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OBJECTIVE To identify the mortality rate from coronary heart disease (CHD) in diabetic Japanese by directly comparing the Tokyo University Hospital cohort and the Joslin cohort using identical protocols. RESEARCH DESIGN AND METHODS Five hundred thirty-eight diabetic patients who were treated at Tokyo University Hospital with a 35- to 62-year age range at entry and with a diabetes duration of RESULTS The percentage of patients who survived at the end of the 24-year period was higher in the Tokyo University cohort (42%) than in the Joslin cohort (12%). The percentage of patients who died from CHD was remarkably lower in the Tokyo University cohort (11%) than in the Joslin cohort (39%). The CHD mortality rate was lower in the Tokyo University cohort than in the Joslin cohort, regardless of the duration of diabetes. CONCLUSIONS Our study confirmed the previous finding that the CHD mortality is lower in diabetic Japanese than in diabetic Caucasians.

64 Japanese postmenopausal patients (pts) (median age 59: range 38–76) with advanced or recurrent breast cancer who had received more than 1 prior regimen (honnonotherapy and/or chemotherapy) were randomized between 2 oral regimen of letrozole for more than 8 weeks, 33 pts (ER+: 18, ER−: 3, unknown: 12) being given 0.5 mg of letrozole daily and 31 pts (ER+: 15, ER−: 3, unknown: 13), 1 mg daily. The tumor responses were peer reviewed and response rates (CR + PR in evaluable cases were 28% (3CR + 6PR/32, 95% C.I.: 14–47%) in 0.5 mg group and 39% (5CR + 6PR/28, 95% C.I.: 22–59%) in the 1 mg group, respectively. Stabilization of the disease for more than 6 months (long NC) was obtained in 19% for the 0.5 mg group and in 29% for the 1 mg group, respectively. Progressive disease was noted in 31% for the 0.5 mg group and in 21% for the 1 mg group, respectively. Clinical adverse experiences were observed in 6% of pts (2/33, 5 events) for the 0.5 mg group and in 6% of pts (2/31, 2 events) for the 1 mg group, all being only of mild severity (grade 1) except one event of grade 2 itching in the 1 mg group. Laboratory test abnonnalities were found in 9% of pts (3/33,6 events) for the 0.5 mg group and in 10% of pts (3/31, 6 events) for the 1 mg group, respectively. Except for one event of grade 2 GOT and GPT elevation noted in the 0.5 mg group, all other events were of either grade 0 or grade 1 severity. Estrone levels were maintained below the detection limit (2.5 pg/ml) and a sustained estradiol suppression was observed, with levels near the detection limit (1 pg/ml) during treatment. There was no clinically relevant changes in the other hormones (aldosterone, cortisol, FSH, LH, testostetone, androstenedione). These highly promising results support further extensive clinical evaluation.

Electromagnetic interactions (excluding nuclear interactions) of cosmic-ray muons were investigated by a combined arrangement of the Mutron magnet spectrometer and calorimeter. The interactions covered their transferred energies ranging from 1 GeV to several TeV produced by muons with energies up to 10 TeV. There is reasonable agreement between the experimental results and the theoretical predictions. For transferred energies less than 10 GeV, however, the observed number of events produced by muons around 1 TeV may be somewhat smaller than theoretically expected. The probability of accompaniment of a muon emerging from thick iron plates is also studied. The data are very useful for the measurement of the muon momentum by the magnet spectrometer. The ratio of the interaction probability for positive muons to that for negative muons is 0.94±0.02 for interactions with energy transfers over 1 GeV. However, by considering the measured accuracy of the value ±0.05 used for the charge ratio of incident muons, there is no evidence to support any suggestion that the interaction cross-sections of positive and negative muons for energy transfers above 1 GeV differ in the range from 100 GeV to 10 TeV.

The cosmic-ray muon momentum spectrum and charge ratio up to momenta \ensuremath{\simeq} 10 TeV/c have been measured with high accuracy. The power index of the differential spectrum of parent mesons at production gradually increases with momentum and becomes 2.84\ifmmode\pm\else\textpm\fi{}0.03 in the momentum range 0.8 to 10 TeV/c. The charge ratio is almost constant at a value of 1.27\ifmmode\pm\else\textpm\fi{}0.02 from 0.1 to 10 TeV/c.

