Noboru Kimura

Indices of relative weight and obesity

Abstract Analyses are reported on the correlation with height and with subcutaneous fat thickness of relative weight expressed as per cent of average weight at given height, and of the ratios weight/height, weight/height squared, and the ponderal index (cube root of weight divided by height) in 7424 ‘healthy’ men in 12 cohorts in five countries. Analyses are also reported on the relationship of those indicators of relative weight to body density in 180 young men and in 248 men aged 49–59. Judged by the criteria of correlation with height (lowest is best) and to measures of body fatness (highest is best), the ponderal index is the poorest of the relative weight indices studied. The ratio of weight to height squared, here termed the body mass index, is slightly better in these respects than the simple ratio of weight to height. The body mass index seems preferable over other indices of relative weight on these grounds as well as on the simplicity of the calculation and, in contrast to percentage of average weight, the applicability to all populations at all times.

Lessons from serum cholesterol studies in Japan, Hawaii and Los Angeles.

Excerpt Two years ago, at the meeting of the College in Philadelphia, we reported some of our findings in South Africa. These data were in conformity with the hypothesis that dietary fat is an impo...

X. Rural Southern Japan

EXPLORATORY surveys in 1956 on the southern Japanese island of Kyushu were important in the background of the entire International Cooperative Study, of which the first five years of follow-up are reported here. The Japanese people and the local doctors were highly cooperative, there was ample confirmation of suggestions that coronary heart disease (CHD) is far less common in Japan than in the United States and many other Western areas, and the concentration of cholesterol in the blood serum was shown to be extraordinarily low (Keys, Kimura et al. 1958). Dietary data indicated that the low serum cholesterol levels observed were largely explained by the extremely low-fat diet, averaging only some 10% of calories from total fats. The view that the relative insusceptibility to CHD and the remarkably low serum cholesterol levels in Japan might reflect racial, i.e., genetic peculiarities was countered by several findings. Japanese from the same general area of Japan who had settled in Hawaii had higher serum cholesterol values and seemed to be much less protected from CHD than their relatives in Japan, while the Nisei in southern California were little if any different from the local white population in regard to CHD and serum cholesterol (Keys, Kimura et al. 1958). Among men of pure Japanese ancestry, the gradient in CHD frequency and in serum cholesterol from

Correlations between electrocardiographic, vectorcardiographic, and echocardiographic findings in patients with left ventricular overload†

Summary Left ventricular echocardiography was employed to assess the vectorcardiographic and electrocardiographic manifestations of left ventricular hypertrophy with or without dilatation. Based upon their echocardiographic and hemodynamic findings, 97 subjects were divided into four groups; 40 patients with left ventricular hypertrophy (LVH), 26 patients with left ventricular dilatation (LVD), 17 patients with aortic regurgitation (AR), and 14 patients with mitral regurgitation (MR). Left ventricular wall thickness, the sum of the thickness of the ventricular septum and posterior wall, correlated well with spatial maximum QRS magnitude (r=0.67) and SV 1 + RV 5 or V 6 (r=0.85) in LVH. On the other hand, dilatation of the left ventricle seemed to play an important role in the augmented QRS voltage in LVD, AR, and MR. A significant correlation was observed between left ventricular diameter at end-diastole (LV diastolic diameter) and QRS interval in LVD, AR, and MR. LV diastolic diameter also correlated with Rx peak time in LVD, Rx and Ry peak times in AR and Ry and Rz peak times in MR. In addition, horizontal QRS configuration was affected by left ventricular dilatation. In LVD and AR, the incidence of a figure-of-8 or clockwise configuration increased in cases with LV diastolic diameter ≥6.5 cm. Thus, left ventricular dilatation was demonstrated to be responsible for prolongation of QRS interval. In LVD and AR, it could induce delay of Rx peak time and consequently QRS loop deformity in the horizontal plane.

The effect of moderate and hard muscular work on the spatial electrocardiogram

Abstract 1. 1. In six normal young men the effect of three basic types of exercise (moderate aerobic: walking at 3 m.p.h., 5 per cent grade for 15 minutes; anaerobic: running at 8 m.p.h., horizontal, 3 minutes; severe aerobic: running at 6 m.p.h., horizontal, for 30 minutes) on spatial mean QRS and T vectors was investigated. 2. 2. Characteristic differences were obtained in the three different types of exercise. In anaerobic work changes of the horizontal angle and the magnitude of the spatial QRS vector contrast with the absence of such changes in the other types of work. 3. 3. Severe aerobic work is characterized by a large shift of the horizontal angle of the T vector to the right, increase of the spatial angle between the mean QRS and T vector, increase of the magnitude of the T vector, and depression of the S-T segment. These changes can be explained on the basis of left ventricular ischemia. The over-all changes in this type of work exceed those in the two other types of work. 4. 4. It is suggested that the shift to the left of the mean T vector and its decrease in moderate aerobic work are due to adaptation, and the opposite changes in severe aerobic work are due to fatigue. 5. 5. On the basis of the results obtained several suggestions for applications to exercise tests in clinical electrocardiography are made.

The spatial orientation of the plane including the mean QRS and T vector of the normal electrocardiogram.

For measurement of the spatial orientation of planes in the analysis of the spatial vectorcardiogram, a simple device is developed to be used with Simonsons vector analyzer for the conventional electrocardiogram. The prospective value of this method is shown for the measurement of the plane including the mean QRS and T vector.