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New NO-generating nanoparticles employing an intermolecular photoredox reaction successfully released NO upon blue light irradiation in vitro.

We examined whether there were any differences in perioperative complications between patients who mobilized on the first postoperative day (early mobilization) and those who mobilized on the second postoperative day after head and neck reconstruction using free tissue transfer.In the control group (n = 74), patients were instructed to mobilize on the second postoperative day (April 2019-March 2020), while in the early mobilization group (n = 101), patients were instructed to mobilize on the first postoperative day (April 2020-March 2021). Mobilization was defined as maintaining a standing position or walking. Clinical data were collected from medical records and retrospectively analyzed.There were no significant differences in clinical background factors, with the exception of intraoperative blood loss volume. The proportion of patients who successfully mobilized on the day of instruction was significantly lower in the early mobilization group (89.1% vs. 98.7%). One case of total flap loss and four cases of partial flap loss occurred in the control group, and three cases of partial flap loss occurred in the early mobilization group. There was no significant difference in partial or total flap loss between the two groups. There were no significant differences in other perioperative complications (wound infection, postoperative bleeding, and delirium) between the two groups. The median postoperative hospital stay was 24.5 and 25.0 days in the control and early mobilization groups, respectively.In this study, early mobilization on the first day after head and neck free flap reconstruction was safe and feasible.

OBJECTIVES To conduct robotic lung resections (RLRs) with views similar to those in open-thoracotomy surgery (OTS), we adopted a vertical port placement and confronting upside-down monitor setting: the robotic open-thoracotomy-view approach (OTVA). We herein discuss the procedures for emergency rollout and conversion from the robotic OTVA to OTS or video-assisted thoracoscopic surgery (VATS). METHODS We retrospectively reviewed the cases of 88 patients who underwent RLR with three-arm OTVA using the da Vinci Xi Surgical System between February 2019 and July 2021. Robotic ports were vertically placed along the axillary line, and 2 confronting monitors and 2 assistants were positioned on each side of the patient. Three possible conversions were prepared: (i) emergency thoracotomy using an incision along the ribs in a critical situation, (ii) cool conversion using vertical incision thoracotomy in a calmer condition and (iii) conversion to confronting VATS. All staff involved in the surgery repeatedly rehearsed the emergency rollout in practice. RESULTS No emergent or cool conversion to OTS occurred. Two patients (2.3%) experienced confronting VATS conversions. One patient underwent an urgent conversion for a moderate haemorrhage from a pulmonary artery branch during left upper lobectomy in the introduction phase. Another patient underwent a calmer conversion during an extended RS6 + S10a segmentectomy, where staples could not be inserted appropriately due to lung lacerations. In all patients, postoperative courses were uneventful. CONCLUSIONS The OTVA setting is a possible option for RLRs. This report describes the emergent rollout and subsequent conversion procedures for this method.

To perform robotic lung resections with views similar to those in thoracotomy, we devised a vertical port placement and confronting upside-down monitor setting: the three-arm, robotic “open-thoracotomy-view approach (OTVA)”. We described the robotic OTVA experiences focusing on segmentectomy and its technical aspects. We retrospectively reviewed 114 consecutive patients who underwent robotic lung resections (76 lobectomies and 38 segmentectomies) with OTVA using the da Vinci Xi Surgical System between February 2019 and June 2022. To identify segmental boundaries, we administered indocyanine green intravenously and used the robotic fluorescence imaging system (Firefly). In all procedures, cranial-side intrathoracic structures, which are often hidden in the conventional look-up-view method, were well visualized. The mean durations of surgery and console operation were 195 and 140 min, respectively, and 225 and 173 min, for segmentectomy and lobectomy, respectively. In segmentectomy, console operation was significantly shorter (approximately 30 min, p < 0.001) and two more staplers (8.2 ± 2.3) were used compared with lobectomy (6.6 ± 2.6, p = 0.003). In both groups, median postoperative durations of chest tube placement and hospitalization were 0 and 3 days, respectively. This three-arm robotic OTVA setting offers natural thoracotomy views and can be an alternative for segmentectomy and lobectomy.

Supplementary Files: Three-Arm Robotic Lung Resection via the Open-Thoracotomy-View Approach Using Vertical Port Placement and Confronting Monitor Setting: Focusing on Segmentectomy

Animation deformity is an undesirable complication after subpectoral implant reconstruction and is defined as skin distortion during activation of the pectoralis major muscle. However, detailed anatomical features of deformities have yet to be clarified. This study aimed to elucidate how (morphology) and where (topology) animation deformity occurs in reconstructed breasts, and to assess causes and prevention of animation deformity.This study included 100 consecutive patients with breast cancer, who underwent unilateral subpectoral implant reconstruction. Animation deformity was evaluated, and the patients were grouped according to both morphologic and topologic features. Univariate and multivariate analyses were performed to identify independent factors associated with deformities.The patients were divided into three groups based on skin distortions with or without implant movement: group I, 60 patients with upper-medial dimpling; group II, 41 patients with upper-lateral folding; and group III, 52 patients with mid-lower lines. Overall, 86 patients (86 percent) showed one or more types of deformity. Among the patients with animation deformity, 24 (28 percent) had implant movement. The authors' study identified axillary dissection as an independent factor for the upper-lateral folding group (OR, 0.30), implant volume for the mid-lower lines group (OR, 1.01), and age for implant movement (OR, 1.06).Animation deformity was commonly observed in the cohort of patients who underwent subpectoral implant reconstruction and exhibited three morphotopologic patterns of deformity. The current study demonstrated that the morphotopologic grouping of animation deformity may assist in suggesting possible causes and preventive surgical procedures for these deformities.Therapeutic, III.

