Search

Direct oral anticoagulants (DOACs) are widely used for the prevention of ischemic stroke and systemic embolism in patients with nonvalvular atrial fibrillation (NVAF). However, the differences in safety and effectiveness among four DOACs, dabigatran, rivaroxaban, apixaban, and edoxaban, in Japanese patients have not been clarified. Therefore, we conducted a retrospective cohort study to directly compare the safety and effectiveness among the four DOACs using the Japan Medical Data Center (JMDC) claims database. We identified 3823 patients with NVAF who started receiving a DOAC between March 2011 and June 2017. The safety outcome was major bleeding (a composite outcome of intracranial, gastrointestinal, respiratory, or renal/urinary tract bleeding) and the effectiveness outcome was the composite of ischemic stroke including transient ischemic attack (TIA) or systemic embolism. We constructed a Cox proportional hazard model to calculate the hazard ratio (HR) for all four DOAC combinations. The risk of major bleeding was significantly lower in the dabigatran group than in the apixaban group (HR, 0.55; 95% confidence interval (CI), 0.31-0.93; p = 0.03). In contrast, there was no significant difference in the risk of major bleeding among the other DOACs. In the composite risk of ischemic stroke including TIA or systemic embolism, there was no significant difference among the four DOACs. This study suggested that in the current use of DOACs in Japanese patients with NVAF, dabigatran had a significantly lower risk of major bleeding than apixaban, but there was no significant difference in effectiveness among the four DOACs.

Oral anticoagulants (OACs) pose a major bleeding risk, which may be increased or decreased by concomitant medications. To explore medications that affect the bleeding risk of OACs, we conducted a nested case-control study including 554 bleeding cases (warfarin, n = 327; direct OACs [DOACs], n = 227) and 1337 non-bleeding controls (warfarin, n = 814; DOACs, n = 523), using a Japanese health insurance database from January 2005 to June 2017. Major bleeding risk associated with exposure to concomitant medications within 30 d of the event/index date was evaluated, and adjusted odds ratios (aORs) were calculated using logistic regression analysis. Several antihypertensive drugs, such as amlodipine and bisoprolol, were associated with a decreased risk of bleeding (warfarin + amlodipine [aOR, 0.64; 95% confidence interval (CI): 0.41-0.98], DOACs + bisoprolol [aOR, 0.51; 95% CI, 0.33-0.80]). As hypertension is considered a significant risk factor for intracranial bleeding in antithrombotic therapy, antihypertensive drugs may suppress intracranial bleeding. In contrast, telmisartan, a widely used antihypertensive drug, was associated with an increased risk of bleeding [DOACs + telmisartan (aOR, 4.87; 95% CI, 1.84-12.91)]. Since telmisartan is an inhibitor of P-glycoprotein (P-gp), the elimination of rivaroxaban and apixaban, which are substrates of P-gp, is hindered, resulting in increased blood levels of both drugs, thereby increasing the risk of hemorrhage. In conclusion, antihypertensive drugs may improve the safety of OACs, and the pharmacokinetic-based drug interactions of DOACs must be considered.

Hepatitis B virus (HBV) infection is difficult to cure owing to the persistence of covalently closed circular viral DNA (cccDNA). We performed single-cell transcriptome analysis of newly established HBV-positive and HBV-negative hepatocellular carcinoma cell lines and found that dedicator of cytokinesis 11 (DOCK11) was crucially involved in HBV persistence. However, the roles of DOCK11 in the HBV lifecycle have not been clarified.The cccDNA levels were measured by Southern blotting and real-time detection polymerase chain reaction in various hepatocytes including PXB cells by using an HBV-infected model. The retrograde trafficking route of HBV capsid was investigated by super-resolution microscopy, proximity ligation assay, and time-lapse analysis. The downstream molecules of DOCK11 and underlying mechanism were examined by liquid chromatography-tandem mass spectrometry, immunoblotting, and enzyme-linked immunosorbent assay.The cccDNA levels were strongly increased by DOCK11 overexpression and repressed by DOCK11 suppression. Interestingly, DOCK11 functionally associated with retrograde trafficking proteins in the trans-Golgi network (TGN), Arf-GAP with GTPase domain, ankyrin repeat, and pleckstrin homology domain-containing protein 2, and ADP-ribosylation factor 1, together with HBV capsid, to open an alternative retrograde trafficking route for HBV from early endosomes (EEs) to the TGN and then to the endoplasmic reticulum (ER), thereby avoiding lysosomal degradation. Clinically, DOCK11 levels in liver biopsies from patients with chronic hepatitis B were significantly reduced by entecavir treatment, and this reduction correlated with HBV surface antigen levels.HBV uses a retrograde trafficking route via EEs-TGN-ER for infection that is facilitated by DOCK11 and serves to maintain cccDNA. Therefore, DOCK11 is a potential therapeutic target to prevent persistent HBV infection.

