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We study the Cauchy problem associated with a quantum Zakharov-type system in three and higher spatial dimensions.Taking the quantum parameter to unit and developing Fourier restriction norm arguments, we establish local well-posedness property for wider range than the one known for the Zakharov system.

Purpose Texture analysis is a computer-assisted technique used to measure intratumoral heterogeneity, which is known to have important roles in cancer research. This study aimed to assess the potential prognostic values of textural features extracted from preoperative 18F-fluorodeoxyglucose positron emission tomography images in patients with resectable oral squamous cell carcinoma. Patients and Methods This retrospective cohort study included patients with oral squamous cell carcinoma who underwent resection surgery. We extracted 31 textural indices from preoperative positron emission tomography images. Overall survival (OS) and disease-free survival (DFS) were chosen as the primary outcome variables, and the primary predictor variables were age, sex, primary tumor location, pathological T and N classification, histologic differentiation, resected margin, perineural and lymphovascular invasion, maximum standardized uptake value, and the 14 textural indices selected in the factor analysis. We analyzed OS and DFS using Kaplan-Meier curves, and the differences between survival curves were determined using a log-rank test. The independent prognostic factors were assessed using the Cox-proportional hazards model. Results We enrolled 81 patients (median age, 67.3 years; range, 32 to 88 years). The median follow-up duration was 50.1 months (range, 6.3 to 133.7 months). The univariable and multivariable analyses revealed that higher entropy values (≥1.91) were associated with worse OS (hazard ratio, 21.49; 95% confidence interval, 1.36 to 340.71; P = .03) and DFS (hazard ratio, 50.69; 95% confidence interval, 5.23 to 491.18; P = .001). Conclusions This study showed that entropy is a statistically significant prognostic factor of both OS and DFS. Texture analysis using preoperative positron emission tomography images may contribute to risk stratification.

Purpose This study aimed to evaluate the prognostic significance of two major indices of intratumoral heterogeneity of 18F-fluorodeoxyglucose uptake by positron emission tomography (PET)/computed tomography (CT), namely heterogeneity index (HI) and heterogeneity factor (HF), in patients with oral squamous cell carcinoma. Methods We performed a retrospective analysis of 62 patients who underwent resective surgery. HI, HF, maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were obtained from pretreatment PET. HI was obtained by dividing SUVmax by SUVmean for the primary lesion; HF was obtained by taking the derivative (dV/dT) of the volume-threshold function from 30 to 70%. Univariate and multivariate analyses for the overall survival (OS) and disease-free survival (DFS) were performed using PET and clinicopathological parameters. Results Univariate and multivariate analyses of OS revealed that higher HI levels (threshold for the SUVmean is 30% of the SUVmax) were associated with poorer OS [hazard ratio (HR) = 11.57; 95% confidence interval (CI) = 1.45–92.28; P = 0.021]. Moreover, univariate and multivariate analyses of DFS revealed that higher TLG levels (threshold for the MTV and SUVmean is 4.0 of the SUV) were associated with poorer DFS (HR = 14.48; 95% CI = 1.27–164.78; P = 0.031). Conclusions HI and TLG may be statistically significant prognostic factors for OS and DFS, respectively.

We study the Cauchy problem of the Klein-Gordon-Zakharov system in spatial dimension $d \ge 5$ with initial datum $(u, \partial_t u, n, \partial_t n)|_{t=0} \in H^{s+1}(\mathbb{R}^d) \times H^s(\mathbb{R}^d) \times \dot{H}^s(\mathbb{R}^d) \times \dot{H}^{s-1} (\mathbb{R}^d)$. The critical value of $s$ is $s_c=d/2-2$. By $U^2, V^2$ type spaces, we prove that the small data global well-posedness and scattering hold at $s=s_c$ in $d \ge 5$.

