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Obesity is associated with increased morbidity and mortality. However, obesity paradox has been discussed in some patients with cardiovascular disease.We investigated the mechanisms of the obesity paradox in acute myocardial infarction (AMI) patients.We evaluated 1634 AMI patients with primary percutaneous coronary intervention (PCI). Patients were divided into 6 subgroups according to baseline body mass index (BMI) (low BMI:20 kg/mDuring the follow-up periods (median, 620 days; range, 344 to 730 days), 8.7% of patients experienced all-cause death. According to the Kaplan-Meier survival analysis, the patients in the younger age group with high BMI demonstrated significantly higher all-cause mortality compared to the other patients in the same age group (P = 0.012). In contrast, patients in the elderly age group with low BMI demonstrated significantly higher all-cause mortality compared to the others in the same age group (P 0.001). Multivariate cox regression analyses showed that low BMI in the elderly age group (HR 1.69, 95% CI 1.12 to 2.55, P = 0.012) and high BMI in the younger age group (HR 2.77, 95% CI 1.19 to 6.45, P = 0.018) were independent predictors of all-cause mortality.The obesity paradox was recognized only in patients in the elderly age group and not in the younger age group. The prognostic impact of BMI may differ by age in AMI patients.

BACKGROUND The aim of this study was to assess the echocardiographic characteristics of chronic hemodialysis (HD) patients with end-stage renal disease (ESRD) in a multicenter prospective cohort study.Methods and Results:Three hundred and fifteen patients with ESRD (67.9±10.6 years, 47.6% male) on chronic HD for ≥1 year were examined on transthoracic echocardiography, including Doppler-derived aortic valve area (AVA) measurement. Only 11.5% and 3.4% of all patients had normal left ventricular (LV) geometry and normal LV filling pattern, respectively. The majority of patients had aortic and mitral valvular calcification, and approximately 50% of all 315 patients had aortic valve narrowing with AVA

Total suspended particulate matter (TSP) was collected during the summer and winter in five Japanese cities spanning Hokkaido to Kyushu (Sapporo, Kanazawa, Tokyo, Sagamihara and Kitakyushu) from 1997 to 2014. Nine polycyclic aromatic hydrocarbons (PAHs) with four to six rings, including pyrene (Pyr) and benzo[a]pyrene (BaP), were identified using high-performance liquid chromatography (HPLC) with fluorescence detection. Two nitropolycyclic aromatic hydrocarbons (NPAHs), 1-nitropyrene (1-NP) and 6-nitrobenzo[a]pyrene (6-NBaP), were identified by HPLC with chemiluminescence detection. A comparison of PAH and NPAH concentrations and [NPAH]/[PAH] ratios such as [1-NP]/[Pyr] and [6-NBaP]/[BaP] revealed the following characteristics in the five cities: (1) In Sapporo, Kanazawa, Tokyo and Sagamihara, the concentrations of PAHs and NPAHs were high at the beginning of the sampling period and then steadily decreased, with NPAHs decreasing faster than PAHs. The large initial [1-NP]/[Pyr] ratios suggest that the major contributor was automobiles but subsequent decreases in this ratio suggest decreased automobile contributions. (2) By contrast, PAH concentrations in Kitakyushu did not decrease during the sampling period, though concentrations of NPAHs decreased. The consistently smaller [1-NP]/[Pyr] ratio and larger [6-NBaP]/[BaP] ratio in Kitakyushu suggests that the major contributor of PAHs was not automobiles but iron manufacturing which uses a large amount of coal. The sudden increase in atmospheric PAH concentrations in the winter of 2014 may also be due to iron manufacturing.

