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Purpose 4-Borono-2-[18F]fluoro-l-phenylalanine ([18F]FBPA) synthesized with [18F]F2, produced using the 18O(p, n)18F reaction, has been reported for increasing radioactivity. However, a dedicated system and complex procedure is required to reuse the costly [18O]O2 gas; also, the use of [18F]F2 as a labeling agent reduces the labeling rate and radiochemical purity. We developed a stable and practical method for [18F]FBPA synthesis by combining [18F]F2, produced using a [18O]O2 single-use system, and a [18F]CH3COOF labeling agent. Methods The produced [18F]F2 was optimized, and then [18F]FBPA was synthesized. For passivation of the target box, 0.5% F2 was pre-irradiated in argon. Gaseous products were discarded; the target box was filled with [18O]O2 gas, and then irradiated (first irradiation). Then, the [18O]O2 gas was discarded, 0.05–0.08% F2 in argon was fed into the target box, and it was again irradiated (second irradiation). The [18F]F2 obtained after this was passed through a CH3COONa column, converting it into the [18F]CH3COOF labeling agent, which was then used for [18F]FBPA synthesis. Results The mean amount of as-obtained [18F]F2 was 55.0 ± 3.3 GBq and that of as-obtained [18F]CH3COOF was 21.6 ± 1.4 GBq after the bombardment. The radioactivity and the radiochemical yield based on [18F]F2 of [18F]FBPA were 4.72 ± 0.34 GBq and 12.2 ± 0.1%, respectively. The radiochemical purity and molar activity were 99.3 ± 0.1% and 231 ± 22 GBq/mmol, respectively. Conclusion We developed a method for [18F]FBPA production, which is more stable and practical compared with the method using [18O]O2 gas-recycling and [18F]F2 labeling agent.

4-Borono-2-[The produced [The mean amount of as-obtained [We developed a method for [

Visual Abstract, Highlights • KUS121 was developed to selectively inhibit the adenosine triphosphatase activity of valosin-containing protein without affecting other cellular functions of valosin-containing protein. • KUS121 preserved adenosine triphosphate levels, reduced endoplasmic reticulum stress, and suppressed cell death in H9C2 rat cardiomyoblast cells, treated with tunicamycin or hydrogen peroxide, or cultured in glucose-free medium. • In murine ischemia and reperfusion injury models, KUS121 treatment after reperfusion attenuated the infarcted size and preserves cardiac function by maintaining adenosine triphosphate levels and reducing ER stress. • In porcine ischemia and reperfusion injury models, intracoronary administration of KUS121 also attenuated the infarcted area in a dose-dependent manner. • These results indicated that KUS121 is a promising novel therapeutic agent for myocardial infarction., Summary No effective treatment is yet available to reduce infarct size and improve clinical outcomes after acute myocardial infarction by enhancing early reperfusion therapy using primary percutaneous coronary intervention. The study showed that Kyoto University Substance 121 (KUS121) reduced endoplasmic reticulum stress, maintained adenosine triphosphate levels, and ameliorated the infarct size in a murine cardiac ischemia and reperfusion injury model. The study confirmed the cardioprotective effect of KUS121 in a porcine ischemia and reperfusion injury model. These findings confirmed that KUS121 is a promising novel therapeutic agent for myocardial infarction in conjunction with primary percutaneous coronary intervention.

Adaptive thermogenesis is essential for survival, and therefore is tightly regulated by a central neural circuit. Here, we show that microRNA (miR)-33 in the brain is indispensable for adaptive thermogenesis. Cold stress increases miR-33 levels in the hypothalamus and miR-33−/− mice are unable to maintain body temperature in cold environments due to reduced sympathetic nerve activity and impaired brown adipose tissue (BAT) thermogenesis. Analysis of miR-33f/f dopamine-β-hydroxylase (DBH)-Cre mice indicates the importance of miR-33 in Dbh-positive cells. Mechanistically, miR-33 deficiency upregulates gamma-aminobutyric acid (GABA)A receptor subunit genes such as Gabrb2 and Gabra4. Knock-down of these genes in Dbh-positive neurons rescues the impaired cold-induced thermogenesis in miR-33f/f DBH-Cre mice. Conversely, increased gene dosage of miR-33 in mice enhances thermogenesis. Thus, miR-33 in the brain contributes to maintenance of BAT thermogenesis and whole-body metabolism via enhanced sympathetic nerve tone through suppressing GABAergic inhibitory neurotransmission. This miR-33-mediated neural mechanism may serve as a physiological adaptive defense mechanism for several stresses including cold stress., 褐色脂肪細胞の燃焼を促す新たなメカニズムを解明 --体の熱産生にマイクロRNA-33が関与--. 京都大学プレスリリース. 2021-02-17.

