The dynamics in polymeric systems affect various important properties including mechanical and thermal behaviors, and extensive studies in this field have been executed not only academically but also ...practically ....
First performed in the early 1950s in children with a large left-to-right shunt or single ventricle and excessive pulmonary blood flow, pulmonary artery banding (PAB) is a palliative surgery designed ...to relieve symptoms. After advances in cardiopulmonary bypass techniques in the 1980s allowed surgeons to perform corrective surgery even in infants, PAB has continued to play a palliative role in balancing the pulmonary to systemic blood flow ratio in critical situations. PAB is also used to retrain the left ventricle in patients with transposition of the great arteries to prepare them for the arterial switch procedure, either following late presentation or following prior atrial repair. Another role played by PAB is to train the left ventricle in patients with congenitally corrected transposition of the great arteries, not only for the purpose of retraining the sub-pulmonary left ventricle but also as an early prophylactic approach in newborns to avoid the severe tricuspid regurgitation sometimes associated with a morphologic right ventricle in the systemic position. Currently, PAB has two indications: 1. to reduce the pulmonary blood flow and relieve the symptoms of congestive heart failure, and 2. to train the sub-pulmonary ventricle for future corrective surgery. Recently, PAB has been successfully employed to treat children with dilated cardiomyopathy (DCM), a disease that has shown considerably increased morbidity and mortality rates and indications for heart transplantation; some of the patients thus treated have shown improved left ventricular function, allowing them to be taken off the waiting list for heart transplantation. In this paper, we review the original and current indications for PAB and explain the surgical technique and strategy. We also present a literature review of the new indications for PAB in patients with pediatric DCM, and compare outcomes in Japan with those in other countries.
Aims/Introduction
It is unclear how changes in body composition induced by sodium–glucose cotransporter 2 (SGLT2) inhibitor treatment correlate with metabolic profile changes. We aimed to clarify how ...metabolic profile changes correlate with body component changes, and if SGLT2 inhibitor treatment causes sarcopenia and bone mineral content (BMC) loss.
Materials and Methods
Moderately obese Japanese type 2 diabetes patients, treated with luseogliflozin for a year, were observed prospectively and evaluated for body composition changes. We analyzed the changes in the individual body components during treatment, and their correlation with other clinical variables.
Results
The efficacy analysis set comprised 37 of 43 enrolled patients. The total fat mass significantly decreased early in the treatment at and after week 4, with a mean decrease of −1.97 kg (95% confidence interval −2.66 to −1.28) at week 24. The visceral fat area at week 24 showed an average downward trend, although this was not significant. The changes in visceral fat area in individual patients showed a significant negative correlation with the extent of the baseline visceral fat area (r = −0.399, P = 0.023). The skeletal muscle mass index showed a significant but small change at and after week 36. The BMC profile showed a transient significant decrease only at week 12. No significant change in BMC was noted at other time‐points.
Conclusions
Luseogliflozin treatment brought about favorable changes in body composition and metabolism of moderately obese Japanese type 2 diabetes patients, accompanied by body fat reduction, and minimal muscle and BMC reduction.
Luseogliflozin treatment was found to be capable of controlling T2D with favorable changes in the body composition and metabolism accompanied by minimal muscle and BMC reduction, even in moderately obese patients. The changes in the visceral fat area at Week 24 in individual patients showed a significant negative correlation with the respective visceral fat area levels at the baseline (r = −0.457, P = 0.0085).
The anomalous dynamics and glass transition behaviors of supercooled liquids under nanoconfinement, such as ultrathin polymer films, have attracted much attention in recent decades. However, a ...complete elucidation of this mechanism has not yet been achieved. For the dynamics of bulk materials without confinement, we previously proposed a dynamically correlated network (DCN) model, which was found to agree well with the experimental data. The model assumes that segments with thermal fluctuations are dynamically correlated to their neighbors to form string-like clusters, which eventually grow into networks as temperature decreases. In this study, we applied the DCN model to nanoconfined free-standing films by using a simple cubic lattice sandwiched between two free surface layers consisting of virtual “uncorrelated” segments. The average size of DCNs at lower temperatures decreased with decreasing thickness because of confinement. This trend was associated with a decrease in the percolation temperature at which the size of DCN diverges. It was also revealed that the fractal dimension of the generated DCNs exhibits a peak with respect to temperature. The segmental relaxation time for free-standing polystyrene films was evaluated, and the predicted thickness dependence of the glass transition temperature qualitatively agreed with the experimental data. The results suggest that the concept of DCN is compatible with the dynamics of free-standing thin films.
We designed and fabricated a multi-core fiber (MCF) in which seven identical trench-assisted pure-silica cores were arranged hexagonally. To design MCF, the relation among the crosstalk, fiber ...parameters, and fiber bend was derived using a new approximation model based on the coupled-mode theory with the equivalent index model. The mean values of the statistical distributions of the crosstalk were observed to be extremely low and estimated to be less than -30 dB even after 10,000-km propagation because of the trench-assisted cores and utilization of the fiber bend. The attenuation of each core was very low for MCFs (0.175-0.181 dB/km at 1550 nm) because of the pure-silica cores. Both the crosstalk and attenuation values are the lowest achieved in MCFs.
