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There are only few reports on surgery for partial atrioventricular septal defect( pAVSD) in patients aged over 70 years. This report is about successful surgical correction of pAVSD in a 79-year-old women. Echocardiography showed left-sided atrioventricular valve regurgitation with cleft and ostium primum atrial septal defect, but without ventricular septal defect. Accordingly, she was diagnosed with pAVSD. Treatment plan included direct cleft closure, patch closure for the ostium primum atrial septal defect, and right atrioventricular annuloplasty. The postoperative course was uneventful. She was followed up without complications for four years. To the best of our knowledge, our patient is the oldest to undergo such surgical techniques in Japan to date.

Atrial remodeling associated with atrial fibrillation (AF) and sleep apnea is well known. Although sleep apnea is known to be associated with left atrial (LA) remodeling, its association with right atrial (RA) remodeling remains unclear. The study aimed to investigate the effect of sleep apnea on RA remodeling.We enrolled 141 AF patients who had undergone ablation. Sleep study results were evaluated using a portable sleep apnea test device. RA and LA volumes were determined by computed tomography (CT), and atrial structural remodeling was defined as atrial volume on CT≥110mL according to previous reports. The atrial substrate was evaluated by three-dimensional electroanatomical mapping.After excluding 30 patients who received more than one catheter ablation or who could not receive enhanced CT, 111 patients were finally analyzed. The patients were classified into four groups according to the presence of RA and/or LA enlargement. Significant differences in AF type, N-terminal pro B-type natriuretic peptide (NT-proBNP) levels, and apnea-hypopnea index (AHI) were observed among the four groups. In univariate analysis, AHI values correlated with NT-proBNP levels (r=0.293, p=0.002), left ventricular ejection fraction (r=-0.198, p=0.044), LA volume (r=0.370, p0.001), and RA volume (r=0.465, p0.001). Multiple regression analysis showed that AHI was an independent predictor of increased RA volume, and LA was excluded as a multiple risk factor in AHI. AF type-adjusted AHI levels correlated with RA volume, and RA remodeling correlated with the percentage of LA low-voltage area.Sleep apnea was strongly associated with RA structural remodeling regardless of paroxysmal and non-paroxysmal AF, and this relationship was more prominent than the effect of LA. Our results suggest that the association between sleep apnea and RA dilatation should be given attention.

A 27-year-old Caucasian male traveler with well-controlled asthma was admitted to our hospital because of severe heart failure (HF). He had a history of cocaine use. Transthoracic echocardiography (TTE) showed severe diffuse hypokinesis of the left ventricle (LV) and a large mobile thrombus in the LV. He was treated with diuretics, inotropes and anticoagulants which led to small improvements in the HF and LV thrombus, however, he needed to undergo left ventricular assist device (LVAD) implantation and surgical removal of a residual LV thrombus due to inotrope-dependency.It is necessary to consider the possibility of cocaine or illicit drug use in a young individual with cardiovascular disease or sudden death even in Japan where cocaine and drugs are prohibited by law, as recreational drug use has been increasing in many countries around the world.

We characterized the adsorption and desorption of α-gel (α-form hydrated crystal) dispersions in aqueous media using a quartz crystal microbalance with dissipation monitoring (QCM-D) technique. The α-gel was formed from a mixture of N-[3-(dimethylamino)propyl]docosanamide (APA-22) L-lactic acid salt, 1-octadecanol (C18OH), and water. The solid substrate employed in this study as a model for hair was silica. The QCM-D measurements revealed that the α-gel dispersions yielded a rigid adsorption film on the negatively charged silica surface. The adsorption mass decreased with decreasing domain size (on the micrometer scale) of the α-gel dispersions. The adsorption film highly restricted the desorption of the α-gel from the silica surface even after rinsing with water. The adsorption film also exhibited excellent lubrication ability in aqueous media both before and after rinsing with water. We expect that the α-gel formed by APA-22 L-lactic acid is a potential ingredient for formulating an environment-friendly hair conditioner owing to its high adsorption, limited desorption, and excellent lubrication abilities on the solid surface.

Percutaneous left atrial appendage (LAA) closure with the Watchman device (Boston Scientific, Marlborough, Massachusetts) is effective in high-risk patients in whom warfarin is contraindicated; it is increasingly being used as an alternative to warfarin for long-term prevention of stroke [(1)][1].

