Background: Arterial stiffness is used as an index of arteriosclerosis. The goal of this study was to clarify whether increased arterial stiffness, evaluated by measuring the brachial-ankle pulse wave velocity (baPWV), is a risk factor for the prognosis of heart failure (HF) patients. Methods and Results: After examination of the baPWV, as well as the levels of neurohumoral factors, the 72 enrolled HF patients were followed up for a survival study, which had a primary endpoint of re-admission because of HF. The secondary endpoint was cardiac death. Results of Cox proportional hazards modeling revealed that baPWV, systolic blood pressure (BP) and brain natriuretic peptide level were factors that affected survival (P<0.05). The patients were divided into 2 groups according to the cutoff baPWV value (1,750 cm/s). Although hemodynamic factors were similar between the groups, the high-baPWV group had a lower event-free survival rate for the primary and secondary endpoints than the low-baPWV group (P<0.05). BP at re-admission was higher in the high-baPWV group (174±30 mmHg) than in the low-baPWV group (121±33 mmHg, P<0.01). Conclusions: Elevated arterial stiffness is a risk factor for re-admission or cardiac death of HF patients. (Circ J 2009; 73: 673 -680)

Amphiphilic random copolymers comprising different hydrophilic poly­(ethylene glycol) (PEG, average number of oxyethylene units = 4.5 or 8.5) and hydrophobic butyl or dodecyl pendants were designed to investigate self-folding and self-assembly behavior in water. The copolymers with controlled composition and chain length were synthesized by ruthenium-catalyzed living radical copolymerization. We revealed that the pendant design was one of the most critical factors to selectively induce intramolecular self-folding or intermolecular self-assembly. In the case of 30 mol % hydrophobic monomers, random copolymers bearing short PEG (on average 4.5 oxyethylene units) and butyl pendants intramolecularly self-folded into unimer micelles in water, independent of chain length. The size of unimer micelles thus increased with increasing chain length. In contrast, random copolymers bearing long dodecyl pendants intermolecularly self-assembled into uniform multichain micelles; the size depended on composition and PEG length. Additionally, the polymer micelles showed thermoresponsive solubility in water. The cloud point temperature was effectively controlled by the pendant structure, composition, and chain length.

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PFAPA syndrome is a clinical entity of unknown etiology characterized by periodic episodes of high fever accompanied by aphthous stomatitis, pharyngitis/tonsillitis, and cervical adenitis [3,5]. Since specific laboratory abnormalities for the PFAPA syndrome are inexistent, it is usually diagnosed clinically after excluding other probable causes of the fever, such as infection [1]. In PFAPA patients, discriminating between a fever attack due to bacterial infection and a fever attack due to noninfectious inflammation constitutes a major difficulty. Because procalcitonin, a propeptide of calcitonin, is reported to be a sensitive marker of systemic bacterial infection [2, 4], we followed peripheral leukocyte counts, CRP values and procalcitonin concentrations during the fever attacks associated with PFAPA syndrome in the hope of defining reliable criteria for its diagnosis. We determined serum procalcitonin concentrations in six PFAPA syndrome patients (two males and four females) with a median age of 7.5 (range 3-10) years and in 32 controls (bacterial, n=10 and non-bacterial, n=22). Sampling was performed on the third to fifth day of fever. In the PFAPA syndrome patients, febrile episodes started at the median age of 2.5 (range 1-7) years with each episode lasting 5-7 days and recurring every 3-4 weeks. The ethical committees of our institutes approved the study protocol and the guardians of all the patients gave their informed consent. Serum procalcitonin concentrations were measured by using the fully automated enzyme immunoluminescent assay (Wako Pure Chemical Industries, Ltd.), which employs katacalcin monoclonal antibody and calcitonin polyclonal antibody labeled with peroxidase for SphereLight 180 (Olympus Corporation). The detection limit was 0.1 ng/ml and the normal reference was set at <0.5 ng/ml. In PFAPA patients, the correlations between procalcitonin, CRP values and leukocyte counts were examined over 13 febrile episodes. Serum procalcitonin values ranged from 0.20 to 11.36 (median value 1.05) ng/ml in positive control subjects (Table 1), while all the negative controls had undetectable levels.During febrile episodes in PFAPA patients, which were confirmed not to be due to adenoviral or group A streptococcal infections, leukocyte counts and serum concentrations of CRP were invariably and significantly Eur J Pediatr (2007) 166:621-622

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