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The triple alpha reaction is one of the most important reactions in the nuclear astrophysics. However, its reaction rate in high temperature environments at T9> 2 was still uncertain. One of the major origins of the uncertainty was that the radiative-decay probability of the 31− state in 12C was unknown. In the present work, we have determined the radiative-decay probability of the 31− state to be 1.3−1.1+1.2×10−6 by measuring the 1H(12C,12Cp) reaction for the first time, and derived the triple alpha reaction rate in high temperature environments from the measured radiative-decay probability. The present result suggests that the 31− state noticeably enhances the triple alpha reaction rate although the contribution from the 31− state had been assumed to be small.

We conducted the coincidence measurement of $\alpha$ particles inelastically scattered from ${}^{20}$Ne at $0^{\circ}$ and decay charged particles in order to search for the alpha-particle condensed state. We compared the measured excitation-energy spectrum and decay branching ratio with the statistical-decay-model calculations, and found that the newly observed states at $E_x$ = 23.6, 21.8, and 21.2 MeV in ${}^{20}$Ne are strongly coupled to a candidate for the 4$\alpha$ condensed state in ${}^{16}$O. This result presents the first strong evidence that these states are the candidates for the 5$\alpha$ condensed state., Comment: 6 pages, 5 figures. The part of the analysis is updated, and some discussions are added

GAGG(Ce) is a novel scintillator with a fast response and high light output without a hygroscopic nature. It is expected to be a useful detector for charged particles at high-counting rates. However, the response of the GAGG(Ce) scintillator to charged particles has not been fully examined. In the present work, the light output and energy resolution of the GAGG(Ce) scintillator were measured for protons and alpha particles at $E_{p}=5$-68 MeV and $E_{\alpha}=8$-54 MeV as well as gamma rays at $E_{\gamma}=662$ keV from a $^{137}$Cs source. The results were compared with those of the CsI(Tl) scintillator. The scintillation efficiencies $dL/dE$ of the GAGG(Ce) and CsI(Tl) scintillators were obtained and parametrized as a function of linear energy transfer $dE/dx$.

We measured both the differential cross section ($\sigma_{p,p^\prime}$ $=d^2\sigma/d\Omega dE_{x}$) and the $\gamma$-ray emission probability ($R_\gamma(E_x)$ $=\sigma_{p,p^\prime\gamma}$/$\sigma_{p,p^\prime}$) from the giant resonances excited by $\rm^{12}C$(\textit{p,p}$^\prime$) reaction at 392 MeV and 0$^\circ$, using a magnetic spectrometer and an array of NaI(Tl) counters. The absolute value of $R_\gamma(E_x)$ was calibrated by using the well-known $\gamma$-ray emission probability from $\rm^{12}C^* ( 15.11$ MeV, $ 1^+$, $T=1$) and $\rm^{16}O^* ( 6.9$ MeV, $2^+$, $T=0$) states within 5\% uncertainty. We found that $R_\gamma(E_x)$ starts from zero at $E_x=16$ MeV, increases to a maximum of 53.3$\pm$0.4$\pm$3.9\% at $E_x=27$ MeV and then decreases. We also compared the measured values of $R_\gamma(E_x)$ with statistical model calculation based on the Hauser-Feshbach formalism in the energy region $E_x=$ 16-32 MeV and discussed the features of $\gamma$-ray emission probability quantitatively.

The triple alpha reaction is one of the most important reactions in the nuclear astrophysics. However, its reaction rate in high temperature environments at T 9 > 2 was still uncertain. One of the major origins of the uncertainty was that the radiative-decay probability of the 3 1 − state in 12C was unknown. In the present work, we have determined the radiative-decay probability of the 3 1 − state to be 1.3 − 1.1 + 1.2 × 10 − 6 by measuring the 1H(12C,12Cp) reaction for the first time, and derived the triple alpha reaction rate in high temperature environments from the measured radiative-decay probability. The present result suggests that the 3 1 − state noticeably enhances the triple alpha reaction rate although the contribution from the 3 1 − state had been assumed to be small.

We perform the first direct mass measurements of neutron-rich calcium isotopes beyond neutron number 34 at the RIKEN Radioactive Isotope Beam Factory by using the time-of-flight magnetic-rigidity technique. The atomic mass excesses of ^{55-57}Ca are determined for the first time to be -18650(160), -13510(250), and -7370(990) keV, respectively. We examine the emergence of neutron magicity at N=34 based on the new atomic masses. The new masses provide experimental evidence for the appearance of a sizable energy gap between the neutron 2p_{1/2} and 1f_{5/2} orbitals in ^{54}Ca, comparable to the gap between the neutron 2p_{3/2} and 2p_{1/2} orbitals in ^{52}Ca. For the ^{56}Ca nucleus, an open-shell property in neutrons is suggested.

