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Objectives: Several factors determining differences between types A and B aortic dissection (AD) have been reported; however, little data exist examining their differences in left ventricular hypertrophy (LVH). We compared the prevalence of LVH in patients with types A and B AD. Methods: We retrospectively analyzed 334 patients with acute AD (227 type A; 107 type B). Concentric hypertrophy (CH; increased left ventricular mass index [LVMI] and relative wall thickness [RWT]) is one of four types of left ventricular (LV) geometry thought to be most associated with hypertension. We compared LVMI and the prevalence of CH in patients with types A or B AD. Multivariate logistic regression analyses of variables associated with type B AD were performed. Results: Comparing type A and B AD, LVMI (95 ± 26 vs.107 ± 28, p

Theoretical and experimental investigations have been performed to obtain carbonic anhydrase (CA) mimic catalysts that are effective for CO2 absorbents containing highly concentrated amines. One of...

OBJECTIVES Thoracic endovascular aortic repair is a widely accepted treatment for chronic aortic dissection because of good early results compared to open surgical repair. We provide early and long-term results of descending thoracic aortic repair for chronic aortic dissection. METHODS Patients who underwent descending thoracic aortic repair for chronic aortic dissection between January 2012 and December 2020 at Kawasaki Aortic Centre were included in this analysis. RESULTS Four hundred ninety-two patients (median age, 64 years; interquartile range, 52–75 years) were included. The median duration of follow-up was 3.2 years (interquartile range, 1.5–5.2 years). The early mortality rate was 2.0% (n = 10); strokes occurred in 17 patients (3.5%); and spinal cord injuries occurred in 30 patients (6.1%). Early major adverse events including early death, stroke, spinal cord injury, tracheostomy and haemodialysis at the time of discharge occurred in 62 patients. Multivariable analysis indicated that age > 70 years and non-elective surgery were predictors of early major adverse events. Among patients without both risk factors (i.e. low-risk patients), 1 early death (0.4%), 3 strokes (1.5%) and 1 spinal cord injury (0.4%) were observed, 2 tracheostomies were performed (0.8%) and no patients required haemodialysis at the time of hospital discharge. The 5-year survival rate was 87.2%. The cumulative incidence of chronic aortic dissection-related aortic reintervention at 5 years was 7.9%. CONCLUSIONS Descending thoracic aortic repair for chronic aortic dissection resulted in good early and long-term results, and it can serve as the gold standard for low-risk patients.

Background The purpose of this study was to reveal the midterm and long-term mortality rates among patients with thoracoabdominal aortic aneurysm (TAAA) after open TAAA repair and to clarify the effect of aneurysm type on mortality. Methods We retrospectively analyzed data for 393 patients (290 men; age, 63.2 ± 12.7 years) who underwent open TAAA repair of elective Crawford extent I, II, or III TAAAs (62, 197, and 134 patients, respectively) between June 2003 and December 2015. The overall survival probability and differences according to aneurysm type were assessed using the Kaplan-Meier product limit method. Also, the effect of aneurysm type on mortality was assessed using the hazard ratio and Cox proportional hazards regression. Results The overall survival probabilities at 3 months, 1 year, 5 years, and 10 years were 90%, 84%, 78%, and 75%, respectively. The age-adjusted relative mortality rate was significantly higher for patients with dissecting aneurysms than for those with nondissecting aneurysms (relative risk, 1.62; 95% confidence interval, 1.03 to 2.55). In the multivariate Cox proportional hazard regression model, the hazard ratio for all-cause mortality did not differ between patients with dissecting and those with nondissecting aneurysms. However, those with dissecting aneurysms had increased mortality rates as their percentage vital capacity decreased (hazard ratio, 0.7; 95% confidence interval, 0.5 to 1.0); a similar trend was not observed for those with nondissecting aneurysms. Conclusions Open TAAA repair can be safely performed with acceptable midterm and long-term results. Poor pulmonary function can impair the survival outcome of patients with dissecting aneurysms.

