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OBJECTIVE The objective of this review is to estimate the population-based incidence and to determine the types of severe infection experienced by patients with rheumatoid arthritis who are taking biological agents. INTRODUCTION Since the late 1990s, a variety of biological and synthetic drugs have been developed to treat rheumatoid arthritis. In recent years, the incidence of severe infection in patients with rheumatoid arthritis in Western nations has been reported by observational studies; however, no systematic review has been conducted on this topic. INCLUSION CRITERIA The following criteria will be considered for inclusion: i) observational studies on patients with rheumatoid arthritis who are taking biological agents; ii) studies reporting the number of severe infections requiring hospitalization for treatment; and iii) studies with person-years of observational data. METHODS MEDLINE, CINAHL, Embase, and Web of Science will be searched to identify published studies. The reference lists of all studies that are selected for critical appraisal will be screened for additional studies. The search for unpublished studies will include MedNar and OpenGrey. Only studies published in English from 1999 to the present will be included. Screening of studies, assessment of methodological quality, and data extraction will be performed by two independent reviewers. If possible, studies will be pooled in statistical meta-analysis. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42020175137.

This study investigated whether the motor execution process of one finger movement in response to a start cue is influenced by the participation of another finger movement and whether the process of the finger movement is dependent on the movement direction. The participants performed a simple reaction time (RT) task, the abduction or flexion of one (index or little finger) or two fingers (index and little fingers). The RT of the prime mover for the finger abduction was significantly longer than that for the flexion, indicating that the time taken for the motor execution of the finger response is dependent on the movement direction. The RT of the prime mover was prolonged when the abduction of another finger, whose RT was longer than the flexion, was added. This caused closer RTs between the prime movers for a two-finger response compared with the RTs for a one finger response. The absolute difference in the RT between the index and little finger responses became smaller when two fingers responded together compared with one finger response. Those results are well explained by a view that the common motor drive triggers the prime movers when two fingers move together in response to a start cue.

Enantiomerically pure 3-methyl-β-proline was synthesized using an asymmetric phase-transfer-catalyzed alkylation of a cyanopropanoate to establish the all-carbon stereogenic center. The catalytic activity of 3-methyl-β-proline in the Mannich-type reaction between a glyoxylate imine and ketones/aldehydes was subsequently investigated. The catalyst was designed and found to be more soluble in nonpolar organic solvents relative to the unsubstituted β-proline catalyst, and as a result allowed for added flexibility during optimization efforts. This work culminated in the development of a highly anti-diastereo- and enantioselective process employing low catalyst loading.

The present study investigated whether the long-interval interhemispheric inhibition (LIHI) is induced by the transcranial magnetic stimulation over the primary sensory area (S1-TMS) without activation of the conditioning side of the primary motor area (M1) contributing to the contralateral motor evoked potential (MEP), whether the S1-TMS-induced LIHI is dependent on the status of the S1 modulated by the tactile input, and whether the pathways mediating the LIHI are different from those mediating the M1-TMS-induced LIHI. In order to give the TMS over the S1 without eliciting the MEP, the intensity of the S1-TMS was adjusted to be the sub-motor-threshold level and the trials with the MEP response elicited by the S1-TMS were discarded online. The LIHI was induced by the S1-TMS given 40 ms before the test TMS in the participants with the attenuation of the tactile perception of the digit stimulation (TPDS) induced by the S1-TMS, indicating that the LIHI is induced by the S1-TMS without activation of the conditioning side of the M1 contributing to the contralateral MEP in the participants in which the pathways mediating the TPDS is sensitive to the S1-TMS. The S1-TMS-induced LIHI was positively correlated with the attenuation of the TPDS induced by the S1-TMS, indicating that the S1-TMS-induced LIHI is dependent on the effect of the S1-TMS on the pathways mediating the TPDS at the S1. In another experiment, the effect of the digit stimulation given before the conditioning TMS on the S1- or M1-TMS-induced LIHI was examined. The digit stimulation produces tactile input to the S1 causing change in the status of the S1. The S1-TMS-induced LIHI was enhanced when the S1-TMS was given in the period in which the tactile afferent volley produced by the digit stimulation just arrived at the S1, while the LIHI induced by above-motor-threshold TMS over the contralateral M1 was not enhanced by the tactile input. Thus, the S1-TMS-induced LIHI is dependent on the status of the S1 modulated by the tactile input, and the pathways mediating the sub-motor-threshold S1-TMS-induced LIHI are not the same as the pathways mediating the above-motor-threshold M1-TMS-induced LIHI.

