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Recently, integrated geophysical‐geological surveys in the Nankai subduction zone in Japan have revealed that slow earthquakes repeatedly occur beneath the outer wedge of the forearc. During December 2020 to February 2021, clustered slow earthquakes propagated around the frontal thrust of the accretionary wedge. The frontal thrust ramps up from the basal décollement and slips over trench‐filling sediment along the landward edge of the Nankai trough floor. Here, the Paleo‐Zenisu ridge has been subducted beneath the inner‐outer slope border. In addition, ocean floor topography and geologic structure revealed by seismic reflection surveys completed before 2022 document that the basement of the Philippine Sea Plate beneath the frontal thrust has a seamount and a horst‐like basement high. The northern edge of the basement high is located at the ramp‐up position of the frontal thrust. The 2020–2021 clustered slow earthquakes started at the Paleo‐Zenisu ridge and propagated to the topographic highs beneath the deformation front. Considering that the relative plate convergence between the upper Amurian Plate of the Nankai forearc and the subducting Philippine Sea Plate is ∼6.0 cm/year, the basement high at the deformation front has uplifted the frontal crest of the wedge at an average rate of 2.7–5.7 mm/year for several tens to hundred thousand years. These rates are among some of the highest rock uplift rates measured in the world. The slow earthquakes in the off‐Kumano Nankai Trough in 2020–2021 are a snapshot of a "living" Nankai frontal thrust during the megathrust interseismic period. Plain Language Summary: Slow earthquakes family: slow slips, very low frequency earthquakes, and tremors are significant events for understanding the interseismic dynamics between large earthquakes along the convergent plate boundary in the ocean. Slow earthquakes took place during December 2020 to February 2021 in the Nankai Trough in Japan and propagated along the frontal edge of the upper plate. Seismic reflection surveys revealed that seamount‐like and horst‐like basement highs exist beneath the front, collide with the upper plate, and uplift trench filling sediments by a ramp thrust. Even the incipient plate boundary of the décollement is initiated within the sediments beneath the Nankai Trough. Such a deformation feature around the front is a source candidate for the slow earthquakes. The uplift rate of the frontal crest of the upper plate presents the same order of a few to several mm/year as that of the foreland of the Himalayan Mountain belt. The slow earthquakes in the off‐Kumano Nankai Trough in 2020–2021 appear the first snapshot of a "living" Nankai frontal thrust during inter‐large seismic period. Key Points: Between 2020 and 2021, slow earthquakes propagated around the frontal thrust of the accretionary wedge in the Nankai Trough off KumanoSeamount and horst‐like basement highs beneath the frontal thrust cause uplift and are associated with the slow earthquake eventsThe average uplift rate of the frontal crest is 2.7–5.7 mm/year, approximately the same order as that of the Himalayan foreland [ABSTRACT FROM AUTHOR]

The causes for forearc basin and megathrust rupture zone segmentation are controversial. The Nankai forearc, Japan, is separated into five domains based on topography: Enshu, Kumano, Muroto, Tosa, and Hyuga. The boundaries of these domains correspond to the rupture limits of large earthquakes. We examined the geologic structure of the boundary region between the Kumano and Muroto domains off the Kii Peninsula using multichannel seismic reflection data to evaluate the role of upper plate composition in controlling segmentation. The results suggest that thick cover sediments and underlying accretionary prism are obliquely thrust landward over the igneous basement complex rock in the region of offshore of Cape Shionomisaki and separate the forearc basin. The igneous basement complex rocks directly overlying the plate interface in the hypocentral regions of 1944 Tonankai and 1946 Nankai earthquakes. The 1944 earthquake originated at the base of the complex, and the rupture extent slipped past its basement boundary, whereas the 1946 event nucleated at the updip boundary of the basement complex. The dense igneous rocks might have worked as a heavily loaded barrier on the seismogenic megathrust and separated the rupture area of both the earthquakes. Upper plate geology may be an important factor in controlling seismogenesis in the Nankai Trough and may serve as an example for understanding the controls on megathrust slip in other subduction zones. Plain Language Summary: The Nankai Trough, Japan is the place where quakes nucleate in the margin and tsunamis repeatedly devastated circum‐Pacific societies. When, where, why, and how the quakes were started in the trench is a central scientific question but unsolved. The historical records of earthquakes suggest that the rupture started around Cape Shionomisaki of the Kii Peninsula, where there is also a topographic segment boundary of the ∼2,000 m deep basin in the middle continental slope. Our research of the geologic structure beneath the earthquake epicenters indicates a dense and hard rock mass situated upon the hypocenters of 1944, and 1946 megaquakes off Cape Shionomisaki. The rock mass might have worked as a heavy load and barrier on the low angle dipping plate boundary fault when the fault slipped the large rupture was propagated in the Nankai Trough. Key Points: The Nankai forearc basin is separated off the Kii Peninsula owing to the existence of middle Miocene igneous basement in the upper plateThe rupture areas of the 1944 Tonankai, 1946 Nankai, and 2016 off‐Mie earthquakes appear to be controlled by the igneous basementThe shallow distribution of very low‐frequency earthquakes and tremors are related to the geological heterogeneity of the upper plate [ABSTRACT FROM AUTHOR]

