Search

Objective: The non-recurrent inferior laryngeal nerve (NRILN) is a nerve anomaly that is associated with the developmentally aberrant subclavian artery. Thus, it is possible to predict NRILN by preoperative diagnosis of an aberrant subclavian artery. Preoperative recognition of the NRILN should be advantageous in the prevention of intraoperative nerve damage. The purpose of this study was to assess the possibility of diagnosis of an aberrant subclavian artery by computed tomography (CT) of the neck, which is often performed before thyroid surgery. Methods: We retrospectively studied the preoperative CT films from 594 thyroid or esophageal surgery patients treated in our hospital between May 1995 and December 2000. An NRILN was identified intraoperatively in 6 of these patients, and a right recurrent inferior laryngeal nerve (RILN) was observed in 588 of these patients. We evaluated whether the brachiocephalic artery could be identified on the CT scan and classified the positional relationship between the right subclavian artery and the tracheoesophagus into three types. Results: The brachiocephalic artery was identified on the CT films in 158 cases, all of which were cases of RILN. The right subclavian artery was detected on the ventral side of the membranous wall of the trachea in all 588 RILN cases, whereas it was detected on the dorsal side in all 6 NRILN cases. Conclusions: It was possible to predict an aberrant subclavian artery by identifying the brachiocephalic artery and position of the right subclavian artery on the CT film of the neck. When an anomaly of the subclavian artery is thus preoperatively detected, NRILN can be preoperatively predicted, which likely will enable prevention of vocal cord paralysis. [ABSTRACT FROM AUTHOR]

To determine predictive factors of the development of restenosis after percutaneous transluminal coronary angioplasty (PTCA), 25 nondiabetic nonobese patients aged <80 years old and 57 consecutive patients with successful direct PTCA with acute myocardial infarction were subjected to a 75-g oral glucose tolerance test (OGTT) and underwent follow-up coronary angiography 4 months later. The relation between the development of restenosis (late loss index: the decrease in the absolute minimal lumen diameter [MLD] at follow-up coronary angiography divided by MLD measured 1 day after PTCA) and the results of OGTT together with basic patient characteristics like age, body mass index, plasma levels of cholesterol, triglycerides, and high-density lipoprotein cholesterol were analyzed. Spearman's rank correlation analysis revealed that neither age, body mass index, nor plasma lipids correlated with late loss index, but only insulin area (p = 0.041) and insulin area/glucose area (p = 0.038) significantly correlated with the development of restenosis; a stepwise multiple regression analysis revealed that the insulin area was the only independent predictor of restenosis (p = 0.019). These results suggest that enhanced insulin secretion in response to glucose plays an important role in the development of restenosis after direct PTCA in non-diabetic patients, which may be through the direct action of insulin on smooth muscle cells of the coronary artery. This study also suggests the importance of performing OGTT for patients undergoing PTCA for the prediction of the development of restenosis. [ABSTRACT FROM AUTHOR]

Although many methods for automated fluorescent-labeled cell detection have been proposed, not all of them assume a highly inhomogeneous background arising from complex biological structures. Here, we propose an automated cell detection algorithm that accounts for and subtracts the inhomogeneous background by avoiding high-intensity pixels in the blur filtering calculation. Cells were detected by intensity thresholding in the background-subtracted image, and the algorithm's performance was tested on NeuN- and c-Fos-stained images in the mouse prefrontal cortex and hippocampal dentate gyrus. In addition, applications in c-Fos positive cell counting and the quantification for the expression level in double-labeled cells were demonstrated. Our method of automated detection after background assumption (ADABA) offers the advantage of high-throughput and unbiased analysis in regions with complex biological structures that produce inhomogeneous background., Highlights: - We proposed a method to assume and subtract inhomogeneous background pattern. (79/85) - Cells were automatically detected in the background-subtracted image. (71/85) - The automated detection results corresponded with the manual detection. (73/85) - Detection of IEG positive cells and overlapping with neural marker were demonstrated. (85/85) .

Background: The distribution of anti-factor Xa activity (AXA) in patients with nonvalvular atrial fibrillation (NVAF) taking edoxaban 15 mg has not been fully elucidated., Methods and Results: The trough and peak AXA were measured in 19 NVAF patients taking edoxaban 15 mg. We compared these results with those in patients taking edoxaban 30 mg. The peak AXA differed significantly between the 15 mg and the 30 mg groups (0.74 ± 0.40 IU/mL vs. 1.25 ± 0.48 IU/mL, respectively; p  < 0.0001)., Conclusions: Peak but trough AXA in the patients receiving edoxaban 15 mg were significantly lower than those in patients receiving edoxaban 30 mg., Competing Interests: The authors declare that there are no conflicts of interest., (© 2024 The Author(s). Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society.)