Objectives This study aimed to investigate whether the levels of rsGFP mRNA and the fluorescence levels of cytomegalovirus (CMV)-promoter-driven rsGFP (red-shifted green fluorescent protein) could be changed by using anticancer agents and also to examine the effects of co-treatment with anticancer agents and scavengers. Methods The pQBI25 vector, which encodes the CMV promoter and the cDNA for rsGFP, was transfected into FR cells (rat skin fibroblast cell line). FR-pQBI25 cells were then exposed to doxorubicin, 5-fluorouracil, methotrexate or paraquat with or without scavengers such as N-acetyl cysteine (NAC) and edaravone for 48 h. Key findings The levels of rsGFP mRNA were found to be significantly higher following doxorubicin, 5-fluorouracil and paraquat treatment but were not changed by methotrexate. These levels of rsGFP mRNA were found to be significantly lower after paraquat/edaravone co-treatment compared with paraquat alone. The fluorescence levels of rsGFP were found to be significantly higher following doxorubicin and paraquat treatment but were not changed by 5-fluorouracil and methotrexate. The levels were also found to be significantly lower after paraquat/edaravone co-treatment compared with paraquat alone and also after doxorubicin/NAC co-treatment compared with doxorubicin alone. Conclusions These findings suggest that CMV-promoter-driven exogenous gene expression may be partly regulated by reactive oxygen species.

We present five cases showing lower cranial nerve palsy. All patients complained of dysphagia due to bilateral IX and X cranial nerve palsy. Serum antibodies to HSV and VZV suggested viral neuropathy. One patient, a 62-year-old man, underwent rehabilitation of swallowing for 1.5 months in order to resume oral intake. Four patients, a 29-year-old woman, 71-year-old woman, 38-year-old-woman and 69-year-old woman, underwent steroid and anti-viral therapy based on the regimen for Ramsay-Hunt syndrome. All patients showed remarkable improvement in oral intake ability. In cases showing acute onset of unilateral cranial nerve palsy, steroid therapy and anti-viral therapy should be considered.

To identify G protein-biased and highly subtype-selective EP2 receptor agonists, a series of bicyclic prostaglandin analogues were designed and synthesized. Structural hybridization of EP2/4 dual agonist 5 and prostacyclin analogue 6, followed by simplification of the ω chain enabled us to discover novel EP2 agonists with a unique prostacyclin-like scaffold. Further optimization of the ω chain was performed to improve EP2 agonist activity and subtype selectivity. Phenoxy derivative 18a showed potent agonist activity and excellent subtype selectivity. Furthermore, a series of compounds were identified as G protein-biased EP2 receptor agonists. These are the first examples of biased ligands of prostanoid receptors.

本研究は，独自に考案した徒手筋力計を用い，多発筋炎8例，皮膚筋炎1例（平均44.8歳，男性3例，女性6例）の頸屈曲，肩関節外転，および下肢伸展挙上筋力の3動作筋力を経時的に測定した。その結果，3動作の総和した筋力は，全例においてクレアチンキナーゼと相関関係を認めた。このことから，3動作の総和筋力は，個人の全身筋力として反映することができ，さらに継時的な測定結果は多発筋炎・皮膚筋炎の病勢を反映するため，急性期のリハビリテーションにおいてその評価と治療効果判定を行う上で有用であることが示唆された。

