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Abstract: Aim: Lactate is produced in and released from skeletal muscle cells. Lactate receptor, G‐protein‐coupled receptor 81 (GPR81), is expressed in skeletal muscle cells. However, a physiological role of extracellular lactate on skeletal muscle is not fully clarified. The purpose of this study was to investigate extracellular lactate‐associated morphological changes and intracellular signals in C2C12 skeletal muscle cells. Methods: Mouse myoblast C2C12 cells were differentiated for 5 days to form myotubes. Sodium lactate (lactate) or GPR81 agonist, 3,5‐dihydroxybenzoic acid (3,5‐DHBA), was administered to the differentiation medium. Results: Lactate administration increased the diameter of C2C12 myotubes in a dose‐dependent manner. Administration of 3,5‐DHBA also increased myotube diameter. Not only lactate but also 3,5‐DHBA upregulated the phosphorylation level of mitogen‐activated protein kinase kinase 1/2 (MEK1/2), p42/44 extracellular signal‐regulated kinase‐1/2 (ERK1/2) and p90 ribosomal S6 kinase (p90RSK). MEK inhibitor U0126 depressed the phosphorylation of ERK‐p90RSK and increase in myotube diameter induced by lactate. On the other hand, both lactate and 3,5‐DHBA failed to induce significant responses in the phosphorylation level of Akt, mammalian target of rapamycin, p70 S6 kinase and protein degradation‐related signals. Conclusion: These observations suggest that lactate‐associated increase in the diameter of C2C12 myotubes is induced via activation of GRP81‐mediated MEK/ERK pathway. Extracellular lactate might have a positive effect on skeletal muscle size. [ABSTRACT FROM AUTHOR]

SUMMARY Hybrid power source three-level inverter is proposed as a main circuit system with energy storage device for increasing regenerative power. This paper proposes a charge and discharge control method to utilize the regenerated energy. The proposed method is verified by experimental tests with a scaled-down model and numerical simulation. [ABSTRACT FROM AUTHOR]

We have developed an analytical method to determine the segregation levels on the same tilt boundaries (TBs) at the same nanoscopic location by a joint use of atom probe tomography and scanning transmission electron microscopy, and discussed the mechanism of oxygen segregation at TBs in silicon ingots in terms of bond distortions around the TBs. The three-dimensional distribution of oxygen atoms was determined at the typical small- and large-angle TBs by atom probe tomography with a low impurity detection limit (0.01 at.% on a TB plane) simultaneously with high spatial resolution (about 0.4 nm). The three-dimensional distribution was correlated with the atomic stress around the TBs; the stress at large-angle TBs was estimated by ab initio calculations based on atomic resolution scanning transmission electron microscopy data and that at small-angle TBs were calculated with the elastic theory based on dark-field transmission electron microscopy data. Oxygen atoms would segregate at bond-centred sites under tensile stress above about 2 GPa, so as to attain a more stable bonding network by reducing the local stress. The number of oxygen atoms segregating in a unit TB area NGB (in atoms nm−2) was determined to be proportional to both the number of the atomic sites under tensile stress in a unit TB area nbc and the average concentration of oxygen atoms around the TB [Oi] (in at.%) with NGB ∼ 50 nbc[Oi]. [ABSTRACT FROM AUTHOR]

Aim The effects of heat shock transcription factor 1 ( HSF1) deficiency on the fibre type composition and the expression level of nuclear factor of activated T cells ( NFAT) family members ( NFATc1, NFATc2, NFATc3 and NFATc4), phosphorylated glycogen synthase kinase 3 α (p- GSK3 α) and p- GSK3 β, micro RNA-208b (miR-208b), miR-499 and slow myosin heavy chain (My HC) m RNAs (Myh7 and Myh7b) of antigravitational soleus muscle in response to unloading with or without reloading were investigated. Methods HSF1-null and wild-type mice were subjected to continuous 2-week hindlimb suspension followed by 2- or 4-week ambulation recovery. Results In wild-type mice, the relative population of slow type I fibres, the expression level of NFATc2, p- GSK3 ( α and β), miR-208b, miR-499 and slow My HC m RNAs (Myh7 and Myh7b) were all decreased with hindlimb suspension, but recovered after it. Significant interactions between train and time (the relative population of slow type I fibres; P = 0.01, the expression level of NFATc2; P = 0.001, p- GSK β; P = 0.009, miR-208b; P = 0.002, miR-499; P = 0.04) suggested that these responses were suppressed in HSF1-null mice. Conclusion HSF1 may be a molecule in the regulation of the expression of slow My HC as well as miR-208b, miR-499, NFATc2 and p- GSK3 ( α and β) in mouse soleus muscle. [ABSTRACT FROM AUTHOR]