Two synthetizations of a novel series of phthalocyanine-based discotic liquid crystals substituted by a polymerizable group, acryloyl group or a norbornene group: 2-(12-acryloyloxydodecyloxy)-3-methoxy-9,10,16,17,23,24-hexakis (3,4-dialkoxyphenoxy)phthalocyaninato copper(II) [abbreviated as (n,12)PcCu(OCH[Formula: see text])(Acryloyl) (7: e ([Formula: see text] = 10), f ([Formula: see text] = 12), g ([Formula: see text] = 14))] and 2-(12-norborn-2-ene carbonyloxydodecyloxy)-3-methoxy-9,10,16,17,23,24-hexakis(3,4-dialkoxyphenoxy)-phthalocyaninato copper(II): [abbreviated as (n, 12)PcCu(OCH[Formula: see text])(Norb) (9e, f, g)]. Their liquid crystalline properties and homeotropic alignment were investigated using a polarizing microscope, a differential scanning calorimetry (DSC), and a temperature-variable X-ray diffractometer. As a result, each of the derivatives gave a Col[Formula: see text] mesophase in the higher temperature region, displaying perfect homeotropic alignment between the two glass plates. In order to obtain the thin film while keeping their homeotropic alignment at room temperature, attempts to polymerize the monomers, 7 and 9, in the Col[Formula: see text] phase showed homeotropic alignment. The polymerization of the acryloyl-substituted monomers (7) was not successful in any of the methods, whereas the polymerization of norbornene-substituted monomers (9) was quite successful by ring-opening metathesis polymerization with a Grubbs catalyst to obtain the novel polymers, poly-(n, 12)PcCu(OCH[Formula: see text])(Norb) (10e, f, g). Each of the polymers (10) were found to show a perfect homeotropic alignment from room temperature to ca. 200[Formula: see text]C of the decomposition temperature. Moreover, it was also revealed from temperature-variable small-angle X-ray diffraction studies that each of the polymers 10 showed a helical Col[Formula: see text] (helical tetragonal columnar) structure. The helical Col[Formula: see text] phase structure may be able for use in organic electroluminescent devices and solar cells in the future.

Background: The involvement of digits in patients with multiple trigger digits often displays specific patterns. We aimed to determine the patterns of involvement of digits in multiple trigger digits and their association with patient-related factors and compare them to those of patients with a single trigger digit. Methods: All patients with trigger digits treated over a 2-year period were retrospectively examined in June 2020. Data regarding the age at occurrence of initial trigger digit, sex, occupation, presence of diabetes mellitus, carpal tunnel syndrome and de Quervain disease, and hand dominance was determined. The data obtained from patients with multiple trigger digits was compared with those with a single trigger digit. Additionally, we investigated the patterns of involvement of the first two affected digits in patients with multiple trigger digits and their association with patient-related factors and compared them to those in patients with a single trigger digit. Results: Three hundred and eighty-seven and 577 patients with multiple and single trigger digits, respectively, were studied. Their median age was 60 (range: 17–92) years. The incidence of concomitant diabetes mellitus was 150% higher in patients with multiple trigger digits than in those with a single trigger digit. Symmetric occurrence and adjacent occurrence patterns were observed in 42.4 % and 28.4% of the 387 patients, respectively. Initial onset in the fifth and sixth decades of life, female sex and a time lag between occurrences were significantly associated with symmetric occurrence. Male sex and simultaneous occurrence in two digits were significantly associated with adjacent occurrence. Diabetes mellitus was not associated with each occurrence pattern. Conclusions: We have confirmed the presence of two involvement patterns in patients with multiple trigger digits: symmetric and adjacent. Our data will help in the prevention, early detection and management of multiple trigger digits. Level of Evidence: Level III (Therapeutic)

Although the chemistry of transition-metal complexes with carbonyl (CO) and thiocarbonyl (CS) ligands has been well developed, their heavier analogues, namely selenocarbonyl (CSe) and tellurocarbonyl (CTe) complexes remain scarce. The limited availability of such CSe and CTe complexes has so far hampered our understanding of the differences between such chalcogenocarbonyl (CE: E=O, S, Se, Te) ligands. Herein, we report the synthesis and properties of a series of cationic half-sandwich ruthenium CE complexes of the type [CpRu(CE)(H2 IMes)(CNCH2 Ts)][BArF 4 ] (Cp=η5 -C5 H5 - ; H2 IMes=1,3-dimesitylimidazolin-2-ylidene; ArF =3,5-(CF3 )2 C6 H3 ). A combination of X-ray diffraction analyses, NMR spectroscopic analyses, and DFT calculations revealed an increasing π-accepting ability of the CE ligands in the order O

