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Leprosy is a neglected tropical disease predominately affecting poor and marginalized populations. To test the hypothesis that poverty-alleviating policies might be associated with reduced leprosy incidence, we evaluated the association between the Brazilian Bolsa Familia (BFP) conditional cash transfer program and new leprosy case detection using linked records from 12,949,730 families in the 100 Million Brazilian Cohort (2007–2014). After propensity score matching BFP beneficiary to nonbeneficiary families, we used Mantel-Haenszel tests and Poisson regressions to estimate incidence rate ratios for new leprosy case detection and secondary endpoints related to operational classification and leprosy-associated disabilities at diagnosis. Overall, cumulative leprosy incidence was 17.4/100,000 person-years at risk (95% CI: 17.1, 17.7) and markedly higher in “priority” (high-burden) versus “nonpriority” (low-burden) municipalities (22.8/100,000 person-years at risk, 95% confidence interval (CI): 22.2, 23.3, compared with 14.3/100,000 person-years at risk, 95% CI: 14.0, 14.7). After matching, BFP participation was not associated with leprosy incidence overall (incidence rate ratio (IRR)Poisson = 0.97, 95% CI: 0.90, 1.04) but was associated with lower leprosy incidence when restricted to families living in high-burden municipalities (IRRPoisson = 0.86, 95% CI: 0.77, 0.96). In high-burden municipalities, the association was particularly pronounced for paucibacillary cases (IRRPoisson = 0.82, 95% CI: 0.68, 0.98) and cases with leprosy-associated disabilities (IRRPoisson = 0.79, 95% CI: 0.65, 0.97). These findings provide policy-relevant evidence that social policies might contribute to ongoing leprosy control efforts in high-burden communities.

BACKGROUND: Universal health coverage is one of the WHO End TB Strategy priority interventions and could be achieved-particularly in low-income and middle-income countries-through the expansion of primary health care. We evaluated the effects of one of the largest primary health-care programmes in the world, the Brazilian Family Health Strategy (FHS), on tuberculosis morbidity and mortality using a nationwide cohort of 7·3 million individuals over a 10-year study period. METHODS: We analysed individuals who entered the 100 Million Brazilians Cohort during the period Jan 1, 2004, to Dec 31, 2013, and compared residents in municipalities with no FHS coverage with residents in municipalities with full FHS coverage. We used a cohort design with multivariable Poisson regressions, adjusted for all relevant demographic and socioeconomic variables and weighted with inverse probability of treatment weighting, to estimate the effect of FHS on tuberculosis incidence, mortality, cure, and case fatality. We also performed a range of stratifications and sensitivity analyses. FINDINGS: FHS exposure was associated with lower tuberculosis incidence (rate ratio [RR] 0·78, 95% CI 0·72-0·84) and mortality (0·72, 0·55-0·94), and was positively associated with tuberculosis cure rates (1·04, 1·00-1·08). FHS was also associated with a decrease in tuberculosis case-fatality rates, although this was not statistically significant (RR 0·84, 95% CI 0·55-1·30). FHS associations were stronger among the poorest individuals for all the tuberculosis indicators. INTERPRETATION: Community-based primary health care could strongly reduce tuberculosis morbidity and mortality and decrease the unequal distribution of the tuberculosis burden in the most vulnerable populations. During the current marked rise in global poverty due to the COVID-19 pandemic, investments in primary health care could help protect against the expected increases in tuberculosis incidence worldwide and contribute to the attainment of the End TB Strategy goals. FUNDING: TB Modelling and Analysis Consortium (Bill & Melinda Gates Foundation), Wellcome Trust, and Brazilian Ministry of Health. TRANSLATION: For the Portuguese translation of the abstract see Supplementary Materials section.

