Heme controls the structural rearrangement of its sensor protein mediating the hemolytic bacterial survival.

Hemes (iron-porphyrins) are critical for biological processes in all organisms. Hemolytic bacteria survive by acquiring b-type heme from hemoglobin in red blood cells from their animal hosts. These bacteria avoid the cytotoxicity of excess heme during hemolysis by expressing heme-responsive sensor proteins that act as transcriptional factors to regulate the heme efflux system in response to the cellular heme concentration.

Pilot study of bisoprolol 8mg transdermal patch at bedtime before coronary computed tomography angiography.

Background: Coronary computed tomography angiography (CCTA) is recommended for first-line evaluation of stable coronary artery disease, and there is a standard protocol to control heart rate (HR) in guidelines. However, time is required to decrease HR to the recommended ≤60 beats per minute (bpm). We investigated whether the bisoprolol 8mg transdermal patch at bedtime on the day before CCTA can achieve a target HR and simplify the CCTA process.

[Development of an inter-professional educational program for home care professionals: Evaluation of short-term effects in suburban areas].

Objective　To examine the short-term effects of an inter-professional educational program developed for physicians and other home care specialists to promote home care in the community.Methods　From March 2012 to January 2013, an inter-professional educational program (IEP) was held four times in three suburban areas (Kashiwa city and Matsudo city in the Chiba prefecture, and Omori district in the Ota ward). This program aimed to motivate physicians to increase the number of home visits and to encourage home care professionals to work together in the same community areas by promoting inter-professional work (IPW).

Association between level of brachial-ankle pulse wave velocity and onset of activities of daily living impairment in community-dwelling older individuals.

Aim: The purpose of the present study was to clarify the longitudinal association between brachial-ankle pulse wave velocity (baPWV) and the onset of impairment in activities of daily living (ADL) among community-dwelling individuals.

Methods: Deaths and the onsets of ADL impairment during 3 years were followed for 450 individuals without ADL impairment at entry who were aged 65 years or older (men : women 181:269; mean age 77 years). They were dichotomized on the median baPWV value at entry.

[Development of a home care educational program for community physicians and other professionals-a trial in Kashiwa City].

From May to October 2011, we conducted an 8-day homecare educational program for physicians, dentists, pharmacists, visiting nurses, long-term care managers, and hospital staff in Kashiwa city, Chiba, which was primarily intended to increase home visits by physicians. The characteristics of the program were as follows: 1) active and busy community physician participation, 2) attendance of practical training by physicians, 3) interprofessional discussion, 4) recruitment of participants from the same city, 5) recommendation of participant recruitment by a community-level professional association such as Kashiwa City Medical Association. By comparison of the pre- and post-program questionnaires completed by participants, the motivation for homecare practice, knowledge about homecare, and interactions with other professionals have increased.

[Home medical care center project for an aging society].

We have to create a new paradigm for home medical care system towards a historical increase of elderly population in Japan. Tokyo University and Chiba University have been collaborating to erect a home medical care support center in Kashiwa, Chiba prefecture. We have been constructing a support center as well as a home care doctor system, and also created a teaching course for GPs to learn a home care doctor activity.

Establishment of a microplate-formatted cell-based immunoassay for rapid analysis of nucleotide excision repair ability in human primary cells.

DNA photolesions induced by UV, cyclobutane pyrimidine dimer (CPD) and (6-4) photoproduct (6-4PP), are repaired by nucleotide excision repair (NER) in human cells. Various immunoassays using monoclonal antibodies specific for the photolesions have been developed and widely used for the analysis of cellular NER activity. In this study, we have newly developed a microplate-formatted cell-based immunoassay, based on indirect immunofluorescence staining with lesion-specific antibodies combined with an infrared imaging system.

Interactions of household composition and required care level with functional and cognitive status among disabled Japanese elderly living in a suburban apartment complex.

Aim: In the forthcoming super-aging society, the appropriate assessment of functional and cognitive conditions of disabled elderly people will become increasingly significant in providing care services. Care level and household composition would be key factors to assess function. There might also be an interaction between the two factors with the function.

Turbulent left-to-right shunt flow through the interatrial septum suggesting high left atrial pressure in patients with heart failure with preserved ejection fraction.

Lutembacher's syndrome is a combination of interatrial septal (IAS) defect or patent foramen ovale (PFO), associated with mitral stenosis. High left atrial (LA) pressure in mitral stenosis exaggerates left-to-right shunt in patients with interatrial communication. We present a case of heart failure with preserved ejection fraction.

Abdominal visceral fat thickness measured by ultrasonography predicts the presence and severity of coronary artery disease.

Abdominal visceral fat plays a critical role in the pathogenesis of metabolic syndrome, which is a risk factor for coronary artery disease (CAD). Ultrasonography (US) distinctively quantifies visceral fat and subcutaneous fat. We measured the maximum preperitoneal visceral fat thickness (Vmax) and the minimum subcutaneous fat thickness (Smin) by US in 185 patients who underwent coronary angiography.

