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Background The purposes of this study were to create a new flow-chart of prehospital electrocardiography (ECG)-transmission, evaluate its predictive ability for ST-elevation myocardial infarction (STEMI) and shorten door-to-balloon time (DTBT). Method and results The new transmission flow-chart was created using symptoms from previous medical records of STEMI patients. A total of 4090 consecutive patients transferred emergently to our hospital were divided into two groups: those in ambulances with an ECG-transmission device with the new flow-chart (ECGT-FC) and those transferred without an ECG-transmission device (non-ECGT) groups. A STEMI group comprising walk-in patients during the same period was used as a control group. The predictive ability of STEMI and the effectiveness of shortening the DTBT by the new flow-chart of ECG-transmission was evaluated. In the ECGT-FC group, the prevalence of STEMI in the ECG-transmission by the new flow-chart were significantly higher than in the non-ECG-transmission patients (6.71% vs. 0.19%; p < 0.001). The sensitivity and specificity of the new ECG-transmission flow-chart were 83.3% and 88.1%, respectively. The median DTBT was significantly shortened ( p = 0.045) and the prevalence of DTBT < 90 min was significantly higher in the ECGT-FC group ( p = 0.018) than the other groups. Conclusion The sensitivity and specificity of the new flow-chart for ECG-transmission were high. The new flow-chart combined with an ECG-transmission device could detect STEMI efficiently and shorten DTBT. [ABSTRACT FROM AUTHOR]

Abstract: We review the clinical status of skeletal involvement and cardiac function in three unrelated patients harboring an in-frame deletion of exons 45 to 55 in the DMD gene followed up for 2 to 7 years. Two younger patients diagnosed as having X-linked dilated cardiomyopathy (XLDCM) developed congestive heart failure without overt skeletal myopathy. Heart failure recurred after viral infection but responded well to diuretics and angiotensin-converting enzyme inhibitors. One older patient diagnosed with Becker muscular dystrophy showed limb-girdle muscular atrophy and weakness at the age of 50, but did not have any cardiac symptoms. Skeletal muscle involvement in each patient remained unchanged, and cardiac function did not worsen in any of the patients during the study. In a younger XLDCM patient, the amount and molecular weight of mutant dystrophin were equally slightly decreased in both skeletal and cardiac muscles. Immunostaining for dystrophin and dystrophin-associated proteins was slightly reduced in both skeletal and cardiac muscle, with no discernible difference between the two. The phenotype of this dystrophinopathy can manifest as XLDCM in younger patients; however, careful attention to cardiac management may result in a favorable prognosis. [Copyright &y& Elsevier]

Abstract: The fabrication of cellulose nanofiber-reinforced composites has been so far problematic due to difficulties in obtaining good dispersion of hydrophilic cellulose fibers in a hydrophobic polymer matrix. A new manufacturing process similar to papermaking, which enables the production of thin sheets made of uniformly dispersed microfibrillated cellulose (MFC) with polylactic acid (PLA) fibers was devised, and the composites were obtained by compression molding of the stacked sheets. The process is suitable for adoption at an industrial scale owing to the high yields and fast dewatering times. The measurement of tensile properties revealed that the modulus, strength, and strain at fracture increased linearly with the MFC content. The improvement in toughness was considered one of the key benefits brought by MFC reinforcement. [Copyright &y& Elsevier]

On March 11, 2011, a huge tsunami attacked the northeastern coast of Japan after a magnitude 9 earthquake. No reports have investigated the impact of tsunamis on the incidence of cardiovascular disease, especially heart failure (HF). We investigated the number and clinical characteristics of hospitalized patients with acute decompensated HF (ADHF) in the east coast of Iwate hit by the tsunami (tsunami area) for a 12-week period around the disaster. For comparison with previous years, numbers of ADHF were surveyed in the corresponding area in 2009 and 2010. In addition, to elucidate the impact of the tsunami, a similar study was performed in a remote area where the tsunami had minimal effect (control area). After the disaster, the number of patients with ADHF in the tsunami area was significantly increased compared to the predisaster period (relative risk 1.97, 95% confidence interval 1.50 to 2.59). The peak was found 3 to 4 weeks after the disaster. In contrast, in the control area, no significant change in ADHF events was observed (relative risk 1.29, 95% confidence interval 0.94 to 1.78). There was a significant correlation between changes in the number of ADHF admissions and percent tsunami flood area (r = 0.73, p <0.001) or the number of shelter evacuees (r = 0.83, p <0.001). In conclusion, these findings suggest that large and sudden changes in daily life and the trauma associated with a devastating tsunami have a significant impact on the incidence of ADHF. [ABSTRACT FROM AUTHOR]

The mudstone of the Yezo Group exposed in Central Hokkaido yields abundant microfossils of calcareous nannofossils, foraminifers, radiolarians and dinoflagellates. Benthic foraminifers consisting of both agglutinated and calcareous species occur abundantly and consistently throughout the sequence, while specimens of planktonic foraminifers are generally fewer than benthics in all samples. We recognized the following 13 planktonic foraminiferal zones assigned to the late Aptian to early Campanian in the Oyubari and Haboro–Kotanbetsu areas; (1) Globigerinelloides spp., (2) Ticinella primula, (3) Biticinella breggiensis, (4) Rotalipora subicinensis–Rotalipora ticinensis, (5) Rotalipora appenninica, (6) Rotalipora globotruncanoides, (7) Rotalipora cushmani (8), Whiteinella archaeocretacea (9) Helvetoglobotruncana helvetica, (10) Marginotruncana pseudolinneiana, (11) Marginotruncana sinuosa, (12) Contusotruncana fornicata, (13) Globotruncana arca. The Globigerinelloides spp. to H. helvetica Zones (late Aptian to early Turonian) can be correlated with standard zones in the Tethyan regions, whereas the assemblages from the M. pseudolinneiana to G. arca zones lack tropical zonal markers of Dicarinella concavata, D. asymetrica and Globotruncanita elevata in many studied sections. The scarcity or lack of tropical zonal species during the late Turonian to early Campanian suggests that the Oyubari and Haboro–Kotanbetsu regions in Hokkaido were located in the Transitional to Boreal biogeographical provinces. [Copyright &y& Elsevier]

Family and twin studies have shown that genetic factors play an important role in the etiology of panic disorder. However, linkage and association studies using DNA markers have yielded inconclusive results. Increased serotonin neurotransmission may cause or be related to panic disorder. Assuming that genes regulating the serotonin system are involved in the pathogenesis of panic disorder, the authors searched for a genetic association of panic disorder with the serotonin 1A (HTR1A), 2A (HTR2A), and 2C (HTR2C) receptor genes. HTR1A, HTR2A and HTR2C polymorphisms were detected by the polymerase chain reaction method with analysis of restriction fragment-length polymorphisms (PCR-RFLP). The subjects were 63 biologically unrelated patients with panic disorder and 100 biologically unrelated normal control subjects who were native Japanese living in the western area of Japan. HTR1A and HTR2C showed no significant association with panic disorder. However, the frequency of the MspI A2 allele of HTR2A was significantly higher in the patients than in the normal control subjects. The study showed a positive association between panic disorder and the HTR2A gene, suggesting that HTR2A plays an important role in the pathogenesis of panic disorder. [Copyright &y& Elsevier]