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Background The aim of the present study was to identify the predictors of postoperative pancreatic fistula (POPF) after distal pancreatectomy (DP). Methods The records of 97 consecutive patients who underwent DP at Ehime University Hospital between June 2009 and August 2020 were retrospectively reviewed. Patients' characteristics, preoperative blood biochemistry data, operative findings, and postoperative findings until postoperative day (POD) 3 were investigated as potential predictors of clinically relevant POPF (CR-POPF). The product of the drainage fluid amylase (DFA) value (U/L) and the drainage amount (mL/day) was defined as DFA output (U/day). Results Of 97 patients who underwent DP, 23 (23.7%) developed CR-POPF. On multivariate analyses, high C-reactive protein (CRP) levels on POD3 (>14.0 mg/dL) and high DFA output on POD3 (>34 U/day) were found to be independent predictors of CR-POPF (odds ratios, 7.580 and 4.751, respectively; 95% confidence intervals, 2.052-27.995 and 1.487-15.175, respectively). Furthermore, the CRP value was helpful for predicting delayed CR-POPF in patients without POPF on POD3, and DFA output was useful for predicting the development of CR-POPF in patients diagnosed with POPF on POD3. Conclusion Postoperative CRP values and DFA output may facilitate appropriate postoperative management after DP.

The mechanistic target of rapamycin (mTOR) is a key mediator of energy metabolism, cell growth, and survival. While previous studies using transgenic mice with cardiac‐specific overexpression of mTOR (mTOR‐Tg) demonstrated the protective effects of cardiac mTOR against ischemia–reperfusion (I/R) injury in both ex vivo and in vivo models, the mechanisms underlying the role of cardiac mTOR in cardiac function following I/R injury are not well‐understood. Torin1, a pharmacological inhibitor of mTOR complex (mTORC) 1 and mTORC2, significantly decreased functional recovery of LV developed pressure in ex vivo I/R models (p, An overview of mTOR signaling in cardiomyocyte Excitation‐Contraction coupling.

BACKGROUND Intraoperative bleeding is a major issue for hepatic surgeons because large intraoperative blood loss causes poor patient outcome. The aim of this study was to identify predictors of intraoperative bleeding during hemi-hepatectomy. Methods This study enrolled 45 living donors for liver transplantation (cohort 1) and 44 patients with various conditions (cohort 2) who underwent hemi-hepatectomy at Ehime University Hospital between January 2010 and March 2019 (Approval number: 1810024). The gap between the ventral horizontal line of the inferior vena cava (IVC) confluent with the right atrium (RA) and the dorsal horizontal line of the hepatic segment of the IVC (IVC-RA gap) was determined from preoperative images. Cardiopulmonary and liver functions were investigated as potential predictors of intraoperative estimated blood loss (iEBL). Results The IVC-RA gap positively correlated with iEBL in cohorts 1 and 2 (r = 0.453, P = 0.002 and r = 0.443, P = 0.003, respectively), and multivariate analysis selected the IVC-RA gap as an independent predictor of iEBL >400 ml in cohorts 1 and 2 (odds ratios 1.177 and 1.115; 95% confidence intervals 1.041-1.330 and 1.007-1.234; P = 0.009 and P = 0.036, respectively). Conclusions The IVC-RA gap is a novel and simple predictor of iEBL.

Purpose: The authors discuss measurement methods and instrumentation useful for the characterization of the gray tracking performance of medical color monitors for diagnostic applications. The authors define gray tracking as the variability in the chromaticity of the gray levels in a color monitor. Methods: The authors present data regarding the capability of color measurement instruments with respect to their abilities to measure a target white point corresponding to the CIE Standard Illuminant D65 at different luminance values within the grayscale palette of a medical display. The authors then discuss evidence of significant differences in performance among color measurement instruments currently available for medical physicists to perform calibrations and image quality checks for the consistent representation of color in medical displays. In addition, the authors introduce two metrics for quantifying grayscale chromaticity consistency of gray tracking. Results: The authors’ findings show that there is an order of magnitude difference in the accuracy of field and reference instruments. The gray tracking metrics quantify how close the grayscale chromaticity is to the chromaticity of the full white point (equal amounts of red, green, and blue at maximum level) or to consecutive levels (equal values for red, green, and blue), with a lower value representing an improved grayscale tracking performance. An illustrative example of how to calculate and report the gray tracking performance according to the Task Group definitions is provided. Conclusions: The authors’ proposed methodology for characterizing the grayscale degradation in chromaticity for color monitors that can be used to establish standards and procedures aiding in the quality control testing of color displays and color measurement instrumentation.