The aim of this study was to investigate the effectiveness of guidance assistance during transbronchial biopsy (TBB) to achieve an appropriate pathway to small and peripheral pulmonary lesions (PPLs) using a combination of fluoroscopy and specialized ray-summation (Ray-sumTBB) images, which were processed from preprocedural lung computed tomography (CT) images. To improve the visibility of the correct pathway to the PPLs, three-dimensional spatial resolution enhancement and CT number conversion processes were applied to the original CT images. The Ray-sumTBB images reconstructed from the processed CT images were used as additional guides. We compared the rates of successful tumor localization and biopsy (arrival rate) between the trial (with Ray-sumTBB) and control (without Ray-sumTBB) groups. The fluoroscopy and examination times were also compared. The arrival rate of the trial group (73.1%) was significantly better than that of the control group (42.3%) (p = 0.048). The fluoroscopy and examination times did not differ significantly between the trial and control groups. No complications were identified in the trial group. Our results suggest that Ray-sumTBB improves the diagnostic accuracy of TBB.

Background Leukocyte immunoglobulin-like receptor B4 (LILRB4) is one of the inhibitory receptors in various types of immune cells including macrophages. Previous reports suggested that LILRB4 could be involved in a negative feedback system to prevent excessive inflammatory responses. However, its role has been unclear in chronic obstructive pulmonary disease (COPD), in which macrophages play a crucial role in the pathogenesis. In this study, we aimed to examine the changes of LILRB4 on macrophages both in the lung specimens of COPD patients and the lungs of a mouse emphysema model. We then tried to compare the differences in both inflammation and emphysematous changes of the model between wild-type and LILRB4-deficient mice in order to elucidate the role of LILRB4 in the pathogenesis of COPD. Methods We prepared single-cell suspensions of resected lung specimens of never-smokers (n = 21), non-COPD smokers (n = 16), and COPD patients (n = 14). The identification of LILRB4-expressing cells and the level of LILRB4 expression were evaluated by flow cytometry. We analyzed the relationships between the LILRB4 expression and clinical characteristics including respiratory function. In the experiments using an elastase-induced mouse model of emphysema, we also analyzed the LILRB4 expression on lung macrophages. We compared inflammatory cell accumulation and emphysematous changes induced by elastase instillation between wild-type and LILRB4-deficient mice. Results The levels of surface expression of LILRB4 are relatively high on monocyte linage cells including macrophages in the human lungs. The percentage of LILRB4+ cells in lung interstitial macrophages was increased in COPD patients compared to non-COPD smokers (p = 0.018) and correlated with the severity of emphysematous lesions detected by CT scan (rs = 0.559, p p = 0.008). LILRB4-deficient mice showed severer emphysematous lesions with increased MMP-12 expression in the model. Conclusions LILRB4 on interstitial macrophages was upregulated both in human COPD lungs and in a mouse model of emphysema. This upregulated LILRB4 may have a protective effect against emphysema formation, possibly through decreasing MMP-12 expression in the lungs.

Aim Orthostatic blood pressure (BP) can fall with reduced stroke volume and arterial elasticity. However, as the reason for orthostatic BP rise is unclear, we investigated the relationship of orthostatic BP rise with frailty in older patients. Methods In 169 consecutive outpatients who visited the frailty clinic, we evaluated orthostatic BP and heart rate changes (i.e. in the sitting position, just after standing up, 1 min after standing and after sitting down). Frailty was evaluated using the Kihon Checklist (KCL) established by the Ministry of Health, Labor and Welfare. Results The mean age was 77.4 ± 6.9 years, and 29% of patients had frailty with a KCL score ≥8. The systolic BP declined in both groups, but patients with frailty experienced a smaller decrease just after standing (-0.2 ± 10.3 vs -6.2 ± 11.5, P = 0.001). During standing for 1 min, elevation of systolic BP was greater in patients with frailty than in those without (8.4 ± 11.6 mmHg vs 3.2 ± 11.2 mmHg, P = 0.009). The difference in elevation of systolic BP remained significant, even after adjusting for confounding factors including systolic BP before standing (P = 0.013). In particular, the KCL score for motor function was significantly correlated with an elevation of orthostatic systolic BP after standing for 1 min, even after controlling for systolic BP before standing and confounding factors (P = 0.020). Conclusions The elevation of systolic BP after standing for 1 min was greater in patients with frailty as diagnosed by the KCL score, especially in relation to reduced motor function. Geriatr Gerontol Int 2019; 19: 525-529.