The Hippo signaling pathway is involved in the pathophysiology of various cardiovascular diseases. Yes‐associated protein (YAP) and transcriptional enhancer activator domain (TEAD) transcriptional factors, the main transcriptional complex of the Hippo pathway, were recently identified as modulators of phenotypic switching of vascular smooth muscle cells (VSMCs). However, the intrinsic regulator of YAP/TEAD‐mediated gene expressions involved in vascular pathophysiology remains to be elucidated. Here, we identified Homeobox A4 (HOXA4) as a potent repressor of YAP/TEAD transcriptional activity using lentiviral shRNA screen. Mechanistically, HOXA4 interacts with TEADs and attenuates YAP/TEAD‐mediated transcription by competing with YAP for TEAD binding. We also clarified that the expression of HOXA4 is relatively abundant in the vasculature, especially in VSMCs. In vitro experiments in human VSMCs showed HOXA4 maintains the differentiation state of VSMCs via inhibition of YAP/TEAD‐induced phenotypic switching. We generated Hoxa4‐deficient mice and confirmed the downregulation of smooth muscle‐specific contractile genes and the exacerbation of vascular remodeling after carotid artery ligation in vivo. Our results demonstrate that HOXA4 is a repressor of VSMC phenotypic switching by inhibiting YAP/TEAD‐mediated transcription., HOXA4 suppresses vascular smooth muscle cell phenotypic switching and vascular remodeling by inhibiting YAP/TEAD‐mediated transcription.

In order to make the experience of traveling in automated vehicles more enjoyable, Virtual Reality (VR) experiences based on the real-world journey have been proposed. Presenting users with VR content synched to the car's actual movement decreases the motion sickness, but it also sharply limits the possible range of VR content. In this paper, we investigate whether the user's subjective perception of speed can be 'modified' by presenting VR content at a different speed than the actual speed of the vehicle, and whether users feel this experience is strange. Study participants viewed VR content occurring at a faster or slower speed than their actual travel speed in an electric wheelchair. Our results show that the participants were able to do this without experiencing a feeling of "strangeness". However, the participants did report higher "strangeness" scores when the speed in the VR content was slower than their actual speed.

Background Micro RNA (miR)‐33 targets cholesterol transporter ATP ‐binding cassette protein A1 and other antiatherogenic targets and contributes to atherogenic progression. Its inhibition or deletion is known to result in the amelioration of atherosclerosis in mice. However, mice lack the other member of the miR‐33 family, miR‐33b, which exists in humans and other large mammals. Thus, precise evaluation and comparison of the responsibilities of these 2 miRs during the progression of atherosclerosis has not been reported, although they are essential. Methods and Results In this study, we performed a comprehensive analysis of the difference between the function of miR‐33a and miR‐33b using genetically modified mice. We generated 4 strains with or without miR‐33a and miR‐33b. Comparison between mice with only miR‐33a (wild‐type mice) and mice with only miR‐33b (miR‐33a −/− /miR‐33b +/+ ) revealed the dominant expression of miR‐33b in the liver. To evaluate the whole body atherogenic potency of miR‐33a and miR‐33b, we developed apolipoprotein E–deficient/miR‐33a +/+ /miR‐33b −/− mice and apolipoprotein E–deficient/miR‐33a −/− /miR‐33b +/+ mice. With a high‐fat and high‐cholesterol diet, the apolipoprotein E–deficient/miR‐33a −/− /miR‐33b +/+ mice developed increased atherosclerotic plaque versus apolipoprotein E–deficient/miR‐33a +/+ /miR‐33b −/− mice, in line with the predominant expression of miR‐33b in the liver and worsened serum cholesterol profile. By contrast, a bone marrow transplantation study showed no significant difference, which was consistent with the relevant expression levels of miR‐33a and miR‐33b in bone marrow cells. Conclusions The miR‐33 family exhibits differences in distribution and regulation and particularly in the progression of atherosclerosis; miR‐33b would be more potent than miR‐33a.

