[The Surgical Indication of Multiple Rib Fractures of Patients by Traumas and Timing of the Surgical Stabilization of Rib Fractures].

It's reported that 10% of the inpatients by traumas have fractured ribs. It's easy to judge if it's the case of flail chest, or respiratory failure due to airway injury or pulmonary contusion. There is no guideline for treatments of a patient who has multiple ribs fractures without respiratory failure. We did the surgical stabilization of rib fractures for 10 cases from 2020 to October 2023. As a result, we find out useful surgical indication for treatment of rib fractures.

[Surgical Case of Bronchial Mucoepidermoid Carcinoma Safely Diagnosed by Enucleation Under the Bronchoscopy After Bronchial Arterial Embolization].

A 28-year-old male presented to our hospital with hemoptysis and his chest computerized tomography (CT) showed the right middle and lower lobe atelectasis due to the tumor of right intermediate bronchial trunk. To reduce the blood flow to the tumor, bronchial arterial embolization was performed and the tumor was resected using Cryoprobe with a flexible endobronchial scope. Thus, we could observe the tumor localization and diagnose before the surgical procedure. We performed the right sleeve middle lobectomy and the right lower lobe was safely preserved.

Associations between motorized transport access, out-of-home activities, and life-space mobility in older adults in Japan.

BACKGROUND: Motorized transport access and out-of-home activities are two potential correlates of Life-space mobility (LSM), a common research topic in mobility studies of older adults. These correlates remain mostly unexplored in previous literature and relating them with LSM can reveal directions for improving the LSM of older adults. METHODS: The associations between motorized transport access, out-of-home activities, and LSM were examined using data from 1,333 older adults (mean age = 70.63) living in 15 cities and towns in Japan. LSM was assessed using composite life-space assessment (LSA) scores. Motorized transport access was measured using dummies showing whether a person had car access (divided into five levels) and used public transport (bus and railway), and out-of-home activities were measured using the number of various activities that were conducted during the most recent weekday and weekend day. Generalized linear models were used to assess the associations. RESULTS: The sample was dominated by males (74.42%), with more than half of the sample had their own cars. On average, each respondent had four activities during two survey days, and shopping was the most common activity. The results showed that owning a car and using railway, as well as various activities were associated with increased composite LSA scores, whereas no cars or only shared cars in home were associated with decreased composite LSA scores. However, these associations differed between males and females. CONCLUSIONS: In this study, different levels of motorized transport access and different types of out-of-home activities were found to associate differently with composite LSA scores. Based on these findings, we suggest that policymakers should provide more transport access, pay more attention to the LSM of older adults with high clinics/hospital activities, and trigger more shopping and daily leisure activities for older adults to improve the LSM of this population.

Analysis of intestinal immunity and flora in a collagen-induced mouse arthritis model: differences during arthritis progression.

Intestinal immunity and flora are reported to be associated with the onset of rheumatoid arthritis. However, differences in the intestinal immunity and flora dynamics between the initial peak and relapse of arthritis have not been investigated. Here we analyzed the lymphocyte populations in different lymphoid tissues, the IgA in feces, and the intestinal flora at the initial peak and the relapse phase of arthritis in a collagen-induced arthritis (CIA) mouse model. In this model compared with the control group, the percentage of RORγt+CD4+ T cells in the mesenteric lymph nodes (mLN) was increased at the initial peak but decreased at the relapse stage of arthritis, and the opposite changes were observed in the spleen. The percentage of Foxp3+CD4+ T cells was unchanged at the initial peak in both tissues but increased only in the mLN at the relapse stage. The IgA in feces increased with the progression of arthritis, and bacterial analysis revealed that some specific bacterial families were changed at the peak and relapse stages of arthritis. Finally, the immune dynamics under different arthritic conditions were examined by integrating these factors using principal component analysis (PCA). PCA showed that the immunological and intestinal flora profiles were different between the initial peak and the relapse of the arthritis. Our findings suggest that the intestinal immunity and the environment change drastically with the progress of arthritis.

Effects of holding soft objects during Cyberball tasks under frequent positive feedback.

