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High quality depth images are required for stable and accurate camera tracking and 3D modeling. The method to improve the depth image quality using deep learning requires large and accurate datasets in advance. Datasets created by Middlebury Datasets which are typical depth image datasets do not always represent the feature of noise caused by depth cameras, and the number of datasets is not enough. In this study, the method for creating datasets for deep learning was developed and evaluated. The proposed method can improve the accuracy of the distance for each pixel by aligning the positions of pixels that capture the same part of the real world with multiple frames. In addition to super-resolution and denoising, the images are preprocessed such as patch division and data augmentation to eliminate the holes in correct depth images. By using this method, large number of real environment datasets can be automatically created. Two neural networks using Middlebury datasets and the datasets generated by the proposed method were trained respectively, and produced high quality depth images with them. In order to compare the Middlebury Datasets and the proposed method, we visually evaluated the hole filling and the smoothness of edges and surfaces of objects from the results. The result showed the network using the datasets created by the proposed method can remove noise rather than that using Middlebury Datasets since they include noise features caused by the performance limits of depth cameras.

We have achieved continuous-wave (CW) operation of gallium nitride (GaN)-based vertical-cavity surface-emitting lasers (VCSELs) fabricated by epitaxial lateral overgrowth (ELO) using dielectric distributed Bragg reflectors (DBRs) as masks for selective growth. The GaN VCSELs exhibited CW operation at a wavelength of 453.9 nm, and the maximum output power was 1.1 mW, which is the highest value reported to date. GaN-based materials have presented challenges for obtaining DBRs with high reflectivity and a wide stopband, precise control of the cavity length and a lateral confinement structure to provide laser operation. The proposed VCSEL is immune to these concerns. Its two dielectric DBRs were obtained free from cracks. A high reflectance of more than 99.9% and a stopband with a width of 80–97 nm were obtained for both DBRs. The cavity length was controlled by epitaxial growth to as short as 4.5 µm. An ITO contact electrode on p-type GaN, which is required for a lateral confinement structure, showed electrical reliability under a high current density of 59.6 kA cm−2. The present data demonstrate that the fabrication process adopted here overcomes the shortcomings that have prevented the widespread use of GaN-based VCSELs.

High-power green laser diodes were successfully fabricated on semipolar {20–21} GaN substrates with a maximum output power of more than 2 W. Semipolar {20–21} GaN was shown to be useful for obtaining a high output power and high wall-plug efficiency in green laser diodes.

We have succeeded in achieving continuous-wave operation of gallium nitride (GaN) based vertical-cavity surfaceemitting lasers (VCSELs), which was fabricated by epitaxial lateral overgrowth (ELO) using dielectric distributed Bragg reflectors(DBRs) as masks for selective growth. The device exhibited CW operation at a wavelength of 453.9nm. The maximum output power was 1.1 mW, which is the highest value reported in previously published articles. The ELO process used for this study represents a breakthrough for challenges which were indicated by other former reports for GaN-based VCSELs and is suitable for mass production.

International audience; BACKGROUND: Scarce data are available regarding the electrocardiographic (ECG) and echocardiographic changes in athletes of Asian origin. DESIGN: We investigate the ECG and echocardiographic patterns in Japanese (J) compared with African-Caribbean (AC) and Caucasian (C) athletes. METHODS: A total of 282 professional soccer players (68 J, 96 AC and 118 C) matched for age, gender, sport and level of achievement was examined. RESULTS: ECGs were without alterations in 62% of J (versus 69% of C, p = non significant and 44% of AC, p < 0.001). The most common alterations in J were sinus bradycardia (69%), incomplete right bundle branch block (RBBB; 43%), early repolarization (18%), isolated increase in R/S-wave (10%), Q-waves (9%). Remarkably, no J athlete showed deeply T-wave inversion, in contrast to 6% of AC (p < 0.05). Occasionally, J showed J-point upward/domed ST-elevation with inverted/biphasic T-wave (6% versus 16.5% in AC, p < 0.01). J demonstrated larger left ventricular (LV) cavity compared with AC and C players (55.2 ± 3.3 versus 52.2 ± 3.8 and 53.9 ± 3.7 mm, respectively, p < 0.01), with an important subset ( > 4%) presenting a markedly enlarged cavity (>60 mm), in the presence of normal systolic/diastolic function and no segmental abnormalities. Therefore, J showed a more eccentric remodelling compared with AC and C (relative wall thickness: 0.31 ± 0.05, 0.38 ± 0.06 and 0.36 ± 0.06, respectively, p < 0.01). CONCLUSION: J players show the most eccentric LV remodelling compared with C and AC players. In association, certain training-related ECG patterns, i.e. sinus bradycardia and isolated increase in R/S-wave voltage, are present in a larger proportion of J players than previously described in C players. Conversely, no J athlete showed deeply T-wave inversion, as commonly found in AC and occasionally in C.