RoFSO technology can easily transmit radio frequency signals using optical carriers in the atmosphere. On the other hand, MIMO transmission have widely used in recent mobile communication, and there are some reports about FSOMIMO transmission. This paper demonstrates a RoFSO- MIMO transmission system which combines technologies of FSO-MIMO and RoF to enhance the flexibility of mobile front-haul. The proposed system uses pilot RF signals to estimate the FSO channel which is affected by atmospheric turbulence and so on. In this paper, we theoretically analyze RF signal quality for various turbulence conditions and show some experimental results of 2x2 RoFSO-MIMO transmission. Performance comparison results will show the effectiveness of the proposed technology.

Background: Hyperuricemia drives the development of nonalcoholic fatty liver disease (NAFLD). Pharmacological inhibition of xanthine oxidase (XO), a rate-limiting enzyme for uric acid (UA) production, has been demonstrated to improve hepatic steatosis in diet-induced obese mice. However, it remains unclear whether inhibition of XO could improve nonalcoholic steatohepatitis (NASH), a more advanced form of NAFLD, in terms of both liver inflammation and fibrosis. Methods: To investigate the effects of febuxostat and allopurinol, XO inhibitors clinically used for gout, on diet-induced NASH, C57BL/6J mice were fed a high-fat, high-cholesterol, and cholate diet (CL diet) with or without either 0.001% febuxostat or 0.003% allopurinol for 18 weeks. Systemic glucose tolerance and insulin sensitivity, liver histology, inflammation, and oxidative stress were tested. Furthermore, we conducted a single-arm, open-label intervention study with febuxostat for NAFLD patients with hyperuricemia. Findings: Despite a similar hypouricemic effect of the XO inhibitors on blood UA level, febuxostat, but not allopurinol, significantly decreased hepatic UA levels in CL diet-fed mice. This reduction in hepatic UA levels was accompanied by alleviated insulin resistance, lipid peroxidation, and classically activated M1-like macrophage accumulation in the liver. Furthermore, in NAFLD patients with hyperuricemia, treatment with febuxostat for 24 weeks decreased the serum UA level, accompanied by a reduction in serum levels of liver enzymes, alanine aminotransferase and aspartate aminotransferase. Interpretation: XO may represent a promising therapeutic target in NAFLD/NASH, especially in patients with hyperuricemia. Trial Registration: The study has been registered with UMIN-CTR (#UMIN000008686). Funding Statement: This work was supported by Grants-in-aid for Scientific Research (B) (25282017) and Challenging Exploratory Research (15K12698) from the Ministry of Education, Culture, Sports, Science, and Technology of Japan and the Japan Diabetes Foundation (to T.O.). This study was also supported by Teijin Pharma Limited. Declaration of Interests: The authors declare no conflict of interest associated with this manuscript. Ethics Approval Statement: The study was approved by the Ethics Committee of Kanazawa University Hospital. All animal procedures were performed in accordance with the Guidelines for the Care and Use of Laboratory Animals of Kanazawa University, Japan.

Multiple pyrenes as pendants of enantioimpure di-/tripeptides (abbreviated as N-LD-C, N-DL-C, N-LLD-C and N-DDL-C) showed pyrene-origin CPL and CD signals, which were associated with conflicting CPL-/CD-signs, compared to the corresponding enantiopure di-/tri-peptides.

Hepatitis C virus (HCV) cell culture systems have facilitated the development of efficient direct-acting antivirals against HCV. Huh-7.5, a subline of the human hepatoma cell line Huh-7, has been used widely to amplify HCV because HCV can efficiently replicate in these cells due to a defect in innate antiviral signalling. Recently, we established a novel cell line, KH, derived from human hepatocellular carcinoma, which showed atypical uptake of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) in a Gd-EOB-DTPA-enhanced magnetic resonance imaging study. KH cells expressed hepatocyte markers including microRNA-122 (miR-122) at a lower level than Huh-7.5 cells. We demonstrated that KH cells could support the entire life cycle of HCV; however, HCV replicated at a lower rate in KH cells compared to Huh-7.5 cells, and virus particles produced from KH cells seemed to have some disadvantages in viral assembly compared with those produced from Huh-7.5 cells. KH cells had more robust interferon-stimulated gene expression and induction upon HCV RNA transfection, interferon-α2b addition, and HCV infection than Huh-7.5 cells. Interestingly, both miR-122 supplementation and IRF3 knockout in KH cells boosted HCV replication to a similar level as in Huh-7.5 cells, suggesting that intact innate antiviral signalling and lower miR-122 expression limit HCV replication in KH cells. KH cells will enable a deeper understanding of the role of the innate immune response in persistent HCV infection.

