Functional analysis of a mutation in the SLCO1B1 gene (c.1628T>G) identified in a Japanese patient with pravastatin-induced myopathy.

In the present study, we analyzed the function of a novel mutation (c.1628T>G, p.Leu543Trp) in the solute carrier organic anion transporter (SLCO) 1B1 gene, encoding organic anion transporting polypeptide (OATP) 1B1, which was identified in a patient with pravastatin-induced myopathy. OATP1B1 variants carrying the mutation (OATP1B1*1a+c.1628T>G or *1b+c.1628T>G) showed a reduced transporting activity toward typical substrates and pravastatin compared with the activity of the references (OATP1B1*1a or *1b). This was due to reduction in V(max) values of the variants, not due to change in their K(m) values. OATP1B1*1b+c.1628T>G was normally expressed on the plasma membrane of HEK293 cells at the same level as that of OATP1B1*1b. Taken together, our results suggest that the mutation c.1628T>G (p.Leu543Trp) reduced the function of OATP1B1 probably due to decrease in turnover rate of one OATP1B1 molecule rather than impairment of protein sorting to the plasma membrane.

Formation of gastrocolic fistula during treatment for peptic ulcer.

We report a case of gastrocolic fistula (GCF) caused by a gastric ulcer and rare endoscopic findings indicating the early stages of GCF formation. The patient was a 58-year-old man who was hospitalized with upper abdominal pain. He was diagnosed as having a gastric ulcer, and was prescribed a proton pump inhibitor (PPI), but did not comply with the medication. One year later, he was again referred with recurrent abdominal pain. Endoscopic examination showed what appeared to be a portion of exposed colonic wall located in the center of an active gastric ulcer, and repeated endoscopy after PPI treatment for 8 days demonstrated a typical GCF. A preoperative diagnosis of GCF was made, and the patient underwent wide gastrectomy with partial resection of the transverse colon.

Novel mechanism for hair shine with special optical enhancement effect on blonde hair.

Compared with dark or brunette hair, blonde hair has different characteristic features of appearance such as bright shine with a soft tonal color. In this report, novel optical mechanisms of the characteristic blonde hair appearance are reported. Optical analyses of goniophotometric measurements were carried out to elucidate the mechanisms of strong reflections observed in blonde hairs. As a result, reflections with much higher intensity than those from the front surface of a fiber were confirmed to play important roles in the case of blonde hair fibers, and the intensities were found to vary with the cross-sectional shape of a fiber, the ellipticity (= minor axis/major axis). From light path simulation analyses, these strong reflections were verified to result from total reflection from the back surface of a fiber. Furthermore, since each hair fiber acts as a lens and/or a reflector, intricate reflection behaviors are suggested to occur as a consequence of the combination of light condensation and total reflection.

Changes in structure and geometric properties of human hair by aging.

To clarify hair changes by aging, the effect of age on hair properties was investigated from macro- to microscopic view points. Sensory hair luster tests were performed on 230 Japanese females from 10 to 70 years of age, revealing that hair luster decreases with age. The age dependence of the hair diameter and the ellipticity of the hair cross section could not explain luster reduction by aging. It has been determined that an irregular increase in fiber curvature occurs with age and is a cause of luster reduction with aging. A detailed structural analysis by synchrotron radiation microbeam X-ray diffraction revealed that the inhomogeneity in the lateral distribution of the hair microstructure increased with age and relates to the irregular increase in curvature. Such an increase in curvature is one of the important factors that leads to a poor alignment of hairs and luster reduction, and is related to the appearance of aging hair.

Characterization of curved hair of Japanese women with reference to internal structures and amino acid composition.