Objective: Hypoxia-inducible factor prolyl hydroxylase (HIF-PH) inhibitors are a new class of anti-anemia agents. We retrospectively evaluated the safety and efficacy of HIF-PH inhibitors in patients with heart failure (HF) complicated by anemia associated with chronic kidney disase. HIF-PH inhibitor treatment was initiated in 32 patients with chronic HF complicated by renal anemia and were followed up for 3 months., Results: Hematocrit and hemoglobin levels markedly improved 3 months after HIF-PH inhibitor treatment. However, levels of NT-proBNP, which is an indicator of HF, did not decrease considerably. Based on the rate of change in NT-proBNP, we divided the patients into "responder" and "non-responder" groups. The results showed that considerably more patients had a ferritin level of less than 100 ng/mL in the non-responder group at baseline. There were substantially more patients with TSAT of less than 20% in the non-responder group at 1 month after HIF-PH inhibitor treatment. The cut-off values to maximize the predictive power of ferritin level at baseline and TSAT value at 1 month after treatment were 41.8 ng/ml and 20.75. HIF-PH inhibitor treatment can be expected to be effective for improving both anemia and HF if ferritin≥41.8 ng/ml at baseline or TSAT≥20.75 at 1 month after treatment., (© 2024. The Author(s).)

Introduction: The efficacy of catheter ablation in patients with low cardiac function has been previously reported; however, only a few studies have included mid-range ejection fraction (mrEF). This study aimed to evaluate the efficacy and safety of atrial fibrillation (AF) ablation in patients with left ventricular ejection fraction (LVEF) < 50%., Methods: This study retrospectively analyzed 79 patients (reduced ejection fraction [rEF]/mrEF, 38/41; paroxysmal/persistent, 37/42; heart failure hospitalizations within one year before ablation, 36 [45.6%]) who underwent the first ablation procedure at our hospital from April 2017 to December 2021. Radiofrequency ablation and cryoablation were performed for 69 and 10 patients, respectively., Results: Complications included pacemaker implantation for postoperative sick sinus syndrome in one patient and inguinal hematoma in one patient. Regarding efficacy, there were significant postoperative improvements in echocardiographic data, blood test values, and diuretic use. After a mean follow-up of 60 months, 86.1% patients had no AF recurrence. There were 9 heart failure hospitalizations (11.4%) and 5 all-cause deaths (6.3%); no significant differences were found between the rEF and mrEF groups. No significant predictors of AF recurrence were found in preoperative patient characteristics., Conclusion: AF ablation in patients with LVEF <50% significantly improved cardiac and renal functions with few complications, resulting in a high non-recurrence rate and reduced heart failure., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Indian Heart Rhythm Society. Published by Elsevier B.V. All rights reserved.)

Observers learn to fear the context in which they witnessed a demonstrator's aversive experience, called observational contextual fear conditioning (CFC). The neural mechanisms governing whether recall of the observational CFC memory occurs from the observer's own or from the demonstrator's point of view remain unclear. Here, we show in male mice that recent observational CFC memory is recalled in the observer's context only, but remote memory is recalled in both observer and demonstrator contexts. Recall of recent memory in the observer's context requires dorsal hippocampus activity, while recall of remote memory in both contexts requires the medial prefrontal cortex (mPFC)-basolateral amygdala pathway. Although mPFC neurons activated by observational CFC are involved in remote recall in both contexts, distinct mPFC subpopulations regulate remote recall in each context. Our data provide insights into a flexible recall strategy and the functional reorganization of circuits and memory engram cells underlying observational CFC memory., (© 2023. The Author(s).)

Episodic memory, which refers to our ability to encode and recall past events, is essential to our daily lives. Previous research has established that both the entorhinal cortex (EC) and hippocampus (HPC) play a crucial role in the formation and retrieval of episodic memories. However, to understand neural circuit mechanisms behind these processes, it has become necessary to monitor and manipulate the neural activity in a cell-type-specific manner with high temporal precision during memory formation, consolidation, and retrieval in the EC-HPC networks. Recent studies using cell-type-specific labeling, monitoring, and manipulation have demonstrated that medial EC (MEC) contains multiple excitatory neurons that have differential molecular markers, physiological properties, and anatomical features. In this review, we will comprehensively examine the complementary roles of superficial layers of neurons (II and III) and the roles of deeper layers (V and VI) in episodic memory formation and recall based on these recent findings., (© 2023 International Society for Neurochemistry.)