A previous study suggested that holding soft objects enhanced expectations of uncertain events and increased social pain under frequent negative feedback; i.e., higher expectations might have induced more disappointment. The present study examined the effects of holding a soft cushion under frequent positive feedback. Participants (n = 42) performed fair-play and over-inclusion blocks in the Cyberball task. Amplitudes of the contingent negative variation (CNV) of event-related brain potentials and subjective ratings of social pain were measured to estimate participants' expectations and emotions, respectively. CNV amplitudes were higher in the over-inclusion block when participants held the soft than the hard cushion. There was a statistically marginal trend (p = .095) for lower social pain scores in the soft cushion condition than the hard cushion condition in contrast to previous findings. These results suggest that holding a soft object does not directly modulate emotions but instead acts through the mediation of enhanced expectations.

Soft haptic sensation increases the expectation in the social context but not in the non-social context.

Previous studies have proposed that holding soft objects can increase expectations to be included in a Cyberball task. The present study investigated whether effects of holding soft objects on expectations are restricted to social contexts or can appear in non-social contexts. Sixty-six participants performed a social or non-social ball task, both modified versions of the Cyberball task. In the social ball task, participants were told that they would play a ball-tossing game with computer-generated players. In the non-social ball task, participants were told that they would take part in a judgement task. During the task, participants held either soft or hard cushions, and their electroencephalographic signals were recorded to evaluate the contingent negative variation (CNV), which is considered to reflect expectation and anticipation of an imperative stimulus. The results showed that participants who performed the social ball task exhibited larger late CNV when they held the soft cushion compared to when they held the hard cushion, whereas participants who performed the non-social ball task exhibited no such difference. The results indicate that holding soft objects increases expectations to be included only in social contexts.

IL-21 Enhances the Development of Colitis-Associated Colon Cancer: Possible Involvement of Activation-Induced Cytidine Deaminase Expression.

Inflammatory bowel diseases are known to be the origin of colitis-associated colon cancer (CAC). We previously reported that dextran sulfate sodium (DSS)-induced colitis is exacerbated in mouse-IL-21-isoform transgenic (Tg) mice. In this study, we assessed the CAC development induced by azoxymethane (AOM) and DSS in our Tg mice. AOM-DSS-induced tumor development was dramatically increased in the Tg mice compared with wild-type mice. IL-21 is known to enhance activation-induced cytidine deaminase (AID) expression in B cells and induce Ab class switching. In contrast, the AID expression in cells other than B cells initiates tumor development in many tissues. Therefore, we investigated whether IL-21 induces the AID expression in the large intestinal epithelial cells (IECs) during CAC development. AID gene and protein expression was increased in the IECs of AOM-DSS- or DSS-treated Tg mice compared with those of wild-type mice. Furthermore, we confirmed IL-21 induced AID gene expression in the purified IECs ex vivo. The present study also showed IL-21R gene expression in unstimulated wild-type mouse IECs, and this gene expression was augmented by TNF-α stimulation. The IL-21R expression and IL-21-induced AID gene activation were further confirmed in the Colon-38 cell line. Taken together, IL-21 may be involved in increasing the risk of CAC by enhancing the AID expression in IECs.

Pedal Misapplication: Interruption Effects and Age-Related Differences.

OBJECTIVE: This study aimed to investigate whether pedal misapplication occurs more frequently when a pedal task is interrupted for a longer period of time. BACKGROUND: Misapplication of a vehicle's brake and accelerator pedals can cause severe traffic accidents, especially for older drivers. The present study provides empirical support for the hypothesis that pedal misapplication occurs more frequently when drivers are interrupted for longer periods of time and is demonstrated more prominently in older drivers. METHODS: Forty younger participants and 40 older participants were asked to perform a pedal choice response task (stepping on either a brake or accelerator pedal) that had been preceded by an interruption task (i.e., touch number task). RESULTS: Pedal misapplications occurred more frequently when the pedal choice response task was preceded by the touch number task for a longer interval (about 120 s) than for a shorter interval (about 30 s). Furthermore, the time-related increase in pedal misapplications was greater for older participants. CONCLUSION: Pedal misapplication increases when the pedal task is interrupted for a longer time period, especially for older adults. APPLICATION: The findings contribute to our understanding of when and where pedal misapplications tend to occur.

GPI-80 Augments NF-κB Activation in Tumor Cells.

