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In these days, mathematics is one of the most important tools for any person. However, in Japan, many students hate and avoid mathematics in their high school age. In Waseda University, one of the biggest and oldest private universities in Japan, special curriculum is constructed for such “Bunkei’’ students who major in social or human science.

p-type SiC crystals doped with aluminum and nitrogen were grown by the sublimation method. We found that Al and N co-doping is effective for stabilized growth of p-type 4H-SiC polytype. We studied the relationship of polytype of grown crystals and the condition of Al and N feeding during the crystal growth. p-type 4H-SiC withp~1 x 1018cm-3are stably-obtained with this method.

Aim The number of elderly patients with heart failure is increasing in Japan owing to the increase in the aging population. In the field of emergency medicine, the treatment and management of elderly patients with heart failure are key issues. We aimed to clarify the clinical characteristics and outcomes of these patients. Methods We enrolled 72 consecutive patients (age, 76.5 ± 12.5 years) with heart failure who were admitted to our hospital between January 1 and December 31, 2010. The characteristics and outcomes of super-elderly patients aged >85 years (n = 21) were compared with those of patients aged ≤85 years (n = 51). Results The overall prevalence of chronic atrial fibrillation was high (43.1%). Underlying diseases, left ventricular function, renal function, in-hospital mortality, hospital stay period, and major complications were similar between the two groups. The super-elderly group had a significantly higher mortality rate and lower event-free survival rate after discharge (log–rank test, P = 0.0018 and P = 0.0032, respectively). The incidence of readmission for heart failure recurrence was 55.0% in the super-elderly group and 25.0% in the younger group. Conclusion There were no significant differences in the background characteristics and in-hospital treatment between super-elderly heart failure patients and younger patients. High mortality and cardiovascular event rates after discharge were observed in the super-elderly group.

The nitrogen (N) and aluminum (Al) co-doped growth of n-type 4H-SiC bulk crystals were performed by sublimation method. In the co-doping growth, we achieved the lowest resistivity of 6.9mWcm, and we also confirmed phenomenon of stacking faults suppression in spite of high N concentration more than 8 x 1019cm-3.

We present the case of a 54-year-old male with an intermediate atrioventricular septal defect (AVSD). He was referred to our institute for treatment of shortness of breath. Two-dimensional transthoracic echocardiography demonstrated an ostium primum defect of the atrial septum, a common atrioventricular valve with mild regurgitations, and an interventricular communication, which are the features of complete AVSD. However, three-dimensional transthoracic echocardiography (3D-TTE) could clearly visualize the tricuspid pouch (i.e., persistence of the tissue in the endocardial cushion), a feature of partial AVSD. 3D-TTE appears to be a useful modality for diagnosis of intermediate AVSD.

症例は74歳，男性．当院糖尿病内科に通院中，発作性心房細動を認めたため，2008年12月心エコー検査を施行したところ，左室後壁に2×5 cmの腫瘤を指摘された．手術歴や外傷歴はなく，3ヵ月後の心エコー検査でも腫瘤径は変化せず，全身のCT検査で悪性腫瘍を示唆する所見を認めないことから，良性心臓腫瘍と判断し，経過観察を行っていた．冠動脈CT検査で前下行枝に狭窄病変の存在が疑われたため，2009年12月に腫瘍精査も兼ねて入院となった．臨床所見及び，その形態やエコー輝度，CT所見から鑑別した結果，線維腫である可能性が最も考えられた．入院時の心エコー検査で，2次元（2D）スペックルトラッキング法を用いて長軸，短軸及び円周方向のstrain解析を行ったところ，腫瘍部位に一致する後壁基部に限局した局所心機能異常が認められた．冠動脈造影では，後壁を灌流する右冠動脈及び左回旋枝に狭窄病変を認めなかったことから，腫瘍の存在そのものが，局所心機能異常の原因の一つとなる可能性が考えられた．2Dスペックルトラッキング法は，左室腫瘍周囲の潜在的心機能異常の検出に有用である可能性が示唆された．

We assessed the amount of visceral fat using ultrasonography (US) and studied its relationship to cardiovascular disease risk factors, particularly blood pressure. The subjects in the first study were 45 male and 61 female outpatients. We measured the visceral fat area (VFA) of each subject using abdominal CT and waist circumference (WC), and visceral fat distance (VFD) using US. The subjects in the second study were 353 male and 457 female inhabitants of a rural community, for whom VFD and WC were measured. We divided subjects into tertiles based on VFD and WC, and studied the relationship between each group and individual risk factors. In an analysis of outpatient subjects, the correlation coefficient between VFA and VFD was satisfactory: r=0.660 for men and r=0.643 for women. In the analysis of the rural subjects, the high VFD group had a significantly higher odds ratio than the low VFD group in high blood pressure (HBP) and hypertriglyceridemia (HTG) for men and in HBP, HTG and low high-density lipoprotein cholesterolemia (LHDL) for women. Moreover, adjusting VFD for body mass index revealed that, in comparison to WC, VFD was significantly related to risk factors. VFD was used as an independent variable in multiple regression analysis with blood pressure level as a dependent variable; no significant association between WC and blood pressure was obtained. Visceral fat assessment by US may be useful for epidemiological study and for clinics with no abdominal CT equipment for identifying high-risk individuals, such as those with metabolic syndrome.

