P1717The clinical impact of intra-aortic balloon pumping for acute coronary syndrome from Mie ACS registry

Background

Intra-Aortic Balloon Pumping (IABP) was widespread used in cases of Acute Coronary Syndrome (ACS) at daily clinical situation in Japan, even though the efficacy of IABP in AMI patients with cardiogenic shock was not proved. The aim of this study was to investigate the efficacy of IABP use in ACS patients in Japan.

Methods

We investigated 2-year all-cause-mortality of 2,660 enrolled ACS patients including 358 patients with IABP and 2,302 patients without IABP from Mie ACS registry.

Results

We compared a 1:1 propensity score-matched cohort of 426 ACS patients with or without IABP (n=213, respectively). 2-year mortality was significantly higher in patients with IABP than without IABP (p=0.02, Figure A). In addition, IABP usage was independent predictor of mortality with hazard ratio of 1.6 by multivariate analysis. However, 2-year mortality was not statistically different between 2 groups only when analyzed patients with shock (p=0.60, Figure B).

Figure 1

Conclusion

IABP was not commonly recommended in ACS patients. However, IABP was might as well used in some situation especially in shock.

P2659Difference of prognostic impact of Killip classification in ACS patients with or without hemodialysis

Background

Cardiovascular deaths are more frequently in hemodialysis (HD) patients compared to general population. However, difference of prognosis of acute coronary syndrome (ACS) patients with or without HD were not well evaluated.

Purpose

The purpose of this study was to evaluate the clinical and prognostic characteristics of ACS patients with HD compared to that of ACS patients without HD.

Methods

We investigated 3427 ACS patients including 63 HD and 3364 non-HD patients between 2013 and 2017 using date from Mie ACS registry, a retrospective and multicenter registry. The primary outcome was defined as all-cause mortality.

Results

HD patients showed significantly higher prevalence of diabetes mellitus, past treatment of coronary artery disease, history of myocardial infarction and Killip ≥2 compared to non-HD patients (p<0.05, respectively). During the follow-up periods (median 719 days), 425 (12.4%) patients experienced all-cause death. HD patients demonstrated the higher all-cause mortality rate compared to that of non-HD patients during the follow-up (11.9% versus 38.1%, p<0.001, chi square). Kaplan Meier survival curves demonstrated that HD and non-HD patients with Killip 1 showed similar 30-day mortality, and Killip ≥2 patients also showed similar prognosis (Left side of figure). On the other hand, all cause mortality at 2 years were higher in Killip 1 HD patients compared to Killip 1 non-HD patients and similar between Killip 1 HD patients and Killip ≥2 non-HD patients in the 30 days landmark analysis (Right side of figure). In addition, cox regression analyses for all cause mortality demonstrated that HD was a strongest independent prognostic factor not of 30-day mortality but of after 30-day mortality with hazard ratio of 4.09 (95% confidential interval: 2.32–7.21, p<0.001).

Figure 1

Conclusion

Careful management are required in chronic phase for ACS patients with HD even in Killip 1 classification.

Gyroid structured aqua-sheets with sub-nanometer thickness enabling 3D fast proton relay conduction

We have succeeded in creating gyroid-nanostructured polymer films having a 3D continuous proton conduction pathway.

A polymerizable amphiphile having two zwitterionic head-groups has been designed. This compound co-organizes with an acid, bis(trifluoromethanesulfonyl)imide (HTf₂N), into a gyroid bicontinuous cubic liquid-crystalline phase. In situ polymerization of this phase has been successfully achieved by UV irradiation in the presence of a photoinitiator, yielding a self-standing gyroid-nanostructured polymer film. When the polymer film is placed under different relative humidity conditions or in water, it absorbs water owing to the strong hydration ability of the zwitterionic parts. It has been found that the polymer film preserves the gyroid nanostructure after the water absorption. Based on reconstructed electron density maps, it is assumed that the absorbed water molecules form a 3D continuous network along the gyroid minimal surface, which satisfies several key conditions for inducing fast proton conduction. As expected, such hydrated films show high ionic conductivities in the order of 10^–1 S cm^–1 when the water content of the film reaches 15.6 wt% at RH = 90%. The high conductivity is attributed to the induction of the Grotthuss mechanism, that is, proton conduction via the hydrogen-bonding network of the incorporated water molecules.