A variety of wild mushrooms were collected in a forest on the Noto Peninsula, Japan, to determine the concentration of 137Cs and 40K. The wild mushroom species belong to the orders Agaricales and Aphyllophorales. The concentration of 137Cs varied widely (1.4–4,100 Bq/kg dry weight) in mushrooms growing in soil. On the contrary, 137Cs concentration levels were relatively low (1.9–20 Bq/kg-dry weight) in mushrooms growing on wood. The concentration of 40K varied widely (12–2,400 Bq/kg-dry weight) in contrast with several previous reports that suggest relatively constant 40K levels in mushrooms. Unusually low concentrations of 40K were observed in a few mushroom species that had very hard fruiting bodies with peculiar shapes. The mean and median of 137Cs concentration in the present study were similar to those previously reported for Japanese mushrooms. Among the Agaricales mushrooms, Entolomataceae and Tricholomataceae families growing in soil had the highest concentration of 137Cs. Among the Aphyllophorales mushrooms, Gomphaceae and Ramariaceae families growing in soil also had the highest 137Cs concentrations. The concentrations of 137Cs and stable Cs in mushroom samples were positively correlated. The concentration ratio of 137Cs/Cs differed between Agaricales and Aphyllophorales mushrooms. The average 137Cs/Cs ratio in mushrooms growing in soil was similar to that calculated for the top soil (

Cardiovascular events are known as poor prognostic factors for hemodialysis (HD) patients. The purpose of this study was to evaluate the clinical and prognostic characteristics of acute myocardial infarction (AMI) in HD patients compared to non-HD patients. From Mie ACS registry, consecutive 2412

Airborne particulates were collected in seven cities in the Pan–Japan Sea countries, Shenyang (China), Vladivostok (Russia), Seoul (South Korea), Kitakyushu, Kanazawa, Tokyo and Sapporo (Japan), in winter and summer from 1997 to 2002. In addition, particulates from domestic coal-burning heaters and diesel engine automobiles were collected in Shenyang and Kanazawa, respectively. Nine polycyclic aromatic hydrocarbons (PAHs) and four nitropolycyclic aromatic hydrocarbons (NPAHs) in the extracts from the particulates were analysed by HPLC with fluorescence and chemiluminescence detections, respectively. The PAHs were fluoranthene, pyrene (Pyr), benz[a]anthracene, chrysene, benzo[b]fluoranthene, benzo[k]fluoranthene, benzo[a]pyrene, benzo[ghi]perylene and indeno[1,2,3-cd]pyrene, and NPAHs were 1,3-, 1,6-, 1,8-dinitropyrenes, and 1-nitropyrene (1-NP). Mean atmospheric concentrations of PAHs in Shenyang and Vladivostok were substantially higher than those in Seoul, Tokyo, Sapporo, Kitakyushu and Kanazawa. However, the mean atmospheric concentrations of NPAHs were at the same levels in all cities except Kitakyushu. The expected seasonal variations (greater PAH and NPAH concentrations in winter than in summer) were observed in all cities. In order to study the major contributors of atmospheric PAHs and NPAHs, both cluster analysis and factor analysis were used and three large clusters were identified. Furthermore, the concentration ratios of 1-NP to Pyr were significantly smaller in Shenyang, Vladivostok and Kitakyushu and the values were close to those observed in particulates from coal stove exhaust. By contrast, in Seoul, Kanazawa, Tokyo and Sapporo the [1-NP]/[Pyr] ratio reached values similar to those of particulates released from diesel-engine automobiles. The [1-NP]/[Pyr] concentration ratio seemed to be a suitable indicator of the contribution made by diesel-engine vehicles and coal combustion to urban air particulates.

Dioxins are present as impurities in agrochemicals applied to the soil. To examine the possibility that dioxins end up in the atmosphere, we compare the homologue composition and some characteristic isomer distributions of polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) in air and soil samples collected at sites in Ishikawa Prefecture, Japan. Tetrachloro dibenzo-p-dioxin (TeCDD) was the most abundant PCDD homologue in the air samples, while octachloro dibenzo-p-dioxin (OCDD) was the most abundant PCDD homologue in the soil samples. However, at several site, the most predominant homologue in the soil sample was not OCDD but TeCDD. The mean ratio of TeCDDs to PCDDs in the air samples was significantly smaller in winter than in other seasons, but no such seasonal variation was observed in the distribution of PCDF homologues. The abundance of PCDF homologues was inversely related to the number of chlorine substitutions in the air samples. The contribution of each toxic isomer (2,3,7,8-chlorine-substituted) to the total toxicity equivalency quantity (TEQ) in the air samples tended to be intermediate between their contributions to the TEQs in the soil and cinder samples. This result suggested that the air samples were influenced by both soil/dust suspension and combustion. In order to clarify the contributions of agrochemicals to dioxins in the air, we focused on the ratios of several characteristic isomers that are indicators of agrochemicals (chloronitrophen: CNP and pentachlorophenol: PCP) to their homologues. Significant decreases in the ratios of the isomers to their homologues in the air samples were observed only in winter, probably as a result of suppression of dust suspension by the snow cover. Therefore, the contribution of combustion to the dioxin concentration in the air was thought to be relatively large in winter.