Background The degree to which abnormal glucose tolerance contributes to the development of coronary artery disease (CAD) has not been clarified in Japanese. The relationship between abnormal glucose tolerance and severity of coronary artery stenosis, as well as the contributions of hypertension, diabetes and other risk factors for CAD to recurrence of the disease, were investigated in the present study. Methods and Results The subjects were 474 consecutive patients (mean age: 63.8±11.3 years) with suspected CAD who were admitted to Sapporo Medical University Hospital during April 1, 1997 to March 31, 2004. The coronary index and stenosis score were higher in subjects with diabetes mellitus (DM) and in subjects with impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) than in subjects with normal glucose tolerance (NGT). Ischemic episodes recurred during the observation period (mean 2.5 years) in 61 of 341 patients diagnosed as having CAD. In the follow-up subjects, systolic blood pressure (SBP) was significantly higher in the recurrence group than in the non-recurrence group, and SBP was a significant variable in logistic regression analysis after adjustment for age, gender, hemoglobin A1c, total cholesterol, body mass index, smoking history, family history and stenosis score. The relative risk of recurrence became 1.7-fold higher with a rise in SBP of 10 mmHg (95% confidence interval: 1.252-2.250). Analysis of the relationship between glucose tolerance and recurrence showed that the rate of recurrence was higher in patients with IFG + IGT + DM than in those with NGT. Conclusions CAD progresses not only in patients with DM but also in those with IGT. The rate of recurrence of ischemic episodes increases in individuals with IGT or DM, and suggesting that hypertension is a risk factor for recurrence of ischemic episodes. Management of glucose tolerance and blood pressure is therefore important for prevention of CAD in Japanese. (Circ J 2007; 71: 20 - 25)

Although gene polymorphisms in the renin-angiotensin system (RAS) are predisposing factors for cardiovascular diseases, the precise mechanisms and interactions among confounding factors have not been clarified. We investigated whether genetic variants of RAS are involved in insulin sensitivity in a Japanese general population. During a medical checkup in 2001, participants (n=550) were recruited from among the residents of the towns of Tanno and Sobetsu, and written informed consent was obtained to participate in the genetic analysis and the epidemiological study. The insertion/deletion (lID) polymorphism of the angiotensin-converting enzyme gene (ACE), the Met235Thr polymorphism of the angiotensinogen gene (AGT), and the A1166C polymorphism of the angiotensin II type 1 receptor gene (AGTR1) were determined by gel electrophoresis or the TaqMan PCR method. We assessed insulin sensitivity using the homeostasis model assessment insulin resistance (HOMA-IR). The RAS gene polymorphisms were not associated with log-transformed values of HOMA-IR, whereas borderline association (p=0.02) was found between the A1166C polymorphism and dichotomous categorization of insulin resistance (defined as HOMA-IRor =1.73). Our results suggested that the A1166C polymorphism of AGTR1 might affect insulin resistance by altering the responsiveness to angiotensin II signaling, though this mechanism is as yet inconclusive. Further study is required to confirm these findings in a larger, multi-ethnic population.

We introduce a new notion of renormalized dissipative solutions for a scalar conservation law u t + div F ( u ) = f with locally Lipschitz F and L 1 data, and prove the equivalence of such solutions and renormalized entropy solutions in the sense of Benilan et al. The structure of renormalized dissipative solutions is useful to deal with relaxation systems than the renormalized entropy scheme. As an application of our result, we prove the existence of renormalized dissipative solutions via relaxation.

Design: The aim of this study was to determine the association between aging and adiponectin level from the aspect of the influence of renal function and sex hormones in humans.Methods: Serum adiponectin and blood urea nitrogen (BUN) levels were measured in 964 subjects (372 males) aged 60.3±12.5 years. Testosterone and free testosterone levels were measured in 123 males, and estrone and estradiol levels were measured in 114 females. The subjects were divided into two age groups; 65 years of age or older (Age ≥65 group) and less than 65 years of age (Age Results: Adiponectin level increased linearly with aging in males, whereas it increased dramatically in females until their 50s. The patterns of changes in adiponectin were similar to those in BUN. In multiple- regression analysis using adiponectin as a dependent variable BUN was selected as a significant independent variable in all subjects and in subjects in the Age ≥65 group, whereas bioactive sex hormones were not selected.Conclusions: A decrease in adiponectin clearance in the kidney may be the cause of high levels of adiponectin in the elderly. Adiponectin level seems to be influenced more strongly by BUN than by sex hormones and to be increased by a decline in renal function with aging.

Background: The aim of the present study was to determine the correlation between the combination of hypertension and diabetes mellitus and arteriosclerosis using pulse wave velocity (PWV). Methods: The subjects were 186 men over the age of 60 years (mean age: 68.8 ± 5.8 years). PWV, systolic blood pressure (SBP), diastolic blood pressure, body mass index, fasting blood sugar (FBS), total cholesterol, triglyceride and HDL cholesterol were measured in all subjects. The subjects were divided into three groups on the basis of FBS level: a normal group (FBS

Results of a 6-year follow-up study were used to determine whether the concept of and the criteria for metabolic syndrome as defined by the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) can be applied to Japanese men for prediction of the occurrence of cardiac disease. The subjects were 808 men who underwent mass health check-ups in 1993 and who were not on medication for hypertension, diabetes or hyperlipidemia. Individuals who had hypertriglyceridemia, hypo-high density lipoprotein (HDL) cholesterolemia, high blood pressure, and/or high fasting plasma glucose levels were identified on the basis of the NCEP-ATP III criteria. Not in conformity with the NCEP-ATP Ill, however, a cut-off value of 85 cm was used for waist girth as an indicator of abdominal obesity. The subjects who had 3 or more risk factors were judged as having metabolic syndrome. The proportion of subjects having metabolic syndrome was 25.3%. In the 6-year follow-up study, cardiac disease occurred in 11.7% of the subjects in the metabolic syndrome group and in 6.7% of the subjects in the non-metabolic syndrome group. Results of regression analysis using Cox's proportional hazards model showed that subjects in the metabolic syndrome group had a 2.2-times greater risk of developing cardiac disease than did subjects in the non-metabolic syndrome group. The concept of metabolic syndrome as defined in the NCEP-ATP III was therefore considered to be useful for predicting the occurrence of cardiac disease in Japanese men.