Subjective Evaluation of Denture Adhesives: A Multicenter Randomized Controlled Trial

INTRODUCTION

Many reports show that denture adhesives improve the retention and stability of dentures. However, few randomized controlled trials have examined the effects of denture adhesives.

OBJECTIVE

This 10-center randomized controlled trial with parallel groups involving 200 edentulous patients wearing complete dentures aimed to evaluate the effects of short-term use of cream and powder denture adhesives.

METHODS

Patients were allocated into 2 cream- and powder-type adhesive groups and 1 control group. Intervention groups were treated with the 2 adhesives (1 each), and the control group received saline solution. Adhesive or control was applied to the denture-mucosal surface for 4 d, and data at baseline and after day 4 of intervention (i.e., 8 meals) were obtained. Patient satisfaction was evaluated with a 100-mm visual analog scale. Oral health-related quality of life was measured with the Japanese version of the Oral Health Impact Profile for Edentulous Patients. Perceived chewing ability was evaluated by a questionnaire regarding ease of chewing and swallowing food. Between-group comparisons were performed with Kruskal-Wallis tests with the Mann-Whitney U test adjusted by Bonferroni correction. Within-group comparisons of pre- and postintervention measurements were performed with the Wilcoxon signed-rank test. Intention-to-treat analysis was also performed.

RESULTS

Between-group comparisons showed no significant differences for general satisfaction or Oral Health Impact Profile for Edentulous Patients. However, significant differences in satisfaction with various denture functions with cream- and powder-type adhesives were seen in pre- and postintervention comparisons (P < 0.05). Significant differences were also observed for perceived chewing ability of hard foods (P < 0.05).

CONCLUSION

These results suggest that although denture adhesives do not invariably improve denture function, they do affect subjective evaluations and possibly chewing of hard foods. Therefore, the effects of denture adhesive use are insufficient to resolve any fundamental dissatisfaction with dentures ( ClinicalTrials.gov NCT01712802 ).

KNOWLEDGE TRANSFER STATEMENT

The results of this study suggest that denture adhesives should be applied under certain conditions; however, an appropriate diagnosis is important before application. These practice-based data provide information to establish evidence-based guidelines for applying denture adhesives.

Craniofacial penetration by a wooden stick

INTRODUCTION

Penetrating craniofacial injuries caused by stick-like foreign bodies occur as a result of accidents particularly in children, and often lead to significant morbidity.

CASE SUMMARY

We describe a 5-year-old boy who sustained facial trauma after falling on a wooden stick which penetrated his left cheek. At the initial visit, his vital and neurological signs were normal. However, the stick had penetrated the frontal lobe to a depth of 3cm via the orbital cavity and the anterior skull base. The stick was successfully removed while visualizing the anterior skull base in an endoscopic transethmoidal approach. A follow-up examination one year after the accident demonstrated normal visual acuity and ocular motility, with no diplopia, tearing or pain.

DISCUSSION

Penetrating facial injuries caused by stick-like objects carry a significantly higher risk of serious neurological involvement. Even if penetrating facial injuries sometimes appear trivial, the external injury site is often insufficient to determine the position of the object within the head. Although the cheek is a rare entry site for intracranial injuries, the extent of damage should be assessed fully before attempting removal.

[A Review of Six Cases of Neuro Endocrine Carcinoma of the Stomach]

Gastric endocrine carcinoma is a comparatively rare type of gastric cancer, accounting for 0.6% of all gastric cancers. Six cases of gastric endocrine carcinomas that were identified from November 2011 to March 2017 were reviewed. The mean age of the patients was 73.3 years, and 1 patient had StageⅠA cancer, 1 had Stage ⅡB, 2 had Stage ⅢA, and 2 had Stage Ⅳ. Three patients had concomitant conventional adenocarcinoma. Four patients underwent total gastrectomy, 3 of whom showed liver metastases after surgery. The prognosis of gastric endocrine carcinoma is poor because it rapidly metastasizes to the liver and lymph nodes. When unresectable metastatic disease occurs, systemic therapy with cytotoxic chemotherapy can be introduced. Chemotherapy is performed in accordance with that for small cell lung cancer; however, the response rate of chemotherapy is very low, so further studies are needed to improve this treatment.

