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A 72-year-old lady with atrial fibrillation and chronic renal failure was hospitalized due to bradycardic shock with electrocardiographic QRS prolongation. She had experienced limb shaking two days before hospitalization, and additionally developed hallucinations one day before admission. Pilsicainide intoxication was diagnosed from a review of her medications and electrocardiographic findings. Consequently, continuous hemodiafiltration was performed resulting in a resolution of the hallucinations and the QRS prolongation. This is a rare case of psychiatric symptoms caused by pilsicainide intoxication. It is important to know the mode of excretion of a drug and to adjust its dose, so that such drug-related incidents can be avoided.

Visible wavelength fluorescent dissolved organic matter (FDOM), usually defined as humic-like FDOM, plays important roles in marine carbon and iron cycles as biorefractory dissolved organic matter and organic ligands, respectively. The major fractions of FDOM in the open ocean have been considered to be of marine origin (autochthonous) according to linear relationships between FDOM and apparent oxygen utilization (AOU) in the mesopelagic (200–1000 m) and bathypelagic (>1000 m) layers. Recently, Yamashita et al. (2020) quantified allochthonous FDOM from the positive deviation of the general FDOM–AOU relationship in the bathypelagic layer and found that allochthonous FDOM derived from the Sea of Okhotsk was conservatively transported to the western North Pacific through the circulation of intermediate water, including North Pacific Intermediate Water (NPIW). However, the contribution of allochthonous FDOM from the Bering Sea, the other source region of NPIW, has not been evaluated. Here, we determined the distributions of allochthonous FDOM in the entire North Pacific, including the Sea of Okhotsk and the Bering Sea, and the spatial distribution of allochthonous FDOM in the density range of NPIW for the entire North Pacific. We found that the major source region of allochthonous FDOM in NPIW was the Sea of Okhotsk but not the Bering Sea, although the water mass contributing to the lower part of NPIW is known to be mainly derived from the Bering Sea. Such different contributions of allochthonous FDOM from the marginal seas are likely due to a lack of expansion of the dense shelf water, which forms at coastal polynya and interacts with shelf sediments with a strong tidal current, to the basin region of the Bering Sea. We also demonstrated that allochthonous FDOM derived from the shelf sediments of the Sea of Okhotsk was conservatively distributed to the wide area of the North Pacific through the circulation of intermediate water, particularly the upper part of NPIW. Furthermore, the negative deviations of the FDOM-AOU relationship in the bathypelagic layer were evident for other water masses, such as Antarctic Intermediate Water (AAIW), suggesting that FDOM can help determine the spatiotemporal distribution of NPIW and its mixing with other water masses, such as AAIW.

The recalcitrant fraction of marine dissolved organic matter (DOM) plays an important role in carbon storage on the earth’s surface. Bacterial production of recalcitrant DOM (RDOM) has been proposed as a carbon sequestration process. It is still unclear whether bacterial physiology can affect RDOM production. In this study, we conducted a batch culture using the marine bacterial isolate Alteromonas macleodii, a ubiquitous gammaproteobacterium, to evaluate the linkage between bacterial growth and DOM production. Glucose (1 mmol C L-1) was used as the sole carbon source, and the bacterial number, the DOM concentration in terms of carbon, and the excitation-emission matrices (EEMs) of DOM were monitored during the 168-hour incubation. The incubation period was partitioned into the exponential growth (0–24 hours) and stationary phases (24–168 hours) based on the growth curve. Although the DOM concentration decreased during the exponential growth phase due to glucose consumption, it remained stable during the stationary phase, corresponding to approximately 4% of the initial glucose in terms of carbon. Distinct fluorophores were not evident in the EEM at the beginning of the incubation, but DOM produced by the strain exhibited five fluorescent peaks during exponential growth. Two fluorescent peaks were similar to protein-like fluorophores, while the others could be categorized as humic-like fluorophores. All fluorophores increased during the exponential growth phase. The tryptophan-like fluorophore decreased during the stationary phase, suggesting that the strain reused the large exopolymer. The tyrosine-like fluorophore seemed to be stable during the stationary phase, implying that the production of tyrosine-containing small peptides through the degradation of exopolymers was correlated with the reutilization of the tyrosine-like fluorophore. Two humic-like fluorophores that showed emission maxima at the longer wavelength (525 nm) increased during the stationary phase, while the other humic-like fluorophore, which had a shorter emission wavelength (400 nm) and was categorized as recalcitrant, was stable. These humic-like fluorophore behaviors during incubation indicated that the composition of bacterial humic-like fluorophores, which were unavailable to the strain, differed between growth phases. Our results suggest that bacterial physiology can affect RDOM production and accumulation in the ocean interior.

