Background: Left ventricular assist devices (LVADs) are widely employed as a therapeutic option for end-stage heart failure. We evaluated the outcomes associated with centrifugal-flow LVAD implantation, comparing 2 device models: the Heartmate 3 (HM3) and the Heartware Ventricular Assist Device (HVAD). Methods: Data were collected from patients who underwent LVAD implantation between June 1, 2015 and December 31, 2022. We analyzed overall survival, first rehospitalization, and early, late, and LVAD-related complications. Results: In total, 74 patients underwent LVAD implantation, with 42 receiving the HM3 and 32 the HVAD. A mild Interagency Registry for Mechanically Assisted Circulatory Support score was more common among HM3 than HVAD recipients (p=0.006), and patients receiving the HM3 exhibited lower rates of preoperative ventilator use (p=0.010) and extracorporeal membrane oxygenation (p=0.039). The overall early mortality rate was 5.4% (4 of 74 patients), with no significant difference between groups. Regarding early right ventricular (RV) failure, HM3 implantation was associated with a lower rate (13 of 42 [31.0%]) than HVAD implantation (18 of 32 [56.2%], p=0.051). The median rehospitalization-free period was longer for HM3 recipients (16.9 months) than HVAD recipients (5.3 months, p=0.013).Furthermore, HM3 recipients displayed a lower incidence of late hemorrhagic stroke (p=0.016). In the multivariable analysis, preoperative use of continuous renal replacement therapy (odds ratio, 22.31; p=0.002) was the only significant predictor of postoperative RV failure. Conclusion The LVAD models (HM3 and HVAD) demonstrated comparable overall survival rates. However, the HM3 was associated with a lower risk of late hemorrhagic stroke.

Ninety percent of the crude drugs consumed in Japan depend on imports. Recently, the Japanese government has been promoting the domestic production of crude drugs. We investigated the history and current situation of the cultivation of medicinal plants and the production of crude drugs in the Tohoku region, where the 71st annual meeting of the Japan Society for Oriental Medicine was held in August 2021. In the Tohoku region, the cultivation of medicinal plants expanded after the Kyoho era of the Edo period. Several medicinal plants in this region have been successfully cultivated and distributed as local specialty products and are being preserved (e.g., Panax ginseng in Aizu, Carthamus tinctorius in Dewa). In some other areas, cultivation has just begun. In each cultivation area, a contractual relationship was established in which local governments, cultivation experts, farmers, Kampo-related associations, and pharmaceutical companies collaborated to continue and expand the cultivation business. To generate revenue, they have been trying to find sales channels not only for crude drugs but also for foods, cosmetics, textiles, and processed products. Although many issues remain to be solved in the distribution of medicinal plants as the source of crude drugs, this survey clarified the ingenuity of medicinal plant cultivation in various areas of the Tohoku region. The results of the investigation are available as videos on the website for members of the Japan Society for Oriental Medicine.

Objectives: Changes in the autonomic nervous system have been observed in patients with depressive disorders by measuring their heart rate variability (HRV). However, whether HRV associates with depressive events in healthy people remains unknown. Methods: Four healthy people participated in the present study. Their HRVs were measured routinely for 6 to 13 months. During this time, two participants reported experiencing two and three bouts of depression, respectively. This approach allowed us to examine changes in the participants’ HRVs by comparing their HRVs from before and after the unexpected depressive events. Changes in HRV were compared against those of two participants who did not report any depressive event. Results: Participants’ low frequency/high frequency (LF/HF) ratios of HRV were lower after the event of depression than before. Their LF/HF ratios increased after recovery from the depressive events. In contrast, two participants who did not report any depressive event showed relatively smaller changes in their LF/HF ratios across measurements. Conclusions These results suggest that the LF/HF ratio may provide an objective measure of subjective experiences of depression and help identify potential cases of clinical depression.

