Developing adaptive control: Age-related differences in task choices and awareness of proactive and reactive control demands.

Developmental changes in executive function are often explained in terms of core cognitive processes and associated neural substrates. For example, younger children tend to engage control reactively in the moment as needed, whereas older children increasingly engage control proactively, in anticipation of needing it. Such developments may reflect increasing capacities for active maintenance dependent upon dorsolateral prefrontal cortex. However, younger children will engage proactive control when reactive control is made more difficult, suggesting that developmental changes may also reflect decisions about whether to engage control, and how. We tested awareness of temporal control demands and associated task choices in 5-year-olds and 10-year-olds and adults using a demand selection task. Participants chose between one task that enabled proactive control and another task that enabled reactive control. Adults reported awareness of these different control demands and preferentially played the proactive task option. Ten-year-olds reported awareness of control demands but selected task options at chance. Five-year-olds showed neither awareness nor task preference, but a subsample who exhibited awareness of control demands preferentially played the reactive task option, mirroring their typical control mode. Thus, developmental improvements in executive function may in part reflect better awareness of cognitive demands and adaptive behavior, which may in turn reflect changes in dorsal anterior cingulate in signaling task demands to lateral prefrontal cortex.

Laparoscopic inguinal hernioplasty after robot-assisted laparoscopic radical prostatectomy.

PURPOSE: To evaluate the efficacy and safety of laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair in patients who have undergone robot-assisted laparoscopic radical prostatectomy (RALP). METHODS: From July 2014 to December 2016, TAPP inguinal hernia repair was conducted in 40 consecutive patients who had previously undergone RALP. Their data were retrospectively analyzed as an uncontrolled case series. RESULTS: The mean operation time in patients who had previously undergone RALP was 99.5 ± 38.0 min. The intraoperative blood loss volume was small, and the duration of hospitalization was 2.0 ± 0.5 days. No intraoperative complications or major postoperative complications occurred. During the average 11.2-month follow-up period, no patients who had previously undergone prostatectomy developed recurrence. CONCLUSIONS: Laparoscopic TAPP inguinal hernia repair after RALP was safe and effective. TAPP inguinal hernia repair may be a valuable alternative to open hernioplasty.

Negative regulation of the anti-human immunodeficiency virus and chemotactic activity of human stromal cell-derived factor 1alpha by CD26/dipeptidyl peptidase IV.

Stromal cell-derived factor 1alpha (SDF-1alpha) is a chemokine that has been shown to prevent infection of T-tropic HIV strains and is a possible substrate of CD26/dipeptidyl peptidase IV (DPPIV). In this study, we show that SDF-1alpha was cleaved at the N-terminal region by CD26/DPPIV and as a result the inhibitory activity of SDF-1alpha against HIV infection disappeared. Moreover, the chemotactic activity of SDF-1alpha also disappeared specifically by DPPIV activity of recombinant soluble CD26. These results suggested that dissemination of T-tropic HIV strains in vivo may be facilitated by CD26/DPPIV via inactivation of functional SDF-1alpha.

Rethinking infant knowledge: toward an adaptive process account of successes and failures in object permanence tasks.

Infants seem sensitive to hidden objects in habituation tasks at 3.5 months but fail to retrieve hidden objects until 8 months. The authors first consider principle-based accounts of these successes and failures, in which early successes imply knowledge of principles and failures are attributed to ancillary deficits. One account is that infants younger than 8 months have the object permanence principle but lack means-ends abilities. To test this, 7-month-olds were trained on means-ends behaviors and were tested on retrieval of visible and occluded toys. Means-ends demands were the same, yet infants made more toy-guided retrievals in the visible case. The authors offer an adaptive process account in which knowledge is graded and embedded in specific behavioral processes. Simulation models that learn gradually to represent occluded objects show how this approach can account for success and failure in object permanence tasks without assuming principles and ancillary deficits.

Detection of complement-fixing antiphospholipid antibodies in association with thrombosis.

