The purpose of this study was to clarify the effects of wearing a cooling jacket and drinking water on thermoregulatory responses during arm cranking exercise in individuals with spinal cord injury (ISCI). Six males with paraplegia (L1-Th6) exercised for 30min at 20 watts in a hot environment (33℃, 80% relative humidity) under three separate conditions: no drinking (ND), drinking water (D), and combination of drinking water and wearing a cooling jacket (). Tympanic membrane temperature (Tty), skin temperature and heart rate were continuously monitored. Although in all conditions Tty increased during exercise, the rate of increase was smallest in . Significant difference was noted between ND and for Tty (P<0.05). The arm and thigh skin temperature were also lower in in comparison to ND and D. Total sweat loss in ND and D (300g) was significantly greater than those in (190g) (P<0.05). Heart rate in significantly decreased at the end of exercise compared to ND. These results indicated that combination of drinking water and wearing a cooling jacket yielded an attenuated thermoregulatory and circulatory strain in ISCI.

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The pressure effects on an S=1 Haldane compound Ni(C₅H₁₄N₂)₂N₃(PF₆) (NDMAP) have been investigated through the magnetic susceptibility (χ) measurements using single crystalline samples and the powder x-ray structural analysis experiment under pressure up to 11.5 kbar. The crystal-axis dependence of χ has been analyzed with the results of quantum Monte Carlo simulation. The results suggest that both the intrachain interaction (J) and single-ion anisotropy (D) are enhanced by pressure: J=31.5 K (P=0 kbar) → 90.0 K (10.0 kbar) and D⁄J=0.3 (P=0 kbar) → 0.4 (9.5 kbar). As for J, there is the linear increase against pressure as ⁄dP=2.0 K/kbar in the pressure region below P=8.0 kbar, at around which ⁄dP rapidly changes to ⁄dP=2.1×10¹ K/kbar. The ratio of D⁄J changes within 0.3–0.4, and this result suggests that D as well as J drastically change at around P=8.0 kbar. Furthermore, at P=9.5 kbar, the development of paramagnetic moment on the easy plane is detected, and it is assumed that the interchain interaction may be also enhanced under pressure. The structural analysis shows that the interchain shrinkage is larger than the intrachain one. However, a result concerning the rapid changes of J and D at around P=8.0 kbar has been not observed, and we suppose that the changes of bond-angles such as –N–Ni–N– and –N–N–N– as well as interatomic shrinkage probably change under pressure. We assume that those bond-angles of NDMAP at around P=9.0 kbar (J\\simeq70 K) may become close to those of Ni(C₅H₁₄N₂)₂N₃(ClO₄) (NDMAZ), where the value of J is 71.0 K.

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The purpose of the present study was to examine the importance of the agonist muscle activity of the post-impact 30 ms phase during drop jump () for effective rebound performance by comparing those of sprint runners and swimmers. The eight sprint runners (SPRINT) and twelve swimmers (SWIM) were participated in this study. They performed from a 0.3-m height box with maximal rebound efforts. Electromyograms (EMG) of the lower leg muscles (medial gastrocnemius [MG], soleus [SOL] and tibialis anterior [TA]), and vertical ground reaction force together with kinematic data were measured simultaneously during . In addition, the onsets of fascicle stretching of the MG and SOL muscles were measured by using high-speed ultrasonography (521Hz) during . The onsets of the fascicle stretching of SOL during were not significantly different between SPRINT and SWIM (15 ± 7 ms and 16 ± 6 ms, respectively). During , SPRINT showed onset of the SOL EMG before the ground contact (-26 ± 19 ms). Meanwhile, SWIM showed the onset of the SOL EMG after the ground contact of (16 ± 19 ms). These results suggest that the SOL muscles for SWIM cannot be fully-activated during the braking phase. Consequently, the rate of force development during the braking phase of and subsequently rebound height could be reduced in SWIM.