Objectives: Although it is well known that obesity is closely related to insulin resistance, the incidence of the development of insulin resistance in people with obesity is not known. In this study, we investigated the incidence of insulin resistance in citizens of two rural communities in Japan. Subjects and methods: The subjects were 102 men and 126 women over the age of 30 years selected from 1035 citizens who had undergone medical examinations in the towns of Tanno and Sobetsu, Hokkaido, in 1991 and 1998. Those who were on medication for hypertension, diabetes, hyperlipidaemia, coronary heart disease and cerebral vessel disease were excluded. The simple index to determine insulin resistance [i.e. homeostasis model assessment (HOMA-R) ≥ 1.73] was used, and subjects who were determined to be positive for insulin resistance according to this index in 1991 were also excluded in order to determine the incidence of insulin resistance in subjects who had no abnormalities other than obesity. The systolic blood pressure (SBP), diastolic blood pressure, body mass index (BMI), triglyceride level, high-density lipoprotein level, blood sugar level, serum insulin value and HOMA-R were measured in all subjects in 1991 and in 1998. Moreover, the subjects were divided into two groups according to BMI, a normal group consisting of subjects with BMI

Objectives: Since arteriosclerosis obliterance in the legs (ASO) causes deterioration of the prognosis of the elderly, prevention of ASO is important for maintenance of their quality of lives. We studied the prevalences of ASO in rural communities in Japan. Methods and results: We measured the ratio of systolic blood pressure in the leg to that in the arm (ABI) using a new device, Form PWV/ABI, in 1398 subjects of both sexes. Subjects with ABI values below 0.9 were considered to have ASO. The prevalence of ASO was 2.7% in all of the subjects, 1.0% in subjects under the age of 60 years, and 3.4% in subjects aged 65 years or more. Multiple regression analysis showed that ABI was correlated with plasma level of total cholesterol in men. There were no significant differences of the mean age, mean fasting plasma glucose level and percentage of patients who smoked between the ASO group and non-ASO group in each sex. Mean cholesterol level in our subjects is lower than the reported levels in Europeans and Americans. The prevalence of ASO increased with increase in the number of risk factors in individual subjects. Conclusions: Among the atherosclerotic risk factors, age and total cholesterol seem to be more important risk factors of ASO than others.

OBJECTIVE—Brachial-ankle pulse wave velocity (baPWV), as an indicator of atherosclerosis in impaired fasting glucose (IFG), was studied in 232 subjects randomly selected from inhabitants of two rural communities in Japan. RESEARCH DESIGN AND METHODS—BMI, systolic blood pressure (SBP), fasting blood glucose (FBS), lipid parameters, ankle brachial pressure index (ABI), and baPWV were measured in each subject. ABI and baPWV were measured using the recently developed device, form ABI/PWV. The subjects were divided into three groups according FBS level: a normal group consisting of subjects with FBS RESULTS—It was found that the baPWV value increased with increasing plasma glucose level. Significant differences were found between the baPWV values in the normal and IFG groups (1,518 vs. 1,673 cm/s, P = 0.01) and in the normal and diabetic groups (1,518 vs. 1,771 cm/s, P < 0.0001). The results of multiple regression analysis showed that FBS was closely related to baPWV as well as to age and SBP. CONCLUSIONS—The relationship between IFG and atherosclerosis remains controversial. Further studies are needed to evaluate whether strict control of blood glucose level in patients with IFG will result in the prevention of atherosclerosis progression.

We examined correlations between the frequency of insulin resistance and the accumulation of coronary risk factors in residents of rural comities in Japanese, using simple criteria for determination of insulin resistance based on evaluation by the euglycaemic-hyperinsulinaemic glucose clamp (GC) method. The subjects were 376 men and 589 women living in two rural communities in Japan. We measured body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), triglyceride (TG), HDL cholesterol (HDL), and homeostasis model assessment (HOMA-R). Correlations between HOMA-R and those parameters were examined. To assess the existence of insulin resistance in these subjects, we used a practical index based on the GC method. The subjects with value of HOMA-R >or= 1.73 have insulin resistance. In addition, the HOMA-R was divided into five quantiles based on the frequency distribution (0.60 or below, from 0.61 to 0.82, from 0.83 to 1.18, from 1.19 to 1.69, and 1.70 or higher), to examine the concentration of risk factors in each group. In total, 74 (19.6%) of the men and 119 (20.3%) of the women had insulin resistance (HOMA-R >or= 1.73). It was found that the higher the HOMA-R, the higher was the number of coronary risk factors, such as hypertension, obesity, hypertriglyceridaemia and hypo HDL cholesterolaemia. The number of coronary risk factors was particular high in subjects with HOMA-R >or= 1.70. HOMA-R in the case of no glucose loading is a useful and practical index for evaluation of insulin resistance and coronary risk factors in the epidemiological study.

The evolution of Kr precipitates at room temperature from nucleation to the formation of solid Kr precipitates in Al implanted with 50 keV Kr+ ions has been studied through the site change of Kr atoms determined by the channelling method. A previous channelling study reported that nucleation centres are various types of Kr–vacancy (V) complexes formed at low implantation doses. In this study, the initial stage of growth of Kr precipitates to bubbles and a key process towards the formation of epitaxially aligned solid Kr precipitates are investigated. The growth of Kr precipitates to bubbles proceeds from the accumulation of Kr atoms migrating to Kr–V complexes by radiation-enhanced diffusion. The Kr bubbles are in the fluid state. As to the epitaxial alignment, the following mechanism is proposed. At implantation doses higher than 2 × 1015 Kr/cm2, small clusters of Kr atoms located at octahedral (O) or displaced O sites are formed on the planes parallel to {111} planes at the bubble-matrix interface at th...