Background Data are scarce on the role of aortic valve area (AVA) to identify those patients with asymptomatic severe aortic stenosis (AS) who are at high risk of adverse events. We sought to explore the prognostic impact of AVA in asymptomatic patients with severe AS in a large observational database. Methods and Results Among 3815 consecutive patients with severe AS enrolled in the CURRENT AS (Contemporary Outcomes After Surgery and Medical Treatment in Patients With Severe Aortic Stenosis) registry, the present study included 1309 conservatively managed asymptomatic patients with left ventricular ejection fraction ≥50%. The study patients were subdivided into 3 groups based on AVA (group 1: AVA >0.80 cm2, N=645; group 2: 0.8 cm2 ≥AVA >0.6 cm2, N=465; and group 3: AVA ≤0.6 cm2, N=199). The prevalence of very severe AS patients (peak aortic jet velocity ≥5 m/s or mean aortic pressure gradient ≥60 mm Hg) was 2.0%, 5.8%, and 26.1% in groups 1, 2, and 3, respectively. The cumulative 5‐year incidence of AVR was not different across the 3 groups (39.7%, 43.7%, and 39.9%; P=0.43). The cumulative 5‐year incidence of the primary outcome measure (a composite of aortic valve–related death or heart failure hospitalization) was incrementally higher with decreasing AVA (24.1%, 29.1%, and 48.1%; P, See Editorial by Tribouilloy et al

The aim of this study was to evaluate the prognostic impact of left ventricular ejection fraction (LVEF) in patients with severe aortic stenosis (AS).The prognostic impact of LVEF in severe AS remains controversial.Among 3,815 consecutive patients with severe AS enrolled in the CURRENT AS (Contemporary Outcomes After Surgery and Medical Treatment in Patients With Severe Aortic Stenosis) registry, the present study population consisted of 3,794 patients after excluding 21 patients without LVEF data. Patients were divided into 4 groups according to LVEF at index echocardiography (50%, 50% to 59%, 60% to 69%, and ≥70%; conservative strategy: n = 388, n = 390, n = 1,025, and n = 800; initial aortic valve replacement strategy: n = 206, n = 170, n = 375, and n = 440). Echocardiographic data were site reported, and there was no echocardiography core laboratory.In the conservative group, the cumulative 5-year incidence of the primary outcome measure (a composite of aortic valve-related death or heart failure hospitalization) was significantly higher in patients with LVEFs 50% and 50% to 59% than in those with LVEFs 60% to 69% and ≥70% (72.3%, 58.4%, 38.7%, and 35.0%, respectively, p 0.001), whereas in the initial aortic valve replacement group, the negative effect of low LVEF was markedly attenuated (20.2%, 20.3%, 17.7%, and 12.4%, respectively, p = 0.03). After adjusting for confounders, LVEF 50% (hazard ratio: 1.82; 95% confidence interval: 1.44 to 2.28; p 0.001) and 50% to 59% (hazard ratio: 1.77; 95% confidence interval: 1.42 to 2.20; p 0.001) but not 60% to 69% (hazard ratio: 1.14; 95% confidence interval: 0.94 to 1.39; p = 0.17) were independently associated with poorer outcomes compared with LVEF ≥70% (reference) in the conservative group. In the initial aortic valve replacement group, the adjusted risk for the primary outcome measure was not significantly different across the 4 LVEF groups.This study demonstrates that survival in patients with severe AS is impaired when LVEF is 60%, and these findings have implications for decision making with regard to the timing of surgical intervention.

Background There are limited data regarding the risk stratification based on peak aortic jet velocity (Vmax) in patients with severe aortic stenosis ( AS ). Methods and Results Among 3815 consecutive patients with severe AS enrolled in the CURRENT AS (Contemporary Outcomes After Surgery and Medical Treatment in Patients With Severe Aortic Stenosis) registry, the study population consisted of 1075 conservatively managed patients with Vmax ≥4.0 m/s and left ventricular ejection fraction ≥50%. The study patients were subdivided into 3 groups based on Vmax (group 1, 4.0 ≤ Vmax AS ‐related events (aortic valve–related death or heart failure hospitalization) was incrementally higher with increasing Vmax (entire population; 38.0%, 49.4%, and 62.8%, P P =0.008; and asymptomatic patients; 29.4%, 38.9%, and 47.7%, P =0.005). After adjusting for confounders, the excess risk of group 2 and group 3 relative to group 1 for AS ‐related events remained significant (hazard ratio, 1.39; 95% CI , 1.07–1.81; P =0.02, and hazard ratio, 1.53; 95% CI , 1.17–2.00; P =0.002, respectively). The effect size of group 3 relative to group 1 for AS ‐related events in asymptomatic patients (N=479) was similar to that in symptomatic patients (N=596; hazard ratio, 1.59; 95% CI , 1.01–2.52; P =0.047, and hazard ratio, 1.67; 95% CI , 1.16–2.40, P =0.008, respectively), and there was no significant overall interaction between the symptomatic status and the effect of the Vmax categories on AS ‐related events (interaction, P =0.88). Conclusions In conservatively managed severe AS patients with preserved left ventricular ejection fraction, increasing Vmax was associated with incrementally higher risk for AS ‐related events. However, the cumulative 5‐year incidence of the AS ‐related events remained very high even in asymptomatic patients with less greater Vmax.