The recalcitrant fraction of marine dissolved organic matter (DOM) plays an important role in carbon storage on the earth’s surface. Bacterial production of recalcitrant DOM (RDOM) has been proposed as a carbon sequestration process. It is still unclear whether bacterial physiology can affect RDOM production. In this study, we conducted a batch culture using the marine bacterial isolate Alteromonas macleodii, a ubiquitous gammaproteobacterium, to evaluate the linkage between bacterial growth and DOM production. Glucose (1 mmol C L-1) was used as the sole carbon source, and the bacterial number, the DOM concentration in terms of carbon, and the excitation–emission matrices (EEMs) of DOM were monitored during the 168-h incubation. The incubation period was partitioned into the exponential growth (0–24 h) and stationary phases (24–168 h) based on the growth curve. Although the DOM concentration decreased during the exponential growth phase due to glucose consumption, it remained stable during the stationary phase, corresponding to approximately 4% of the initial glucose in terms of carbon. Distinct fluorophores were not evident in the EEMs at the beginning of the incubation, but DOM produced by the strain exhibited five fluorescent peaks during exponential growth. Two fluorescent peaks were similar to protein-like fluorophores, while the others could be categorized as humic-like fluorophores. All fluorophores increased during the exponential growth phase. The tryptophan-like fluorophore decreased during the stationary phase, suggesting that the strain reused the large exopolymer. The tyrosine-like fluorophore seemed to be stable during the stationary phase, implying that the production of tyrosine-containing small peptides through the degradation of exopolymers was correlated with the reutilization of the tyrosine-like fluorophore. Two humic-like fluorophores that showed emission maxima at the longer wavelength (525 nm) increased during the stationary phase, while the other humic-like fluorophore, which had a shorter emission wavelength (400 nm) and was categorized as recalcitrant, was stable. These humic-like fluorophore behaviors during incubation indicated that the composition of bacterial humic-like fluorophores, which were unavailable to the strain, differed between growth phases. Our results suggest that bacterial physiology can affect RDOM production and accumulation in the ocean interior.

Purpose – The authors develop a program, named eBraille, to translate Japanese text into braille and thereby generate braille documents easily. Public access to this program is provided to anyone via the Internet. The paper aims to evaluate the translation accuracy of the eBraille program.Design/methodology/approach – eBraille is a CGI program that is accessible via a web browser. The core of the program is a braille translating engine called the Kobe University Intelligent Braille Engine for ChaSen (KUIC). It is based on Japanese Braille Transcription Rules (Japanese Braille Committee, 2001). To evaluate the translation accuracy of eBraille, a corpus was utilized that was created from ordinary text and braille newspaper articles.Findings – The paper finds that eBraille translation accuracy is equivalent to or better than that of other stand‐alone braille translation programs. This result suggests that the program achieved the goal of being applicable for practical use. In addition, the program is utilize...

[Purpose] The purpose of this study was to investigate the durability of the effect on the dynamic control structure after performance of the Approximation technique (ApT) administered to the lower extremity. Body sway was measured on a stabilometer under two conditions: one without a stimulus, and the other with a disturbance stimulus. [Subjects] The subjects were 38 healthy males, 19 to 27 years of age. [Methods] Participants in the experimental group stood on two scales, and we performed ApT from the iliac crests toward the long axes direction of lower extremities on each leg for one minute in turn and confirmed the approximation with a 10 kg load. Experimental group performed the stabilometer in an unstable environment and we measured the center of gravity sway after the intervention. The control group was measured without performing the maneuver. [Results]Significant differences in Area of Ellipse (AoE) and locus length per unit area (L/A) after ApT for lasted for 70 minutes. [Conclusion] We conclude ApT is a useful improved stability of center of gravity for 70 minutes.