We study the Cauchy problem for the Zakharov system in spatial dimension $d\ge 4$ with initial datum $ (u(0), n(0), \partial_t n(0) )\in H^k(\mathbb R^d)\times \dot{H}^l(\mathbb R^d)\times \dot{H}^{l-1}(\mathbb R^d)$. According to Ginibre, Tsutsumi and Velo ([9]), the critical exponent of $(k,l)$ is $ ((d-3)/2,(d-4)/2 ). $ We prove the small data global well-posedness and the scattering at the critical space. It seems difficult to get the crucial bilinear estimate only by applying the $U^2,\ V^2$ type spaces introduced by Koch and Tataru ([23], [24]). To avoid the difficulty, we use an intersection space of $V^2$ type space and the space-time Lebesgue space $E:=L^2_tL_x^{2d/(d-2)}$, which is related to the endpoint Strichartz estimate.

It has been shown that losartan, an angiotensin II receptor blocker (ARB), reduces serum uric acid levels. However, the effects of losartan on serum uric acid levels in the patients treated with a thiazide diuretic have not been fully elucidated. We have investigated the effects of losartan compared with other ARBs on blood variables and blood pressure control in hypertensive patients treated with a thiazide diuretic using data from the COMFORT study. The present analysis included a total of 118 hypertensive subjects on combination treatment with ARBs except for losartan and a diuretic who were randomly assigned to a daily regimen of a combination pill (losartan 50 mg/hydrochlorothiazide 12.5 mg) or to continuation of two pills, an ARB except for losartan and a diuretic. Blood pressures were evaluated at 1, 3, and 6 months after randomization and changes in blood variables including serum uric acid were evaluated during 6 months treatment period. Mean follow-up blood pressure levels were not different between the combination pill (losartan treatment) group and the control (ARBs except for losartan) group. On the other hand, serum uric acid significantly decreased in the combination pill group compared with the control group (-0.44 versus + 0.10 mg/dl; p = 0.01), although hematocrit, serum creatinine, sodium and potassium were not different between the groups. These results suggest that the treatment regimen switched from a combination therapy of ARBs except for losartan and a diuretic to a combination pill (losartan/ hydrochlorothiazide) decreases serum uric acid without affecting blood pressure control.

Recent years, many companies have faced with dilemmas. One of the dilemmas is that research and development (R&D) achievements of these companies do not necessarily lead to business outcomes of themselves. In order to solve this dilemma, we proposed a structure that is called “multi-program platform structure” as a methodology for obtaining multiple perspectives. However, since this structure did not have a concept of time-series, in this paper, we examined to extend by introducing the concept of time-series to this structure. Moreover, this extension will be explained that the gap between two R&D programs (for the customer perspective and for the business process perspective) is carried out the dynamic alignment through the activities of the R&D.

C型慢性肝疾患患者における肝がんは一旦発生すると根治治療後も肝内転移や多中心性再発が極めて高率におきる．IFNが投与可能となり著効群・肝機能改善群において肝がんの発生率低下作用が報告され，さらに最近では進行肝がんに対する治療として抗がん剤との併用で相加相乗的な有効性も報告されている．そこで今回我々は肝がん治療後にウイルス排除とともにIFN（の抗腫瘍効果）による肝がんの再発予防効果を目的としIFN投与を施行しえた8例について検討した．肝がん治療は初発例1例，再発例7例でIFN投与治療の結果は著効群が4例とそれ以外の群が4例であった．そしてIFN治療後著効群からは2例再発したが，再発腫瘍の治療後を含め全例無再発で極めて予後良好で，著効以外の症例は肝がんの再発を繰り返し対照的な結果であった．肝がんの根治治療後のIFN治療はウイルスが消失した場合，その後の肝がん再発予防に大変重要であると考えられた．

β-Lactoglobulin (β-LG) was modified and conjugated to xylobiose using the Maillard reaction. The antioxidant activity of the Maillard reaction product, β-LG-xylobiose, was measured in vitro and compared to that of conjugated β-LG-lactose. The reaction for 7 days led to conjugated β-LG-xylobiose with a relative molecular mass ranging between 19 and 22 kDa based on SDS-PAGE analysis. It is confirmed that xylobiose bound to β-LG by gas-liquid chromatography. One milligram of conjugated β-LG-xylobiose contains 108 μg of xylobiose, while the available e-amino group content decreased to 40% after the Maillard reaction. Conjugated β-LG-xylobiose had a higher radical scavenging activity than free β-LG. As the modification by xylobiose had a higher efficiency than the modification by lactose, it is found that xylobiose is a useful oligosaccharide for protein modification. Furthermore, the radical scavenging activity of β-LG was improved by modification with xylobiose.