イネの浮遊葯培養において，カルス誘導時の葯密度（培地1 ml当たりの置床葯数）がカルス形成率におよぼす影響，およびカルスに付着した液体培地の除去が植物体再分化率におよぼす影響を明らかにした．生理的に均質な葯を供試するため，ポットに密植栽培したイネの主稈穂の特定位置の穎花から1核中期～後期の花粉を含む葯を採取した．1区当たり1000葯前後を供試し，カルス誘導（液体培地で35日間），カルス増殖（寒天培地で7日間），植物体再分化（寒天培地で60日間）の三段階培養法で培養した．水稲品種「キタアケ」の葯を，0.9葯/ml ～ 12葯/mlの範囲で5段階の密度で液体培養しカルスを誘導した．カルス形成率は，0.9葯/ml ～ 6葯/mlの範囲では葯密度の低下に伴ない増加したが，6葯/mlと12葯/mlとの間では明らかな傾向が認められなかった．カルス誘導時の葯密度は緑色植物再分化率に影響しなかった．次に，水稲品種「キタアケ」および「きらら397」の葯を供試し，液体培地で誘導したカルスを寒天培地に移植する時に，カルスに付着した液体培地を1 ～ 2秒間濾紙で除去すると，除去しなかった場合（慣行区）に比べて緑色植物再分化率が13 ～ 18%増加した．以上の結果より，イネの浮遊葯培養の効率は，カルス誘導期に3葯/mlあるいはそれ以下の葯密度で培養すること，および液体培地で誘導したカルスを寒天培地に移植するときにカルスに付着した液体培地を濾紙で1 ～ 2秒間除去すること，によって高められる．

イネ浮遊葯培養の優点はカルスを多量に誘導できることであるが，カルスの発生と増加の実態は明らかでない．本研究では液体培地上で誘導されたカルスには，花粉起源のカルスとそれが分割して増えたカルスの2種類があることを示し，それらの時期別の発生数を調べた．水稲品種「キタアケ」の葯を液体培地に置床し，7日ごとに実体顕微鏡の下でカルス数を数えた後，全カルスを液体培地から除去してさらに培養を続けた．このようにして計測されたカルスを，それぞれの計測日の前7日間に形成された花粉起源のカルスとみなした．花粉起源のカルスは培養開始の2週間目に発生し始め，35日目まで毎週連続的に発生した．一方，液体培地にカルス1個を入れて単独培養し，7日目ごとにカルスの増加数を調べたところ，1週間後には1.6倍，2週間後には2.8倍，3週間後には4.8倍に増加した．花粉起源カルスの時期別発生数と分割起源カルスの経時的増加率から，35日目の全カルス数中に占める分割起源カルスの割合を推定すると46.7%であった．浮遊葯培養法を育種技術として利用してゆくためには，分割起源カルスが元のカルスと遺伝的に同じかどうかを確認することが重要である．

本研究ではイネの浮遊葯培養において，パラフィルム不使用が培養効率におよぼす影響を明らかにして培養法の改善に役立てようとした．生理的に均質な葯を供試するため，ポットに密植栽培したイネの主稈穂の特定穎花から1核中期～後期の花粉を含む葯を採取し，1区当たり1000葯前後を培養した．カルス誘導期およびカルス増殖期のシャーレ，植物体再分化期の試験管に対して，それぞれ独立にパラフィルムで封じた区と封じなかった区を設け，両区の培養効率を比べた．カルス誘導期におけるパラフィルム不使用の効果は，パラフィルム不使用のシャーレでも培地のコンタミネーションや蒸発を起こさない二重チャンバー法によって実験した．カルス誘導期の実験では水稲品種「きらら397」，カルス増殖期の実験では水稲品種「キタアケ」，植物体再分化期の実験では水稲品種「キタアケ」および「キタアケ」の葯培養から復元された10系統を供試した．その結果，カルス誘導期のシャーレをパラフィルムで封じないで培養すると封じて培養した場合に比べて，カルス形成率は実数値で212%（比率で1.6倍） ～ 289%（3.8倍）増加したが，パラフィルム不使用区のシャーレで形成されたカルスの緑色植物再分化率はパラフィルム使用区のそれに比べてやや低かった．カルス増殖期のシャーレをパラフィルムで封じないで培養すると，緑色植物再分化率が8%（1.1倍）増加した．さらに植物体再分化期の試験管をパラフィルムで封じないで培養すると，緑色植物再分化率が8%（1.3倍）～9%（1.2倍）増加した．以上の結果より，イネ葯培養効率を簡易に高める手段として，プラスチックシャーレや試験管の蓋をパラフィルムで封じないで培養することを推奨する．