Background Leprosy remains concentrated among the poorest communities in low-and middle-income countries and it is one of the primary infectious causes of disability. Although there have been increasing advances in leprosy surveillance worldwide, leprosy underreporting is still common and can hinder decision-making regarding the distribution of financial and health resources and thereby limit the effectiveness of interventions. In this study, we estimated the proportion of unreported cases of leprosy in Brazilian microregions. Methodology/Principal findings Using data collected between 2007 to 2015 from each of the 557 Brazilian microregions, we applied a Bayesian hierarchical model that used the presence of grade 2 leprosy-related physical disabilities as a direct indicator of delayed diagnosis and a proxy for the effectiveness of local leprosy surveillance program. We also analyzed some relevant factors that influence spatial variability in the observed mean incidence rate in the Brazilian microregions, highlighting the importance of socioeconomic factors and how they affect the levels of underreporting. We corrected leprosy incidence rates for each Brazilian microregion and estimated that, on average, 33,252 (9.6%) new leprosy cases went unreported in the country between 2007 to 2015, with this proportion varying from 8.4% to 14.1% across the Brazilian States. Conclusions/Significance The magnitude and distribution of leprosy underreporting were adequately explained by a model using Grade 2 disability as a marker for the ability of the system to detect new missing cases. The percentage of missed cases was significant, and efforts are warranted to improve leprosy case detection. Our estimates in Brazilian microregions can be used to guide effective interventions, efficient resource allocation, and target actions to mitigate transmission., Author summary Leprosy remains an important public health problem that affects vulnerable populations in low- and middle-income countries. In this study, we estimated how many cases were not detected in each Brazilian microregion by the surveillance system during the period of 2007 until 2015. Using a mathematical model, we found out that around 10% of the estimated number of cases occurring in the country in the study period were missed by the health system, and this represented over 33 thousand cases overall. These findings are important as undetected and therefore untreated cases can progress and lead to lifelong disabilities. In addition, missing cases prevents the health system from evaluating exposed contacts, which could lead to further delays in diagnosis. Describing the magnitude, location and correlates of leprosy underreporting at the microregional level will inform the efforts of policymakers and program managers in designing interventions and allocating resources to achieve leprosy control targets.

Leprosy remains an important health problem in Brazil - the country register the second largest number of new leprosy cases each year, accounting for 14% of the world's new cases in 2019. Although there was increasing advances in leprosy surveillance worldwide, the true number of leprosy cases is expected to be much larger than the reported. Leprosy underreporting impair planning effective interventions and thoughful decisions about the distribution of financial and health resources. In this study, we estimated leprosy underreporting for each Brazilian microregion in order to guide effective interventions and resouce allocation to improve leprosy detection in the country. We extracted the number of new cases of leprosy from 2007 to 2015 and population and socioeconomic information from the 2010 Census for each Brazilian municipality and grouped data in microregions. We applied a Bayesian hierarchical model to obtain the best explicative model for leprosy underreporing using Grade 2 of leprosy-related disabilities as a proxy to explain the incidence rates. Then, we estimated the number of missing leprosy cases (underreported cases) and the corrected leprosy incidence rates for each Brazilian microrregion.

Background: Preterm birth (25 times higher for LBW (HR=25.8; (95% CI:25.5-26.1) compared to normal birth weight (NBW). 18% of all live births were included in one of the small vulnerable newborn phenotypes. Of those 8.2% were term-SGA (4.7%NBW, 3.5%LBW), 0.6% were term-AGA-LBW, 8.3% preterm-AGA (3.8%NBW, 4.5%LBW) and 1.0% preterm-SGA-LBW. Compared to term-AGA-NBW, the highest mortality risk was for preterm-LBW phenotypes (HR=36.2(95%CI 35.6-36.8) preterm-AGA-LBW, HR=62.0(95%CI 60.8-63.2) preterm-SGA-LBW). The increased mortality risk associated with vulnerable newborn phenotypes was highest in the first month of life, with attenuated but continued high risk in the post-neonatal period and 1-4 years of age. Interpretation: Our findings support the value of using more detailed phenotypes to identify those at highest risk. More granular data can inform care at the individual level, advance research, especially for prevention, and accelerate progress towards global targets such as the Sustainable Development Goals. Funding: Wellcome Trust

