Duodenal Ulcer as a Postoperative Complication in the Donor in Living-Donor Liver Transplantation.

INTRODUCTION: Donor safety is one of the most important factors in living-donor liver transplantation. Duodenal ulcer (DU) is a common postoperative complication. Here we aimed to reveal the risk factors associated with postoperative DU in the donors. METHODS: Between April 2007 and March 2017, 318 cases underwent donor hepatectomy for liver transplantation at Kumamoto University Hospital. We classified the donors into two groups: a DU group and a non-DU group. DU was defined as mucosal break with unequivocal depth requiring an endoscopic procedure. The characteristics and clinical factors of the donors were retrospectively analyzed. RESULTS: Postoperative DU occurred in 17 donors during the study period. The mean interval after donor hepatectomy to occurrence of DU was 124.8 ± 185.4 days. The two groups were comparable in terms of age at time of the donor hepatectomy (P = .45). The male-to-female ratio (P = .03) was significantly different between the two groups and left-side hepatectomy was performed more often in the DU group (P = .003). Multivariable logistic regression revealed that left-side hepatectomy was independently associated with postoperative DU in the donors. CONCLUSIONS: These findings indicated that left-side hepatectomy is a risk factor for postoperative DU in the donors.

The primate amygdala: Neuronal representations of the viscosity, fat texture, temperature, grittiness and taste of foods.

The primate amygdala is implicated in the control of behavioral responses to foods and in stimulus-reinforcement learning, but only its taste representation of oral stimuli has been investigated previously. Of 1416 macaque amygdala neurons recorded, 44 (3.1%) responded to oral stimuli. Of the 44 orally responsive neurons, 17 (39%) represent the viscosity of oral stimuli, tested using carboxymethyl-cellulose in the range 1-10,000 cP. Two neurons (5%) responded to fat in the mouth by encoding its texture (shown by the responses of these neurons to a range of fats, and also to non-fat oils such as silicone oil ((Si(CH(3))(2)O)(n)) and mineral oil (pure hydrocarbon), but no or small responses to the cellulose viscosity series or to the fatty acids linoleic acid and lauric acid). Of the 44 neurons, three (7%) responded to gritty texture (produced by microspheres suspended in cellulose). Eighteen neurons (41%) responded to the temperature of liquid in the mouth. Some amygdala neurons responded to capsaicin, and some to fatty acids (but not to fats in the mouth). Some amygdala neurons respond to taste, texture and temperature unimodally, but others combine these inputs. These results provide fundamental evidence about the information channels used to represent the texture and flavor of food in a part of the brain important in appetitive responses to food and in learning associations to reinforcing oral stimuli, and are relevant to understanding the physiological and pathophysiological processes related to food intake, food selection, and the effects of variety of food texture in combination with taste and other inputs on food intake.

Orbitofrontal cortex: neuronal representation of oral temperature and capsaicin in addition to taste and texture.

The primate orbitofrontal cortex is a site of convergence of information from primary taste, olfactory and somatosensory cortical areas. We describe the discovery of a population of single neurons in the macaque orbitofrontal cortex that responds to the temperature of a liquid in the mouth. The temperature stimuli consisted of water at 10 degrees C, 23 degrees C, 37 degrees C and 42 degrees C. Twenty-six of the 1149 neurons analyzed (2.3%) responded to oral temperature. The tuning profiles of the neurons to temperature showed that some of the neurons had graded responses to increasing temperature (27%), others responded to cold (10 degrees C) stimuli (27%), and others were tuned to temperature (46%). The neuronal responses were also measured to taste stimuli, viscosity stimuli (carboxymethyl-cellulose in the range 1-10,000 cP), and capsaicin (10 microM). Of 70 neurons with responses to any of these stimuli, 7.1% were unimodal temperature; 11.3% were temperature and taste-sensitive; 7.1% were temperature and viscosity-sensitive; and 11.3% were temperature, taste and viscosity sensitive. Capsaicin activated 15.7% of the population of responsive neurons tested. These results provide the first evidence of how the temperature of what is in the mouth is represented at the neuronal level in the orbitofrontal cortex and the first evidence for any primate cortical area that in some cases this information converges onto single neurons with inputs produced by other sensory properties of food, including taste and texture. The results provide a basis for understanding how particular combinations of oral temperature, taste, and texture can influence the palatability of foods.

Effects of reversible block of callosal afferent inputs on the response characteristics of single neurons in the cortical taste area in rats.

We examined the change in magnitude of the taste responses of single neurons in the cortical taste area (CTA) in one side by reversibly blocking the CTA in the other side with a local anesthetic, procaine-HCl, in urethane-anesthetized rats. Taste responses of 68 taste neurons were continuously recorded for up to 2 h until recovery from the treatment, and those in 50 of them were found to be affected significantly. No remarkable difference was noted in the spatial distribution of the affected and non-affected neurons in the CTA. Many of the affected neurons were located in layers IV and V of area GI and in layer V of area DI. In most cases, changes in the taste responses of single neurons were in one direction, i.e., either a decrease or an increase, but in a few cases they decreased or increased depending on the stimulus. The taste profile of callosal inputs was estimated by subtracting responses after treatment from the control responses before treatment. The results suggest that the CTAs on both sides are functionally connected by way of callosal fibers as anatomical studies indicate, and that the CTA in one side receives excitatory or inhibitory inputs from the other side.