The bone mineral density（BMD）of the proximal region of femur specimens was measured by dual-energy X-ray absorptiometry （DXA）.BMD measurement of proximal femur by DXA was influenced according to the depth of water by way of the body thickness. The BMD of the Ward’s triangle，and then the trochanteric area was significantly lower detected than the femoral neck through the depth of water. Notable error occured at 28 cm or more depth of water. The BMD of the femoral neck was not almost affected by the position of the hip from neutral to internal rotation. The position from neutral to external rotation of the hips is desirable as the limb position for DXA. The BMD of femoral neck is thought to be appropriate for the diagnosis of osteoporosis and detection of a risk factor of femoral neck fracture.

Three distinct mesoscale convective systems (MCSs), composing a tropical cloud cluster, observed on January 18-19, 1993 were investigated. This event was observed by two Doppler radars on Manus Island (2°S, 147°E), Papua New Guinea, during the TOGA-COARE IOP. The cloud cluster was formed within the radar range, and extended to a diameter of about 200 km. The environmental wind was weak, but a strong vertical shear existed at the middle level (3-8 km). The first characteristic MCS moved faster than the environmental wind, and thus is referred to as a fast-moving convective system (FMCS). The orientation of this FMCS was nearly perpendicular to the direction of the dominant vertical shear. Behind the convective cell of the FMCS, an anvil echo extended to upper levels. The front inflow had two branching sub-flows in front of the convective cell with a strong downdraft. The lower level outflow from the downdraft also branched out to southward and northward flows. The branching inflow and outflow were associated with symmetrically-arranged strong convergence regions. These features were similar to a structure produced by the storm splitting, and is recognized as a squall line system with a three-dimensional structure. The second MCS was composed of individual convective cells, moving at a slower speed than the first system. This slow-moving convective system (SMCS) was associated with the south-easterly inflow at lower levels, and extended in a line parallel to the vertical shear direction from north to south. The last system was a stratiform-looking echo system marked by an obvious bright band at the melting level. This system brought more precipitation than the other MCSs. In the echo system, a vortex with a diameter of 20 km was found at the middle layer (4-6 km). In the middle layer, some vertical circulations were also found, and vertical circulations with a maximum velocity of 5 m s -1 were found in the upper layer (> 6 km). These circulations seemed to cause the heavy precipitation.

Observations of tropical convection and cloud clusters with two X-band Doppler radars were carried out on Manus Island, Papua New Guinea for two and a half months from 12 November 1992 during the Intensive Observation Period (IOP) of the TOGA-COARE. Several different types of clouds were observed by Doppler radars during the period, such as squall lines, convective clouds and stratiform clouds associated with cloud clusters, isolated convective clouds over the island in the day time, etc. Outlines of the observations on Manus Island and brief reviews of the results of these observations are described. Preliminary summaries of the analyses on the observations are: 1) A warm rain process dominates at the beginning stage of radar echo development and the maximum radar reflectivity is recognized at this stage, 2) The maximum echo top height is observed within 3 hours from the first echo, 3) The maximum echo area within the radar range was analyzed a few to several hours later than the time of maximum echo top height corresponding to the size of cloud cluster, 4) In the long-lasting stratiform echo, updrafts independent from those below the melting layer were identified above the melting layer. It is concluded that further studies utilizing these observational data may reveal the structure and the evolution mechanism of tropical cloud clusters.