The integration of disparate large and heterogeneous socioeconomic and clinical databases is considered essential to capture and model longitudinal and social aspects of diseases. However, such integration is challenging: databases are stored in disparate locations, make use of different identifiers, have variable data quality, record information in bespoke purpose-specific formats and have different levels of metadata. Novel computational methods are required to integrate them and enable their statistical analyses for epidemiological research purposes. In this paper, we describe a probabilistic approach for constructing a very large population-based cohort comprised of 114 million individuals using linkages between clinical databases from the National Health System and administrative databases from governmental social programmes. We present our data integration model for creating data marts (epidemiological data) and discuss our evaluation results in controlled and uncontrolled scenarios, which demonstrate that our model and tools achieve high accuracy (minimum of 91%) in different probabilistic data integration scenarios.

Summary Current-year Fagus crenata seedlings survive damping-off in the forest-edge plot compared to those in the closed-stand plot. Greater illumination found in the forest-edge plot is likely to influence the defense of seedlings against pathogenic attack, by increasing the amount of phenolic compounds and forming periderm. This study aimed to clarify the chemical defense system by (i) isolation of antifungal compounds from seedling hypocotyls in the forest-edge plot, (ii) quantification of antifungal compounds in hypocotyls in the forest-edge and closed-stand plots, (iii) estimation of their antifungal activities against Cylindrocarpon sp. and Colletotrichum dematium and (iv) clarification of localization of phenolics in the hypocotyl tissues. Catechin and epicatechin were isolated as antifungal compounds showing inhibition of microconidia germination of Cylindrocarpon sp. and mycelial growth of Cylindrocarpon sp. and C. dematium. In the beginning of July when damping-off was the most severe in the closed-stand plot, the total amount of catechin and epicatechin in the forest-edge seedlings was approximately three times greater than that in the closed-stand seedlings. Flavan-3-ols, including catechin and epicatechin, were distributed mainly in the epidermal tissue on June 1 and in cortical tissues on June 15 and July 6, all from plants harvested from the forest-edge plot. We conclude that F. crenata could survive damping-off through chemical defense via catechin and epicatechin production and its distribution in seedling hypocotyls.

Summary Ciboria batschiana, a fructicolous Discomycete, is a pathogen of Quercus serrata acorns, which containconsiderable amounts of tannins in the cotyledons. It was hypothesized that the severity ofC. batschiana infection may differ according to individual acorn tannin content. To examine thishypothesis, we investigated the relationship between survival of acorns to C. batschiana and tannincontent, estimated non-destructively using near infrared spectroscopy analysis. In addition, aninoculation experiment showed that acorns with higher tannin contents were more resistant toC. batschiana than those with lower tannin contents. We conclude that infection success ofC. batschiana differs with tannin content of individual acorns. 1 Introduction In Europe the fungus Ciboria batschiana (Zopf) Buchwald, a fructicolous Discomycete, is awell known pathogen of Quercus acorns (seeds) (Schro¨der et al. 2004). Following acornattack the fungus forms a pseudosclerotium, causing diseased cotyledons to turn black andcorky, with subsequent development of apothecia on the pseudosclerotium the followingautumn. Apothecia eject huge numbers of ascospores, which infect mature acorns(Schro¨der 2002). Severe decay of individual acorns by C. batschiana causes irrevocabledeterioration in acorn viability (Schro¨der et al. 2004). In nature, where the annualinfection rate varies, C. batschiana can destroy up to 80% of an acorn crop (Procha´zkova´et al. 2005). Spread of C. batschiana may also result in severe losses in seedling populationsof oaks in forests (Procha´zkova´ et al. 2005).In Japan, C. batschiana apothecia develop on Quercus serrata and Quercus crispula(syn. Quercus mongolica var. grosseserrata) acorns (Otani 1990) and inoculations haveshown that C. batschiana is pathogenic to such acorns (Y. Ichihara, Y. Masuya, andT. Kubono, unpublished). Cotyledons of Q. serrata acorns contain large amounts oftannins (Takahashi and Shimada 2008). Tannins have antimicrobial properties,inhibiting extracellular microbial enzymes, or acting directly on microbial metabolism(Scalbert 1991). The tannin content of individual Q. serrata acorns varies greatly(Takahashi and Shimada 2008). Therefore, we hypothesized that infection byC. batschiana may differ according to the tannin content of individual acorns. Toexamine this hypothesis, we investigated the relationship between acorn survival againstC. batschiana and acorn tannin content, which was non-destructively estimated beforeinoculation using near infrared spectroscopy (NIRS).For. Path. 40 (2010) 96–99 doi: 10.1111/j.1439-0329.2009.00612.x 2009 Blackwell Verlag GmbH