We studied the structures and properties of gel samples prepared by mixtures of N-[3-(dimethylamino)propyl]docosanamide (APA-22) acid salt (APA-22 L-lactic acid), 1-octadecanol (C18OH), and water. The gel samples prepared at the mole ratios [APA-22 L-lactic acid]:C18OH = 1:3, 1:4, and 1:5 yielded two phases; one being the α-gel (α-form hydrated crystal) phase, incorporating a significant quantity of water between lamellar bilayers, and the other being the excess water phase. The lamellar d-spacing remained practically unaltered at these mole ratios, thus maintaining the quantity of water incorporated between the lamellar bilayers relatively constant. Starting at 30°C, the gel samples transformed into a lamellar liquid crystal phase at high temperatures (85°C) and a β-gel phase at low temperatures (5°C). Interestingly, following dilution by pure water, the viscosity of the gel samples decreased with increasing C18OH content. We expect that the viscosity change affects the performance of the gel samples as hair conditioners.

We determine the effects of the α-gel (α-form hydrated crystal) domain size on the viscosity of water-diluted α-gels consisting of the N-[3-(dimethylamino)propyl]docosanamide (APA-22) L-lactic acid salt, 1-octadecanol (C18OH), and water. A decrease in the C18OH mole content results in increased domain size and viscosity of the water-diluted α-gel system. Additionally, when a sample is prepared by slow cooling and/or at low stirring speed, the domain size and viscosity of the water-diluted α-gel system increase. A similar increase in the domain size and viscosity of the α-gel system is observed for annealed samples. The observed change in the α-gel domain size is explained by the crystal growth theory.

There is increased interest in creating high-power short duration (HPSD) ablation lesions in the field of atrial fibrillation (AF) radiofrequency ablation (RFA). We evaluated the lesion characteristics and collateral damage using two separate RFA protocols setting (HPSD: 50 W and 7 s vs control: 25 W and 30 s) in vitro model. Sixteen freshly killed porcine hearts were obtained, and the atrium and ventricle slabs were harvested for ablation. The each slabs were placed in a tissue bath with circulating 0.9% NaCl at maintained temperature 37 °C. RFA was performed with 4 mm tip irrigated force sensing catheter. All lesions were ablated under recording the electrical parameters using with Ensite Navx system (St. Jude Medical, St. Paul, Minnesota). After RFA, lesion characteristics were assessed for each lesion. Thirty-five lesions were made for each ablation protocol (total 70 lesions for analysis). Ablation parameters were similar between two groups (HPSD vs control; impedance drop (Ω): 34.2 ± 13.1 vs 36.1 ± 8.65 P = 0.49, contact force (g): 13.9 ± 4.37 vs 14.6 ± 5.09, P = 0.51, lesion size index: 4.8 ± 0.52 vs 4.73 ± 0.59, P = 0.62). Although the lesion volume was similar, the HPSD ablation creates wider but more shallower lesions compared to control group (HPSD vs control; lesion volume: 29.6 ± 18.1 mm3 vs 35.5 ± 17.1 mm3 P = 0.16, lesion diameter: 4.98 ± 0.91 mm vs 4.45 ± 0.74 mm P = 0.0095, lesion depth: 2.2 ± 0.76 mm vs 2.8 ± 1.56 mm P = 0.046). Of these, 38 lesions were assessed for adjacent tissue damage and adjacent tissue damages were more frequent seen in control group (HPSD vs control; 1/19 (5.26%) vs 6/19 (31.5%), P = 0.036). Effective lesions were made with HPSD, thereby reducing RFA procedure time. Although the lesion volume was similar between two groups, collateral damage was less seen in HPSD group attributed by lesion characteristics.

In photosystem II, redox potential Em of primary quinone QA shifts by approximately +150 mV upon inactivation of the Mn4CaO5 cluster. Although this phenomenon is important in photoprotection, the molecular mechanism of the positive Em(QA–/QA) shift remains unclear. Here, we investigated the effect of Mn depletion on the interaction of QA using light-induced ATR-FTIR spectroscopy. It was shown that Mn depletion hardly changed a QA–/QA FTIR difference spectrum, indicating that the H-bond interaction of QA and its immediate surroundings were virtually unchanged by Mn4CaO5 cluster inactivation. On the basis of this result, a possible mechanism of the Em(QA–/QA) shift is discussed.

Purpose: The purpose of this study was to analyze the developmental changes in Necker cube copying and isometric perspective cube copying abilities of Japanese children of typical development. Methods and Results: [Study-1] A total of 40 individuals aged 5 - 18 years participated in Study-1. The Necker cube copying task was administered, and scores were assigned based on the method developed by Yorimitsu et al. (2013). The results showed that the scores increased significantly for children in the 8 - 9 years age group (p < 0.01).[Study-2] A total of 32 individuals aged 6 - 10 years participated in Study-2. The isometric perspective cube copying task was administered, and scores were assigned based on the method developed by Otomo (2009). The results showed that the scores increased significantly for children in the 7 - 8 years age group (p < 0.05). Conclusions: Japanese children of typical development were able to perform the Necker cube copying task from approximately nine years of age. The same participants were able to perform the isometric perspective cube copying task from approximately eight years of age.