Background: Postoperative pain management in thoracotomy patients often is difficult. Furthermore, pediatric patients present more challenges because of their inability to effectively communicate ...their pain intensity. The purpose of this study was to evaluate the use of continuous field block through intercostal muscles as postoperative pain management in pediatric thoracotomy. Methods: Between 2014 and 2018, 11 patients underwent an ASD closure using a cardiopulmonary bypass via a mini-right thoracotomy through the fourth intercostal space. At the time of chest closure, a single-shot field block via the fourth intercostal muscles was performed with levobupivacaine (0.6 mg/kg). The first five patients were only given the single-shot field block (Single group). The remaining six patients were given levobupivacaine continuously (0.1 mg/kg/hr) through an indwelling catheter until the chest tube removal (Continuous group). The groups' vital signs, total amounts of acetaminophen used, postoperative courses were compared. Results: Although the heart rate did not differ between the groups, the respiratory rate was significantly higher in the Single group versus the Continuous group at 16 and 32 hr post-surgery (35.6 ± 9.7/min vs. 18.5 ± 4.7/min; p=0.007, 43.0 ± 10.4 vs. 25.3 ± 3.1; p=0.042, respectively). The accumulated dosage of acetaminophen given by postoperative day 2 was significantly higher in the Single group versus the Continuous group (55.3 ± 22.1 mg/kg vs. 7.8 ± 17.4 mg/kg; p=0.012). Conclusions: Continuous field block via intercostal muscles after ASD closure via a mini-right thoracotomy in children was effective to stabilize the vital signs and reduce the analgesic medication use.
Immunoglobulin A (IgA) is essential for defense of the intestinal mucosa against harmful pathogens. Previous studies have shown that
, the major phylum of gut microbiota together with
, impact IgA ...production. However, the relative abundances of species of
responsible for IgA production were not well understood. In the present study, we identified some specific
species that were associated with gut IgA induction by
-based profiling of species distribution among
The levels of IgA and the expression of the gene encoding activation-induced cytidine deaminase (AID) in the large intestine lamina propria, which is crucial for class switch recombination from IgM to IgA, were increased in soluble high-fiber diet (sHFD)-fed mice. We found that
was the most abundant
species in both sHFD- and normal diet-fed mice. In addition, the gut IgA levels were associated with the relative abundance of
group species such as
,
, and
Conversely, the ratio of
to other
species was reduced in insoluble high-fiber diet fed- and no-fiber diet-fed mice. To investigate whether
increases IgA production, we generated
monoassociated mice and found increased gut IgA production and AID expression. Collectively, soluble dietary fiber increases the ratio of gut
group, such as
, and IgA production. This might improve gut immune function, thereby protecting against bowel pathogens and reducing the incidence of inflammatory bowel diseases.
Immunoglobulin A (IgA) is essential for defense of the intestinal mucosa against harmful pathogens. Gut microbiota impact IgA production, but the specific species responsible for IgA production remain largely elusive. Previous studies have shown that IgA and
, the major phyla of gut microbiota, were increased in soluble high-fiber diet-fed mice. We show here that the levels of IgA in the gut and the expression of activation-induced cytidine deaminase (AID) in the large intestine lamina propria, which is crucial for class switch recombination from IgM to IgA, were correlated with the abundance of
group species such as
,
, and
monoassociated mice increased gut IgA production and AID expression. Soluble dietary fiber may improve gut immune function, thereby protecting against bowel pathogens and reducing inflammatory bowel diseases.
TGR5, a G protein–coupled bile acid receptor, is expressed in various tissues and regulates several physiological processes. In the skeletal muscle, TGR5 activation is known to induce muscle ...hypertrophy; however, the effects on glucose and lipid metabolism are not well understood, despite the fact that the skeletal muscle plays a major role in energy metabolism. Here, we demonstrate that skeletal muscle–specific TGR5 transgenic (Tg) mice exhibit increased glucose utilization, without altering the expression of major genes related to glucose and lipid metabolism. Metabolite profiling analysis by capillary electrophoresis time-of-flight mass spectrometry showed that glycolytic flux was activated in the skeletal muscle of Tg mice, leading to an increase in glucose utilization. Upon long-term, high-fat diet challenge, blood glucose clearance was improved in Tg mice without an accompanying increase in insulin sensitivity in skeletal muscle and a reduction of body weight. Moreover, Tg mice showed improved age-associated glucose intolerance. These results strongly suggest that TGR5 ameliorated glucose metabolism disorder that is caused by diet-induced obesity and aging by enhancing the glucose metabolic capacity of the skeletal muscle. Our study demonstrates that TGR5 activation in the skeletal muscle is effective in improving glucose metabolism and may be beneficial in developing a novel strategy for the prevention or treatment of hyperglycemia.
The dermal papilla (DP) plays pivotal roles in hair follicle morphogenesis and cycling. However, characterization and/or propagation of human DPs have been unsatisfactory because of the lack of ...efficient isolation methods and the loss of innate characteristics in vitro. We hypothesized that culture conditions sustaining the intrinsic molecular signature of the human DP could facilitate expansion of functional DP cells. To test this, we first characterized the global gene expression profile of microdissected, non-cultured human DPs. We performed a 'two-step' microarray analysis to exclude the influence of unwanted contaminants in isolated DPs and successfully identified 118 human DP signature genes, including 38 genes listed in the mouse DP signature. The bioinformatics analysis of the DP gene list revealed that WNT, BMP and FGF signaling pathways were upregulated in intact DPs and addition of 6-bromoindirubin-3'-oxime, recombinant BMP2 and basic FGF to stimulate these respective signaling pathways resulted in maintained expression of in situ DP signature genes in primarily cultured human DP cells. More importantly, the exposure to these stimulants restored normally reduced DP biomarker expression in conventionally cultured DP cells. Cell growth was moderate in the newly developed culture medium. However, rapid DP cell expansion by conventional culture followed by the restoration by defined activators provided a sufficient number of DP cells that demonstrated characteristic DP activities in functional assays. The study reported here revealed previously unreported molecular mechanisms contributing to human DP properties and describes a useful technique for the investigation of human DP biology and hair follicle bioengineering.
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