To investigate structural characteristics associated with variations in slip behavior on the plate boundary in the Nankai subduction zone, we conducted seismic reflection surveys in the central‐western Nankai Trough. Data were processed by pre‐stack depth migration. The resulting depth map of the top of the subducting Philippine Sea plate shows detailed topographic features of the plate boundary, including subducting seamounts and large‐scale undulations of the plate surface. We report the presence of a structurally anomalous region, potentially with low velocity, in the overriding plate at the boundary between the zone of large coseismic slip during the 1946 Nankai earthquake and the area producing slow earthquakes. This anomaly appears to be related to depth‐dependent variations in plate boundary slip style and plate coupling in the central‐western Nankai Trough. Plain Language Summary: The central‐western Nankai Trough off southwestern Japan is one of the best locations to study variations in slip style on the plate boundary fault in subduction zones because the fault slip distribution during the latest great earthquake, the distribution of slow earthquakes, and interplate coupling are known from previous studies. We conducted seismic surveys along densely distributed survey lines to image detailed subsurface structures in the central‐western Nankai Trough. A three‐dimensional map of the plate boundary fault geometry was created from seismic profiles used in this study. We found a structural anomaly, interpreted as a low‐velocity zone in the overriding plate, at the boundary between the slip zone of great earthquakes and the zone of slow earthquakes. This anomaly might be related to the variation of the plate boundary fault slip styles. Key Points: The topography of the subducting plate is mapped with densely spaced seismic profiles in the central‐western Nankai TroughAn arcuate structural anomaly in the overriding plate ∼100 km long with potentially low velocity coincides with the Tosabae TroughThe arcuate anomaly is located at the boundary between regions of strong and weak plate coupling [ABSTRACT FROM AUTHOR]

Drilling during IODP NanTroSEIZE Expedition 316 led to the recovery of cores from the basal décollement in the frontal part of the Nankai accretionary prism and from a splay fault branching from the décollement at 25‐km landward of the prism toe. The core from the splay fault shows a main shear zone and two secondary shear zones. The main shear zone can be divided into two subzones. The upper subzone consists of a 1.2‐mm thick foliated gouge zone truncated downward by a through‐going fault encompassing a 0.4‐mm thick weakly foliated gouge interval. A nearby 200‐μm thick granular injection vein is interpreted as derived from the fault. The lower subzone consists of a foliated clayey gouge. A 70‐μm thick granular injection vein is also observed along this subzone. In the basal décollement core, microstructures consist of foliated gouge along a flat‐lying shear zone and seven flat‐lying or gently dipping secondary or incipient shear zones above. A redox front lies beneath the main shear zone. The shear zone and the redox front are truncated by a fault surface outlined by microbreccia developed at the expense of the overlying foliated gouge. Foliated gouge from the shear zones is tentatively interpreted as resulting from slow slip or aseismic creep. The weakly foliated gouge, the microbreccia, and the granular injection veins are interpreted as resulting from coseismic slip. The presence of the redox front beneath the main shear zone of the décollement fault core is interpreted as a consequence of oxidizing fluid flow along the microbreccia‐bearing fault. Plain Language Summary: To understand why some large subduction zone earthquakes are followed by destructive tsunamis and others are not is a key issue in seismic hazard assessment. Tsunami genesis is suspected to depend mainly on the capacity of faults in shallow parts of subduction zones to either transfer seismic slip from hypocentral depth upward or to dampen it before it reaches the surface. Expedition 316 of the IODP NanTroSEIZE program drilled across and retrieved cores from two major fault zones in the frontal part of the Nankai accretionary prism off Kii Peninsula. The rocks constituting the cored fault zones show microstructures which testify to both slow slip (plate tectonic steady‐state creep velocity or slow slip transient event velocity) and rapid slip (conventional earthquake slip velocity). It follows that in the Nankai Trough off Kii Peninsula, earthquake rupture can propagate along either of the major faults known there. Key Points: IODP Expedition 316 drilling across two fault zones in the Nankai accretionary prism allowed the recovery of intact cores of fault rocksFault rocks consist of microbreccia and weakly foliated gouge along sharp planar fault surfaces and foliated clayey gouge in millimeter‐thick shear zonesMicrobreccia and weakly foliated gouge suggest propagation of seismic slip along fault surfaces, while foliated gouge suggests aseismic or slow slip along shear zones [ABSTRACT FROM AUTHOR]