Background: While anticoagulant therapy is standard management for atrial fibrillation (Af), dual antiplatelet therapy (DAPT) is needed after stent implantation for coronary artery disease. HAS-BLED score estimates risk of major bleeding for patients on anticoagulation to assess risk-benefit in Af care. However, it is little known about usefulness of HAS-BLED score in Af patient treated with coronary stents requiring DAPT or DAPT plus warfarin (triple therapy: TT). The aim of this study was to evaluate the role of HAS-BLED score on major bleeding in Af patients undergoing DAPT or TT. Methods: A total of 837 consecutive patients were received PCI in our hospital from Jan. 2007 to Dec. 2010, and 66 patients had Af or paroxysmal Af at the time of PCI. Clinical events including major bleeding (cerebral or gastrointestinal bleeding) were investigated up to 3 years. Patients were divided into 2 groups based on HAS-BLED score (High-risk group: HAS-BLED score≥4, n=19 and Low-risk group: HAS-BLED score Results: Baseline characteristics were not different between High-risk and Low-risk group except for age. Overall incidence of major bleeding was observed in 8 cases (12.1%) at 3 years follow-up. Major bleeding event was significantly higher in High-risk group compared with Low-risk group (31.6% vs. 4.3%, p=0.002). However, management of DAPT and TT was not different between the 2 groups. Among component of HAS-BLED score, renal dysfunction and bleeding contributed with increased number of the score. Conclusion: High-risk group was more frequently observed major bleeding events compared with Low-risk group in patients with Af following DES implantation regardless of antiplatelet/anticoagulant therapy.

Between Aril 1975 and December 1976, the second nationwide survey of Meniere's disease in Japan was made by the 17 members of the Meniere's Disease Research Committee of Japan. The epidemiological data from 520 patients with definite Meniere's disease were analyzed in comparison with those from the 126 patients in the non-Meniere vertiginous group (Control A) and the 228 patients in the rhinolaryngological group (Control B). The male:female ratio of definite cases of Meniere's disease was almost the same, and the age distribution peaked at the age group of 40--49 years for males, while the peak for females was at the age group of 30--39 years. 5.8% of the 520 patients had a close relative who also suffered from Meniere's disease. From the epidemiological features, it may appear that the occurrence of vertiginous attacks in Meniere's disease is influenced much more by individual than by environmental factors. However, this feature can be considered as another evidence of the psychosomatic disorders involved in Meniere's disease.

The present study indicates that visual signals responsible for OKN are conducted through the retinal ganglion cells mainly contralaterally, and only in the ventral region of the retina ipsilateral to the injection site. The retinal ganglion cells projecting into the NOT ipsilateral to the injection site were identified as small- and medium-sized cells in the rat. The density of the ventral ganglion cells of the retina contralateral to the injection site was lower than that in any other regions of the retina except for the dorsal region of the retina, and the density of the ventral ganglion cells ipsilateral to the injection site was about 4 times greater than that on the contralateral side. This finding requires physiological investigation in the future.

