 8.9, mean number of recovered oocytes was 4.4 and recovery rate was 49.1%. Cleavage rate was 52.6% and pregnancy rate was 23.1%. 3 pregnant patients were all single pregnancy and they had normal deliveries with healthy infant.

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We reported the relations between ages and cause of death in multiply handicapped patients, who died in national hospitals from 1982 to 1994. The mean age at death of all cases is 17.38±10.45 years old. Those of pneumonia and bronchitis are 15.59±10.09 years old (p<0.0001), 12.09±6.50 years old (p=0.0036), respectively. Those are lower significantly as compared to that of all cases. Renal failure is 20.65±9.86 years old (p=0.0468), and ileus is 25.36±11.09 years old (p<0.0001). Those are higher significantly as compared to that of all cases. Most common cause of death among each group of patients under 6 years of age, over 6 years of age and under 18 years of age, over 18 years of age and under 40 years of age, over 40 years of age, are pneumonia.

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[in Japanese]

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Recently hemorrhagic pulmonary infarction is considered to be one of most common causes of death in Duchenne muscular dystrophy. Cause of hemorrhagic pulmonary infarction in Duchenne muscular dystrophy is still unknown. Recently, we experienced a patient with Fukuyama congenital muscular dystrophy who suddenly died of hemorrhagic pulmonary infarction.
In this paper, we reported hemorrhagic pulmonary infarction in Fukuyama congenital muscular dystrophy for the first time and discussed the pathophysiology of hemorrhagic pulmonary infarction in muscular dystrophies.

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Here, I report a recently experienced case of concomitant occurrences of ectopic calcification in the pelvic cavity and a rapid destruction of the hip joint. The patient was a 47-year-old woman who had been undergoing dialysis for long since 1978. She visited us with a complaint of hip joint pain. The ectopic calcification in her pelvic cavity was apart from the hip joint only by a capsula. From the evidence that the tumoral calcification in the pelvic cavity had a shrinking tendency after the artificial joint replacement, it was suggested that the mechanism underlying the development of the ectopic calcification might been different from that for the rapid destruction type of conarthrosis, however, there may be some common factor mediating the both as an inducer.

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We report successful treatment of multipule problematic behaviors of a mentally retarded patient. The case was a 30 years old male. He was diagnosed as mild mental retardation. At the age of 27, he started to exhibit checking rituals and agressive behaviors. At the age of 28, he experienced repeated rectal prolapse. Soon after that episode he started food refusal and vomiting additionally. At the age of 30, he injured himself. He was admitted to our hospital as an emergency case. He continued to show various impairment of behaviors during admission. We identified stimuli which preceded these behaviors.

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We report a case of Bartter's syndrome complicated by rectal cancer, and discuss the perioperative management of Bartter's syndrome. A 26-year-old woman was admitted because of anemia and hypokalemia. Barium enema examination revealed an apple-core sign in the rectosigmoid region. Adenocarcinoma was diagnosed on the basis of histologic examination of a biopsy specimen. Bartter's syndrome was suspected because blood pressure was normal, despite markedly elevated levels of plasma renin activity and aldosterone, and hypokalemic metabolic alkalosis was present. Intravenous potassium canrenoate and potassium chloride were given, and after serum potassium levels had returned to normal range, anterior resection of the rectum was performed. The patient was given general anesthesia (50% nitrous oxide-oxygen with 0.2% to 1.0% enflurane) and epidural 2% mepivacaine. Postoperatively Bartter's syndrome was diagnosed on the basis of preoperative findings, impaired vasopressor response to angiotensin II, and evidence of hyperplasia of the juxtaglomerular apparatus in kidney biopsy specimens.

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