We tested the hypothesis that uric acid levels predict new-onset hypertension in the Japanese general population. Normotensive individuals who visited our hospital for a yearly health checkup (n=8157, men=61.0% and age=50.7±12.2 years) were enrolled in the present study. After baseline evaluation, participants were followed up for a median of 48.3 months (range 4.9-101.0 months), with the endpoint being the development of hypertension, defined as systolic blood pressure (BP) ⩾140 mm Hg, diastolic BP ⩾90 mm Hg or the use of antihypertensive medication. The impact of uric acid and other cardiovascular risk factors at baseline on future BP and development of hypertension was assessed. During follow-up, 19.0% of women (n=605) and 29.5% of men (n=1 469) participants developed hypertension. Incident hypertension was increased across the quartiles for baseline uric acid levels (P<0.0001), and multivariate Cox proportional hazards analysis revealed a significant and independent association between the uric acid level and the onset of hypertension in both men and women participants (P<0.05). Furthermore, uric acid was independently and positively correlated with future BP (P<0.05). Thus, uric acid is an independent predictor of new-onset hypertension in both women and men. [ABSTRACT FROM AUTHOR]

The present study investigated factors that modify or affect arterial stiffness as assessed by brachial-ankle pulse wave velocity (baPWV) in the general population. Subjects had previously participated in a physical checkup program (n=911), and baPWV and urinary albumin and sodium excretion were also measured. Urine albumin was expressed as the ratio of urine albumin to urine creatinine. Individual salt intake was assessed by estimating 24-h urinary salt excretion and expressed as the ratio of estimated salt intake to body weight. The mean blood pressure and baPWV were 127.1±15.2/77.0±9.5 mm Hg and 15.9±3.3 m s−1, respectively. Univariate analysis demonstrated that baPWV correlated with various factors including age, blood pressure, electrocardiogram voltage (SV1+RV5), urine albumin and salt intake. Multivariate regression analysis revealed that electrocardiogram voltage (P<0.001), systolic blood pressure (P<0.0001), urine albumin (P<0.001) and salt intake (P<0.001), independently correlated with baPWV after adjustment for other possible factors. Similar results were obtained for participants not taking any medication. These results suggest that the baPWV value is independently associated with individual salt intake and cardiac and renal damage, and could be a useful procedure for identifying individuals with concealed risk of cardiovascular disease. [ABSTRACT FROM AUTHOR]