Novel V- and Y-Shaped Light-Emitting Liquid Crystals with Pentafluorinated Bistolane-Based Luminophores

Herein, we describe the synthesis of novel light-emitting liquid-crystalline (LC) compounds bearing pentafluorinated bistolane-based luminophores with a V- or a Y-shaped molecular geometry and the evaluation of their LC and photophysical characteristics. The V- or Y-shaped compounds exhibited a unique LC phase and showed photoluminescence (PL) behavior under various circumstances, such as in dilute solution or in the solid state. Notably, PL characteristics were observed even under high-temperature conditions with a crystal (Cr) to LC phase transition, although the PL efficiency (Φ PL) was gradually reduced because of thermal molecular motion. Interestingly, Φ PL was found to be completely recovered through the LC → Cr phase transition during the cooling process; the PL characteristics of the V- or Y-shaped compounds were sensitively changed by external thermal stress, giving these compounds the ability to act as thermoresponsive PL sensing materials.

Improvement of lipidic bicontinuous cubic phases by the addition of a zwitterion with strong hydration ability and kosmotropicity

The water activity of lipidic bicontinuous cubic phases is successfully reduced by adding an imidazolium-based zwitterion with strong hydration ability and kosmotropicity.

Dimension control of ionic liquids

Ionic liquids have established themselves as promising soft compounds for bringing innovation to materials science. For further developing functions and abilities of ionic liquids, one of the most important challenges is to organize ionic liquids into dimensionally ordered states. In this feature article, we will present the organization of ionic liquids by endowing them with liquid-crystalline properties. In particular, focusing on the specific abilities and properties of functional ionic liquids, a variety of nanostructured ionic materials have been developed and their unique and enhanced functions have been revealed. Some potential uses of organized ionic liquids have also been mentioned.

Phase Angle Is a Useful indicator for Muscle Function in Older Adults

AIM

Phase angle (PhA) can be determined through bioelectrical impedance analysis and is a unique variable for skeletal muscle. The objective of this study was to evaluate the relationship between PhA and muscle mass/quality in older adults. In addition, we attempted to determine the cutoff value of PhA for poor muscle function.

METHODS

Community-dwelling Japanese older men (n=285, 81.1±7.1 years) and women (n=724, 80.4±6.8 years) participated in this study and were classified into four groups based on the Asian Working Group for Sarcopenia (normal, presarcopenia, dynapenia, and sarcopenia). We measured PhA using bioelectrical impedance analysis, muscle quantity and quality indicators using ultrasonography, muscle strength, and physical performance and compared them in four groups. We also tried to determine the cutoff value of PhA for poor muscle function.

RESULTS

We found a significant difference in PhA among the four groups in men (P<0.05), and the dynapenia (3.61±0.75°) and sarcopenia groups (3.40±0.74°) showed significantly lower values than the normal group (4.50±0.86°) (P<0.05), but not the presarcopenia group (4.12±0.85°). In women, a significant difference was also observed among the four groups (P<0.05), and the dynapenia (3.41±0.65°) and sarcopenia groups (3.31±0.66°) showed significantly lower measures than the normal group (4.14±0.71°) (P<0.05), but not the presarcopenia group (4.07±0.51°). The receiver-operating characteristic curve analysis indicated the best cutoff value of PhA (men: 4.05°, women: 3.55°) to discriminate sarcopenia and dynapenia from normal and presarcopenia.

CONCLUSION

These findings suggest that PhA is a useful indicator for muscle function.

Fournier's gangrene caused by penetration of a rectal cancer followed by neoadjuvant chemotherapy

Background

Fournier’s gangrene is a necrotizing fasciitis of the genital and perineal region. It may progress, affecting the groin, the thigh, or even the abdominal wall.

Despite adequate treatment (debridement and antibiotics), the mortality rate is very high, reaching 20–35%. Fournier’s gangrene caused by penetration of a rectal cancer followed by neoadjuvant chemotherapy is very rare. We report this case with a review of the literature.