Antiphospholipid antibody (aPL) is a hallmark of antiphospholipid syndrome (APS), characterized by thrombosis and recurrent fetal loss. We developed a novel ELISA system to detect complement-fixing ability of anticardiolipin antibody (aCL), and evaluated its clinical usefulness through studying the prevalence of the antibodies in rheumatic diseases, especially in association with thrombosis and recurrent abortion. Among 189 patients with rheumatic diseases, the complement-fixing aCL was positive in 26 (83.9%) of 31 patients with APS and 2 (1.3%) of 158 with other disease categories, whereas it was not positive among 52 normal subjects. Twenty-seven of 28 patients (96.4%), who were positive for complement-fixing aCL, had the episodes or history of thrombosis and/or recurrent abortion, at the time we studied. The remaining one in this group developed APS manifesting pulmonary infarction and occlusion of mesenteric artery 6 months after the evaluation. The sensitivity and specificity of this assay system were 75.0% and 99.3%, respectively, in relation with thrombotic episodes. On the other hand, the IgG aCL were positive in 28 (77.8%) of 36 cases with recent thrombotic episodes and 24 (15.7%) of 153 cases with no recent thrombotic episodes. The sensitivity and specificity of IgG aCL assay system were 77.8% and 84.3%, respectively, in relation with thrombotic episodes. These results indicate that complement-fixing aCL may specifically occur in association with the episodes of thrombosis and/or recurrent abortion in patients with APS compared to IgG-aCL. The method for detecting the complement-fixing aCL is simple, and it provides the useful diagnostic marker for thrombotic manifestations associated with APS.

A case of pulmonary arteriovenous malformation in a patient with brain abscess successfully treated with video-assisted thoracoscopic resection.

A 45-year-old women was admitted to the hospital with a brain abscess due to asymptomatic pulmonary arteriovenous malformation (PAVM). The brain abscess was removed by craniotomy and excision following antibiotic therapy. The stapled wedge excision of the lung with the PAVM was successful under video-assisted thoracoscopic surgery.

Rapid inhibitory effect of tacrolimus on T cell migration by suppressing CD29-related functions.

OBJECTIVE: To clarify the direct effect of Tacrolimus (FK506) on T cell function in relation to CD29. METHODS: Human T cell line H9 and phytohemagglutinin (PHA)-activated T cells were incubated with or without Tacrolimus. The cells underwent cell migration assay by using fibronectin-coated trans-wells, and at the same time the degree of adherence by cultured cells to fibronectin-coated plastic wells was measured. For H9 cells, intracellular filamentous actin formation and the cell surface expression of CD3, CD11a, CD25, CD26, CD44, CD29 were measured by using flow cytometry. Intracellular tyrosin-phosphorylation induced by fibronectin by CD29 stimulation in H9 cells was analyzed by immunoblotting. RESULTS: The ability of H9 cells and PHA-activated T cells incubated with Tacrolimus for 2 hours (hrs) to migrate and to adhere to fibronectin was significantly suppressed. However, the inhibiton was transient, because the ability of cells incubated with Tacrolimus for 24 hrs to migrate was not affected despite the suppression of cell replication. Tacrolimus showed slight but significant reduction of cell surface expression of CD29 within 4 hrs, but CD3, CD11a, CD25, CD26 and CD44 were not affected. Tacrolimus rapidly inhibited intracellular filamentous actin formation; the maximum inhibition was within 2 hrs and the effect was not observed at 6 hrs. Intracellular tyrosin-phosphorylation induced by CD29 stimulation was also inhibited by, Tacrolimus in H9 cells. CONCLUSION: Tacrolimus appeared to have transient early phase inhibitory effects on CD29-related function that may be associated with T cell migration.

Preoperative diagnosis of strangulated obturator hernia using ultrasonography.

BACKGROUND: Obturator hernia is rarely recognized before surgical intervention, since it is relatively infrequent and its definitive diagnosis is difficult. To change this situation, we introduced ultrasound examination in 1993 for differential diagnosis of strangulated obturator hernia among patients with bowel obstruction of unknown cause. PATIENTS AND METHODS: Between 1993 and 1995, we encountered 15 patients with suspected obturator hernia based on the presence of bowel obstruction of unknown cause and so-called predisposing factors. These patients underwent ultrasound examinations. RESULTS: The 4 patients with bowel obstruction caused by strangulated obturator hernia were all correctly diagnosed preoperatively by ultrasonography and were successfully cured by surgery. The time required for diagnosis was shorter than reported previously (average 16.5 h). CONCLUSIONS: Ultrasonography is useful and reliable for the diagnosis of strangulated obturator hernia and can decrease the morbidity and mortality associated with delayed diagnosis.

The effects of changes in bite pressure and mucosal stimulation on the perception of mandibular position in man.

In edentulous subjects, the mandibular position (MP) was altered by adjustable hydraulic jacks attached to the denture base. The MP which they began to perceive as high (HMP) was shifted toward the closed position when the bite pressure against the incisal region was increased. Thus the perception of MP may be modulated by information concerning the distribution of bite pressure. The HMP also shifted toward the closed position when the incisal palatal region of the denture-supporting mucosa was subjected to increased mechanical stimulation, the distribution of the bite force being constant. Therefore, mechanoreceptors in the mucosa may be involved in the perception of MP by providing precise information as to the distribution of bite pressure.