In the present study, we tested the hypothesis that up-titrating the dose of an angiotensin receptor blocker (ARB) is superior to combined treatment with an ARB and a calcium channel blocker for the same degree of blood pressure (BP) reduction, with respect to urinary albumin excretion in diabetic patients treated with a standard dose of the ARB. Hypertensive patients with type 2 diabetes mellitus and albuminuria (30 mg g−1 creatinine) were enroled in the study, and were either started on or switched to candesartan (8 mg per day) monotherapy. After a 12-week run-in period, baseline evaluations were performed and patients with BP 130/80 mm Hg were randomly assigned to receive either candesartan (12 mg per day) or candesartan (8 mg per day) plus amlodipine (2.5 mg per day) for a further 12 weeks. The primary end-point was a reduction in urinary albumin levels. Although there was no significant difference in the BP reduction between the two groups, the reduction in urinary albumin was greater in the up-titrated than the combination therapy group (−40±14% vs −9±38%, respectively; P<0.0001). Thus, up-titration of candesartan more effectively reduces urinary albumin excretion than combined candesartan plus amlodipine in hypertensive patients with diabetes for the same degree of BP reduction. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to evaluate the capability of (11)C-methionine (MET)-PET/CT and (18)F-2-deoxy-2-fluoro-D: -glucose (FDG)-PET/CT to diagnose primary prostate cancer using recently developed Gemini TF PET/CT (Philips Healthcare, Cleveland, OH). Methods: Twenty men who had been referred for a diagnostic work-up for prostate cancer were enrolled in this study. MET- and FDG-PET/CT by high-resolution mode were carried out on the same day prior to prostate biopsy and each maximum standardized uptake value (SUVmax) was compared with the pathological findings. The regions of interest (about 100 mm(2) small round) were placed at standard 6 points of the peripheral zone and 4 points in the apex of the transitional zone in cases that had undergone biopsy of the internal gland. We summed two scores if a specimen had inhomogeneous Gleason scores (e.g. GS 7; 4 + 3) and doubled the score when the Gleason score was the same (e.g. GS 8; 4 × 2). We divided the tumors into three groups. If the summed Gleason score of the specimens was 5 or less, they were grouped as NG (no grade with the Gleason score). If the summed Gleason score was 6 or 7, the tumors were defined as LG (low Gleason score group), and if the summed Gleason score was 8, 9 or 10, the tumors were classified as HG (high Gleason score group). The mean SUVmax was calculated and one-way analysis of variance or Kruskal-Wallis test and the Tukey post hoc test were performed for statistical comparisons. The capabilities of MET and FDG for diagnosing prostate cancer were evaluated through analysis of the area under the curve of the receiver operating characteristic (ROC) curve. The cut-off levels of SUVmax for the highest accuracy were determined by the results of the ROC analysis, and the sensitivity, specificity and accuracy were calculated. Results: The PET images, obtained with Gemini TF PET/CT, allowed visual identification of anatomical locations within the prostate gland. Among the mean SUVmax of MET, FDG early phase and FDG delayed phase, the differences between NG and HG were all statistically significant (P < 0.01). With MET the difference between NG and LG was also significant (P < 0.05). And for the elevation rate from FDG early to delayed phase, the difference between NG and HG was significant (P < 0.05). The cut-off SUVmax, sensitivity, specificity, accuracy for distinguishing between NG and LG + HG by MET, FDG early and delayed phase were 3.15/78.7/75.6/78.3, 2.81/61.7/80.0/70.7 and 3.00/62.8/78.9/70.7, respectively. And the same factors between NG + LG and HG were 3.76/70.1/89.7/82.6, 2.88/70.1/82.9/78.3 and 3.47/62.7/86.3/77.7, respectively. Conclusions: In terms of the capability to diagnose prostate cancer of high Gleason score (≥8), there was no significant difference between MET and FDG. MET appears to be useful for detecting prostate cancer of both low and high Gleason score. [ABSTRACT FROM AUTHOR]

Patients with infective endocarditis (IE) often have renal complications which may include infarcts, abscesses and glomerulonephritis (GN). Furthermore, it is generally accepted that there is an association between IE and anti-neutrophil cytoplasmic antibody (ANCA). Here, we report the case of a 24-year-old man who developed rapidly progressive GN in the course of IE due to infection with α-streptococcus. The initial clinical manifestation of the condition was severe sacroiliitis without fever. Sandwich ELISA showed that the patient was positive for PR3-ANCA at low titer, and the classical complement pathway was also activated. Renal biopsy demonstrated several lesions: focal embolic GN, GN with immune deposits and focal and segmental crescentic necrotizing GN. Treatment with antibiotics and steroids led to eradication of the infection, and resolution of the renal disease was accompanied by immediate disappearance of PR3-ANCA and hypocomplementemia. During a 4-year follow-up period, no recurrence was observed. There have only been 7 case reports of GN associated with IE and PR3-ANCA in which the renal pathology has been described, and the current report is the first to document renal pathology in a patient with isolated pulmonic valve IE and PR3-ANCA. Moreover, this report is the first to show a change in renal biopsy findings in response to treatment. A review of the 7 literature cases and that of our patient showed that none involved pauci-immune GN. Hence, further studies are needed to clarify the prevalence of pauci-immune GN in ANCA-positive IE patients. [ABSTRACT FROM AUTHOR]