SummaryObjectiveIt is usually suggested that life expectancy of top athletes especially in endurance sports is longer than that of sedentary people. On the other hand, heart rate recovery (HRR) after exercise is an independent risk factor for cardiovascular disease and mortality, but differences in HRR between various top athletes are unclear. We examined HRR in various top athletes to clarify a role of HRR that may affect their life expectancy.MethodsHRR was defined as the difference between the heart rate at peak exercise and that at 2min after the finish of exercise using symptom-limited maximal graded bicycle ergometer exercise testing. The relationships between HRR with the grade of static and dynamic component of classification of sports, age, and body mass index (BMI) were estimated.SubjectsThe subjects were 720 male athletes participating in the National Sports Festival Japan in 2005–2008 and age-matched 28 sedentary controls.ResultsHRR was significantly correlated (p

Tip leakage vortex cavitations originating from the tip clearance of an oscillating hydrofoil were observed experimentally. It was found that the delay between the unsteady and the steady-state results of the tip leakage vortex cavitation increase, and that the maximum cavity size decreases when the reduced oscillating frequency increases. To simulate the unsteady characteristics of tip leakage vortex cavitation, a simple calculation based on slender body approximation was conducted taking into account the effect of cavity growth. The calculation and experimental results of the cavity volume fluctuation were found to be in qualitative agreement.

A new lithium ionic conductor of the thio-LISICON (LIthium SuperIonic CONductor) family was found in the binary Li 2 S–P 2 S 5 system; the new solid solution with the composition range 0.0≤ x ≤0.27 in Li 3+5 x P 1− x S 4 was synthesized at 700 °C and characterized by X-ray diffraction measurements. Its electrical and electrochemical properties were studied by ac impedance and cyclic voltammetry measurements, respectively. The solid solution member at x =0.065 in Li 3+5 x P 1− x S 4 showed the highest conductivity value of 1.5×10 −4 S cm −1 at 27 °C with negligible electronic conductivity and the activation energy of 22 kJ mol −1 which is characteristic of high ionic conduction state. The extra lithium ions in Li 3 PS 4 created by partial substitution of P 5+ for Li + led to the large increase in ionic conductivity. In the solid solution range examined, the minimum conductivity was obtained for the compositions, Li 3 PS 4 ( x =0.0 in Li 3+5 x P 1− x S 4 ) and Li 4 P 0.8 S 4 ( x =0.2 in Li 3+5 x P 1− x S 4 ); this conductivity behavior is similar to other thio-LISICON family with the general formula, Li x M 1− y M y ′S 4 (M=Si, Ge, and M′=P, Al, Zn, Ga, Sb). Conduction mechanism and the material design concepts are discussed based on the conduction behavior and the structure considerations.

New lithium ionic conductor, thio-LISICON (LIthium Super Ionic CONductor) is reviewed. The thio-LISICON has a general composition of Li4-x M1-yM'yS4, where the M and M' are Ge, Si or P, Al, Ga, respectively. In the thio-LISICON family, Li3.25Ge0.25P0.75S4 showed the highest conductivity of 2.2 × 10-3 Scm-1 at 25 °C among the materials synthesized, and the conductivity value is comparable to or even higher than liquid-electrolytes. The thio-LISICON has a structure similar to the γ-Li3PO4 type. Materials relationships to the oxides LISICON family is indicated. The advantages of the solid electrolyte to all solid-state lithium battery are discussed.

Objectives The goal of our study was to define the structural characteristics of the heart in Japanese 100-km ultramarathon runners. Background During screening of participants in a 100-km ultramarathon, we found some participants who had larger cardiac chambers than had ever been previously reported. Methods A total of 291 male participants in a 100-km ultramarathon age from 20 to 73 years were examined using echocardiography. Results The mean heart rate (HR) was 50.6 ± 5.6 beats/min (38 to 79 beats/min), the systolic blood pressure (SBP) was 110.5 ± 5.6 mm Hg (94 to 138 mm Hg), the diastolic blood pressure (DBP) was 65.9 ± 6.6 mm Hg (58 to 90 mm Hg), the left ventricular end-diastolic diameter (Dd) was 61.8 ± 6.9 mm (42 to 75 mm), the left ventricular end-systolic diameter (Ds) was 39.6 ± 6.0 mm (23.0 to 55.0 mm), the interventricular septal thickness (IVS) was 10.2 ± 1.9 mm (5 to 19 mm), the posterior wall thickness (PW) was 10.0 ± 1.4 mm (5 to 15 mm), the aortic diameter (Ao) was 38.5 ± 4.0 mm (27 to 50 mm), the left atrial diameter (LA) was 40.2 ± 4.8 mm (26 to 49 mm), and the systolic wall stress (WS) was 221.5 ± 52.9 kdyne/cm2(108.0 to 537.6 kdyne/cm2). Significant predictors of these parameters were the monthly running distance for HR, SBP, DBP, Dd, Ds, Ao, LA, and WS, as well as the age for IVS, PW, and Ao. Conclusions Thirty-three participants had a Dd larger than 70 mm. Moreover, some athletes had a larger aorta and left atrium than had ever been previously reported. The oldest runner was 73 years old.

We have investigated antiferromagnetic coupling between semiconductor quantum dots. Electron spin is observed to flip at 80 ps after photoexcitation via the interdot-exchange interaction. The spin relaxation time under the antiferromagnetic order is extended to 10–12 ns, one order of magnitude longer than that in isolated quantum dots. The antiferromagnetic order exists at temperatures lower than 50–80 K. The photoluminescence experiments for various carrier densities show that antiferromagnetic coupling disappears when the electron pairing probability is low. A model calculation based on the Heitler–London approximation supports the finding that the antiferromagnetic order is observable at low temperature.