OBJECTIVE Unattended automated office blood pressure (AOBP) may be a better estimate of true blood pressure (BP) than conventional office BP by physicians or nurses. However, measurement of AOBP is cumbersome in general clinical practice. We compared unattended AOBP by the patients themselves using the rigid cuff in the waiting room with attended AOBP and home BP (HBP) (N = 72). METHODS Unattended AOBP by patients was measured in the waiting room using a rigid cuff with the fully automated device (Omron, HEM-907, triple BP readings taken at 1-min intervals after 5 min of rest). Attended AOBP was measured using a soft cuff by a physician in an examination room without specific resting time. HBP was measured for 5 consecutive days. RESULTS The mean age was 76.5 ± 8.6 years. The mean systolic unattended AOBP by patients, attended AOBP and HBP were 139.3 ± 16.6, 144.8 ± 17.1 and 139.1 ± 14.4 mmHg, respectively. Unattended AOBP by patients was significantly related to attended AOBP (r = 0.798; P

Background: Previous reports on schwannomas of the upper extremities have mainly focused on proximal involvement. This study aimed to evaluate pre- and peri-operative findings in schwannomas of the distal upper extremities and assess the accuracy of diagnosis and surgical outcome. Methods: We identified 24 patients with isolated tumors. Seven patients had schwannomas located in the forearm, eleven in the hand, and six in the digits. We collected the following data: preoperative clinical and magnetic resonance imaging findings, provisional diagnosis, surgical findings and procedures, tumor volume, and postoperative clinical findings. Data were compared between tumors of different locations. Results: The mean age of our cohort at the time of surgery was 48.0 years and the mean follow-up period was 10.6 months. All patients with forearm schwannomas were diagnosed preoperatively by the presence of the Tinel-like sign and suggestive magnetic resonance imaging findings. In contrast, schwannomas in the hands and digits often lacked these diagnostic features; only five patients with hand schwannomas and one with digit schwannoma were correctly diagnosed. Microsurgical enucleation was the most common treatment. Ten patients reported newly acquired paresthesia after operation, which resolved within the follow-up period in nine patients. Three of the four patients with preoperative paresthesia and one patient who underwent enucleation with surgical loupes still had paresthesia at the final follow-up. Conclusions: In schwannomas of the distal upper extremities, a more distal location is associated with a lower occurrence of the Tinel-like sign and fewer suggestive magnetic resonance imaging findings, resulting in lower diagnostic accuracy. However, intra-operative diagnosis is usually straightforward and microsurgical enucleation does not cause iatrogenic nerve deficit. When treating soft tissue tumors in the hand and digits that present without specific or suggestive findings, the possibility of schwannoma should be considered.

We aimed to investigate the effects of maternal chewing on prenatal stress-induced cognitive impairments in the offspring and to explore the molecular pathways of maternal chewing in a mice model. Maternal chewing ameliorated spatial learning impairments in the offspring in a Morris water maze test. Immunohistochemistry and Western blot findings revealed that maternal chewing alleviated hippocampal neurogenesis impairment and increased the expression of hippocampal brain-derived neurotrophic factor in the offspring. In addition, maternal chewing increased the expression of glucocorticoid receptor (GR) and 11&beta, hydroxysteroid dehydrogenase isozyme 2 (11&beta, HSD2) and decreased the expression of 11&beta, HSD1 in the placenta, thereby attenuating the increase of glucocorticoid in the offspring. Furthermore, maternal chewing increased the expression of 11&beta, HSD2, FK506-binding protein 51 (FKBP51) and FKBP52 and decreased the expression of 11&beta, HSD1, thereby increasing hippocampal nuclear GR level. In addition, maternal chewing attenuated the increase in expression of DNMT1 and DNMT3a and the decrease in expression of histone H3 methylation at lysine 4, 9, 27 and histone H3 acetylation at lysine 9 induced by prenatal stress in the offspring. Our findings suggest that maternal chewing could ameliorate prenatal stress-induced cognitive impairments in the offspring at least in part by protecting placenta barrier function, alleviating hippocampal nuclear GR transport impairment and increasing the hippocampal brain-derived neurotrophic factor (BDNF) level.