Nanostructured vanadium (V) alloys are expected to exhibit high performance under neutron irradiation environments. However, their ultra-fine or refined grains cause significant decrease in flow stress at high temperatures due to grain boundary sliding (GBS), which is the major concern for their high-temperature structural applications such as future fusion reactors. The contribution of GBS to plastic deformation is known to depend strongly on grain size (GS) and may give more significant influence on long-time creep test results than on short-time tensile test results. In order to improve the creep resistance through elucidation of the effect of GS on the uniaxial creep behavior of nanostructured V alloys, a solution and dispersion hardened V alloy, V–1.4Y–7W–9Mo–0.7TiC (in wt%), with GSs from 0.58 to 2.16 μm was developed by mechanical alloying and HIP processes, followed by annealing at 1473–1773 K, and creep tested at 1073 K and 250 MPa in vacuum. It is shown that the creep resistance of V–1.4Y–7W–9Mo–0.7TiC increases monotonically with GS: The creep life for the alloy with 2.16 μm in GS is as long as 114 h, which is longer by factors of 2–30 than those for the other finer grained alloys and by two orders than that for coarse-grained V–4Cr–4Ti (Nifs heat2, GS: 17.8 μm) that is a primary candidate material for fusion reactor structural applications. The minimum (steady state) creep rate decreases with increasing GS as έ s ∝ (1/ l ) 3 , where έ s is the steady state creep rate and l is the grain diameter. The observed superior creep resistance of V–1.4Y–7W–9Mo–0.7TiC is discussed in terms of GS effects on dislocation glide/climb, GBS, and strain hardening capability enhanced by solution and dispersion hardening.

Creep resistance is the major concern of vanadium and its alloys for fusion reactor structural applications. In order to elucidate the effects of grain size on the creep behavior of solution and dispersion strengthened vanadium alloys, V–1.6Y–8W–0.8TiC specimens with fine grain sizes from 0.58 to 1.45 μm were prepared by mechanical alloying and HIP without any plastic working and tested at 1073 K and 250 MPa in vacuum. It is shown that the creep resistance of V–1.6Y–8W–0.8TiC depends strongly on grain size and increases with increasing grain size: The creep life for the grain size of 1.45 μm is almost one order longer than that of 0.58 μm, and about two orders longer than that of V–4Cr–4Ti (NIFS-Heat 2) although the grain size of V–4Cr–4Ti is as large as 17.8 μm. The observed creep behavior is discussed in terms of grain size effects on dislocation glide and grain boundary sliding.

The dynamic magnetization process is studied in CoFeB films for high frequency application by using a time-resolved imaging technique. The domain wall mobility of 12 m/sOe was observed at the resonant frequency of 220 kHz. The effective wall mass, viscous damping constant, and restoring force constant were evaluated in CoFeB films.

In order to investigate the pyrolytic characteristics of the burning residue of fire-retardant wood, a multifunctional fire-resistance test oven aimed at simulating the course of a fire was used to burn fire-retardant wood and untreated wood. Samples at different distances from the combustion surface were obtained and a thermogravimetric analysis (TG) was applied to test the prrolytic process of the burning residue in an atmosphere of nitrogen. The results showed that: 1) there was little difference between fire-retardant wood and its residue in the initial temperature of thermal degradation. The initial temperature of thermal degradation of the combustion layer in untreated wood was higher than that in the no burning wood sample; 2) the temperature of the flame retardant in fire-retardant wood was 200°C in the differential thermogravimetry (DTG). The peak belonging to the flame retardant tended to dissipate during the time of burning; 3) for the burning residue of fire-retardant wood, the peak belonging to hemicellulose near 230°C in the DTG disappeared and there was a gentle shoulder from 210 to 240°C; 4) the temperature of the main peaks of the fire-retardant wood and its burning residue in DTG was 100°C lower than that of the untreated wood and its burning residue. The rate of weight loss also decreased sharply; 5) the residual weight of fire-retardant wood at 600°C clearly increased compared with that of untreated wood. Residual weight of the burning residue increased markedly as the heating temperature increased when burning; 6) there was a considerable difference with respect to the thermal degradation temperature of the no burning sample and the burning residue between fire-retardant wood and untreated wood.

