A number of studies have been published which have attempted to define the electrocardiographic (ECG) changes with aging, but most of them were obtained from cross-sectional studies. To distinguish ECG changes related to physiological aging from those associated with arteriosclerosis, we assessed the ECG changes of 500 apparently healthy subjects, aged 60 years and older in 1992, who had been followed at the Keio Health Consulting Center for over 15 years. All subjects had no overt cardiovascular diseases in 1992. We compared the ECG in 1992 with that taken over 15 years ago. Changes in ECG during that period were also reviewed. With aging, the mean axis deviated to the left, the mean QTc interval was shortened, and the mean PR interval was prolonged. ST segmental change, atrial overloading, bundle branch block developed newly in 16%, 8% and 7% of, respectively. There were no relationships among axis deviation, PR interval change, or QTc shortening and coronary risk factors. QTc prolongation and ST segmental change were strongly related to hypertension or impaired glucose tolerance. When ECG changes in those under 65 years old were compared with those over 80 years old, the incidence of ST segmental change in those over 80 years old was significant higher. This study was not a prospective study but suggested each type of ECG change related to aging was affected by physiological and/or pathological factors in a distinct way and had different phases of development and progression.
Clinical and radiological studies were performed on 58 patients with rheumatoid arthritis (RA) who had sustained 64 femoral neck fractures. All but one patient were female, the mean age was 66.5 years, and mean duration of RA was 17 years. Only 3 hips showed rheumatoid changes. Sixteen fractures of 14 patients were spontaneous fractures without trauma. Ipsilateral total knee replacements were performed on 5 patients with spontaneous fractures.Results of treatment were analyzed on 47 fractures in 43 patients that could be followed up for more than 1 year (mean 42 months). Clinical results were evaluated by ability of ambulation and complications such as nonunion and avascular necrosis of the femoral head. All 4 fractures treated conservatively and 5 of 9 displaced fractures treated by internal fixation developed complications. Femoral head replacements had a high rate of proximal migration (23.8%) and distal migration (76.2%), and ambulation ability was lowered significantly in 10 patients with distal migration for more than 5mm. On the other hand, satisfactory results were obtained on all 6 fractures treated by total hip replacements (THR). THR is advisable for treatment of displaced femoral neck fracture in patients with RA.
C-type lectin-like receptor 2 (CLEC-2) is a platelet-activated receptor expressed on the surface of platelet membranes. Soluble CLEC-2 (sCLEC-2) has been receiving attention as a predictive marker for thrombotic predisposition. The present study examined the relationship between sCLEC-2 level and degree of coagulation disorder in septic patients. Seventy septic patients were divided into the sepsis-induced disseminated intravascular coagulation (DIC) (SID) group (n = 44) and non-SID group (n = 26). The sCLEC-2 levels were compared between the two groups. Because we suspected that the sCLEC-2 level was affected by the platelet count, we calculated the sCLEC-2/platelet count ratio (C2PAC index). We further divided septic patients into four groups using the Japanese Association for Acute Medicine (JAAM) DIC scoring system (DIC scores: 0-1, 2-3, 4-5, and 6-8). The C2PAC index was significantly higher in the SID group (2.6 ± 1.7) compared with the non-SID group (1.2 ± 0.5) (P < .001). The C2PAC indexes in the four JAAM DIC score groups were 0.9 ± 0.3, 1.1 ± 0.3, 1.7 ± 0.7, and 3.6 ± 1.0, respectively, and this index increased significantly as the DIC score increased (P < .001). According to the receiver-operating curve analysis, the area under the curve (AUC) and optimal cutoff value for the diagnosis of SID were 0.8051 and 1.4 (sensitivity, 75.0%; specificity, 76.9%), respectively. When the C2PAC index and D-dimer level, one of the main fibrinolytic markers, were selected as predictive markers for SID diagnosis in stepwise multiple logistic regression analysis, it was possible to diagnose SID with a high probability (AUC, 0.9528; sensitivity, 0.9545; specificity, 0.8846). The C2PAC index is a useful predictor of SID progression and diagnosis in septic patients.
Though there are several methods of instrumental surgery for scoliosis, we tried Luque Spinal Segmental Instrumentation (L-S. S. I.) on two cases of neuromuscular scoliosis. One is a spinal deformity caused by cerebral palsy, and the other is a case of the cervical cord injury with tetraplegia. Both cases got better condition than that before operation. L-S. S. I. provides secure internal fixation and correction force over conventional Harrington Instrumentation, so no external fixation is needed after surgery. Even if the patient has sensory disturbance, this instrumentation makes its maintenance easy. Spasticity with neuromuscular disease causes hook-bone stress or fracture and rod migration easily in Harrington Instrumentation. But in L-S. S. I. such cases are few. Compared with Harrington Instrumentation, loss of correction, ocurrence of pseudarthrosis are less in L-S. S. I.. And some reports mention that L-S. S. I. does not require bone graft. Selection of the length of spine to be instrumented, control for head decompensation, trunk shift and pelvic obliquity are other problems. But taking all things into consideration, we think that L-S. S. I. is a useful method for neuromuscular scoliosis.
Journal Article Enrichment of n-Alkane Assimilation-Deficient Mutants of Candida Yeast by Synergistic Effect of Nystatin and Pyrrolnitrin Get access Keiji Yano, Keiji Yano Department of Agricultural Chemistry, The University of Tokyo, Bunkyo-ku, Tokyo 113, Japan Search for other works by this author on: Oxford Academic Google Scholar Masahide Kawamura, Masahide Kawamura Department of Agricultural Chemistry, The University of Tokyo, Bunkyo-ku, Tokyo 113, Japan Search for other works by this author on: Oxford Academic Google Scholar Masamichi Takagi Masamichi Takagi Department of Agricultural Chemistry, The University of Tokyo, Bunkyo-ku, Tokyo 113, Japan Search for other works by this author on: Oxford Academic Google Scholar Agricultural and Biological Chemistry, Volume 45, Issue 4, 1 April 1981, Pages 1017–1018, https://doi.org/10.1080/00021369.1981.10864645 Published: 01 April 1981 Article history Received: 05 November 1980 Published: 01 April 1981