A calorimeter with a volume of 3.6×4×2.4 m 3 has been built in the Institute for Cosmic Ray Research, University of Tokyo to study the interactions of cosmic ray muons of known momenta. The calorimeter is located between the two magnets of MUTRON, a magnet spectrometer built by the same laboratory to measure muon momenta up to a maximum of 17 TeV c −1 . In this article, the design of the calorimeter is described and the characteristics of the counters used are reported. The expected number of the interactions and the accuracy of energy determinations by the calorimeter are also discussed.

A whiteware body composition containing 30% alumina was investigated to study the effects of milling and sieving raw materials on bending strength and Weibull distribution of fired bodies. Test bars were formed by slip casting into a rectangular shape (10b×5b×70mm) and fired at 1350°C for 1h in a reducing atmosphere. Mean bending strength of the fired specimens increased with milling time, almost proportionally to time. Weibull modulus, however, decreased with milling time, because of a small amount of coarse grains which remained in the slip even after long milling. Removing the coarse grains in the slip through a finer sieve resulted in increased strength and higher Weibull modulus. It was found that quartz grains included in the raw feldspar were more effective as fracture sources than feldspar itself. A mean bending strength of 240MPa and Weibull modulus of 21 were obtained from the slip milled for 24h and sieved through 350mesh.

This paper dealts with the investigation about the formation of PZT and about its sintering under an atmosphere of oxygen in regard to the non-stoichiometry with an excess PbO (massicot, β-PbO).The results obtained are as follows.(1) The formation of PZT increased under the atomosphere of oxygen, and the reason could be explained in terms of Hedvall's effect.(2) The heating behavior of the excess β-PbO in the starting powder was described as;in oxygen: β-PbO-β-PbO+intermediate phase (570-720°C)→a-PbOin air: β-PbO→β-PbO+α-PbO→β-PbO+α-PbO+intermediate phase (700-730°C)→α-PbO(3) The temperature at which a liquid phase appeared on heating agreed with that at which all of the excessive β-PbO in the starting powder were converted into α-PbO.(4) The dielectric constant of specimens sintered under the atmosphere of oxygen had a higher value than that of specimens obtained in the air.

The present report deals with the carbonization of coals such as Tempoku coal (C%, 71. 8), Taiheiyo coal (C%, 77.5) and Yabari (C%, 84. 3) at about 20, 600, 800, 1000 kg/cm2 in order to examine the effects of carbonization pressure.From the results of proximate analyses, ir analyses, x-ray diffraction analyses, nmr measurement and structural analyses using densimetric method of carbonization products and their pyridine extracts andresidues, it proved that carbonization products of both Tempoku coal (low rank coal) and Y-abari coal (coking coal) were affected by carboni-zation pressure, and that the latter was more sensitive under high carbonization pressure.In the case of Tempoku coal, the yield and the aromaticity varied under high carbonization pressure while the volatile matter did not changs. Then it would actually be difficult to find what parts of the coal substances had been affected carbonization pressure.

Background:The Pravastatin Anti-atherosclerosis Trial in the Elderly (PATE) found that the prevalence of cardiovascular events (CVEs) was significantly lower with standard-dose (10–20 mg/d) pravastatin treatment compared with low-dose (5 mg/d) pravastatin treatment in elderly (aged ⩾ 60 years) Japanese patients with hypercholesterolemia. Small differences in on-treatment total cholesterol and low-density lipoprotein cholesterol (LDL-C) levels between the 2 dose groups in the PATE study were associated with significant differences in CVE prevalence. However, the reasons for these differences have not been determined. How sex and age differences influence the effectiveness of pravastatin also remains unclear.Objectives:The aims of this study were to determine the relationship between reduction in LDL-C level and CVE risk reduction in the PATE study and to assess the effects of sex and age on the effectiveness of pravastatin treatment (assessed using CVE risk reduction).Methods:In this post hoc analysis, Cox regression analysis was performed to study the relationship between on-treatment (pravastatin 5–20 mg/d) LDL-C level and CVE risk reduction using age, sex, smoking status, presence of diabetes mellitus and/or hypertension, history of cardiovascular disease (CVD), and high-density lipoprotein cholesterol level as adjustment factors. To explore risk reduction due to unspecified mechanisms other than LDLrC reduction, an estimated Kaplan-Meier curve from the Cox regression analysis was calculated and compared with the empirical (observed) Kaplan-Meier curve.Results:A total of 665 patients (527 women, 138 men; mean [SD] age, 72.8 [5.7] years) were enrolled in PATE and were followed up for a mean of 3.9 years (range, 3–5 years). Of those patients, 50 men and 173 women were ⩾75 years of age. Data from 619 patients were included in the present analysis. In the calculation of model-based Kaplan-Meier curves, data from an additional 32 patients were excluded from the LDL-C analysis because there were no data on pretreatment LDL levels; hence, the data from 587 patients were analyzed. A reduction in LDL-C level of 20 mg/dL was associated with an estimated CVE risk reduction of 24.7% (hazard ratio [HR] = 0.753; 95% CI, 0.625-0.907; P = 0.003). Risk was reduced by 22.2% in patients aged