Comparison of jaw-opening reflex response elicited by anterior and posterior tooth tapping in the cat.

The response elicited by various levels of controlled mechanical stimuli to maxillary teeth was studied in 8 adult cats anaesthetized with alpha-chloralose. When an anterior tooth was tapped, short (4-6 ms) and long (16-20 ms) latency responses were recorded from the mylohyoid nerve. On the other hand, when a posterior tooth was tap-stimulated, only the long-latency response was induced. The effects of ether narcosis on the responses were studied. As the short-latency response was induced only by anterior tooth tapping and its amplitude increased according to increases in stimulus intensity, the response may be related to the protection of the mouth from entrance of harmful materials. The long-latency response was induced by light tapping on both anterior and posterior teeth and its amplitude increased according to increases in stimulus intensity to the posterior teeth rather than the anterior teeth. As it was readily inhibited by ether, the long-latency response may have a reflex centre in an area like the brain stem reticular formation which is particularly sensitive to ether and may be related to the regulation of jaw movement in mastication.

The origin of short- and long-latency mylohyoid nerve responses elicited by high-intensity electrical stimulation of intradental nerve in cats.

A double reflex response of the mylohyoid nerve to the jaw depressor muscles after electrical stimulation of the intradental nerves was recorded in cats anaesthetized with alpha-chloralose. The threshold value of the long-latency (16-19 ms) response was almost 20 times greater than that of the short-latency (5-8 ms) response. At the threshold intensity of the long-latency response, the short-latency response with shorter latency appeared. After extirpation of the stimulated tooth pulp, the short-latency response with a lower threshold disappeared, whereas the short-latency response with a higher threshold and the long-latency response both persisted and showed no change in threshold or latency. These findings indicate that the low-threshold, short-latency response was due to excitation of pulpal nerve fibres, while the high-threshold, short-latency response and the long-latency response were both due to excitation of extrapulpal afferent fibres as a result of the spread of current outside the tooth.

Effects of chelated sera and alteration in calcium concentration on the growth of oral epithelial cells in primary culture.

The purpose of this study were to examine the distribution of growth-promoting activity of some chelated sera and to investigate the relationship between calcium concentration in culture medium and the growth-promoting activity of the chelated sera in comparison with that of the original serum. Results showed that the chelated serum obtained by acidic resin treatment promoted colony formation, while the number of colonies decreased in cultures containing either dialyzed serum or chelated one obtained by treatment with alkaline resin. The acid-chelated serum and its lyophilized materials maintained the growth-promoting activity for 6 months or more in a deep freezer. This activity depended on the calcium concentration of culture medium in the range from 0.06 to approximately 1.5 mM. The optimal concentration of this material for growth promotion was 4 mg/ml as the protein density, which was about a quarter of that for the original serum protein. Sera from different sources treated with the acidic resin also showed similar effect on the growth. This finding strongly suggests that the acid-chelated serum and its lyophilized protein contain a keratinocyte growth factor(s).

GABAC receptors mediate slow membrane potentials in neurons of the rat major pelvic ganglia.

Effects of gamma-aminobutyric acid (GABA) on the neuronal membrane of the rat major pelvic ganglia (MPG) were studied using intracellular recording techniques, in vitro. Application of GABA (100 microM) to MPG neurons induced a depolarization (GABAd) associated with a decreased membrane input resistance and a slow hyperpolarization (s-GABAh) associated with an increased membrane input resistance. The GABA depolarization had two phases, a fast depolarization (f-GABAd) and a subsequent slow depolarization (s-GABAd). Bicuculline (60 microM) blocked the f-GABAd but not the s-GABAd and s-GABAh. Picrotoxin (100 microM) blocked all the GABA responses. Imidazole-4-acetic acid (I4AA, 100 microM), a GABAc receptor antagonist, depressed the s-GABAd and s-GABAh, but did not block the f-GABAd. Cis-4-aminocrotonic acid (CACA), a GABAc receptor agonist, produced a depolarization followed by a hyperpolarization in MPG neurons. I4AA (100 microM) depressed the CACA-induced responses. It was concluded that GABAA receptors mediate the f-GABAd and that GABAc receptors mediate the s-GABAd and s-GABAh, in neurons of the rat MPG.

[Cell adhesion molecules on lymphocytes and their role on signal transduction].

