A case of successful replantation of a totally avulsed scalp in a 40-year-old woman is presented. During a 19-hr surgical procedure, bilateral superficial temporal arteries and veins were anastomosed. The postoperative course was uneventful, except for partial necrosis of the distal end of the avulsed flap, i.e., the occipital region. Since the first successful scalp replantation using microsurgical technique was reported in 1976, the authors have found at least 32 subsequently reported cases. Of these, there were 22 cases of entire scalp avulsion (more than 80 percent of the scalp), including 15 females and seven males. A summary of these cases is included. From analysis of the reported cases of entire scalp avulsion, the keys to success in scalp replantation are considered to be the adequate selection of vessels for repair and the use of vein grafts, if necessary.
Aflatoxins (AFs) are toxic metabolites produced by Aspergillus spp. Because AFs are potent carcinogens in humans and animals, many countries have set regulatory limits for AFs in foods to prevent dietary exposure. From a global food safety perspective, in 2023, the Codex Alimentarius Commission established the maximum level (ML) of total AFs in certain cereals and cereal-based products, including polished rice. Therefore, validated analytical methods for AFs detection are necessary.
Abstract It has been demonstrated that moderate alcohol consumption provides protection against the development of type 2 diabetes. However, several other reports suggested that moderate alcohol intake may increase the risk of type 2 diabetes in non-obese Japanese. The aim of present study was to investigate the effect of 1-week alcohol abstinence on hepatic insulin sensitivity and fasting plasma glucose (FPG) in non-obese Japanese men. We recruited 8 non-obese Japanese men with mildly elevated FPG and drinking habits alcohol (mean frequency; 5.6 ± 2.5 times/week, mean alcohol consumption; 32.1 ± 20.0 g/day). Before and after the 1-week alcohol abstinence, we used the 2-step hyperinsulinemic-euglycemic clamp to measure endogenous glucose production (EGP) and insulin sensitivity (IS) in muscle and liver. One-week alcohol abstinence significantly reduced both FPG by 7% (from 105.5 ± 11.7 to 98.2 ± 7.8 mg/dl, P < 0.01) and fasting EGP by 6% (from 84.1 ± 4.2 to 77.6 ± 1.6 mg/m 2 per min, P < 0.01), respectively. Two–step clamp study showed that alcohol abstinence significantly improved hepatic-IS, but not muscle-IS. In conclusion, one week alcohol abstinence improved hepatic IS and FPG in non-obese Japanese men with mildly elevated FPG and drinking habits alcohol.
Recent genome-wide association studies demonstrated that common variants of solute carrier family 30 member 8 gene (SLC30A8) increase susceptibility to type 2 diabetes. SLC30A8 encodes zinc transporter-8 (ZnT8), which delivers zinc ion from the cytoplasm into insulin granules. Although it is well known that insulin granules contain high amounts of zinc, the physiological role of secreted zinc remains elusive. In this study, we generated mice with β cell-specific Slc30a8 deficiency (ZnT8KO mice) and demonstrated an unexpected functional linkage between Slc30a8 deletion and hepatic insulin clearance. The ZnT8KO mice had low peripheral blood insulin levels, despite insulin hypersecretion from pancreatic β cells. We also demonstrated that a substantial amount of the hypersecreted insulin was degraded during its first passage through the liver. Consistent with these findings, ZnT8KO mice and human individuals carrying rs13266634, a major risk allele of SLC30A8, exhibited increased insulin clearance, as assessed by c-peptide/insulin ratio. Furthermore, we demonstrated that zinc secreted in concert with insulin suppressed hepatic insulin clearance by inhibiting clathrin-dependent insulin endocytosis. Our results indicate that SLC30A8 regulates hepatic insulin clearance and that genetic dysregulation of this system may play a role in the pathogenesis of type 2 diabetes.
We experienced a case of malignant orbital tumor in a 72-year-old Japanese man. He noticed protrusion of his left eye, and received resection of the left orbital tumor. The tumor contained several different components such as high-grade invasive ductal carcinoma, low-grade/minimally invasive adenocarcinoma and pleomorphic adenoma. Pathological diagnosis of high-grade invasive ductal carcinoma ex pleomorphic adenoma of the left lacrimal gland was made. He had undergone surgical removal of the left lacrimal gland tumor at the other hospital 19 years before, and the surgical specimen revealed that most part of the tumor was pleomorphic adenoma but low-grade/minimally invasive adenocarcinoma was included as a minor component (low-grade/minimally invasive adenocarcinoma ex pleomorphic adenoma). Thus, we could observe the natural course of low-grade/minimally invasive adenocarcinoma ex pleomorphic adenoma which transformed into high-grade invasive ductal carcinoma ex pleomorphic adenoma. Lacrimal gland ductal carcinoma is an extremely rare tumor, and only 25 cases have been reported before in English literature. Moreover, our case is the 5th case of lacrimal gland ductal carcinoma ex pleomorphic adenoma.
Pulse rate variability (PRV), derived from Laser Doppler flowmetry (LDF) or photoplethysmography, has recently become widely used for sleep state assessment, although it cannot identify all the sleep stages. Peripheral blood flow (BF), also estimated by LDF, may be modulated by sleep stages; however, few studies have explored its potential for assessing sleep state. Thus, we aimed to investigate whether peripheral BF could provide information about sleep stages, and thus improve sleep state assessment. We performed electrocardiography and simultaneously recorded BF signals by LDF from the right-index finger and ear concha of 45 healthy participants (13 women; mean age, 22.5 ± 3.4 years) during one night of polysomnographic recording. Time- and frequency-domain parameters of peripheral BF, and time-domain, frequency-domain, and non-linear indices of PRV and heart rate variability (HRV) were calculated. Finger-BF parameters in the time and frequency domains provided information about different sleep stages, some of which (such as the difference between N1 and rapid eye movement sleep) were not revealed by finger-PRV. In addition, finger-PRV patterns and HRV patterns were similar for most parameters. Further, both finger- and ear-BF results showed 0.2–0.3 Hz oscillations that varied with sleep stages, with a significant increase in N3, suggesting a modulation of respiration within this frequency band. These results showed that peripheral BF could provide information for different sleep stages, some of which was complementary to the information provided by PRV. Furthermore, the combination of peripheral BF and PRV may be more advantageous than HRV alone in assessing sleep states and related autonomic nervous activity.