Electromyography (EMG) has been commonly used for the precise identification of animal behavior. However, it is often not recorded together with in vivo electrophysiology due to the need for additional surgeries and setups and the high risk of mechanical wire disconnection. While independent component analysis (ICA) has been used to reduce noise from field potential data, there has been no attempt to proactively use the removed "noise," of which EMG signals are thought to be one of the major sources. Here, we demonstrate that EMG signals can be reconstructed without direct EMG recording using the "noise" ICA component from local field potentials. The extracted component is highly correlated with directly measured EMG, termed IC-EMG. IC-EMG is useful for measuring an animal's sleep/wake, freezing response, and non-rapid eye movement (NREM)/REM sleep states consistently with actual EMG. Our method has advantages in precise and long-term behavioral measurement in wide-ranging in vivo electrophysiology experiments., Competing Interests: The authors declare no competing interests., (© 2023 The Authors.)

The isolation of the Koala retrovirus-like virus from Australian megabats and the identification of endogenous retroviruses in the bat genome have raised questions on bat susceptibility to retroviruses in general. To answer this, we studied the susceptibility of 12 cell lines from 11 bat species to four well-studied retroviruses (human and simian immunodeficiency viruses [HIV and SIV] and murine leukemia viruses [B- and N-MLV]). Systematic comparison of retroviral susceptibility among bats revealed that megabat cell lines were overall less susceptible to the four retroviruses than microbat cell lines, particularly to HIV-1 infection, whereas lineage-specific differences were observed for MLV susceptibility. Quantitative PCR of reverse transcription (RT) products, infection in heterokaryon cells, and point mutation analysis of the capsid (CA) revealed that (i) HIV-1 and MLV replication were blocked at the nuclear transport of the pre-integration complexes and before and/or during RT, respectively, and (ii) the observed lineage-specific restriction can be attributed to a dominant cellular factor constrained by specific positions in CA. Investigation of bat homologs of the three previously reported post-entry restriction factors constrained by the same residues in CA, tripartite motif-protein 5α (TRIM5α), myxovirus resistance 2/B (Mx2/MxB), and carboxy terminus-truncated cleavage and polyadenylation factor 6 (CPSF6-358), demonstrated poor anti-HIV-1 activity in megabat cells, whereas megabat TRIM5α restricted MLV infection, suggesting that the major known CA-dependent restriction factors were not dominant in the observed lineage-specific susceptibility to HIV-1 in bat cells. Therefore, HIV-1 susceptibility of megabat cells may be determined in a manner distinct from that of primate cells. IMPORTANCE Recent studies have demonstrated the circulation of gammaretroviruses among megabats in Australia and the bats' resistance to HIV-1 infection; however, the origins of these viruses in megabats and the contribution of bats to retrovirus spread to other mammalian species remains unclear. To determine the intrinsic susceptibility of bat cells to HIV-1 infection, we investigated 12 cell lines isolated from 11 bat species. We report that lineage-specific retrovirus restriction in the bat cell lines can be attributed to CA-dependent factors. However, in the megabat cell lines examined, factors known to bind capsid and block infection in primate cell culture, including homologs of TRIM5α, Mx2/MxB, and CPSF6, failed to exhibit significant anti-HIV-1 activities. These results suggested that the HIV-1 susceptibility of megabat cells occurs in a manner distinct from that of primate cells, where cellular factors, other than major known CA-dependent restriction factors, with lineage-specific functions could recognize retroviral proteins in megabats.