The variation of hair curvature in Japanese women was quantitatively investigated and the structure of curved hair was characterized with transmission electron microscopy (TEM) and amino acid analysis. Two hundred and thirty Japanese women volunteers, aged from 10 to 70 years, were randomly selected. The evaluation of the volunteers' natural hair shape showed that 53% of Japanese women have straight hair, while the remaining 47% have curved hair (varying from a slightly wavy shape to a frizzy style). The average curl radius of the volunteers' hair was determined to be 4.4 +/- 2.3 cm, and ranged widely from 0.6 to 16 cm. The TEM observation of curved hair fiber revealed an inhomogenous internal structure between the outer and inner regions of the curved shape. In relation to the inhomogeneous structure of the curved hair, different amino acid composition of the hair keratin was observed between the outer and inner regions. Interestingly, these results of the TEM observation and the amino acid analysis are analogous to the difference between the ortho- and paracortical cells in wool fibers, suggesting the universal structure of curved mammalian hair.

Formation of nanostructure on hair surface: its characteristic optical properties and application to hair care products.

Uneven structures on hair fiber surface, such as lift up of cuticle or build up of hair spray ingredients, generally cause a diffuse reflection which results in a dull and unhealthy appearance. However, in the case of finer structure than wavelength of visible light, the optical properties change significantly. An application of the phenomenon to hair care products is reported in this paper. Formation of the fine structure on hair surface was achieved by only a shampoo and rinse-off conditioner system including amino-silicone. Chroma enhancement of hair and light introduction into hair fibers were observed simultaneously with formation of the fine structure on the hair surface. The light introduction phenomenon is understood in terms of "Effective Medium Approximation" (EMA). The simulation study based on EMA indicates that a very low refractive index surface is expected to be realized, which well explains the optical experimental results. When the shampoo and conditioner system developed to form the structure on fiber surface was applied to dyed hair, enhancement and long-lasting of vivid appearance was confirmed in spite of dye elution.

Rationale and design of ASSAF-K (A study of the safety and efficacy of anticoagulant therapy in the treatment of atrial fibrillation in Kanagawa).

BACKGROUND: Atrial fibrillation (AF) is one of the most prevalent cardiac arrhythmias associated with substantially increased risks of ischemic stroke and thromboembolism. Oral anticoagulants (OACs) are the cornerstone of AF management and effectively prevent AF-related stroke. As new non-vitamin K antagonist OACs (NOACs) have become available, the landscape of stroke prevention in AF has changed. However, there are considerable gaps between daily clinical practice and current guideline-based recommendations for anticoagulant therapy in Japan. Consequently, little is known about the real-world setting and the current use of NOACs, especially by practitioners in Japan. METHODS: We conducted a prospective, observational study in 3847 patients with AF who were enrolled in clinics and hospitals located in Kanagawa Prefecture from September 2013 through March 2015. The participating centers included practitioners (small clinics), medium-sized hospitals, and university hospitals. The primary endpoints were epidemiologic characteristics, status of treatment with anticoagulants and antiplatelet agents, outcomes, and adverse events, including cerebrovascular disease, bleeding, and death. RESULTS: The mean CHADS2 score was 1.81±1.27, the mean CHADS2-Vasc score was 3.02±1.58, and the mean HAS-BLED score was 2.23±1.06, respectively. The usage rate of warfarin was 44.2% overall, and the usage rate of NOACs was 33.5%. CONCLUSIONS: The results of the study are expected to serve as the basis for providing clinical practice guidance to healthcare institutions in Japan, with the ultimate goals of better characterizing the appropriate use of OACs and providing clinical decision support to physicians to facilitate the design of appropriate therapeutic strategies and the selection of anticoagulants for the management of AF.

Does massive intraabdominal free gas require surgical intervention?