Introduction: Diabetes mellitus is associated with an increased production of reactive oxygen species and a reduction in antioxidant defenses. The aim of this study is to determine the association between the incidence of Type 2 diabetes and gene polymorphisms of glutathione S-transferase (GST), which modulates oxidative stress. Materials & Methods: The associations between the incidence of Type 2 diabetes and the GSTT1 and GSTM1 genotypes were analyzed in 469 Japanese participants in a health-screening program. Results: The clinical characteristics and smoking status were obtained from the health screening record. The incidence of diabetes was 1.5-fold higher in the GSTT1 and GSTM1 null (-) genotype than the GSTT1 and GSTM1 present (+) genotype, respectively. Although the effect of each null genotype was not significant, the combined GSTT1+/GSTM1+ genotypes conferred a significant reduction in risk of diabetes in comparison with the other combinations of genotypes (adjusted odds ratio [OR]: 0.30; 95% confidence interval [CI]: 0.12–0.71). In stratified analyses by smoking status, the incidence of diabetes was significantly higher in never-smokers with the GSTT1- genotype than those with the GSTT1+ genotype (OR: 2.85; 95% CI: 1.17–6.94) and increased significantly in current smokers (OR: 5.91; 95% CI: 1.96–17.88). The effect of the GSTM1- genotype was significant only in current smokers. Conclusion: This study demonstrated that the GSTT1- and GSTT1-/GSTM1- genotypes are independent risk factors for development of Type 2 diabetes regardless of the smoking status of the patient, and that these genotypes and current smoking were interactively associated with the incidence of Type 2 diabetes.

A nonlinear mixed-effect modeling (NONMEM) program was used to evaluate the effects of cytochrome P450 (CYP) 2C9 and CYP2C19 polymorphisms on the phenobarbital (PB) population clearance for Japanese epileptics. The pharmacokinetics of the 260 PB concentrations at a steady-state obtained from 79 patients was described with a one-compartment open pharmacokinetic model with first-order elimination. The covariates screened included the total body weight (BW), age, gender, PB daily dose, CYP2C9 and CYP2C19 genotypes, the coadministered antiepileptic drugs (AEDs), and complications. The final model of PB apparent clearance was as follows: CL = 0.23 x (BW/40)0.21 x 0.52CYP2C9*1/*3 x 0.68VPA x 0.85PHT x 0.85SMID x (1 + etaCL) where CL = the clearance of PB; CYP2C9*1/*3 = 1, otherwise 0; VPA = 1 if valproic acid is coadministered, otherwise 0; PHT = 1 if phenytoin is coadministered, otherwise 0; SMID = 1 if complications of severe or profound mental retardation with a significant behavior impairment are presented, otherwise 0; and etaCL = the independent random error distributed normally with the mean zero and variance equal to omegaP2. The total clearance of PB decreased by 48% in patients with CYP2C9*1/*3 genotype in comparison with those with CYP2C9*1/*1 genotype (P < 0.001). An effect of CYP2C19 polymorphisms was not detected. To our knowledge, this is the first report to demonstrate that the CYP2C9 genotype affects the PB metabolism in routine care, but the results should be further verified in other ethnic populations.

まず後藤より、鍼灸師が国民医療の担い手として機能する条件を満たしていくための卒後教育、そして卒前教育も同時に考える必要があるという視点からの提言と、社会へのアピールとしても免許更新性を考えたらどうかと提案した。山田は、鍼灸治療の本質は「不定愁訴の治療」であり、「家庭鍼灸師」になるべきと提案があり、卒後教育は、学校、業界、学会が一体で具現化することが必要と発言した。北小路は、明治鍼灸大学附属病院と鍼灸センターの有機的連携により構築された、卒後教育システムの紹介をした。内容は、医療との連携にても通用する卒後研修であった。小川は、自身の治療院でのスタッフ教育と、教員養成施設での経験から、開業免許などの新しい制度を考えるべきと提案した。山岡は、愛媛県立中央病院東洋医学研究所での卒後研修プログラムについて、お灸によるケア技術、全人的病人把握法としての時系列分析法等の紹介があった。フロアからは、卒後研修の内容や、卒前教育における改善等についての発言があった。