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運動学的視点から見た活動再建の考え方…伊勢　眞樹　176

立位・歩行の機能再建…長谷　公隆　181

ロボットによる対麻痺者の歩行再建…田辺　茂雄，平野　　哲，才藤　栄一　185

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A 26-year-old man presented with a case of angiocentric glioma manifesting as medically refractory epilepsy. Magnetic resonance imaging revealed a hyperintense lesion in the right superior frontal gyrus on T₂-weighted imaging, with cortical hyperintense rim on T₁-weighted images and minimum contrast enhancement. Video-electroencephalography (EEG) monitoring characterized his seizures as originating from the right frontal lobe. Long-term EEG recording from implanted subdural electrodes disclosed epileptic activities extending beyond the margin of the radiological lesion. Extended cortical resection of the superior frontal gyrus including the tumor and the surrounding epileptic cortices was performed. Postoperatively, he became seizure-free with antiepileptic medication during a 12-month follow-up period. Histological examination of the surgical specimen showed the characteristic findings of angiocentric glioma. Associated cortical dyslamination consistent with cortical dysplasia was found in the surrounding cortex. Angiocentric glioma is a slow-growing or stable tumor frequently presenting with intractable epilepsy. Surgical treatment would be aimed primarily at control of epilepsy. Complete lesionectomy usually results in postoperative seizure freedom, but the present case shows evidence for associated cortical dysplasia with this tumor entity. Careful pre-surgical evaluation for epilepsy is necessary to achieve better seizure outcome.

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We report a case of osseous choristoma on the tongue radix. A 25-year-old woman with Turner syndrome was seen for a 10-year-old asymptomatic tongue tumor. Assuming it to be benign, we totally resected the tumor through an oral approach under general anesthesia. The pathological diagnosis was osteoma of the tongue, called osseous choristoma. She had undergone estrogen and progestogen treatment for Turner syndrome. We concluded that estrogen treatmenat triggered osseous choristoma due to accelerated new bone formation.

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To evaluate the behavior of circulating endothelin and atrial natriuretic peptide (ANP) during coronary artery bypass graft (CABG) surgery, blood samples from patients with coronary artery disease (n=8) were investigated before, during and after operation. Plasma levels of endothelin and ANP were determined using the radioimmunoassay method. Baseline plasma levels were compared to those of normal volunteers (n=6). Left ventricular function at rest and as a response to isometric exercise was evaluated using radionuclide ventriculography before and after coronary bypass surgery.
The mean endothelin value was found to be within normal limits, however the mean ANP value was slightly higher than control. Patients had significantly improved left ventricular systolic and diastolic function after surgery. The mean endothelin level was higher than initial values immediately after extra-corporeal circulation and returned to initial values in two hours. However, ANP values were increased and remained higher than initial values. Baseline endothelin values were negatively correlated with systolic function parameters, whereas endothelin and heart rate had a positive correlation before extra-corporeal circulation.
Coronary artery bypass graft surgery may cause an increase in the circulating endothelin level either due to endothelial injury or due to myocardial ischemia and hypothermia. Following surgery, increased endothelin levels returned to normal values immediately.

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This retrospective study investigated the correlations between red blood cell (RBC) count, hemoglobin, and hematocrit on admission, and mortality in 140 patients with subarachnoid hemorrhage (SAH). Correlations between the hematological parameters RBC count, hematocrit, hemoglobin, white blood cell (WBC) count, and platelet count on admission and mortality were investigated. Association of each variable with mortality was tested by univariate and multivariate logistic regression analysis. Univariate analysis showed that mortality was associated with RBC count, hematocrit, hemoglobin, and platelet count. Multivariate logistic regression analysis revealed hematocrit, WBC count, and platelet count were significant independent predictors for mortality after SAH. Hematocrit was a new significant predictor related to mortality in patients with SAH.

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A 7-year-old boy presented with acute onset of left hemiparesis and headache, followed by disturbance of consciousness. Neuroimaging studies showed pontine hemorrhage. Surgery was performed to remove a massive hematoma. Histological examination of the wall revealed anaplastic astrocytoma. Postoperative radiation therapy and several types of chemotherapy were administered. However, the tumor recurred and he died 9 months after onset. Hemorrhagic onset of pontine glioma is rare and carries an extremely poor prognosis.