Aim Effects of heat shock transcription factor 1 ( HSF1) deficiency on heat stress-associated increase in slow soleus muscle mass of mice were investigated. Methods Both HSF1-null and wild-type mice were randomly assigned to control and heat-stressed groups. Mice in heat-stressed group were exposed to heat stress (41 °C for 60 min) in an incubator without anaesthesia. Results Significant increase in wet and dry weights, and protein content of soleus muscle in wild-type mice was observed seven days after the application of the heat stress. However, heat stress had no impact on soleus muscle mass in HSF1-null mice. Neither type of mice exhibited much effect of heat stress on HSF mRNA expression ( HSF1, HSF2 and HSF4). On the other hand, heat stress upregulated heat shock proteins ( HSPs) at the mRNA ( HSP72) and protein ( HSP72 and HSP110) levels in wild-type mice, but not in HSF1-null mice. The population of Pax7-positive nuclei relative to total myonuclei of soleus muscle in wild-type mice was significantly increased by heat stress, but not in HSF1-null mice. Furthermore, the absence of HSF1 gene suppressed heat stress-associated phosphorylation of Akt and p70 S6 kinase (p-p70S6K) in soleus muscle. Conclusion Heat stress-associated increase in skeletal muscle mass may be induced by HSF1 and/or HSF1-mediated stress response that activates muscle satellite cells and Akt/p70S6K signalling pathway. [ABSTRACT FROM AUTHOR]

Towards the realisation of reliable communication systems using simple nanoscale transceivers, this Letter presents a method for the non‐coherent detection of digitally phase‐modulated signals. Without the synchronisation of the phases of the transmitted and received carrier signals, data transmission cannot be reliably achieved. To address this issue, the proposed method is developed using a nanoscale receiver that receives the binary phase‐modulated signal through the mechanical vibration of a carbon nanotube cantilever. The present analysis reveals that this receiver has an interesting characteristic: the two decision statistics available in the receiver have a phase difference of π/2, which means that at least one of the statistics is fairly reliable regardless of the synchronisation error. Through the selection of the more reliable of the two statistics, the proposed method achieves low error in the estimation of the transmitted data even without carrier phase synchronisation. This Letter presents the derivation of the proposed rule for selecting the statistic and numerical results that demonstrate the effectiveness of the proposed method. This Letter is expected to contribute to the realisation of future communication applications using nanoscale transceivers. [ABSTRACT FROM AUTHOR]

Serum specific IgE and IgG4 in 70 patients with seasonal rhinitis caused by Japanese cedar pollens were determined before and during the pollen season. Seasonal increase rate in specific IgE was significantly smaller in the immunotherapy patients than the pharmacotherapy patients, and seasonal increase in specific IgG4 was significant in the immunotherapy patients only. Seasonal increase rate in specific IgE was not significantly different between the patients who responded markedly to short-term immunotherapy and those who did not. On the other hand, seasonal increase rate in specific IgG4 was significantly different between them. In contrast, seasonal increase rate in specific IgE was significantly smaller in the patients who showed marked response to the long-term immunotherapy than those who did not show marked response to the long-term immunotherapy, but seasonal increase rate in specific IgG4 was not significantly different between them. In conclusion, our results suggest that modulation of specific IgG4 response and specific IgE response might be involved in the early and late symptom relief during immunotherapy, respectively. However, further studies might be necessary to definitively establish the clinical roles of specific IgE and specific IgG4 in immunotherapy. [ABSTRACT FROM AUTHOR]

During the past two decades, considerable attention has been devoted to the clinical role of serum-specific IgE and IgG4 following immunotherapy. To definitely discuss the clinical role of serum-specific IgG4, we should know the natural course of serum-specific IgG4 in the untreated patient with allergic rhinitis. To our knowledge, however, no such kind of study can be found in the literature. Our present study focused on the long-term follow-up of serum-specific IgE and IgG4 in patients who were not treated with immunotherapy for perennial allergic rhinitis. They were scheduled to take no medication for their perennial nasal symptoms for 8 years. Serum-specific IgE and IgG4 in untreated patients with perennial allergic rhinitis never significantly change during the observation period. These data will be of great value for studies in serologic changes following active treatment for atopic diseases. Additionally, our study suggests that a reduction in serum-specific IgE and an increase in serum-specific IgG4 following immunotherapy are not the result of an immunotherapy-independent and age-related phenomenon but the result of active immunologic modulation by immunotherapy. [ABSTRACT FROM AUTHOR]