The influence of underneath magnetization of Nd-Fe-B sintered magnets on surface domain configurations was investigated using a Kerr microscope by cutting the magnets at an angle to the c-axis. When the angle formed by the surface and the c-axis is larger than 30 degrees, the observed domain configurations change to maze patterns because of an increase in the demagnetizing field at the surface. In contrast, when the cutting angle is 10 degrees, residual magnetization increases with the applied field. It was found that at a cutting angle of 10 degrees, the underneath domain configurations can be indirectly observed through the surface by propagation of magnetic flux from the underneath grains.

We consider the sum of coefficients which are in the Dirichlet series expansion of symmetric square L-functions. In this paper, we obtain two estimates of this sum in weight and level aspects. These imply two estimates of the sum of the n 2th Fourier coefficients of cusp forms.

Severe damages to natural vegetation, agriculture, and forestry caused by overpopulation of sika deer (Cervus nippon) have markedly increased in Japan in recent years. To devise a population management plan of sika deer, information on the distribution and population size of the animal in each region is indispensable. An easy and effective method to obtain this information is to count the fecal pellets in the field. However, the habitat of sika deer in Japan overlaps that of Japanese serow (Capricornis crispus). Additionally, it is difficult to discriminate between the feces of both animals. Here, we present a rapid and precise diagnostic method for discriminating between the feces of sika deer and Japanese serow using loop-mediated isothermal amplification (LAMP) targeting cytochrome b gene in the mitochondrial DNA. Our results showed that the LAMP can discriminate between the feces of sika deer and Japanese serow, and the method is simpler and more sensitive than the conventional molecular diagnostic method. Since LAMP method does not require special skills for molecular biology techniques, even the field researchers who have never done a molecular experiment can easily carry out the protocol. In addition, the entire protocol, from DNA extraction from fecal pellet to identification of species, takes only about 75 min and does not require expensive equipment. Hence, this diagnostic method is simple, fast, and accessible to anyone. As such, the method can be a useful tool to estimate distribution and population size of sika deer.

There is a diversity of opinions and policies on nuclear power generation, which involves a large number of stakeholders. Although public acceptance is indispensable, public attitudes toward nuclear power are ambivalent. The understanding of a broad spectrum of engineers engaged in the electric power industry should form the basis for social acceptance, since nuclear power should be evaluated from the overall perspective of energy supply and demand. The electricity industry today has to deal with some fundamental problems such as competition, stability of the supply of electric power and global environmental issues. The value of nuclear power,er generation depends upon the socio-economic conditions of a region where it is provided. In any case, nuclear power technology of some form seems to be the only solution to these energy-related problems from the long-term perspective based on today's knowledge. In the meantime, a peculiarity of nuclear technology is public concern over safety, radioactive waste disposal, and misuse. Currently, there are several R&D programs aiming to solve these questions, from the improvement of large capacity power generation reactors and small-size reactors for various energy applications, to innovative fast breeder reactors. There seems to be no single technology that will satisfy the demands of all stakeholders. Increasing the technological options through R&D will ease public acceptance, together with efforts to abolish nuclear weapons and ensure transparency in industrial activities.