The maintenance of a balance between work and disease treatment is an important issue in Japan. This study explored factors that affect collaboration between occupational physicians (OPs) and attending physicians (APs). A questionnaire was mailed to 1,102 OPs. The questionnaire assessed the demographic characteristics of OPs; their opinions and behaviors related to collaboration, including the exchange of medical information with APs; and the occupational health service system at their establishments. In total, 275 OPs completed the questionnaire (25.0% response rate). Over 80% of respondents believed OPs should collaborate with APs. After adjusting for company size, collaboration ≥10 times/yr (with regard to both returning to work following sick leave and annual health check-ups for employees) was significantly associated with environmental factors, such as the presence of occupational health nurses (odds ratio (OR): 5.56 and 5.01, respectively, p0.05). The majority of OPs believed that collaboration with APs is important for supporting workers with illnesses. Support systems including prescribed forms of information exchange and occupational health nurses, play pivotal roles in promoting this collaboration.

Three new compounds, 1-3, together with 22 known compounds, were isolated from the fruits of Piper retrofractum. The structures of the new compounds were elucidated on the basis of spectroscopic data analysis and comparison with literature values. Compound 1 was found to enhance the neurite outgrowth of NGF-mediated PC12 cells at concentrations ranging from 0.1 to 10 μM.

In photosystem II, redox potential E

BACKGROUND To reduce myocardial damage caused by implantable cardioverter defibrillator (ICD) shock, the left axilla was studied as an alternative pulse generator implantation site, and compared with the traditional implantation site, the left anterior chest. METHODS AND RESULTS Computer simulation was used to study the defibrillation conduction pattern and estimate the simulated defibrillation threshold (DFT) and myocardial damage when pulse generators were placed in the left axilla and left anterior chest, respectively; pulse generators were also newly implanted in the left axilla (n=30) and anterior chest (n=40) to compare the corresponding DFT. On simulation, when ICD generators were implanted in the left axilla, compared with the left anterior chest, the whole heart may be defibrillated with a lower defibrillation energy (left axilla 6.4 J vs. left anterior chest 12.0 J) and thus the proportion of cardiac myocardial damage may be reduced (2.1 vs. 4.2%). Clinically, ventricular fibrillation was successfully terminated with a defibrillation output ≤5 J in 86.7% (26/30) of the left axillary group, and in 27.5% (11/40) of the left anterior group (P

Background Subcutaneous implantable cardiac defibrillator (S-ICD) systems have a lower invasiveness than traditional ICD systems, and expand the indications of ICD implantations. The S-ICD standard defibrillation shock output energy, however, is approximately 4 times that of the traditional ICD system. This raises concern about the efficacy of the defibrillation and myocardial injury. In this study, we investigated the defibrillation efficacy and myocardial injury with S-ICD systems based on computer simulations. Methods and results First, computer simulations were performed based on the S-ICD system configurations proposed in a previous study. Furthermore, simulations were performed by placing the lead at the left or right parasternal margin and the pulse generator in the superior and inferior positions (0-10 cm) of the recommended site. The simulated defibrillation threshold (DFT) for the 4 S-ICD system configurations were 30.1, 41.6, 40.6, and 32.8 J, which were generally similar to the corresponding clinical results of 33.5, 40.4, 40.1, and 34.3 J. Conclusions The simulated DFT were generally similar to their clinical counterparts. In the simulation, the S-ICD system had a higher DFT but relatively less severe myocardial injury compared with the traditional ICD system. Further, the lead at the right parasternal margin may correspond to a lower DFT and cause less myocardial injury.

The IF3 gene was isolated by expression cloning from a cDNA library of mouse oocytes. This gene was revealed to have no homology to any known gene and its cDNA encodes a 202-amino acid protein that contains a signal-peptide sequence. Moreover, an IF3 isoform, IF3 2 , was expressed in both liver and ovary. Its cDNA encoded a 92-amino acid protein contains a signal-peptide sequence, which may be an alternative splice and frameshift form of IF3. The mRNA of IF3s was expressed in oocytes, ovary, and liver. Moreover, the gene expression of IF3s was regulated in a development-dependent manner in preimplantation-embryo and liver. Both IF3 1 and IF3 2 isoforms induced the differentiation of 2T3 and ATDC5 cells to the osteogenic and chondrogenic phenotype, respectively, suggesting that IF3s may modulate the differentiation status. Our findings suggest that IF3 may be one of the secreted factors that regulate oogenesis and certain liver functions.