In this study, airborne particulates were collected at three sites, two in a downtown area and the other in a suburban area of Kanazawa, Japan in each season for 7 years. Two polycyclic aromatic hydrocarbons (PAHs), pyrene (Py) and benzo[a]pyrene (BaP) and four nitropolycyclic aromatic hydrocarbons (NPAHs), 1-nitropyrene (NP) and 1,3-, 1,6-, and 1,8-dinitropyrenes (DNP) were determined by high-performance liquid chromatography with fluorescence and chemiluminescence detection. At the downtown sites, the mean concentration of each DNP was about two orders of magnitude lower than that of 1-NP and more than three orders of magnitude lower than those of Py and BaP. This tendency reflected the composition of PAHs and NPAHs in diesel-engine exhaust particulates. Concentrations of these PAHs and NPAHs were higher at the downtown sites than at the suburban site, suggesting the dilution of these compounds during the transportation from the downtown to the suburban area. The concentration ratios of NPAHs to PAHs were larger at the downtown sites than at the suburban site. Studies using UV light and sunlight showed that degradation of NPAHs was faster than that of PAHs. Thus, the lower concentrations of NPAHs in the suburban sites may be due to their being photodegraded faster than PAHs during the atmospheric transportation from the downtown area to the suburban area.

Airborne particulates were collected at a site near a group of factories in Kitakyushu, one of the most industrialized cities in Japan, and at downtown sites in Sapporo and Tokyo, typical large commercial cities. We determined the levels of polycyclic aromatic hydrocarbons (PAHs) and nitropolycyclic aromatic hydrocarbons (NPAHs), which are known to be carcinogenic and/or mutagenic. The atmospheric concentrations of most PAHs with 4-, 5-, and 6-rings were higher in Kitakyushu and Tokyo than in Sapporo. On the other hand, atmospheric concentrations of the strongly mutagenic NPAHs were the highest in Sapporo, intermediate in Tokyo, and lowest in Kitakyushu. The atmospheric concentrations of 1-nitropyrene (1-NP) in Kitakyushu were one order of magnitude lower than those in the two commercial cities. Therefore the concentration ratios of NPAHs to their nucleus PAHs were significantly smaller in Kitakyushu than in the two commercial cities. This result suggested that the atmospheric levels of NPAHs in Kitakyushu were comparatively low, although the air in Kitakyushu was as heavily polluted with PAHs as the air in Tokyo. The concentration ratio of dinitropyrenes (DNPs) to 1-NP in Kitakyushu was much higher than that in the other two cities. A possible reason for the above two differences between the two types of cities is the contribution of chimney exhaust of steel manufacturing plants in Kitakyushu, which contains high concentrations of PAHs.

Airborne particulates were collected during the same periods in downtown Kanazawa, Sapporo and Tokyo and polycyclic aromatic hydrocarbons (PAHs) and nitropolycyclic aromatic hydrocarbons (NPAHs) were determined together with several heavy metal elements and water-soluble inorganic ions. The mean concentrations of metal elements and inorganic ions were the highest in Tokyo, followed by Sapporo and the lowest in Kanazawa both in winter and summer, and were strongly dependent on the amount of airborne particulates. These tendencies were different from the cases of PAHs and NPAHs. Correlations between the organic compounds (PAHs and NPAHs) and several inorganic pollutants were strong only in winter samples of Sapporo, but not so strong in Kanazawa and Tokyo. Because PAHs and NPAHs and several combustion-origin inorganic substances are, in general, detected mainly in the fine airborne particulates, it was reasonable that the significant correlations were found only in the winter samples of Sapporo where the generation of the coarse and crustal particulates were suppressed by snow or ice. Though the atmospheric concentrations of PAHs and NPAHs in Kanazawa were much lower than in Sapporo, the correlation among the NPAH compounds and between PAHs and NPAHs were surprisingly similar in these two cities. The strong correlations indicated that the atmospheric behaviors of the PAHs and NPAHs studied were similar in the two cities and that the source of PAHs and NPAHs might be the same. On the contrary, strong correlations were not observed in Tokyo, suggesting the possibility of multiple sources or formations/degradations of PAHs and

