The case-fatality rate from acute myocardial infarction (AMI) appears to have been declining in recent decades, so the present study reviewed the trend in in-hospital case-fatalities from AMI in Miyagi Prefecture, Japan, 1980-1999. The causes of death and the effects of gender and age on the trend were also analyzed. From the AMI registration database of the Miyagi Study Group for AMI, 12,961 cases of AMI were analyzed. The 30-day in-hospital case-fatality was calculated from the data for 1980-1999: data for causes of death were available for 1980-1997, and the data concerning primary percutaneous transluminal coronary angioplasty (PTCA) for AMI were available for 1997-1999. The in-hospital case-fatality rate declined from 17.0% in the early 80s to 7.3% in the late 90s (approximately 57% reduction). The in-hospital case-fatality rate was higher in female patients. Rhythm failure substantially decreased in the late 1980s. failure is decreasing, but is still the biggest problem. The in-hospital case-fatality rate was significantly lower in patients received PTCA. The declining trend in the in-hospital case-fatality rate suggests the benefits of current therapeutic procedures, including primary PTCA, for AMI. failure is an important target for further decreasing the trend. (Jpn Circ J 2001; 65: 941 - 946)

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Eosinophilic gastrointestinal diseases (EGIDs) are distinct immunologic diseases that show a variety of clinical manifestations and endoscopic findings with unknown cause or association of immunologic diseases. The incidence of eosinophilic esophagitis (EoE) seems to be increasing, although it is still unclear whether this is general phenomenon or attributable to an increased awareness of the disease. Our aim was to examine clinical features, endoscopic findings, and associated diseases of 4 cases of EGIDs. These cases included 1 eosinophilic gastroenteritis and 4 EoE, 3 men and 1 woman, and the mean age was 46±7 year-old. The most common endoscopic findings were mucosal edema, linear furrows, and rings in esophagus, and white specks in colon. An increased number of eosinophils was infiltrated in esophageal or colonic epithelium. Two cases were complicated with celiac disease (CD), and scleroderma, respectively and all cases were associated with gastroesophageal reflux disease. While one case complicated with CD showed a marked serum eosinophilia, others were in normal serum eosinophils. Three cases were treated with a proton-

inhibitor and the symptoms improved in 2 cases.

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We present a case of a 47-year-old man with Type 2 diabetes mellitus who attempted suicide with 2, 100 U of insulin injected subcutaneously. Administration of dextrose intravenously was required to maintain the blood glucose concentration normally for 5 days. Moreover, hypokalemia, hypophosphatemia, and hypomagnesemia were also seen for 24 hours after insulin injection. The serum phosphorus and magnesium concentrations decreased to nadirs of 1.6 mg/dl and 1.6 mg/dl respectively 7 hours after insulin injection. Electrolyte disorders other than hypokalemia may be induced in hypoglycemic patients by massive insulin overdose.
(Internal Medicine 39: 55-57, 2000)

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Successful resection of an ascending aortic aneurysm under cardiopulmonary bypass associated with auxiliary carotid and coronary perfusion is reported. The advantages of the cardiopulmonary bypass such as the present method in surgery of aneurysms of the ascending aorta and aortic arch are discussed.

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We report the outcomes of prophylactic cerebral reconstructive surgery aimed at reducing the incidence of perioperative cerebral infarction in patients with intracranial or extracranial occlusive cerebrovascular disease who were scheduled to undergo cardiac surgery. Before the surgery, carotid artery ultrasonography, magnetic resonance angiography (MRA) of the carotid artery, and magnetic resonance imaging (MRI) and MRA of the brain were performed on 875 patients. The high-risk group was defined as: patients with cervical carotid artery stenosis of at least 90%, those with a reduced cerebral perfusion reserve because of occlusion of the internal carotid or middle cerebral artery, and those with a reduced cerebral perfusion reserve because of major intracranial artery stenosis of at least 75%. According to the degree of cardiac reserve, patients in the high-risk group underwent carotid artery stenting (CAS), carotid endarterectomy (CEA), superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis, or percutaneous transluminal angioplasty (PTA). Of the 875 patients, 29 (3.3%) were classified in the high-risk group, and 16 underwent prophylactic revascularization and cardiac surgery. Prophylactic revascularization included CAS in 7 patients (including stenting of the intracranial internal carotid artery in 1 patient), CEA in 4, STA-MCA in 4 and PTA in 1. Cardiac surgery was performed on 870 of the 875 patients, and perioperative cerebral infarction occurred in 11 (1.3%). It is uncertain whether our treatment strategy significantly reduced the incidence of perioperative cerebral infarction because of the lack of accurate information on the number of patients with this condition before the present study. However, 73% of patients had a score of 1 or 2 on the modified Rankin Scale 1 month after the onset of cerebral infarction, suggesting that our strategy improved the outcome.