Purpose The GEST study showed non-inferiority of S-1 but not superiority of gemcitabine plus S-1 (GS) to gemcitabine alone for overall survival with the data by the cut-off date of 31st July in 2010 for chemo-naïve patients with advanced pancreatic cancer. We considered it important to determine whether S-1 maintains non-inferiority after a long-term follow-up in the GEST study and to obtain a firm positive conclusion. In addition, it may be an interesting challenge to explore the efficacious profile of GS in the long-term follow-up study. Using the data from the follow-up period, background and efficacy in patients from Taiwan and Japan, as well as the rates of tumor shrinkage in locally advanced and metastatic patients (Waterfall plot) were also analyzed. Methods The results of the primary analysis were reconfirmed, and subset analysis of overall survival and progression-free survival was performed based on the overall survival data updated by the cut-off date of 31st July in 2011. Results The median follow-up period was 29.8 months, and 795 deaths occurred (95.6%). The median overall survival was 8.8 months for gemcitabine, 9.7 months for S-1 (hazard ratio [HR], 0.96; 97.5% confidence interval [CI], 0.79–1.17), and 9.9 months for GS (HR 0.91; 97.5% CI 0.75–1.11). In patients with performance status (PS) 0, the median overall survival was 9.8 months for gemcitabine, 10.9 months for S-1, and 10.5 months for GS. In patients with PS 1, the median overall survival was 6.2 months for gemcitabine, 6.3 months for S-1, and 9.6 months for GS. Conclusion Our survey reconfirmed the non-inferiority of S-1 to gemcitabine and showed S-1 can be used as one of the standard treatment options for advanced pancreatic cancer. Trial registration ClinicalTrials.gov: NCT00498225. Electronic supplementary material The online version of this article (doi:10.1007/s00432-017-2349-y) contains supplementary material, which is available to authorized users.

Background Effective prophylactic therapies have not been established for hepatocellular carcinoma recurrence. Peretinoin represents one novel option for patients with hepatitis C virus-related hepatocellular carcinoma (HCV-HCC), and it was tested in a multicenter, randomized, double-blind, placebo-controlled study. Methods Patients with curative therapy were assigned to one of the following regimens: peretinoin 600, 300 mg/day, or placebo for up to 96 weeks. The primary outcome was recurrence-free survival (RFS). Results Of the 401 patients initially enrolled, 377 patients were analyzed for efficacy. The RFS rates in the 600-mg group, the 300-mg group, and the placebo group were 71.9, 63.6, and 66.0 % at 1 year, and 43.7, 24.9, and 29.3 % at 3 years, respectively. The primary comparison of peretinoin (300 and 600-mg) with placebo was not significant (P = 0.434). The dose–response relationship based on the hypothesis that “efficacy begins to increase at 600 mg/day” was significant (P = 0.023, multiplicity-adjusted P = 0.048). The hazard ratios for RFS in the 600-mg group vs. the placebo group were 0.73 [95 % confidence interval (CI) 0.51–1.03] for the entire study period and 0.27 (95 % CI 0.07–0.96) after 2 years of the randomization. Common adverse events included ascites, increased blood pressure, headache, presence of urine albumin, and increased transaminases. Conclusions Although the superiority of peretinoin to placebo could not be validated, 600 mg/day was shown to be the optimal dose, and treatment may possibly reduce the recurrence of HCV-HCC, particularly after 2 years. The efficacy and safety of peretinoin 600 mg/day should continue to be evaluated in further studies. Electronic supplementary material The online version of this article (doi:10.1007/s00535-014-0956-9) contains supplementary material, which is available to authorized users.