Laminates of an iron-aluminum alloy (20Al) and three types of steel---chromium molybdenum (CrMo). high carbon (FeCMn), and precipitation hardening steel with niobium carbide (FeCNb)--were fabricated at 600 °C and 1000 °C by clad rolling based on the compression stress ratio of 20Al to steel. The laminates fabricated at 600 °C exhibit a deformation microstructure with partial recrystallization, while those at 1000 °C reveal a refined microstructure. The 20Al layer of all the laminates exhibit a {001}<110> texture, and the intensity of the texture increases with a decrease in the fabrication temperature and an increase in the reduction. The bending deformability of a laminate increases with a decrease in the compression stress ratio and by a reduction in the intensity of the {001}<110> texture. The clad plate is further rolled at room temperature to a thickness of approximately 150 µm, which enables winding without damage. It is concluded that a high-strength steel at high temperatures and a high Al content in the Fe-Al alloy is beneficial for the fabrication of deformable laminates. [ABSTRACT FROM AUTHOR]

A large bank-protection works project undertaken during winter (from late October 2001, to late March 2002) in the middle reaches of the River Shinano, Japan's longest river, drastically altered the riverbed structure. To assess the effect of the project on the river's crane flies, we collected larvae and pupae with a Surber sampler in the construction area and in a control area from April to June, 2002. We also collected crane fly adults with light traps around the construction area from April to July of 2000, 2001 and 2002, as background information for the effects portion of this study. As a result, we described a total of 31 newly recorded crane fly species in the middle reaches of the River Shinano. In all three years of study, the sex ratio for all taxa combined was 74.8 to 75.5 percent males. Antocha was the dominant taxon, Antocha (Antocha) bifida was the dominant species, and its abundance did not differ significantly among years. The age structure of the Antocha bifida larval population changed in the construction area following construction, but not in the control area. Our data suggest that the bank-protection project significantly affected the Antocha bifida larval population in the study area. [ABSTRACT FROM AUTHOR]

We present the case of a 69-year-old man with nephrotic syndrome and renal insufficiency, who developed lobular glomerulonephritis. An electron microscopy examination of a renal biopsy showed micro-tubular structures of 24 nm in diameter in the subendothelial space and the paramesangial area. These deposits were PAS-positive and Congo red-negative, and revealed predominantly positive staining for κ light chain. There was no evidence of diseases with highly organized glomerular deposits, such as amyloidosis, cryoglobulinemia, systemic lupus erythematosus or paraproteinemia. Therefore, the patient was diagnosed to have immunotactoid glomerulopathy (ITG). During a seven-year course he has not developed any disease known to be associated with organized glomerular immune deposits. Hence, we believe ITO occurred as a primary glomerular disease in this case. We also highlight cases of ITG with microtubular deposits that have been reported in Japan, compare these cases to previous reports, and show that the characteristics of the Japanese cases are male predominance; a high incidence of membranoproliferative glomerulonephritis (MPGN); a low incidence of monoclonal gammopathy and hematological malignancies and a higher incidence of hypocomplementemia. [ABSTRACT FROM AUTHOR]

The authors encountered a very rare case of paradoxical brain embolism resulting from pulmonary arteriovenous fistula and coincident pulmonary embolism. Enhanced computed tomography was useful for diagnosing this infrequent condition. [ABSTRACT FROM AUTHOR]

Hashimoto Y, Kondo Y, Kimura G, Matsuzawa I, Sato S, Ishizaki M, Imura N, Akimoto M & Hara S (2004) Histopathology 44, 353–359 Cyclooxygenase-2 expression and relationship to tumour progression in human renal cell carcinoma Cyclooxygenase (COX), which catalyses the synthesis of prostaglandins from arachidonic acid, has two isoforms; COX-1 and COX-2. There is ample evidence to suggest an important role for COX-2 in cancer. The aim of this study was to evaluate the clinical significance of COX-2 expression and its localization in the development and progression of human renal cell carcinoma (RCC). The expression and localization of COX-2 were evaluated in human RCC tissues from 75 patients by immunohistochemistry. Immunoreactive COX-2 protein was observed in all cases of RCC, and the levels of COX-2 expression were correlated with tumour grade and pathological stage. Expression of COX-2 was higher in the granular cell subtype than in the clear cell subtype of RCC. Immunoelectron microscopy revealed that COX-2 was expressed in the nuclear membrane, rough endoplasmic reticulum, Golgi complex and mitochondrial membrane of RCC cells. COX-2 overexpression within these intracellular organelles in RCC may be associated with renal cell carcinogenesis and COX-2 may be a useful biomarker in RCC. [ABSTRACT FROM AUTHOR]