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A 26-year-old female with idiopathic moyamoya disease developed chest pain with concomitant ST depression on electrocardiography. Coronary angiography detected no stenotic lesions in the epi- cardial coronary arteries. The clinical diagnosis was vasospastic angina pectoris. She was medicated with calcium antagonists, which reduced the frequency of chest pain episodes. Angina pectoris is a rare occurrence in young patients with moyamoya disease. Coronary artery disease and moyamoya disease may have common etiological factors.

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A case of multiple myeloma whose plasma cells showed hemophagocytosis is reported. A 70-year-old man was diagnosed having multiple myeloma with circulating plasma cells (15%). The plasma cells assumed the morphology of plasmacytoid lymphocytes and 22% of them showed phagocytosis of erythrocytes, platelets, or erythroblasts. Clinically, no osteolytic lesion was found. Immunological marker study revealed 34% of the plasma cells had receptors for C₃.
The clinical features of patients with phagocytic plasma cell myeloma in the previous reports were compared with those of common myeloma patients. It is proposed that phagocytic plasma cells tend to migrate to peripheral blood from the bone marrow and have a decreased tendency to form tumor masses.

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A 47-year-old man presented to our hospital after suffering transient loss of consciousness and falling to the floor. On admission, his Glasgow Coma Scale score was 11 (E3V3M5), and he exhibited restlessness. Blood examination revealed hyperthyroidism. Computed tomography showed slight traumatic subarachnoid hemorrhage. He developed fever and tachycardia, and was diagnosed with thyroid crisis. Magnetic resonance imaging showed a brain contusion in the right frontal lobe, and encephalopathy signs in the right frontal and insular cortex. Immunocytochemical examinations suggested Hashimoto's disease, and hormone examinations revealed plasma levels were undetectably low of adrenocorticotropic hormone (ACTH) and low of cortisol. Pituitary stimulation tests showed inadequate plasma ACTH and cortisol response, consistent with isolated ACTH deficiency (IAD). The final diagnosis was IAD associated with Hashimoto's disease. Hydrocortisone replacement therapy was continued, and the patient was nearly free from neurological deficits after 18 months. The neuroimaging abnormalities gradually improved with time.

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本試験では，新開発 LED 照明による室内環境制御による快適性について，睡眠改善効果および日中使用時の生体への作用により検証するため，成人男性を対象としたランダム化 2 試験区クロスオーバー試験を実施した．ピッツバーグ睡眠質問票 (PSQI) にて睡眠障害の基準である 5 点以上を示す 12 名において，新開発照明または従来照明の条件下で，睡眠 (22:00～7:00) および 4 時間の精神作業負荷を実施した．
その結果，睡眠評価において，新開発照明（試験色 1）は眠り SCAN による睡眠状態の評価，セントマリー病院睡眠質問票による主観的評価により，顕著な睡眠改善効果が確認された．さらに，日中使用時の評価において，新開発照明（試験色 2）は，照度が低いにも関わらず，作業能率の低下をはじめ日中の作業時において悪影響となる作用は認められなかった．
新開発 LED 照明は就寝前の適切な照度および色温度の環境をつくり，室内環境の快適性を高める有用な機器であると考えられた．

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A 15-year-old high school boy visited our hospital because of the passing of “Cola”-like dark urine which occurred immediately after “Kendo” training and lasted for several hours only.
“Kendo” exercise test was performed: he was instructed to repeat to step barefoot strenuously on floor board (“fumikomi” training) for 60 minutes.
The examination of the urine and blood taken immediately after exercise revealed the hallmarks of intravascular hemolysis including a raised plasma hemoglobin value, lowered serum haptoglobin, elevated serum lactic dehydrogenase level and hemoglobinuria with no red blood cell in sediment. Only a trace of myoglobin was detected in the urine. These abnormalities gradually decreased in intensity and all of them except serum haptoglobin were normalized 24 hours after the exercise test.
Based on the clinical findings and the results of exercise test, a diagnosis of march hemoglobinuria following “kendo” exercise was made. The trace of the myoglobin in the urine was considered to be due to physiological phenomenon for muscle activity.
It was reported in addition that his apparently healthy elder brother was tested in the same way and the urine was straw colored and clear, with no hemoglobin, while the blood showed significant increases of plasma hemoglobin and serum lactic dehydrogenase and a significant decrease of serum haptoglobin.

