小児心電図では記録時の体動, 年齢による変化, 大規模データベースの欠如などの理由で, インテリジェント化は他分野に比べて遅れている. しかし, 学校保健法改正に伴う児童・生徒の心臓集団検診普及に従って, 新たな年齢別・性別の診断基準によって作られた可搬性の高い機器の完成が望まれる.

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1984年から1992年の9年間の,学生のランニング中の突然死の全国疫学調査を実施し,次の結果を得た.学生の全スポーツ中の突然死のうちランニング中の突然死は約42.0%を占め,最多である.進学するに伴い,ランニング中の突然死は増加し高校生でピークに達する.男性の比率は上昇し高校生と,大学生・短期大学生および他学生との間で顕著である.疾患群は減少する傾向にある.また,剖検死因では約85%を心臓疾患が占め,死因(剖検率25.8%)において占める心臓系疾患の割合である94.5%よりも,約10%少ない.検死のみによる死因の決定では心臓疾患とされやすいことが危惧され,正確な死因を確定し今後の予防に貢献するためにも剖検による死因の決定が不可欠である.

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1976年から1995年までの20年間の東京都23区内の学生・生徒の急死例の疫学調査を実施した。総数は255件であり,年別,月別,発生時状況,学生・生徒別,性別,健康状態,死因,治療状況,受診状況について検討し次の結果を得た。学生・生徒の急死は年平均12.8件発生し経年変化はほぼ一定であり,8月に多い。学校管理下での発生は約3割であり,そのうちスポーツ中は約6割である。男女比はどの学生も2:1であり,どの学生の健康状態でも健康群(自分が健康であると確信しているもの)と疾患群(直接死因となりうる既往症を指摘されているもの)の比率は約1:1である。死因は急性心機能不全63件,気管支喘息34件,心筋炎22件の順に多い。健康群の比率が高い死因は,急性心機能不全,心筋炎,脳内出血,クモ膜下出血,消化管疾患である。心筋炎,消化管疾患,気管支喘息で療養中の比率が高く,虚血性心疾患でスポーツ中,肥大型心筋症で歩行中の比率が高い。来院時心肺停止が約6割,病院外死亡および救急入院・受診中死亡は各2割である。突然発症した例は117件(45.9%)であり,症状があったが容体急変まで医療機関にかからなかった例は60件(23.5%)である。症状があり医療機関を受診したが自宅で容体急変した例は37件(14.5%)であり,消化管疾患の60%および心筋炎の45.5%がこの経過である。学生・生徒の突然死を予防するうえで,最多を占める原因不明の急性心機能不全の突然死機序の解明が待たれ,心筋炎のように発症からある程度の経過があるものについては早期診断・適切な経過観察の方法の確立が求められる。

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目的：perimembranous VSD症例の生後1か月時点における標準12誘導心電図による予後予測の有用性を明らかにすること．

対象と方法：生後1か月時点で標準12誘導心電図が施行され，1歳時に経過観察を受けたperimembranous VSD 44例を対象として，自然閉鎖群（C群）14例，未閉鎖群（U群）17例，手術群（O群）13例の3群に分類し，心電図所見を比較検討した．また，O群対非O群（C群＋ U群），C群対非C群（O群＋ U群）により手術および自然閉鎖の予測因子も検討した．

結果：結果は（C群vs. U群vs. O群，p値）と記載する．3群の比較ではO群でV1の陽性T波（0％ vs. 11.8％ vs. 84.6％，p＜0.001）が有意に多く，V5のR波が有意に高かった（1.81 (0.72–2.88) mV vs. 2.07 (0.90–3.77) mV vs. 2.34 (1.55–3.85) mV, p＝0.027）．O群と非O群の比較ではV1の陽性T波が有意に多く（84.6％ vs. 6.5％，p＜0.001），V1のR波は有意に高かった（1.64 (0.60–4.73) mV vs. 1.21 (0.29–2.62) mV, p＝0.015）．一方，非C群とC群の比較ではV1の陽性T波が有意に少なく（0％ vs. 43.3％，p＝0.003），V5のR波（1.81 (0.72–2.88) mV vs. 2.13 (0.90–3.85) mV, p＝0.025）とS波（0.61 (0.35–1.55) mV vs. 0.99 (0.26–2.98) mV, p＝0.036）は有意に低かった．