The unique electrocatalytic properties of core/shell-structured bimetallic nanoparticles (NPs) are generally attributed to core-induced electronic effects on surface atoms. For small core/shell NPs, however, size-dependent electronic modifications can be non-negligible. Here, using synchrotron-based photoelectron spectroscopy, we identified both size- and core-induced modifications in the surface electronic states of core/shell NPs with approximately monolayer-thick Pt shells completely covering Ru cores. The embedded Ru cores were found to induce a downward shift in energy of the d states of the surface Pt atoms. However, with a decrease in core size from 1.9 to 1.3 nm, these Ru-core-induced, low-lying d states increased in energy and decreased in intensity. Extended X-ray absorption fine structure measurements indicated that this size-induced electronic modification can be associated with a decrease in the number of Pt–Ru bonds per surface Pt atom. The observed size- and core-induced electronic modifica...

We have been investigating the molecular efficacy of electroacupuncture (EA), which is one type of acupuncture therapy. In our previous molecular biological study of acupuncture, we found an EA-induced gene, named acupuncture-induced 1-L (Aig1l), in mouse skeletal muscle. The aims of this study consisted of identification of the full-length cDNA sequence ofAig1lincluding the transcriptional start site, determination of the tissue distribution ofAig1land analysis of the effect of EA onAig1lgene expression. We determined the complete cDNA sequence including the transcriptional start site via cDNA cloning with the cap site hunting method. We then analyzed the tissue distribution ofAig1lby means of northern blot analysis and real-time quantitative polymerase chain reaction. We used the semiquantitative reverse transcriptase-polymerase chain reaction to examine the effect of EA onAig1lgene expression. Our results showed that the complete cDNA sequence ofAig1lwas 6073 bp long, and the putative protein consisted of 962 amino acids. All seven tissues that we analyzed expressed theAig1lgene. In skeletal muscle, EA induced expression of theAig1lgene, with high expression observed after 3 hours of EA. Our findings thus suggest that theAig1lgene may play a key role in the molecular mechanisms of EA efficacy.

This study tested the hypothesis that the determinants of mild liver injury are prerequisites for more severe idiosyncratic hepatotoxicity. This study verified whether the possible risk factors for rare idiosyncratic valproic acid (VPA)-induced hepatotoxicity, VPA clearance and/or serum carnitine concentrations are common to those for a mild elevation in transaminases in VPA-treated patients. VPA clearance was calculated in 172 Japanese patients with epilepsy, using a non-linear mixed-effects regression program. Carnitine concentrations were determined in a subset of 60 patients. The relationships between VPA clearance, carnitine concentration and levels of transaminases and ammonia were evaluated by Pearson's correlation coefficients. The final model of VPA apparent clearance (CL/F) was as follows: CL/F (L h−1) = 0.012 × (BW/40)0.34 × dose0.55 × 0.90gender × 1.32PHT × 1.11CBZ × 1.12PB, where BW = total body weight (kg); gender = 1 if female, 0 if male; PHT/CBZ/PB = 1 if phenytoin, carbamazepine, or phenobarbital, respectively, is coadministrated, otherwise 0. Either a higher VPA clearance or acyl/free carnitine ratio and a lower total and/or free carnitine concentration, but not VPA concentration, were associated with the mild elevation in transaminases or ammonia. These results support the initial hypothesis, while also helping to clarify the mechanism of severe idiosyncratic hepatotoxicity with VPA.

We synthesized a methanol electrocatalyst with high activity and low noble metal content. The electrocatalyst consists of carbon&supported PtRu nanoparticles, which have 1-2 Pt monoatomic layers on Ru nanocores. In spite of the pure Pt surface, the catalyst showed high catalytic activity when used in the anode of a direct methanol fuel cell. Clearly the underlying Ru atoms modified the property of the surface Pt atoms, bringing about the high catalytic activity.