First results are presented of a study on the impact of O and Ge doping on {113}-defect formation in Si using in situ 2 MeV e-irradiation in a high voltage electron microscope. Comparison with undoped Si, reveals a suppression of {113}-defect formation due to O and Ge. The observations are discussed in the frame of a theoretical model assuming quasi-chemical reactions to describe the intrinsic point defect behaviour during irradiation as a function of irradiation temperature and specimen thickness. It is shown that for irradiations at high temperatures, intrinsic point defect diffusivity values derived from crystal growth and metal diffusion experiments can be used to explain the observations semi-quantitatively. [ABSTRACT FROM AUTHOR]

Objective To further analyse the significance and mutual relationship of thyroid function-linked alterations in cortisol metabolism that have been separately and variously reported. Patients and measurements Twenty-four-hour urine samples from 21 patients with hyperthyroidism (Graves’ disease), 16 patients with hypothyroidism (Hashimoto's thyroiditis), 21 healthy age- and sex-matched controls for hyperthyroidism, and 16 healthy age- and sex-matched controls for hypothyroidism were evaluated for 6β-hydroxycortisol (6β-OHF), tetrahydrocortisol (THF), tetrahydrocortisone (THE), allo-tetrahydrocortisol (allo-THF), urinary free cortisol (UFF), urinary free cortisone (UFE) and 17-hydroxycorticosteroid (17-OHCS). Results Urinary 17-OHCS, THE and allo-THF levels increased considerably in hyperthyroid patients compared to the controls, while UFF and THF showed no difference between the two groups. Urinary 6β-OHF was significantly lower in the hyperthyroid patients than in the controls. Both the urinary allo-THF + THF/THE and the UFF/UFE ratios were significantly lower in the hyperthyroid patients than in the controls, whereas only the former was significantly higher in the hypothyroid patients than in the controls. The urinary allo-THF/THF ratio was significantly higher in the hyperthyroid patients and significantly lower in the hypothyroid patients than in the controls. In an analysis of pooled subjects including all groups ( n = 64), free T4 levels correlated negatively ( P < 0·0001) with the urinary allo-THF + THF/THE ratio but not with the UFF/UFE ratio. The serum levels of free T4 correlated positively ( P < 0·0001) with the urinary allo-THF/THF ratio. Conclusion The thyroid hormones seem to affect the total 11β-HSD activity (allo-THF + THF/THE) more strongly than the renal 11β-HSD2 activity (UFF/UFE). 5α-reductase activity (allo-THF/THF) is also enhanced in hyperthyroidism, while the reduction of urinary 6β-OHF in hyperthyroidism might be a secondary effect of the altered activity of the total 11β-HSD and 5α-reductase. [ABSTRACT FROM AUTHOR]

The effects of interferon (IFN) on the B-cell response to Staphylococcus aureus Cowan strain I (SAC) were studied comparatively with natural human IFN-α, IFN-β and IFN-γ, employing equal units of their anti-viral activity. First, the response was investigated in peripheral mononuclear cells obtained from healthy individuals, and next, confirmed in cultures employing B-cell enriched populations derived from tonsils obtained at tonsillectomy from patients with chronic tonsillitis. B cells were purified by rosetting out T cells with sheep red cells followed by the removal of adherent cells on a plastic surface. The results show that the SAC-stimulated lymphoproliferative response was enhanced in the presence of IFN-γ in a dose-related manner, at concentrations ranging from 10 to 1000 IU/ml, both in peripheral mononuclear cells and tonsillar B-cell enriched fractions. In contrast, IFN-α and IFN-β did not enhance or suppress SAC-stimulated blastogenesis in either lymphocyte preparation. The enhancing effects specific to IFN-γ were more remarkable in cultures stimulated with a suboptimal dose (0.002%) of SAC than when the optimal dose (0.005%) was employed. [ABSTRACT FROM AUTHOR]

