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ObjectiveThe ideal vaginal environment is maintained by Lactobacillus species, which keep the vagina clean and free of infections, including sexually transmitted diseases and human papilloma virus infection. Other reported health benefits of Lactobacillus include a favorable impact on fertility and immunity, leading to a reduced risk of gynecological malignancies. Age-related decline in estrogen affects the population of Lactobacillus, leading to dominance of pathogenic flora and increased diversity in vaginal microbiota. In this study, we compared the differences between the vaginal microbiota of premenopausal and postmenopausal women. In addition, we examined the relationships between vaginal and gut microbiota, as well as their relationships to sex hormones and equol producing ability.MethodsThis was a cross-sectional study of 35 premenopausal and 35 postmenopausal women, ranging from 27 to 76 years of age. We compared parameters such as the composition of the gut and vaginal microbiota, vaginal pH, sex hormones in the blood (estradiol and follicular stimulating hormone), and urinary equol concentration.ResultsIn the vaginal microbiota of premenopausal women, Lactobacillus species constituted approximately 71.98%, and pathogenic flora constituted approximately 16.87%. They were 10.08% and 26.78%, respectively, in the vaginal microbiota of postmenopausal women. Therefore, the proportion of Lactobacillus was significantly low, whereas microbial diversity and vaginal pH were significantly high (pLactobacillus were inversely correlated with vaginal microbial diversity and vaginal pH.ConclusionPostmenopausal women had significantly low Lactobacillus and high pathogenic flora in their vaginal flora, whereas such age-related differences were not identified in gut microbiota. There were significant correlations among the bacterial species inhabiting the gut and vaginal microbiota, especially in postmenopausal women, indicating potential crosstalk between each other.

We focused on "returning to the horizontal position," one of the measures for preventing well leg compartment syndrome implemented at our hospital, and aimed to clarify the effect of intraoperative positional changes by operating table rotation on blood perfusion in the lower extremities during lithotomy in patients under general anesthesia. This prospective observational study examined 64 patients scheduled to undergo general anesthesia in the lithotomy position from March 2021 to May 2022. The primary endpoint was the perfusion index (PI) of the lower limb before and after operating table rotation. The baseline lower limb PI before the operating table rotation was 2.376 (1.591), and the lower limb PI after the change from Trendelenburg to the horizontal position was as follows: immediately after, 2.123 (1.405); 5 minutes, 1.894 (1.138); 10 minutes, 1.915 (1.167); and 15 minutes, 1.993 (1.218). Compared with the baseline, no significant difference was noted in the change in the lower limb PI due to the Trendelenburg to horizontal positional change. The baseline lower leg pressure before the operating table rotation was 51.4 (13.4) mm Hg, and the lower leg pressure after the change from the Trendelenburg to the horizontal position was as follows: immediately after, 36.6 (10.3) mm Hg; 5 minutes, 36.5 (10.2) mm Hg; 10 minutes, 36.4 (10.0) mm Hg; and 15 minutes, 36.5 (10.2) mm Hg. Compared with the baseline, the change in lower leg pressure due to the Trendelenburg to horizontal positional change showed a significant decrease immediately afterward (P .001). After operating table rotation from the Trendelenburg to the horizontal position, the lower limb PI did not change significantly after 15 min. However, lower leg pressure showed a significant decrease immediately after returning to the horizontal position. This result provides evidence for operating table rotation as a preventive measure for well leg compartment syndrome.

The chirality of spherical liquid crystal droplets was investigated in this study. We report the effect of confinement on blue phase III (BPIII) spheres. We investigated the behaviours of the spher...

Background: Efficient management of the operating room is crucial, and it necessitates accurate scheduling of surgeries. We hypothesized that it would be possible to develop an estimation formula for the preparation time of anesthesia induction surgery by incorporating not only the anesthesia factors and the surgical factors, but also “clinical department” as a factor in the estimation formula.Materials and methods: This was a retrospective observational study that analyzed 7921 scheduled surgical cases. Regression analysis using clinical department, six anesthesia factors and five surgical factors was performed to develop an analysis and an equation for estimating the time required for anesthesia induction surgery.Results: Our estimation formula wielded high accuracy (R2 = 0.808). Particularly, there was only a difference of less than 3 minutes for surgeries under general anesthesia. In addition, modeling preparation time using “medical interventions performed in the operating room” as a factor instead of patient characteristics was found to be beneficial.Conclusions: It was possible to develop a highly accurate formula for estimating preparation time of anesthesia induction surgery by analyzing the anesthesia factors and the surgical factors and incorporating the clinical department as an estimation factor.