Studies reveals that plasma leptin levels (LEP) in females are higher than those in males, and that LEP in hypertensive subjects are higher than those in BMI-matched normotensive subjects. To investigate the relationships among LEP, blood pressure (BP) and insulin sensitivity, we studied these relationships in 133 Japanese males and 263 females. LEP were positively correlated with BP, body mass index, body fat mass (FM) and homeostasis model assessment (HOMA). Regression analysis in which age and FM were adjusted showed LEP were associated with BP and HOMA. Even with adjustment by age, FM and HOMA, LEP were still positively correlated BP in males. LEP in insulin-resistant hypertensives was significantly higher than those in insulin-sensitive hypertensives, in insulin-sensitive normotensives and in insulin-resistant normotensives in males. However, in females, a significantly higher LEP was observed in insulin-resistant subjects than in insulin-sensitive subjects regardless of hypertension. These data suggest that it would be sexual difference in the relationships among hyperleptinemia, hyperinsulinemia and hypertension.

An investigation of acute myocardial infarction (AMI) was performed in Obihiro City, Hokkaido from October 1.1990 to March 31.1996. Based on the recorded cases, we conducted an investigation on the progress of 194 survivors by questionnaires, and we investigated the factors affecting long-term prognosis of AMI. The mean follow-up period was 1.62 years. The mean age at onset and frequency of hypertension were higher in women than in men. On the other hand, a larger percentage of men smoked and drank alcohol. Kaplan-Meier analysis showed that survival was strongly influenced by aging, drinking, prior history of AMI or stroke, renal dysfunction, cardiac failure and early rehabilitation. Using Cox's hazard model, it was found that mortality risk increases 1) by 1.5 times for an increase of 10 years in age (2.6-times higher for people over 65 years old), 2) by 2.5 times for people with a history of AMI or stroke, 3) by 4.6 times for people with renal dysfunction, and 4) by 5.7 times for people with cardiac failure of Killip class III or IV. On the other hand, it was found that mortality risk decreases 1) by 0.3 times for people who drink alcohol, 2) by 0.1 times for people who have undergone PTCA, and 3) by 0.3 times for people who have undergone rehabilitation. The mortality risk is high for people who do not drink alcohol and those who have not undergone rehabilitation using Cox's hazard model adjusted all those factors. In conclusion, prognostic predictor in chronic-stage acute myocardial infarction are aging, drinking, prior history of AMI or stroke, renal dysfunction, cardiac failure, early rehabilitation, and PTCA. The results also indicated that, regardless of the historical and clinical characteristics, early rehabilitation is very important to increase the probability of long-term survival.

The prevalence of glucose intolerance was surveyed in 8,063 people over 30 years old from the general population of Japan. The data used in the analysis were from the Fourth National Circulatory Disorders Basic Survey, which was conducted in 1990. Survey items included history of diabetes mellitus, body mass index (BMI) and daily life activity. Blood and urine were also examined, and the blood glucose levels, presence or absence of sugar in urine, and levels of glycohemoglobin (HbA1c) were determined. Glucose intolerance was identified from the blood glucose level, HbA1c level and history of diabetes mellitus. The frequency of glucose intolerance was 8.6% in all subjects (11.9% in men and 6.3% in women). The frequency was higher in older people: 1.7 times higher in men over 65 years old and 2.5 times higher in women over 65 years old. Among people over 40 years old, glucose intolerance was significantly more prevalent in men than in women. It was also significantly more prevalent in men living in big cities than in men living in rural areas. Among obese male subjects and men with a low level of activity in daily life, the frequency of glucose intolerance was higher than in normal male subjects. The level of activity in daily life tended to be lower for people living in big cities than for those in rural areas. The results suggest that the prevalence of glucose intolerance depends on the environment in which people live. The results also indicate that raising the level of activities in daily life might help prevent diabetes mellitus.

The number of elderly patients with heart failure is increasing in Japan owing to the increase in the aging population. In the field of emergency medicine, the treatment and management of elderly patients with heart failure are key issues. We aimed to clarify the clinical characteristics and outcomes of these patients.We enrolled 72 consecutive patients (age, 76.5 ± 12.5 years) with heart failure who were admitted to our hospital between January 1 and December 31, 2010. The characteristics and outcomes of super-elderly patients aged85 years (The overall prevalence of chronic atrial fibrillation was high (43.1%). Underlying diseases, left ventricular function, renal function, in-hospital mortality, hospital stay period, and major complications were similar between the two groups. The super-elderly group had a significantly higher mortality rate and lower event-free survival rate after discharge (log-rank test,There were no significant differences in the background characteristics and in-hospital treatment between super-elderly heart failure patients and younger patients. High mortality and cardiovascular event rates after discharge were observed in the super-elderly group.

A 75-year-old woman was admitted to our hospital with stable effort angina pectoris. The coronary angiogram showed 90 % stenosis at the left anterior descending artery and stenting was successfully performed. Three months later, a newly audible systolic heart murmur was heard. Computed tomography revealed a ventricular septal perforation. Coronary angiogram immediately after stenting showed major septal branch was intact but two small septal branches were occluded. In the angiography after septal perforation occurred, these small septal branches remained occluded and stent restenosis was not observed. The ventricular septal perforation was presumed to be due to occlusions of minimal septal branches.

Two methods are proposed and demonstrated successfully for low temperature atomic layer epitaxy (ALE) of Si, where H atoms play essential roles. The first method is the use of H as a self-limiting factor. Trisilane (Si3H8) was used as source gas and the substrate temperature was modulated in order to alternate steps in an ALE cycle. When the temperature was less than 380°C in the adsorption step and more than 520°C in the desorption step, respectively, the grown layer thickness per cycle was 0.8 ML/cycle. The second method is the use of atomic H as an active reducer of a self-limiting factor. A clean surface was exposed to dichlorosilane (SiH2Cl2) as source gas to grow an Si monolayer covered with CI. Next, atomic H was injected to reduce CI from the surface. An ideal monolayer growth was obtained with the substrate temperature over 540°C.