Background The safety, tolerability, pharmacokinetics (PK) and anti-tumor activity of enzalutamide were investigated in patients with castration-resistant prostate cancer (CRPC) in Japan through a multicenter phase I/II study. Methods In phase I, patients with progressive metastatic CRPC received single, then multiple, ascending doses of enzalutamide 80, 160 or 240 mg/day. After assessment of tolerability at multiple doses of 160 mg/day for 4 weeks, post-docetaxel patients with CRPC and measurable disease were enrolled into phase II; receiving long-term administration of enzalutamide 160 mg/day. Results Nine and 38 patients were enrolled in phase I and II, respectively. During phase I, enzalutamide was well tolerated in each cohort; PK parameters were similar to those of non-Japanese populations in other studies. By week 12, overall response rate was 5.3 % and clinical benefit rate was 47.4 %. Prostate-specific antigen response rate (≥50 % reduction from baseline) was 28.9 %. Treatment-emergent adverse events reported in >20 % of patients in phase II were decreased weight, decreased appetite and constipation. No seizures were observed. Conclusion Enzalutamide at 160 mg/day was well tolerated, with PK and safety profiles similar to the non-Japanese population. Anti-tumor activity was observed in post-docetaxel Japanese patients with metastatic CRPC. Apparent differences in anti-tumor activity compared with the AFFIRM study (a phase III trial in a diverse population of patients with CRPC post-docetaxel) may be attributed to differences in treatment history prior to starting enzalutamide. Particularly in Japan, the influence of sequence in hormone treatments, including combined androgen blockade therapy, should be considered. Trial registration: ClinicalTrials.gov NCT01284920. Electronic supplementary material The online version of this article (doi:10.1007/s10147-016-0952-6) contains supplementary material, which is available to authorized users.

Objective: We aimed to assess the effects of age, comorbidity, and disease-specific functions on utility scores derived from three methods on prostate cancer. Methods: A total of 330 Japanese prostate cancer patients were asked to answer self-administered questionnaires. Community-weighted utility scores were derived from the EuroQoL-5D (EQ-5D) and the Short Form-36 (SF-36), while the patient’s directly elicited utility score was derived from time trade-off technique. Univariate and multivariate analyses were performed to examine the relation between covariates and utility scores. We assigned age, the Index of Co-existent Disease, and disease-specific functions including sexual, urinary, bowel, and hormonal function as covariates. Results: Bowel and hormonal function were related to utility scores, while age and sexual function were not. Comorbidities were more closely related to utility scores derived from EQ-5D and SF-36. Conclusions: These results contribute to an understanding of which factor has an impact on utility scores in patients with prostate cancer.

Background In chronic heart failure (CHF), it remains unclear whether the minimal dose of beta-blockade is related to survival benefits and which parameter predicts morbidity and mortality. We sought to determine the minimal dose related to survival benefits by comparing the efficacy and safety of three doses of carvedilol and the best predictive parameter for effective outcomes in Japanese patients with CHF. Methods In this prospective, randomized, stratified trial, 364 patients with mild to moderate CHF were assigned to a daily carvedilol dose of 2.5, 5, or 20mg, plus optimal standard therapy. Findings During the mean 3-year follow-up, resting heart rate (HR) and BNP were significantly reduced with dose–response relations in the early period but without dose–response relations in the late period. The LVEF and the LVDd were increased and decreased, respectively, without a dose–response relation. No significant difference was seen in the composite primary endpoint of all-cause mortality and hospitalization for cardiovascular diseases and heart failure. Multivariate analysis indicated early decreases in HR and BNP predicted long-term outcomes. However, adverse events increased dose-dependently. Among 237 polymorphisms in 87 heart failure-related genes, the osteopontin G-156 del genotype was associated with an event-free survival rate (Wilcoxon test, P=0.030). Conclusions A low carvedilol dose is effective if the HR and/or plasma BNP has been reduced. Carvedilol therapy should be guided by reductions in HR and/or BNP, especially by initial HR reduction, but not only by its dose. OPN might be a surrogate genetic marker for long-term event-free survival.