Recent studies have discovered a relationship between glycosylphosphatidylinositol (GPI)-anchored protein 80 (GPI-80)/VNN2 (80 kDa GPI-anchored protein) and malignant tumors. GPI-80 is known to regulate neutrophil adhesion; however, the action of GPI-80 on tumors is still obscure. In this study, although the expression of GPI-80 mRNA was detectable in several tumor cell lines, the levels of GPI-80 protein were significantly lower than that in neutrophils. To clarify the function of GPI-80 in tumor cells, GPI-80-expressing cells and GPI-80/VNN2 gene-deleted cells were established using PC3 prostate cancer cells. In GPI-80-expressing cells, GPI-80 was mainly detected in vesicles. Furthermore, soluble GPI-80 in the conditioned medium was associated with the exosome marker CD63 and was also detected in the plasma obtained from prostate cancer patients. Unexpectedly, cell adhesion and migration of GPI-80-expressing PC3 cells were not modulated by anti-GPI-80 antibody treatment. However, similar to the GPI-80 family molecule, VNN1, the pantetheinase activity and oxidative state were augmented in GPI-80-expressing cells. GPI-80-expressing cells facilitated non-adhesive proliferation, slow cell proliferation, NF-κB activation and IL-1ß production. These phenomena are known to be induced by physiological elevation of the oxidative state. Thus, these observations indicated that GPI-80 affects various tumor responses related to oxidation.

[Idiopathic Intrapulmonary Hematoma Need to Differentiate from Pulmonary Metastasis of Malignant Melanoma:Report of a Case].

A 74-year-old man had previously been treated for primary malignant melanoma of the bladder. Three years after surgery, 8 mm round nodule in the right lower lobe was found on chest computed tomography. The nodule increased to 11 mm after three months, and resected with a diagnosis of metastatic malignant melanoma. By pathology, it was diagnosed as an intrapulmonary hematoma.

Interleukin-12p40 variant form reduces Interleukin-12p80 secretion.

IL-12 is a key cytokine for the promotion of CD4+ T cells differentiation to type 1 helper T cells. IL-12 is a heterodimer (IL-12p70) consisting of p40 and p35 subunits, and is mainly secreted from activated antigen-presenting cells, such as macrophages and dendritic cells (DCs). In this study, we found that activated mouse bone marrow-derived DCs (BMDCs) produced a p40 splice variant form mRNA in addition to the conventional p40 mRNA. This p40 variant mRNA was produced by alternative splicing in exon 5, and possessed a premature stop codon. As a result, the p40 variant protein contained 157 amino acids of the N-terminal part of p40 and an additional 10 novel amino acids. When the p40 variant was expressed in HEK-293T cells, it was not secreted from the cells. To investigate the function of the p40 variant, it was co-expressed with p40 and/or p35. The p40 variant did not affect the secretion of IL-12p40 or IL-12p70, or the function of the secreted p70. In contrast, the secretion of IL-12p80, a homodimeric IL-12 with two p40 subunits, was significantly decreased when the p40 variant was expressed. This new splicing variant p40 may act to fine-tune the function of IL-12p80.

GPI-80 as a Useful Index for Myeloid Cell Heterogeneity and a Potential Prognostic Biomarker for Metastatic Renal Cell Carcinoma.

Myeloid-derived suppressor cells (MDSCs), which include neutrophilic MDSCs and monocytic MDSCs, exhibit high immunosuppressive activity. Glycosylphosphatidylinositol-anchored 80 kD protein (GPI-80) is selectively expressed on mature neutrophils in healthy individuals. Increased GPI-80 expression on monocytes and variations in GPI-80 expression on neutrophils indicate the appearance of MDSCs in the peripheral blood of cancer patients. However, it is still unclear whether GPI-80 expression on myeloid cells, neutrophilic MDSCs and monocytic MDSCs, is correlated with the clinical outcomes of patients with cancer. In this study, we investigated the characteristics of myeloid cells expressing GPI-80 and the implication of GPI-80 expression in the clinical outcomes of patients with metastatic renal cell carcinoma (mRCC), in which primary renal cell carcinoma spreads from the kidney to other organs. The study included 20 patients with mRCC (a mean age of 66.0 years) and 16 healthy volunteers (a mean age of 47.8 years). To determine the heterogeneity of myeloid cells in peripheral blood samples, we performed the three-dimensional principal component analysis using the combination of GPI-80, CD16, and latency-associated peptide-1 (LAP), derived from the N-terminal region of transforming growth factor-ß1 precursor. The results showed that myeloid cells in mRCC patients were widely distributed and clearly distinguishable from those in the healthy volunteers. The survival analysis revealed that GPI-80 expression on neutrophils and monocytes was correlated with poor prognostic outcomes of patients with mRCC. In conclusion, the expression of GPI-80 on myeloid cells, a useful index for the heterogeneity of MDSCs, serves as a potential prognostic biomarker for mRCC.