Recently, various projection display systems with projection optics have been developed and introduced. Among these systems, CRT projection displays seem to have better performance for large area displays for home use from the viewpoint of resolution, brightness and smoothness for fast moving pictures. In addition, CRT projection displays will provide excellent picture quality for ongoing and upcoming digital broadcasting. This paper updates the latest development and discusses advantages and disadvantages of CRT based projection displays.

A 60-year-old man was transferred to our hospital in shock about 12 hours after onset of abdominal pain, vomiting, and diarrhea following a party he attended the previous night. There were no significant problems in his medical history. On admission he showed signs of hypotension, high fever, cyanosis, ecchymoses, and anuria. Laboratory examination revealed a marked decrease in white blood cells and platelets, liver and renal dysfunction, hypoglycemia, and metabolic acidosis. An abdominal computed tomographic scan demonstrated a small spleen. Sepsis with disseminated intravascular coagulation (DIC) and acute renal failure was suspected. He was treated with heparin, dopamine, epinephrine, methylprednisolone, and piperacillin and underwent continuous hemofiltration with endotoxin absorption. Despite these treatments his condition deteriorated rapidly and he died 18 hours after onset of symptoms. An autopsy showed a hypoplastic spleen, weighing only 44g, extensive hemorrhage in the bilateral adrenal cortexes, and no septic focus. A blood culture yielded Streptococcus pneumoniae. Immunochemical analysis revealed a marked decrease in the IgG2 level. These findings suggested that the patient had developed fulminant pneumococcal sepsis with DIC and Waterhouse-Friderichsen syndrome due to immunosuppression following a hypoplastic spleen. We should examine the immunological functions including hyposplenism when a healthy person suddenly develops septic shock without any readily identifiable cause.

A 49-year-old man ingested about 200ml of Fenvalerate (synthetic pyrethroid)-Dimethoate (organophosphate) mixture with suicidal intent. He was in deep coma (GCS 3) on admission, 1 hour after ingestion, with a pupil size of 6mm on both sides. He had tachycardia, hypotension, hyperemic bulbar conjunctiva, blushed skin, and decreased activity of serum cholinesterase (Δph 0.45). These signs were compatible with pyrethroid poisoning. He was intubated and received gastric lavage. Six hours after ingestion, he developed systemic muscular fasciculation and clonic convulsion. Diazepam, midazolam, and vecuronium were given intravenously, but both conditions gradually worsened. Twelve hours after ingestion, he showed signs of organophosphate poisoning, such as miosis, increased salivation, and low serum cholinesterase (ΔpH 0.01). Atropine was given intravenously and he underwent direct hemoperfusion (DHP) on the 2nd and 3rd hospital days. Strong muscular fasciculation and convulsion markedly decreased after the 1st DHP. The patient was discharged on the 20th hospital day without any neurological sequelae.This case suggests that the signs of pyrethroid poisoning may develop very early and DHP that is effective for frcating muscular fasciculation and convulsion due to poisoning pyrefhroid.

The relationships between the speed of deterioration in severe asthma attack and clinical characteristics as measured by arterial blood gas values, duration of mechanical ventilation needed, and course of peak inspiratory pressure (PIP) during mechanical ventilation were studied. Twenty-six patients with severe bronchial asthma who underwent mechanical ventilation were classified into 3 groups according to the time interval from the first symptoms of asthma attack to endotracheal intubation: rapid onset group-(ROG: n=9

Tests, using a newly devised “2 pressures/2 systems” method, have been performed to measure the fluid-borne vibration characteristics, i. e., the characteristics of the source flow ripple and source impedance, of axial piston pumps with two kinds of valve plates. This method has proved to give more repetitive measurements of the source flow ripple and source impedance than those from any other method, and the results show good qualitative agreement with the theoretical model. Appropriateness of the results are verified using them to predict the pressure ripple in a typical hydraulic circuit with known propagation characteristics and comparing this with measured pressure ripple. The correlation shows good agreement up to around the 15th (around 3.5kHz) harmonic component.