Background and Aims The purpose of hemodiafiltration (HDF) is to remove small- to large molecular weight solutes in order to prevent and treat complications and to improve the prognosis of dialysis patients. Especially, larger low molecular weight proteins (LMWPs) must be removed efficiently. β2-microglobulin (MG) (molecular weight [MW], 11.8 kDa: Stokes radius, 15.6A), is considered as an important marker of dialysis efficiency. However, MW of β2-MG is too small as a marker in HDF. Conversely, α1-MG (MW, 33 kDa: Stokes radius, 28.4A) is the most appropriate marker for evaluation of solute removal efficiency of HDF because of the following reasons: (1) optical molecular size; (2) not very low physiological blood concentration; (3) stable production rate; (4) removal by convection; and (5) accumulation in ESRD. Efficient removal of α1-MG without losing albumin (Alb) (MW,66 kDa: Stokes radius, 35.5A) is impossible even by HDF. In this study, we investigated the relationship between LMWP removal efficiencies and the volume of Alb leakage by analyzing the results of patients undergoing HDF. And we also evaluated the trend of the serum levels of patients who had received high-efficiency HDF for more than three years Method Eighty-seven patients who had received HDF in 2018–2019 were included. The results of HDF (a total of 435 sessions) were analyzed (blood flow rate, 261.5±28.5 mL/min; replacement fluid volume, 48.7 L/s pre-dilution on-line HDF and 14.2 L/s post-dilution on-line HDF). The removal efficiencies of β2-MG, prolactin (PRL), and α1-MG, and the volume of Alb leakage were examined. In addition, the relationship between the removal efficiency of each solute and the volume of Alb leakage was investigated. Changes in serum Alb level were analyzed in 13 patients who continued to receive high-efficiency HDF (the removal rate of α1-MG was 30% or more) for more than three years. Results Analysis of the results (mean ± SD) obtained from a total of 435 sessions (87 patients) showed that the removal rates of β2-MG, PRL, and α1-MG were 80.7 ± 4.5%, 75.8±9.4 and 33.8 ± 9.4%, respectively, and the Alb leakage was 3.9 ± 1.8 g/s. The equations of the approximate curve between Alb leakage and β2-MG, PRL, and α1-MG removal rates were expressed as follows: ï½™= 1.4197ln(x) + 78.972 (R2 = 0.0426), y = 9.7185ln(x) + 64.134 (R2 =0.4632), and ï½™™= 11.225ln(x) + 20.282 (R2 = 0.6191), respectively. These results indicate that the dynamics between Alb leakage and α1-MG removal are very similar. That is, although the molecular weight of Alb is twice as that of α1-MG, the difference in their Stokes radius is 20%; therefore, separate removal of Alb and α1-MG is impossible. The mean serum Alb level in 13 patients who received high-efficiency HDF for 3 years or longer was 3.59 ± 0.23 g/dL in January 2017 and 3.69 ± 0.28 g/dL in December 2019, revealing no changes. Conclusion The efficient removal of larger LMWPs leads to the leakage of Alb. However, an Alb leakage of 3 to 6 g/s has little influence on the serum Alb level of patients. Thus, α1-MG is the most appropriate marker of the solute removal efficiency of HDF.

INTRODUCTION We examined the safety and effectiveness of interval laparoscopic appendectomy (ILA) for adult appendiceal mass (AAM) and then used a novel white blood cell (WBC) parameter to identify the types of AAM cases for which nonsurgical treatment followed by ILA is effective. METHODS We reviewed the cases of 956 patients who had undergone appendectomy between April 2012 and March 2018 at our facility. Of these patients, 49 had AAM, including 34 who underwent ILA. We examined the safety and effectiveness of ILA by comparing it with laparoscopic appendectomy (LA); specifically, the 34 cases treated with ILA were compared with 477 cases of adult uncomplicated appendicitis treated with LA from the same patient cohort. We then examined the factors associated with not successfully completing the planned nonsurgical treatment and interval before ILA. Patient demographics and clinical variables were reviewed. RESULTS Patients who had undergone ILA had longer operative times than those who had undergone LA (P = .0059), but they also had shorter postoperative hospital stays (P

PURPOSE The purpose of this study was to compare the midfacial fracture patterns and management approaches between pediatric and adult patients. METHODS We retrospectively analyzed 164 pediatric patients (

Highlights • A foramen of Winslow hernia is rare and difficult to diagnose. • We report a post operative complication of foramen of Winslow herniation from left to right. • There are no previous reports of a foramen of Winslow hernia with this presentation. • It has been thought that closure of the foramen is not necessary. • However, as there are no reports about the complications due to closing the Foramen of Winslow, the foramen should be closed, whenever possible., Introduction A foramen of Winslow hernia (FWH) is a type of internal hernias. Generally, the contents of the hernia pass through the foramen of Winslow from right to left. The case presented in this report is very unusual, as the small intestine in the hernia passed through the foramen from left to right. Presentation of case A 67-year-old woman developed a sudden abdominal pain 15 days after laparoscopic subtotal colectomy. Abdominal contrast-enhanced computed tomography (CT) examination revealed a FWH, and an emergency surgery was scheduled. The small intestine was found to be herniating from the cavity of the omental bursa through the foramen of Winslow, to the right side of the hepatoduodenal ligament, and was incarcerated. The incarcerated intestine was reduced, and the necrotic part of the intestine was resected. In addition, the foramen of Winslow and the cavity of omental bursa were closed to prevent relapse. Conclusion To our knowledge, here we report the first FWH of which the contents of the hernia are herniated from left to right, in literature. Whether the Foramen should be closed or not requires discussion, however, we conclude that the foramen should be closed when possible, acknowledging previous reports and the present case.

A highly active Pd/Cu cooperative catalytic system based on biphenylene-substituted di-tert-butylruthenocenylphosphine (R-Phos) was developed for performing Suzuki–Miyaura coupling reactions of (hetero)aryl, alkenyl, and benzyl bromides with (hetero)arylboronic acid pinacol esters. A variety of sterically and/or electronically diverse bromides and boronate esters were successfully coupled in good to excellent yields at room temperature using 0.1 mol % Pd and 5 mol % Cu.