Solid-state lithium batteries with a unique construction are reported in this paper. These batteries contain two kinds of lithium ion-conductive solid electrolytes, LiI–Li2S–P2S5 glass contacted with the anode material and Li3PO4–Li2S–SiS2 glass or Li2S–GeS2–P2S5 crystalline material contacted with the cathode. The former electrolyte was selected as that stable to electrochemical reduction, and the latter two to oxidation. This construction made it possible to use graphite as the anode and LiCoO2 as the cathode in the solid-state lithium battery. The energy density of the battery is 390 W h·l−1 and 160 W h·kg−1 per total volume and weight of the cathode and anode layers, respectively, which are comparable to those of commercialized Li-ion batteries.

The dry and wet methods of preparation for composite inorganic solid electrolytes including styrene–butadiene copolymer (SBR) or silicone rubber (silicone) as polymer binder are investigated, and their electrochemical properties are analyzed. The SBR composite electrolytes prepared by the dry process showed higher conductivity than the one done by the wet process. For the composite electrolyte prepared by the wet process, the SBR coating on the electrolyte particles blocked lithium-ionic conduction. The electrolytes prepared by the dry process, on the other hand, showed the dispersion of SBR granular domains in the electrolyte matrix, which results in good contact between the electrolyte particles. However, by choosing an adequate polymer such as silicone rubber, the wet-processed composite shows a high Li ion-conductivity.

The structure of high lithium ionic conductors, thio-LISICON (LIthium SuperIonic CONductor), Li 4 GeS 4 , was determined by X-ray and neutron Rietveld analysis. Li 4 GeS 4 has orthorhombic space group Pnma with the lattice parameters, a =14.0340(3), b =7.7548(2), c =6.15023(17) A. The structure is related to the γ-Li 3 PO 4 type and is composed of hexagonal close-packed sulfide ion arrays with germanium ions distributed over the tetrahedral sites which form the framework structure. The Li + ions in Li 4 GeS 4 are located in both the octahedral and tetrahedral sites. The LiS 6 octahedra are connected with each other by sharing edges and form (LiS 6 ) ∞ chains along the b -axis. The chain is linked with the adjacent LiS 4 tetrahedra, which might form the lithium conduction pathway.

The new lithium ionic conductors, thio-LISICON (LIthium SuperIonic CONductor), were found in the ternary Li2S–SiS2–Al2S3 and Li2S–SiS2–P2S5 systems. Their structures of new materials, Li4+xSi1−xAlxS4 and Li4−xSi1−xPxS4 were determined by X-ray Rietveld analysis, and the electric and electrochemical properties were studied by electronic conductivity, ac conductivity and cyclic voltammogram measurements. The structure of the host material, Li4SiS4 is related to the γ-Li3PO4-type structure, and when the Li+ interstitials or Li+ vacancies were created by the partial substitutions of Al3+ or P5+ for Si4+, large increases in conductivity occur. The solid solution member x=0.6 in Li4−xSi1−xPxS4 showed high conductivity of 6.4×10–4 S cm−1 at 27°C with negligible electronic conductivity. The new solid solution, Li4−xSi1−xPxS4, also has high electrochemical stability up to ∼5 V vs Li at room temperature. All-solid-state lithium cells were investigated using the Li3.4Si0.4P0.6S4 electrolyte, LiCoO2 cathode and In anode.

The relationship between the location and size of an infarction and QT dispersion was investigated in 84 Japanese patients with chronic myocardial infarction (54 with anteroseptal infarction and 30 with inferior infarction). The control group consisted of 23 subjects without ischemic heart disease (13 normal subjects and 10 hypertensive patients). Corrected QT dispersion (maximum corrected QT interval minus minimum corrected QT interval: QTc dispersion), was significantly larger in the anterior infarction group than in the control group (69.9+/-21.5 msec vs 53.0+/-17.6 msec), while the inferior infarction group showed no significant difference from control subjects. QTc dispersion was significantly greater in the patients with large anterior infarcts than in those with small anterior infarcts (80.5+/-20.5 msec vs 61.9+/-18.8 msec). In patients with chronic myocardial infarction, QT dispersion is influenced by the infarct location and size. Accordingly, interpretation of QT dispersion data should take these factors into consideration.

Objective -We assessed the reflection pressure wave using noninvasive measurement of wave intensity (WI) in patients with cardiomyopathy. Methods and results - Subjects included 8 patients with hypertrophic cardiomyopathy (HCM group) and 10 patients with dilated cardiomyopathy (DCM group).Twelve healthy subjects were used as a control group. By using a combined Doppler and echo-tracking system, changes in vascular diameter (dD) and blood flow velocity (dV) were recorded simultaneously at the common carotid artery and dD x dV was measured as WI. In the components of WI, the positive component of early systolic phase (FE) and the negative component following FE (B) were significantly reduced in the DCM group. There was a significant positive correlation between FE and B in all 3 groups. The appearance time of B was significantly shorter in the HCM group and significantly longer in the DCM group compared with the control group. Conclusions - It was suggested that the value of the reflection pressure wave was influenced by the left ventricular contractility, and that the effect of the reflection pressure wave appeared earlier in patients with HCM and later in patients with DCM compared with the control subjects.