We describe a rare case of an 81-year-old man who presented with severe epigastralgia. A chest radiograph showed massive free gas bilaterally in the diaphragmatic spaces. Computed tomography (CT) scan also showed massive free gas in the peritoneal cavity with portal venous gas. We used a wait-and-see approach and carefully considered surgery again when the time was appropriate. The patient received conservative therapy with fasting, an intravenous infusion of antibiotics, and nasogastric intubation. The patient soon recovered and was able to start eating meals 4 d after treatment; thus, surgical intervention was avoided. Thereafter, colonoscopy examination showed pneumatosis cystoides intestinalis in the ascending colon. On retrospective review, CT scan demonstrated sporadic air-filled cysts in the ascending colon. The present case taught us a lesson: the presence of massive intraabdominal free gas with portal venous gas does not necessarily require surgical intervention. Pneumatosis cystoides intestinalis should be considered as a potential causative factor of free gas with portal venous gas when making the differential diagnosis.

Repeated Duodenal Stump Perforation Using a Stapling Device Following Subtotal Gastrectomy With Roux-en-Y Reconstruction for Advanced Gastric Cancer: Lessons From a Rare Case.

Closure of the duodenal stump using a stapling device is commonly applied in Roux-en-Y reconstruction after gastrectomy. However, serious and possibly fatal duodenal stump perforation can develop in extremely rare cases. We describe a case of subtotal gastrectomy with Roux-en-Y reconstruction followed by repeated duodenal stump perforations. A 79-year-old man with a long history of diabetes and hypertension was admitted to our institution with epigastralgia and right hypochondralgia. Computed tomography and an upper gastrointestinal imaging series revealed remarkable wall thickening of the gastric antrum and corpus. Upper endoscopy also showed a giant ulcerative lesion in the same area. The lesion was confirmed by histology to be poorly differentiated adenocarcinoma. The patient underwent open subtotal gastrectomy with Roux-en-Y reconstruction. However, duodenal stump perforation occurred repeatedly on postoperative days 1, 3, and 19, which caused peritonitis. The patient was kept alive through duodenal stump repair, an additional resection using a stapling device, and repeated drainage treatments; but he suffered considerable morbidity due to these complications. We report a case of a life-threatening duodenal stump perforation after subtotal gastrectomy, highlighting lessons learned from the profile and clinical course. Abdominal surgeons should be aware of the possibility of this serious complication of duodenal stump perforation, and be able to perform immediate interventions, including life-saving reoperation.

Influence of internal structure of hair fiber on hair appearance. II. Consideration of the visual perception mechanism of hair appearance.

The optical properties of hair fibers were studied, focusing on the reflections (highlights) from both the front and the back surfaces of the fiber in consideration and on the effect these have on the perceptions of hair appearance. The two reflections are distinguished from each other by sight, because only the back surface reflection is colored by melanin granules and/or dyestuffs inside the fiber. When we observe a flat plate as a model for hair without a cuticle structure, the visual angle between the two light loci correlates with the thickness of the model plate and gives an impression of depth. In the case of hair with a cuticle angle, the visual angle is maintained even when the fiber thickness is reduced. This visual angle causes an overestimation of the thickness and enhances the impression of depth. The visual angle changes dramatically with a curl curvature change of the hair tress, meaning that the impression of depth is also dynamically changed by a small change in hairstyle. The dynamic change in the impression of depth probably causes a vibrant impression. The following are required for beautiful hair appearance along with an impression of depth and vibrancy: (a). Internal structure without light scattering origins is essential to observe vivid colored highlights from the back surface. (b). Well-ordered cuticles are essential to get intensive double highlights from the front and back surfaces. (c). A properly curved hairstyle is essential to obtaining a more vibrant impression.

Influence of internal structures of hair fiber on hair appearance. I. Light scattering from the porous structure of the medulla of human hair.

In this study the influence of the medulla structure on hair appearance was examined. Hair with a porous medulla gave a whitish and lusterless appearance because of light scattering from the fiber center, whereas in the cases without pores, a clear and brilliant appearance was observed. The optical influences of the medulla pores were measured by a spectral goniophotometer, and obtained data were analyzed in terms of the CIE L*a*b* color system. Both contrasts in lightness and apparent color (chroma and hue) decreased in the hair with medulla pores, and the decreases in contrast caused a whitish and lusterless appearance. The distribution of the amount of medulla pores was investigated for Japanese females. The histogram was further analyzed by hair care behavior of individual panelists, and it was found that the pores in the medulla can be generated in a heat-drying process.