Objective To examine whether maternal chewing affects prenatal stress-induced behavioral alternations associated with the changes in apoptosis-related proteins and serotonin pathway of the mouse offspring. Design Pregnant mice were assigned to control, stress, and stress/chewing groups. Stress mice were placed in restraint tubes, from gestational day 12 until parturition. Stress/chewing mice were given a wooden stick for chewing during stress period. Morris water maze and hole-board tests were applied for behavioral alterations in one-month-old male pups. Hippocampal mRNA expression of B-cell lymphoma 2 (Bcl-2) and Bcl-2 associated X protein (Bax) was analyzed by quantitative real-time PCR. Serotonin and tryptophan hydroxylase expression level in the dorsal raphe nucleus was investigated immunohistochemically. Results Prenatal stress impaired the spatial learning, induced anxiety-like behavior, increased the ratio of hippocampal Bax/Bcl-2 expression, and decreased the expression of serotonin and tryptophan hydroxylase in dorsal raphe nucleus of the offspring. Maternal chewing ameliorated prenatal stress-induced cognitive impairment, anxiety-like behavior, and attenuated the increased ratio of hippocampal Bax/Bcl-2 expression, and the downregulated serotonin signaling in dorsal raphe nucleus of the offspring. Conclusions Our results indicate that maternal chewing could improve prenatal stress-related anxiety-like behavior and cognitive impairment in mouse offspring, at least in part by affecting hippocampal apoptotic response and central serotonin pathway.

Patients with smoking-independent lung cancer mainly consist of females, yet the molecular background of this epidemiological feature, other than epidermal growth factor receptor (EGFR) mutation, remains unclear. Several studies have revealed the association between female hormone-associated factors and the prognosis of lung cancer, however the data remain inconsistent. The present study focused on the expression of estrogen receptor (ER)α in order to elucidate this association in smoking-independent lung cancer. Immunohistochemistry staining (IHC) of aromatase, ERα and ERβ was performed against formalin-treated tissues from 38 patients who had never-smoked who underwent complete surgical resection between 2012 and 2013. Among them, adequate RNA of the tumor and adjacent normal lung cancer was extracted from 31 matching deep frozen samples. Considering the IHC results, reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was performed to measure the expression level of 2 different exons of ERα, exon 6 and exon 7, which are part of the ligand binding domain of ERα, using the Taqman gene expression assay. Extra-nuclear expression of ERα using IHC demonstrated a statistically significant association with pathological invasiveness. RT-qPCR results exhibited a decreased expression of ERα exon 7 in invasive tumor tissues, compared with their adjacent normal tissues. This is consistent with the findings of previous in vitro studies indicating that extra-nuclear ERα were exon 7 splicing variants. No difference was observed in ERα exon 7 expression between normal and tumor tissues in non-invasive lung cancer tissues. When considering the EGFR mutation status, EGFR wild-type lung cancers exhibited decreased ERα exon 7 expression levels compared with EGFR mutated lung cancers. Extra-nuclear expression of ERα, which may represent exon 7 splicing variants of ERα, showed statistical association with pathological invasiveness in smoking-independent lung cancer. The post-translational splicing mechanism of ERα may be involved in the acquired invasiveness of smoking independent lung cancer.

Chronic psychological stress is a risk factor for osteoporosis. Maternal active mastication during prenatal stress attenuates stress response. The aim of this study is to test the hypothesis that maternal active mastication influences the effect of prenatal stress on bone mass and bone microstructure in adult offspring. Pregnant ddY mice were randomly divided into control, stress, and stress/chewing groups. Mice in the stress and stress/chewing groups were placed in a ventilated restraint tube for 45 minutes, 3 times a day, and was initiated on day 12 of gestation and continued until delivery. Mice in the stress/chewing group were allowed to chew a wooden stick during the restraint stress period. The bone response of 5-month-old male offspring was evaluated using quantitative micro-CT, bone histomorphometry, and biochemical markers. Prenatal stress resulted in significant decrease of trabecular bone mass in both vertebra and distal femur of the offspring. Maternal active mastication during prenatal stress attenuated the reduced bone formation and increased bone resorption, improved the lower trabecular bone volume and bone microstructural deterioration induced by prenatal stress in the offspring. These findings indicate that maternal active mastication during prenatal stress can ameliorate prenatal stress-induced lower bone mass of the vertebra and femur in adult offspring. Active mastication during prenatal stress in dams could be an effective coping strategy to prevent lower bone mass in their offspring.

Thymic carcinoma is a rare mediastinum malignant tumor derived from thymic epithelial cells. With the exception of complete resection, an effective therapy has not been established to date for advanced or relapsed thymic carcinoma. The present study examined the protein expression of excision repair cross-complementation group 1 (ERCC1) and class III β-tubulin (TUBB3), which are consider to be indicators of the anticancer activity of platinum-based and taxane-based chemotherapy, respectively. The expression of ERCC1 and TUBB3 proteins was examined in 40 thymic carcinoma patients who underwent either surgical resection or core-needle biopsy. The present study investigated whether the expression of ERCC1 and TUBB3 proteins was associated with the overall survival and clinicopathological factors of thymic carcinoma patients. The expression of ERCC1 and TUBB3 proteins was also evaluated in 50 patients who underwent curative resection for non-small cell lung cancer (NSCLC). The expression of ERCC1 and TUBB3 proteins was positive in 8 cases (20%) among the thymic carcinoma patients. ERCC1 was expressed in 21 cases (42%), while TUBB3 was expressed in 27 cases (54%), among the 50 NSCLC patients evaluated in the present study. Only complete resection was observed to be associated with a better prognosis than incomplete resection (P=0.0341). Other clinicopathological factors, including expression of ERCC1 and TUBB3 proteins, exhibited no effect on overall survival. The expression of ERCC1 and TUBB3 proteins in the thymic carcinoma cases was lower than that in the NSCLC cases. The present results suggest a possibility for better antitumor effects of platinum-based and taxane-based chemotherapy on thymic carcinoma patients.

