Hydrogen sulfide (H(2)S) has been established as the third gaseous signaling molecule following nitric oxide and carbon monoxide and participates in a variety of cellular functions such as modulation ...of neuronal transmission, endothelium-dependent vasorelaxation, stimulation of angiogenesis and regulation of insulin release. Although cystathionine β-synthase and cystathionine γ-lyase have been regarded as the main producers of H(2)S in many tissues including brain, liver and kidney, Kimura and his colleagues have recently communicated that 3-mercaptopyruvate sulphurtransferase coupled with cysteine (aspartate) aminotransferase is responsible for the production of H(2)S in the vascular endothelium of the thoracic aorta Shibuya et al. (2009) J. Biochem. 146, 623-626. This finding provides a new insight into the production of the physiologically important signaling molecule.
We demonstrate a robust 3-dB directional coupler which has a narrow silicon wire core and a wide gap. Sensitivity to the gap variation is decreased to one tenth that of a conventional directional ...coupler. Better spectral stability due to the enhanced robustness to waveguide geometrical fluctuations was experimentally verified.
We present a polarization-diversity 4 Formula Omitted 4 optical switch composed of silicon-wire waveguides. The proposed 4 Formula Omitted 4 switch does not require a polarization rotator, which ...enforces a modification in a standard complementary metal-oxide-semiconductor (CMOS) process to achieve vertical asymmetry. The switch is fabricated on a 300-mm silicon-on-insulator (SOI) wafer with argon fluoride (ArF) immersion lithography, and its footprint is 2.1 mm Formula Omitted 1.1 mm. The switch exhibited a 12.5-dB on-chip loss, a 1.9-dB polarization-dependent loss, and an approximately 5-ps differential group delay.
We propose a tracking algorithm based on the steepest descent method for adaptive polarization-mode-dispersion (PMD) compensation. Transmission simulations at 160 Gb/s are conducted under the ...condition that the PMD fluctuates with a sequential random state of polarization change at a rate of 0.13 rad per 4 ms on average. The results show that our algorithm can successfully compensate PMD variations at speeds where a conventional hill-climbing-based tracking algorithm cannot maintain effective PMD compensation.
Presented is a parametric tunable dispersion compensation (PTDC) for 43 Gbit/s WDM channels with mixed modulation formats of OOK and QPSK. The residual dispersion for the OOK channels is successfully ...compensated for, while the QPSK channels with digital coherent detection maintain a good signal quality regardless of various settings of PTDC that involve nonlinear processes of wavelength conversion based on four-wave mixing. Specific design issues on PTDC are discussed, considering the characteristics of the modulation formats of the received channels.
Implementation of appropriate oral anticoagulant treatment for the prevention of stroke in very elderly patients with atrial fibrillation is challenging because of concerns regarding bleeding.
We ...conducted a phase 3, multicenter, randomized, double-blind, placebo-controlled, event-driven trial to compare a once-daily 15-mg dose of edoxaban with placebo in elderly Japanese patients (≥80 years of age) with nonvalvular atrial fibrillation who were not considered to be appropriate candidates for oral anticoagulant therapy at doses approved for stroke prevention. The primary efficacy end point was the composite of stroke or systemic embolism, and the primary safety end point was major bleeding according to the definition of the International Society on Thrombosis and Haemostasis.
A total of 984 patients were randomly assigned in a 1:1 ratio to receive a daily dose of 15 mg of edoxaban (492 patients) or placebo (492 patients). A total of 681 patients completed the trial, and 303 discontinued (158 withdrew, 135 died, and 10 had other reasons); the numbers of patients who discontinued the trial were similar in the two groups. The annualized rate of stroke or systemic embolism was 2.3% in the edoxaban group and 6.7% in the placebo group (hazard ratio, 0.34; 95% confidence interval CI, 0.19 to 0.61; P<0.001), and the annualized rate of major bleeding was 3.3% in the edoxaban group and 1.8% in the placebo group (hazard ratio, 1.87; 95% CI, 0.90 to 3.89; P = 0.09). There were substantially more events of gastrointestinal bleeding in the edoxaban group than in the placebo group. There was no substantial between-group difference in death from any cause (9.9% in the edoxaban group and 10.2% in the placebo group; hazard ratio, 0.97; 95% CI, 0.69 to 1.36).
In very elderly Japanese patients with nonvalvular atrial fibrillation who were not appropriate candidates for standard doses of oral anticoagulants, a once-daily 15-mg dose of edoxaban was superior to placebo in preventing stroke or systemic embolism and did not result in a significantly higher incidence of major bleeding than placebo. (Funded by Daiichi Sankyo; ELDERCARE-AF ClinicalTrials.gov number, NCT02801669.).
Cardiac involvement and pulmonary hypertension (PH) are life-threatening complications in sarcoidosis.
This study aimed to investigate the utility of plasma NT-proBNP in the assessment of these ...conditions in sarcoidosis patients.
A prospective, observational study was performed on 150 consecutive Japanese sarcoidosis patients. Doppler echocardiography was performed in all subjects, and those who were successfully evaluated for PH status were included in the analysis. Cardiac sarcoidosis was diagnosed based on Japanese guidelines, and PH was defined as estimated systolic pulmonary artery pressure (sPAP) > or = 35 mmHg. The diagnostic accuracy of NT-proBNP according to the presence of cardiac sarcoidosis and PH was assessed based on receiver-operator characteristic (ROC) curves.
130 subjects were successfully evaluated for PH status. Of these, 29 met the diagnostic criteria of cardiac sarcoidosis, and 21 were diagnosed with PH. Plasma NT-proBNP levels were significantly higher in patients with cardiac sarcoidosis (p < 0.0001). Stepwise regression analysis showed that presence of cardiac sarcoidosis, decreased ejection fraction and increased sPAP were all independently associated with higher plasma NT-proBNP levels. Plasma NT-proBNP showed good accuracy in identifying patients with cardiac sarcoidosis (area under the ROC curve; AURC = 0.913). However, even when patients with cardiac sarcoidosis were excluded, plasma NT-proBNP levels could not be used reliably to identify patients with PH (AURC = 0.681).
In patients with sarcoidosis, plasma NT-proBNP levels are a useful biomarker to identify cardiac involvement, but not to identify PH.
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