To determine if there are common genes that contribute to the susceptibility for schizophrenia, first-stage genome-wide scan was carried out by genotyping 417 short-tandem repeat (STR) markers in 338 individuals from 130 families with 148 affected sib-pairs identified at 16 sites nationwide in Japan. Data was from the Japanese Schizophrenia Sib-pair Linkage Group (JSSLG), which is a multi-site collaborative study group established to create a national resource for genetic studies of schizophrenia in Japan. All subjects were Japanese, and the probands and their siblings had schizophrenia. Multipoint non-parametric linkage analysis and exclusion mapping were performed with GENEHUNTER software. Simulation studies suggested that in the absence of linkage we could expect one multipoint maximum LOD score (MLS) of 1.9 per genome scan. An MLS of 3.7 would be expected only once in every 20 genome scans and thus corresponds to a genome-wide significance of 0.05. No loci in the initial screen fulfilled the criteria for significant or suggestive evidence for linkage. Ten chromosomes (1, 2, 3, 4, 5, 8, 9, 14, 17, and 20) had at least one region with a nominal P value

Our experimental goal is to study the non-resonant triple alpha reaction rate at low temperture (T < 108 K). The 13C(p,d) reaction at 66 MeV has been used to probe the alpha-unbound continuum state in 12C just below the 2nd 0+ state at 7.65 MeV. The transition strength to the continuum state is predicted to be sensitive to the non-resonant triple alpha reaction rate. The experiment has been performed at iThemba LABS. We report the present status of the experiment.

This paper proposes a multipath propagation model for line-of-sight (LOS) street microcells with building roof base sites (BS) in urban areas, Multipath propagation characteristics are of great importance in evaluating the performance of digital systems and designing wireless links. Typical delay profiles are measured to clarify their statistical characteristics in LOS street microcells. The channel sounder used is a sliding correlator with 30-Mb/s PN code and a center frequency of 2.6 GHz. The measurements clarify the features of delay profile and mean RMS delay spread. The proposed delay profile model explains one plausible mechanism of multipath propagation. The delay profiles calculated using the model agreed well with the measured profiles. Furthermore, the factors influencing the RMSs delay spread are investigated, and the regression equation of medium RMS delay spread on a sidewalk is established. The proposed model can evaluate the transmission characteristics of wireless digital communication systems in multipath propagation environments.

Introduction: Long–term outcome of spinal cord injury (SCI) patients was compared between those managed by suprapubic cystostomy (SPC) and clean intermittent catheterization (CIC) w

Communication between nerves and mast cells is a prototypic demonstration of neuroimmune interaction. However, whether mast cell activation occurs as a direct response to neuronal activation or requires an intermediary cell is unclear. Addressing this issue, we used an in vitro coculture approach comprising cultured murine superior cervical ganglia and rat leukemia basophilic cells (RBLs; possesses properties of mucosal-type mast cells). Following loading with the calcium fluorophore, Fluo-3, neurite-RBL units (separated by

Summary A special furnace for smoke-heating logs, with increased far-infrared radiation (FIR), was produced to improve the wood quality. Green sugi (Cryptomeria japonica D.Don) logs were smoke-heated with the direct use of this system. In a short time, this process increased the temperature inside the logs up to 80–100 °C uniformly, without any damage to the wood. The great increase in steam pressure inside the log resulted in the rupture of pit membranes (PMs) with a high frequency, leading to a decrease in the moisture contents of the logs. It was found that when a temperature of 80 °C is attained inside the log, the rupture of PMs occurs. The rupture proceeds from the outer sapwood towards the pith, accompanied by the radiation heat transfer within the log. By the rupture of PMs, smoke-heated sugi wood showed a large improvement in permeability.