Background The guidelines recommend combination therapy for patients who are unable to achieve target BP with monotherapy; some fixed dose therapies including an angiotensin II receptor blocker (ARB) and diuretics are available in Japan. However, to date there have been few reports on this long-term treatment and the patient profiles suited for this combination remain ambiguous. Method The Aichi Research on Combination therapy for Hypertension Study was a multicenter, open-label, prospective observational study that investigated the efficacy and safety of 1-year treatment with the losartan-hydrochlorothiazide (HCTZ) combination tablet in patients with hypertension uncontrolled by either ARB monotherapy or combination therapy with a calcium channel blocker (CCB). An ARB was switched to a losartan-HCTZ tablet after a pre-observation period. Results A total of 614 of 648 patients were evaluable (mean age, 66.3 years; 52.8% men; mean baseline blood pressure, BP, 157.7/87.9 mmHg). The BP had decreased significantly to 138.0/78.2 mmHg by month 3 (p

Suppurative knee joint infection probably due to intraarticular steroid injection, has been increasing recently. In this study, we report the results of a follow-up survey conducted in eleven patients (chiefly those with over five-year course after onset) who were referred to our hospital from other medical institutions during the past ten years.For clinical assessment knee joint function was evaluated on the basis of the “SANDAIGAKU” tentative plan. On X-ray medial and lateral joint spaces were determined bilaterally on the frontal image of lower limbs in the standing position, and PF joint spaces were measured on the lateral image. Evaluation was made for each item before disease onset, one year after surgery, and at the time of final follow-up.All eight patients who could be followed up for over five years have experienced no recurrence of the suppurative arthritis after surgery, and their gait ability was relatively satisfactory. Total scores of the “SANDAIGAKU” tentative plan improved in four patients, declined by 15 points or less in three patients, and significantly declined in one patient. Medial joint space was 3.9mm on average before surgery, 2.6mm one year after surgery and 0.9mm at the time of the final survery. Lateral joint space was also reduced in size in chronological order from 4.6mm to 3.9mm and 2.0mm, respectively. PF joint space also chronologically decreased from 2.5mm to 1.3mm and 0.6mm, respectively.

Background Concern over the potential cardiotoxicity of anti-malarial drugs inducing a prolonged electrocardiographic QT interval has resulted in the almost complete withdrawal from the market of one anti-malarial drug - halofantrine. The effects on the QT interval of four anti-malarial drugs were examined, using the guinea pig heart. Methods The guinea pig heart was isolated, mounted on a Langendorff apparatus, and was then perfused with pyruvate-added Klebs-Henseleit solutions containing graded concentrations of the four agents such as quinidine (0.15 - 1.2 μM), quinine (0.3 - 2.4 μM), halofantrine (0.1 - 2.0 μM) and mefloquine (0.1 - 2.0 μM). The heart rate-corrected QaTc intervals were measured to evaluate drug-induced QT prolongation effects. Results Quinidine, quinine, and halofantrine prolonged the QaTc interval in a dose-dependent manner, whereas no such effect was found with mefloquine. The EC50 values for the QaTc prolongation effects, the concentration that gives a half-maximum effect, were quinidine < quinine ≈ halofantrine. Conclusions In this study, an isolated, perfused guinea pig heart system was constructed to assess the cardiotoxic potential of anti-malarial drugs. This isolated perfused guinea pig heart system could be used to test newly developed anti-malarial drugs for their inherent QT lengthening potential. More information is required on the potential variation in unbound drug concentrations in humans, and their role in cardiotoxicity.