The major hydroxy fatty acids of cellular lipids in Flavobacterium meningosepticum and Flavobacterium sp. King's group IIb were identified as 2-hydroxy 13-methyltetradecanoic, 3-hydroxy 13-methyltetradecanoic, 3-hydroxy palmitic, and 3-hydroxy 15-methylhexadecanoic acids using gas chromatography-mass spectrometry and GC-mass fragmentography. The concentration of these hydroxy fatty acids comprised up to 30-40% of the total extractable and 20-30% of the bound lipid fatty acids, respectively. From the stability for mild alkaline hydrolysis, 2-hydroxy fatty acids seemed to be attached with ester linkage, and 3-hydroxy fatty acids with amide linkage. [ABSTRACT FROM AUTHOR]

This study was designed to determine seasonal changes in cytokines, soluble CD23 and specific IgE in the serum of patients with seasonal allergic rhinitis, and the effect of immunotherapy on these seasonal changes. Fifty-four patients with seasonal allergic rhinitis caused by Japanese cedar pollens were divided into a medication group and an immunotherapy group. The patients of the medication group were treated with nonsedating antihistamines alone during the pollen season. The patients of the immunotherapy group had been treated for variable periods (mean, 5.0 ± 3.2 years) with immunotherapy using Japanese cedar pollen antigens. Serum samples were collected before and during the pollen season from each patient, to determine specific IgE, interleukin-4 (IL-4), interferon-γ (IFN-γ) and soluble CD23 levels in serum. A significant increase in specific IgE and IL-4 and a significant decrease in IFN-γ were observed during the pollen season in the medication group. In contrast, in the immunotherapy group, none of specific IgE, IL-4 and IFN-γ was significantly changed following natural exposure to pollens. However, these effects were not significant in patients undergoing immunotherapy for 3 or fewer years. Seasonal rates of increase in specific IgE and IL-4 differed significantly between good responders and poor responders to immunotherapy, but seasonal rates of decrease in IFN-γ did not. A seasonal rate of increase in soluble CD23 was significantly correlated with a seasonal rate of increase in specific IgE, in both the medication and the immunotherapy groups. The seasonal rate of increase in soluble CD23 was significantly smaller in the good responders than in the poor responders to immunotherapy. In conclusion, pollen immunotherapy reduces the seasonal increase in specific IgE, IL-4 and soluble CD23 in serum, and in addition switches the seasonal preferential activation of Th-2 cells to reciprocal activation of Th-1 cells with treatment over several years. It is likely that the mechanisms responsible for the clinically beneficial effects of immunotherapy principally involve the modulation of Th-2 rather than Th-1 cytokines. [ABSTRACT FROM AUTHOR]

The rate of release of the soluble form of interleukin-2 receptor (soluble IL-2R) reflects T cell activation in vivo. Since T lymphocytes play a central role in respiratory allergic disorders, the measurement of serum levels of soluble IL-2R may be useful in analysing the disease state of allergic disorders. The study has aimed at investigating the seasonal changes in serum soluble IL-2R in 81 patients with seasonal allergic rhinitis due to Japanese cedar pollens, with special reference to the effect of anti-allergic pharmacotherapy and immunotherapy. Serum samples were obtained twice from each patient, before and during the pollen season, and all the serum samples were simultaneously used for determination of soluble IL-2R and cedar pollen-specific immunoglobulin E (IgE). Seasonal elevation in soluble IL-2R was not associated with the good clinical outcome but was associated with the poor clinical outcome, irrespective of pharmacotherapy or immunotherapy. Additionally, successful immunotherapy suppressed seasonal elevation of serum soluble IL- 2R more strongly than successful pharmacotherapy. and seasonal increase rates in soluble IL-2R were inversely correlated with the duration of immunotherapy. Seasonal increase rates in soluble IL-2R were significantly correlated with seasonal increase rates in specific IgE in both the medication group and the immunotherapy patients. These results may suggest that seasonal changes in serum soluble IL-2R may serve as an indicator for clinical outcome of seasonal allergic rhinitis, that the magnitude of T cell activation could affect specific IgE production, and that T cell activation could be gradually modulated as immunotherapy proceeds. In conclusion, seasonal changes in serum soluble IL-2R may serve as an objective indicator for clinical outcome of seasonal allergic rhinitis. [ABSTRACT FROM AUTHOR]