Objective Skeletal muscle is the main target organ for glycemic control, and the serum creatinine level is a convenient indicator of the skeletal muscle mass. This study aimed to assess the potential relationship between the serum creatinine level and the onset of impaired fasting glucose (IFG). Methods In this large, community-based, retrospective longitudinal cohort study, we examined the records of 7,905 Japanese participants (3,863 men, 4,042 women) of 18-80 years of age who underwent annual health checkups at a single center between April 2003 and August 2013. After applying the exclusion criteria, 6,490 participants were reviewed to identify those with the onset of IFG, defined as a fasting plasma glucose ≥6.11 mM. Among the participants, 278 met the criterion for the onset of IFG during the observation period. Results Creatinine levels were higher in male subjects who exercised periodically and were exercise conscious in comparison to those who did not exercise, and were higher in female subjects who exercised periodically in comparison to female subjects who did not exercise and who were not exercise conscious. Additionally, the serum creatinine level was negatively associated with the onset of IFG in both men [adjusted hazard ratio, 0.98; 95% confidence interval (CI), 0.96-0.99; p=0.008] and women (adjusted hazard ratio, 0.94; 95% CI, 0.91-0.97; p

Ab initio quantum chemical calculations, combined with the SMD solvation model, have been conducted to reveal CO2 absorption mechanisms and the origin of the reduced stability of carbamate in aqueous solution of 2-amino-2-methyl-1-propanol (AMP). The calculated Gibbs free energy change for all the elementary steps in the conversion of carbamate to bicarbonate reveals that the reduced thermodynamic stability of AMP carbamate is largely ascribable to the shift of the equilibrium from the carbamate to the zwitterion intermediate, from which CO2 can be released and successively converted to bicarbonate. This feature of AMP is an attribute of the electronic effects of the substitution by methyl groups specifically at the α-carbon. Furthermore, the steric effects of the methyl groups are investigated from a dynamical point of view that suggests a new scenario in which the methyl groups promote the release of CO2 from the zwitterion intermediate.

This work low viscous new amine based non-aqueous solvent (NAS) was developed for recovery of carbon dioxide (CO2) from post-combustion flue gases. The NAS system was made by mixing alkyl-functionalized single amine/polyamine as absorbent and alcohol/non-alcohol as solvent. The developed NAS does not form any precipitate/solid upon exposure to CO2 and showed low viscosity (cP < 20) homogeneous mixture (single phase) at the whole range of CO2 loading with the advantages of higher absorption and regeneration rates, higher cyclic capacities, and higher CO2 recoveries compared to bench mark MEA-based aqueous absorbents.

The therapeutic effects of C16, which is an inhibitor of RNA-dependent protein kinase (PKR), on growth of hepatocellular carcinoma (HCC) cells and tumor progression in vitro and in vivo were evaluated. Huh7 cells, a human HCC cell line, were used. The effects of C16 on cell viability were evaluated with the MTT assay, and real-time RT-PCR was performed. Huh7 cells were grafted into immunodeficient mice, and the in vivo effects of C16 on tumorigenesis were examined. C16 suppressed proliferation of HCC cells in a dose-dependent manner in vitro. Mouse models with xenograft transplantation showed that the inhibitor suppressed the growth of HCC cells in vivo. Moreover, C16 decreased angiogenesis in HCC tissue in the xenograft model. Consistent with these results in mice, transcript levels of vascular endothelial growth factor-A and factor-B, platelet-derived growth factor-A and factor-B, fibroblast growth factor-2, epidermal growth factor, and hepatocyte growth factor, which are angiogenesis-related growth factors, were significantly decreased by C16 in vitro. In conclusion, the PKR inhibitor C16 blocked tumor cell growth and angiogenesis via a decrease in mRNA levels of several growth factors. C16 may be useful in the treatment of HCC.