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A 3-year-old girl presented with a transethmoidal meningoencephalocele manifesting as recurrent rhinorrhea. Initially, she developed meningitis, but after treatment she experienced rhinorrhea. Two months later, she again presented with rhinorrhea. Neuroimaging studies revealed a small protrusion (15 mm × 10 mm) at the roof of the ethmoidal sinus. Nasal endoscopy confirmed the diagnosis of meningoencephalocele. The operative findings revealed a small hole in the left olfactory bulb, which had descended into an enlarged foramen along with the arachnoid membrane. The left olfactory bulb was removed, and the enlarged foramina of the lamina cribrosa were covered with a frontal pericranial flap. The defect in the bone was very small, but contributed to the development of meningitis and leakage of the cerebrospinal fluid. Basal cephalocele should be considered in a patient with recurrent rhinorrhea and intracranial infections, even in the absence of any apparent anomaly.

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　ストーマ旁ヘルニアはストーマ造設後にみられる後期合併症の一つであるが，絞扼性イレウスを呈するものはまれである．我々は先行する脱出腸管とは別係蹄の腸管が嵌入したことによって絞扼性イレウスを発症したと考えられる回腸導管ストーマ旁ヘルニアの1例を経験した．症例は86歳の女性で，30年前膀胱癌のために膀胱全摘術および回腸導管造設術を受けていた．数年前から回腸導管ストーマ旁ヘルニアを認めていたが，経過観察していた．平成20年1月起床後にストーマ周囲に著明な膨隆を認め，精査の結果回腸導管ストーマ近傍から小腸および結腸が脱出し，嵌頓していたため，緊急手術を施行した．ヘルニア嚢内には30 cmの回腸と5 cmの横行結腸を認めた．壊死した2か所の脱出腸管を切除し，ヘルニア門の単純縫合閉鎖を施行した．再発を認めず外来経過観察中である．

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Seed dispersal effectiveness (SDE) is one of the best parameters for estimating the benefit that a plant obtains from a dispersal agent. SDE includes quantitative and qualitative components. Previous avian studies of SDE estimation have been conducted mainly in temperate shrub lands or in tropical forests; data are limited for temperate forests, especially, the quality of seed-deposition sites. In this study, we estimated the SDE of birds for Wild Cherry Cerasus jamasakura and Giant Dogwood Cornus controversa fruits in a temperate Japanese forest. These trees prefer sunny sites so we focused on the light conditions at seed-deposition sites and categorized three microhabitat types: forest-gap, forest-edge, and forest-interior. We observed avian seed removal at fruiting trees, conducted a bird census to estimate microhabitat selectivity and collected bird-dispersed seeds. We then counted seedling emergence. Finally, we constructed generalized linear mixed models that combined bird census and dispersed seed data to identify influential seed disperser(s) for each tree species. Frugivorous behavior was recorded for eight avian species for C. jamasakura and 12 for C. controversa. Of these birds, one for the former, and two for the latter preferentially selected forest-gap or forest-edge trees during each fruiting period. The density of dispersed seeds and seedlings was higher in the forest-gap or forest-edge. Additionally, the frequency with which Japanese White-eye Zosterops japonicus visited was a significant variable for seed density in each microhabitat. The results suggested that microhabitat selectivity may affect the density of dispersed seeds in each microhabitat. Furthermore, a bird with a high quantitative SDE may not necessarily also have a high qualitative SDE. Thus, it is important to estimate qualitative and quantitative SDE by focusing especially on the seed-deposition site for each bird in order to evaluate the actual SDE in temperate forests.

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