本研究では,徒手筋力計を用いた複数動作の最大等尺性筋力の総和における正常人値を求め,臨床における本法の有用性を示すことを目的とした.平均的体格者120名(20～79歳)を正常人調査の対象とした.仰臥位における頸部屈曲,上肢外転,下肢伸展挙上の3項目について測定を行い,男女別,年代別の3項目総和筋力の正常人値を求めた.臨床においては,ミオパシーなどの全身的筋力低下の症例に本法を経時的に行い,総和筋力は病状をよく反映した.徒手筋力計は,取り扱いの簡便さが最大の利点であり,その信頼性についても測定手技の熟練により大きな問題はない.3項目総和筋力は,ミオパシー症例などの臨床評価に有用である.

The regulation of gene expression after the introduction of an exogenous gene is a problematic aspect of gene therapy. The purpose of this study was to use doxorubicin to regulate exogenous gene expression in a vector containing the cytomegalovirus (CMV) promoter. The pQBI25 vector, which encodes the CMV promoter and the cDNA for red-shifted green fluorescent protein (rsGFP), was transfected into a rat skin fibroblast cell line (FR cells). The pEGFP vector, encoding the CMV promoter and enhanced green fluorescent protein (EGFP) cDNA, was transfected into human hepatoma HepG2 cells. FR-pQBI25 cells were then continuously exposed to doxorubicin and methotrexate for 96 and 48 h, respectively; HepG2-pEGFP cells were continuously exposed to doxorubicin for 48 h. The levels of c-fos, c-jun and rsGFP mRNA, as well as the levels of rsGFP protein, in the FR-pQBI25 cells were found to be significantly higher following exposure to doxorubicin. However, the level of rsGFP protein was not changed by exposure to methotrexate. The level of EGFP protein in the HepG2-pEGFP cells was also significantly higher following exposure to doxorubicin. To examine the effect of cessation of doxorubicin exposure, FR-pQBI25 cells that had been exposed to doxorubicin for 48 h were re-plated in fresh medium without doxorubicin for a further 48 h. The increased levels of c-fos, c-jun and rsGFP mRNA and rsGFP protein seen after treatment with doxorubicin had reduced by 48 h after the cessation of exposure to doxorubicin. These findings suggest that CMV-driven exogenous gene expression may be regulated by doxorubicin.

Synchrotron radiation has been utilized for producing the intensity difference in resonant X-ray magnetic scattering (RXMS) of ferrimagnetic BaTiMnFe10O19 at the BL-6C beamline of the Photon Factory. The energy of incident X rays was selected as E = 7.1245 keV within the threshold region of Fe K absorption edge from the observation of X-ray magnetic circular dichroism (XMCD). An asymmetrical ratio between RXMS intensities in left- and right-handed circular polarizations makes it possible to determine the magnetic crystal structure. The residual functions of Σ(ΔRobs − ΔRcalc)2 related to the ratio were used to evaluate magnetic moments for individual Fe sites in the least-squares calculations, refined as multiplicity parameters of atomic scattering factor. The canting angles of the spin of Fe atoms have been derived for BaTiMnFe10O19, which are 90°, 0° and 31° for octahedral 2a, 4f2 and 12k sites, respectively.

本研究の目的は12誘導心電図で診断困難な陳旧性下壁梗塞例が体表面電位図あるいはベクトル心電図でどの程度診断可能かを検討する事である。12誘導心電図aVFに幅0.02秒以上0.04秒未満, 深さR波の1/4未満のQ波を示す43例を対象とし, これらの症例を心臓カテーテル検査所見等に基づいて梗塞群 (24例) と非梗塞群 (19例) に分けた。梗塞群の体表面電位図ではQRS開始後10～20msecにかけて極小が左背部から背部下方, あるいは背部下方から右胸部下方へと動くのが特徴的であった。一方, 非梗塞群では極小は同じ時期に背部から右胸部上方, あるいは左前胸部から背部下方へと移動した。QRS開始後10msecと20msec時の極小の位置に基づく電位図の下壁梗塞診断基準を設定するとsensitivityは83%, specificityは95%であった。一方, YoungとWilliamsのベクトル心電図診断基準ではsensitivityは79%, specificityは26%であった。