Aim Although methicillin-resistant Staphylococcus aureus (MRSA) is commonly isolated from respiratory specimens in healthcare-associated pneumonia (HCAP), it is difficult to determine the causative pathogen because of the possibilities of contamination/colonization. The present study aimed to identify clinical predictors of the true pathogenicity of MRSA in HCAP. Methods Patients with HCAP with positive MRSA cultures in the sputum or endotracheal aspirates who were admitted to Seirei Mikatahara General Hospital, Hamamatsu, Japan, from 2009 to 2014 were enrolled. According to the administered drugs and the treatment outcomes, patients with true MRSA pneumonia (MP) and those with contamination/colonization of MRSA (false MP) were identified. Baseline characteristics were compared between groups, and clinical predictors of true MP were evaluated by logistic regression analyses. Results A total of 93 patients (mean age 78.7 ± 12.6 years) were identified and classified into the true MP (n = 16) or false MP (n = 77) groups. Although baseline characteristics were broadly similar between groups, the true MP group had significantly more patients with PaO2 ≤ 60 Torr/pulse oximetry saturation ≤90% and those with MRSA single cultivation. Both variables were significant predictors of true MP in multivariate analysis (odds ratio of PaO2 ≤ 60 Torr/pulse oximetry saturation ≤90%: 5.64, 95% confidence interval 1.17–27.32; odds ratio of MRSA single cultivation: 4.76, 95% confidence interval 1.22–18.60). Conclusions Poor oxygenation and MRSA single cultivation imply the true pathogenicity of MRSA in HCAP with positive respiratory MRSA cultures. The present results might be helpful for the proper use of anti-MRSA drugs in this population. Geriatr Gerontol Int 2017; 17: 456–462.

cope There is a growing necessity for efficacious natural supplements with antioxidant effects on the brain, in particular, hippocampal function. One such compound, which also has a neuroprotective effect, is the carotenoid astaxanthin (ASX). Despite ASX's potential benefit to the brain, very little is known about its effect on hippocampal plasticity and cognition. Thus, we investigated the effect of ASX on adult hippocampal neurogenesis (AHN) and spatial memory using a mouse model. Methods and results Dose-response was examined in mice fed ASX-supplemented diets (0, 0.02, 0.1, and 0.5%) to define the effect of ASX on AHN. In conjunction with AHN results, hippocampus-dependent cognitive function was assessed. We delineated molecular mechanisms associated with ASX-enhanced AHN using DNA microarray analysis. Results revealed that ASX enhanced cell proliferation and survival at 0.1% and 0.5% doses. Newborn mature neurons were higher only with 0.5% ASX, which also enhanced spatial memory. Transcriptomic profiling revealed potential AHN-associated molecules (Prl, Itga4, and Il4) that were ASX induced. Their downstream factors, identified through Ingenuity Pathway Analysis, were positively correlated with ASX-induced increases in spatial memory. Conclusion ASX supplementation enhanced AHN and spatial memory, and a DNA microarray approach provided, for the first time, novel molecular insights into ASX action.

We report a cyclic sample pooling technique devised in two-dimensional liquid chromatography-electrospray ionization mass spectrometry (LC-ESI-MS) shotgun proteomics that renders deeper proteome coverage; we combined low pH reversed-phase (RP) LC in trifluoroacetic acid in the first dimension, followed by cyclic sample pooling of the eluate and low-pH RP-LC in formic acid in the second dimension. The new protocol has a significantly higher resolving power suitable for LC-ESI-MS/MS shotgun proteomics.

The Dabie orogenic belt in central China extends along the Triassic suture between the Sino–Korean and Yangtze cratons. The structure of the metamorphic rocks have been investigated in the Shima–Wumiao area near the southeastern end of the Dabie orogenic belt. Detailed mapping revealed that the metamorphic sequence in this area can be subdivided into four subhorizontal lithotectonic units. These units are denoted by I, II, III, and IV in the order of structural bottom to top. Unit I is composed of felsic gneiss, eclogite, and minor pelitic gneiss. Unit II consists of felsic gneiss and eclogite with coesite pseudomorphs. Unit III consists of felsic gneiss, pelitic gneiss, metacarbonate, and eclogite with occasional coesite inclusion. Unit IV is composed of felsic gneiss, amphibolite, and minor pelitic gneiss. Those metamorphic rocks underwent penetrative ductile deformation which is denoted by gently south-dipping or subhorizontal foliation and NNW-trending mineral lineation. Deformation microstructures in oriented samples from Units I and II indicate consistent northward displacements of the hanging wall and those from Units III and IV indicate southward displacements. The subhorizontal structure and opposite shear directions between Units I–II and Units III–IV suggest northward extrusion of UHP metamophic units (II and III). The subduction polarity could be opposite to the extrusion trend. The UHP metamorphism in the Dabie orogenic belt is attributable to southward subduction of the Sino–Korean craton beneath the Yangtze craton.