OBJECTIVES We sought to determine the prevalence of right bundle branch block (RBBB) and ST segment elevation in the working Japanese population, as well as the event rate during a three-year prospective follow-up period. BACKGROUND A poor prognosis of RBBB and ST segment elevation has been reported in Europe and South America, even in asymptomatic patients; however, a large population of asymptomatic patients with sporadic RBBB and ST segment elevation has not been studied. METHODS Ten thousand 12-lead electrocardiograms (ECGs) were obtained during annual check-ups of working adults in the Tokyo area. This three-year prospective follow-up study consisted of 105 patients, including 20 with ventricular fibrillation, 18 with syncope and 67 who were asymptomatic. They were registered from 46 institutions in Japan. RESULTS The prevalence of ECG abnormalities in working adults was 0.16%. A coved-type ST segment elevation was related to a history of cardiac events, and 18% of registered patients had PR prolongation and 9.5% had left-axis deviation. The cumulative cardiac event-free rate was 67.6% in the symptomatic group and 93.4% in the asymptomatic group (p = 0.0004) after three years. CONCLUSIONS The recurrence rate of cardiac events in symptomatic patients was similar to that reported previously, but it was very low in sporadic asymptomatic patients. The ECG findings may help us to select patients for further examination and more accurate evaluation of their prognoses.

A 25-year-old man was found to have an abnormal cardiac contour on a chest radiograph, and was referred. Transesophageal echocardiography suggested herniation of the left atrial appendage (LAA) through a gap in the pericardium, and magnetic resonance imaging indicated congenital partial absence of the pericardium. Cardiac dysfunction was caused by compression from the enlarged left atrium and thrombi were thought to be present in the appendage, so surgery was performed. The intraoperative diagnosis was congenital LAA aneurysm. Although distinguishing between congenital LAA aneurysm and congenital absence of the pericardium is reported to be possible with magnetic resonance imaging, we were unable to so in this case. (Jpn Circ J 2001; 65: 56 - 59)

3チャネルディジタルホルター心電計を用い, Frank XYZ誘導から合成12誘導心電図 (Syn-ECG) を記録する方法を開発した, 本研究では, Syn-ECGがP波, QRS波, T波のみならず虚血性ST偏位も正確に再現することが可能であるかを検討した.対象は, ディジタルホルター心電計を装着時に標準12誘導心電図 (St-ECG) を記録した健常者15名および運動負荷試験を施行した連続72名中虚血性ST下降を認めた15名とした.健常者のSt-ECGとSyn-ECGのP波の形状, QRS波に対するR波およびT波振幅の比率, 運動負荷誘発虚血性ST下降の形状とQRS波に対するST偏位の比率を比較した.健常者臥位時のSyn-ECGは, St-ECGと近似した, さらに, Syn-ECGは運動時の虚血性ST偏位の比率においても近似した.Syn-ECGは, P波, QRS波, T波のみならず虚血性ST偏位に関しても形態的, 量的に近似した.本法は, 虚血性ST偏位の診断にも適応可能と考えられた.

A 61-year-old female, with a history of uterine and cervical cancer treated with radical hysterectomy and 2 years of postoperative chemotherapy, presented to the emergency department with dyspnea on exertion. Computed tomography of the chest revealed a large pericardial effusion and a sacciform aneurysm of the ascending aorta. The patient subsequently underwent emergency pericardiocentesis with drainage of approximately 330 ml of a bloody and turbid effusion. Cultures from the effusion yielded group B streptococcus. Multiple organ failure and disseminated intravascular coagulation syndrome occurred in the acute phase, but gradually improved with continuous antibiotic therapy. On the 194th hospital day, in situ reconstruction of the ascending aorta was successfully performed using a synthetic graft. Although rarely reported, both purulent bacterial pericarditis and mycotic aneurysm can be life-threatening.

The present study investigated the serial changes in serum magnesium (Mg) and erythrocyte concentration of Mg in patients with acute myocardial infarction (AMI) and the relationship between these changes and left ventricular ejection fraction (LVEF) at 1 month after the onset of infarction. The study group comprised 26 patients with AMI (mean age, 57.9+/-8.9 years). Serum Mg and erythrocyte Mg were measured on hospital days 1, 2, 4, 7 and 21. The change in erythrocyte Mg during the acute phase was calculated as a ratio: [(erythrocyte Mg at day 2)-(erythrocyte Mg at day 1)]/(erythrocyte Mg at day 1). The change in serum Mg was calculated similarly. The following results were obtained. (1) Serum Mg tended to increase from the onset of myocardial infarction (day 1: 1.86+/-0.19, day 2: 1.93+/-0.22, day 4: 2.17+/-0.23; day 7: 2.25+/-0.20; day 21: 2.12+/-0.15 mg/dl). (2) Erythrocyte Mg on day 2 and day 4 showed a significant decrease compared with day 1 (day 1: 2.45+/-0.40, day 2: 2.09+/-0.41, day 4: 2.07+/-0.37, day 7: 2.22+/-0.33, day 7: 2.34+/-0.28 mg/dl per 400x10(4)/mm3 cells). (3) A significant positive correlation was observed between the change in serum Mg and LVEF (r=0.55, p