Pressure and temperature (P–T) conditions of mélange formation are estimated from fluid inclusions within “syn-mélange” veins developed in the necks of boudins of sandstone blocks in the mélange of the Shimanto accretionary complex, south-west Japan. The mélange records décollement-zone processes. P–T conditions are in the range of 81 (+15) to 235 (±18) MPa and 150 (±25) to 220 (±31)°C. Assuming a constant fluid-pressure to lithostatic-pressure ratio for each data set, we estimate a P–T gradient of between 10.0°C/km (+0.2/−1.5) (lithostatic pressure) and 4.2°C/km (+0.1/−0.9) (hydrostatic pressure) from these results. The estimated lithostatic P–T gradient is much lower than that calculated from the age of the subducting oceanic plate. The estimated P–T conditions suggest that the mélange was formed within the seismogenic zone (hypothesized from thermal modeling), although the deformation mechanism of mélange (i.e. dominant diffusive mass transfer mainly in shale matrix with minor brittle breakage mainly in sandstone blocks) does not show evidence of seismic deformation. In addition, at the time of syn-mélange vein formation, a shale matrix of mélange has injected into the vein, which indicates a ductile deformation of shale. A possible explanation for this discrepancy is that the mélange was formed during the interseismic period. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the effect of considerably high left ventricular filling pressure with mitral regurgitation on mitral annular velocity during early diastole.Subjects: Two hundred and forty-three patients who underwent cardiac catheterization for evaluation of chest pain.Methods: Mitral annular velocity during early diastole was measured by colour M-mode tissue Doppler imaging. Patients were divided into the following three groups according to the cardiac catheterization data. Group A (n=147): patients having left ventricular relaxation time constant τ<46 ms and left ventricular end-systolic volume index <38 ml m−2; group B (n=88): patients having τ≥46 ms and/or end-systolic volume index ≥38 ml m−2; group C (n=8): patients having mean pulmonary capillary wedge pressure ≥16 mmHg in addition to τ≥46 ms and end-systolic volume index ≥38 ml m−2.Results: Mitral annular velocity during early diastole was significantly less in group B (4·8±1·4 cm s−1) than in group A (7·7±1·9 cm s−1). However, there was no significant difference between groups A and C (8·3±0·8 cm s−1). A transmitral E/A >1·0 was observed in 12/147 patients of group A, 10/88 of group B, and 8/8 of group C. The incidence of ≥Sellers' grade II mitral regurgitation was higher in group C than the others.Conclusions: A paradoxically faster mitral annular velocity during early diastole is found in patients having left ventricular dysfunction with moderate to severe mitral regurgitation and considerably high left ventricular filling pressure. Attention should be paid to an interpretation of mitral annular velocity during early diastole regarding left ventricular early diastolic performance in patients having mitral regurgitation with an E/A >1·0 in their transmitral flow. Copyright 2002 The European Society of Cardiology. Published by Elsevier Science Ltd. All rights reserved. [ABSTRACT FROM AUTHOR]

Study Objectives: We examined whether autonomic functions assessed by heart rate variability (HRV) during standardized head-up tilt testing (HUTT) predict risk for death in stable patients with coronary artery disease (CAD).Design and Setting: Retrospective cohort study in medium-sized university general hospital.Measurements and Results: In a cohort of 250 patients with CAD who were undergoing elective coronary angiography, we analyzed HRV during standardized HUTT under paced breathing with discontinuation of treatment with all medications. During a subsequent mean follow-up period of 99 months, there were 13 cardiac deaths and 12 noncardiac deaths. Cox regression analysis adjusted for cardiovascular risks revealed that increased postural change (supine to upright) in the power of low-frequency component (LF) power predicted an increased risk for cardiac death (relative risk [per 1-ln ms(2) increment], 4.36; 95% confidence interval, 1.64 to 11.6), while neither the high-frequency component nor its response to HUTT predicted any form of death. When the patients were trichotomized by the level of postural LF change (large drop, < or = - 0.6 ln[ms(2)]; small drop and rise, > 0 ln[ms(2)]), the three groups did not differ in terms of clinical features or CAD severity at baseline or coronary interventions during the follow-up period; however, the 8-year cardiac mortality rates were 0%, 6%, and 12%, respectively (p = 0.008 [log rank test]). Additionally, the difference was enhanced when analyzed excluding 64 patients who had been treated with a beta-blocker during the follow-up period (0%, 7%, and 15%, respectively; p = 0.006 [log rank test]).Conclusions: The postural response of HRV predicts the risk for death in patients with CAD. Postural LF increase (LF rise), in particular, is an independent risk factor for cardiac death. [ABSTRACT FROM AUTHOR]