Non-technical summary Exercise training elicits an increase in the basal level of muscular glycogen. This happens when glycogen recovers to above its basal level (supercompensation) after it decreases with acute exercise. Although untested, it is hypothesized that, similar to that of skeletal muscle, brain glycogen supercompensation occurs after acute exhaustive exercise. We provide evidence that exhaustive exercise induces glycogen supercompensation not only in skeletal muscles, but also in the brain. Furthermore, we observed exercise training-induced increases in basal glycogen levels in the cortex and hippocampus, which are involved in motor control and cognitive function. This suggests that, like skeletal muscles, the brain adapts metabolically, probably to meet the increased energy demands of exercise training.

Geological observations in the Horoman area, south-central Hokkaido, show that the Horoman peridotite complex of the Hidaka metamorphic belt is a tectonic slice about 1200 m thick. The peridotite slab is intercalated into a gently east-dipping structure. The underlying unit is a Cretaceous–Paleogene accretionary complex. Riedel shear planes in the sedimentary layers of the accretionary complex near the structural bottom of the peridotite slab indicate top-to-the-west (thrust) displacement. The overlying unit is composed of felsic–pelitic gneisses and mafic–felsic intrusive rocks (the Hidaka metamorphic rocks). The boundary surface between the peridotite complex and metamorphic rocks forms a domal structure. Microstructures of sheared metamorphic rocks near the structural top of the peridotite slab indicate top-to-the-east (normal) displacement. The results combined with previous studies suggest that the Horoman peridotite complex was emplaced onto the Asian margin (Northeast Japan) during the collision between the Asian margin and the Hidaka crustal block.

Background and objective: Acute exacerbations of interstitial pneumonias (IP) can occasionally occur, and have an extremely poor prognosis. Recently, direct haemoperfusion with a polymyxin B immobilized fibre column (PMX-DHP) was shown to have a beneficial effect in acute exacerbations of IPF. However, little is known about the efficacy of PMX-DHP in acute exacerbations of other IP. This study investigated the effectiveness and safety of PMX-DHP in acute exacerbations of IP. Methods: The study subjects consisted of five patients with an acute exacerbation of IP, including three with IPF, one with idiopathic interstitial pneumonia (IIP) with atypical radiological findings of IPF, and one with myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA)-related IP. The patients were treated with two courses of 3–12 h each of PMX-DHP, concurrently with corticosteroids alone or plus cyclophosphamide. Results: After two courses of PMX-DHP, the PaO2/fraction of inspired oxygen (FiO2) (P/F) ratio increased rapidly from an average of 93 to 260 mm Hg, and there was radiological improvement in all patients. However, one patient treated for 3 h each time eventually died of respiratory failure, and two patients treated for 6 h each time died from respiratory infections. The other two patients were treated for 12 h each time, and the therapeutic effects lasted longer, with both surviving longer than 48 days. No adverse effects were detected apart from thrombocytopaenia. Conclusion: PMX-DHP therapy was safe and effective in improving oxygenation in acute exacerbations of IPs, either with corticosteroids alone or plus cyclophosphamide, and may be beneficial for the treatment of this condition.

Midkine (MK) is a heparin-binding growth factor encoded by a retinoic acid responsive gene. To investigate the possible contribution of MK to genesis of colorectal carcinomas, an immunohistochemical examination of protein expression was conducted in sporadic and ulcerative colitis (UC)-associated tumors. MK expression significantly differed among normal mucosa, adenomas with low-grade dysplasia (LGD), adenomas with high-grade dysplasia (HGD) and invasive adenocarcinomas: MK expression was increased along with tumor progression. UC-associated lesions (regenerative mucosa of UC, UC-associated dysplasia and UC-associated adenocarcinoma) had similar variations. MK expression in UC-associated lesions was significantly higher than in normal mucosa, although there was no significant difference among UC-associated lesions. However, in UC-associated dysplasia, MK expression did not differ between the upper and lower halves, in contrast to adenoma with LGD and HGD, in which MK expression was significantly higher in the upper than lower halves, corresponding to cell proliferative zone. Furthermore, correlations with Ki-67 and single-strand DNA labeling, respectively, reflecting cellular proliferative activity and apoptosis, were noted in sporadic but not UC-associated lesions. These results suggest that MK is involved in genesis/development of sporadic colorectal tumors as well as of UC-associated tumors, but might contribute differently to genesis/development in these two types of tumors.