We report a 70-year-old women with Eisenmenger's syndrome. Eisenmenger's syndrome with ventricular septal defect was diagnosed at another hospital when she was 32 years old. Then, she was referred to our hospital at age 60 old and she now is according to the out patient in over clinic. She have mild cardiac function, NYHA classification, was II-M, polycythemia cell blood count 535 x 10(4) and 17.2 g/dl in hemoglobin. Echocardiography suggested serious Eisenmenger's syndrome. The left ventricle was compressed, the blood pressure of the right ventricle exceeded 105 mmHg, and the onset of the right to left shunt flow was thought to be 250 msec bored on the electrocardiogram Q wave. The reason why the progression of complicated obstructive pulmonary artery disease was slow may have been become of the mildness of her polycythemia, and this is presumed to be the reason for her long survival to age 70.

OBJECT The purpose of this study was to elucidate differences in readmission rates and late outcome in outpatients with chronic heart failure treated in different clinical settings. PATIENTS AND METHODS This study included 65 consecutive patients who were admitted to our CCU due to acute heart failure for the first time and discharged from our institution. After their discharge, 31 were cared for by a cardiologist in the outpatient clinic of our institution (group A) and the other 34 were cared for by a general practitioner in a clinic (group B). The various findings during the acute phase and the follow-up period were retrospectively compared between the two groups. In addition, the incidence of unexpected readmission and prolonged outcomes were compared between the two groups. RESULTS The patients in group B were older than those in group A, but no other differences were noted in patient characteristics. More patients in group A required more than one hospitalization within 6 months from discharge (group A, 35.5%; group B, 8.9%, p

This study was undertaken in patients with heart failure to investigate the relation between plasma norepinephrine (NE) concentration and Mg dynamics. The study subjects comprised 16 patients with chronic heart failure (mean age 64.9±10.0 years). Cardiopulmonary exercise testing was performed on all patients, and anaerobic threshold (AT), peak oxygen uptake (peak VO2) and peak exercise time were measured. Resting and peak values of plasma NE concentration and serum and erythrocyte magnesium concentration were also measured. The results were as follows: the serum Mg concentration was increased significantly immediately after exercise (p

The purpose of this study was to evaluate cardiopulmonary responses during submaximal cycle exercise at various angles of backrest inclination. Ten healthy Japanese men of mean age 25.9 yrs, height 170.6 cm, and body mass 66.1 kg, performed cycle exercises at a constant workload which reached the anaerobic threshold, at 20 degrees, 40 degrees, and 60 degrees of backrest inclination from the vertical plane, but the angle between the seat and back rest was kept at 110 degrees. The results were as follows: 1) Both cardiac output and stroke volume showed a higher value at the resting control state and during exercise as the backrest angle increased. 2) Oxygen consumption, carbon dioxide output, heart rate, gas exchange ratio, and oxygen pulse were not affected by the angle of backrest inclination. 3) Tidal volume at 20 degrees of backrest inclination was higher than at 60 degrees. 4) No significant differences were found in minute ventilation between each backrest angle. These findings suggest that changes in the backrest angle significantly alter cardiopulmonary parameters at rest and during exercise; in particular, an angle difference of 40 degrees may be enough to alter tidal volume, cardiac output and stroke volume, but not the minute ventilation.

To detect the minute electric potential inside the QRS complex, a new frequency domain method was designed using short-time First Fourier Transforms (SFFT) and high-frequency sampling (oversampling). SFFT improved the frequency resolution by oversampling that was applied to this analysis. The electric potential data of 15,000 points received weighted, running average processing and was subtracted from the original waveform to reduce the low-frequency component. The data in a segment of 160 ms, including QRS, was processed by frequency analysis with the SFFT computation routine. The ECG of healthy individuals was analyzed by this method and its usefulness evaluated. The processing waves of the X-axis, Y-axis, and Z-axis of a representative normal subject were formed into 3 groups of peak electric potential. SFFT enabled the detection of the structure inside the QRS complex without signal averaging, and is considered capable of evaluating the process of excitement inside the QRS complex in the various heart diseases. (Jpn Circ J 1999; 63: 941 - 944)

Recent observations have shown that plasma levels of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) correlate with cardiac function or prognosis in heart failure patients. However, relatively little is known about changes in their plasma concentration during commonly occurring physiological states such as fatigue. Therefore, this study was designed to examine the physiological changes of plasma ANP and BNP concentrations using a chronic sleep-deprivation model. Bicycle ergometer cardiopulmonary exercise tests were performed in 10 healthy volunteers (mean age: 22.7 years). Blood samples for measuring ANP and BNP were drawn during the resting state and immediately after each exercise test. Cardiac output (CO) was measured during the exercise test by the impedance method. The study conditions were designed as follows: (A) a day following a period of normal sleep (control state) and (B) a day preceded by 1 month during which sleep lasted