The maximum power peak has sharpened in recent years owing to the widespread use of air conditioners and other such equipment. Additionally, the gap between power demand during the day and night, as well as that among the seasons, is widening, while the annual load factor is on the decline. These factors prevent the effective use of generating facilities and are driving costs up. Countermeasures in the form of promotion of load leveling from the demand side have become a national priority. It was in these circumstances that the New Energy and Industrial Technology Development Organization (NEDO) officially requested that Kyushu Electric Power Co., Inc. (KEPCO) develop a load leveling technology for the future. For eight years starting in 1986, KEPCO conducted a demonstration test in which it directly controlled customer water heaters and air conditioners in a district of the city of Kagoshima. In addition, the company started a test in 1994 to demonstrate load leveling effects through indirect load control in a district of the city of Fukuoka. This load control involved providing customers on the demand side with their own load curves, electricity charge data, and other information so that they would themselves experiment with electricity use. This paper will outline the Centralized Load Control System demonstration test and discuss the system configuration and the 1996 test results of indirect load control that generated effects such as a peak reduction of 0.1 kW per household. © 1999 Scripta Technica, Electr Eng Jpn, 128(2): 7–17, 1999

Recent studies of elderly patients demonstrate high mortality from acute myocardial infarction (AMI) and increased risk with advancing age. Although many oldest old AMI patients (≥ 85 years) have been treated by primary percutaneous coronary intervention (pPCI) in the aging society, the prognostic

This paper describes the development of the Automatic Fault Point Locating and Sectional Isolating System. This system locates a single-line-to-ground fault point at each pole by using ground-current sensors, and isolates the faulted section by controlling pole switches with no outage of unfaulted sections. The ground-current sensor is connected to the line between allied ground terminals of pole devices and grounded conductor. It detects a ground fault current of more than 0.64 amperes that is determined so as to avoid an unexpected operation by stray current, but to detect the fault current accurately, and sends out an emergency signal with time delay of 0.1 s. Sectional isolation starts when both the emergency signal from the sensor and relay operation signals from a substation are received and ends within a feeder circuit-breaker tripping time of 1.5 s.

Water samples were collected at 17 sites in Kahokugata Water Basin, a closed water basin in central Japan. We determined the concentration of dioxins of the water samples. Linear relationships between toxic equivalent (TEQ) concentrations of dioxin and concentrations of suspended solid (SS) were obtained at sites in Kahokugata Lagoon and in the rivers flowing into the lagoon. Homologue composition of polychlorinated dibenzo-p-dioxins (PCDDs) and dibenzofurans (PCDFs) indicated that all the water samples were still strongly influenced by chlorinated herbicides, such as chloronitrofen (CNP) and pentachlorophenol (PCP) that had been widely used in rice fields. The main isomer distributions of the PCDD homologues were not significantly different among the sampling sites, while the main isomer distributions of the PCDF homologues were considerably different among the sampling sites. At a few sampling points in the downstream part of one of the rivers, high concentrations of 1,3,6,7,8-pentachloro dibenzofuran (1,3,6,7,8-PeCDF) and its related isomers (1,3,6,8-chlorine-substituted PCDFs) were traced to a dye manufacturing plant. These non-toxic isomers are usually only minor constituents in environmental water samples and are not indicators of any known dioxin sources. The dyeing discharge was found to make a contribution only in the water samples collected near the plant and the seasonal variation of the contribution might depend on the flow rate of the river.