Effects of phosphines on palladium catalyzedethoxycarbonylation of 4, 4'-dihalobiphenyl derivatives under high pressure of carbon monoxide were studied in the presence of amine and ethanol. In ethoxycarbonylation of 4, 4'-dibromobiphenyl (Ia), the presence of excess triphenylphosphine (Ph3P) ligand over palladium promoted selective formation of diethyl biphenyl-4, 4'-dicarboxylate (IIa), however, palladium complex with low Ph3P/Pd ratios gave ethyl 4'-bromobiphenyl-4-carboxylate (IIIa) selectively. Chelate diphosphines, 1, 3-bis(diphenylphosphino)propane (dppp) and 1, 4-bis(diphenylphosphino)-butane (dppb) produced palladium complexes having much higher activities than Ph3P in ethoxycarbonylation of several 4, 4'-dibromobiphenyl derivatives. Ia, 2, 7-dibromo-9, 10-dihydrophenanthrene (Ib), 2, 7-dibromofluorene(Ic), and 2, 7-dibromofluorenone (Id) quantitatively yielded their corresponding diesters by using Pd-dppp catalysts. Mechanisms of the palladium catalyzed reactions are discussed.

パラジウム-ホスフィン触媒による4,4'-ジブロモビフェニルのエトキシカルボニル化反応における固液相間移動触媒の効果を検討した。固体塩基として炭酸水素ナトリウム, 相間移動触媒としてヨウ化テトラブチルアンモニウムを用いた際, ホスフィンとして1,3-ビス (ジフェニルホスフィノ) プロパンを配位子とするパラジウム触媒が穏和な条件で高い活性を示し, 高選択率で4-ブロモ-4-ビフェニルカルボン酸エチルを与えた。しかし, 生成物の選択性にはあまり影響が認められなかった。相間移動触媒であるハロゲン化テトラアルキルアンモニウムにおいて, アニオンに関しては塩化物, アルキル基に関しては低級のものの促進効果が大きかった。また, 固体塩基としては炭酸カリウム, 炭酸ナトリウム, 炭酸水素ナトリウム等の効果が大きかったが, 炭酸リチウム, 酢酸ナトリウム等では著しく反応が阻害された。また, 一酸化炭素圧も反応に阻害効果を示した。この反応系ではカルボニル化反応は通常の系と同様に進行し, 律速段階は基質のパラジウム触媒への酸化的付加であり, 相間移動触媒は触媒からの臭化水素の脱離を促進していると考えた。

This study was undertaken to investigate the effects on the nuclear maturation and subsequent embryonic development of bovine oocytes exposed to heat stress (HS) when treating bovine oocytes before in vitro maturation (IVM) with 1 µM cyclosporin A (CsA), an inhibitor of mitochondrial permeability transition pore opening. Mitochondrial activity, reactive oxygen species (ROS), and apoptosis levels of the oocytes were also assessed. Nuclear maturation rates of both the HS-exposed oocytes treated with or without CsA groups (HS + CsA or HS group) were significantly lower (P

Poor clinical outcomes for hemodialysis (HD) patients compared to non-HD patients after coronary intervention have been reported. Although coronary intervention using sirolimus-eluting stents (SESs) might be expected to reduce restenosis in HD patients, little is known about the efficacy of the SESs. The purpose of the present study was to compare the clinical and angiographic outcomes of HD patients with non-HD patients after SES implantation. The study population consisted of 170 consecutive patients (234 lesions) who had undergone successful coronary SES implantation. The patients were classified into 2 groups, an HD group (18 patients, 27 lesions) and a non-HD group (152 patients, 207 lesions). The incidence of any clinical event was significantly higher in the HD group than in the non-HD group (50.0% versus 12.5%, P < 0.0001). Target lesion revascularization was necessary in 6 patients (33.3%) in the HD group and in 7 patients (4.6%) in the non-HD group (P < 0.0001). The Cox proportional-hazards regression model on cardiac events identified HD patients (P = 0.0301, hazard ratio = 2.704) as an explanatory factor. Moreover, the Cox proportional-hazards regression model on target lesion revascularization identified HD (P = 0.0004, hazard ratio = 6.921) and in-stent re-stenosis lesion (P = 0.0293, hazard ratio = 3.323) as explanatory factors. The present study suggests that compared with non-HD patients, HD patients with coronary artery disease treated by SESs have a poorer clinical outcome.

The purpose of this study was to determine the relationship between hypertension and onset of cardiovascular disease in Japan. As part of an ongoing epidemiological survey of cardiovascular diseases in Hokkaido, Japan, 1,798 subjects (806 males and 992 females; mean age in the initial year of the survey, 58.6+/-11.8 years) were selected, after excluding subjects who had been taking antihypertensive drugs, from a total of 2,136 subjects who had undergone medical examinations in 1991 in the town of Tanno and in 1992 in the town of Sobetsu, two rural communities in Hokkaido. Height, weight, casual systolic and diastolic blood pressures in the sitting position and blood biochemical values of all subjects were measured, and the subjects were divided into blood pressure level groups according to the 1999 World Health Organization/International Society of Hypertension (WHO/ISH) criteria. The follow-up survey was concluded at the end of August in 1999. The endpoints in this study were onset of circulatory disease or death due to circulatory disease. During the follow-up period, circulatory diseases (ischemic heart disease or stroke) occurred in 94 of the subjects. The incidence rates of cardiovascular disease (per 1,000 persons/year) for subjects divided into blood pressure groups according to the 1999 WHO/ISH blood pressure classification were 6.24 for the optimal+normal blood pressure level group, 11.26 for the normal high blood pressure level group, and 15.83 for the grade 1-3 hypertension group. Thus, the incidence rate of circulatory disease increased as the blood pressure level increased, and there was a significant difference between the incidence rate in subjects in the grade 1-3 hypertension group and the incidence rate in subjects in the optimal+normal blood pressure level group (p

