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We report a case of spontaneous coronary artery dissection located next to a myocardial bridge in a patient with concomitant takotsubo cardiomyopathy. A fusion image with multidetector-row computed tomography and single-photon emission computed tomography played an important role in the diagnosis of these lesions. (Level of Difficulty: Advanced.), Graphical abstract

Objective Persistent renal damage (RD) three months after exposure to contrast media is associated with contrast-induced acute kidney injury (CI-AKI) and poor clinical outcomes. Little is known about the role of preprocedural hydration on persistent RD in patients with chronic kidney disease [CKD; estimated glomerular filtration rate (eGFR)

Aim: The objective of this study was to evaluate the effects of a comprehensive intervention program named SPRING, which utilizes a hot spring facility, in community-dwelling older adults in a randomized controlled trial. Methods: A total of 60 community-dwelling elderly people (mean age, 72.7±6.0 years) participated in this program. After baseline investigation, participants were randomly assigned to an intervention group (n=31) or a control group (n=29). The intervention group participated in a comprehensive intervention program (including exercise classes, nutrition classes and bathing) twice a week for 3 months. After 3 months and 6 months, we evaluated the effects of the intervention. Results: The attendance rate of the intervention group was 76%, and there were no accidents or injuries associated with this program. After 3 months, grip strength and one-leg standing with eyes-open scores significantly improved among the intervention group, compared with the control group (p=0.028; p=0.003, respectively). On follow-up, grip strength, one-leg standing with eyes-open scores and the World Health Organization Well-Being Index (WHO-5) scores were statistically significantly maintained or had improved in the intervention group (p=0.001; p=0.024; p=0.027, respectively). Conclusion: The comprehensive intervention program SPRING may improve physical function among community-dwelling older adults. In addition, SPRING may have long-term beneficial effects for older adults. Language: en

VF event detected by CRTD, but thoracic impedance increased remarkably higher before and during syncope. After withdrawal of diuretics, his symptoms disappeared and thoracic impedance decreased to the former level. Conclusion: It is not easy to recognize adequate volume for each patient, especially on dry side. This is the first case report showing that thoracic impedance may be useful for detecting not only wet side, but also dry side. Further study is required to evaluate thoracic impedance value in detecting hypovolemia.

In semiconductor fabrication it is difficult to form channels with precisely controlled lengths, even when using plasma etching which itself is highly precise. This is because of fluctuations in the processes preceding the etching, as, for example, in the developed resist dimensions. This paper proposes a method for controlling channel lengths which relies on an optimized over-etching, the extra etching time after the normal etch completion depending on the variation in resist dimension, etc. In the method a phenomenological model is set up for the rate of change of channel length as a function of the resist dimension and etching cross section, and the polysilicon layer thickness and its phosphorus doping density as determined by sheet resistance. The model coefficients are estimated by a Kalman filter on wafer and lot measurement data. The results of production line experiments with the present method show a reduction in channel length variation by one-half compared with the previous uncontrolled method.

Concentrations of free amino acids were measured in the cerebral cortices of post-mortem brains from 5 histologically verified cases of Alzheimer-type dementia (ATD) and 8 histologically normal controls. The concentration of glutamate in the ATD brains was significantly lower in the superior frontal, orbital, cingulate and inferior temporal cortices when compared with the control brains. The concentrations of taurine and γ-aminobutyric acid in the ATD brains were significantly lower in the inferior temporal cortex. These findings suggest that amino acid neurons could be involved in ATD.

Concentrations of free amino acids were measured in the temporal cortex of postmortem brains from four histologically verified cases with Alzheimer-type dementia (ATD) and eight histologically normal controls. The concentrations of taurine, glutamate, and gamma-aminobutyric acid, which are all neurotransmitter candidates, were significantly lower in the ATD brains than in the controls. These findings suggest that the involvement of amino acid neurons in ATD cannot be ruled out.

The steady state trough concentrations (Cmin) and pharmacokinetics of valproic acid were investigated in schizophrenic patients during the treatment of valproic acid, 200 mg, twice daily and after the one dose of 400 mg, respectively, with and without haloperidol (6 to 10 mg/day, N = 6) or chlorpromazine (100 to 300 mg/day, N = 6). Four to 5 Cmin were monitored just before the morning valproic acid dose for 3 to 4 days preceding the kinetic study. The overall Cmin of valproic acid with chlorpromazine (33.2 +/- 1.7 micrograms/ml, N = 25) was significantly (p less than 0.01) greater than without (27.1 +/- 1.4 micrograms/ml, N = 25). The majority of the mean valproic acid concentrations observed after the 400-mg dose were significantly (p less than 0.05 to 0.01) greater during the chlorpromazine treatment as compared to those without the phenothiazine. The mean t1/2 was shortened from 15.4 +/- 1.4 to 13.5 +/- 1.2 hours (p less than 0.05) with a comparable increase in the clearance from 7.18 +/- 0.38 to 8.32 +/- 0.34 ml/hour/kg (p less than 0.01) after the discontinuation of chlorpromazine. All the patients revealed an increase in the valproic acid clearance after the chlorpromazine therapy was discontinued. When viewed overall, such a trend as found in the chlorpromazine group was not observed in the haloperidol group. The results suggest that chlorpromazine, but not haloperidol, inhibits the metabolism of valproic acid. However, the clinical significance of the interaction awaits future study.