Case presentation

A 68-year-old man visited the emergency room due to perineal pain during which he accepted the chemotherapy for locally advanced rectal cancer. Abdominal CT scan showed extensive emphysema in the scrotum and gluteus maximus muscle. We diagnosed as Fournier’s gangrene caused by penetration of a rectal cancer. We performed debridement, left orchiectomy, transverse colostomy with double orifices. Post-operative day 30, we performed abdominoperineal resection. We performed CapeOX therapy eight courses as adjuvant chemotherapy. The patient had no recurrence for 1 year and 2 months after the operation.

Conclusions

Going forward, knowledge gained from this case will increase the opportunity to perform neoadjuvant chemotherapy for locally advanced rectal cancer. In medical treatment, we must put the possibility of Fournier’s gangrene in mind and treat as soon as possible.

Thermoresponsive luminescence properties of polyfluorinated bistolane-type light-emitting liquid crystals

We developed and characterized four polyfluorinated bistolane derivatives. These compounds, which possess either two alkoxy substituents or an alkoxy group and a bromine atom in their two molecular terminals, were synthesized from readily available 4-alkoxy-1-ethynylbenzene with a facile three-step procedure. Their thermodynamic and photophysical properties were evaluated in detail, and they were found to display both liquid-crystalline (LC) and photoluminescence properties. Remarkably, the photoluminescence behaviors dramatically changed during the thermal phase transition between the crystal and LC phases. Thus, these polyfluorinated bistolanes may be promising candidates for thermoresponsive luminous molecules.

[A Case of Advanced Gastric Cancer Treated with Curative Resection after Preoperative Secondary Chemotherapy with Irinotecan after Primary Chemotherapy with Docetaxel, Cisplatin, and S-1]

A 70-year-old man was diagnosed with advanced gastric cancer based on esophagogastroduodenoscopy(EGD). Abdominal computed tomography(CT)showed swelling of the lymph nodes and invasion to the liver and pancreas. The patient was treated using combined docetaxel, cisplatin, and S-1(DCS)chemotherapy. After 2 courses of treatment, the primary tumor and lymph node metastases continued to grow. The patient was treated using secondary chemotherapy with irinotecan (CPT-11). After 1 course of treatment, the primary tumor and regional lymph nodes reduced in size. We performed curative total gastrectomy with D2 lymph node dissection. There has been no recurrence for 15 months after adjuvant chemotherapy with capecitabine and oxaliplatin(CapeOX). Therefore, CPT-11 therapy is a possible option for the management of advanced gastric cancer after DCS therapy.

Functional Liquid Crystals towards the Next Generation of Materials

Since the discovery of the liquid-crystalline state in 1888, liquid crystal science has made great advances through fusion with various technologies and disciplines. Recently, new molecular design strategies and new self-assembled structures have been developed as a result of the progress made in synthetic procedures and characterization techniques. Since these liquid crystals exhibit new functions and properties derived from their nanostructures and alignment, a variety of new functions for liquid crystals, such as transport for energy applications, separation for environmental applications, chromism, sensing, electrooptical effects, actuation, and templating have been proposed. This Review presents recent advances of liquid crystals that should contribute to the next generation of materials.

Plasma Amino Acid Concentrations Are Associated with Muscle Function in Older Japanese Women

BACKGROUND

Although several previous studies have found benefits for amino acid supplementation in terms of muscle function, the role of plasma amino acid concentrations on sarcopenia are not well addressed yet.

OBJECTIVE

The aim of this study was to compare the amino acid concentrations at each stage of sarcopenia (normal, pre-sarcopenia, dynapenia, and sarcopenia) in community-dwelling older Japanese adults.

SETTING AND SUBJECTS

Community-dwelling older Japanese women (n=232, 79.4±7.0 years) participated in this study.

MEASUREMENTS

We measured plasma amino acid concentrations, 5-m walking speed, grip strength, and skeletal muscle mass using a bioelectrical impedance data acquisition system and compared them among participants at each stage of sarcopenia.