Both the incidence of diabetes mellitus (DM) and mortality from Hepatocellular carcinoma (HCC) are increasing in Japan. As the association of overall cancer and HCC with impaired glucose tolerance (IGT) has been studied rarely in the world including Japan, this study assessed their associations using cohort data of Hokkaido, Japan.After getting ethical consent, this study included 908 men and 1,081 women aged 30-77 years during 1977-78 and collected detailed information using the baseline survey. The subjects were followed until 2002 and deaths were recorded using ICD-9. Classifying them into three groups of diabetes status namely DM, IGT, and normal, the relative risk (RR) of mortality was estimated by diabetes status using multivariate Cox model.This study revealed no association between overall cancer and diabetes status. However, the RR of mortality from HCC was about 11 times (HR= 10.8, 95%CI: 1.3-92.5) higher in IGT compared with normal group. DM group also showed higher risk of mortality than normal group.HCC mortality was significantly high among IGT group. However, as the results of the study were based on small data, further studies with large cohort are needed to address the association of IGT with overall cancer and HCC mortality in Japan.

It is unclear whether the role of insulin resistance in the development of atherosclerotic cardiovascular disease is similar in populations in which the incidence of atherosclerotic diseases significantly differs from that in Western countries. The aim of this study was to determine the relationship between insulin resistance and the development of cardiovascular disease in the Japanese population. We conducted 75 g-oral glucose tolerance tests (OGTTs) on 1,928 inhabitants of two towns in Hokkaido, Japan. Subjects using antihypertensive agents and known diabetic patients were excluded from the study. Data from the remaining 1,227 subjects (540 males and 687 females; mean age 56.0 +/- 10.8 years) were used for the analysis, and 1,051 subjects were seen in a follow-up care setting for a period of 8 years. The presence of insulin resistance was defined according to the guidelines reported our previous study: insulin levels of 64.0 mU/l or higher 2 h after the 75 g-OGTT. The insulin-resistant (IR) group had several risk factors such as hypertension, diabetes, treated or untreated hypercholesterolemia, hypertriglyceridemia, low high-density-lipoprotein (HDL) cholesterol levels, and obesity. During the follow-up period of 8 years, the incidence of coronary artery disease, which was adjusted for age, body mass index, sex, systolic blood pressure, fasting plasma glucose, total cholesterol, triglyceride, and HDL cholesterol was significantly (3.2 times) higher in the IR group than in the insulin non-resistant group. The results suggested that insulin resistance is an independent risk factor for coronary artery disease in Japanese subjects, as has also been demonstrated in the case of individuals in Europe and USA.

OBJECTIVE The present study was conducted in order to investigate risk factors for heavy burden of family caregivers. STUDY DESIGN Cross-sectional study. PARTICIPANTS 51 pairs of the frail elderly and their family caregivers in one town in Hokkaido. RESULTS Compared to those with a lighter burden, family caregivers with heavier burden looked after the frail elderly with more behavior disturbances due to dementia. They cared for the elderly longer and had less time to go out without accompanying their charges than less burdened caregivers. On the other hand, the elderly had similar activities of daily living and degree of need of care between the two groups. In addition, physical caring time did not differ between the two groups. These findings suggest that the psychological burden may be more important than the physical burden. In addition, caregivers used only 30-40% of services they had the right to use with long-term care insurance. These findings suggest that more convenient services for users should be provided.

We introduce a new notion of renormalized dissipative solutions for a scalar conservation law $u_{t}+\mathrm{div}\, {\mathrm{\mathbf{F}}}(u)=f$ with locally Lipschitz ${\mathrm{\mathbf{F}}}$ and $L^{1}$ data, and prove the equivalence of such solutions and renormalized entropy solutions in the sense of Benilan et al. The structure of renormalized dissipative solutions is more useful in dealing with relaxation systems than the renormalized entropy scheme. As an example, we apply our result to contractive relaxation systems in merely an $L^{1}$ setting and construct a renormalized dissipative solution via relaxation.

OBJECTIVE Adiponectin, which is secreted specifically by adipose tissue, has been shown to have an anti-atherosclerotic effect and to improve insulin resistance. The aim of this study was to determine the correlations of plasma adiponectin concentration with insulin resistance and atherosclerosis. DESIGN AND METHODS We investigated the relationships of adiponectin concentration with insulin sensitivity, high-sensitivity C-reactive protein (hCRP) and pulse wave velocity (PWV) in male inhabitants of rural communities in Japan. hCRP and PWV were used as an indexes of atherosclerosis. RESULTS A negative correlation was found between homeostasis model assessment (HOMA) as an index of insulin resistance and adiponectin concentration. Results of stepwise regression analysis for adiponectin showed that age, HOMA and serum triglyceride (TG) were independently correlated with adiponectin. Multiple regression analysis for lipid profile was also performed and revealed that adiponectin and HOMA were independently correlated with TG and serum high density lipoprotein (HDL)-cholesterol but not with serum total cholesterol. A significant negative correlation was found between adiponectin and hCRP in all subjects, and a significant negative correlation between adiponectin and PWV was also found in subjects equal or less than 70 years old. When HOMA was added to this analysis, HOMA was found to be independently correlated with hCRP and PWV, but the adiponectin level did not appear to be a significant predictor of hCRP or PWV. CONCLUSIONS The results suggest that adiponectin plays a role in lipid metabolism and correlates with atherosclerosis either directly or through insulin resistance.