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A tubular electrolytic cell of ultra micro volume, made of a single carbon fiber (7μm o.d., 15mm length) as the working electrode material and a fused silica tube (50μm i.d.) as the flow cell part, was designed for use as the electrochemical detector in micro high performance liquid chromatography (micro HPLC). The effective cell volume is about 0.03μl. This detector with carbon fiber was useful for detection of catecholamines and their metabolites. Their detection limits were about 1-2pg and the linear dynamic range was about 10³. The detector was successfully applied to urinary catecholamine analysis by micro HPLC and to rapid detection of electroactive species in fast micro HPLC.

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The effect of antisense oligodeoxynucleotides (ODNs) of plasma membrane Ca²⁺-pumping ATPase (PMCA) on rat aortic vascular smooth muscle cells (VSMCs) in primary culture was examined. More than 80% of the PMCA expressed in cultured VSMCs was the PMCA-1B subtype. Exposed to antisense ODNs against PMCA-1, not only the expression of the PMCA protein but also mRNA of PMCA-1B was diminished in a concentration-dependent manner. Extracellular Na⁺-independent ⁴⁵Ca²⁺ efflux catalyzed via PMCA was inhibited with antisense ODNs. Both the resting and ionomycin- or ATP-stimulated levels of intracellular Ca²⁺ were increased by antisense ODNs. Furthermore, prolonged treatment with antisense ODNs caused apoptosis in VSMCs. The occurrence of apoptosis was inhibited by FK506, a potent immunosuppressant. These results demonstrate that the PMCA was specifically inhibited by antisense ODNs and suggest that PMCA plays an important role in regulation of intracellular Ca²⁺ concentrations, especially at the resting condition to prevent an occurrence of apoptosis that may be induced through the activation of calcineurin.

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The resolution of strain measurements using Brillouin scattering in an optical fiber depends on the pulse width of a laser pulse. It was considered that there was a lower limit for pulse width, since the line width of the Brillouin spectrum was broader for shorter pulses. This lower limit is about 10 ns and corresponds to a spatial resolution of 1 m. However, on the contrary, Bao et al. recently discovered a phenomenon in which the line width of the spectrum decreased for a very short pulse with a width of 1 ns when there was light leakage. In this paper, we analyze this phenomenon by solving coupled wave equations using a perturbation method, and clarify the cause of the phenomenon. We then propose an improved Brillouin measurement method using a two-step pulse inspired by the phenomenon and show that its spatial resolution is about 10 cm, which is one digit smaller than the present lower limit.

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The distribution of a tremorgenic mycotoxin, paxilline (1), was investigated in 19 species belonging to the genus Emericella. It was found that Emericella desertorum, E. foveolata, and E. striata produced paxilline (1). A new type of indoloditerpene, emindole (4), was also found in E. quadrilineata. A new tremorgenic indoloditerpene, 1'-O-acetylpaxilline (3), was isolated from the mycelium of E. striata. Its structure was established on the basis of spectroscopic investigations.

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Respiration-dependent H⁺ and Na⁺ pumps and the driving force for ATP synthesis of a psychrotrophic bacterium, strain 13A, isolated from the bottom layer of Lake Vanda, Antarctica, were examined with intact cells. This bacterium was able to grow well over a pH range of 5 to 10 at 25°C in a synthetic medium containing sodium succinate as a carbon source. The growth at alkaline pH was resistant to a protonophore, carbonylcyanide m-chlorophenylhydrazone (CCCP). Endogenous respiration induced by the O₂-pulsing of an anaerobic cell suspension resulted in transient acidification and CCCP-dependent alkalization of the suspension at both pH 6.5 and 8.5. Strong inhibition of the acidification by CCCP indicated that the acidification is attributable to a respiration-dependent primary H⁺ . The inhibition by 2-n-heptyl-4-hydroxyquinoline N-oxide (HQNO) and Na⁺-dependence of the alkalization suggested that a respiration-dependent primary Na⁺ is responsible for the CCCP-dependent alkalization. In vivo, the synthesis of ATP through endogenous respiration at pH 6.5 and 8.5 was strongly inhibited by CCCP and HQNO, respectively. Therefore, it is suggested that ATP synthesis in this bacterium at pH 6.5 is driven by an electrochemical potential of H⁺ across membranes (Δμ_H⁺), and at pH 8.5 by Δμ_Na⁺ but not Δμ_H⁺. Even at a Na⁺ concentration as low as 2.1mM, this bacterium grew well and exhibited CCCP-resistant growth at alkaline pH. These results strongly suggest that Na⁺ is indispensable as a coupling ion of energy metabolism to sustain the growth of this bacterium not only in Na⁺-ubiquitous environments but also under alkaline conditions.