[Bronchial Typical Carcinoid Tumor Treated with Two-stage Resection;Report of a Case].

A 45-year-old woman, who had been treated for bronchial asthma, was referred to our hospital with symptoms of dyspnea. Upon examination, we found the right main bronchus to be almost completely occluded by an endobronchial tumor. For the purpose of diagnosis and relieving the dyspnea, we performed a rigid bronchoscopic tumor resection with a high frequency snare. The tumor was pathologically diagnosed as a typical bronchial carcinoid, and a right upper lobectomy and wedge resection of the right main bronchus was carried out 1 month later.

[Congenitial Pulmonary Airway Malformation in an Adult with Pneumonia].

Congenitial pulmonary airway malformation (CPAM) most commonly present respiratory distress in the prenatal or neonatal period, but may rarely be asymptomatic and is incidentally found in adult patients with acute or recurrent pneumonia. Herein, we report a case of a 26-year-old asymptomatic adult male patient with pneumonia of the right lower lobe. He was also found to have multiple cystic lesions in the same lobe which was suspected to be CPAM, and the right lower lobectomy was performed.

Augmentation of the expression of the eotaxin receptor on duodenal neutrophils by IL-21.

Inflammation can occur via different mechanisms, such as via acute and chronic responses, on numerous occasions and function accordingly through various roles. There are more than five subsets of neutrophils; neutrophilic heterogeneity is modulated by the inflammatory condition. To understand the characteristics of inflammation, identification of atypical neutrophils is important. In this study, we found that the expression of eotaxin receptor (CD193) on atypical neutrophils in the duodenum is augmented in IL-21 isoform transgenic (Tg) mice. In a series of studies, we have established a Tg mouse strain to further investigate the functions of IL-21 in vivo. Interestingly, Tg mice immunized with ovalbumin (OVA) were more sensitive to OVA-induced systemic anaphylaxis as compared with wild type mice with duodenal and splenic gross congestion. Further analysis conducted in the duodenum of Tg mice revealed that only the number of neutrophils migrating into the duodenum was significantly increased prior to immunization. Previous studies have shown that the gastrointestinal compartment and the spleen constantly produce eotaxin, which regulates basal levels of tissue eosinophils. Therefore, we analyzed CD193 expression on neutrophils and eosinophils. As expected, its expression by duodenal neutrophils was upregulated in Tg mice. Furthermore, the addition of IL-21 into bone marrow cell culture increased the number of CD193+ neutrophils, which easily migrated into the duodenum. These observations suggested that CD193+ neutrophils increase in number under inflammatory conditions due to chronic IL-21 production.

Protein Tyrosine Phosphatase SHP-2 Is Involved in the Interleukin-21-Induced Activation of Extracellular Signal-Regulated Kinase 1/2.

The cytokine interleukin-21 (IL-21) is mainly produced from activated CD4+ T cells and natural killer T (NKT) cells. IL-21 enhances the proliferation and differentiation of T cells and B cells and also increases cytotoxicity of CD8+ T cells and NK cells through the IL-21 receptor and its downstream signaling molecules such as signal transducers and activator of transcription 3 (STAT3) and extracellular signal-regulated kinase 1/2 (ERK1/2). SH2 domain-containing tyrosine phosphatase (SHP-2) is ubiquitously expressed, including hematopoietic cells. SHP-2 has been implicated in the regulation of IL-6 and IL-3 signaling, but its function in IL-21 signaling has not been investigated. Therefore, we studied the role of SHP-2 in IL-21 signaling by SHP-2 overexpression and knockdown experiments. For the SHP-2 overexpression, we used 293T human embryonic kidney cells, in which the IL-21 receptor system were easily reconstituted and high amounts of exogenous SHP-2 were expressed by vector transfection. In 293T cells, overexpressed SHP-2 caused the increase in the degree of the IL-21-induced ERK1/2 activation. Subsequently, SHP-2 knockdown experiments were performed in the mouse pro-B cell line, BAF21RWT-1, which constitutively expresses human IL-21 receptor and proliferates in an IL-21-dependent manner. SHP-2 knockdown reduced the degree of the IL-21-induced ERK1/2 activation and suppressed cell proliferation. These results suggest that SHP-2 may augment the ERK1/2 activity and cell proliferation activity in IL-21 signaling. We propose that SHP-2 is involved in the IL-21-mediated ERK1/2 activation and cell proliferation.