Objective Tooth loss induced neurological alterations through activation of a stress hormone, corticosterone. Age-related hippocampal morphological and functional changes were accelerated by early tooth loss in senescence-accelerated mouse prone 8 (SAMP8). In order to explore the mechanism underlying the impaired hippocampal function resulting from early masticatory dysfunction due to tooth loss, we investigated the effects of early tooth loss on plasma corticosterone levels, learning ability, neurogenesis, and synaptophysin expression in the hippocampus later in life of SAMP8 mice. Design We examined the effects of tooth loss soon after tooth eruption (1 month of age) on plasma corticosterone levels, learning ability in the Morris water maze, newborn cell proliferation, survival and differentiation in the hippocampal dentate gyrus, and synaptophysin expression in the hippocampus of aged (8 months of age) SAMP8 mice. Results Aged mice with early tooth loss exhibited increased plasma corticosterone levels, hippocampus-dependent learning deficits in the Morris water maze, decreased cell proliferation, and cell survival in the dentate gyrus, and suppressed synaptophysin expression in the hippocampus. Newborn cell differentiation in the hippocampal dentate gyrus, however, was not affected by early tooth loss. Conclusion These findings suggest that learning deficits in aged SAMP8 mice with tooth loss soon after tooth eruption are associated with suppressed neurogenesis and decreased synaptophysin expression resulting from increased plasma corticosterone levels, and that long-term tooth loss leads to impaired cognitive function in older age.

The first tellurocarbonyl complex with a half-sandwich structure [CpRuCl(CTe)(H2IMes)] was synthesized by a ligand substitution reaction. The practically complete series of the CpCE complexes [CpRuCl(CE)(H2IMes)] (E = O, S, Se, Te) were systematically explored. The tellurium atom in the CTe complex could be smoothly replaced with lighter chalcogen atoms.

Background: Appendiceal mass sometimes requires extended resection and difficult to treat postoperative complications. Interval appendectomy has been performed mainly in the field of pediatric surgery to avoid them. Recently, there are a few reports on interval laparoscopic appendectomy (ILA). We examined not only the safety and effectiveness of ILA for adult appendiceal mass (AAM), but also the appropriateness of ILA for which cases should be treated non-surgically for ILA or converted to surgical treatment. Methods: Among 956 appendectomies performed between April 2012 and March 2018, there were 49 cases of AAM, of which 34 cases underwent ILA; ILA group. The safety and efficacy of ILA were examined by comparing with 477 cases of adult uncomplicated appendicitis underwent laparoscopic appendectomy (LA); LA group. The appropriateness of ILA was examined by comparing with the remaining 15 cases of AAM; non-ILA group. Results: The ILA group had a longer operation time than the LA group, but the postoperative hospital stay was shorter, and no significant difference were found in the bleeding volume, the days required for oral intake of solid food, and the perioperative complications. Examining the factors for failure of non-surgical treatment or relapse of inflammation during interval period, higher WBC day3 / day0 was found to be an independent risk factor. Conclusion: ILA against AAM was almost as safe and effective as LA for adult uncomplicated appendicitis. WBC day3 / day0 may be effective as an objective parameter for judging the termination of non-surgical treatment for ILA. This determination to convert ineffective non-surgical treatment to surgical treatment earlier may reduce the burden on the patient.

Background: Patients with some thumb polydactyly subtypes are regarded as having a high risk of secondary deformities or poor treatment outcomes. Radially deviated type is one of these subtypes, but its characteristics and definitive treatment outcomes remain unclear. This study aimed to evaluate the pre- and intraoperative findings and surgical outcomes of this subtype. Methods: We identified eight patients with unilateral and proximal phalanx-type polydactyly. The mean age at surgery was 14.6 months, and the mean follow-up period was 7.2 years. We investigated the patients’ initial radiograms, surgical procedures and findings, changes in alignment of the retained thumb, and postoperative outcomes using the Japanese Society for Surgery of the Hand scoring system. Results: Although the gross appearance of the thumb was a radial deviation, there was an ulnar deviation at the metacarpophalangeal joint on radiography. The ulnar proximal phalanges were delta phalanges in three patients and were connected with the radial proximal phalanges by cartilage in five patients. We retained the ulnar thumbs in all patients and corrected the alignment in seven cases; open wedge osteotomy was performed for three patients with a delta phalanx, and tendon transfers from the radial to ulnar thumb were performed for the other four. The mean outcome score was 17.6/20, with one patient with excellent, six with good, one with fair, and none with poor scores. One patient experienced recurrent radial deviation around the interphalangeal joint five years after surgery and underwent corrective osteotomy, but the other patients maintained good alignment. Conclusions: Radially deviated thumb polydactyly is not simply radially deviated; the shape of the proximal phalanx of the ulnar thumb is important to determine the surgical procedure. However, our results indicated that the alignment is almost manageable, and the surgical outcome was comparable to that of patients with a proximal phalanx-type thumb polydactyly.