In order to clarify the mechanism of pine wilt caused by the pinewood nematode (PWN), Bursaphelenchus xylophilus, nematode migration in tissues and disease symptoms in Pinus thunbergii seedlings were investigated. One-year-old seedlings were inoculated with different pathogenic isolates of PWN under two different temperatures. At an early stage of symptom development, a virulent isolate of PWN multiplied in both bark and xylem and was distributed in cortical resin canals, cortical tissue, and xylem resin canals at 30°C. Cell death and disease symptoms developed in both bark and xylem. The virulent isolate of PWN at 25°C and the avirulent isolate of PWN at 30°C were distributed mainly in cortical resin canals, but rarely in xylem resin canals and cortical tissue. Disease symptoms and cell death occurred in cortical resin canals and rarely occurred in other tissues. These results demonstrated that the virulent isolate of PWN at low temperature and avirulent nematodes could not easily migrate to xylem resin canals and cortical tissue. It was shown that cell death and early symptom development coincided with PWN migration and, therefore, PWN invasion induces cell death and early symptom development.

Summary The distribution of cortical resin canals and periderm formation in the cortex of Pinus thunbergii was studied in relation to early invasion of the pinewood nematode, Bursaphelenchus xylophilus. Nematode invasion was restricted in stem cuttings of P. thunbergii in which periderm closed cortical resin canals. Early invasion of the nematodes was also restricted in stem cuttings where wound periderm had formed in response to prior nematode inoculation. It was concluded that early invasion of pinewood nematodes in living bark tissue is restricted by periderm in mature stems and by wound periderm that had formed as the result of previous nematode infection.

In pace with the worldwide trend, the Japanese electric power industries are being deregulated and entering into competitive markets. Generation and a large size retail market are open to competition. The transmission system is open for use by new power suppliers, while utilities get the freedom of new business expansion. Traditional electric power utilities and new players are actively preparing for the new environment. This article discusses the challenges and opportunities for engineers in the electric power industry created by the changes occurring in the industry today.

Cathodic polarization curves for the reduction of oxygen and protons on platinum and iron electrodes under thin electrolyte layers (X{sub f}: 1 mm to 10 {micro}m) were measured to elucidate the effects of the thickness and the pH of the electrolyte layer on the initial atmospheric corrosion stage of iron. A limiting current was exhibited on the cathodic polarization curves under neutral electrolyte layers containing 0.1 to 2 M NaCl, which was inversely proportional to the thickness of the electrolyte layer down to approximately 20 {micro}m. This result indicates that oxygen diffusion through the electrolyte layer is the rate-determining step (rds) for the oxygen reduction process. Meanwhile the limiting current under still thinner layers (X{sub f}: 10 to 20 {micro}m) was independent of the thickness, where an oxygen dissolution step at the air/electrolyte interface is the rds because of the considerably higher diffusion rate under such very thin electrolyte layers. AC impedance corrosion monitoring of iron for the period of 4 h was performed under electrolyte layers of different thickness (X{sub f}: 1 mm to 10 {micro}m) and pH (pH 3.0, 4.0, and 5.7). The results indicated that the corrosion rate showed a maximum at an electrolyte thickness of 20more » to 30 {micro}m in all cases, and the effect of pH on the atmospheric corrosion rate was negligible, except for cases wherein a relatively thick electrolyte layer (>1 mm) was present for a short exposure period (

The impedance behavior of metals covered with a thin electrolyte layer has been investigated. A transmission line (TML) circuit type behavior, which was attributed to an uneven current distribution profile over a working electrode, was observed in a wider frequency range as the thickness and the concentration of the electrolyte were decreased. It was found from the theoretical analysis based on the TML model that the current distribution profile becomes uniform at least in the low frequency limit when the phase shift θ goes further than −45 ° on a plot of θ vs. log f(f = frequency). In such a condition, an accurate corrosion rate can be determined from the obtained polarization resistance Rp. The EIS has been applied to investigate the dependence of the atmospheric corrosion of stainless steel and of copper on the thickness of the electrolyte layer. The corrosion rate of stainless steel covered with an NaCl solution layer was independent of the thickness at least down to the thickness of 10 μm because it was controlled by the anodic process. The corrosion rate of copper covered with a neutral Na2SO4 solution was independent of the thickness at least down to 10 μm, whereas the copper covered with an acidic solution of pH 3 showed a maximum at a thickness of several tens of micrometers.