Neuroimmunological disorders are involved in the pathogenesis of atopic dermatitis (AD), partly through enhanced sensory nerve-skin mast cell interaction. Cell adhesion molecule 1 (CADM1) is a mast-cell adhesion molecule that mediates the adhesion to, and communication with, sympathetic nerves.To investigate the role of mast cell CADM1 in the pathogenesis of AD, CADM1 expression levels by comparing between lesional and nonlesional skin mast cells of an AD mouse model, which was developed by repeated application of trinitrochlorobenzene, and to examine, in cocultures, how the alterations in CADM1 detected in lesional mast cells might affect the sensory nerve-mast cell interaction.AD-like lesional and nonlesional skin mast cells were collected separately by laser capture microdissection. CADM1 expression was examined by reverse transcription-polymerase chain reaction and CADM1 immunohistochemistry. In cocultures, adhesion between dorsal root ganglion (DRG) neurites and IC2 mast cells was analysed by loading a femtosecond laser-induced impulsive force on neurite-attendant IC2 cells, while cellular communication was monitored as the IC2 cellular response ([Ca(2+)]i increase) after nerve-specific stimulant-induced DRG activation.AD-like lesional mast cells expressed three-fold more CADM1 transcripts than nonlesional cells. This was supported at the protein level, shown by immunohistochemistry. In coculture, CADM1 overexpression in IC2 cells strengthened DRG neurite-IC2 cell adhesion and doubled the population of IC2 cells responding to DRG activation. A function-blocking anti-CADM1 antibody abolished these effects in a dose-dependent manner.Increased expression of CADM1 in mast cells appeared to be a cause of enhanced sensory nerve-mast cell interaction in a hapten-induced mouse model of AD.

A multipath propagation model and a prediction equation for r.m.s. delay spread are discussed for LOS street microcells with building roof base sites in urban areas. The proposed model is established to explain a mechanism of multipath propagation. The delay profiles calculated using the model agreed well with the measured profiles. The factors influencing the r.m.s. delay spread are investigated based on the model, then it is found that the factors are LOS and road width, etc. The prediction equation for medium r.m.s. delay spread based on those factors is proposed.

Multipath propagation characteristics are of great importance in evaluating the performance of digital systems and designing wireless links. This paper describes statistical multipath propagation modeling for microcells in indoor, pedestrian, and vehicular environments. The channel impulse response is measured to clarify the statistical characteristics in urban areas, residential areas and indoors. The measuring channel sounder is the sliding correlator using 30 Mbit/s PN code with center frequency of 2.6 GHz. The measurements clarify the features of delay profile, mean RMS (root mean square) delay spread and local (or instantaneous) RMS delay spread. Furthermore, tapped-delay-line parameters for multipath propagation simulators based on this modeling are proposed. The proposed model is applicable to the evaluation of transmission characteristics of wireless digital communication systems in multipath fading environments.

We describe a patient with treatment-resistant schizophrenia who had a duplication in the cytochrome P450IID6 (CYP2D6) gene. This severely ill 71-year-old-woman had responded poorly to several neuroleptics. Molecular genetic study revealed CYP2D6 gene duplication, which results in excessive activity of CYP2D6 that metabolizes various commonly used neuroleptics. The mutation may have contributed to treatment resistance in this case.

Palmitoyl-CoA (Pal-CoA) lowered the respiratory control ratio (RCR), and induced mitochondrial membrane permeability transition (MPT) and cytochrome c (Cyt. c) release from isolated rat liver mitochondria. L-Carnitine suppressed the Pal-CoA-induced dysfunction, MPT, and Cyt. c release of isolated mitochondria. This suppression was inhibited by cephaloridine, an inhibitor of carnitine uptake into mitochondria. Cyclosporin A (CsA), an inhibitor of MPT, and BSA also suppressed the Pal-CoA-induced MPT. In the presence of inorganic phosphate (P(i)), Ca2+-induced MPT was suppressed by BSA, L-carnitine, and chlorpromazine, an inhibitor of phospholipase A2. In the presence of a low concentration of Ca2+, 3,3',5-triiodothyronine, long chain fatty acids, salicylic acid, and diclofenac induced MPT by a mechanism that was suppressed by BSA, L-carnitine, or chlorpromazine. During the incubation of mitochondria on ice, their respiratory competence decreased; L-carnitine and BSA also prevented this decrease. Mitochondrial depolarization in pheochromocytoma PC12 cells was induced by either serum deprivation or arachidonic acid by a mechanism that was suppressed by acetyl-L-carnitine. These results indicate that some MPTs may be regulated by fatty acid metabolism and that the Pal-CoA-induced MPT plays an important role in the induction of apoptosis.