Association between brachial-ankle pulse wave velocity and 3-year mortality in community-dwelling older adults.

With aging, arterial stiffness increases and results in cardiovascular diseases. Recently, high brachial-ankle pulse wave velocity (baPWV), measured using a new noninvasive device to estimate arterial stiffness, was reported to be associated with the prevalence of cardiovascular diseases. The purpose of this study was to clarify the association between baPWV with 3-year mortality in community-dwelling older adults and to determine the cutoff value of baPWV in terms of mortality.

Plasma adiponectin levels and left ventricular remodeling in hypertrophic cardiomyopathy.

Adiponectin, which is an adipose-derived protein with antiatherosclerogenic activities, has been reported to be elevated in patients with heart failure. However, there are no reports on the significance of adiponectin in patients with hypertrophic cardiomyopathy (HCM). The purpose of this study was to elucidate the clinical significance of plasma adiponectin levels in HCM patients.

3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors prevent the progression of renal dysfunction in Japanese hypertensive patients.

Aim: The aim was to determine whether the use of statins prevents the progression of chronic kidney disease (CKD) in hypertensive patients.

Methods: We retrospectively reviewed data obtained from hypertensive patients, and subjects with diabetes mellitus and those undergoing hemodialysis were excluded. At total of 227 patients were enrolled (83 men, mean age 73 years) and 90% of the patients were of CKD stage 2 or 3.

Hypertrophic cardiomyopathy in the elderly.

Hypertrophic cardiomyopathy (HCM) is a relatively common genetic cardiac disorder with heterogeneous morphological, functional and clinical features. Although the risk of sudden death and incapacitating symptoms in young patients has been focused upon, the disease has been found with increasing frequency in elderly patients. However, there have been few studies on clinical features of HCM in the elderly.

Clinical profiles of hypertrophic cardiomyopathy with apical phenotype--comparison of pure-apical form and distal-dominant form.

Background: Hypertrophic cardiomyopathy (HCM) with an apical phenotype, in which hypertrophy of the myocardium predominantly involves the apex of the left ventricle, is not uncommon in Japan, but its morphologic variations are not well recognized. The aim of this study was to investigate if these variations have different clinical characteristics although they are still confused to be the same.

Methods And Results: Patients with the apical phenotype were divided into 2 groups, the "pure-apical" form and the "distal-dominant" form, and their clinical profiles were compared.

B-type natriuretic peptide is predictive of hospitalization in community-dwelling elderly without heart diseases.

Aim: To examine prospectively the relationship between plasma B-type natriuretic peptide (BNP) levels in community-dwelling elderly and their hospitalization.

Methods: A total number of 644 subjects aged 65 years or older were recruited from the annual community health examinations. Those with a history of stroke or neurological findings were not included.

[Severe pulmonary hypertension and congestive heart failure in an elderly patient with Basedow's disease].

An 83-year-old woman was admitted to our hospital with dyspnea. A chest X-ray showed cardiomegaly and pulmonary congestion. An echocardiogram revealed severe tricuspid regurgitation and markedly elevated transtricuspid pressure gradient of 103 mmHg.

Four blood pressure indexes and the risk of stroke and myocardial infarction in Japanese men and women: a meta-analysis of 16 cohort studies.

Background: Information has been sparse on the comparison of 4 blood pressure (BP) indexes (systolic BP [SBP], diastolic BP, pulse pressure, and mean BP [MBP]) in relation to long-term incidence of stroke and myocardial infarction, particularly in middle-aged and older Asians.

Methods And Results: The Japan Arteriosclerosis Longitudinal Study Group conducted a meta-analysis of 16 cohort studies in Japan. A total of 48,224 men and women 40 to 89 years of age participated at baseline, and 1231 stroke events and 220 myocardial infarction events occurred during an average 8.

Improvement in prognosis of dilated cardiomyopathy in the elderly over the past 20 years.

Background And Purpose: Although dilated cardiomyopathy (DCM) had a poor prognosis in the past, recent studies have shown better survival. However, little is known about the improvement of prognosis in the elderly. This study sought to clarify the changes in prognosis in elderly patients with DCM over the past 20 years.

Hypertrophic cardiomyopathy with mild left ventricular remodeling: echocardiographic assessment using left ventricular wall motion score.

Objectives: The present study sought to investigate the echocardiographic features of hypertrophic cardiomyopathy (HCM) with mild left ventricular (LV) remodeling, particularly in relation to wall motion abnormalities.

Methods: Among the 137 consecutive patients with HCM, 13 patients (mean age 52 +/- 13 years) who progressed to mild LV systolic dysfunction (LV ejection fraction (LVEF) of 35-50%) were studied. By reviewing the echocardiograms of these patients, wall motion score index (WMSI) was scored using 16 segments model.