Based on the software model proposed at SID 2006 [5], we've developed a prototype hardware of real-time image transmission system supporting environments where both computer desktop images requiring interactive responsiveness and real-time motion picture images coexist. The architecture of the prototype is described in detail

A computational method based on the finite element method is proposed for the first time to evaluate the band structure and the guided mode of an acoustic wave propagating in a photonic crystal fiber (PCF). By using this method, it is found that an acoustic band gap (ABG) is formed within a PCF and that there exists a propagating guided acoustic mode localized at the defects in the PCF due to the trapping effect of the ABG. © 2005 Wiley Periodicals, Inc. Electron Comm Jpn Pt 2, 88(3): 27–35, 2005; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/ecjb.20089

The ability to image cardiomyocyte apoptosis in vivo with high-resolution MRI could facilitate the development of novel cardioprotective therapies. The sensitivity of the novel nanoparticle AnxCLIO-Cy5.5 for cardiomyocyte apoptosis was thus compared in vitro to that of annexin V-FITC and showed a high degree of colocalization. MRI was then performed, following transient coronary artery (LAD) occlusion, in five mice given AnxCLIO-Cy5.5 and in four mice given an identical dose (2 mg Fe/kg) of CLIO-Cy5.5. MR signal intensity and myocardial T2* were evaluated, in vivo, in hypokinetic regions of myocardium in the LAD distribution. Ex vivo fluorescence imaging was performed to confirm the in vivo findings. Myocardial T2* was significantly lower in the mice given AnxCLIO-Cy5.5 (8.1 versus 13.2 ms, P

Background Insulin-like growth factor-I (IGF-I) peptide has beneficial effects on cardiomyocyte function and survival, many of which are mediated through the serine-threonine kinase, Akt. However, concerns about systemic effects of IGF-I peptide limit its clinical application. The present study tested whether local IGF-I expression could mediate cardioprotection without elevating serum [IGF-I]. Methods The ability of a recombinant adenovirus encoding IGF-IB (Ad.IGF-I) to activate Akt and protect cardiomyocytes from hypoxia-induced apoptosis in vitro was compared with the effects of IGF-I peptide or expression of constitutively active Akt (myr-Akt). In vivo, cardiac IGF-I gene transfer was performed prior to ischemia-reperfusion injury (IRI). Effects on the ischemic and infarcted areas were assessed while serum [IGF-I] was measured by radioimmunoassay. Results Compared with IGF-I peptide, Ad.IGF-I achieved more sustained activation of Akt and reduced hypoxia-induced apoptosis at lower media IGF-I concentrations. In a co-culture system, Ad.IGF-I protected both infected and uninfected cells from hypoxic injury, while myr-Akt protected only infected cells. In vivo cardiac injection of Ad.IGF-I mediated significant local IGF-I expression, without affecting serum [IGF-I] levels. After IRI, Ad.IGF-I did not affect the ischemic area but reduced infarct size ∼50% (32 ± 13 vs. 64 ± 14% AAR in Ad.GFP rats, p < 0.003), although the transgene was expressed in only ∼15% of the ischemic region, consistent with possible paracrine benefit. Conclusions Somatic gene transfer of IGF-I may offer strategic advantages over both systemic delivery of IGF-I peptide and expression of cell autonomous cardioprotective transgenes such as Akt by mediating autocrine and paracrine cardiomyocyte protection without elevating serum [IGF-I] levels. Copyright © 2002 John Wiley & Sons, Ltd.

Summary Background Previous studies have shown that rat peritoneal mast cells and mast cell model rat basophilic leukaemia (RBL-2H3) cells generate intracellular reactive oxygen species (ROS) in response to antigen challenge. However, the physiological significance of the burst of ROS is poorly understood. Objective The present study was undertaken to investigate the role of superoxide anion in mediator release in rat and human cell systems. Methods RBL-2H3 cells were directly stimulated with anti-rat FceRI α-subunit monoclonal antibody (mAb). For the analysis of human cell system, leucocytes were isolated by dextran sedimentation from healthy volunteers or from patients, and challenged either with anti-human FceRI mAb or with the relevant antigens. Superoxide generation was determined by chemiluminescence-based methods. The releases of histamine and leukotrienes (LT)s were determined by enzyme-linked immunosorben assay (ELISA). Results Cross-linking of FceRI on RBL-2H3 cells or on human leucocytes from healthy donors by the anti-FceRI mAb resulted in a rapid generation of superoxide anion, as determined by chemiluminescence using superoxide-specific probes. Similarly, leucocytes from patients generated superoxide anion in response to the challenge with the relevant allergen but not with the irrelevant allergen. Furthermore, diphenyleneiodonium (DPI), a well-known inhibitor of flavoenzymes suppressed the superoxide generation and the release of histamine and LTC4 induced by the anti-FceRI mAb or by allergen in parallel. Conclusion These results indicate that both RBL-2H3 cells and human basophils generate superoxide anion upon FceRI cross-linking either by antibody or by allergen challenge and that blockade of the generation prevents the release of allergic mediators. The findings strongly support the role of superoxide generation in the activation of mast cells and basophils under both physiological and pathological conditions. The findings suggest that drugs regulating the superoxide generation have potential therapeutic use for allergic disorders.