It has been shown that cell adhesion molecules, which mediate lymphocyte adhesion have an ability to provide costimulation signals in the cells. One of the representative adhesion molecules on T lymphocytes, b1 integrin is comprised by several subunits sharing a common b1 subunits, CD29, which is defined by monoclonal anti-4B4 antibody. We have demonstrated that b1 integrins function as a cell surface receptor for extracellular matrix (ECM) protein, such as collagen and fibronectin. We also found that fibronectin, ligand of b1 integrin, synergized with anti-CD3 antibody to promote proliferation of CD4 T cell in a serum free culture system, and also induced an independent signal which would be distinct from the CD3/TcR-mediated signal pathway of activation through the induction of an AP-1 transcription factor. Recent studies revealed that there is an accumulation of CD4+CD29+ T cells, memory T cells as well as prominent increase of a variety of inflammatory cytokines in the synovial fluid of patients with rheumatoid arthritis (RA). This suggests that b1 integrins may play an important role for the inflammatory mechanism in RA. Regulation of signal transduction mediated by adhesion molecules on lymphocytes may be the possible effective way for controlling the pathological inflammatory process in RA.

Radiologic and endoscopic studies of gastric ulcers associated with Candida infection.

The radiologic and endoscopic studies in 30 lesions of 30 gastric peptic ulcers associated with candida infection diagnosed histologically and the follow-up studies in 23 lesions of 23 patients over period of 6 months to 12 years were performed. 1. The ratio of male to female was 5:1, 43% were found over 7th decade and 33% with systemic diseases. 2. Although the ulcers showed no characteristic endoscopic and radiologic features, half of them were found in the upper part of the stomach (60%), measured more than 2.0 cm in diameter (54%), with UI-II in depth (54%), with unclear border (60%). 3. The curability of gastric ulcers was low with 30% cured in 6 months or more of follow-up period. 4. The continuity of candida infection, bleeding or perforation from the ulcer, candidemia or fatal accident were not encountered without antimycotic treatment.

[A case of far advanced breast cancer with distant metastases which had mostly disappeared after chemoendocrine therapy].

We report a case of far advanced breast cancer showing an excellent response to chemo-endocrine therapy. A 40-year-old female with a huge ulcerated tumor on her left anterior chest visited our hospital. Distant metastases were found in the lymph nodes, liver and bone. Therefore, endocrine therapy (toremifene and medroxyprogesterone acetate) and chemotherapy (cyclophosphamide, Therarubicin and 5-fluorouracil) were started as a combination treatment. As a result, the main tumor and metastatic lesion were remarkably reduced, and extended mastectomy with resection of right axillary lymph nodes was performed. Histologically, cancer cells in the primary lesion mostly disappeared, and only one lymph node in the left axillary lesion showed metastasis. No recurrence was found for 16 months after the surgical treatment. The combined therapy in the present case was extremely effective.

[Laparoscopic colo-rectal surgery].

Laparoscopic colorectal surgery was less invasive for patients although it was difficult to perform complete resection of colon combined with regional lymph node. The skillful manner of the laparoscopic surgery was required for the surgical team. The laparoscopic equipments, in order to perform curative dissection of mesenterium and intermediate lymph node, such as Ultrasonic-aspiration surgical unit (USU) or Harmonic scalpel laparoscopic coagulation shears (LCS), were useful for safer dissection of D2 regional lymph node. Meticulous manner of grasping forceps and special dissectors was made sufficient lymph node dissection. The reconstruction of extracorporeal anastomotic technique by hand or valtrac (biofragmentable anastomosis ring) were safer manner for anastomosis after resection of the right side colon. Reconstruction by double stapling technique of linear stapler and circular stapler was admired for anastomosis for left side colonic and rectal surgery. We had safely performed locar resection in 3, partial resection with Do dissection in 2, with D1 dissection in 14, with D2 dissection in 21 and right and left hemicolectomy in 1 each.

[V gene repertoire and pathogenic autoantibodies].

The studies for autoantibody-associated V genes have failed to find any V gene which might be specific for pathogenic autoantibodies in humans; Namely, both normal subjects and patients have immunoglobulin V genes which can encode autoantibodies. Also single V gene can encode antibodies for both foreign antigens and autoantigens. However, some germline V genes such as V3-7 and VH4-21 are preferentially used for autoantibodies and may be regarded as prototype V genes for autoantibodies. Although somatic mutation in V genes is characteristic in IgG autoantibodies, 0-81 idiotype-positive IgM antibodies, which may be precursor B cells for pathogenic anti-DNA antibody also included many somatic mutations in VH genes, indicating an intrinsic abnormality in B cell development in SLE. Some studies also indicated an abnormal V gene repertoire in autoimmune states. These results may be attributed to dysregulation of autoantibody-associated B cell development.