We prepared some blue phase (BP) materials with different concentrations of reactive monomers. They exhibited a cubic blue phase (cubic BP) or blue phase III (BPIII). We obtained their polymer-stabilised cubic BP and BPIII liquid crystals using photo-polymerisation. The temperature ranges of both BPs widened with increasing monomer concentration. After removing the low-molecular-weight materials, we observed the remaining polymer networks using field-emission scanning electron microscopy (SEM). We investigated the relationship between the polymer-stabilised BP (PS-BP) temperature range and polymer network morphology. The polymer network derived from the non-stabilised PS-BPIII exhibited µm-sized pores. Increasing the monomer concentration, the BPIII temperature range widened from 13 K to more than 49 K and the pore size dramatically decreased from several µm to about 100 nm. On the other hand, periodic nanoporous structures were partially observed even for the PS-cubic BP. The nanoporous structures were spread to the whole area for the PS-cubic BP with a wide BP temperature range. Furthermore, we discuss how the polymer network stabilises BPIII.

This chapter focusses on the dynamics of interactions among multiple niche-innovations and multi-regimes that occur under the pressure of slow but structural landscape changes. The energy transition, for example, is one of the core and broad changes that fundamentally impact not only the energy system but also systems of food, agriculture, and healthcare, as well as patterns of economic activity. Little work has been done on sustainability transitions that involve multiple niche-innovations, which may interact with each other as well as with regimes. This chapter investigates the case of the city of Higashiomi, Shiga, Japan, where a community business project called the “Welfare Mall” clustered local production of food, energy, and elderly care in one shopping mall-like venue. The project is ongoing as of this writing. This chapter focuses on the common struggles and challenges of regimes in different domains under the pressure of fundamental landscape shifts. Using the concepts of multi-level and multi-regime, the central issue concerns how the bottom-up attempt of multi-niche innovations from a geographically local context interacts with multiple regimes. We identify the multi-niche as a nexus of geographic proximity and multi-domain interaction, and therefore as a typical example of urban transition. Furthermore, the case underscores the relevance of reflexive activities for urban transition management.

Loperamide-induced suppressive effects on central nervous system closely relate to a lack of or decline in the P-glycoprotein (P-gp) function. The aim of this study was to determine the loperamide-induced sedative effect quantitatively and to investigate possible alterations in the pharmacokinetics of digoxin, a substrate for P-gp, in Japanese subjects.Loperamide hydrochloride (2 mg) was administered orally to 26 subjects and the critical flicker-fusion frequency threshold (CFF) values were measured every 30 min separately by portable instrument. Further, digoxin (0.25 mg) was administered to 8 subjects, and the plasma concentration was determined.In five subjects who complained of drowsiness, the CFF values more remarkably decreased compared with those in the other subjects. The Tmax and mean residence time (MRT) values of digoxin pharmacokinetics in four subjects with drowsiness were significantly lower and Cmax was higher than those in four subjects with marginal effect. Moreover, there were good correlations between the CFF value-time profile and the Cmax, Tmax, and MRT of digoxin.The determination of the CFF value after oral administration of loperamide will be useful for evaluating varied P-gp function and for anticipating individual variations in the disposition of P-gp substrates in humans.

Peripheral nerve injury often leads to neuropathic pain, which might involve sympathetic postganglionic nerve fiber sprouting in the dorsal root ganglion. Recent studies suggest the effectiveness of ropivacaine in blocking neuropathic pain. To determine if ropivacaine affects sympathetic sprouting, we used pheochromocytoma (PC-12) cells, which differentiate into neurons on exposure to nerve growth factor (NGF). PC-12 cells were precultured in the presence of 50 ng/mL of NGF for 4 days. Neurite outgrowth was quantified as neurite extension after 24-, 48-, and 72-h exposure to ropivacaine at doses ranging from 10 to 200 microg/mL. Ropivacaine inhibited the neurite outgrowth in a dose-dependent manner. The inhibitory effect of ropivacaine was completely reversible because the NGF-stimulated neurite outgrowth was recovered to control level after washing out ropivacaine. Ropivacaine, therefore, may exert its therapeutic action on neuropathic pain, at least in part, by suppressing sympathetic sprouting.

Nuclear factor-kappa B (NF-κB) regulates gene expression upon immune and inflammatory responses. It has been demonstrated that redox regulation by thiols is involved in the signal-transduction cascade. In this study, we examined the effect of glutathione (GSH) on the NF-κB activity and the expression of NF-κB subunits induced by tumor necrosis factor-α (TNF-α) using mouse vascular endothelial cells. GSH inhibited the serine phosphorylation of IκB-α by TNF-α, leading to the downregulation of NF-κB-DNA binding activity followed by decreased expression of p65/p50 and IκB mRNAs. The regulation of the autoregulatory loop for the NF-κB activation and the expression of NF-κB subunits may be important in endothelial cells in response to cytokines.