The basal part of the interventricular septum (IVS) is known to show different hypertrophic features from those observed in the other parts of the left ventricular wall. These are considered to reflect physiological changes that occur with normal aging. However, these changes have not been carefully evaluated, and their clinical significance has not been defined. We assessed these changes echocardiographically. The subjects were patients at least 70 years of age in whom localized hypertrophy in the basal part of the IVS was seen during the whole cardiac cycle on echocardiography. The prevalence was 6.3% among 96 consecutively studied patients. All 6 patients had a history of hypertension. Echocardiographic findings were as follows: 1) the left atrium was mildly or moderately dilated, 2) there was no evidence of either dilatation or narrowing of the left ventricular cavity, 3) the left ventricular wall motion appeared normal and indices of systolic function were within normal limits in all subjects except one who had a history of myocardial infarction, 4) the angle formed by the aorta and the IVS averaged 106.7 degrees (range: 95 to 120 degrees), 5) Doppler examination showed increases in the ratio of the peak flow velocity during atrial systole to the peak flow velocity early in diastole, and 6) prolongation of the deceleration time of the flow velocity early in diastole. The last of these findings suggested left ventricular diastolic dysfunction, but peak flow velocity at the left ventricular outflow tract was normal. There was no evidence of stenosis of the left ventricular outflow tract. Localized hypertrophy in the basal part of the IVS in elderly patients could be a type of cardiac hypertrophy caused by hypertension. On echocardiography, the basal part of the IVS seemed to protrude toward the left ventricular cavity, but there was no evidence of stenosis in the left ventricular outflow tract.

心室頻拍の発現を予測する指標としての3段階の低域遮断 (H1: 100Hz, H2=120Hz, H3=160Hz) と450Hzの高域遮断フィルタを用いた多段階高周波心電図の有用性を検討した.いすれも通常用いられている100Hz以下を減衰し高域を記録し得るフィルタである.対象は, 陳旧性心筋梗塞74例と健常者27例の計101例である.それぞれのQRS持続時間 (QRSD) とQRSの終末部の持続性低電位 (FP=

Brain natriuretic peptide (BNP) secretion increases after myocardial infarction (MI); its plasma level may reflect the degree of left ventricular dysfunction. This study examines how aerobic exercise therapy for MI influences BNP secretion. Subjects included 70 patients (mean age, 62.0±11.3 years) who were divided into four groups: (1) 20 patients with an anterior MI and exercise training; (2) 20 patients with an anterior MI and no exercise training; (3) 15 patients with an inferior MI and exercise training; and (4) 15 patients with an inferior MI and no exercise training. The training groups performed aerobic exercise 3 times a week for 2 months. Exercise intensity was defined as a heart rate of anaerobic threshold (AT), derived from the treadmill cardiopulmonary exercise testing at 1 month after the onset of MI. The subjects underwent cardiopulmonary exercise testing again at 3 months after the onset of MI. To measure BNP, blood samples were obtained in the resting state and immediately after the peak exercise. AT and peak oxygen uptake increased in the training group with anterior MI and in both the training and nontraining groups with inferior MI. Significant serial change in plasma BNP level was not observed in the inferior MI groups. Plasma BNP level decreased longitudinally only in the nontraining anterior MI group. It was concluded that exercise training in patients with an anterior MI could delay the recovery of left ventricular function, but will increase exercise tolerance. (Jpn Circ J 1998; 62: 658 - 664)

We have previously reported that chronic sleep deprivation causes a deficiency of intracellular magnesium (Mg) and decreased exercise tolerance. The aim of this study was to clarify whether oral administration of Mg could be effective in restoring the exercise tolerance that is decreased by chronic sleep deprivation. A bicycle ergometer cardiopulmonary exercise test was performed by 16 healthy volunteers (mean age 21.9 years). They were divided into 2 groups: 8 received doses of 100 mg of Mg orally per day for 1 month (Mg group) and the remaining 8 received no Mg and served as the control group. The study conditions were designed as follows: (1) the usual state (good sleep); and (2) the sleep-deprived state (sleeping time up to 60% less than the usual state for 1 month). The ratio of intracellular Mg content of the sleep-deprived state to the usual sleep state was significantly higher in the Mg group (p

Outcomes of primary angioplasty in 6 elderly patients with acute myocardial infarction who were admitted to the hospital between July of 1994 and June of 1997 were reviewed retrospectively. Emergency coronary angiography was done in 7 of 16 patients (44%) who were at least 85 years old and primary angioplasty was done in 6 patients (38%). Dilatation was successful in all 6 patients. Congestive heart failure occurred in 4 patients and cardiogenic shock occurred in 1 patient, but no patient died during hospitalization. Blood transfusion and surgical resection were done in 1 patient because of a giant hematoma and pseudoaneurysm at the puncture site. Although the creatinine level increased after angioplasty in all 6 patients, dialysis therapy was not needed. All patients were alive and none had angina at follow-up (mean follow-up period = 16.5 months). Primary angioplasty was successful in patients at least 85 years old; both short-term and long-term outcomes were good. Primary angioplasty should be considered to be an effective treatment for acute myocardial infarction in people 85 years old and older.