Recently we found that, in non-dipper type of essential hypertensive patients who showed the lack of nocturnal fall in blood pressure, circadian rhythm of urinary sodium excretion rate was disturbed. In the present study we examined whether postural change in natriur-esis is also disturbed in non-dippers. Sixteen inpatients with essential hypertension were maintained on a relatively high sodium diet containing 10 to 12 g of NaCl per day for 8 days. On the 7th day of the study period, 24-h ambulatory blood pressures were measured, and 5-7th days urinary samples were collected for both daytime and night-time. On the last day of the study period, patients stood for 2 h and then lay down for 2 h. Urinary volume and excretion rates of creatinine and sodium were measured every hour in both positions. Night-time urinary sodium excretion rate was significantly higher in non-dippers (n = 9) than that in dippers (n = 7). Night/day ratio of mean arterial pressure had a positive relationship with night/day ratio of urinary sodium excretion rate. In non-dippers, but not in dippers, the mean value of U[SUBNa]V during upright position was significantly lower than that during supine position. There was a significantly negative relationship between upright/supine ratio of U[SUBNa]V and night/day ratio of MAP or night/day ratio of U[SUBNa]V. In patients with non-dipper type of essential hypertension, both natriuresis patterns, circadian rhythm and postural change, were disturbed. [ABSTRACT FROM AUTHOR]

In healthy subjects, blood pressure falls during the night to 10%–20% less than that during the daytime. In some patients, such as those with hypertension and renal diseases, on the other hand, night-time blood pressure does not fall. This so-called nondipping phenomenon is tightly linked with high sodium sensitivity of blood pressure, microalbuminuria, and glomerular capillary hypertension. Interrelationships among these factors lead us to consider the important role of the kidney. I would like to propose that loss of renal functional reserve is the key to link these interrelationships. Loss of renal functional reserve, reduced ultrafiltration capacity, or enhanced tubular sodium reabsorption induces the sodium-sensitive type of hypertension. When sodium intake is high in patients with impaired renal function reserve, the defect in sodium excretory capability becomes evident, elevating blood pressure during the night (that is, nocturnal hypertension or nondipping) in order to compensate for diminished natriuresis during the daytime, causing enhanced pressure natriuresis during the night. Under such conditions, glomerular capillary pressure is also elevated dependent on systemic blood pressure, and increased albumin leakage into urine is its marker. When sodium intake is low, on the other hand, the defect remains latent, allowing blood pressure during the night to be lowered, that is dipping, as is seen in normal subjects. [ABSTRACT FROM AUTHOR]

Map to microscopic-scale structural analysis of the Hanazono Assemblage of the Shimanto Belt in SW Japan, an excellent example of a deeply buried accretionary complex, indicates a detailed process from underthrusting to underplating. The earliest underthursting process is recorded in fabric of melange, which has deformed by shear along the decollement, characterized by thinning strain due to extensional breakage of blocks of sandstone and exotic materials, such as basalt and pelagic sediments of oceanic affinities. The deformation mechanism for melange formation for domain I is plastic flow, concordant with metamorphic grade, which is higher than that of domain II. The deformation mechanism for domain II is predominantly pressure solution partly with grain-scale brittle breakage for the less metamorphosed part of the Hanazono Assemblage. The posterior underplating process recorded is contraction and thickening due to thrust stacking and folding. Locations of the folds developed beneath thrusts are emphasized because they are a line of evidence of thickening. The main deformation mechanism of the second stage is plastic flow for domain I and cataclasis for domain II. The cataclasis in domain II may be a result of change in strain rate and seems to be related to seismicity at the time of underplating. Kinematics deduced from fabric analysis of the earliest deformed melange indicates a good consistency with a relative plate motion between the Eurasian and oceanic plates that is estimated from a hot spot reference plate circuit model by Engebretson et al. [1985], while that of the subsequent thrusting is not. This fact suggests that strain partitioning in association with oblique subduction of oceanic plate was minimum during subduction. Another possibility for strain partitioning is the requirement of coupling between plates that are recorded by the deformation mechanisms. [ABSTRACT FROM AUTHOR]