RESULTS

The proportions of normal, pre-sarcopenia, dynapenia, and sarcopenia patients were 40.5% (n=94), 12.1% (n=28), 26.3% (n=61), and 21.1% (n=49), respectively. Significant differences were observed for concentrations of leucine, branched-chain amino acid (BCAAs), and essential amino acid (EAAs) among the four groups (p<0.05), and the dynapenia and sarcopenia groups showed significantly lower concentrations of leucine than the normal group (p<0.05).

CONCLUSIONS

This study indicated a positive relationship between plasma leucine, BCAA and EAA concentrations and muscle function. A longitudinal study is needed to determine the causal relationship between leucine/BCAA concentrations and muscle function.

Fibroblast growth factor 13 regulates glioma cell invasion and is important for bevacizumab-induced glioma invasion

Glioblastoma has the poorest prognosis, and is characterized by excessive invasion and angiogenesis. To determine the invasive mechanisms, we previously used two glioma cell lines (J3T-1 and J3T-2) with different invasive phenotypes. The J3T-1 showed abundant angiogenesis and tumor cell invasion around neovasculature, while J3T-2 showed diffuse cell infiltration into surrounding healthy parenchyma. Microarray analyses were used to identify invasion-related genes in J3T-2 cells, and the expressed genes and their intracellular and intratumoral distribution patterns were evaluated in J3T-2 cell lines, human glioma cell lines, human glioblastoma stem cells and human glioblastoma specimens. To determine the role of the invasion-related genes, invasive activities were evaluated in vitro and in vivo. Fibroblast growth factor 13 (FGF13) was overexpressed in J3T-2 cells compared to J3T-1 cells, and in human glioma cell lines, human glioblastoma stem cells and human glioblastoma specimens, when compared to that of normal human astrocytes. Immunohistochemical staining and the RNA-seq (sequencing) data from the IVY Glioblastoma Atlas Project showed FGF13 expression in glioma cells in the invasive edges of tumor specimens. Also, the intracellular distribution was mainly in the cytoplasm of tumor cells and colocalized with tubulin. Overexpression of FGF13 stabilized tubulin dynamics in vitro and knockdown of FGF13 decreased glioma invasion both in vitro and in vivo and prolonged overall survival of several xenograft models. FGF13 was negatively regulated by hypoxic condition. Silencing of FGF13 also decreased in vivo bevacizumab-induced glioma invasion. In conclusion, FGF13 regulated glioma cell invasion and bevacizumab-induced glioma invasion, and could be a novel target for glioma treatment.

Development of Glassy Bicontinuous Cubic Liquid Crystals for Solid Proton-Conductive Materials

Glassy bicontinuous cubic liquid crystals are developed to be a matrix having a hydrophilic infinite periodic minimal surface (IPMS). They function as a scaffold for water, leading to the formation of a 3D continuous hydrogen-bonding network of water molecules along the IPMS. This material design is advantageous for developing novel electrolytes with rigidity and high proton conductivity.

Pathogenic factors in Candida biofilm-related infectious diseases

Candida albicans is a commonly found member of the human microflora and is a major human opportunistic fungal pathogen. A perturbation of the microbiome can lead to infectious diseases caused by various micro-organisms, including C. albicans. Moreover, the interactions between C. albicans and bacteria are considered to play critical roles in human health. The major biological feature of C. albicans, which impacts human health, resides in its ability to form biofilms. In particular, the extracellular matrix (ECM) of Candida biofilm plays a multifaceted role and therefore may be considered as a highly attractive target to combat biofilm-related infectious diseases. In addition, extracellular DNA (eDNA) also plays a crucial role in Candida biofilm formation and its structural integrity and induces the morphological transition from yeast to the hyphal growth form during C. albicans biofilm development. This review focuses on pathogenic factors such as eDNA in Candida biofilm formation and its ECM production and provides meaningful information for future studies to develop a novel strategy to battle infectious diseases elicited by Candida-formed biofilm.

Induction of bicontinuous cubic liquid-crystalline assemblies for polymerizable amphiphiles via tailor-made design of ionic liquids

The lyotropic liquid-crystalline behavior of polymerizable amphiphiles has been tuned by using tailor-made ionic liquids as solvents so as to induce the formation of bicontinuous cubic assemblies having 3D interconnected nanochannels. The fixation of the amphiphilic assemblies has been successfully achieved by in situ photopolymerization.