SummaryBackground Elpamotide is an HLA-A*24:02-restricted epitope peptide of vascular endothelial growth factor receptor 2 (VEGFR-2) and induces cytotoxic T lymphocytes (CTLs) against VEGFR-2/KDR. Given the high expression of VEGFR-2 in biliary tract cancer, combination chemoimmunotherapy with elpamotide and gemcitabine holds promise as a new therapy. Patients and Methods Patients with unresectable advanced or recurrent biliary tract cancer were included in this single-arm phase II trial, with the primary endpoint of overall survival. Survival analysis was performed in comparison with historical control data. The patients concurrently received gemcitabine once a week for 3 weeks (the fourth week was skipped) and elpamotide once a week for 4 weeks. Results Fifty-five patients were registered, of which 54 received the regimen and were included in the full analysis set as well as the safety analysis set. Median survival was 10.1 months, which was longer than the historical control, and the 1-year survival rate was 44.4 %. Of these patients, injection site reactions were observed in 64.8 %, in whom median survival was significantly longer (14.8 months) compared to those with no injection site reactions (5.7 months). The response rate was 18.5 %, and all who responded exhibited injection site reactions. Serious adverse reactions were observed in five patients (9 %), and there were no treatment-related deaths. Conclusion Gemcitabine and elpamotide combination therapy was tolerable and had a moderate antitumor effect. For future development of therapies, it will be necessary to optimize the target population for which therapeutic effects could be expected.

Background: Bone metastasis (BM) is a frequent complication in patients with advanced lung cancer and it causes skeletal-related events (SREs). Our study aim is to prospectively investigate the incidence of BM, incidence and types of SRE, and predictive factors of BM and SREs. Methods: Newly diagnosed, advanced non–small-cell lung cancer (NSCLC) or small-cell lung cancer (SCLC) patients were enrolled into the study. Patients were followed up every 4 weeks to monitor the development of SREs. Treatment for lung cancer was performed at the discretion of the investigator. Results: Two hundred seventy-four patients were enrolled in this study between April 2007 and December 2009 from 12 institutions. Patients included 77 cases of SCLC and 197 of NSCLC (stage IIIB/IV = 73/124). Median follow-up time was 13.8 months. The incidence of BM at initial diagnosis was 48% in stage IV NSCLC and 40% in extensive stage (ED)-SCLC. Forty-five percent of patients who developed BM had SREs consisting of pathologic fracture (4.7%), radiation to bone (15.3%), spinal cord compression (1.1%), and hypercalcemia (2.2%). Multivariate analysis revealed that factors predicting BM are stage IV, performance status 1 or greater and higher bone alkaline phosphatase in NSCLC patients, higher lactate dehydrogenase, and lower parathyroid hormone–related peptide in SCLC patients. Factors predicting SREs were stage IV, age 64 or younger, and lower albumin in NSCLC patients. Multivariate analysis of SRE was not performed for SCLC because of the small number of events. Conclusion: Predictive factors should be taken into consideration in future randomized studies evaluating BM and SREs.

This paper discusses the development of an efficient, lightweight switched-mode power supply (SMPS) for reducing cost and energy consumption and for simplifying essential maintenance procedures at small telephone offices. This SMPS consists of a voltage regulator, control circuits, protection circuits and five rectifier units including one redundant unit. Each rectifier unit weighs only 9 kg and can be handled by one person during maintenance. These features are realized through the employment of a single-ended forward-type 20-kHz conversion circuit. Furthermore, an effective decrease in rectifier unit weight and power loss is accomplished by designing the input filter to suppress high-frequency voltage ripple only, while designing for low-frequency voltage ripple to be absorbed in the conversion circuits. The efficiency of each rectifier unit is maximized by developing and using a new high-speed, high-voltage transistor for the conversion circuit and by improving the winding methods used in fabricating the transformer and the inductor, as well as by a loss reduction technique for the input filter. Accordingly, this SMPS can convert 200-volt, three-phase AC power to 48-volt DC with better than 90% efficiency, and it can supply output power up to 5 kW.

Publisher Summary The results of clustering cases depend on the variables used for analysis and, vice verse. The results of clustering variables depend on the cases used, whether those results are obtained by the application of automated classification techniques such as the k-means method or by the visual inspection of the output of ordination techniques, such as principal component analysis. It is a usual practice for consultants of data analysis to recommend their clients to reanalyze the data by deleting or sub-setting cases and/or variables to verify the stability and generality of the results of the analysis. The remedy for the problems in selecting cases and/or variables to be used in classification is to classify all cases and all variables simultaneously. A number of block clustering methods are proposed for the simultaneous clustering. Clustering is characterized as a method of increasing the goodness of fit of each model or decreasing the number of parameters of a well-fitted model through two operations—localization and merging, respectively.