Introdução: Os mecanismos responsáveis pela evolução do diabetes associado à obesidade entre pacientes bariátricos são alvos de muitos estudos atualmente. As principais linhas de pensamento envolvem alterações no índice de massa corporal (IMC), hormônios gastrointestinais, inflamação sistêmica e a reformatação ou reeducação alimentar. A maioria destes quesitos foi examinada sob a ótica do curto prazo, sendo que informações concernentes a casos com 10 anos de pós-operatório ainda são escassos. Objetivos: Avaliar o desfecho da homeostase glicídica tardio após a DGYR, em pacientes com e sem diabetes prévio, e documentar os parâmetros clínicos e nutricionais que diferenciem estes grupos. Metodologia: Estudo observacional controlado retrospectivo e prospectivo de 100 pacientes submetidos à derivação gástrica em Y de Roux. Estes pacientes foram divididos em dois grupos iniciais, um com diabetes no pré-operatório e outro sem diabetes. Em seguida, os dois foram subdivididos em quatro subgrupos conforme a evolução do diabetes, sendo eles refratário, responsivo, estáveis e não estáveis, respectivamente. Dados demográficos, laboratoriais, nutricionais, prescrições medicamentosas e evolução clínica do diabetes no pós-operatório a longo prazo foram coletados. Resultados: Dos 96 pacientes efetivamente avaliados, a idade situou-se em 50,39 (± 10,98) no grupo refratário, 56,63 (± 8,29) no grupo responsivo, 47,62 (± 10,72) no grupo estável e 48,17 (± 10,45) no grupo não estável. O sexo feminino prevaleceu em todos os grupos. Uma taxa de 66,7% dos pacientes com diabetes alcançaram a remissão da doença após a DGYR, o tempo de diagnóstico de diabetes pré-operatório se relacionou com o grupo refratário, e uma população de novos diabéticos se configurou tardiamente em pacientes sem a doença no período pré-operatório. Conclusão: 1) A derivação gástrica em Y de Roux induziu remissão em 66,7% dos pacientes com diabetes prévio; 2) O tempo de diagnóstico de diabetes tipo 2 esteve associado com ausência da resposta cirúrgica; 3) Pacientes euglicêmicos desenvolveram diabetes após a intervenção na proporção de 17,7%, comprovando que a proteção do procedimento bariátrico contra a instalação do diabetes tipo 2 se atenua com o passar dos anos; 4) Tanto os pacientes com a glicemia anormal quanto os euglicêmicos submetidos à DGYR, necessitam de um seguimento a longo prazo do homeostase glicídica Introduction: The mechanisms responsible for the development of diabetes associated with obesity among bariatric patients are targets of many ongoing studies. The main lines of thought involve changes in body mass index (BMI), gastrointestinal hormones, systemic inflammation and reformatting nutritional education. Most of these issues were examined from a short term perspective, with information concerning cases after 10 years still scarce. Objectives: Evaluate the outcome of long term of glucose homeostasis after DGYR in patients with and without previous diabetes, and document the clinical and nutritional parameters that differentiate these groups. Methods: An observational retrospective and prospective controlled study with 100 patients undergoing Roux-en-Y gastric bypass. These patients were divided into two initial groups, one with diabetes preoperatively and another without. Then the two groups were subdivided into four subgroups according to the evolution of diabetes, namely refractory, responsive, stable and unstable respectively. Demographic, laboratory, nutritional, and clinical information along with drug prescriptions were collected Results: Among the 96 patients effectively studied, age was 50.39 (± 10.98) in the refractory group, 56.63 (± 8.29) in the responsive group, 47.62 (± 10.72) in the stable group and 48 , 17 (± 10.45) in the unstable group. Females were the majority in all groups. About 66,7% of patients with diabetes achieved disease remission after DGYR, and duration of diabetes was associated with the refractory group. A population of new-onset diabetes was identified in patients without disease in the preoperative period. Conclusion: 1) Roux-en-Y gastric bypass induced remission in 66,7% of patients with previous diabetes; 2) Duration of diagnosis of type 2 diabetes was associated with surgical response, 3) Euglycemic patients developed diabetes after the intervention in the proportion of 17,7%, proving that the protection of bariatric procedure against type 2 diabetes is attenuated over the years; 4) Both patients with abnormal glucose profile as well as those euglycemic undergoing DGYR, require long follow-up of glucose homeostasis

