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In patients with severe hypertension, chronic heart failure or a history of stroke, the lower limit of autoregulation of cerebral blood flow (CBF) is shifted to higher levels of blood pressure (BP) than those observed in healthy subjects. The aim of pharmacotherapy for hypertensive patients with an impaired autoregulation of CBF should be to reduce BP while preserving an appropriate CBF. In the present study, 16 hypertensive patients who had had an episode of stroke more than 4 weeks previously were administered the angiotensin II (AT1) receptor antagonist losartan at daily doses of 25-100?mg for 4 weeks. Systolic and diastolic blood pressures were recorded for 24?h using an ambulatory BP monitoring system. CBF in both hemispheres of the cerebrum and cerebellum was quantified using single photon emission tomography with N-isopropyl-p-[123I]iodoamphetamine. At baseline, CBF was 29.7±6.7?ml/min/100?g in the cerebrum and 31.5±7.5?ml/min/100?g in the cerebellum. At the end of treatment, BP was lower, while CBF increased by 7.7%in the cerebrum, and remained at the baseline level in the cerebellum. Thus, CBF was preserved despite the reduction in BP. We consider the use of losartan is advantageous for hypertensive patients with a history of stroke in whom autoregulation of CBF is potentially impaired.Journal of Human Hypertension (2004) 18, 693-699. doi:10.1038/sj.jhh.1001735 Published online 6 May 2004 [ABSTRACT FROM AUTHOR]

HLA antigens of patients with adult T cell leukaemia (ATL), T cell malignant lymphoma (T-ML), and healthy carriers of human T cell leukaemia virus type I (HTLV-I) were investigated in an endemic area of ATL in Japan. Sixty-two patients with ATL were subdivided into three groups based on their clinical features, including two unclassified patients; 36 acute type. 10 chronic type, and 14 smouldering type. The frequency of HLA-Bw62 was significantly increased in acute ATL, compared with control (Pc <0.0002). Increased frequency of HLA-DQw3 was observed in patients with ATL. T-ML positive for the antibody to HTLV-I (Ab-positive), and Ab-positive healthy carriers, compared with control (Pc < 0.001, Pc< 0.01 and Pc < 0.0001, respectively). In addition, class I HLA antigens of peripheral lymphocytes of patients with ATL, especially acute ATL, showed altered expression, either extra antigens or decreased antigens. Analysis of 21 families, where more than two members were Ab-positive, showed that there was no linkage between the HLA complex and susceptibility to the virus infection. In 44 couples, in which either or both spouses were Ab-positive, no association with class ! HLA antigens was found in either Ab-positive spouses or Ab-negative sprouses. These findings might indicate that one class II HLA-linked gene controlled susceptibility to HTLV-I infection, and another class I HLA-linked gene exerted an influence on the clinical course of ATL. [ABSTRACT FROM AUTHOR]

Little is known about the ecology of insect species in the hyporheic zone of rivers, despite its importance in understanding how species survive in specialized habitats. We report on the life history and trophic characteristics of the hyporheic stonefly species Alloperla ishikariana Kohno, 1953 (Order: Plecoptera, Family: Chloroperlidae) in a gravel-bed river in northern Japan, using year-round sampling of both benthic and hyporheic larvae, as well as flying adults in the riparian zone. Adults emerged between May and August, and the larval cohort structure consisted of three sized groups with some sex dimorphism in their body size, with an average growth rate of 0.0043 mg/day. Diet analyses based on C and N stable isotope ratios indicated minimal ontogenetic diet shifts. In contrast, the temporal diet shift was more apparent with higher dependence on Oligochaeta in winter, with an increasing dependence on Chironomidae in spring and early summer. Other insect taxa, namely, Leuctridae and small-sized Lepidostoma, demonstrated a high to moderate affinity for the hyporheic zone. Alloperla ishikariana spent most of its larval stage in the hyporheic zone. With adults living from 7 to 10 days, A. ishikariana completes a life span of approximately 3 years with its larval stage in the dark. [ABSTRACT FROM AUTHOR]

A survey and inventory of tree canopy biodiversity for cryptogams (myxomycetes, macrofungi, mosses, liverworts, lichens and ferns) in the Great Smoky Mountains National Park resulted in the discovery of an undescribed myxomycete species. This taxon is classified in the order Physarales, family Didymiaceae and genus Diachea. A combination of morphological characteristics distinguishes Diachea arboricola H.W. Keller & M. Skrabal sp. nov. from all other species in the genus: peridium iridescent gold to silvery gray; stalk reddish orange above and whitish below, filled with crystals; capillitial threads stiff, dichotomously branched and arising from the tip of the columella; spore ornamentation uniformly covering the entire spore surface, appearing spiny with light microscopy, with scanning electron microscopy as vertical processes with capitate, clustered, spike-like tips. This type of spore ornamentation has not been found in any other Diachea species. Diachea arboricola is known only from the tree canopy, ranging in height from roughly 3 to 21 m, on three tree species, Fraxinus americana, Juniperus virginiana and Quercus alba. Observations of plasmodial growth and fruiting body development are described based on moist chamber cultures. Tree canopy observations in situ suggest that the plasmodium of this species migrates over extensive vertical areas of tree bark. Ecological factors are discussed that include pH of bark substrata. The species description is based on abundant sporangia from 17 different collections. A key to the species of Diachea is provided to aid in the identification of this taxon. [ABSTRACT FROM AUTHOR]