Long-term outcome of spinal cord injury (SCI) patients was compared between those managed by suprapubic cystostomy (SPC) and clean intermittent catheterization (CIC) with particular emphasis on an incidence of urinary tract complications and patients perception for urinary management.The study comprised 61 SCI patients; 34 patients managed with SPC (group A), while 27 with CIC (group B). After stabilization of their condition, all were followed annually on an outpatient basis with clinical history, urinalysis, urinary imaging and renal function studies. Mean follow-up periods were 8.6 and 9.9 years for groups A and B, respectively. Between groups, a comparative study was performed on the incidence of urinary complications such as renal dysfunction, hydronephrosis, vesicoureteral reflux, symptomatic genitourinary infection and urinary stone. Satisfaction with urinary management was also estimated using the questionnaires during follow-up.Renal dysfunction, hydronephrosis and vesicoureteral reflux were not found in either group. Symptomatic genitourinary infection was seen in 4 (12%) of group A and 7 (26%) of group B, respectively. The incidence of renal stone was 3 (9%) in group A and 1 (4%) in group B. A significant difference was not found between two groups in these urinary complications. On the contrary, bladder stone was seen more frequently in group A (65%) than in group B (30%) with a significant difference (p0.001). The degrees of incontinence, bother score of daily activities, and overall satisfaction showed no significant difference between the two groups.Except for bladder stones, SPC is a valuable option of urinary management for quadriplegic patients, the results of which were comparable to paraplegic SCI patients managed with CIC.

The clinical benefit of cholesterol-lowering treatment is unknown in the Japanese elderly in whom the prevalence of morbidity and mortality related to coronary artery disease are known to be low. To evaluate the efficacy of cholesterol-lowering treatment with 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor in Japanese elderly patients with documented coronary artery disease, 121 patients with serum cholesterolor = 150 mg/dl prospectively received HMG-CoA reductase inhibitor, and 271 patients undergoing cholesterol-lowering treatment based on dietary therapy alone served as historical controls. The 143 elderly patients ageor = 65 years in the 2 groups had similar baseline serum total cholesterol level (201 +/- 30 vs 202 +/- 31 mg/dl), age (71 +/- 4 vs 70 +/- 4 years), proportion of men (37/53 vs 64/90), number of diseased vessels (1.7 +/- 0.9 vs 1.5 +/- 1.0), and incidences of other classical coronary risk factors, including hypertension, diabetes mellitus, smoking, obesity and family history of coronary artery disease. In all 392 patients, similar trends were observed, including serum total cholesterol level (208 +/- 33 vs 201 +/- 34 mg/dl). With HMG-CoA reductase inhibitors, serum total cholesterol level was reduced by 14% in the elderly subjects and by 13% in all patients. During the follow-up of approximately 3 years, cardiac events occurred in 5 patients (one elderly) in the treatment group and 38 patients (12 elderly) in the control group. Kaplan-Meier survival estimates revealed a higher event-free survival rate with HMG-CoA reductase inhibitors in the elderly subjects (98% vs 85%, p0.05) and in all patients (94% vs 86%, p0.05). Cox proportional hazard modeling also demonstrated a significant reduction in risk for cardiac events with drug therapy (relative risk 0.32, p0.05), in addition to the number of diseased vessels (relative risk 1.8, p0.01). In contrast, no additional risk was observed with advancing age. Cholesterol-lowering treatment with HMG-CoA reductase inhibitors is effective to improve the prognosis of Japanese elderly patients, including those with normal serum cholesterol level.

Communication between nerves and mast cells is a prototypic demonstration of neuroimmune interaction. However, whether mast cell activation occurs as a direct response to neuronal activation or requires an intermediary cell is unclear. Addressing this issue, we used an in vitro coculture approach comprising cultured murine superior cervical ganglia and rat leukemia basophilic cells (RBLs; possesses properties of mucosal-type mast cells). Following loading with the calcium fluorophore, Fluo-3, neurite-RBL units (separated by50 nm) were examined by confocal laser scanning microscopy. Addition of bradykinin, or scorpion venom, dose-dependently elicited neurite activation (i.e., Ca2+ mobilization) and, after a lag period, RBL Ca2+ mobilization. Neither bradykinin nor scorpion venom had any direct effect on the RBLs in the absence of neurites. Addition of a neutralizing substance P Ab or a neurokinin (NK)-1 receptor antagonist, but not an NK-2 receptor antagonist, dose-dependently prevented the RBL activation that resulted as a consequence of neural activation by either bradykinin or scorpion venom. These data illustrate that nerve-mast cell cross-talk can occur in the absence of an intermediary transducing cell and that the neuropeptide substance P, operating via NK-1 receptors, is an important mediator of this communication. Our findings have implications for the neuroimmune signaling cascades that are likely to occur during airways inflammation, intestinal hypersensitivity, and other conditions in which mast cells feature.