This study evaluated whether the use of Levovist improves endocardial border delineation during dobutamine stress echocardiography.Thirty patients (20 men and 10 women) were enrolled in this study. Dobutamine was infused intravenously using an incremental regimen of 5, 10, 20, 30, and 40 micrograms/kg/min, each dose for 3 min. Levovist (277 mg/ml), dissolved in 9 ml of 5% dextrose, was infused intravenously. Two ml was infused at rest, 10, and 20 micrograms/kg/min. Three ml was infused at peak dobutamine dosage. Echocardiograms were recorded on videotapes. A endocardial border delineation score index (EDSI) was used for image analysis. The EDSI was obtained from each of 12 segments of the left ventricular wall (30 patients) in the rest and peak stress periods, before and after Levovist. Data from a total of 1,440 segments were analyzed separately.The mean EDSI at rest was 2.2 +/- 0.6 without contrast medium, and 2.4 +/- 0.7 with contrast medium (p0.05). The mean EDSI during peak stress was 2.0 +/- 0.7 without contrast medium, and 2.2 +/- 0.6 with contrast medium (p0.05). The wall-by-wall EDSI revealed that the delineation of apical-septal, mid- and apical-lateral, apical-inferior, and apical-anterior segments was improved significantly with Levovist in the rest and peak stress periods.Delineation of the apical-septal, mid- and apical-lateral, apical-inferior, and apical-anterior segments was improved significantly with Levovist during dobutamine stress echocardiography.

We measure the effect of incentive payments on residential time-of-day (TOD) electricity demand in summer, using data from a residential TOD electricity pricing experiment in the Kyushu region of southern Japan. During the experiment, participating households could receive incentive payments if they reduce their peak usage share. Results based on an econometric model indicate that households have shifted their electricity usage from peak to off-peak periods in response to the incentive payment, but the effect of the incentive payment on load shifting was modest.

We performed screening for osteoporosis for the early detection of a decrease in the bone mineral density. The subjects consisted of 852 inhabitants (308 males and 544 females) aged 40 years or more in Nansei (population, 12, 107) in Mie Prefecture. Interviews, measurement of height and body weight, blood examination, and determination of the bone mineral density by the MD method were performed. In addition, a questionnaire on diet was carried out. The bone mineral density was decreased in 76 subjects (8.9%), of whom females were the majority. Height and body weight were significantly lower in the group with decreased bone mineral density than in the group with normal bone mineral density. The serum calcium (Ca), alkaline phosphatase (ALP), and inorganic phosphorus (P) levels were similar in the two groups. Concerning the family profile, the percentage of subjects living alone was significantly higher (p < 0.05) in the group with decreased bone mineral density (13.5%) than in the group with normal bone mineral density (3.6%). Screening for osteoporosis is still in the trial stage and involves various problems that require further studies. As subjects for screening, females before, during, and immediately after menopause are important.

We examined left ventricular (LV) diastolic pulsus alternans associated with systolic pulsus alternans in a patient with hypertrophic cardiomyopathy. Alternation in abnormal LV diastolic pressure waveforms persistently declining into mid-diastole (incomplete relaxation) and normal diastolic pressure were noted. Diastolic pulsus alternans was not corrected by isoproterenolol and may possibly be independent of systolic pulsus alternans.

症例は54歳,女性.貧血精査のため入院.諸検査にても原因不明で,対症療法で経過観察されたが,貧血が増悪し再入院.小腸透視にて陥凹性病変が認められ,小腸潰瘍の診断で開腹術が施行された.腸間膜付着側に穿通し,凝血を容れた直径2cmの潰瘍が認められ,病理学的に潰瘍合併小腸憩室と診断された.小腸憩室は頻度が少なく,臨床症状に乏しいため診断に難渋するとされる.本例は,慢性の貧血の原因として診断されたまれな1例と考えられた.

Diesel-engine exhaust and airborne particulates were collected in downtown and suburban areas and five mutagenic nitroarenes (2-nitrofluoranthene (NF), 1-, 2- and 4-nitropyrenes (NPs) and 6-nitrochrysene (NC) in benzene-ethanol extracts were determined by high-performance liquid chromatography with chemiluminescence detection. 1- and 4-NPs and 6-NC were found in diesel-engine exhaust particulates, however, 2-NF and 2-NP were not detected. On the other hand, all five nitroarenes were found in airborne particulates. Diurnal concentration patterns of 4-NP and 6-NC in the downtown area were similar to the pattern of 1-NP, but the patterns of 2-NF and 2-NP were different from the pattern of 1-NP. These results strongly suggested that 2-NF and 2-NP are formed in the atmosphere. Of the five nitroarenes, 2-NF had the largest suburban / downtown concentration ratio. 2- and 4-NPs and 6-NC all showed larger ratios than did 1-NP. These results showed that 2-NF and 2-NP were formed in the atmosphere, but that the secondary formation of 4-NP and 6-NC were not known. Taking mutagenic activity and the atmospheric concentration into consideration, the mutagenic contribution of 2-NF was estimated to be comparable with that of 1-NP in the downtown area, and more than that of 1-NP in the suburban area. This result suggested that the mutagenic contribution of the minor nitroarenes formed in urban air might not be negligible.