Objective Low urine pH is associated with several metabolic diseases, such as dyslipidemia, diabetes, and metabolic syndrome. However, the association between low urine pH and non-alcoholic fatty liver disease (NAFLD) remains unknown. Therefore, we conducted a community-based cross-sectional study to investigate this association. Methods Between April 2013 and March 2014, the records of 4,945 Japanese subjects who had undergone annual health checkups were reviewed to identify subjects who met the diagnostic criteria for NAFLD. Patients Based on urine pH, the participants were classified into four groups; a low urine pH was defined as ≤5.5. Of the 3,411 subjects who qualified for enrollment, 1,028 met the diagnostic criteria for NAFLD. Results The prevalence of NAFLD was significantly increased with decreasing urine pH in both men and women (p

Background There are few effective medications for non-alcoholic steatohepatitis (NASH). We investigated the efficacy of ipragliflozin (selective sodium-glucose cotransporter-2 inhibitor [SGLT2I]) for the treatment of patients with type 2 diabetes mellitus (T2DM) complicated by non-alcoholic fatty liver disease (NAFLD). Methods We prospectively enrolled patients with T2DM complicated by NAFLD treated at our institutions from January 2015 to December 2016. Patients received oral ipragliflozin (50 mg/day) once daily for 24 weeks. Body composition was evaluated using an InBody720 analyzer. We used transient elastography to measure liver stiffness and the controlled attenuation parameter for the quantification of liver steatosis in patients with NASH. Results Forty-three patients with T2DM and NAFLD were enrolled (12 with biopsy-proven NASH and 31 with NAFLD diagnosed by ultrasonography). After 24 weeks, body weight, hemoglobin A1c (HbA1c), aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase, body fat mass, and steatosis were significantly decreased compared to baseline measurements in patients with NASH. However, muscle mass was not reduced, and liver stiffness showed a statistically insignificant tendency to decrease. NAFLD patients also showed a significant reduction in body weight, HbA1c, AST, and ALT compared to baseline measurements. Conclusion Ipragliflozin may be effective in patients with T2DM complicated by NAFLD.

Aims/Introduction The association between urine pH and abnormal glucose tolerance in men and women is unclear; therefore, we carried out a community-based, cross-sectional study to investigate sex-specific associations between these values, possible indicators of prediabetes and type 2 diabetes. Materials and Methods We enrolled 4,945 Japanese individuals (2,490 men and 2,455 women), who had undergone annual health checkups. To investigate the relationship between low urine pH and abnormal glucose tolerance, participants were divided into three groups based on their fasting plasma glucose levels (

Aims/Introduction No reports have been published on the association between dietary intake habits and nocturia in the diabetes population. We therefore evaluated this issue among Japanese patients with diabetes mellitus. Materials and Methods Study participants in the present study were 785 Japanese patients with type 2 diabetes mellitus. Self-administered questionnaires were used to assess each type of dietary intake habit. Vegetable intake habit was assessed by the following question: “Do you have vegetables or seaweed every day?” We used the following two outcomes: (i) nocturia: ≥2 voids per night; and (ii) severe nocturia: ≥3 voids per night. Adjustment was made for age, sex, body mass index, glycated hemoglobin, hypertension, dyslipidemia, smoking, drinking, exercise habit, stroke, ischemic artery disease, diabetic nephropathy, diabetic neuropathy and diabetic retinopathy. Results The prevalence of nocturia, severe nocturia, and vegetable intake habit was 39.9%, 14.4% and 67.3%, respectively. After adjusting for confounding factors, vegetable intake habit was independently inversely associated with nocturia and severe nocturia: the adjusted odds ratios were 0.67 (95% confidence interval [CI] 0.48–0.94) and 0.46 (95% CI 0.30–0.71), respectively. Among male patients, vegetable intake habit was independently inversely associated with severe nocturia, but not nocturia: the adjusted OR was 0.51 (95% CI 0.29–0.88). Among female patients, vegetable intake habit was independently inversely associated with nocturia and severe nocturia: the adjusted ORs were 0.44 (95% CI 0.24–0.79) and 0.34 (95% CI 0.15–0.78), respectively. Conclusions We found an inverse association between vegetable intake habit and nocturia in Japanese patients with type 2 diabetes mellitus.