An innovative masticatory efficiency test using odour intensity in the mouth as a target marker: a feasibility study

A large number of studies have reported the findings for masticatory efficiency tests; however, some objective masticatory efficiency tests have a drawback, in that subjects are required to spit out the test material. This study examined the possibility of a masticatory efficiency test that evaluates the intensity of odours released when chewing an odour compound-containing material. A total of 20 volunteers were used in this study. The odour intensity in the breath after chewing a gum was measured by portable odour sensor device. The odour intensity after chewing the gum was measured over four chewing durations and at four intervals between spitting out and measurement of the odour intensity. The volume of stimulated saliva was measured by calculating the difference in the weight of the gauze before and after chewing to examine the effect of saliva flow. With an increase in chewing duration, odour intensity reduced. The odour intensity was the highest immediately after chewing. There was a positive correlation between odour intensity and gummy jelly-related masticatory efficiency test value (G-METV), which was significant for 10-s chewing. The regression equation was calculated from three objective variables of odour intensity and G-METV as dependent variable. Pearson's correlation coefficient between G-METV and the odour intensity-related masticatory efficiency value (O-METV) was 0·68. The coefficient of variation of O-METV was significantly lower than that of G-METV. These results suggest that the masticatory performance can be estimated by measuring the odour intensity immediately after chewing food containing odour compounds for 10 s.

Back Cover: Induction of an Infinite Periodic Minimal Surface by Endowing An Amphiphilic Zwitterion with Halogen-Bond Ability (ChemistryOpen 5/2016)

The Back Cover picture illustrates the attachment of iodine atoms onto the headgroup of an amphiphilic zwitterion, which leads to the formation of a bicontinuous cubic liquid‐crystalline assembly with a primitive‐type infinite periodic minimal surface. More information can be found in the Communication by T. Ichikawa, H. Ohno and co‐workers on page 439 in Issue 5, 2016 (DOI: 10.1002/open.201600054).

Gallbladder Visualization on CT Shortly after Angiography with Ioxaglate

Thirty-five patients underwent CT examination 15 to 30 min after abdominal angiography with ioxaglate. The gallbladder was visualized in 12 patients in the absence of clinical evidence of renal impairment. Gallbladder opacification on CT examinations shortly after angiography shows that the hepatobiliary tract is important in the excretion of ioxaglate.

Direct MR arthrography of plica synovialis mediopatellaris

Objective: To evaluate the efficacy of direct MR arthrography for diagnosing plica synovialis mediopatellaris (PSM).

Material and Methods: Twenty-two knees of 19 patients were examined by direct MR arthrography. In 19 of those knees, field-echo T2*-weighted transaxial images were obtained with intra-articular administration of 40 ml of saline (“direct MR arthrography”). In the other 3 knees, T1-weighted transaxial images were obtained with intra-articular administration of 40 ml of gadopentetate dimeglumine. Conventional MR images were evaluated prior to direct MR arthrography in 12 of the 22 knees. The results of direct MR arthrography and conventional MR imaging were compared with the arthroscopic findings.

Results: Direct MR arthrography demonstrated 17 of 19 PSMs proved on arthroscopy. The features of 16 PSMs on direct MR arthrography corresponded accurately with the arthroscopic classification. Conventional MR demonstrated only 3 plicae.

Conclusion: Direct MR arthrography enabled accurate diagnosis of PSMs and could replace diagnostic arthroscopy.

Aberrant Right Gastric Vein Directly Communicating with Left Portal Vein System

In 3 patients with primary hepatic malignancies, a communication between the right gastric vein and the left portal vein system was recognized at angiography. The right gastric vein entered directly into the left lateral portal veins in 2 patients and into the left medial portal veins in one. Portal angio-CT performed in one patient demonstrated a specific defect only in the left lateral superior area of the liver, consistent with the segmental opacification of the portal vein branch recognized on the angiogram. This rare communication was seen in 3 (1.5%) of 200 consecutive patients who underwent celiac angiography and is most likely an anomaly in which the right gastric vein directly enters the left portal vein instead of the portal vein trunk. When interpreting a filling defect not associated with a mass lesion on portal angio-CT for hepatic neoplasms or the right gastric vein communicating with the left portal vein system on the angiogram, this particular anomaly should be considered.