During the period from January 1973 to June 1975, 60 cases with definite Meniere's disease and 30 cases with sudden deafness were listed according to such criteria for the diagnosis of both diseases as determined by the Research Committee of Japan. A neurootological assessment for both diseases were performed in our series. In patients with definite Meniere's disease, hearing impairment was characterized by deficiency in detecting low- and middle-pitched tones and fluctuation of auditory threshold in low frequency range. In sudden deafness, highly impaired hearing loss, i.e., total deafness, was frequently observed (45%). However, recruitment occurred at the same incidence (80%) in both diseases tested. The incidence of spontaneous nystagmus was almost the same regardless of associated vertigo and the course of both diseases. Moreover, it was also recognized that a reduction of caloric responses was a better indication for assessment of the affected ear in both diseases.

Previous studies have shown that smoking is a risk factor for periodontitis and that it has a suppressive effect on gingival bleeding. This study examined the relationship between smoking, including past smoking, and periodontal conditions, mainly gingival bleeding, in a community-based health investigation.Smoking status was examined in 958 subjects, along with the quantity of tobacco currently or previously smoked (never, former light, former heavy, current light, and current heavy). We analyzed the influence of smoking on probing depth (PD), clinical attachment loss (CAL), and gingival bleeding on probing (BOP).In multivariate logistic regression analyses, current heavy smokers were at a significantly greater risk for having a higher proportion of teeth with PDor =4 mm and a higher proportion of teeth with CALor =5 mm; however, they had a lower risk for having a high BOP than did those who had never smoked. Moreover, both former light and former heavy smokers had significantly lower risks for high BOP. When the analysis was limited to subjects with PDor =4 mm, former heavy and current heavy smokers showed a significant suppression of high BOP compared to never smokers.This study suggests that smoking is significantly associated with PD and CAL and that current and past smoking has a suppressive effect on BOP.

A 50-year-old man who had suffered from old myocardial infarction presented with an episode of syncope. DC shock was required for the interruption of frequent pleomorphic ventricular tachycardia (VT). Although the treatment for heart failure decreased the frequency of VT attacks, hemodynamically unstable VT occurred several times. A 12-lead Holter electrocardiogram was used to determine the triggering premature ventricular contraction (PVC) and catheter ablation was performed by targeting this PVC. The site of origin of the triggering PVC was considered to be located between damaged cardiac muscle and intact Purkinje's fiber. No episode of PVC and VT was observed after a few days of ablation. An implantable cardioverter defibrillator was implanted but VT did not recur for more than 20 months.

Although recent studies suggest a relationship between alcohol consumption and periodontal disease, the dose-response relationship between drinking and the severity of periodontitis is unclear.Alcohol consumption was evaluated using the frequency of drinking and the daily alcohol intake for 961 individuals aged 40 to 79 years. Periodontal status was evaluated using probing depth (PD) and clinical attachment loss (CAL).Alcohol consumption was linearly associated with the extent of PD and CAL in univariate analyses (P0.001). In multivariate logistic regression analyses, the subjects drinking 15 to 29.9 g alcohol per day (odds ratio [OR] = 2.7; 95% confidence interval [CI] = 1.1 to 6.6) or more than 30 g per day (OR = 2.5; 95% CI = 1.1 to 5.7) had a significantly higher risk of having more than 35% of their teeth with PDor = 4 mm than non-drinkers, independent of other confounding variables. No significant relationship between drinking and CAL was observed in the multivariate analysis.These results suggest that the effect of drinking on periodontal condition is limited to subjects with deep periodontal pockets associated with more than one-third of their teeth.

Background: Recent studies have reported a relationship between obesity and periodontal disease. Obesity is the strongest risk factor for type 2 diabetes, which is, in turn, a risk factor for periodontal disease. An oral glucose tolerance test is necessary to diagnose diabetes; however, no study has examined the relationship between obesity and periodontal disease by taking oral glucose tolerance test results into consideration. Methods: In all, 584 Japanese women aged between 40 and 79 years old, with at least 10 teeth, underwent health examinations. Body mass index, waist–hip ratio, body fat, and oral glucose tolerance test results were used as independent variables with known risk factors for periodontal disease. Mean probing pocket depth and mean attachment loss were used as the dependent variables. Results: In all of the analyses, body mass index, body fat, and waist–hip ratio were significantly associated with the highest quintile of mean probing pocket depth, even when adjusted for oral glucose tolerance test results. In the multivariate analysis, the subjects with the highest quartile of body mass index had a significantly higher odds ratio (OR) for the highest quintile of mean probing pocket depth [OR, 4.3; 95% confidence interval (CI), 2.1–8.9; p