BACKGROUND: Body mass-independent parameters might be more appropriate for assessing cardiometabolic abnormalities than weight-dependent indices in Asians who have relatively high visceral adiposity but low body fat. Dual-energy X-ray absorptiometry (DXA)-measured trunk-to-peripheral fat ratio is one such body mass-independent index. However, there are no reports on relationships between DXA-measured regional fat ratio and cardiometabolic risk factors targeting elderly Asian men. METHODS: We analyzed cross-sectional data of 597 elderly men who participated in the baseline survey of the Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) study, a community-based single-center prospective cohort study conducted in Japan. Whole-body fat and regional fat were measured with a DXA scanner. Trunk-to-appendicular fat ratio (TAR) was calculated as trunk fat divided by appendicular fat (sum of arm and leg fat), and trunk-to-leg fat ratio (TLR) as trunk fat divided by leg fat. RESULTS: Both TAR and TLR in the group of men who used ≥ 1 medication for hypertension, dyslipidemia, or diabetes ("user group"; N = 347) were significantly larger than those who did not use such medication ("non-user group"; N = 250) (P < 0.05). After adjusting for potential confounding factors including whole-body fat, both TAR and TLR were significantly associated with low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglyceride, fasting serum insulin, and the insulin resistance index in the non-user group and non-overweight men in the non-user group (N = 199). CONCLUSION The trunk-to-peripheral fat ratio was associated with cardiometabolic risk factors independently of whole-body fat mass. Parameters of the fat ratio may be useful for assessing cardiometabolic risk factors, particularly in underweight to normal-weight populations.
Absorptiometry, Photon ; Adiposity/physiology* ; Aged ; Aged, 80 and over ; Biomarkers/metabolism* ; Cardiometabolic Risk Factors ; Cross-Sectional Studies ; Humans ; Intra-Abdominal Fat/diagnostic imaging* ; Japan ; Male ; Osteoporosis/etiology* ; Prospective Studies ; Risk Assessment ; Risk Factors ; Thorax/diagnostic imaging*

BACKGROUND: The Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) study was launched to investigate risk factors for osteoporotic fractures, interactions of osteoporosis with other non-communicable chronic diseases, and effects of fracture on QOL and mortality. METHODS: FORMEN baseline study participants (in 2007 and 2008) included 2012 community-dwelling men (aged 65-93 years) in Nara prefecture, Japan. Clinical follow-up surveys were conducted 5 and 10 years after the baseline survey, and 1539 and 906 men completed them, respectively. Supplemental mail, telephone, and visit surveys were conducted with non-participants to obtain outcome information. Survival and fracture outcomes were determined for 2006 men, with 566 deaths identified and 1233 men remaining in the cohort at 10-year follow-up. COMMENTS The baseline survey covered a wide range of bone health-related indices including bone mineral density, trabecular microarchitecture assessment, vertebral imaging for detecting vertebral fractures, and biochemical markers of bone turnover, as well as comprehensive geriatric assessment items. Follow-up surveys were conducted to obtain outcomes including osteoporotic fracture, cardiovascular diseases, initiation of long-term care, and mortality. A complete list of publications relating to the FORMEN study can be found at https://www.med.kindai.ac.jp/pubheal/FORMEN/Publications.html .
Aged ; Bone Density ; Cardiovascular Diseases/etiology* ; Cohort Studies ; Geriatric Assessment ; Humans ; Independent Living ; Japan/epidemiology* ; Long-Term Care/statistics & numerical data* ; Male ; Middle Aged ; Osteoporosis/etiology* ; Osteoporotic Fractures/etiology* ; Risk Factors

Objectives: Changes in the autonomic nervous system have been observed in patients with depressive disorders by measuring their heart rate variability (HRV). However, whether HRV associates with depressive events in healthy people remains unknown. Methods: Four healthy people participated in the present study. Their HRVs were measured routinely for 6 to 13 months. During this time, two participants reported experiencing two and three bouts of depression, respectively. This approach allowed us to examine changes in the participants’ HRVs by comparing their HRVs from before and after the unexpected depressive events. Changes in HRV were compared against those of two participants who did not report any depressive event. Results: Participants’ low frequency/high frequency (LF/HF) ratios of HRV were lower after the event of depression than before. Their LF/HF ratios increased after recovery from the depressive events. In contrast, two participants who did not report any depressive event showed relatively smaller changes in their LF/HF ratios across measurements. Conclusions These results suggest that the LF/HF ratio may provide an objective measure of subjective experiences of depression and help identify potential cases of clinical depression.