Impact of Donor and Recipient Single Nucleotide Polymorphisms in Living Liver Donor Transplantation for Hepatitis C

INTRODUCTION

Recently, several studies have shown that specific single nucleotide polymorphisms (SNPs) affect liver fibrosis progression in patients with hepatitis C virus (HCV) infection. In this study, we examined the impact of donor and recipient SNPs on the progression of fibrosis after liver transplantation for HCV infection.

METHODS

This cohort study enrolled 43 patients with HCV infection who underwent liver transplantation at our hospital. We evaluated 5 genotypes (rs4374383, rs2629751, rs9380516, rs8099917, and rs738409) that have been reported to be significant predictors of fibrosis in HCV infection using a Taqman assay.

RESULTS

Liver fibrosis (stage ≥ F1, New Inuyama classification) was detected at 1 year after liver transplantation in 30 cases (70%). The rs2629751 non-AA-genotype was found to be significantly associated with fibrosis progression at 1 year after liver transplantation (AA:GG or GA = 46%:88%, P < .05). The primary outcome was stage ≥F2 (portoportal septa) or liver-related mortality in 22 patients. The time to stage ≥F2 fibrosis or liver-related mortality was significantly different only in terms of the donor rs2629751 genotype (AA:GG or GA = 5.5 ± 0.6 years:3.6 ± 0.7 years, P = .025).

CONCLUSIONS

The rs2629751 genotype may be an important predictor of posttransplant outcome in HCV-infected patients. This result might be useful in donor selection for liver transplantation in HCV-infected patients and may guide therapeutic decisions regarding early antiviral treatment.

Down-regulation of Irf8 by Lyz2-cre/loxP accelerates osteoclast differentiation in vitro

Interferon regulatory factor 8 (Irf8) is a transcription factor that negatively regulates osteoclast differentiation and Irf8 global knockout (Irf8^−/−) mice have been shown to have reduced bone volume resulting from increased osteoclast numbers. However, detailed analysis of the functions of Irf8 in osteoclast precursors with a monocyte/macrophage linage is difficult, because the population and properties of hematopoietic cells in Irf8^−/− mice are severely altered. Therefore, to clearly elucidate the functions of Irf8 during osteoclastogenesis, we established myeloid cell-specific Irf8 conditional knockout (Irf8^fl/fl;Lyz2^cre/+) mice. We found that trabecular bone volume in the Irf8^fl/fl;Lyz2^cre/+ mice was not significantly affected, while exposure to M-CSF and RANKL significantly increased TRAP activity in vitro in osteoclasts that underwent osteoclastogenesis from bone marrow-derived macrophages (BMMs) induced from bone marrow cells (BMCs) of those mice by addition of M-CSF. Our results also showed that expression of Irf8 mRNA and protein in BMMs obtained from Irf8^fl/fl;Lyz2^cre/+ mice and cultured with M-CSF was reduced. These findings predicted that Lyz2/Lyz2-cre expression is induced when BMCs differentiate into BMMs in cultures with M-CSF. In osteoclast differentiation cultures, Lyz2 was gradually increased by M-CSF during the first 3 days of culture, then rapidly decreased by the addition of RANKL with M-CSF during the next 3 days. Furthermore, BMCs differentiated into osteoclasts while maintaining a low level of Lyz2 expression when cultured simultaneously with both M-CSF and RANKL from the initiation of culture. These findings suggest that Lyz2-cre expression is induced along with differentiation to BMMs by BMCs obtained from Irf8^fl/fl;Lyz2^cre/+ mice and cultured with M-CSF. In addition, Irf8 was down-regulated by activation of the cre/loxP recombination system in BMMs and osteoclastogenesis was accelerated. Based on our results, we propose the existence in vivo of a new lineage of osteoclast precursors among BMCs, which differentiate into osteoclasts without up-regulation of Lyz2 expression.