An uncomplicated cystitis caused by CO2-dependent Proteus mirabilis was observed in a 64-year-old Japanese female patient with Sjogren's syndrome in the Aomori Kyoritsu Hospital, Aomori, Japan. The initial P. mirabilis isolate came from a midstream urine specimen containing large numbers of Gram-negative, rod-shaped organisms that failed to grow on both Drigalski agar and sheep blood agar incubated in ambient air. The organism did grow when the urine was cultured overnight on blood agar under anaerobic conditions. Hence, we believed that the organism was an anaerobe. Further investigation revealed that the isolate grew on sheep blood agar along with swarming when the atmospheric CO2 concentrations were increased to 5%. Initially, we failed to characterize or identify the P. mirabilis isolate or determine its antimicrobial susceptibilities using the MicroScan WalkAway-40 System because the isolate did not grow in the system. However, the isolate was subsequently identified as P. mirabilis based on its morphological, cultural, and biochemical properties by using the commercially available kit systems, Quick ID-GN and ID-Test EB-20. This identification of the isolate was confirmed by sequencing the 16S rRNA gene of the organism. To our knowledge, this is the first clinical isolation of capnophilic P. mirabilis.

The significance of intestinal P-glycoprotein (P-gp) in determining the oral bioavailability of tacrolimus has been still controversial. In this study, we reevaluated the interaction of tacrolimus with P-gp in the rat small intestine, by evaluating its absorption from the rat small intestine and its modulating effect on the absorption of known P-gp substrates (digoxin, methylprednisolone, and vinblastine). Intestinal absorption of tacrolimus itself was as extensive as other P-gp modulators such as cyclosporine and verapamil. While cyclosporine and verapamil significantly increased the absorption of methylprednisolone and vinblastine through potent inhibition of intestinal P-gp, tacrolimus failed to achieve this. When cyclosporine and tacrolimus were intravenously administered to rats, digoxin absorption was significantly increased by cyclosporine but not by tacrolimus. When tacrolimus was coadministered with clotrimazole, a specific CYP3A inhibitor, into the rat small intestine, the area under the curve of tacrolimus blood concentrations increased more than seven-fold compared with that of tacrolimus alone. Our present results strongly suggest that the interaction between tacrolimus and P-gp is limited in the rat small intestine and that extensive metabolism by CYP3A enzymes is more responsible for the low oral bioavailability of tacrolimus. It was considered that the extensive absorption of cyclosporine and verapamil was closely associated with their potent ability to inhibit intestinal P-gp.

Advanced glycation end products (AGEs) are believed to play an important role in the development of angiopathy in diabetes mellitus. Previous reports suggested a correlation between accumulation of AGEs and production of vascular endothelial growth factor (VEGF) in human diabetic retina. However, the mechanisms involved were not revealed. In this study, we investigated the transcriptional regulation of the expression of vascular endothelial growth factor (VEGF) by AGEs, and possible involvement of reactive oxygen species (ROS) in the induction. We employed an AGE of bovine serum albumin (BSA) prepared by an incubation of BSA with D-glucose for 40 weeks and N(epsilon)-(carboxymethyl)lysine (CML), a major AGE. The expression of VEGF was induced by CML-BSA in RAW264.7 mouse macrophage-like cells. CML-BSA stimulated the DNA-binding activity of activator protein-1 (AP-1). Promoter assay showed that the induction of VEGF was dependent on AP-1. The activity of Ras/Raf-1/MEK/ERK1/2 was involved in the CML-BSA-stimulated signaling pathways to activate the AP-1 transcription with a peak at 1 h. AGE-BSA also induced VEGF mediated by AP-1, however, there was a difference of effect between AGE-BSA and CML-BSA in the activation of AP-1. AGE-BSA-stimulated AP-1 activity showed a peak at 5 h, which paralleled the formation of ROS. Reduction of AGE-BSA with NaBH4 or addition of vitamin E attenuated the AGE-BSA-stimulated signaling pathways leading to the same pattern as for CML-BSA-stimulated signals. These results suggest an important role for AGEs in stimulation of the development of angiogenesis observed in diabetic complications, and that ROS accelerates the AGE-stimulated VEGF expression.

Poly(9-vinyladenine) (PVAd) was immobilized or coated on macroporous silica gel to be used as a stationary phase for HPLAC of nucleosides and nucleotides. The stationary phases showed nucleobase-selective recognition ability for nucleic acid constituents and gave practically useful HPLAC columns. On the basis of the results, the relationships between separation ability and the structure of PVAd are discussed.