Rock mass characterization is required for many applications in rock engineering practice including excavation design, support design, stope design, amongst others. For these purposes, it is necessary to obtain design input parameters such as deformation moduli and strength parameters for numerical modeling. Although such parameters can ultimately be determined from in situ tests, at the preliminary design stage, where access to underground is limited, the practical way to obtain these parameters is to apply a rock mass classification system to characterize the rock mass and estimate the rock mass properties. Over the years, many classification systems, such as RQD, Rock Mass Rating, Q and Geological Strength Index (GSI) systems, have been developed. Amongst them, the Q system is widely used for rock support system design and the GSI system is used for estimating design parameters. The GSI system is the only rock mass classification system that is directly linked to engineering parameters such as Mohr–Coulomb, Hoek–Brown strength parameters or rock mass modulus. However, the application of the existing GSI system is hindered by the facts that the use of the system is to some extent subjective and requires long-term experience.In the present study, a quantitative approach to assist in the use of the GSI system is presented. It employs the block volume and a joint condition factor as quantitative characterization factors. The approach is built on the linkage between descriptive geological terms and measurable field parameters such as joint spacing and joint roughness. The newly developed approach adds quantitative means to facilitate use of the system, especially by inexperienced engineers.The GSI system is applied to characterize the jointed rock masses at two underground powerhouse cavern sites in Japan. GSI values are obtained from block volume and joint condition factor, which in turn are determined from site construction documents and field mapping data. Based on GSI values and intact rock strength properties, equivalent Mohr–Coulomb strength parameters and elastic modulus of the jointed rock mass are calculated and compared to in situ test results. The point estimate method is implemented to approximate the mean and variance of the mechanical properties of the jointed rock masses. It is seen that both the means and variances of strength and deformation parameters predicted from the GSI system are in good agreement with field test data. [Copyright &y& Elsevier]

BACKGROUND: More strokes were observed in the Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT) among patients assigned to darbepoetin alfa. We sought to identify baseline characteristics and postrandomization factors that might explain this association. METHODS AND RESULTS: A multivariate logistic regression model was used to identify baseline predictors of stroke in 4038 patients with diabetes mellitus, chronic kidney disease, and anemia randomized to receive darbepoetin alfa or placebo. To determine whether postrandomization blood pressure, hemoglobin level, platelet count, or treatment dose were responsible for the increased risk related to darbepoetin alfa, we performed a nested case-control analysis (1:10 matching) identifying nonstroke controls with propensity matching. The risk of stroke was doubled with darbepoetin alfa. Overall, 154 patients had a stroke, 101/2012 (5.0%) in the darbepoetin alfa arm and 53/2026 (2.6%) in the placebo arm (hazard ratio 1.9; 95% confidence interval, 1.4-2.7). Independent predictors of stroke included assignment to darbepoetin alfa (odds ratio 2.1; 95% confidence interval, 1.5-2.9), history of stroke (odds ratio 2.0; 95% confidence interval, 1.4-2.9), more proteinuria, and known cardiovascular disease. In patients assigned to darbepoetin alfa, postrandomization systolic and diastolic blood pressure, hemoglobin level, platelet count, and darbepoetin alfa dose did not differ between those with and without stroke. Additional sensitivity analyses using maximal values, latest values, or changes over varying periods of exposure yielded similar results. CONCLUSIONS: The 2-fold increase in stroke with darbepoetin alfa in TREAT could not be attributed to any baseline characteristic or to postrandomization blood pressure, hemoglobin, platelet count, or dose of treatment. These readily identifiable factors could not be used to mitigate the risk of darbepoetin alfa-related stroke. CLINICAL TRIAL REGISTRATION: http://www.clinicaltrials.gov. Unique identifier: NCT00093015. [ABSTRACT FROM AUTHOR]

: Several studies in Western countries showed that proton-pump inhibitors are superior to histamine2-receptor antagonists or placebo in the treatment of non-erosive gastro-oesophageal reflux disease. The efficacy of acid-suppressive drugs for non-erosive gastro-oesophageal reflux disease in Japan, in which the prevalence ofHelicobacter pyloriinfection is higher compared with Western countries, is unknown.: To compare the efficacy of famotidine and omeprazole in Japanese patients with non-erosive gastro-oesophageal reflux disease by a prospective randomized multicentre trial.: A total of 98 patients received either famotidine 20 mg b.d. (n = 48) or omeprazole once daily (n = 50). Frequency of gastro-oesophageal reflux disease symptoms and health-related quality of life were evaluated at baseline and after 4 weeks of treatment. Complete relief was defined as no gastro-oesophageal reflux disease symptoms during the 7-day interval in week 4.: Complete relief was achieved in 23 (48%) of patients receiving famotidine and 28 (56%) of patients treated with omeprazole. In the famotidine group, complete relief rate inH. pylori-negative patients was significantly lower thanH. pylori-positive patients (35% vs. 64%). Both famotidine and omeprazole improved most scales of health-related quality of life. Omeprazole significantly improved reflux score irrespective ofH. pyloriinfection while famotidine significantly improved reflux score inH. pylori-positive patients but not inH. pylori-negative patients.: Omeprazole is more effective than famotidine for the control of gastro-oesophageal reflux disease symptoms inH. pylori-negative patients, while similar efficacy is observed inH. pylori-positive patients with non-erosive gastro-oesophageal reflux disease. [ABSTRACT FROM AUTHOR]