AIM To determine the relationship between adiponectin level and coronary risk factors in men. METHODS The subjects were 395 elderly men in two rural communities (Tanno, Sobetsu) in Japan. Blood pressure in the sitting position (SBP/DBP), after overnight fasting, plasma glucose level (FPG), total cholesterol (TC), triglyceride (TG), HDL cholesterol (HDL) and serum adiponectin were measured. The subjects were divided into two adiponectin level groups, a high adiponectin level (> or = 7.94 microg/ml) group (H-Adipo group) and a normal adiponectin level (< 7.94 microg/ml) group (N-Adipo group), and into two age groups, 70 years of age or older (70 or older group) and less than 70 years of age (under 70 group). RESULTS Adiponectin showed negative correlations with BMI, FPG, TC and TG and positive correlations with age, SBP and HDL. In multiple regression analysis using adiponectin as a dependent variable. BMI, SBP, FPG, TG and HDL were selected as independent variables. Age and HDL in the H-Adipo group were significantly higher than those in the N-Adipo group, and BMI, FPG, TC and TG in the H-Adipo group were significantly lower than those in the N-Adipo group. In the 70 or older group. SBP and adiponectin were significantly higher and BMI, DBP, FPG, TC and TG were significantly lower than those in the under 70 group. The mean number of total coronary risk factors in the 70 or older group (1.71) was significantly lower than that in the under 70 group (2.06). CONCLUSIONS Coronary risk factors other than systolic blood pressure were significantly reduced in the older subjects.

Hypertension and diabetes are risk factors for arteriosclerosis and have a synergistic effect on the progression of arteriosclerosis. The aim of this study was to determine the correlation between complications of hypertension and diabetes and arteriosclerosis as assessed by pulse wave velocity (PWV) in elderly subjects. The subjects of this study were 186 people aged 60 years or older (mean age: 68.8 +/- 5.8 years) who were scheduled to undergo health examinations. PWV, systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), fasting blood sugar (FBS), total cholesterol (TC), triglyceride (TG) and HDL cholesterol (HDL) were measured in each subject. The patients were divided according to the American Diabetes Association (ADA) diagnostic criteria for diabetes based on fasting blood sugar level into the following three groups: a normal (NGT) group (FBS110 mg/dl), an impaired fasting glucose (IFG) group (110or = FBS126 mg/dl) and a diabetes mellitus (DM) group (FBSor = 126 mg/dl or receiving treatment for diabetes). Based on the JNC-VI and WHO/ISH diagnostic criteria, subjects who had a SBP of 140 mmHg or higher or a DBP of 90 mmHg or higher or who had been taking hypotensive drugs were assigned to the hypertension (HT) group, and the other subjects were assigned to the normotension (NT) group. PWV showed significant positive correlations with SBP and FBS (r = 0.499 and r = 0.300, respectively). The effects of hypertension on PWV were significantly higher in subjects with HT than in subjects with NT in all of the glucose tolerance groups (all p0.01). Moreover, in the subjects with HT, PWV started to increase from the IFG stage, and PWV was significantly higher in the DM groups than in the NGT group (p0.01). In multiple regression analysis using PWV as an objective variable, SBP and FBS were selected as significant explanatory variables. The results of this study indicate the need for stricter management of elderly people with slight glucose tolerance impairment and hypertension in order to prevent the occurrence of arteriosclerosis.

We conducted a review of previous cohort studies on the association between a history of diabetes mellitus (DM) and the occurrence of cancer. We limited the papers to those concerning cohort studies on 9 cancer sites, i.e. the kidney, liver, biliary tract, pancreas, colon or rectum, prostate, breast, endometrium, and ovary, in addition to all cancers. With regard to kidney, liver, biliary tract, pancreatic, colorectal, breast, and endometrial cancers, the risk of cancer development has been consistently reported to be positively associated with DM by two or more cohort studies. In contrast, DM was shown to relate negatively to the risk of prostate cancer by two cohort studies. However, there were no cohort studies which showed an either significantly positive or negative association of DM with ovarian cancer. Elevated levels of insulin or IGFs among DM patients have been proposed as a causal mechanism of increased risk for most of the reviewed cancers. In addition, increased estrogen levels in DM patients have been suggested to explain the casual mechanism of increased risk for kidney, breast and endometrial cancers, and decreased risk for prostate cancer. On the other hand, the possibility of detection bias has been suggested in the association of DM with the risk of most of these cancers. Obesity and heavy consumption of alcohol have been indicated as confounding factors in the relationship of DM to the risk for some of them. Thus, further studies are necessary for firm conclusions regarding the association of DM with cancer risk.

Brachial-ankle pulse wave velocity (baPWV), as an indicator of atherosclerosis in impaired fasting glucose (IFG), was studied in 232 subjects randomly selected from inhabitants of two rural communities in Japan.BMI, systolic blood pressure (SBP), fasting blood glucose (FBS), lipid parameters, ankle brachial pressure index (ABI), and baPWV were measured in each subject. ABI and baPWV were measured using the recently developed device, form ABI/PWV. The subjects were divided into three groups according FBS level: a normal group consisting of subjects with FBS110 mg/dl, an IFG group consisting of subjects with FBS 110-125 mg/dl, and a diabetic group consisting of subjects with FBSor =126 mg/dl and subjects taking hypoglycemic agents. The parameters in the three groups were compared. RESULTS-It was found that the baPWV value increased with increasing plasma glucose level. Significant differences were found between the baPWV values in the normal and IFG groups (1,518 vs. 1,673 cm/s, P = 0.01) and in the normal and diabetic groups (1,518 vs. 1,771 cm/s, P0.0001). The results of multiple regression analysis showed that FBS was closely related to baPWV as well as to age and SBP.The relationship between IFG and atherosclerosis remains controversial. Further studies are needed to evaluate whether strict control of blood glucose level in patients with IFG will result in the prevention of atherosclerosis progression.