Gemcitabine is an antineoplastic drug commonly used in the treatment of several types of cancers including pancreatic cancer and non-small cell lung cancer. Although gemcitabine-induced cardiotoxicity is widely recognized, the exact mechanism of cardiac dysfunction causing arrhythmias remains unclear. The objective of this study was to electrophysiologically evaluate the proarrhythmic cardiotoxicity of gemcitabine focusing on the human rapid delayed rectifier potassium channel, hERG channel. In heterologous hERG expressing HEK293 cells (hERG-HEK cells), hERG channel current (IhERG) was reduced by gemcitabine when applied for 24 h but not immediately after the application. Gemcitabine modified the activation gating properties of the hERG channel toward the hyperpolarization direction, while inactivation, deactivation or reactivation gating properties were unaffected by gemcitabine. When gemcitabine was applied to hERG-HEK cells in combined with tunicamycin, an inhibitor of N-acetylglucosamine phosphotransferase, gemcitabine was unable to reduce IhERG or shift the activation properties toward the hyperpolarization direction. While a mannosidase I inhibitor kifunensine alone reduced IhERG and the reduction was even larger in combined with gemcitabine, kifunensine was without effect on IhERG when hERG-HEK cells were pretreated with gemcitabine for 24 h. In addition, gemcitabine down-regulated fluorescence intensity for hERG potassium channel protein in rat neonatal cardiomyocyte, although hERG mRNA was unchanged. Our results suggest the possible mechanism of arrhythmias caused by gemcitabine revealing a down-regulation of IhERG through the post-translational glycosylation disruption possibly at the early phase of hERG channel glycosylation in the endoplasmic reticulum that alters the electrical excitability of cells., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Wei et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Purpose: The CARTOFINDER mapping system analyzes activation patterns using unipolar potentials during atrial fibrillation (AF), where isoproterenol (ISP) is conventionally used to induce non-pulmonary vein (PV) foci and confirm PV arrhythmogenicity. In 20 patients with persistent AF who underwent ablation at our hospital, arrhythmogenic foci were evaluated using both these methods., Methods: Before pulmonary vein isolation (PVI), PV and left atrium (LA) were analyzed during AF using CARTOFINDER, and the isolation line was determined based on the results. After PVI, ISP was loaded after return of sinus rhythm and confirmation of the presence of arrhythmogenic foci. The activation site in LA was ablated at the discretion of the surgeon., Results: Focal activation sites detected by CARTOFINDER correlated with the arrhythmogenic foci induced by ISP in the PVs. The results also showed that a greater number of focal activation sites in the PVs correlated to an increased response to ISP administration. In one patient, it was observed that the focal activation site identified in the PV also coincided with the site of the origin of automaticity induced by ISP after PVI., Conclusion: CARTOFINDER and ISP both reliably determined the presence of arrhythmogenic foci in PV, in patients with persistent AF. Knowledge of the nature of arrhythmogenic foci in non-PV is considered to be a topic for future studies, and further data collection is required., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purpose: Compared with conventional pulmonary vein isolation (PVI) with radiofrequency ablation, PVI with cryoballoon is an easier and shorter procedure without reconnection, particularly in the superior pulmonary vein. However, the durability of the cryoballoon may be reduced due to anatomical factors and the position of the pulmonary vein (PV). Further, inadequate isolation of the carina leads to recurrence of atrial fibrillation (AF). We aimed to determine whether using contrast-enhanced computed tomography (CT) for patient selection improves the early success rate and prevents the recurrence of AF in PVI with cryoballoon., Methods: We evaluated patients who underwent ablation for paroxysmal atrial fibrillation in our hospital between July 2019 and November 2020. After excluding patients with contraindications for cryoablation, 50 patients were selected through visual inspection of the results of preoperative contrast-enhanced CT. A treatment plan was established, and the clinical course and outcomes were followed up., Results: Of the 200 PVs of the 50 patients, only 8 PVs (4%) were incompletely isolated with a single cryoablation. Six of the eight PVs were successfully isolated with additional cryoablation. Only 2 patients (4%) underwent additional PVI with radiofrequency ablation. Four patients had AF recurrence within a mean follow-up period of 14.3 ± 5.1 months. The rate of sinus rhythm maintenance was 92%. PV reconnection was observed in 2 patients. None of the patients had postoperative atrial flutter., Conclusions: Selecting patients for cryoablation according to contrast-enhanced CT findings made the procedure easier to perform, leading to improved early success rates and clinical course., (© 2021. The Author(s).)

Objective: "Join," an imaging technology-based telemedicine system, allows simultaneous radiological information sharing between physically remote institutions, virtually connecting advanced medical institutions and rural hospitals. This study aimed to elucidate the health economics effect of Join for neurological telemedicine in rural areas in Hokkaido, Japan., Methods: Information concerning 189 requests for patient transfer from Furano Kyokai Hospital, a regional rural hospital, to Asahikawa Medical University Hospital (AMUH), an advanced academic medical institution, was retrospectively collected. The Join system was established between Furano Kyokai Hospital and AMUH in February 2019. Data collected from patients between April 2017 and December 2018 were included in the non-Join group, and those collected between February 2019 and October 2020 were included in the Join group. Clinical variables, reasons for patient transfer requests, duration of hospital stay, and medical costs per patient were analyzed between these two groups. Furthermore, clinical characteristics were compared between patients who were transferred and not transferred based on Join., Results: More patients were discharged < 7 days after transfer to AMUH in the non-Join group compared with the Join group (p = 0.02). When focusing on the Join group, more patients who were not transferred were discharged < 1 week (p < 0.01). On the other hand, more patients required surgery (p = 0.01) when transferred. The ratio of patients whose medical cost was < USD5000 substantially decreased, from 33% for the non-Join group to 13% for the Join group., Conclusions: An imaging technology-based telemedicine system, Join, contributed to reducing unnecessary neuro-emergency patient transfer in a remote rural area, and telemedicine with an integrated smartphone system allowed medical personnel to effectively triage at a distance neuro-emergency patients requiring advanced tertiary care.