An electrochemical impedance spectroscopy (EIS) technique has been applied to estimate the corrosion rates of metals covered with a thin electrolyte layer. A two electrode cell system, which consists of a pair of identical metal electrodes embedded in parallel in epoxy resin, was used for measuring the corrosion rates. The impedance measurements for Type 304 stainless steels covered with an NaCl solution layer and ordinary carbon steels with an H 2 SO 4 solution layer, 10–1000 μm in thickness, were carried out in the frequency range of 10 mHz–10 kHz to determine the equivalent circuit of a metal-thin electrolyte layer interface and the influence of current (potential) distribution over the electrode surface on the EIS data. It was found that the obtained EIS data can be described by a transmission line (TML) model, in which the current distribution over the electrode surface is considered. The analysis of current distribution based on a TML model demonstrated that EIS data give information on the current distribution under the application of AC voltage. If the phase shift θ goes further than −45 ° on a plot of θ vs logf(f—frequency) the current distribution becomes uniform at least in the low frequency limit, and consequently an accurate corrosion rate can be determined from the obtained polarization resistance. The impedance of copper covered with an Na 2 SO 4 solution was measured to investigate the influence of the thickness of the electrolyte layer on the atmospheric corrosion rate. For copper covered with a neutral Na 2 SO 4 solution of pH 6, the corrosion rate was independent of the thickness at least down to the thickness of 10 μm. whereas the corrosion rate of copper covered with acidic solutions of pH 3 indicated a maximum at a thickness of several 10s of micrometers.

We investigated the patterns of DNA rearrangements at loci for Ig JH genes in patients with severe combined immunodeficiency (SCID). Four SCID patients without B cells (B- SCID) and four SCID patients with B cells (B+ SCID) were examined. Bone marrow cells of these patients were transformed with EBV. The majority of the transformed cells from three B- SCID patients had the germline configuration at their JH gene loci. The rearranged fragments from one patient were analyzed extensively. The rearranged regions in all of the fragments had a common structure wherein two fragments derived from the JH-S mu region were connected inversely. The possible presence of rearranged forms of VHDJH and DHQ52JH sequences in bone marrow cells of two B- SCID patients were examined directly by the polymerase chain reaction (PCR) method. In one patient, we found neither a VHDJH sequence nor a DHQ52JH sequence within the range of sensitivity of the PCR method. In another patient, we found a VHDJH sequence at an extremely low level and DHQ52JH sequences at a relatively low level. Either RAG-1 or RAG-2 gene was not expressed in the B- SCID-derived cell lines. B+ SCID patients did not show any abnormalities in terms of VHDJH rearrangements. These results indicate that B- SCID may be caused by defects in factors involved in V(D)J rearrangements.

Leptographium species are anamorphs of Ophiostoma, commonly isolated from conifer. There are, however, a small number of these fungi that have been collected from angiosperm hosts. In this study, we describe Leptographium pruni, sp. nov. isolated from the bark of Prunus jamasakura infested by the bark beetle Polygraphus ssiori. This new species is unusual in having a distinct Sporothrix synanamorph with ramoconidia. No evidence of a teleomorph was found, but a high level of tolerance to the antibiotic cycloheximide and the presence of a Sporothrix synanamorph suggest that L. pruni is an Ophiostoma anamorph. Analysis of sequence data for the domain 1 region of the LSUrDNA operon also supports the phylogenetic relationship of L. pruni with Ophiostoma. In addition, sequence data suggest that L. pruni is related to other species of Leptographium rather than Pesotum species with distinct Sporothrix synanamorphs.