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Objective The long-term use of proton

inhibitors (PPIs) may induce adverse events in many organs, including the stomach. The chronic use of PPIs has been associated with the growth of fundic gland polyps (FGPs) and of gastric black spots. This study assessed the incidence of gastric lesions with cobblestone-like appearance in PPI users.

Methods The clinical characteristics and endoscopic findings of patients who underwent upper gastrointestinal endoscopy after using PPIs for at least six months were analyzed. The biopsy specimens from patients with gastric cobblestone-like lesions (GCLLs) were examined histopathologically.

Patients This study analyzed 171 patients who underwent upper gastrointestinal endoscopy after more than 6 months of PPI use in Mitsugi Public General Hospital from January 1, 2015, to March 31, 2016.

Results Of the 171 patients, 60 (35.1%) had GCLLs and 111 (64.9%) did not. There were no significant between-group differences in age, sex, duration of PPI use, and receipt of Helicobacter pylori eradication therapy. Atrophic gastritis of the corpus was significantly less frequent in the GCLL than in the non-GCLL group (55.0% vs. 47.8%, p=0.0097). Among the GCLL group, histological examinations of 24 patients revealed cystic dilation of the fundic gland in 19 (79.2%), parietal cell hyperplasia in 18 (75.0%), and cytoplasmic vacuolation in 7 (29.2%).

Conclusion GCLLs occurred frequently in long-term PPI users, especially in patients without atrophic gastritis. The pathological findings of GCLLs included parietal cell hyperplasia and fundic gland cysts. The clinical importance of these new lesions remains uncertain, but they should be observed carefully.

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This paper proposes an intelligent diagnosis method for a centrifugal system with frequency-domain symptom parameters using wavelet Transform, rough sets and fuzzy neural network to detect faults and distinguish fault types at an early stage. The wavelet transform is used to extract fault features to capture the fault information hidden in signals. The diagnosis knowledge for the training of neural network can be acquired by rough sets. A fuzzy neural network called "partially-linearized neural network (PNN)" is proposed, by which the fault types of machinery can be quickly and effectively distinguished on the basis of the possibilities of symptom parameters. The non-dimensional symptom parameters that can reflect the characteristics of signals are also described in frequency-domain. Practical examples of diagnosis for a centrifugal system are shown to verify the efficiency of the method.

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Analysis of the hyperthermophilic archaeon Pyrococcus horikoshii OT3 genome database led to the discovery and cloning of acylphosphatase (ORF PH0305a). To elucidate the first structure of archaeal acylphosphatase, we determined the crystal structure of P. horikoshii acylphosphatase at 1.72 Å resolution. The space group of the crystals was P3₂21, with unit-cell parameters a = b = 86.6 Å and c = 75.4 Å. The overall fold of P. horikoshii acylphosphatase was very similar to the structures of the eukaryotic enzymes. The conformation of putative active site was highly conserved.


(Communicated by Masanori OTSUKA, M.J.A.)

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Hydraulic torques of centrifugal pumps driven in two-phase flow are estimated using gas and liquid velocities at the impeller exit which are obtained from momentum conservation equations of both phases in the impeller, in the equations friction loss coefficients between the impeller wall and the phases as well as on the gas-liquid interface are chosen so as to fit a calculated value to a test datum in an appropriate condition. The estimated values show pretty good agreement with test data for pressures of 3.3 and 6.9 MPa and void fractions of 30 - 70% in several operation modes of normal directional flow and rotation. Although the agreement is not good in operation modes of reverse directional flow and rotation, the variation of the estimated torque with void fraction shows a tendency similar to that of the test data.