結論：perimembranous VSD症例の生後1か月時点における標準12誘導心電図は予後予測に有用であることが示唆された．

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This study investigated the applicability of item response theory to a questionnaire survey. Parents of 288 kindergarten students were asked about their children's food tastes and eating habits. The Squared Simple Logistic Model, which is an unfolding model of the item response theory, was applied to the food survey data. Food taste parameters and individual taste parameters for food were computed using the maximum likelihood method and Newton-Raphson method. The applicability of item response theory to the questionnaire survey was examined by considering the correlations of food taste parameters and eating habits, the fitness of the model to the data, and comparison of the results with Quantification Theory Type Three. The following results were obtained:
1) Food taste parameters corresponded to the degree to which a child likes the taste of healthy/unhealthy food. Food taste parameters were significantly correlated with bad eating habits, and fitted the model sufficiently.
2) Considering the information function of the scale comprising food taste parameters, this scale was not a screening test type but rather a selective test type or a discriminating test type, and successfully discriminated among three types of eaters: “problematic,” “intermediate,” and “good.”
3) Using Quantification Theory Type Three, which, unlike item response theory, does not assume any latent traits, two sets of food taste category weights for individual data, divided randomly, were computed. The correlation between the two sets of category weights was lower than that of food taste parameters selected using item response theory. This finding indicated the advantage of item response theory over Quantification Theory Type Three from the standpoint of parameter stability.
4) Finally, to enhance the practicability of this scale, a conversion table for typical data with a high likelihood of fitting into a parameter we had already obtained, as well as showing a good fit to individual taste parameters, was devised.

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The purpose of this study is to obtain the normal ranges of electrocardiograms of Japanese elementary school children and to compare with each group separated by age and sex. Materials and Methods The subjects were 984 healthy children (506 boys and 478 girls) selected at random from all children (3532 boys and girls) in an elementary school in Nagoya, Japan. They were accepted as healthy children on the basis of their daily unrestricted activity and through a series of medical examinations. The subjects were sub-divided into twelve groups by sex and age for further analysis of their electrocardiograms. The 12 conventional leads and Lead V₃R were recorded for all subjects. The amplitudes and intervals of electrocardiographic deflections were carefully measured in each lead. In this paper 95 percentile of frequency distribution was accepted as a normal range for each component of the record. Results and Discussion RR interval was longer with increasing age both in boys and girls. The increasing rate of RR interval was more prominent in the boys than in the girls, and the difference of mean RR intervals reached a statistical significant level in the groups of 10 and 11 years old. According to above data, it was concluded that the normal range of RR interval should be set up separately; 0.48 to 1.00sec. for 6-9 years, and 0.54 to 1.08 sec. for 10-11 years. Although PQ interval also increased along with age, no significant difference was found for boys and girls. The normal ranges of PQ interval were 0.12 to 0.18 sec. for 6-9 years and 0.13 to 0.19sec. for 10-11 years respectively. The increasing rate of QT interval was less remarkable than RR or PQ intervals, and the mean of boys was significantly longer than that of girls in elder age group. A single normal range could be accepted for QT intervals as 0.28 to 0.40sec. for the all age groups. Though PQ interval tended to be longer with increasing RR interval except in the group with tachycardia, no significant correlation was observed for PQ and RR intervals. Correlation coefficients of RR with QT intervals were very high and proved statistically significant both in boys and girls and for all age groups.

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学童心臓集団検診の中にホルター心電図法を実用化し, その意義について検討した。検診対象約20万人のうち何らかの異常のあった2, 037人中重篤な不整脈, 危険の大きい不整脈を持った患児76名を対象とした。
そのうち心室性期外収縮42名中Lown重症度分類4A以上が8名, 3度房室ブロックの患児では運動時心室性頻拍が認められ, また洞不全症候群が発見されるなどその意義は大きく, 学校生活の管理区分や指導にはきわめて有用であった。
しかしその記録, 解析には多大の時間と労力を必要とするのでその解決法についても述べた。

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The relation of obesity to systolic blood pressure, HDL-cholesterol and ratio of low-and very-low-density lipoprotein cholesterol to high-density lipoprotein cholesterol (atherogenic index: AI) was investigated in 1, 216 subjects aged 9-10, and 12-13 years in Susono City, Shizuoka prefecture. In boys, the risk-factor variables showed strong correlation to trunk fat levels (subscapular skinfold). Among girls, fat levels in the both trunk and limb showed less correlation with the variables than among boys.
Furthermore, among obese (i.e., obesity index of over 20%) boys, trunk fat levels correlated even more strongly with the risk-factor variables. Since obesity correlates with risk-factor variables in children, prevention of obesity onset in early life may be important in reducing the risk of atherosclerotic disease in later life.

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