Osteoporosis in elderly patients

Recent reports indicate an increased prevalence of reflux esophagitis (RE) in Japan. There are many factors causing RE, and many kinds of changes associating aging are important in the cause of RE in elderly patients. We reported that the osteoporosis and the orthopedics degenerative disease in elderly people had relation in development of symptoms of RE of our country. The elderly are complicated with posture change (kyphosis) due to osteoporosis caused by menopause; some pharmaceutical agents such as bisphosphonates (BPs) or NSAIDs. Furthermore, it is necessary to provide elderly RE treatment with the all-inclusive treatment not only the conventional medical treatment which made the PPI maintenance therapy but a living environment, complications, an oral medicine including BPs and NSAIDs.     

SGLT2 inhibitor lowers serum uric acid through alteration of uric acid transport activity in renal tubule by increased glycosuria

Sodium glucose cotransporter 2 (SGLT2) inhibitors have been reported to lower the serum uric acid (SUA) level. To elucidate the mechanism responsible for this reduction, SUA and the urinary excretion rate of uric acid (UE_UA) were analysed after the oral administration of luseogliflozin, a SGLT2 inhibitor, to healthy subjects. After dosing, SUA decreased, and a negative correlation was observed between the SUA level and the UE_UA, suggesting that SUA decreased as a result of the increase in the UE_UA. The increase in UE_UA was correlated with an increase in urinary d ‐glucose excretion, but not with the plasma luseogliflozin concentration. Additionally, in vitro transport experiments showed that luseogliflozin had no direct effect on the transporters involved in renal UA reabsorption. To explain that the increase in UE_UA is likely due to glycosuria, the study focused on the facilitative glucose transporter 9 isoform 2 (GLUT9ΔN, SLC2A9b), which is expressed at the apical membrane of the kidney tubular cells and transports both UA and d ‐glucose. It was observed that the efflux of [¹⁴C]UA in Xenopus oocytes expressing the GLUT9 isoform 2 was trans‐stimulated by 10 mm d ‐glucose, a high concentration of glucose that existed under SGLT2 inhibition. On the other hand, the uptake of [¹⁴C]UA by oocytes was cis‐inhibited by 100 mm d ‐glucose, a concentration assumed to exist in collecting ducts. In conclusion, it was demonstrated that the UE_UA could potentially be increased by luseogliflozin‐induced glycosuria, with alterations of UA transport activity because of urinary glucose. © 2014 The Authors. Biopharmaceutics & Drug Disposition. Published by John Wiley & Sons Ltd.     

Synthesis of Multilayered DLC Films with Wear Resistance and Antiseizure Properties

Diamond-like carbon (DLC) films have attracted considerable interest for application as protective films in diverse industrial parts. This is attributed to their desirable characteristics, such as high hardness, low coefficient of friction, gas-barrier properties, and corrosion resistance. Antiseizure properties, in addition to wear resistance, are required during the die molding of polymer and polymer-matrix composite parts. Graphite films can be easily peeled because the vertically stacked graphene sheets are bonded via weak van der Waals forces. The present study demonstrates the fabrication of multilayered DLC/Cu films, where the Cu film functions as a catalyst for the formation of a graphite-like layer between the DLC and Cu films. The DLC/Cu film was synthesized on a Si (100) substrate via plasma-enhanced chemical vapor deposition and magnetron sputtering. The peelability, wear resistance, microstructure, texture, and cross-section of the film were experimentally analyzed. The results indicated a variation in the peelability with the deposition conditions of the Cu film that comprised particles with diameters of several nanometers. The DLC film at the interface in contact with the Cu film was transformed into a graphite-like state i.e., graphitized. The surface of the multilayered film exhibited antiseizure properties with the peeling of the upper DLC film. The multilayered film also exhibited wear resistance owing to the repeated appearances of a new DLC film. It is expected that the wear-resistant films with antiseizure properties demonstrated in the present study will be utilized in various industrial sectors.     

The Association of Cardio-Ankle Vascular Index (CAVI) with Biatrial Remodeling in Atrial Fibrillation

Aim: Arterial stiffness results in elevated left ventricular filling pressure and can promote atrial remodeling due to chronic pressure overload. However, the impact of arterial stiffness on the process of atrial remodeling in association with atrial fibrillation (AF) has not been fully evaluated. Methods: We enrolled 237 consecutive patients diagnosed with AF who had undergone ablation; data from 213 patients were analyzed. Cardio-ankle vascular index (CAVI) was used as a marker of arterial stiffness. The left atrial (LA) and right atrial (RA) volumes were determined by computed tomography imaging; atrial conduction and voltage amplitude were evaluated using a three-dimensional electromapping system used to guide the ablation procedure. Result: In univariate analysis, CAVI significantly correlated with atrial structural and electrical remodeling (LA volume index, r =0.297, P =0.001; RA volume index, r =0.252, P =0.004; LA conduction velocity, r =0.254, P = 0.003; LA mean voltage, r =−0.343, P =0.001, RA mean voltage; r =−0.245, P =0.015). Multivariate regression analysis revealed that CAVI and plasma levels of N-terminal B-type natriuretic peptide were independent determinants of LA and RA remodeling, respectively. On the other hand, age and LA conduction velocity were independent variables with respect to CAVI. Age-adjusted CAVI was highest in long-standing persistent AF when compared with measures of persistent or paroxysmal AF. Conclusion: CAVI was closely associated with biatrial remodeling in patients diagnosed with AF. These results suggest that arterial stiffness may play a significant role with respect to disease progression.