Although the aVL lead in exercise electrocardiography is reported to be helpful in identifying a significant narrowing of the left anterior descending coronary artery (LAD), its role in exercise testing has not been fully evaluated. Accordingly, 821 patients who underwent both standard exercise testing and coronary angiography were evaluated. In patients with aVL lead ST elevation, the incidence of a significant narrowing of the LAD (124/165 vs 348/656; p0.001) was higher than in those without. Multiple logistic regression analysis revealed that the 2 most important variables that correlated with aVL lead ST elevation were a greater number of leads with ST depression in the inferior leads and a smaller amplitude of R wave in the aVL lead. In contrast, variables correlating with aVL lead ST depression in the majority of cases were a greater number of leads with ST depression in all leads and the presence of inferior lead ST elevation. The results of this study indicate that although aVL lead ST elevation could be a marker for LAD narrowing, more important factors such as inferior lead ST-segment depression and the R-wave amplitude of the aVL lead should be taken into consideration. In contrast, ST depression in the aVL lead mostly represents exercise-induced myocardial ischemia of greater extent and severity.

Clinical efficacy and safety of pareteral sulbactam/ampicillin (SBT/ABPC) was compared with cefotiam (CTM) in a randomized clinical trial of pneumonia in the elderly at 13 National Hospitals of Kyushu island. 37 patients received SBT/ABPC 3 g i.v., b.i.d., and 31 patients received CTM 1 g i.v., b.i.d. for 7 to 14 days. 1. 68 patients (37 for SBT/ABPC and 31 for CTM) were evaluated for safety. No statistical differences were noted in the patients' backgrounds of either group. 2. The clinical efficacy of SBT/ABPC was 96.3% (26/27 cases) while CTM was 75.2% (17/23 cases). This was found to be statistically significant (Fisher's exact test: p0.05). 3. 100% of evaluated cases (10 for SBT/ABPC and 4 for CTM) showed bacterial elimination. 4. No side effects were observed in the study. 5. Abnormal laboratory findings were noted in 10.8% (4/37 cases) for SBT/ABPC and 3.2% (1/31 cases) for CTM. The major adverse events were mild elevation of GOT, GPT and A1-P for SBT/ABPC, and mild platelets overproduction for CTM. No statistical differences were noted in both groups. These results are consistent with SBT/ABPC as a highly effective antibiotic in the treatment of elderly patients with pneumonia.

A 32-year-old woman presented with a rare case of tricuspid valve endocarditis causing inflammatory reopening of the spontaneously closed ventricular septal defect (VSD), associated with aortic valve malformation. She was admitted to our hospital because of fever lasting 4 weeks. Severe aortic regurgitation was revealed by color Doppler echocardiography. Blood culture identified Microccus faecalis. Antibiotics were administered over 3 weeks, but serial echocardiography showed a developing vegetation in the right ventricle and left-to-right shunt flow. The diagnosis was infective endocarditis complicated by aortic ring abscess and interventricular septal fistula. Surgery performed on the 22nd hospitalized day found a vegetation of the tricuspid valve, a membranous type of VSD, and aortic valve malformation. Aortic valve replacement, patch closure of VSD, and tricuspid valvuloplasty achieved a successful outcome.

A 14-membered ring macrolide, erythromycin, acts not only as an antibacterial but also as an anti-inflammatory agent. We have previously reported that erythromycin modulates neutrophil functions and ameliorates neutrophil-induced endothelial cell damage through the action of cyclic AMP-dependent protein kinase (PKA) and nitric oxide (NO). We investigated the effect of erythromycin on human endothelial cell functions. Erythromycin enhanced intracellular calcium ion concentration ([Ca2+]i) of endothelial cells and NO release from endothelial cells. The enhancement of NO release from endothelial cells by erythromycin was abolished by addition of EGTA in the medium and was partially reduced by addition of H-89, an inhibitor of PKA. These results suggest that erythromycin enhances NO release from endothelial cells through the action of PKA and [Ca2+]i. In addition, constitutive NO synthase (cNOS) protein expression of endothelial cells was dose-dependently enhanced by treatment with erythromycin, which might also contribute to the enhancement of NO release from endothelial cells by erythromycin. The effect of erythromycin as an anti-inflammatory agent might be partially mediated through the enhancement of NO release from endothelial cells and the drug might be a useful tool for the investigation of cNOS of endothelial cells.