Yokukansan (YKS) is a traditional Japanese herbal medicine. It has been currently applied for treating behavioral and psychological symptoms of dementia in Japan. We investigated the effect of YKS on learning ability, hippocampal cell proliferation, and neural ultrastructural features in senescence-accelerated mouse prone 8 (SAMP8), a proposed animal model of Alzheimer's disease. Five-month-old male SAMP8 mice were randomly assigned to control and experimental groups. The control group had drug-free water ad libitum. The experimental mice were given 0.15% aqueous solution of YKS orally for eight weeks. Learning ability was assessed in Morris water maze test. Hippocampal cell proliferation was investigated using bromodeoxyuridine immunohistochemical method. The neural ultrastructural features, including myelin sheath and synapse, were investigated electron microscopy. Administration with YKS improved the hippocampal cell proliferation in dentate gyrus, and ameliorated learning impairment in SAMP8 mice. Numerous lipofuscin inclusions were presented in hippocampal neurons of the control mice. However, little were found after treatment with YKS. Myelin sheath was thicker and postsynaptic density length was longer after treatment with YKS. Administration with YKS ameliorated learning impairment in SAMP8 mice, mediated at least partially via delaying neuronal aging process, neurogenesis, myelin sheath and synaptic plasticity in the hippocampus. These results suggest that YKS might be effective for preventing hippocampus-dependent cognitive deficits with age.

Objective To investigate whether maternal chewing during prenatal stress alters the responsivity of young offspring to novel stress, we examined the expression of hippocampal glucocorticoid receptors and mineralocorticoid receptors, and the levels of hypothalamic corticotropin-releasing hormone in young adult mouse offspring of dams exposed to restraint stress during pregnancy. Design To induce stress, the dams were placed in a ventilated restraint tube for 45 min each day from day 12 of pregnancy through parturition. While restrained in the tube, one group of dams was provided a wooden stick for chewing. Hippocampal expression of glucocorticoid receptor and mineralocorticoid receptor messenger ribonucleic acid was assessed in 1-month-old pups. Hypothalamic expression of corticotropin-releasing hormone messenger ribonucleic acid was examined before and after exposing the offspring to a novel stressor. Results Prenatal stress significantly decreased hippocampal expression of both glucocorticoid receptor and mineralocorticoid receptor messenger ribonucleic acid in the offspring, and increased the expression of corticotropin-releasing hormone messenger ribonucleic acid in the hypothalamic paraventricular nucleus in the offspring after novel stress exposure. Maternal chewing during exposure to prenatal stress attenuated the decreased hippocampal expression of both glucocorticoid receptor and mineralocorticoid receptor messenger ribonucleic acid, and the increased corticotropin-releasing hormone messenger ribonucleic acid expression in the hypothalamic paraventricular nucleus in the offspring. Conclusions Downregulation of hippocampal glucocorticoid receptor and mineralocorticoid receptor expression in offspring due to prenatal stress, which may be associated with increased susceptibility to novel stress in adulthood, are attenuated by allowing the dams to chew on a wooden stick.

Prenatal stress (PS) induces learning deficits and anxiety-like behavior in mouse pups by increasing corticosterone levels in the dam. We examined the effects of maternal chewing during PS on arginine vasopressin (AVP) mRNA expression in the dams and on neurogenesis, brain-derived neurotrophic factor (BDNF) mRNA expression, learning deficits and anxiety-like behavior in the offspring. Mice were divided into control, stress and stress/chewing groups. Pregnant mice were exposed to restraint stress beginning on day 12 of pregnancy and continuing until delivery. Mice in the stress/chewing group were given a wooden stick to chew during restraint stress. PS significantly increased AVP mRNA expression in the paraventricular nucleus (PVN) of the hypothalamus in the dams. PS also impaired learning ability, suppressed neurogenesis and BDNF mRNA expression in the hippocampus, and induced anxiety-like behavior in the offspring. Chewing during PS prevented the PS-induced increase in AVP mRNA expression of the PVN in the dams. Chewing during PS significantly attenuated the PS-induced learning deficits, anxiety-like behavior, and suppression of neurogenesis and BDNF mRNA expression in the hippocampus of the offspring. Chewing during PS prevented the increase in plasma corticosterone in the dam by inhibiting the hypothalamic-pituitary-adrenal axis activity, and attenuated the attenuated the PS-induced suppression of neurogenesis and BDNF expression in the hippocampus of the pups, thereby ameliorating the PS-induced learning deficits and anxiety-like behavior. Chewing during PS is an effective stress-coping method for the dam to prevent PS-induced deficits in learning ability and anxiety-like behavior in the offspring.