"Seishu Hanaoka and his surgery" by Shuzo Kure is one of the most important books for the study of Seishu Hanaoka. However, several incorrect descriptions have been pointed out in the book. Therefore, we checked the content about Seicho Kamata, a distinguished disciple of Seishu Hanaoka (p.154-163) in the book, and found three incorrect descriptions. The figure being described as that of Seicho Kamata is his father's. His graveyard being described as "Nyohoji" is truly "Daizenji". Seicho Kamata is also described as the second distinguished disciple of Seishu Hanaoka ; however, authors think that he was the first distinguished disciple from his career. Further investigation into the content of the book is necessary.

To eliminate ammonium sulfate haze caused from sulfuric acid residue on the mask surface, we have been working for resist stripping and cleaning without the use of sulfuric acid process. This paper describes sulfate-free photomask cleaning technology by improving ozone cleaning process.

As both hormonal and hemodynamic alterations similar to those occurring during exercise can also be produced in humans by hypoglycemia, the present study explored changes in hemodynamic parameters during hypoglycemia and the effects of the alpha 1-adrenergic blocker, prazosin, on those responses in hypertensive patients. In the control group, which did not receive prazosin, plasma epinephrine, plasma norepinephrine and plasma renin activity (PRA) all increased along with a rise in blood pressure during hypoglycemia. On the other hand, the blood pressure decreased despite similar increases in plasma catecholamine levels and PRA in the prazosin treated group. The hemodynamic parameters, analyzed using M-mode echocardiography, changed in both the control and prazosin groups during hypoglycemia; stroke volume and cardiac output showed similar increases. However, while the total peripheral resistance did not change significantly in the control group, it decreased in the prazosin group during hypoglycemia. In accord with the changes in total peripheral resistance, the increment in mean-velocity of circumferential fiber shortening (m-Vcf) during hypoglycemia was greater in the prazosin group than in the control. These results suggest that: hypoglycemia stimulates the sympatho-adrenal axis which then releases catecholamines leading to a rise in blood pressure and tachycardia; In contrast, the blood pressure decreases during hypoglycemia in the prazosin group despite an increase in plasma catecholamines, because the alpha-receptors are blocked by prazosin and the unopposed beta-adrenergic effects of the catecholamines are pronounced enough to reduce the total vascular resistance.

加齢に伴う脳卒中後片麻痺患者の下肢機能の予後とリハビリテーション (以下リハと略す) 阻害因子などを知るために, 脳CTスキャン上1側の内包後脚のみに大きさが固定した長径15mm以下 (実物大計算値) の責任病巣がみられた98例 (43～87歳) を検討し次の結論を得た.I. 下肢機能の予後: (1)加齢に伴い, 独歩自立は直線的に減少し (p

The rise time and the peak of a pulsed discharge current are measured under various experimental conditions such as the change in capacitances of both storage and peaking condensers. It is shown that the peak of the discharge current can be determined by the law of the second voltage‐time area. The relation between the rise time and the peak is also made clear.

The effects of hypertonic mannitol on postischemic cerebral circulation were studied in 20 dogs. Mannitol, 2 g/kg iv, was infused into ten dogs during a 2-h period starting 1.5 h after 6 min of complete cerebral ischemia. One hour postischemia, regional cerebral blood flow (rCBF) was 36% in the control group (ten dogs) and 39% in the mannitol group. In the control group, rCBF increased gradually thereafter to 70% of the preischemic value 10 h postischemia, whereas the restoration of rCBF was suppressed in the mannitol group. During the postischemic period, intracranial pressure (ICP) increased significantly in the control group, but it did not change significantly in the mannitol group. The effects of mannitol on rCBF and ICP in the present study can be explained primarily by decreased body water due to urinary loss. The administration of mannitol does not necessarily improve postischemic cerebral circulation.