In recent years, many growth factors and cytokines have been shown to be related to arteriosclerosis, and hepatocyte growth factor (HGF) has been reported to be associated with hypertension. In the present study, we investigated the relationship between HGF and hypertension by measuring the serum HGF concentration and performing 24-h ambulatory blood pressure monitoring (ABPM) in 47 randomly selected male and female subjects who underwent a medical examination for cardiovascular disease. The results were as follows. 1) The mean serum HGF concentration in the subjects was 0.35+/-0.14 ng/ml. 2) The serum HGF concentration was positively correlated with both the nighttime systolic and diastolic blood pressures (r=0.42, p

We investigated the relationship between insulin-resistance (IR) and remnant-like particle cholesterol (RLP-C) using 472 subjects (174 men and 298 women) randomly selected from inhabitants of two rural communities in Japan, Tanno and Sobetsu. The level of fasting immunoreactive insulin (FIRI), fasting blood glucose (FBS), total cholesterol (TC), triglyceride (TG), HDL cholesterol, LDL cholesterol, and RLP-C were measured in each subject. Homeostasis model assessment (HOMA-R) was used as an indicator of IR. The subjects were divided into two groups according to the value of HOMA-R: an IR group of subjects with HOMA-Rapproximately equal to 1.73 and a normal (NR) group of subjects with HOMA-R1.73. There was a significant positive correlation between HOMA-R and RLP-C. The value of RLP-C was higher in the IR group than in the NR group (7.1 vs. 3.9 mg/dl in men and 5.3 vs. 3.6 mg/dl in women). The frequency of hyper RLP cholesterolemia (RLP-Capproximately equal to 7.5 mg/dl) was higher in the IR than in the NR group (23.7 vs. 6.6% in men and 20.3 vs. 6.6% in women). The results of multiple regression analysis showed that HOMA-R was closely related to RLP-C. The results of this study suggest that RLP-C is closely associated with IR syndrome.

There have been very few studies on life prognosis of cardiovascular disease according to blood pressure stratification in the Japanese. Therefore, in Japan, although treatment of hypertension is possible, albeit at times difficult, due to the availability of various antihypertensive medications, the appropriate time at which treatment should be started remains a problem.To investigate the long-term prognosis of cardiovascular disease in the Japanese general population according to blood pressure stratification in the Japanese.A community-based prospective cohort study of 1996 men and women between the ages of 40 and 64 years at the baseline examination was conducted over an 18-year period. Information on death was obtained from local public health nurses and death certificates. The causes of death were clarified by questionnaires sent to doctors in the hospital in which the deceased was hospitalized, and the causes of death were analysed in each blood pressure category at baseline examination.Mortality from cardiovascular disease increased with increases in the level of blood pressure and was significantly higher inor = 140 mmHg group in systolic blood pressure andor = 90 mmHg group in diastolic blood pressure, adjusted for age, sex and other cardiovascular risk factors in the Japanese general population. However, mortality risk from cardiovascular disease did not have a J-shaped relationship with systolic and diastolic blood pressure.We conclude that the optimum time for starting treatment in Japanese people is when blood pressure is 140/90 mmHg or less.

Cardiac calcinosis is a common complication of end stage renal disease. A newly observed risk of thromboembolism is reported in four patients with mobile cardiac calcinosis, treated with long term dialysis. Rapidly growing mobile calcification was confirmed by echocardiography. Each patient had an imbalance in serum calcium × inorganic phosphate (Ca × P product ⩾ 50); this imbalance could not be treated due to the sudden death of the patient or the need for surgical resection to prevent recurrent cerebral thromboembolism. Histological examination revealed intracardiac calcinosis in three cases, and each case showed haemodialysis hypoparathyroidism (intact PTH

A survey of acute myocardial infarctions (AMI) that occurred from October 1990 through September 1993 in Obihiro City, Hokkaido, was conducted. A total of 114 new cases of AMI was registered over the 3-year period. The incidence rate of AMI was 33.4 cases per 100,000 men per year and 137 cases per 100,000 women per year (total, 23.2 cases). The mean age at which AMI occurred was 11 years higher in women (71.1 +/- 9.4 years) than in men (60.0 +/- 11.8 years). In men, AMI was most common during the eighth decade of life, while in women the incidence of AMI increased after menopause. The ratio of cases of AMI to cases of stroke in the same period was 1:4.5. These results did not differ from the results of other surveys done over the same period in seven other area of Japan. To study risk factors for myocardial infarction, the data were grouped according to the results of medical examinations. Hypertension, diabetes, obesity and smoking were common among people with AMI. The incidence rate of hypercholesterolemia did not differ between those with AMI and those without, and only a relatively small number of people with AMI drank alcohol. Past reports have pointed out changes in the 'structure' of cardiovascular disease in Japan, which have accompanied changes in diet and lifestyle. This study has shows that aging hypertension, diabetes, obesity, and smoking are risk factors for myocardial infarction. Proper management, including early detection of these factors, will help to prevent of ischemic heart disease in Japan.

Data from an 18-year prospective study were used to investigate the effect of accumulation of arteriosclerotic risk factors in elderly people on cerebrovascular and cardiovascular disease mortality rates. Risk factors include smoking, hypertension, diabetes mellitus, hyperlipidemia, and obesity. We compared survival rates between a group with few risk factors (two risk factors) and a group with many risk factors (or = two risk factors) in four groups of subjects: middle-aged men (61-years-old) and middle-aged women and elderly men (or = 61-years-old) and elderly women. In the elderly male group, the survival rate was lower in subjects with many risk factors than in those with few risk factors. In the middle-aged male group, however, there was no difference between the two risk groups. On the other hand, in the middle-aged female group, the survival rate was lower in subjects with many risk factors than in those with few risk factors, while no difference was found between the two risk groups in the elderly female group. The results indicated that the effects of an accumulation of risk factors are different in men and women and greater in elderly men than in elderly women.