In the present paper, we investigated CO 2 capture with six amine based absorbents, including three formulated solvents. Aqueous solutions of the amines (mass fraction; 30% for single amine and >30% for blended solvents) were used to evaluate the performance for CO 2 capture. Gas scrubbing, vapor-liquid equilibrium (VLE), and reaction calorimetry experiments were conducted in the laboratory to obtain the absorption rate, the amount of CO 2 absorbed, cyclic CO 2 capacity, and heat of reaction for each absorbent. The results of these absorbents were compared with the conventional amine absorbents (MEA, AMP, DEA, and MDEA). Three high performing formulated absorbents (RN-1, RN-2, and RN-3) were developed, and these had lower heats of reaction, higher cyclic capacities, and comparable absorption rates compared with MEA. Some blended solvents were already demonstrated with real blast furnace gas at pilot test plants with capacities of 1 ton-CO 2 /day and 30 ton-CO 2 /day and showed promising results in terms of reducing absorbent regeneration energy.

We made 13 C-NMR analyses under high-pressure conditions to understand the absorbed forms of CO 2 in the chemical CO 2 solvents for high-pressure CO 2 capture, RH-2b and an MDEA aqueous solution. The pressure of CO 2 in the cell for NMR analyses was approximately 0.1 MPa, 1.6 MPa, or 4.0 MPa. The NMR peaks observed at 125 ppm, 158 ppm, and 161 ppm were analyzed for each pressure; these peaks were derived from physically absorbed CO 2 , alkyl carbonate, and bicarbonate, respectively. As the absorbed form of CO 2 in RH-2b, only bicarbonate ion (161 ppm) has been observed. It is considered that the CO 2 physically absorbed in RH-2b is react with H 2 O and the form of CO 2 changes to bicarbonate in the aqueous solution. Thus, the chemical absorption to generate bicarbonate in RH-2b is thought to be enhanced with increase in the pressure of CO 2 due to the improvement in physical absorption under the high-pressure.

Aim Nocturia is common among patients with type 2 diabetes mellitus, but limited evidence regarding the association between body mass index (BMI) and nocturia exists among such patients. The aim of the present study, therefore, was to evaluate the association between BMI and nocturia among Japanese patients with type 2 diabetes mellitus. Methods Study participants were 809 Japanese patients with type 2 diabetes mellitus. Study participants were considered to have nocturia if they answered “two or more” to the question: “How many times do you typically wake up to urinate from sleeping at night until waking in the morning?” We used the following two outcomes: (i) moderate nocturia was defined as ≥2 voids per night; and (ii) severe nocturia was defined as ≥3 voids per night. Participants were categorized into four groups according to their BMI: (i) BMI

Aims/Introduction To date, there is no evidence regarding the association between physical activity (PA) and erectile dysfunction (ED) among Japanese patients with type 2 diabetes mellitus. We investigated this issue among Japanese patients with type 2 diabetes mellitus. Materials and Methods Study participants were 460 male Japanese patients with type 2 diabetes mellitus. The definitions of exercise habit, walking habit and fast walking were based on a self-administered questionnaire regarding PA behavior. Participants were classified into one of four PA levels based on the number of ‘Yes’ answers to the three questions in the questionnaire: (i) lowest; (ii) lower; (iii) moderate; and (iv) higher. Severe ED and moderate-to-severe ED were based on Sexual Health Inventory for Men score