As interest in studying environmental issues has grown, the mechanical properties of eco-friendly materials have been studied. In our research, a card machine that enables raw materials to loose and to mix uniformly was used. Fibrous polypropylene and cotton or ramie fiber were used as raw materials since many textiles and apparel are made of such fibers. From a viewpoint of reuse, the loosing technique of the card machine can be effective. We designed anisotropic composites by using the card machine followed by the hot press process. The tensile, flexural and compression properties were investigated. Ramie fiber reinforced polypropylene (RP) was stronger than cotton fiber reinforced polypropylene (CP); however, breaking elongation of composites of CP is superior to that of RP because of the character of natural fiber. The density of composites applied to the loosing technique also affected the strength of composites. It was clear that density is an important parameter to describe the performance of a green composite. Moreover, it was found that the initial fracture in flexural behavior is affected by the compression strength of composites using the loosing technique.

In this paper, a novel path planning and a novel tracking control way of wheeled mobile robot is proposed. Since wheeled mobile robots have nonholonomic constraint, it is impossible to track an arbitrary trajectory at an arbitrary speed. In the conventional ways, the path that the robots can track and that fills the requirement like the collision avoidance etc. is planned. In addition tracking control aims to make the robot follow accurately this path. However, when the robot swerves from the trajectory, it is necessary to plan the trajectory again in such methods. According to the planning way, such a trouble can be raised with the action of the robot because the amount of calculation is huge. Then, this paper aims to track the trajectory, which is assumed not to be able to track because of nonholonomic constraint, in a constant permissible error range. In addition, it is proposed that a novel tracking control method by which the robot can return to the trajectory when the robot swerves from it. Besides, the way to give the commands taking the performance of the actuator into consideration is proposed.

In Japan, the rate of Ca-induced Ca release (CICR) using skinned fibers of skeletal muscle has been employed as a diagnostic test for malignant hyperthermia (MH) susceptibility, since most of the typical fulminant MH patients showed an enhancement of CICR rate. Recently the Ca releasing channel responsible for the CICR was reported to be mainly the ryanodine binding Ca protein which was identified as the causative site of MH muscle according to recent genetic studies. Among patients with enhanced CICR rate, one point mutation for Arg 2434 His was recognized in a family. Although this site is related to the central core disease (CCD), this pathological change could not be observed in this patient. This is the first report describing a gene mutation in a MH family identified in Japan.

Economic expansion and population growth in Asia have caused sharp increases in electricity consumption. Though technology may be essentially "universal", there are regional and cultural factors to be dealt with. As Asia will continue to develop from now on, the technology necessary for and suitable to Asia will be an important part of the technology system of the world. Here, the author argues that, in order to achieve further development in allowing Asia to solve its own problems, the broad activity of R&D should be carried out by electric power supply industries and R&D organizations in this area. International exchange of information and cooperation will increase its efficiency and quality.

We investigated the use of the spatial ventricular gradient (VG) from vectorcardiogram (VCG) to determine whether significant repolarization differences were present in patients with WPW syndrome compared with normal subjects and also examined which VG parameter (i.e., elevation, azimuth, and magnitude) reflected the differences in repolarization properties during preexcitation. VG was calculated in 49 patients of Wolff-Parkinson-White (WPW) syndrome (group A: left-sided accessory pathway, n = 29; group B: right-sided, n = 20). Group N consisted of 607 normal subjects. In group A, the azimuth of VG was significantly (p0.01) greater than in groups B and N. In group B, the elevation of VG was significantly (p0.01) greater than in groups A and N. There were no significant differences in the magnitude of VG among groups. QRS duration was significantly (p0.01) related with the elevation of VG in group B. These findings suggested that VG is useful for spatial evaluation of repolarization abnormalities during preexcitation, which are related to the site of the accessory pathway.