This retrospective longitudinal study investigated the association between the Q192R polymorphism of the high-density lipoprotein-associated multifunctional antioxidant enzyme, paraoxonase-1 (PON1), and lung function decline, while taking into account smoking history.The demographic, occupational, and respiratory symptom information and lung function variables were obtained from 216 male Saskatchewan grain workers.An interaction between the PON1 genotypes and smoking status was observed. Current smokers with the 192R allele had a lower forced expiratory volume in the first second (FEV(1)) and FEV(1) per forced vital capacity (FVC). The annual decline rate of FEV(1)/FVC in current smokers was greater among 192R allele carriers than noncarriers (0.58+/-0.05 vs. 0.35+/-0.04 %/yr, p0.0001). A similar result was observed with FEV(1) (40.9+/-6.4 vs. -33.0+/-7.0 mL/yr, p=0.10). The annual decline rate of FVC was not influenced by the genotypes.These results strengthened the previous findings of our cross-sectional study, suggesting that the 192R allele may be a novel genetic risk factor for airway injury among current smokers.

Introduction: Paraoxonase-1 (PON1) is a high-density, lipoprotein-associated, multifunctional antioxidant enzyme that is detected in nonciliated bronchiolar epithelial cells, although its role in the lung has not yet been clarified. We therefore investigated the association between the PON1 Q192R polymorphism and lung function. Patients & Methods: A total of 216 male Saskatchewan grain handlers provided demographic, occupational and respiratory-symptom information by means of questionnaires, and thereafter underwent PON1 Q192R genotyping and lung-function testing. Results: Mean lung-function values did not differ among the Q192R genotypes. However, current smokers with the Q/Q genotype had a higher mean percent predicted forced expiratory volume in the first second (FEV1), and absolute and percent predicted FEV1 per forced vital capacity (FVC) compared with current smokers with at least one 192R allele (100.9 ± 11.2% vs 92.0 ± 15.1%, p = 0.01; 78.0 ± 5.9% vs 74.1 ± 6.8%, p = 0.03; and 96.8 ± 7.1% vs 92.1 ± 8.3%, p = 0.03; respectively). The incidence of subjects with FEV1/FVC less than 70% was significantly higher in current smokers with at least one 192R allele than in nonsmokers with the Q/Q genotype (odds ratio: 5.0; 95% confidence interval: 1.5–17.4). The protective effect of the Q/Q genotype was not found in nonsmokers. The FVC was not influenced by either PON1 genotype or smoking status. Conclusion: The results obtained from grain handlers suggest that PON1 may play some role in the protection of the airways against the toxicity of cigarette smoke, and the 192R allele may be a novel genetic risk factor for airway injury.

Complementary and alternative medicine (CAM) may provide patients with an alternative to traditional medicine, but an assessment of its efficacy is required. One CAM method, electroacupuncture (EA) treatment, is a maneuver that utilizes stimulation of acupuncture needles with a low-frequency microcurrent. To study the effect of short-term EA, we evaluated the differential expression of genes induced by EA in mouse skeletal muscle for up to 24 h. We then used RT-PCR to confirm the expression patterns of six differentially expressed genes. Bioinformatics analysis of their transcription control regions showed that EA-inducible genes have numerous common binding motifs that are related to cell differentiation, cell proliferation, muscle repair, and hyperplasia. These results suggested that EA treatment may induce cell proliferation in skeletal muscle. To verify this possibility, we used EA to stimulate mouse skeletal muscle daily for up to 1 mo and examined the long-term effects. Immunohistochemical analysis showed that nuclei of muscle cells treated with EA for 1 mo, especially nuclei of satellite cells, reacted with anti-human PCNA. Also, expression of the gene encoding myostatin, which is a growth repressor in muscle satellite cells, was suppressed by daily EA treatment for 1 wk; EA treatment for 1 mo resulted in more marked suppression of the gene. These molecular findings constitute strong evidence that EA treatment suppresses myostatin expression, which leads to a satellite cell-related proliferative reaction and repair in skeletal muscle.