OBJECTIVE: The aim of this study was to show a technique and the results of 60-day survival rate under treatment of Acute Type A Aortic Dissection by Transapical Aortic Cannulation Technique. MATERIAL AND METHODS: The data has been investigated through 12 years surgery experience since June 2003 in Acute Type A Acute Aortic Dissection by Transapical Aortic Cannulation Technique. This study was approved and reviewed by the ethical committee of the Kawasaki Saiwai Hospital, Kawasaki, Japan. Statistical Analysis: Cox proportional hazard regression was employed to analyze risk ratio, and Kaplan Meier curve was used to estimate the survival time. Statistically were significant at p < 0.05. RESULTS: The study population (n =309) was investigated for survival analysis. The person-time was 6363.50 person/months. We found that, the death outcome was 29 persons (9.38%). The mortality rate was 4.55/1000 person/months (95% Confidence Interval = 3.17-6.56/1000 person-month) CONCLUSION: Risk factors influencing the survival rate in Acute Type A Aortic Dissection included Coronary Artery Disease, Preoperative Hemodynamic Deterioration, Total Arch Replacement, cardiopulmonary bypass technique using only Deep Hypothermic Circulatory Arrest, Deep Hypothermic Circulatory Arrest with Retrograde Cerebral Perfusion and Deep Hypothermic Circulatory Arrest with Antegrade Selective Cerebral Perfusion. The enlargement of Ascending Aortic diameter and Proximal Descending Aorta diameter increased the death rate by 11% and 18%, respectively. Each time the diameter expanded 1 mm, and the operation time extended 1 minute, the death rate was increased by 1%.

Two female siblings aged 87 and 90 years were clinically diagnosed as pancreatic cancer by abdominal ultrasonography and abdominal contrast-enhanced CT. Pancreatic cancer of these patients was confirmed during the autopsy. Both patients shared risk factors of pancreatic cancer; old age, diabetes, and passive smoking. Strong family history of pancreatic cancer was found in these two patients as their father and younger brother were also suffering from this cancer. The present study seems to report two eldest cases of familial pancreatic cancer in siblings. How to cite this article: Kashimoto Y, Onji M, et al. Familial Pancreatic Cancer at Elderly Siblings in Japan. Euroasian J Hepatogastroenterol 2019;9(1):52-54.

Transforming growth factor-β (TGF-β) and bone morphogenetic protein (BMP) play important roles in bone metabolism. Smad ubiquitination regulatory factors (Smurfs) regulate TGF-β/BMP signaling via ubiquitination, resulting in degradation of signaling molecules to prevent excessive activation of TGF-β/BMP signaling. Though Smurf2 has been shown to negatively regulate TGF-β/Smad signaling, its involvement in BMP/Smad signaling in bone metabolism has not been thoroughly investigated. In the present study, we sought to evaluate the role of Smurf2 in BMP/Smad signaling in bone metabolism. Absorbable collagen sponges containing 3 μg of recombinant human BMP2 (rhBMP2) were implanted in the dorsal muscle pouches of wild type (WT) and Smurf2−/− mice. The rhBMP2-induced ectopic bone in Smurf2−/− mice showed greater bone mass, higher mineral apposition and bone formation rates, and greater osteoblast numbers than the ectopic bone in WT mice. In WT mice, the ectopic bone consisted of a thin discontinuous outer cortical shell and scant inner trabecular bone. In contrast, in Smurf2−/− mice, the induced bone consisted of a thick, continuous outer cortical shell and abundant inner trabecular bone. Additionally, rhBMP2-stimulated bone marrow stromal cells (BMSCs) from Smurf2−/− mice showed increased osteogenic differentiation. Smurf2 induced the ubiquitination of Smad1/5. BMP/Smad signaling was enhanced in Smurf2−/− BMSCs stimulated with rhBMP2, and the inhibition of BMP/Smad signaling suppressed osteogenic differentiation of these BMSCs. These findings demonstrate that Smurf2 negatively regulates BMP/Smad signaling, thereby identifying a new regulatory mechanism in bone metabolism.