Soluble intercellular adhesion molecule-1 (sICAM-1) in sera was measured in some allergic disorders, but serum sICAM-1 levels in perennial allergic rhinitis remain to be determined. Our study was aimed at elucidating whether the serum sICAM-1 levels in patients with perennial allergic rhinitis are different from those in nonatopic healthy volunteers and whether immunotherapy can modulate sICAM-1 levels. Serum sICAM-1 was determined in 20 nonallergic volunteers and 137 patients with perennial allergic rhinitis by a sandwich enzyme-linked immunosorbent assay. Our study demonstrated that the level of sICAM-1 in untreated patients is significantly elevated, as compared with nonatopic subjects. Immunotherapy could decrease sICAM-1 in perennial allergic rhinitis, but this suppressive effect became apparent only after many years of immunotherapy. In patients on immunotherapy, a close correlation was observed between sICAM-1 and nasal symptom scores. To take these lines of evidence together, a decrease in sICAM-1 might be related to the working mechanism of immunotherapy, and serum sICAM-1 could be used to monitor the effect of immunotherapy. [ABSTRACT FROM AUTHOR]

We investigated the effect of several lectins, such as soy bean lectin (SBA), concanavalin A (Con A), and wheat germ agglutinin (WGA), on the transport of some food ingredients (isoflavones, quercetin glycosides, carnosine/anserine) across Caco-2 cell monolayers. After incubation of food ingredients (0.03∼2 mmol/L) in the presence or absence of lectins (1∼180 μg/ml) on the apical side, aliquots were taken from the apical and basolateral solution, and were subjected to HPLC analysis. We also examined the effect of lectins on the permeability of the tight junction by measuring the transepithelial electrical resistance (TER) value of the Caco-2 cell monolayer. Isoflavones, which was not transported to the basolateral solution without lectins, could be transported in the presence of lectins, whereas their aglycones were detected at the same levels with or without the lectin treatment. The transport of quercetin glycosides also increased in the presence of lectins, however, that of peptides was not affected by the lectins. Con A and WGA, but SBA, decreased the TER value, indicating that Con A and WGA increased the transport via paracellular pathway, whereas SBA did via a different pathway. [ABSTRACT FROM AUTHOR]

Presents a case of subcutaneous nodular fat necrosis with lipase-secreting acinar cell carcinoma. Description of a women with multiple erythematous subcutaneous nodules on lower extremities and right hand; Presence of septal panniculitis in a nodule on left leg; Details of serum biochemical studies.

Evaluates the case of a 39-years old pregnant women with cerebral hyperperfusion in Japan. Medical history of the patient; Examination of cerebral circulatory changes through magnetic resonance imaging; Increase in blood flow volume; Hypotheses of the pathogenesis of eclampsia.

An abstract of the article "Epidemiology of Systolic Dysfunction in Japan," by M. Ramadan and colleagues is presented.

Thanatophoric dysplasia is a sporadic, lethal congenital skeletal dysplasia. There are two major subtypes: (1) a short, curved femur characterizes type I; and (2) a straighter femur with cloverleaf skull characterizes type II. We, here, present a case of type I disease. A 30-year-old pregnant woman was referred to the ultrasound unit due to fetal short extremities at 19 weeks and 4 days of gestation. Ultrasound revealed short limbs and a severely small thorax. Every limb bone was markedly short, and the femur, tibia, fibula and humerus were remarkably curved. 3D ultrasound demonstrated the abnormal appearance of extremities. Cranial and intracranial structures were normal. One week later, no growth of limb bones was seen. Thanatophoric dysplasia type I was strongly suspected and counseling of the couple was done. Pregnancy was terminated at 21 weeks of gestation and a female fetus was aborted. Short and curved limb bones were confirmed by postnatal X-ray. Genomic DNA obtained by cord blood showed a point mutation in the fibroblast growth factor receptor 3 (FGFR3) gene; a C to T substitution at position 742 in the FGFR3 gene, resulting in a Arg248Cys substitution, known to be associated with type I disease. By ultrasound in the second trimester, prenatal diagnosis of skeletal dysplasia can be feasible. However, differentiating this lethal disease from non-lethal skeletal disorders should be done prudently. [ABSTRACT FROM AUTHOR]