OBJECTIVE—Several studies have shown associations between diabetes and various types of cancer other than gastric cancer. The aim of this cohort study was to evaluate the impact of fasting plasma glucose (FPG) levels on gastric cancer occurrence. RESEARCH DESIGN AND METHODS—A total of 2,466 Japanese subjects aged ≥40 years were stratified into three groups according to FPG tertiles (5.8 mmol/l, high FPG) and followed up prospectively for 9 years. RESULTS—During the follow-up, 66 subjects experienced gastric cancer. In men, the age-adjusted incidences were significantly higher in the modest-FPG (7.0 per 1,000 person-years, P < 0.05) and high-FPG (7.2, P < 0.05) groups than in the low-FPG group (2.2). In women, the high-FPG group also had a significantly higher age-adjusted incidence of gastric cancer compared with the low-FPG group (2.5 vs. 0.8, P < 0.05). The multivariate analysis with Cox’s proportional hazards model revealed that the risks of gastric cancer in the modest-FPG (relative risk [RR] 2.3 [95% CI 1.1–5.0]) and high-FPG (3.1 [1.5–6.4]) groups were significantly higher than that in the low-FPG group, even after adjusting for other comprehensive risk factors, including Helicobacter pylori status, smoking, and dietary factors. However, this FPG-cancer association was observed only among H. pylori–seropositive subjects. CONCLUSIONS—Our findings suggest that a modest increase in FPG is a risk factor for gastric cancer and that hyperglycemia is a possible cofactor increasing the risk posed by Helicobacter pylori infection.

Inflammation is hypothesized to play a significant role in the development of type 2 diabetes; however, reports on clinical inflammatory conditions are limited. Studies have suggested that periodontitis affects glucose control in diabetics. This community-based study examined the relationship between periodontitis and glucose tolerance status, including changes in status. The relationship between periodontal condition and the results of a 75-g oral glucose tolerance test was examined in 961 adults in 1998. Deep pockets (mean pocket depth > 2.0 mm) were significantly associated with impaired glucose tolerance and with diabetes as compared with shallow pockets (< 1.3 mm). In the subgroup with normal glucose tolerance 10 years previously, subjects who subsequently developed impaired glucose tolerance were significantly more likely to have deep pockets. Deep pockets were closely related to current glucose tolerance status and the development of glucose intolerance.

Background and Purpose— The slowdown of a steeply declining trend in cardiovascular mortality has been reported in Japan, but precise reasons for this trend are uncertain. Methods— We established 3 study cohorts of Hisayama residents aged ≥40 years without a history of stroke or myocardial infarction in 1961 (1618 subjects, first cohort), 1974 (2038 subjects, second cohort), and 1988 (2637 subjects, third cohort). We followed up with each cohort for 12 years, comparing the incidence, mortality, and survival rate of cardiovascular disease. Results— The age-adjusted incidence of cerebral infarction significantly declined by 37% for men and by 32% for women from the first to the second cohort. It continued to decline by 29% for men, but the decline decelerated for women in the third cohort. The incidence of cerebral hemorrhage steeply declined by 61% from the first to the second cohort in men only, while it was sustained for both sexes in the third cohort. Stroke mortality continuously declined as a result of these incidence changes and significant improvement of survival. In contrast, the incidence and mortality rate of coronary heart disease were unchanged except for the increasing incidence in the elderly. The prevalence of severe hypertension and current smoking significantly decreased, while that of glucose intolerance, hypercholesterolemia, and obesity greatly increased among the cohorts. Conclusions— Our data suggest that the decline in stroke incidence is slowing down and that the incidence of coronary heart disease has been increasing in the elderly in recent years. Insufficient control of hypertension and the increase in metabolic disorders may contribute to these trends.