The empathic ability to vicariously experience the other's fearful situation, a process called observational fear (OF), is critical to survive in nature and function in society. OF can be facilitated by both prior similar fear experience in the observer and social familiarity with the demonstrator. However, the neural circuit mechanisms of experience-dependent OF (Exp OF) remain unknown. Here, we demonstrate that hippocampal-basolateral amygdala (HPC-BLA) circuits in mice without involving the anterior cingulate cortex, considered a center of OF, mediate Exp OF. Dorsal HPC neurons generate fear memory engram cells in BLA encoding prior similar fear experiences, which are essential for Exp OF. On the other hand, ventral HPC neurons respond to the familiar demonstrator's aversive situation during Exp OF, which reactivates the fear memory engram cells in BLA to elicit Exp OF. Our study provides new insights into the memory engram-dependent perception-action coupling that underlies empathic behaviors like Exp OF., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

A number of studies have reported diminished attention to the eyes in individuals with autism spectrum disorder (ASD). These studies predominantly used static images of faces as stimuli. Recent studies, however, have shown enhanced response to eye contact in typically developing (TD) individuals when they observe a person in a live interaction. We investigated physiological orienting to perceived eye contact in adolescents with ASD and TD adolescents when they observed a person in live interaction or viewed a photograph of the same person's face. We measured heart rate (HR) deceleration as an index of attentional orienting. Adolescents with ASD, as well as TD adolescents, showed significant HR deceleration for the direct gaze compared to an averted gaze in the live condition, but not in the photographic condition. The results suggest an intact response to perceived eye contact in individuals with ASD during a live face-to-face interaction. LAY SUMMARY: Individuals with autism spectrum disorder (ASD) have a different eye gaze pattern when observing photographic faces. However, little is known about how individuals with ASD process a real person's face. We measured heart rate (HR) and found that adolescents with ASD showed the typical decline in HR when they made eye contact with a real person, which suggests that both groups of individuals directed their attention to eye contact in a live face-to-face interaction., (© 2022 International Society for Autism Research and Wiley Periodicals LLC.)

Empathy and mindfulness are currently major topics of scientific interest. Although it is well-known that mindfulness-typically as an outcome related to meditation-generates empathy at the state level, only a small number of studies have documented the trait (i.e., personality) level association between mindfulness and empathy. Furthermore, the underlying mechanisms (subcomponents and mediator variables) that support this association remain unclear. Thus, here, with a focus on the trait level, we investigated relationships among multiple subcomponents of trait mindfulness and trait empathy (Study 1). Next, we reexamined the aforementioned relationships in an independent sample, with the further aim of investigating relevant mediation factors (Study 2). We found that two attention-related components of trait mindfulness-observing and acting with awareness-reliably and positively related to both affective and cognitive dimensions of trait empathy (i.e., empathic concern and perspective taking). Furthermore, we found that effortful control, reappraisal, and trait alexithymia mediated relationships between the aforementioned attention-related components of trait mindfulness and empathic concern. Taken together, our results suggest that the links between mindfulness and empathy are multidimensional and complex. These findings may ultimately contribute to an understanding of the mechanisms underlying the positive effects of meditation on empathy., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Himichi, Osanai, Goto, Fujita, Kawamura, Smith and Nomura.)

Cardiac involvement of malignant lymphoma is relatively common, although such a phenomenon has subclinical manifestations that are difficult to detect. We herein describe a patient with atrial fibrillation and sick sinus syndrome as the main symptoms. Computed tomography showed a mass in the right atrium extending into the superior vena cava (SVC). We implanted the patient with a leadless pacemaker. Transvenous biopsy revealed a diffuse large B-cell lymphoma. The patient was treated successfully with chemotherapy including rituximab. This case suggested that cardiac lymphoma may cause sick sinus syndrome, and leadless pacemaker implantation is a safe treatment option in patients with partial SVC obstruction.