In 51 cases with prostatic cancer, 88 with prostatic hypertrophy, 109 with prostatitis, and 174 normal subjects, the following five parameters were calculated from prostatic ultrasonograms scanned transrectally; prostatic weight (W), presumed circle area ratio (PCAR), anteroposterior diameter/transverse diameter (ATR), asymmetry index (ASI), and dissimilarity index (DSI). The W and PCAR were higher in cancer and hypertrophy than in prostatitis and normal subjects. The ATR and ASI were higher in cancer. The DSI was lower in hypertrophy. A canonical discriminant analysis using these five parameters disclosed two canonical variates that were useful to separate the disease entities: one separated cancer and hypertrophy from prostatitis and normal subjects, and the other separated cancer from hypertrophy. The coefficients of these variates indicated that cancer was separated from prostatitis and normal subjects by increases in W and ATR and from hypertrophy by the greater effect of increases in ATR (as compared to PCAR) and the small increases in W.

Conventional series-resonant converters suffer from wide variations in conversion frequency during constant voltage regulation, resulting in audible noise under light-load conditions. A new series-resonant converter has been developed in order to eliminate this problem. The converter uses a parallel resonant circuit with a resonant frequency of over 20 kHz installed in series with the load circuit. The output voltage is thus regulated by varying the conversion frequency in a higher area than that of a conventional series-resonant converter. An efficient, lightweight small-sized rectifier is developed using this new series-resonant converter. The rectifier unit can convert 200-volt AC to 48-volt DC and is capable of supplying an output current of 30 amps. Efficiency for 50 to 100% output current is 92%. The new rectifier is also free from any audible noise.

To evaluate the toxicity and efficacy of an i.v. preparation of BU (12.8 mg/kg), combined with CY (120 mg/kg), a prospective study was performed on 30 Japanese patients (median age, 30 years) with hematologic malignancies undergoing hematopoietic SCT (28 allogeneic transplants from an HLA-matched donor and 2 autologous transplants). There were no significant toxicities, and all but one patient showed evidence of granulocyte engraftment at a median of 14 days for allogeneic and 11 days for autologous transplantation. Grades II-IV acute and chronic GVHD occurred in 9 (9/27, 33%) and 16 patients (16/27, 59%), respectively. Non-relapse mortality at days 100 and 365 was 3 and 17%, respectively. The pharmacokinetics of i.v. BU showed close inter- and intrapatient consistency; the area under the plasma concentration-time curve of the first administration remained at less than 1500 micromol min/l in 27 of the 29 patients (93%), and between 900 and 1350 micromol min/l in 22 patients (73%). As all of the profiles overlap with data from non-Japanese patients, we conclude that racial factors may not seriously influence the bioactivity of i.v. BU.

Background Chronic kidney disease (CKD) eventually progresses to end-stage renal disease (ESRD). However, risk factors associated with CKD progression have not been well characterized in Japanese patients with CKD who are less affected with coronary disease than Westerners. Methods A large-scale, multicenter, prospective, cohort study was conducted in patients with CKD and under nephrology care, who met the eligibility criteria [Japanese; age 20–75 years; and estimated glomerular filtration rate (eGFR): 10–59 mL/min/1.73 m2]. The primary endpoint was a composite of time to a 50 % decline in eGFR from baseline or time to the initiation of renal replacement therapy (RRT). The secondary endpoints were the rate of decline in eGFR from baseline, time to a 50 % decline in eGFR from baseline, time to the initiation of RRT, and time to doubling of serum creatinine (Cre) concentration. Results 2966 patients (female, 38.9 %; age, 60. 3 ± 11.6 years) were enrolled. The incidence of the primary endpoint increased significantly (P

The influences of education and activity on memory of Japanese older adults were investigated. The Benton Visual Retention Test was given to 302 individuals (145 men and 157 women) aged 69 to 71 (average age 70) living in a suburb of Tokyo. Participants were retested 5 years later (average age 75). Memory as evaluated by Benton correct scores declined in both men and women during the 5 years. The influence of the first time Benton score, education, activity, and sex on the second-time Benton score was analyzed by multiple regression analysis. The second Benton score was strongly influenced by the initial score. Level of education and activity contributed to memory after 5 years. No difference in the magnitude of memory changes was found between men and women. The first time Benton score by education term showed a weak but negative contribution.