The usefulness of rabbit serum as a culture medium for postimplantation rat embryos was examined. Rat embryos at day 9.5 of gestation were cultured in a mixture of rat and rabbit sera at various ratios (v/v) for 48 h. In 100% rat serum, a usual medium, rat embryos grew well.On the contrary, rat embryos died with little growth in 100% rabbit serum. In 75% rabbit and 25% rat sera, rat embryos grew but were morphologically abnormal. In 50% rabbit and 50% rat serum, however, rat embryos grew well showing no morphological abnormalities, as in 100% rat serum. It was concluded from these results that rabbit serum couldbe used at a proportion up to 50% as a medium for postimplantation rat embryo culture in a mixed form with rat serum. The rat embryo culture using rabbit serum as a medium would be useful in developmental toxicity studies, especially those involving species differences and toxicokinetics. [ABSTRACT FROM AUTHOR]

PURPOSE. To examine the validity of the nursing diagnosis body image disturbance and to specify its major and minor defining characteristics in Japanese culture. METHODS. A qualified sample of 149 RNs with an average of 10 years of clinical experience and knowledge of nursing diagnosis was given a questionnaire consisting of 21 defining characteristics from NANDA, 8 additional items from the literature, and 2 distracting characteristics. FINDINGS. Four major diagnostic content validation (DCV) scores of 0.75 and higher and 15 minor defining characteristics with DCV scores from 0.60 to 0.74 were identified. CONCLUSIONS. This study provides a foundation for further study of culturally appropriate defining characteristics for use in Japan. [ABSTRACT FROM AUTHOR]

Background: The Clinical Frailty Scale (CFS) is a useful frailty marker for predicting clinical outcomes in patients undergoing invasive therapy. However, the clinical impact of CFS after transcatheter edge-to-edge repair in patients with mitral regurgitation (MR) remains unclear. This study aimed to elucidate the association between the baseline frail status defined by the CFS and clinical outcomes with or without postprocedural MR ≥2+ (post-MR ≥2+) after transcatheter edge-to-edge repair., Methods and Results: Based on a Japanese multicenter registry (OCEAN [Optimized Catheter Valvular Intervention]-Mitral), data from 2078 patients with MR who underwent transcatheter edge-to-edge repair were analyzed. The patients were classified into 5 groups: CFS 1 to 3, 4, 5, 6, and ≥7. The procedural and clinical outcomes and post-MR ≥2+ were compared among the groups. All-cause mortality for up to 2 years was explored using Cox proportional hazards regression analysis. Although the rates of acute procedural success and post-MR ≥2+ were similar, all-cause mortality at 2 years was significantly increased across the 5 CFS categories (15.5%, 23.8%, 27.7%, 34.6%, and 48.8%, respectively, P <0.001). The incremental CFS categories and post-MR ≥2+ were independent predictive risk factors of all-cause mortality (all P <0.05). Among the patients with 5 CFS categories, the incidence of all-cause mortality was higher in those with post-MR ≥2+ than in those without (all P <0.05)., Conclusions: Although prognosis was poor in patients with higher CFS grade after transcatheter edge-to-edge repair, minimizing modifiable factors of residual MR is warranted to improve the clinical outcomes., Registration Information: URL: https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr&#95;view.cgi?recptno=R000027188; Unique identifier: UMIN000023653.

Background: Data on the risk of cardiovascular-related mortality in patients with cancer are limited., Methods and Results: This retrospective cohort study used data from the Osaka Cancer Registry and vital statistics in Japan between 1985 and 2013. The causes of death were investigated, and the risk of fatal heart disease was analyzed. Standardized mortality ratios were calculated to compare the risk of fatal heart disease between patients with cancer and the general population. Fine and Gray competing risk regression models were used to assess the risk of fatal heart disease among patients with cancer. In total, 682 886 patients with cancer were included in the analysis, and 335 635 patients died during the study period. Heart disease was the leading cause of noncancer deaths, with 10 686 deaths. Among the patients who died of heart disease, 5017 had ischemic heart disease, 3598 had heart failure, 356 had hypertensive disease, and 1715 had other heart diseases. The standardized mortality ratio for heart disease was 2.80 (95% CI, 2.74-2.85). The standardized mortality ratio for ischemic heart disease, heart failure, and hypertensive disease were 3.26 (95% CI, 3.17-3.35), 2.69 (95% CI, 2.60-2.78), and 5.97 (95% CI, 5.38-6.63), respectively. The risk of fatal heart disease increased over time after cancer diagnosis. Men were more likely to die of heart disease than women (subdistribution hazard ratio, 1.08 [95% CI, 1.02-1.16]). The risk of fatal heart disease among cancer survivors has decreased in recent years., Conclusions: Cancer survivors have a higher risk of fatal heart disease than the general population.