Stress can induce a serious epileptic encephalopathy that occurs during early infancy. Recent studies have revealed that prenatal stress exposure is a risk factor for the development of infantile spasms. Our previous work demonstrates that prenatal stress with betamethasone-induced alterations to the expression of the K⁺/Cl⁻ co-transporter (KCC2) in gamma-aminobutyric acid (GABA) interneurons lowers the seizure threshold in exposed animals. Here, we further investigated the mechanisms involved in this KCC2 dysfunction and explored possible treatment options. We stressed Sprague-Dawley rats prenatally and further treated dams with betamethasone on gestational day 15, which increases seizure susceptibility and NMDA (N-Methyl-D-aspartate)-triggered spasms on postnatal day 15. In this animal model, first, we evaluated baseline calpain activity. Second, we examined the cleavage and dephosphorylation of KCC2. Finally, we checked the effect of a calpain inhibitor on seizure occurrence. The phosphorylated-N-methyl-D-aspartate Receptor 2B (NR2B):non-phosphorylated NR2B ratio was found to be higher in the cortex of the prenatally stressed beta-methasone model. We further found that the betamethasone model exhibited increased phosphorylation of calpain-2 and decreased phosphorylation of KCC2 and Glutamic acid decarboxylase 67 (GAD67). After using a calpain inhibitor in prenatal-stress rats, the seizure frequency decreased, while latency increased. GABAergic depolarization was further normalized in prenatal-stress rats treated with the calpain inhibitor. Our study suggests that calpain-dependent cleavage and dephosphorylation of KCC2 decreased the seizure threshold of rats under prenatal stress. Calpain-2 functions might, thus, be targeted in the future for the development of treatments for epileptic spasms.
Animals ; Betamethasone ; Brain Diseases ; Calpain ; Epilepsy ; gamma-Aminobutyric Acid ; Glutamate Decarboxylase ; Humans ; Infant ; Infant, Newborn ; Interneurons ; Models, Animal ; N-Methylaspartate ; Phosphorylation ; Rats ; Rats, Sprague-Dawley ; Risk Factors ; Seizures ; Spasm ; Spasms, Infantile

BACKGROUND: Laser therapy can be used as an alternative treatment for onychomycosis; however, there are somelimitations to its efficacy as a single agent. OBJECTIVE: To evaluate the effectiveness of combination therapy with 1,064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser and topical efinaconazole in onychomycosis treatment and identify factors influencing the therapeutic outcomes of combination treatment. METHODS: Big toenails with onychomycosis were treated by 1,064-nm Nd:YAG laser at 4-week intervals with daily application of topical efinaconazole. Therapeutic response was assessed through onychomycosis severity index (OSI) and percentage of nail infected (PNI), and its association with a variety of factors that may affect treatment outcome was evaluated. RESULTS: One hundred big toenails were included in the study and significant clinical improvements were observed after treatment (OSI improvement score = 76.68 ± 28.83, PNI improvement score = 72.37 ± 30.37). There was no difference in treatment response according to the number of laser treatments, onychomycosis clinical type, or initial severity. However, patient age was negatively correlated with clinical improvement (p = 0.019). Also, female patients had better therapeutic responses than male patients. CONCLUSION Combined treatment with Nd:YAG laser and topical efinaconazole has a significant therapeutic effect on onychomycosis. A randomized controlled trial is warranted in the future.

No abstract available.
Aluminum* ; Onychomycosis* ; Yttrium*

OBJECTIVES: Current treatments for osteoporosis were prevention of progression, yet it has been questionable in the stimulation of bone growth. The mesenchymal stem cells (MSCs) treatment for osteoporosis aims to induce differentiation of bone progenitor cells into bone-forming osteoblasts. We investigate whether human umbilical cord blood (hUCB)-MSCs transplantation may induce bone regeneration for osteoporotic rat model induced by ovariectomy. METHODS: The ovariectomized (OVX) group (n = 10) and OVX-MSCs group (n = 10) underwent bilateral ovariectomy to induce osteoporosis, while the Sham group (n = 10) underwent sham operation at aged 12 weeks. After a femoral defect was made at 9 months, Sham group and OVX group were injected with Hartmann solution, while the OVX-MSCs group was injected with Hartmann solution containing 1 × 107 hUCB-MSCs. The volume of regenerated bone was evaluated using micro-computed tomography at 4 and 8 weeks postoperation. RESULTS: At 4- and 8-week postoperation, the OVX group (5.0% ± 1.5%; 6.1% ± 0.7%) had a significantly lower regenerated bone volume than the Sham group (8.6% ± 1.3%; 12.0% ± 1.8%, P < 0.01), respectively. However, there was no significant difference between the OVX-MSCs and Sham groups. The OVX-MSCs group resulted in about 53% and 65% significantly higher new bone formation than the OVX group (7.7% ± 1.9%; 10.0% ± 2.9%, P < 0.05). CONCLUSIONS: hUCB-MSCs in bone defects may enhance bone regeneration in osteoporotic rat model similar to nonosteoporotic bone regeneration. hUCB-MSCs may be a promising alternative stem cell therapy for osteoporosis.
Animals ; Bone Development ; Bone Regeneration ; Female ; Fetal Blood ; Humans ; Mesenchymal Stem Cell Transplantation ; Mesenchymal Stromal Cells ; Models, Animal ; Osteoblasts ; Osteogenesis ; Osteoporosis ; Ovariectomy ; Rats ; Stem Cells ; Umbilical Cord