Alterations in the nuclear and cellular size of human hepatocytes occurring with age, and particularly in senescence, were studied by microphotometry. The material studied was obtained in 35 cases of sudden death, involving 17 males and 18 females ranging in age from 16 to 100 years. Cells of the peripheral zones of hepatic lobules were analyzed. The following results were obtained: 1. The mean nuclear area of hepatocytes remained relatively constant in subjects under 60 years of age but showed an increase in those over 60, this increase being associated with a greater standard deviation. 2. Volumetric analysis showed that the modal value included between 61 and 100% (mean 86%) of the cell nuclei examined and did not increase with age. This cell population was presumed to consist of diploid cells, the size of which remained constant. 3. An increase in mean nuclear area was due to the appearance of cells with larger nuclei which probably were the result of polyploidization. 4. Hepatocyte size increased with age. Analysis of the nucleus-to-cell sizes showed that the increase in cell size with age was more significant than the increase in nuclear size. 5. Cellular enlargement was more closely correlated with decrease in gross liver weight than with nuclear enlargement.

入院した70～89歳の脳血管障害患者で,リハを受けたにもかかわらず寝たきり,全介助状態で退院した86(男44,女42)例について下記の検索をした.I.退院先:(1)自宅退院は23例(26.7%)で,近年その率は減少傾向にある.(2)転院は63例(73.3%)で,その特徴は長期入院可能な老人病院へが大多数(49例)であった,身寄りなし患者は特養入所が多かった(p

The photoconductivity and luminescence of additively colored KCl crystals by excitation with light in the F band were measured at room temperature as a function of the M center concentration. With the growth of the M band, the photocurrent decreased, while the emission intensity increased. This result would suggest that for a crystal containing M centers the photoconductivity due to the F center and the luminescence due to the M center are the competing processes in the excited state of F centers.

The problems of thermal stress and vibration of structural components and structures, resulting from the aerodynamic heating encountered in the supersonic flight and from the extremely high temperature induced in combustion chambers and exhaust pipes, have been of great importance in connection with the development of missiles and artificial satellites. In the present paper, the fundamental equations of non-linear free flexural vibration for a heated rectangular plate, taking the initial deflection into account, are solved approximately by employing a method of successive approximation, and the influences of the initial deflection, temperature change and large amplitude on the period of free vibration are established. Then, some experimental results on the free vibration of a plate subjected to the change in temperature are presented. It is shown that the experimental results agree qualitatively with the theoretical one.

Age-related alterations in the size of human hepatocytes (both mononudear and binucieate forms), were studied in histological sections and in separated cells and nuclei using cytophotometrical and microspectro-photometrical methods. The following results were obtained : 1. The volume of nuclear DNA increased in proportion to nuclear size. The increase occurred in a group pattern reflecting nuclear polyploidization. 2. Cell size increased in proportion to nuclear size. Tetraploid cells (4C) were roughly two times greater than diploid cells (2C). 3. In most of the binucieate cells examined, the ploidy class of the two nuclei in a binucieate cell was observed to be equal. Heterogeneity of the ploidy class among the nuclei of a binucieate cell was present in less than 1% of total binucieate cells examined. The nuclear DNA volume of individual nuclei in binucieate cells appeared to be the same as that of mononuclear cells. 4. The cell size of binucieate cells corresponded with that of mononuclear cells whose ploidy class was the same as the sum of the ploidy classes of two nuclei of a binucieate cell. 5. The incidence of binucieate cells in the lobular periphery was about 4 to 6% in the third decade, and increased slightly with age up to 5 to 7% in the tenth decade. 6. The incidence of binucieate cells in the liver at different ages followed a similar pattern to that observed in mononudear cells whose ploidy class was half of the sum of ploidy classes of the two nuclei of the binucieate cell.