Influence of internal structures of hair fiber on hair appearance. III. Generation of light-scattering factors in hair cuticles and the influence on hair shine.

The effects of thermal treatments on hair fiber induced by blow-drying have been investigated. It was found that the hair shows whitish and powdery appearance after heat drying, especially when dark hair is rapidly dried from a wet condition. For all kinds of hair, the appearance of numerous glittering speckles was confirmed on the cuticle surface by optical microscopic observations. SEM images of hair transverse and longitudinal sections with glittering speckles revealed that the splitting of cuticle layers generated by blow-drying occurred not only at the outermost parts of cuticle cells but also at the inner parts of the cellular interfaces. The release and uptake of moisture through fiber surfaces induces deformation of cuticle cells, probably because of anisotropic swelling or drying of the cells. The cuticles with glittering speckles are found to be fragile and are easily damaged in combination with other mechanical stresses such as combing force. Furthermore, the authors have found an efficient system for both improving hair shine and preventing cuticle damage caused by the blow-drying/combing process.

Effect of nifekalant for acute conversion of atrial flutter: the possible termination mechanism of typical atrial flutter.

BACKGROUND: Nifekalant is a class III antiarrhythmic drug, which is usually used for suppression of ventricular tachycardia (VT) and fibrillation. We studied the efficacy of nifekalant for acute conversion of atrial flutter (AFL) in a prospective, open label study in the intensive care unit (ICU) of cardiovascular medicine. METHODS: This study consisted of 31 patients. Twenty-six patients (84%) suffered from structural heart diseases. AFL was developed in 15 patients (48%) while on antiarrhythmic therapy with class IA or IC drugs (I-AFL group) for suppressing atrial fibrillation (AF) and in the remaining patients without such drugs (S-AFL group). Patients with prolonged QT interval, hypokalemia were excluded. All patients received one dose of 0.3 mg/kg of nifekalant over 10 minutes under continuous ambulatory monitoring. Four patients with common AFL in each group received nifekalant during electrophysiologic (EP) study. RESULTS: Nifekalant had an overall AFL conversion efficacy of 77.4% within 60 minutes. Eleven patients in S-AFL group (68.8%) and 13 patients in I-AFL group (86.7%) could be converted with mean conversion times of 10.8 +/- 6.2 and 15.0 +/- 8.0 minutes, respectively (n.s.). Conversion rate was significantly higher in patients with a short duration of arrhythmia. The two modes of AFL termination were mainly demonstrated and the preferential mode significantly differed between the two groups. One patient in each group with excessive QT prolongation (6.5%) developed torsade de pointes (TdP), requiring electrical shock in one patient (3.3%). CONCLUSIONS: Nifekalant can be used for conversion of AFL with a potent efficacy even in patients with structural heart diseases. However, caution should be required for developing TdP.

A head-to-head isomer of di-mu-pivalamidato-kappa4N,O-bis[(1,10-phenanthroline-kappa2N,N')platinum(II)] dinitrate dihydrate.

In the title compound, [Pt(2)(C(5)H(10)NO)(2)(C(12)H(8)N(2))(2)](NO(3))(2)*-2H(2)O, the intradimer Pt-Pt distance is relatively short [2.8489 (17) A], which must be due to the strong intramolecular pi-pi-stacking interactions between the phenanthroline moieties. The dimers stack along the c axis, forming one-dimensional columns in which very intriguing d-d, pi-pi and d-pi interactions exist. Although the dimer-dimer Pt...Pt distances are very long [4.340 (2) and 4.231 (2) A], some short interdimer Pt...C contacts leading to strong interdimer associations are found [3.325 (19) and 3.402 (19) A].