The long-term relative benefits of thrombolysis and mechanical reperfusion therapy following acute myocardial infarction (AMI) have not been established. The purpose of this study was to compare left ventricular function, left ventricular remodeling and late outcome after AMI for different reperfusion therapies. Thirty consecutive patients suffering their first anterior wall myocardial infarction with coronary stenoses limited to the left anterior descending coronary artery were studied. They included 10 patients who underwent intracoronary thrombolysis (ICT), 10 who underwent PTCA and 10 who underwent noninterventional medical treatment. All patients underwent coronary angiography (CAG) during the acute phase of AMI and also during the follow-up period, and left ventriculography during the follow-up period and clinical follow-up was performed (mean clinical follow-up period: 53 +/- 31 months). No significant difference in global ejection fraction was noted among the groups, although the end-diastolic volume index (EDVI) in the PTCA group (79.4 +/- 17.5 ml/m2) was significantly smaller than in the noninterventional (106.1 +/- 25.1 ml/m2) and ICT (107.9 +/- 28.3 ml/m2) group (p0.05). The regional wall motion index (RWMI) for the anterior region in the PTCA group (-2.7 +/- 0.8) was greater (p0.05) than in the noninterventional (-3.4 +/- 0.6) and ICT (-3.3 +/- 0.6) groups. A significant linear correlation was found between EDVI and % diameter stenosis and also between RWMI and % diameter stenosis following reperfusion (p = 0.01). There was no difference in the incidence of cardiac death, nonfatal reinfarction, bypass surgery or congestive heart failure among the groups. Disturbed left ventricular regional wall motion and remodeling benefit most from angioplasty because of prompt restoration of adequate blood flow. However, there was no difference in late outcomes following AMI among the three groups.

症例は62歳の男性. 輸血歴なく, 飲酒歴なし. 昭和61年, 肝障害で近医に入院歴あり. このときHBs抗原は陰性であった. 肝庇護療法のみで肝機能は改善し, 以後7年間自他覚症状なく経過していた. 通院観察中もトランスアミナーゼは正常値を持続した. 平成6年2月, GPT164IU/lと肝障害再燃を認め当科入院. HBs抗原陰性, HCV抗体 (第二世代) 陰性で, 抗核抗体は20, 480倍と高力価を, Ig-Gは3, 458mg/dlと高値を示した. 腹腔鏡下肝生検では肝表面は軽度不整を認め, 組織像では形質細胞浸潤を伴う慢性肝炎, 活動性の像を呈した. 上記より自己免疫性肝炎と診断し, プレドニゾロン投与にて肝機能は速やかに改善した. 本症は当初, 非B型肝障害と診断され, 無治療にも拘らず7年もの長期間, 無症候性に経過した後に再燃したと考えられた. 自己免疫性肝炎の発症様式を考える上で, また男性例であることから示唆に富むと思われ報告した.

To investigate the time sequence of glomerular cell proliferation in acute human glomerulonephritis, renal biopsy tissues were examined from 15 acute post-streptococcal glomerulonephritis (APSGN) patients (who were biopsied 1-31 days after onset), using an immunoperoxidase technique with monoclonal antibodies against proliferating cell nuclear antigen (PCNA) and various cell surface markers. Few, if any, PCNA+ cells were observed in normal glomeruli, but many cells were positive for PCNA in the acute phase of APSGN. Glomerular PCNA+ cells were observed either within glomerular tufts, or lining Bowman's capsule (parietal epithelial cells); the number of positive cells tended to decrease exponentially as the disease duration increased (r = -0.91, P < 0.0001). PCNA+ cells within glomerular tufts were further identified by double immunostaining. PCNA was not found in PMN or T cells, but a small proportion of macrophages were PCNA+. Most of the remaining PCNA+ cells were resident glomerular cells; the proportion of PCNA+ endothelial cells (CD31+) was over 80 per cent in the early phase, but as the disease continued the proportion of mesangial cells (alpha-smooth muscle actin+) increased to about half of the total PCNA+ cells within the tuft. These data indicate that the hypercellular glomeruli in APSGN are due not only to immune cell infiltration, but also to resident glomerular cell proliferation, probably induced by locally produced growth factors.

Impaired cardiac function after strenuous exercise, such as an ultramarathon or triathlon, has been ascribed to “cardiac fatigue.” However, a reduction of cardiac function in strenuous sports in the absence of coronary artery disease might also be based on myocardial injury because of excess catecholamines. We studied the cardiac injury in runners of a 100-km ultramarathon by determination of levels of serum troponin T, which is highly specific for myocardial injury. Blood was collected from 13 healthy adult men before, immediately after, and the next morning after participation in a 100-km ultramarathon. Creatine kinase (CK), isozyme of CK with muscle and brain subunits (MB), and cardiac troponin T levels were determined. Creatine kinase levels were 207 ± 108 IU/L before the marathon, 10,313 ± 10,273 IU/L immediately after, and 10,799 ± 6593 IU/L on the next day. Creatine kinase MB levels at the same time points were 12 ± 14 IU/L, 197 ± 170 IU/L, and 166 ± 108 IU/L, respectively. Cardiac troponin T level was ⩽0.1 ng/mL in all subjects before the marathon and increased significantly to a mean of 0.68 ± 0.73 ng/mL immediately after, exceeding the normal limit in seven subjects. It then returned to normal (0.15 ± 0.07 ng/mL) on the next day, while CK, which referred to skeletal muscle damage, was still elevated at a high level. Because cardiac troponin T levels increased after the ultramarathon, myocardial injury was considered to have occurred.