In order to prove the tension mooring system is safe and useful, Japan Marine Science and Technology Center performed the TLP sea test by utilizing the prototype floating platform. The previous papers of this study discussed the design of the tension mooring system on basis of the results of theoretical considerations and model tests, and introduced the outline of the sea test.This paper discusses on the measuring system and data analysis in the TLP sea test and the dynamic response characteristics of the TLP.The tension measuring system which utilizes the combination of conventional chain-guide wheel and compressive load cell was proved to give the varying tensions about twice larger than the theoretically expected ones. The reason of this overestimation is supposed to be that under the static initial tensions, the varying tensions attenuate while going around the chain-guide wheel and then the load cell measures the larger load out of balance.This inference was proved to be true through the direct measurement of the loads of the chain at both sides of the wheel in the second sea test (1987).The significant values of the varying tensions are estimated and compared well with the theoretical values.The horizontal movement of the TLP is another topic in this study. The surge/sway acceleration of the TLP were measured by utilizing the pitch/roll inclination meters. The yawing motions were measured by the monitor TV camera installed on the deck of the TLP.

The tension mooring of the floating ocean structures seems promising to expand the ocean space exploitation. This kind of mooring method becomes relatively inexpensive in deep ocean, and has many advantages such that it can suppress the motion of the floating structures and needs only minimum mooring space.This paper presents the results of the fundamental study on the tension mooring. A semisubmersible model with 4 footing columns is tautly moored by the rubber-chain cable in the regular waves. The results of the study are following.(1) The rubber-chain cable has a nonlinear load-elongation characteristics. The static characteristics before stress relaxation is applicable to the dynamic analysis.(2) The heaving and pitching motions of the floating structures are negligible, but the surging motion increases as the wave length does.(3) The frequency responses of the tension fluctuations of the cable do not depend on the material in case of the large initial tension. The axial rigidity of the rubber-chain cable is, however, much less than that of the wire cable so that in designing the rubber-chain tension mooring system, we must carefully set the natural frequency of the system sufficiently out of the wave spectrum.(4) The snap load easily occurs when the initial tension is small.(5) The analysis model is applicable to the design of the tension mooring system. It predicts, however, much larger snap load. The authors expect that the analysis model will be improved by including the nonlinear hydrodynamic forces.

正常30例, 異常Q波を有する陳旧性前壁梗塞30例, 異常Q波を有しない陳旧性前壁梗塞32例の体表面電位図を記録し, その極小の位置をQRS開始後5msec毎に比較検討した。正常群と梗塞群の極小の位置は, QRS開始後5, 10, 15, 20, 25msecにおいて危険率0.1%以下の有意差を示した。正常群と, 心電図上診断が容易な異常Q波を有する陳旧性前壁梗塞群あるいは心電図で診断困難な異常Q波を有しない陳旧性前壁梗塞群とはQRS開始後15msecの極小の位置で最もよく区別された。QRS開始後15msecにおいては, 異常Q波を有する梗塞群30例全例の極小が, また, 異常Q波を有しない梗塞群32例では26例の極小が前胸部に位置し, これと異なり正常例では30例中29例の極小が背部に位置した。これらの所見は, 陳旧性前壁梗塞の有無の診断における電位図の有用性を示唆する。

In 24 patlents with old inferoposterior myocardlal infarction, body surface isopotentlal maps were compared with left ventriculographlc findings. In 10 patients with asynergy restricted to the inferior and/or posterolateral segment, surface potential abnormalities due to Infarction were observed during specific phases of QRS and In specific portions on the chest surface depending on the locstton and extent of ventricular severe asynergy (akinesls and dyskinesls). However, the remaining eight patients with coexisting severe asynergy in the anterior, apical, or septal segment showed surface potentlal maps quite different from those of the former patients. It is suggested that body surface lsopotentlal maps are a useful clinical tool for detecting the location and extent of ventricular severe asynergy In patlents with old lnferoposterlor myocardlal infarction. (AM HEART J 104:1262, 1982.)