To elucidate whether atherosclerotic aortic plaque detected by transesophageal echocardiography can be a clinically useful marker for coronary artery disease in the elderly.Atherosclerotic aortic plaque detected by transesophageal echocardiography has been reported to be a marker for coronary artery disease. Its significance may be important particularly in the elderly population, although to our knowledge, there are no data yet available.We performed transesophageal echocardiography on 84 patients who had previously undergone coronary arteriography. The criteria used to diagnose atherosclerotic plaque on transesophageal echocardiography were the presence of focally or linearly increased echodensity of the aortic intima with lumen irregularity and thickening or ulceration.Significant coronary artery disease (or = 50% stenosis) was detected in at least one major coronary artery in 27 of the 84 patients. Aortic plaques were detected by transesophageal echocardiography in 25 of the 27 patients (93%) with coronary artery disease and in 30 of 57 patients (53%) without coronary disease (p0.001). Among 24 patients 70 years or older, aortic plaques were present in 13 of 14 (93%) patients with coronary artery disease and 9 of 10 patients (90%) without coronary disease. Among 60 patients younger than 70 years, aortic plaques were present in 12 of 13 patients (92%) with coronary artery disease and 21 of 47 patients (45%) without coronary disease (p0.01). The independent association between coronary artery disease and the presence of aortic plaque, age, gender, and other coronary risk factors was examined by multiple logistic regression analysis. In patients 70 years or older, the presence of aortic plaque failed to be a predictor of significant coronary artery disease, although it was indeed a strong predictor of coronary artery disease in patients younger than 70 years (p0.05).In elderly patients, atherosclerotic aortic plaque detected by transesophageal echocardiography is not useful in predicting significant coronary artery disease. It is useful only in a relatively younger population.

The prognostic importance of age among well-known prognostic factors such as extent of coronary artery lesions, cardiac function, and myocardial ischemia was evaluated in 147 elderly patients with coronary artery disease aged 65 years or older who underwent dipyridamole perfusion scintigraphy and coronary angiography. After excluding 32 patients who initially underwent percutaneous transluminal coronary angioplasty (PTCA) or coronary artery bypass grafting (CABG), 115 patients who were initially treated medically were analysed by the Cox model for cardiac events during a mean follow-up period of 29 +/- 22 months. Among the 114 patients who were available for follow-up, nine patients (7.9%) had cardiac events, including five cardiac deaths and four non-fatal cardiac events (requiring PTCA or CABG). When the 114 patients were divided into three age-groups; 53 patients aged 65-69 years, 42 aged 70-74 years and 19 aged 75 years or older, the incidence of cardiac death was highest in those aged 75 years or older. Univariate analysis showed that age of 70 years or older (hazards ratio 15.15, p = 0.004), scintigraphic diffuse slow washout (hazards ratio 8.77, p = 0.002), and triple-vessel or left main trunk disease (hazards ratio 6.36, p = 0.05) were important prognostic factors. Multivariate analysis showed that scintigraphic diffuse slow washout (hazards ratio 6.33, p = 0.05), and triple-vessel or left main trunk disease (hazards ratio 11.94, p = 0.05) were statistically significant as independent prognostic factors. However, when age of 70 years or older was included in the analysis, it showed higher hazards ratio (21.21, p = 0.03) than that of scintigraphic diffuse slow washout (7.36) or triple-vessel or left main trunk disease (5.30). Age of 70 years or older may be a significant prognostic factor in elderly patients with coronary artery disease which has an equivalent importance to the extent of coronary lesions.

Serum troponin T, a myocardial contractile protein, has been reported to be a sensitive marker for the diagnosis of acute myocardial infarction. However, there have been few reports on its ability to detect coronary reperfusion and to predict left ventricular function in the chronic stage. Twenty two patients (20 males and 2 females, 61 +/- 10 y.o.) with acute myocardial infarction were enrolled in this study. They were divided into 2 groups, one with successful reperfusion (group A: n = 13) and one without reperfusion (Group B: n = 9) and the serial changes of their serum troponin T levels were evaluated. Serum myosin light chain was measured in another group of patients with acute myocardial infarction without history of old myocardial infarction (group C: n = 8). The slope of the logarithm of serum troponin T on a time-value curve was calculated from the time of admission to the first peak within 24 hours of the onset of acute myocardial infarction. The correlation coefficient between the late peak of serum troponin T and the left ventricular ejection fraction in 11 patients with first Q wave acute myocardial infarction was compared with that between the serum myosin light chain peak and the left ventricular ejection fraction in group C. 1) The slope of the logarithm of serum troponin T on the time-value curve in group A was greater than that in group B (0.57 +/- 0.45 vs. 0.22 +/- 0.16) (p0.05). 2) There was a good correlation between the late peak level of serum troponin T (78 +/- 10 hours after the onset) and the left ventricular ejection fraction in 11 patients with first Q wave acute myocardial infarction (r = -0.84, p0.01), which was similar to that of the serum myosin light chain peak and the left ventricular ejection fraction (r = -0.72, p0.05). On the other hand, there was no correlation between the peak level of serum creatine phosphokinase and the left ventricular ejection fraction (r = -0.55, NS). The serum troponin T levels 24, 36, 48 and 60 hours after the onset also correlated well with the left ventricular ejection fraction (r = -0.65, -0.7, -0.65 and -0.89, respectively). We conclude that the serial measurement of serum troponin T in patients with acute myocardial infarction is useful in the evaluation of left ventricular function in the chronic stage and that it is a potential non-invasive predictor of coronary reperfusion.