Fine structure with endochondral ossification of the calcifying cartilage and bone matrix in the nucleus of ossification were investigated by a scanning electron microscope, using fracture surfaces of the nucleus in the cartilagious sternum of the fetus.The chondrocyte lacunar wall in the superficial layer of the nucleus of ossification was formed by numerous calcospherites, and its surface was rough. The longitudinal septa of the hypertrophic layer was strand-shaped and calcified. The calcifying cartilage matrix in the part of the center of the trabeculae of the layer of ossification was mostly formed by dense calcified matrix. The gap of the calcospherites was formed by collagen fibrils. The calcifying cartilage matrix of the layer of ossification was highly calcified. There were many osteocyte lacunae showing irregularly arranged in the bone matrix of the fracture surface. The osteocyte lacunar wall was formed with dense networks of collagen fibrils.

Introduction Tympanoplasty consists of a series of operative procedures, which not only eliminate chronic infections of the middle ear completely but also improve hearing. The purposes of tympanoplastic procedures are the elimination of inflammatory processes and postinflammatory changes in the middle ear in order to diminish ear discharge and to obtain dry ear and the reconstruction of the damaged sound-conduction mechanism in order to facilitate sound conduction to the inner ear and restore the hearing. In our experience there are cases where tympanoplasty failed to eliminate the inflammatory processes or to restore hearing in chronic otitis media. I have, therefore, clinically observed these cases of failure in order to clarify manipulation of the labyrinth windows and their surroundings and assure accomplishment of both aims of tympanoplasty. Material I examined 242 tympanoplasty cases operated on by us for chronic middle ear suppuration from October, 1957, to November, 1958. The cases included

Disophrol Chronotab, an oral constrictive agent of mucous membrane of upper respiratory tract was given to 23 patients. The results suggest that Disophrol Chronotab is a very valuable drug for treating allergic, hypertrophic rhinitis.Side effects were noted in 38% of patients, but there was no severe condition.

Of the patients in whom operative construction of the middle ear (tympanoplasty) was carried out with the objective of eradication of infection and restoration of hearing during 1954, the findings were recorded in detail in 125 cases of chronic otitis media and 22 cases of postradical mastoidectomy. The results of examination of the state of the stapes in these cases are presented here. The state of the stapes is not only closely related to the restoration of hearing, but treatment of this part is also an extremely important problem from the standpoint of elimination of inflammation and restoration of hearing. Mobility of the stapes also determines the necessity or unnecessity for fenestration, and the presence or absence of the stapes is important from the standpoint of method of treatment. The basis for operative procedures in chronic otitis media to eradicate inflammation, prior to determination of whether to carry out secondary

I. INTRODUCTION TO INDICATE the hearing acuity by audiometer, the lowest pattern of threshold is generally used. No questions regarding this method have so far been raised. Hearing acuity, however, is important for speech on the one hand, and hearing above threshold is practically important on the other. The threshold alone, therefore, does not perfectly indicate practical hearing. In other words, the threshold value indicates the hearing acuity only when the intensity of the presented tone is parallel with the loudness or perceived tone. Fowler (1928), however, found a phenomenon in which the loudness rapidly increases in correspondence to small increases in intensity, and he called this phenomenon "recruitment" of tonal loudness. From this fact we cannot say in cases in which this phenomenon exists that the threshold pattern indicates actual hearing. Fowler1 (1936) published the balance test of loudness with the binaural loudness comparison and emphasized the possibility of

The author has been performing tympanoplastic surgery for chronic suppurative otitis media since 1952, and the surgical procedures have again and again been improved.

The author pursued the causes of failure in tympanoplasty by performing revision operations in 65 failed cases of tympanoplasty, and on these an attempt was made to clarify the operative controls necessary to avoid the failure in tympanoplasty. Thus, he suggests that the following controls be adopted as standards in all cases of tympanoplastic surgery: 1. The antrum and mastoid control, 2. The perilabyrinth control, 3. The ossicular chain control, 4. The epitympanum control, 5. The oval window control, 6. The round window control, 7. The tympanic sinus control, 8. The meso-tympanum control, 9. The hypotympanum control, 10. The tube control, 11. The drum membrane control. By adopting these 11 controls of the middle ear we can perform tympanoplasty with the object of satisfying both elimination of infection in the middle ear and restoration of hearing.