Background: The orphan nuclear receptor RORα is highly expressed in the Purkinje cells of the cerebellum during the postnatal development of brain. A recent observation has been made that the RORα gene is disrupted in staggerer mice—which show a cell-autonomous defect in the development of the Purkinje cells. Results: In order to understand the functions of RORα in cerebellar development, I attempted to identify its target genes. Transient expression study demonstrated that transcription of the Purkinje cellprotein-2 (Pcp-2) gene is activated by RORα,which binds as a monomer to a single half-site motif (RORE) within the promoter region. Its transcription was also activated by retinoic acid receptor (RAR) which binds as a heterodimer with RXR to a retinoic acid responsive element (RARE) in the downstream region. Interestingly, the RORα-mediated transcription is further activated synergistically by RAR. Conclusion: That the Pcp-2 gene is a targetof RORα, and is suggested that its transcription is also regulated by RAR.

APP695 is a transmembrane precursor of Abeta amyloid. In familial Alzheimer's disease (FAD), three mutations V642I/F/G were discovered in APP695, which has been suggested by multiple studies to be a cell surface signaling receptor. We previously reported that normal APP695 encodes a potential GO-linked receptor with ligand-regulated function and that expression of the three FAD mutants (FAD-APPs), not normal APP, induces cellular outputs by GO-dependent mechanisms. This suggests that FAD-APPs are constitutively active GO-linked receptors. Here, we provide direct evidence for this notion. Reconstitution of either recombinant FAD-APP with GO vesicles induced activation of GO, which was inhibitable by pertussis toxin, sensitive to Mg2+ and proportional in quantity to the reconstituted amounts of FAD-APP. Consistent with the dominant inheritance of this type of FAD, this function was dominant over normal APP, because little activation was observed in APP695-GO vesicles. Experiments with antibody competition and sequence deletion indicated that His657-Lys676 of FAD-APP, which has been specified as the ligand-dependent GO-coupling domain of normal APP, was responsible for this constitutive activation, confirming that the three FAD-APPs are mutationally activated APP695. This study identifies the intrinsic signaling function of APP to be a novel target of hereditary Alzheimer's disease mutations, providing an in vitro system for the screening of potential FAD inhibitors.

One century has passed since fugu toxin was named tetrodotoxin (TTX) by Tahara. Chemical problems such as crystallization of tetrodotoxin and subsequent structure determination were solved by research groups headed by Tsuda, Hirata, Woodward, and Mosher. The International Symposium on the Chemistry of Natural Products in Kyoto (1964) was well known as symposium which the structure of TTX was internationally clarified. Since the first isolation of toxin from taricha torosa (imori) as natural source except for fugu fishes, distribution of toxin in nature has been widely investigated. And, it was proved that toxin is not produced by fugu fishes, but rather is formed by sea bacteria (30 sp.) such as Alteromonas sp, Vibrio sp, Shewanella. However, it seems to be difficult to explain the tetrodotoxin accumulation at high concentration in fugu by only toxin production by bacteria. TTX analogues were isolated from natural origins such as crabs, fish, annelids, and algae. Based on the structure of these toxin analogues, the biosynthesis of toxin and the structure-activity relationship (Na+ channel) were proposed by Yasumoto-Yamashita. The findings of wide distribution of toxin in nature may be attributed to development of highly sensitive detection method for toxin. The interesting proposal for the biosynthesis and the structure activity, and the detection method for toxin are outlined in this review.

We here document two cases of von Recklinghausen's disease with both pheochromocytomas and gastrointestinal stromal tumors (GIST). It is very rare that these three disorders are found to occur simultaneously, although the fact that preoperative detection of GIST is difficult except with large tumors may be important in this respect. In the present cases, GIST were not evident on preoperative computed tomography and magnetic resonance imaging, and were identified unexpectedly during surgery. Our findings indicate that investigation of the intraperitoneal space should be performed during adrenalectomy for pheochromocytomas with von Recklinghausen's disease.