We prepared 16 novel chiral peptide–pyrene organic luminophores with different distances between the fluorescent pyrene groups and investigated their properties in CHCl3 at room temperature. The peptide–pyrene organic luminophores bearing two pyrene groups emit strong excimer circularly polarized luminescence (CPL) in the solution state. Two pendant pyrenyl groups in a series of chiral oligopeptides clearly revealed excimer CPL in chloroform at 480–490 nm (|gem| ≈ (2–8) × 10–3). When the distance between the two pyrenes increased, the sign of the CPL signals was inverted twice, while the sign of the corresponding circular dichroism (CD) signals was retained, (|gCD| ≈ (3–8) × 10–5).

Simeprevir is a novel NS3/4A protease inhibitor (PI) of hepatitis C virus (HCV). The baseline polymorphism NS3-Q80K is frequently observed in genotype (GT) 1a HCV and often associated with treatment failure in simeprevir-containing regimens. We aimed to elucidate mechanisms of treatment failure due to NS3-Q80K. We included a Q80R mutation in our study and generated a series of Huh-7.5 cell lines, each of which harbored either wild-type GT 1a strain H77S.3 or the Q80K or Q80R variant. The cells were cultured with increasing concentrations of simeprevir, and NS3 domain sequences were determined. The mutations identified by sequence analyses were subsequently introduced into H77S.3. The sensitivity of each mutant to the NS3/4A PIs simeprevir, asunaprevir, grazoprevir, and paritaprevir was analyzed. We introduced the mutations into GT 1b strain N.2 and compared the sensitivity to simeprevir with that of GT 1a strain H77S.3. While simeprevir treatment selected mutations at residue D168, such as D168A/V in the wild-type virus, an additional mutation at residue R155, R155K, was selected in Q80K/R variants at simeprevir concentrations of

Among l- and d-oligopeptides with multiple pyrenes as pendants, the dipeptides with two and three pyrenes showed blue-coloured circularly polarised luminescence as high as |gem| ≈ (0.86−1.1) × 10−2 at around 450 nm, reflecting from exciton couplets of twisted pyrenes.

Field surveys and indoor experiments were conducted to prevent the outbreak of green tide by Ulva pertusa at Osaka Nanko Bird Sanctuary. Reduction of biomass of Ulva pertusa was observed at stations where exposure rate to the air was from 30 to 40%. In addition, the exposure rate of 30 to 40% to the air showed no negative impacts on the benthic microalgae and macro-benthic animals. Laboratory experiments revealed that photosynthesis activity of Ulva pertusa decreased when exposed to air for 4 to 7 hours at 25- 35℃. Salinity decrease from 30 to 25 or 20 psu in accompanied with exposure to the air drastically inhibited the photosynthesis of this species. These results suggest the possibility of controlling a green tide of Ulva pertusa without any damage to benthic microalgae and macro-benthic animals by a combination of ground level and low salinity.

Mutations in the mitochondrial DNA (mtDNA) displacement loop (D-loop) region were investigated to clarify the possible molecular mechanisms underlying the development of lung tumors induced by N-nitrosobis(2-hydroxypropyl)amine (BHP) in rats. Male Wistar rats, 6 weeks of age, were given 2000 ppm BHP in their drinking water for 12 weeks and then maintained without further treatment until sacrifice at 25 weeks. Genomic DNA was extracted from paraffin-embedded tissues and polymerase chain reaction (PCR)-single strand conformation polymorphism (SSCP) analysis, followed by nucleotide sequencing, was performed. Eleven out of 24 hyperplasias (45.6%), 8 out of 16 adenomas (50.0%), and 14 out of 21 adenocarcinomas (66.7%) showed numerical changes, in a polymeric C-tract at positions 16,086-16,092 of the mtDNA D-loop, with a one base insertion of cytosine increasing the length of the C-tract, from the seven nucleotides observed in normal lung tissues from non-BHP treated rats, to eight. These changes were all homoplasmic and no changes were found in lung lesions when the length of the C-tract in the normal lung tissues adjacent to the lesions was seven. These results suggest that alterations in the mtDNA D-loop may occur in an early phase of lung carcinogenesis induced in rats by BHP.