老年者脳血管障害に対するリハビリテーション効果を調査し, 阻害因子, 退院先について検討した. 昭和58年4月から59年3月までの1年間に東京都養育院附属病院に入院し理学療法をうけた平均71歳の脳血管障害150例 (男89, 女61例) を対象とした. 日常生活動作能力 (ADL) は歩行機能に注目し, 1度は独歩 (杖使用も含む), 2度は室内移動, 3度はベッド周囲, 4度は寝たきりと分類した.結果: (1) 脳血管障害は出血27例, 梗塞123例であった. (2) 訓練期間は1カ月以内29例, 3カ月以内69例, 6カ月以内52例であった. (3) 開始時ADLは1度から4度まで6, 25, 40, 79例で, 終了時は同じく, 40, 47, 36, 27例で3, 4度が減り1, 2度が増加した. (4) 終了時ADLに及ぼす影響. 年齢は加齢とともに1度は減じ, 4度は増加した. 片麻痺は左62例, 右73例, 両側片麻痺15例で改善に差はなかった. 訓練開始までの期間では6カ月未満開始群は60%が改善し, それ以後の開始群は60%が3度, 4度に留った. その他知的機能低下, 意欲低下, 患側無視, 皮質枝系梗塞は阻害因子であった. (5) 終了時ADLと退院先の関係は101例 (67.3%) が自宅に退院し, 49例 (32.7%) は諸施設内に留った. ADL別にみると障害が進むにつれて施設ケアの割合が多く, 4度では自宅退院がわずか33.3%であった.以上, 老年者でもリハビリテーションにより半数以上は1度2度に改善するが, 高齢, 訓練の遅れ, 痴呆, 意欲低下等の阻害因子のため自宅に退院できないものが33%に達した.

This study compared a new method to estimate sinoatrial conduction time (SACT) using continuous atrial pacing proposed by Narula et al with the widely used method using premature atrial stimulation originally proposed by Strauss et al. The estimated SACTs by the two methods were obtained in 19 patients with normal sinus node (SN) function (Group A) and 8 patients with abnormal SN function (Group B). Estimate of the SACT by the Narula method was taken as the difference between the first atrial return cycle after pacing and the basic sinus cycle length (BSCL). The Narula method was performed for a train of 8 consecutive beats at three different pacing cycle length (PCL); PCL (1) greater than or equal to BSCL--50, PCL (2) greater than or equal to BSCL--100 and PCL (3) greater than or equal to BSCL--150 msec. In group A, the estimated SACTs by the Strauss method was 185 +/- 49.3 msec, meanwhile the SACTs by the Narula method were 148 +/- 80.7 at PCL (1), 181 +/- 58.7 at PCL (2) and 212 +/- 84.5 msec at PCL (3) (mean +/- SD); the coefficient of correlation between the Strauss method and the Narula method were 0.58, 0.84, and 0.67, respectively. On the other hand, in group B, atrial return cycles by the Narula method were abnormally prolonged (over 215 msec) in 5 of 8 cases (63%) even at PCL (2) and in all of the cases (100%) at PCL (3). By the Strauss method, SACTs in 6 of 8 cases could not be defined; however it was possible to assess the type of SN dysfunction by the pattern of the atrial return cycles. In conclusion, the estimated SACT by the Narula method at PCL (2) corresponded well with the SACT by the Strauss method in patients with normal SN function. However, it was difficult to determine SACT in patients with Sick Sinus Syndrome by both methods.

Size alterations, both of cell and nucleus, of the centenarian hepatocyte followed a pattern proportionate to aging which was observed in the hepatocyte of non-centenarian groups and clearly followed nonagenarian in location on the graph. When size alterations of the hepatocyte were considered as an aging parameter, the present observation suggests that the centenarian could be a group next to the nonagenarian. The results obtained by present cytomorphometrical analysis do not favor a hypothesis that the centenarian is a select population in terms of longevity.

The left ventricular filling and wall movement were investigated in subjects with a third heart sound or ventricular gallop by echocardiography. Nine patients with ventricular gallop, who had left ventricular volume overload disease, and 6 normal subjects with a third heart sound had higher normalized peak rate of increase of the left ventricular dimension (peak dD/dT/D) than 10 normal subjects without a third heart sound (p less than 0.01). The normalized lengthening rate in the rapid filling phase was also higher in patients with ventricular gallop than in normal subjects without a third heart sound (p less than 0.05). The time from the second heart sound to peak dD/dT/D and rapid filling time did not show statistically significant values between subjects with ventricular gallop or a third heart sound and those without a third heart sound. These results suggest that higher peak filling, larger filling volume in the rapid filling phase and more abrupt cessation of the outward movement of the left ventricular wall may be a cause of the production of ventricular gallop in patients with left ventricular volume overload and of the physiological third heart sound.

A patient with click and late systolic murmur syndrome originating in the right side of the heart is described. Prolapse of the anterior tricuspid leaflet was demonstrated by subxiphoid two-dimensional echocardiography alone. Neither of the mitral leaflets showed any evidence of prolapse on the echocardiogram. The prolapsed anterior tricuspid leaflet and mild regurgitation were confirmed by right heart cineangiogram.