Most denitrifiers produce nitrous oxide (N 2 O) instead of dinitrogen (N 2 ) under aerobic conditions. We isolated and characterized novel aerobic denitrifiers that produce low levels of N 2 O under aerobic conditions. We monitored the denitrification activities of two of the isolates, strains TR2 and K50, in batch and continuous cultures. Both strains reduced nitrate (NO 3 − ) to N 2 at rates of 0.9 and 0.03 μmol min −1 unit of optical density at 540 nm −1 at dissolved oxygen (O 2 ) (DO) concentrations of 39 and 38 μmol liter −1 , respectively. At the same DO level, the typical denitrifier Pseudomonas stutzeri and the previously described aerobic denitrifier Paracoccus denitrificans did not produce N 2 but evolved more than 10-fold more N 2 O than strains TR2 and K50 evolved. The isolates denitrified NO 3 − with concomitant consumption of O 2 . These results indicated that strains TR2 and K50 are aerobic denitrifiers. These two isolates were taxonomically placed in the β subclass of the class Proteobacteria and were identified as P. stutzeri TR2 and Pseudomonas sp. strain K50. These strains should be useful for future investigations of the mechanisms of denitrifying bacteria that regulate N 2 O emission, the single-stage process for nitrogen removal, and microbial N 2 O emission into the ecosystem.

The projections of the nucleus of the optic tract (NOT) were studied in cats using three kinds of retrograde tracers (horseradish peroxidase wheat germ agglutinin (WGA-HRP), dextran fluorescein (DF) and dextran tetramethylrhodamine (DTR)). First, in the cases that WGA-HRP were injected into the rostral part of medial vestibular nucleus (VN), a significant number of retrograde-labeled neurons, which concentrated between 600 and 800 μm from the rostral part of the NOT, were observed in the NOT ipsilateral to the injection sites. Second, no double-labeled neurons were found following injections of DF in the medial VN and DTR in the nucleus prepositus hypoglossi (NPH) at the same time. In this experiment, it was made clear that two different kinds of neurons in the NOT projected to the medial VN and the NPH, respectively.

To determine whether the beneficial effects of alcohol on lipid concentrations are mediated by insulin levels, we performed a cross-sectional analysis in 2103 nondiabetic men and women aged 40 to 79 years from a general Japanese population in Hisayama. The multivariate-adjusted sum of fasting and 2-hour postloading insulin levels and the insulin resistance index significantly decreased with elevating alcohol intake levels in men (P < 0.01 for the trend) but not in women. No dose-response relations between alcohol intake and glucose levels were observed. In both sexes, high-density lipoprotein cholesterol (HDLC) significantly increased with elevated alcohol intake (P < 0.01), whereas total cholesterol and low-density lipoprotein cholesterol (LDLC) were inversely correlated with alcohol intake (P < 0.01). In contrast, triglycerides (TGs) levels in men showed a J-shaped relation to alcohol dose, with moderate drinkers (10-29 g/d) having the lowest levels. Estimates using regression models indicated that for men, 10% of the alcohol-induced increase in HDLC and 2% of the alcohol-induced decrease in LDLC were insulin mediated. It was also estimated for male subjects that 36% of the reduction in TGs due to low to moderate alcohol intake was mediated by low levels of insulin and that this insulin-mediated pathway reduced the positive alcohol-TG relation by 13% in cases of moderate to heavy drinking. Our data suggest that regular alcohol consumption dose-dependently increased insulin sensitivity among male nondiabetics, but the insulin-mediated beneficial effects of alcohol on lipid concentrations were relatively small.