The authors investigated the DNA methylation patterns of the E-cadherin, Connexin 26 (Cx26), Rassf1a and c-fos genes in the early phase of rat hepatocarcinogenesis induced by a choline-deficient L-amino acid-defined (CDAA) diet. Six-week-old F344 male rats were continuously fed with the CDAA diet, and three animals were then killed at each of 4 and 8 days and 3 weeks. Genomic DNA was extracted from livers for assessment of methylation status in the 5' upstream regions of E-cadherin, Cx26, Rassf1a and c-fos genes by bisulfite sequencing, compared with normal livers. The livers of rats fed the CDAA diet for 4 and 8 days and 3 weeks were methylated in E-cadherin, Cx26 and Rassf1a genes, while normal livers were all unmethylated. In contrast, normal livers were highly methylated in c-fos gene. Although the livers at 4 days were weakly methylated, those at 8 days and 3 weeks were markedly unmethylated. Methylation patterns of CpG sites in E-cadherin, Cx26 and Rassf1a were sparse and the methylation was not associated with gene repression. These results indicate that gene-specific DNA methylation patterns were found in livers of rats after short-term feeding of the CDAA diet, suggesting gene-specific hypermethylation might be involved in the early phase of rat hepatocarcinogenesis induced by the CDAA diet.

Mutations in the mitochondrial DNA (mtDNA) displacement loop (D-loop) region were investigated to clarify the possible molecular mechanisms underlying the development of hamster pancreatic tumors. Female Syrian golden hamsters received 30 mg/kg N-nitrosobis(2-oxopropyl)amine (BOP), followed by repeated exposure to an augmentation pressure regimen consisting of a choline-deficient diet combined with ethionine, then methionine injections and a further administration of 20 mg/kg BOP. A total of 11 pancreatic duct adenocarcinomas (PDAs) were obtained 10 weeks after beginning the experiment, and three cell lines established from subcutaneously transplantable PDAs in syngeneic hamsters were examined for mutations using polymerase chain reaction (PCR) - single strand conformation polymorphism (SSCP) analysis. No mutations were detected in the 11 PDAs and 3 cell lines. These results suggest that alterations of the mtDNA D-loop might not be involved in BOP-induced pancreatic duct carcinogenesis in hamsters.

A 78-year-old man with hepatocellular carcinoma was admitted to our hospital for vertigo after transcatheter arterial chemoembolization. Contrast-enhanced magnetic resonance imaging revealed metastasis in the cerebellar vermis. Although the cerebellar metastasis decreased in size after cyberknife radiotherapy, multiple enhancing nodules appeared in the cerebral ventricles. A diagnosis of intraventricular dissemination from the cerebellar metastatic lesion originating from the hepatocellular carcinoma was made. Six intrathecal administrations of 20 mg of methotrexate through lumbar puncture resulted in a dramatic decrease in the intraventricular dissemination. Although intraventricular dissemination recurred 4 months later, these lesions disappeared after an additional 8 administrations of intrathecal methotrexate. Intraventricular dissemination arising from hepatocellular carcinoma is rare. Here we report a case that was successfully treated by intrathecal chemotherapy with methotrexate.

In the present study, the authors conduct subsonic wind‐tunnel experiments, in order to investigate the effect of a depth‐to‐width ratio λ upon the tumbling of a simple two‐dimensional rectangular‐cross‐section prism. The authors carry out both flow visualisation and velocity measurement using a hot‐wire anemometer, together with the synchronised measurement of a prism’s attack angle α, which are analised using a phase‐averaging technique. As a result, there are two modes for λ

Mutations of the mitochondria DNA (mtDNA) displacement loop (D-loop) were investigated to clarify different changes of exogenous and endogenous liver carcinogenesis in rats. We induced hepatocellular carcinomas (HCCs) in rats with N-nitrosodiethylamine (DEN) and a choline-deficient l-amino acid-defined (CDAA) diet. DNAs were extracted from 10 HCCs induced by DEN and 10 HCCs induced by the CDAA diet. To identify mutations in mtDNA D-loop, polymerase chain reaction (PCR)-single strand conformation polymorphism (SSCP) analysis, followed by nucleotide sequencing, was performed. Mutations were detected in 5 out of 10 HCCs (50%) induced by DEN. Four out of 5 mutations were G/C to A/T transitions at positions 15707, 15717, 15930, and 16087, and one T/A to C/G transition at position 15559. By contrast, no mutations were found in 10 HCCs induced by the CDAA diet. These results demonstrated that mutations in mtDNA D-loop occur in rat HCCs induced by DEN but not by the CDAA diet, suggesting that mtDNA D-loop is a target of exogenous liver carcinogenesis in rats.

The film thickness (20–200 nm) dependence of the crystalline structure, lattice parameters and electrical properties of highly strained Pb(Zr,Ti)O3 (PZT) thin films on MgO(100) was investigated. The PZT films were practically c-axis orientation. As the film thickness decreased (< 100 nm), the tetragonality ratio of PZT also decreased owing to the inner expanding strain in the in-plane direction. The dielectric constant decreased and the structural phase transition temperature shifted to a lower temperature corresponding with the decrease in the tetragonality ratio. The electric displacement-electric field (D-E) hysteresis curves for the thick (> 40 nm) films exhibited a certain amount of remanent polarization in the in-plane direction, implying the formation of a-domains. The relationship between electrical properties and the inner strain is discussed.