16歳の若年女性でtoxic epidermal necrolysis (TEN) 治療中に, 高度な急性肝内胆汁うっ滞を発症. 種々内科的治療に抵抗性にて, 難治性慢性肝内胆汁うっ滞へ移行し, 約3年の短期間に続発性胆汁性肝硬変症に進展し, 死亡した極めて稀な例を経験した. 本症例はSherlockらの提唱するthe disappearing intrahepatic bile ductsの範躊にはいるが, 臨床的にprimary biliary cirrhosis (PBC), Alagille病, Byler病などは否定的であった. アセトアミノフェンの服用歴とLST陽性やTEN様の皮疹, ステロイドの中止後胆汁うっ滞の悪化を認めたことより, 薬剤アレルギーが病態の背景にあり, 肝内胆管の潜在的なhypoplasiaやprimary screlosing cholangitis (PSC) の存在が病態の増悪因子となった可能性が示唆された, 残された治療選択は肝移植のみと考えられたが, 高度な胆汁うっ滞を主とした病態においては, 経過中にその適応および時期の適切な判断を下すことは難しく, 類似症例の参考となると考えられ報告した.

日本心電学会「運動負荷心電図の標準化に関する委員会」では, 同学会の抗狭心症薬判定小委員会のトレッドミル試験による薬効評価基準を実際の労作狭心症例180人 (平均年齢59.9±9.2歳) について検討した.投与薬剤は各種抗狭心症薬であり, Bruce法によるトレッドミル負荷試験をおこなった.この基準は同一運動時間のST下降度と運動耐容時間を個別に判定するものである.同一運動時間のST下降度の「やや改善」以上は60.9%, 運動耐容時間の「やや改善」以上は62.2%であった.運動負荷試験による薬効評価に適した症例は, 観察期に運動誘発胸痛があり, 2mm以上のST下降があり, 運動耐容時間が6分前後の症例と考えられた.同一運動時間のST下降度と運動耐容時間による総合判定は, 改善度が高くなる傾向にあった.

脳血栓症急性期において, エンドセリン-1 (ET-1) は経時的に低下し, 組織プラスミノーゲンアクチベーター (t-PA) は鏡像的に増加する.今回はそのメカニズムの解析を目的に基礎的, 臨床的検討を行った.培養血管内皮細胞へのオザグレルナトリウム添加で培養液中の両因子濃度は非添加対照と差が認められない.トロンビン添加で両因子とも対照より有意の高値を示した.このことから両因子の脳血栓症急性期の変化に治療薬剤や凝固の直接的関与は否定される.急性期1～7病日のET-1とt-PAの各変化量が逆相関を示した “逆相関群” では相関しない “非相関群” に比してt-PAのインヒビターPAI-1の遊離型 (free) PAI-1の相対的高値が認められた.t-PAはET-1放出を抑制する既報の成績からt-PA増加がET-1放出を主導的に抑制し, 急性期の血栓抵抗性をfree PAI-1高値例においては誘導しているものと考えられた.すなわち, 脳血栓症治療に際しては抗血小板・抗凝固だけではなく, このt-PA・PAI-1の線溶系を考慮すべきである.

全国107施設の運動負荷試験に関するアンケート調査により, 推定累積運動負荷試験1, 779, 352件 (マスター2階段試験951, 512件, エルゴメーター法215, 972件, トレッドミル法611, 868件) における事故について検討を行った.死亡事故6件, 入院を要する重篤事故37件であり, 検査10, 000件当たりの事故率は, 死亡0.034, 心筋梗塞発症0.129であった.死亡を含む重篤事故の基礎疾患が明らかであったのは31件であり, 内訳としては心筋梗塞13%, 不安定狭心症13%, 狭心症32%であり, 肥大型心筋症, 拡張型心筋症, 弁膜症などその他が42%であった.事故の内容 (総数40件) は, 心筋梗塞発症57.5%, 不安定狭心症12.5%, 持続性ST上昇10%, その他20%であった.事故の原因としては, 報告のあった33件の中で過度の虚血6%, 過度の負荷15%, 不安定狭心症に負荷を行った6%, その他15%であり, 原因不明が58%を占めた.過去に事故の経験の有無による運動中止基準の比較では, 運動中止心拍数および収縮期血圧が事故の経験ある施設において年齢別推定最大心拍数85%以上や収縮期血圧250mmHg以上の設定など中止基準の設定が高い傾向を認めたが, 運動中止STレベルには差を認めなかった.本邦における運動負荷試験に伴う事故の発生頻度は, 過去の諸外国の報告よりは少ない傾向であったが, 事故の原因として不安定狭心症に負荷を行った例や過剰負荷の例が認められ, 事故の防止のため負荷試験の適応と禁忌, 運動中止基準の遵守がより必要と考えられた.