Induction of an Infinite Periodic Minimal Surface by Endowing An Amphiphilic Zwitterion with Halogen-Bond Ability

We have designed an amphiphilic zwitterion with an iodine‐substituted imidazolium cation. Although it forms a layered assembly with flat interfaces, the addition of an equimolar amount of bis(trifluoromethane)sulfonimide results in the formation of a bicontinuous cubic liquid‐crystalline assembly with a primitive‐type infinite periodic minimal surface, where its zwitterionic headgroup sits regularly. IR measurements revealed that halogen bond between the iodine atoms on the imidazolium cation and the anions is involved in its molecular‐assembly behavior. The present results clearly indicate the potential utility of halogen bonding to control the dimensionality and continuity of the ionic/nonionic interface of amphiphiles in bulk and consequent mesophase patterns, which may be a significant new molecular technology for precisely arranging functional molecules on a 3D continuous interfaces.

Design of ionic liquid-based polyelectrolytes by combining ‘nanostructurisation’ and ‘zwitterionisation’

We have designed nanostructured polyelectrolytes through the co-aggregation of micelles bearing polyzwitterion and lithium salts.

A new complex alkali metal aluminium amide borohydride, Li2Al(ND2)4BH4: synthesis, thermal analysis and crystal structure

The first reported compound containing both [Al(ND₂)₄]⁻ and BH₄⁻ anions, Li₂Al(ND₂)₄BH₄, was formed in ball-milled LiAl(ND₂)₄ + 2LiBH₄ and NaAl(ND₂)₄ + 2LiBH₄. Its crystal structure was solved and refined in a monoclinic unit cell.

Construction of gyroid-structured matrices through the design of geminized amphiphilic zwitterions and their self-organization

Gemini amphiphilic zwitterions exhibit thermotropic bicontinuous cubic liquid-crystalline phases having a 3D continuous ionic domain.

Ionic Switch Induced by a Rectangular-Hexagonal Phase Transition in Benzenammonium Columnar Liquid Crystals

We demonstrate switching of ionic conductivities in wedge-shaped liquid-crystalline (LC) ammonium salts. A thermoreversible phase transition between the rectangular columnar (Colr) and hexagonal columnar (Colh) phases is used for the switch. The ionic conductivities in the Colh phase are about four orders of magnitude higher than those in the Colr phase. The switching behavior of conductivity can be ascribed to the structural change of assembled ionic channels. X-ray experiments reveal a highly ordered packing of the ions in the Colr phase, which prevents the ion transport.

Sleep disturbances and quality of life in patients after living donor liver transplantation

BACKGROUND

Following improvements in patient and graft survival after liver transplantation (LT), the recipients' quality of life has become an important focus of patient care. Sleep is closely related to physical and mental health; however, sleep disturbances in LT patients have not yet been evaluated.

METHODS

We assessed 59 LT patients (aged ≥18 years) between September 2011 and September 2012. The patients completed the restless legs syndrome (RLS), 36-item short-form health survey (SF-36), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS) questionnaires. In addition, laboratory data were obtained and neuropsychological tests (NPT) were performed during study entry.

RESULTS

Thirty-eight patients (64%) were included in the poor sleep group (PSQI ≥6 or ESS ≥10). The SF-36 scores were lower in the poor sleep group than in the good sleep group. Eleven patients (18%) had RLS. An NPT score ≥3 indicated minimal hepatic encephalopathy (MHE3). The MHE3 group consisted of 22 patients (43%). The time after LT was shorter; serum albumin, branched chain amino acid/tyrosine molar ratio (BTR), and role limitations due to poor physical health were lower; and serum ammonia levels were higher in the MHE3 group than in the MHE0-2 group. When the poor sleep group was divided into subgroups (control, MHE, RLS, and unknown), MHE patients had high model for end-stage liver disease scores, high ammonia levels, and low BTR, whereas RLS patients showed a short time after LT.

CONCLUSION

Sixty-four percent of recipients were classified as poor sleepers. SF-36 scores were lower for poor sleepers than good sleepers. RLS and MHE are major diseases that cause sleep disturbances in patients after LT.