SummaryIn this study, we have investigated that after the intraperitoneal infection with murine cytomegalovirus (MCMV), the CD3+ CD4– CD8–(double negative; DN) T-cell receptor (TCR)αβ+ T cells increased in peritoneal cavity, liver and spleen in both resistant C57BL/6 and susceptible BALB/c mice. The total cellular population of these cells showed peak levels around day 5 after infection in all the three investigated organs and the following phenotypical and functional characteristics emerged. The peritoneal DN TCRαβ+ T cells expressed highly skewed TCRVβ8 on day 5 after infection compared with the uninfected mice, but those in spleen and liver showed moderate and low skewed TCRVβ8, respectively. The percentages of NK1.1+ DN TCRαβ+ T cells gradually decreased as did modulation of some of their activation markers consistent with an activated cell phenotype. The peritoneal DN TCRαβ+ T cells on day 5 after infection expressed the genes of interferon-γ (IFN-γ), tumour necrosis factor-α, Eta-1 (early T-cell activation-1) and MCP-1 (monocyte chemoattractant protein 1) but lacked expression of interleukin-4 (IL-4). After in vitro stimulation with phorbol 12-myristate 13-acetate and calcium ionophore in the presence of Brefeldin A, higher frequencies of intracellular IFN-γ+ DN TCRαβ+ T cells were detected in all three investigated organs of infected mice compared with those of uninfected mice. Stimulation of peritoneal DN TCRαβ+ T cells with plate-bound anti-TCRβ monoclonal antibodies showed proliferation and also produced IFN-γ but not IL-4. These results suggest that DN TCRαβ+ T cells were activated and may have an antiviral effect through producing IFN-γ and some macrophage-activating factors during an early... [ABSTRACT FROM AUTHOR]

Summary. Interstitial pneumonia caused by cytomegalovirus (CMV) is a fatal disease in immunocompromised patients. In order to examine the defense mechanism against the virus in the lung, we employed an intratracheal infection model in susceptible mice. In mice infected intratracheally with murine CMV, a protracted infection was observed where infectious virus was detected up to 21 days of infection. During this prolonged infection, massive accumulation in the lung of CD8+ T cells with activated phenotypes occurred and these CD8+ T cells showed direct ex vivo cytolytic activity against target cells pulsed with the nonamer peptide derived from IE1 protein of the virus, which has been shown to be the dominant epitope recognized by most of virus-specific CTL. Moreover, adoptive transfer of in vitro induced IE1 peptide-specific CTL line showed no anti-virus effect in the lung, although they were effective in the spleen. Hence, there is reason to assume the IE1-specific CTL induced in vivo or in vitro plays limited roles during the prolonged infection in the lung. [ABSTRACT FROM AUTHOR]

Summary Cytomegalovirus (CMV) causes severe opportunistic infection in immunocompromised hosts. The importance of conventional αβ T cells in protection against CMV infection has been well documented. However, the role of the second T‐cell population (which express the γδ T‐cell receptor) in CMV infection is not known. In the present study, we analysed the function and protective role of γδ T cells in a murine cytomegalovirus (MCMV) infection model. After intraperitoneal infection with MCMV, the number of γδ T cells increased in the liver and peritoneal cavity from day 3, and reached a peak on day 5. The γδ T cells showed an activated T‐cell phenotype and predominantly expressed Vγ1, which is known to be expressed by heat‐shock protein 65 (hsp 65)‐specific γδ T cells. Analysis of cytokine expression demonstrated that the MCMV‐induced γδ T cells expressed interferon‐γ (IFN‐γ) and tumour necrosis factor‐α (TNF‐α) but not interleukin‐4 (IL‐4), implying their participation in the cell‐mediated immune response against MCMV. Depletion of γδ T cells by anti‐T‐cell receptor (TCR) γδ monoclonal antibody (mAb) treatment resulted in significant increase of virus titre and decrease of IFN‐γ in the liver on day 3 after MCMV infection, which further supports the importance of γδ T cells in early protection against infection. Finally, the MCMV‐induced γδ T cells produced IFN‐γ in vitro in response to hsp 65. Our results suggest that γδ T cells participate in early protection against MCMV infection through recognition of hsp 65 and production of IFN‐γ. [ABSTRACT FROM AUTHOR]