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Background N-terminal pro-B-type natriuretic peptide (NT-proBNP) is elevated in patients with acute coronary syndrome (ACS), and is a powerful predictor of long-term mortality. Differences in the clinical utility and pathophysiological implication of NT-proBNP and conventional cardiac markers in patients with ST elevation (STE) vs non-STE (NSTE) ACS were investigated in the present study. Methods and Results Ninety consecutive patients admitted with acute chest pain and a diagnosis of unstable angina or acute myocardial infarction were analyzed. Patients with ≥Killip class II were excluded to focus on the effect of myocardial ischemia on the release of cardiac markers. The markers were measured on admission and analyzed according to the time from onset. Conventional cytosolic marker (creatine kinase-MB) and myofibril marker (troponin T: TnT) were both significantly higher in STE-ACS patients compared with NSTE-ACS patients. Conversely, NT-proBNP was significantly higher in NSTE-ACS patients than STE-ACS especially within 3 h of onset, suggesting a larger ischemic insult despite the smaller extent of myocardial necrosis compared with STE-ACS patients. There was no significant correlation between NT-proBNP level and left ventricular ejection fraction (LVEF) obtained at acute-phase echocardiography in either NSTE-ACS patients (LVEF 57.7±11.2%) or STE-ACS patients (LVEF 55.1±12.7%). Comparison between NT-proBNP and TnT levels revealed a marked difference of elevations, with significantly augmented elevation of NT-proBNP (p<0.001) in NSTE-ACS patients as compared with prominent elevation of TnT in STE-ACS patients. Conclusions NT-proBNP is an early sensitive marker of myocardial ischemia that rises much higher in the earlier phase as compared with conventional markers of myocardial damage, especially in NSTE-ACS patients. (Circ J 2006; 70: 1372 - 1378)

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This paper presents recent findings from RTRI regarding the development of fundamental technologies for maglev (magnetic levitation) and the application of maglev technology to the conventional railway system. This paper also introduces the latest developments regarding the future use of maglev, information reported at WCRR2019, and related news from and outside Japan.

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Four cases with ascending aortic aneurysm-two saccular aneurysms, one with dissecting aneurysm of DeBakey's type I and one with aneurysmal dilatation of the ascending aorta associated with aortic regurgitation-successfully operated upon by means of cardiopulmonary bypass, are presented, and the special considerations of surgery of these conditions are described.

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Previous studies have shown that activated neutrophils and their myeloperoxidase (MPO)-derived products play a crucial role in the pathogenesis of non-steroidal anti-inflammatory drug (NSAID)-related small intestinal injury. The aim of the present study is to identify dihalogenated proteins in the small intestine on indomethacin administration. Intestinal damage was induced by subcutaneous administration of indomethacin (10 mg/kg) in male Wistar rats, and the severity of the injury was evaluated by measuring the area of visible ulcerative lesions. Tissue-associated MPO activity was measured in the intestinal mucosa as an index of neutrophil infiltration. The dihalogenated proteins were separated by two-dimensional polyacrylamide gel electrophoresis (2D-PAGE) using novel monoclonal antibodies against dibromotyrosine (DiBrY), and they were identified by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) peptide mass fingerprinting and a Mascot database search. Single administration of indomethacin elicited increased ulcerative area and MPO activity in the small intestine. 2D-PAGE showed an increased level of DiBrY-modified proteins in the indomethacin-induced injured intestinal mucosa and 6 modified proteins were found. Enolase-1 and albumin were found to be DiBrY modified. These proteins may be responsible for the development of neutrophil-associated intestinal injury induced by indomethacin.

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A new method of high-performance liquid chromatographic three-potential electrochemical detection was developed and applied for determining , DOPA, NE, E, 3MT, DOPAC, HVA, MHPG, DEP, 5HT and 5HIAA in rat-brain tissue. The proposed method employed a coulometric electrochemical detector coupled with a conditioning cell and a dualelectrode analytic cell. Three individual potentials were applied to the electrodes in order to oxidize-reduce the analytes. This detection system could effectively avoid interfering substance peaks, and could accurately quantify eleven components of catecholamines and serotonin as well as metabolites. The present method showed normal linearity with quantity injection of the standards; the detection limit was 0.17-1.22pg for all analytes of interest. In a measurement of neuroamines in rat-brain, the recovery of all target components averaged 74.5%.

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