Air samples were collected at suburban Kanazawa and concentrations of dioxins in both gaseous and particulate phases were determined separately. The concentrations of the gaseous phase of dioxins increased with increasing temperature. Co-planar polychlorinated biphenyls (co-PCBs), whose vapor pressures are higher than those of polychlorinated dibenzo-p-dioxins (PCDDs) and dibenzofurans (PCDFs), were mainly in the gaseous phase samples in all the seasons. The gaseous phase ratios [gaseous phase/(gaseous phase + particulate phase)] of tetrachloro dibenzo-p-dioxins and dibenzofurans (TeCDD/DFs) were high regardless of the temperature. However, the gaseous phase ratios of penta-hepta CDD/DFs varied widely depending on the temperature. Gas/particle partitioning of atmospheric dioxins depended on not only the number of chlorine-substitutions but also the positions of the chlorine-substitutions. The position of chlorine-substitution in an isomer affects the isomer's molecular polarity. Dioxin isomers with higher molecular polarity, which have shorter retention times on the selected ion monitoring (SIM) chromatograms of their homologues, tended to be distributed unevenly in the gaseous phase. In addition, the differences in the gaseous phase ratios between the isomers with higher molecular polarity and those with lower molecular polarity increased with decreasing temperature.

Air samples were collected at the sides of busy traffic roads in downtown Kanazawa, Sapporo and Tokyo during the same periods both in the daytime and in the night, in winter and summer. We determined the levels of polycyclic aromatic hydrocarbons (PAHs) and nitropolycyclic aromatic hydrocarbons (NPAHs), which are known to be carcinogenic and/or mutagenic. PAHs and NPAHs were analyzed simultaneously with an HPLC system with fluorescence detection for PAHs and another HPLC system with chemiluminescence detection for NPAHs, respectively. The amounts of airborne particulates were larger in the daytime than in the night in all three cities. This result was thought to reflect the diurnal change of such urban activities as traffic volume. Many of the PAH and NPAH compounds showed higher concentrations in the daytime than in the night, and also showed higher concentrations in winter than in summer in the three cities. This result coincided with the trends observed in our continuous surveys in downtown Kanazawa for several years. However, 5-ring PAHs, such as benzo [a] pyrene, and dinitropyrenes in Tokyo did not show such diurnal or seasonal differences. The composition ratio of NPAHs and the contribution of diesel-engine vehicles to the atmospheric concentrations of NPAHs were calculated from all the data of this survey. The concentration ratio of dinitropyrenes to 1-nitropyrene became larger with an increase in the ratio of diesel-engine vehicles to the total vehicles registered, suggesting a large contribution of diesel-engine vehicles to the concentrations of these NPAHs in urban air.

Polycyclic aromatic hydrocarbons (PAH) and nitropolycyclic aromatic hydrocarbons (NPAH) in airborne particulates collected simultaneously at downtown and suburban sites and in exhaust particulates from diesel and gasoline engine vehicles were determined. The mean concentrations of all compounds in the atmosphere were lower at the suburban site. The differences between the two sites were smaller in airborne particulates than in the atmosphere. However, the difference in NPAH concentrations in particulates between the two sites was greater than the difference in PAH concentrations, suggesting that the NPAH were less stable than the PAH. The concentrations of 1-nitropyrene and 1,3-, 1,6- and 1,8-dinitropyrenes were generally much higher in automobile exhaust particulates than in airborne particulates because the former were collected directly. However, 2-nitrofluoranthene and 2-nitropyrene were observed in airborne particulates but not in automobile exhaust particulates. The diurnal concentrations s...