To elucidate the mechanism of force generation by actomyosin motor, a measuring system was constructed, in which an in vitro motility assay was combined with an optical trapping technique. An actin filament of several micron long was attached to a gelsolin-coated polystyrene bead, and was allowed to interact with a small number (approximately 1/1 micron actin filament) of rabbit skeletal heavy meromyosin (an active subfragment of myosin) molecules bound to a nitrocellulose-coated coverglass. The bead position was determined at 33-ms intervals. We measured the force generation event at relatively low (100-400 nM) ATP concentration so that the occurrence of individual force generation events could be detected with our time resolution. The actin-bound bead held in the optical trap moved in a stepwise manner in the direction of the actin filament only in the presence of ATP. At the trap strength of 0.3 pN/nm, the maximum size of the step was 11 nm, and the maximum force associated with the movement was 3.3 pN.

Aggressive combined resections were carried out, on 24 lung cancer cases which showed invasion into surrounding organs. Those cases with wide infiltration of the ribs, and into surrounding intercostal tissues, and for those with invasion to diaphragm, the outcome of the operations was rather poor but, for those with invasion in pericardium and left atrium, fairly favorable results were obtained. These present results indicated that aggressive resections of adjacent organs is to be recommended for cases without N 2 infiltration. Experiences from these operations have taught us the importance and useful of diagnosis of the status of invasion of the tumor, during the operation by ultrasonogram (IUS), with direct contact of the probe to the thoracic wall or mediastinal organs, to discriminate the areas of chest wall and mediastinal organs that require resections. This method, in combination with esophagus ultrasonic endoscopy (EUS), enabled defining the infiltrated areas with accuracy far exceeding that obtained by tactile examination. Techniques of, and observations obtained by these examination methods are presented.

A 63-year-old male receiving steroid for active Behçet's disease was admitted of massive hemoptysis. A pseudoaneurysm of about 5 cm in diameter caused by rupture of the aortic wall penetrating into the lung was detected on the descending thoracic aorta. Operation was performed using left atrium-femoral artery bypass with centrifugal pump. The technique of graft interposition was selected rather than patch closure to prevent postoperative anastomotic aneurysm. We consider that in the treatment of inflammatory aneurysm, use healthy aortic wall for suture and end-to-end anastomosis are very important. In spite of steroid supplementation, the inflammatory reaction get worse postoperatively and the dosage of steroid had to be increased to control inflammation. The patient is well 20 months after surgery.

4, 6-0-Benzylidene-D-glucopyranose (BG), a derivative of benzaldehyde (BA), whose anti-tumour action has often been reported, showed responses in 10 out of 24 patients (41.7%). These patients consisted of 11 cases of primary lung cancer, 4 of metastatic lung cancer, 5 of gastric cancer, and one each of cancer of the sigmoid colon, liver, pancreas and prostate. There were two complete responses (one each of ipsilateral lung metastasis from breast cancer and metastatic liver lesions due to gastric cancer). The mean total dose of BG was 392.6 g, given by intravenous infusion of 1.2 g BG in 100 ml saline twice daily. The treatment was discontinued when no response was observed after two months. Careful monitoring showed no toxic action of BG at these large doses. Complete necrotic liquefaction of tumour, without any damage to surrounding tissue, was seen in 2 of 3 cases in which histological examination was feasible. It is apparent that BG, like BA, is not a cytotoxic agent in the ordinary sense, but its mechanism of action is still unknown. Images Figure 2 Figure 3