Apurinic/Apyrimidinic Endonuclease 1/Redox Factor-1 (Ape1/Ref-1) Modulates Antigen Presenting Cell-mediated T Helper Cell Type 1 Responses.

Apurinic/apyrimidinic endonuclease 1/redox factor-1 (Ape1/Ref-1) is a multifunctional protein possessing DNA repair, redox control, and transcriptional regulatory activities. Although Ape1/Ref-1 plays multiple roles in the immune system, its functions in helper T (Th) cell activation and differentiation are largely unknown. In this study, the function of Ape1/Ref-1 in Th cell activation was analyzed using an Ape1/Ref-1 redox-specific inhibitor, E3330. When splenocytes from OT-II mice, which are ovalbumin (OVA)-specific T-cell receptor transgenic mice, were activated with OVA in the presence of E3330, the induction of IFN-γ-producing OT-II T cells was significantly increased. In contrast, E3330 did not enhance IFN-γ production from plate-bound anti-CD3 antibody-stimulated CD4+ T cells in the absence of antigen presenting cells (APCs). Furthermore, E3330-pretreated and OVA-pulsed APCs also enhanced the IFN-γ production from OT-II T cells. These results suggested that E3330 enhances Th1 responses by modifying APC function. E3330 did not alter the surface expression of MHC-II or the co-stimulatory molecules CD80 and CD86 on APCs. On the other hand, E3330 up-regulated the IL-12 p35 and p40 gene expression, and IL-12 surface retention, but decreased the IL-12 secretion from Toll-like receptor (TLR) ligand-stimulated APCs. These results were confirmed with Ape1/Ref-1 knockdown experiments. Taken together, our findings indicated that the suppression of Ape1/Ref-1 redox function leads to an increased cell surface retention of IL-12 and enhances Th1 responses. This is the first study to demonstrate that Ape1/Ref-1 modulates the IL-12 production and secretion from APCs and controls Th1 immune responses.

Responses to affective pictures depicting humans: late positive potential reveals a sex-related effect in processing that is not present in subjective ratings.

We examined sex-related effects in the amplitudes of the late positive potential (LPP), an event-related potential elicited by the presentation of emotional stimuli. Sixteen females and 18 males viewed emotional pictures to perform a visual detection task. In female participants, viewing unpleasant pictures elicited larger LPP (550-900 ms) when the pictures contained humans (human pictures) than when they did not contain humans (non-human pictures). For male participants, the results were reversed, with smaller LPP for unpleasant human pictures. Subjective ratings of valence in both female and male participants showed that unpleasant human pictures were evaluated less negatively than unpleasant non-human pictures. The results indicate that greater LPP amplitude for human than for non-human pictures occurred in females irrespective of subjective evaluations. This suggests that relatively robust processes in females cause sex-related effects in sensitivity to human pictures.

Sense of agency in continuous action: Assistance-induced performance improvement is self-attributed even with knowledge of assistance.

In a task involving continuous action to achieve a goal, the sense of agency increases with an improvement in task performance that is induced by unnoticed computer assistance. This study investigated how explicit instruction about the existence of computer assistance affects the increase of sense of agency that accompanies performance improvement. Participants performed a continuous action task in which they controlled the direction of motion of a dot to a goal by pressing keys. When instructions indicated the absence of assistance, the sense of agency increased with performance improvement induced by computer assistance, replicating previous findings. Interestingly, this increase of sense of agency was also observed even when instructions indicated the presence of assistance. These results suggest that even when a plausible cause of performance improvement other than one's own action exists, the improvement can be misattributed to one's own control of action, resulting in an increased sense of agency.

Mathematical fixation: Search viewed through a cognitive lens.

We provide a mathematical category theory account of the size and location of the authors' Functional View Field (FVF). Category theory explains systematic cognitive ability via universal construction, that is, a necessary and sufficient condition for composition of cognitive processes. Similarly, FVF size and location is derived from a (universal) construction called a fibre (pullback) bundle.