Poor tolerance of beta-blockers by elderly patients with heart failure

Despite the well-understood importance of beta-blocker therapy in heart failure, it is sometimes not possible to use beta-blockers in elderly patients due to poor tolerance. In this report, we describe the case of an 83-year-old patient with severe systolic heart failure complicated by aortic valve stenosis and atrial fibrillation. A simple therapeutic approach involving discontinuation of beta-blockers remarkably alleviated the symptoms such as left ventricular ejection fraction, and improved the chest radiography and laboratory findings; further, atrial fibrillation converted to sinus rhythm. It is important to carefully administer beta-blocker therapy to elderly patients with heart failure, especially after considering cardiac output

A Case of Pancreatic Carcinoma with Bilateral Hilar 18F-FDG and 67Ga Hyperaccumulation

Article信州医学雑誌 66(2): 151-155(2018)journal articl

Selective loss of GABAB receptors in orexin/hypocretin-producing neurons results in disrupted sleep/wakefulness architecture

We generated mice with a selective loss of GABAB receptors in orexin neurons. Orexin neurons in these GABAB1<sup>-/-(orexin)</sup> mice showed reduced responsiveness to GABA<sub>A</sub> receptor agonists due to a compensatory increase in GABAA receptor-mediated inhibition. This increased GABA<sub>A</sub> receptor-mediated inhibition of orexin neurons is due to orexin-1 receptor-mediated activation of local GABAergic interneurons. Surprisingly, orexin neurons were also less responsive to glutamate, apparently because the augmented GABA<sub>A</sub> receptor-mediated inhibition increases the membrane conductance and shunts excitatory currents. These observations indicate that absence of GABA<sub>B</sub> receptors decreases the sensitivity of orexin neurons to both excitatory and inhibitory inputs. GABAB1<sup>-/-(orexin)</sup>mice exhibited severe fragmentation of sleep/wake states during both the light and dark periods without affecting total sleep time or inducing cataplexy, indicating that GABA<sub>B</sub> receptors are crucial regulators of orexin neurons and that "fine tuning" of orexin neurons by inhibitory and excitatory inputs is important for the stability of sleep/waking states

Monitoring Observations of the Jupiter-Family Comet 17P/Holmes during 2014 Perihelion Passage

We performed a monitoring observation of a Jupiter-Family comet, 17P/Holmes, during its 2014 perihelion passage to investigate its secular change in activity. The comet has drawn the attention of astronomers since its historic outburst in 2007, and this occasion was its first perihelion passage since then. We analyzed the obtained data using aperture photometry package and derived the Afrho parameter, a proxy for the dust production rate. We found that Afrho showed asymmetric properties with respect to the perihelion passage: it increased moderately from 100 cm at the heliocentric distance r_h=2.6-3.1 AU to a maximal value of 185 cm at r_h = 2.2 AU (near the perihelion) during the inbound orbit, while dropping rapidly to 35 cm at r_h = 3.2 AU during the outbound orbit. We applied a model for characterizing dust production rates as a function of r_h and found that the fractional active area of the cometary nucleus had dropped from 20%-40% in 2008-2011 (around the aphelion) to 0.1%-0.3% in 2014-2015 (around the perihelion). This result suggests that a dust mantle would have developed rapidly in only one orbital revolution around the sun. Although a minor eruption was observed on UT 2015 January 26 at r_h = 3.0 AU, the areas excavated by the 2007 outburst would be covered with a layer of dust (<~ 10 cm depth) which would be enough to insulate the subsurface ice and to keep the nucleus in a state of low activity.Comment: 25 pages, 6 figures, 2 tables, ApJ accepted on December 29, 201

Quadrupolar Susceptibility and Magnetic Phase Diagram of PrNi2_2Cd20_{20} with Non-Kramers Doublet Ground State

In this study, ultrasonic measurements were performed on a single crystal of cubic PrNi$_2$Cd$_{20}$, down to a temperature of 0.02 K, to investigate the crystalline electric field ground state and search for possible phase transitions at low temperatures. The elastic constant $(C_{11}-C_{12})/2$, which is related to the $\Gamma_3$-symmetry quadrupolar response, exhibits the Curie-type softening at temperatures below $\sim$30 K, which indicates that the present system has a $\Gamma_3$ non-Kramers doublet ground state. A leveling-off of the elastic response appears below $\sim$0.1 K toward the lowest temperatures, which implies the presence of level splitting owing to a long-range order in a finite-volume fraction associated with $\Gamma_3$-symmetry multipoles. A magnetic field-temperature phase diagram of the present compound is constructed up to 28 T for $H \parallel$ [110]. A clear acoustic de Haas-van Alphen signal and a possible magnetic-field-induced phase transition at $H \sim$26 T are also detected by high-magnetic-field measurements.Comment: 13 pages, 7 figure

Dust from Comet 209P/LINEAR during its 2014 Return: Parent Body of a New Meteor Shower, the May Camelopardalids

We report a new observation of the Jupiter-family comet 209P/LINEAR during its 2014 return. The comet is recognized as a dust source of a new meteor shower, the May Camelopardalids. 209P/LINEAR was apparently inactive at a heliocentric distance rh = 1.6 au and showed weak activity at rh < 1.4 au. We found an active region of <0.001% of the entire nuclear surface during the comet's dormant phase. An edge-on image suggests that particles up to 1 cm in size (with an uncertainty of factor 3-5) were ejected following a differential power-law size distribution with index q=-3.25+-0.10. We derived a mass loss rate of 2-10 kg/s during the active phase and a total mass of ~5x10^7 kg during the 2014 return. The ejection terminal velocity of millimeter- to centimeter-sized particles was 1-4 m/s, which is comparable to the escape velocity from the nucleus (1.4 m/s). These results imply that such large meteoric particles marginally escaped from the highly dormant comet nucleus via the gas drag force only within a few months of the perihelion passage.Comment: 18 pages, 4 figures, accepted on 2014 December 11 for publication in the Astrophysical Journal Letter