Objective: This study assessed the efficacy and safety of end-to-end anastomosis of the trachea following segmental resection in chronic tracheal stenosis. Methods: End-to-end anastomoses of the trachea were performed in 35 patients with chronic tracheal stenosis; 18 patients with tracheal invasion of thyroid cancer and 17 patients with long-term intubation and blunt injuries of the trachea. Results: All operations were successful, except one whose unilateral recurrent nerve had not been identified in the recurrent thyroid cancer invasion with trachea. Conclusion: This operation provides a one-step cure for the stenosed trachea and can be applied to the resection of less than six tracheal segments.

Insulin resistance may be a factor in the etiology of hypertension, and habitual alcohol intake may modify this relationship. We prospectively examined this hypothesis in 1,133 nonhypertensive, nondiabetic Japanese subjects, aged 40–79 years. Alcohol drinkers were more frequent among men than women at baseline (57.7 vs. 8.2%). The age-adjusted incidence of hypertension significantly increased with the elevating baseline insulin levels in women (P = .003 for trend), but not in men. The age- and sex-adjusted insulin levels and insulin resistance index decreased with elevating alcohol intake, while fasting glucose levels remained unchanged, suggesting that alcohol improves insulin sensitivity. Among nondrinkers, the age-adjusted incidence of hypertension significantly increased with elevating insulin tertiles in both sexes (P = .048 and .002 for trend in men and women, respectively), but not among drinkers. Our findings suggest a close association between insulin resistance and the incidence of hypertension in Japanese. However, alcohol modified and reduced this relationship.

This study retrospectively assessed the parameters that affect pulse generator longevity in 78 patients implanted with dual-chamber pacemakers. Longevity was studied in 52 generators: 14 Cosmos II, 17 Relay, 11 Ellite II, and 10 Thera DR. The lifetimes of Cosmos II and Ellite II were significantly prolonged compared to those of Relay and Thera DR. The comparative study was conducted to evaluate the effect of low-impedance leads (ThinLine I, n = 10) on generator longevity compared with a standard lead (Irox, n = 16). No significant variation in pacing threshold was found between the groups. However, the low-impedance group provided significantly lower cell voltage and higher cell impedance during all follow-up periods compared with the standard lead impedance group. The internal current of the pacemaker with rate response and sophisticated diagnostic memory function (Relay, n = 5, and Marathon DR, n = 5) increased significantly compared with the conventional pacemaker (Cosmos II, n = 5). In conclusion, the selection of unnecessary pacing parameters and the selection of low-impedance leads should be avoided in order to extend generator longevity.

Background The question remains as to whether light to moderate alcohol intake is associated with an increased risk of hypertension. Methods In 1978, a total of 1101 residents (433 men and 668 women) in a subrural community, Hisayama, in Japan, aged 40 years or more, with normal blood pressure, who were free from cardiovascular disease, were enrolled in a 10-year follow-up study. Inquiries regarding regular drinking were made in an interview based on a self-administered questionnaire. Results During the follow-up, 101 men and 166 women developed hypertension (blood pressure ≥140/90 mm Hg or use of antihypertensive drugs). The age-adjusted incidence of hypertension among current male drinkers increased significantly even with a light intake of alcohol (