To examine the role of lifestyles in the subsequent development of renal damage, the association of smoking, drinking and physical activity with subsequent proteinuria was investigated utilizing a longitudinal study. The subjects were 7,701 males aged 20-84 years, who participated in health examinations at Aichi Prefectural Center of Health Care, Nagoya, Japan, both in 1989-1990 and 1992-1993, and who showed no proteinuria at the first examination. Lifestyles at the first examination were compared between 140 men with, and 7,561 men without, newly developed proteinuria at the second examination. Age-adjusted odds ratios (ORs) of lifestyle factors for proteinuria were computed, and further the ORs were adjusted for age, systolic blood pressure, fasting plasma glucose level and other covariates obtained using multiple logistic regression analysis. Major significant findings which emerged from the present study were as follows. (a) The greater the consumption of alcohol per day, the higher the risk of subsequent proteinuria (trend p = 0.003). Heavy drinkers who consumed more than 58 g of alcohol per day experienced an increased risk (OR relative to non-drinker: 2.52). (b) Those who exercised less than once a week, and those who avoided walking even a short distance were at an increased risk (OR: 1.46, 1.55, respectively). Heavy drinking and low physical activity were found to be significantly associated with an increased risk of subsequent proteinuria even after adjusting for the covariates. An increasing risk of subsequent proteinuria with number of cigarette smoked per day was observed by univariate and multivariate analysis but without statistical significance.(ABSTRACT TRUNCATED AT 250 WORDS)

Isopotential map, constructed from ECGs of many body surface electrodes, is an expression of body surface distribution of cardiac potentials at a moment. This ECG mapping technique, providing far more information than the conventional 12-lead ECG recordings, has proved moving multiple dipoles of the heart as electric power generator, and has clarified break through minimum indicative of the right ventricular epicardial depolarization. It is also utilized for diagnosis of right ventricular or posterior myocardial infarction, left ventricular hypertrophy, localization of accessory pathway in WPW syndrome, indication for intervention in acute myocardial infarction, identification of responsible coronary artery in angina pectoris, risk of ventricular tachycardia etc. Further information on the heart will be expected through this mapping technique.

The significance of phrenic nerve block was studied in the anesthetic management of laparoscopic cholecystectomy. Right phrenic nerve block with 1% mepivacaine 10 ml was performed after the patients were epidurally catheterized and anesthetized with isoflurane and nitrous oxide in oxygen. Intraoperative anesthetic requirement and postoperative shoulder pain incidence in patients with this block were compared with those in patients without block. Addition of the phrenic nerve block to general and epidural anesthesia did not reduce the intraoperative dosage of isoflurane, but it significantly prevented occurrence of postoperative right shoulder pain. It is known that phrenic nerve contains sensory element and that laparoscopic procedures of gall bladder elicit noxious stimuli which cannot be blocked by ordinary epidural anesthesia for abdominal surgery. Also, shoulder pain is said to be phrenic nerve-mediated referred pain. Our study suggests that blockade of these stimuli is effective in preventing postoperative event rather than intraoperative.

To assess the effects of right ventricular (RV) pacing on body surface QRST distributions, we recorded QRST isointegral maps (I-maps) during sinus rhythm and RV pacing in 25 patients with anterior myocardial infarction (MI), 19 with inferior MI, and 14 without MI. The QRST values at each lead point recorded during sinus rhythm and RV pacing with an 87-lead system were analyzed with a paired t-test in each patient. An abnormal decrease in the QRST value of the I-map was assessed by the difference map, which indicated a "-2SD area," where the QRST integral value was less than the normal range (mean - 2SD) calculated from 608 normal individuals. The I-maps were similar during the two activation sequences in patients with and without MI. However, during RV pacing, QRST values significantly decreased over the upper right anterior chest and increased over the lower left anterior chest and back. The sigma DMs (sum of QRST integral values below the normal range) for both activation sequences were strongly correlated in patients with anterior MI and with inferior MI (r = 0.91 and r = 0.92, respectively; P0.001). Although small but significant changes in QRST values were detected, the distribution of the "-2SD area" and the sigma DM were similar during both activation sequences in patients with prior MI. Thus, these findings demonstrate that an altered activation sequence produces small but significant changes in QRST values but that I-maps still provide information that is useful for the diagnosis of MI during RV pacing.