The biological process of dinitrogen (N2) gas formation from fixed nitrogen compounds such as nitrate (NO3−) plays an important role in maintaining homeostasis of the global environment. Bacterial denitrification was long considered the sole biological reaction responsible for this condition, and its systems have been characterized in detail (3, 8, 20). Denitrification physiologically functions as anaerobic respiration in which NO3− is used as the terminal electron acceptor when oxygen (O2) is unavailable. Known bacterial denitrifying systems consist of four steps that successively reduce NO3− to N2 and involve nitrite (NO2−), nitric oxide (NO), and nitrous oxide (N2O) as intermediates. Production of the enzymes catalyzing each step is induced by nitrogen oxides and suppressed by O2 (3, 20). During the past decade, denitrifiers have been discovered in a variety of taxa including filamentous fungi (9, 10), yeasts (15), and actinomycetes (1, 11). All of these novel denitrifiers produce N2O as the major denitrification product. Both nitrogen atoms in the N2O product are derived from nitrate (or nitrite) (1, 9-11, 15). The phenomenon is therefore defined as denitrification, since the process should include the formation of an N—N bond (20). This system in several fungi is localized at respiring mitochondria, where it acts as anaerobic respiration, as it does in bacterial systems (5, 13, 16). Another unique feature of the fungal system is the involvement of cytochrome P450 (P450nor) as NO reductase (Nor) (6). Biological processes other than bacterial denitrification evolve N2 from fixed nitrogen compounds, but their molecular mechanisms and physiological significance remain to be elucidated. We identified simultaneous fungal codenitrification and denitrification, in which a hybrid N2 species is formed by combining two nitrogen atoms derived from NO2− and from other nitrogen compounds (10, 14). The denitrifying fungi Fusarium solani and Cylindrocarpon tonkinense evolve hybrid N2 species (10). The fact that the denitrifying fungus Fusarium oxysporum evolves N2O instead of N2 by codenitrification only when a nitrogen compound in addition to NO2− such as azide, salicylhydroxamic acid, or ammonium (NH4+) is available (14) suggests that the mechanisms of this process differ among fungal species. Anammox is a third N2-generating metabolic process that has been identified in the strictly anaerobic chemolithotrophic Planctomycetales (12), in which NH4+ is combined with NO2− to form N2. The actinomycetes form a unique taxon among gram-positive bacteria. Although actinomycetes naturally proliferate in soil and in aqueous environments, little is known about how they accomplish denitrification. Denitrifiers also occur among actinomycetes (1, 11), and the system of Streptomyces thioluteus has been characterized previously (11). All of the actinomycete denitrifiers found in these studies evolve N2O from NO3− or NO2−, and thus, no known actinomycete strains contain a complete denitrifying system that can thoroughly reduce NO3− to N2. The present study continues screening for denitrifying actinomycetes (11) by using a highly sensitive N2 detection system equipped with an isotope mass spectrometer and NO3− labeled with a stable isotope ([15N]NO3−). The results showed that Streptomyces antibioticus B-546 has N2-producing activity and that most of the N2 molecules are formed via intracellular codenitrification that is induced simultaneously with denitrification.

Moderately elevated plasma total homocyst(e)ine (tHcy) levels have been linked with cardiovascular disease. However, the findings of previous studies regarding the relationship between tHcy levels and subtypes of cerebral infarction (CI) have been conflicting. The aim of the present study was to examine this issue in a community-based case-control study performed in Hisayama Town in Japan. Fasting tHcy levels were compared among 75 CI cases, of which 43 were lacunar (LI), 24 atherothrombotic (ATI) and 8 cardioembolic infarctions (CEI), and 248 age- and sex-matched healthy controls. The mean tHcy concentrations were higher in CI than in controls (13.0 vs. 11.8 µmol/l; p = 0.018). LI and CEI also had significantly higher tHcy levels than did the corresponding controls (12.3 vs. 11.3 µmol/l for LI; p = 0.037 and 16.3 vs. 12.7 µmol/l for CEI; p = 0.036). The same tendency was also observed for ATI, but the difference was only marginally significant probably due to the small number of the cases (13.4 vs. 11.9 µmol/l; p = 0.087). After adjustment for age, sex, hypertension, serum creatinine, total protein, folate and vitamin B12 levels, the risk of LI was not significant in the second tertile of the tHcy distribution, but significantly increased in the third compared with the first tertile (adjusted odds ratio, AOR, 3.4; 95% confidence limits, CL, 1.3–8.9; p = 0.015), while the risk of ATI was significant even in the second tertile (AOR, 5.0; 95% CL, 1.0–23.7; p = 0.042) and higher in the third tertile (AOR, 7.5; 95% CL, 1.5–38.3; p = 0.015). However, the odds ratios for CEI could not be estimated, as there was no case of CEI in the first tertile. These findings suggest that elevated tHcy is an independent risk factor for all subtypes of CI, but that its impact is higher in ATI and probably in CEI than in LI.