Binocularly suppressed stimuli induce brain activities related to aesthetic emotions.

Introduction: Aesthetic emotions are a class of emotions aroused by evaluating aesthetically appealing objects or events. While evolutionary aesthetics suggests the adaptive roles of these emotions, empirical assessments are lacking. Previous neuroscientific studies have demonstrated that visual stimuli carrying evolutionarily important information induce neural responses even when presented non-consciously. To examine the evolutionary importance of aesthetic emotions, we conducted a neuroscientific study using magnetoencephalography (MEG) to measure induced neural responses to non-consciously presented portrait paintings categorised as biological and non-biological and examined associations between the induced responses and aesthetic ratings. Methods: MEG and pre-rating data were collected from 23 participants. The pre-rating included visual analogue scales for object saliency, facial saliency, liking, and beauty scores, in addition to 'biologi-ness,' which was used for subcategorising stimuli into biological and non-biological. The stimuli were presented non-consciously using a continuous flash suppression paradigm or consciously using binocular presentation without flashing masks, while dichotomic behavioural responses were obtained (beauty or non-beauty). Time-frequency decomposed MEG data were used for correlation analysis with pre-rating scores for each category. Results: Behavioural data revealed that saliency scores of non-consciously presented stimuli influenced dichotomic responses (beauty or non-beauty). MEG data showed that non-consciously presented portrait paintings induced spatiotemporally distributed low-frequency brain activities associated with aesthetic ratings, which were distinct between the biological and non-biological categories and conscious and non-conscious conditions. Conclusion: Aesthetic emotion holds evolutionary significance for humans. Neural pathways are sensitive to visual images that arouse aesthetic emotion in distinct ways for biological and non-biological categories, which are further influenced by consciousness. These differences likely reflect the diversity in mechanisms of aesthetic processing, such as processing fluency, active elaboration, and predictive processing. The aesthetic processing of non-conscious stimuli appears to be characterised by fluency-driven affective processing, while top-down regulatory processes are suppressed. This study provides the first empirical evidence supporting the evolutionary significance of aesthetic processing.

Association of Baseline Serum Soluble Tumour Necrosis Factor Receptor Levels with the Response of Rheumatoid Arthritis to Janus Kinase Inhibitor Therapy.

Aim: The aim of this study was to investigate whether cytokines associated with tumour necrosis factor- (TNF-) α and interleukin- (IL-) 6 signalling could predict rheumatoid arthritis (RA) clinical remission (CR) with Janus kinase inhibitor (JAKinib) treatment using the Simplified Disease Activity Index (SDAI). Methods: Eighty-nine patients with RA treated with JAKinibs were enrolled, and their clinical data were collected retrospectively. CR was defined as an SDAI ≤ 3.3 after 6 months of treatment with JAKinib. The serum samples of 89 patients were analysed for IL-6, soluble IL-6 receptor (sIL-6R), soluble gp130 (spg130), and soluble TNF receptor- (sTNFR-) I and sTNFR-II titres. Results: There were no significant differences in the baseline clinical parameters between the CR and non-CR groups. Serum levels of IL-6, sIL-6R, and sgp130 were not significantly different; whereas, the serum sTNFR-I and sTNFR-II levels were significantly lower in the CR group. Univariate and multivariate logistic regression analysis showed that the baseline log sTNFR II values (OR: 0.002; p = 0.034) were predictors of CR. Conclusions: Patients with RA can be stratified prior to JAKinib administration using serum sTNFR-I and sTNFR-II levels but not serum IL-6 axis cytokine levels (IL-6, sIL-6R, and sgp130).

Involvement of YKL-40-positive macrophages commonly identified in polymyositis and dermatomyositis in the pathogenesis of myositis: a retrospective study.

YKL-40 is implicated in inflammation and tissue repair, but no reports have investigated its involvement in myositis in polymyositis (PM) and dermatomyositis (DM). Therefore, we aimed to investigate the relationship between YKL-40 and PM/DM. We retrospectively enrolled 35 patients diagnosed with PM/DM along with 26 healthy controls (HCs). Both PM and DM were diagnosed according to Bohan and Peter's criteria. Serum YKL-40 levels were measured, age-corrected to YKL-40 percentile values, and compared to HCs. Patients with myositis without interstitial lung disease were also enrolled and compared to HCs. Immunofluorescence staining was performed to identify YKL-40-positive inflammatory cells in muscle biopsy samples from two patients each with PM and DM. Age-corrected serum YKL-40 levels were significantly higher in patients with PM/DM compared to HCs with and without lung disease; however, these levels decreased significantly after treatment. Immunohistochemical analysis showed infiltration of YKL-40-positive inflammatory cells into the intramuscular sheath and perimuscular membrane. Immunofluorescence staining showed CD68 expression in YKL-40-positive inflammatory cells, suggesting that these cells were macrophages. To the best of our knowledge, this is the first study to demonstrate that YKL-40-positive macrophages are present in PM and DM, indicating that YKL-40 may be involved in PM/DM.

A piezoelectric micromachined ultrasound transducer combined with recording electrodes for acute brain preparations in vitro.

BACKGROUND: Ultrasound stimulation is used to noninvasively stimulate the local and deep areas of the brain. However, the detailed cellular mechanisms of neural activation are still unclear because studies on micro-stimulation at the cellular level are lacking. NEW METHOD: To modulate neural activity at the cellular level, we developed a piezoelectric micromachined ultrasound transducer (PMUT), having circular diaphragms for application on acute brain slice preparations. To monitor neural activities, additionally, we fabricated recording microelectrodes onto the same PMUT device for closed-loop application. RESULTS: To examine the PMUT-driven cellular responses of a brain slice, intracellular calcium signals in individual cells were measured using two calcium indicators. We successfully observed the intracellular responses triggered by the ultrasound of our novel PMUT. In addition, we performed recordings of local field potentials in a brain slice, demonstrating its usefulness as a simultaneous recording interface. COMPARISON WITH EXISTING METHOD(S): Conventional ultrasound stimulators are open-loop systems that risk inducing excessive neural activity because of the absence of neural activity monitoring. In contrast, our PMUT is packaged in a single device with both stimulation and sensor interface for neuromodulation. Further, there are no published reports on in vitro microdevices that can be used for ultrasound stimulation in rodent cortical slices that are several hundred micrometers thick, which maintain the cortical laminar structure and intrinsic neural networks. CONCLUSIONS: Our findings suggest that this novel PMUT device has the potential for being a powerful tool for in vitro brain slice applications and effective closed loop ultrasound stimulation.

[COMPONENT ANALYSIS OF THREE ANISAKIASIS ALLERGY CASES IN OUR DEPARTMENT].

Reactivity to an anisakis allergen component was examined in three patients with a history of an anisakiasis anaphylaxis. Case 1, a 38-year-old man, allergic symptoms appeared 0.5 hours after ingestion, and the component Ani s 1 and 3 were positive. Case 2, a 44-year-old woman, allergic symptoms appeared 4 hours after ingestion, and components Ani s 3 and 12 were positive. Case 3, a 36-year-old woman, developed allergic symptoms 7 hours after ingestion of fish and shellfish, and tested positive for Ani s 1, 4, and 12. Case 3 reacted strongly to both heated and unheated Anisakis extract, while cases 1 and 2 reacted weakly to heated Anisakis extract. The most common allergen was Ani s 12, followed by Ani s 1, when analyzed in conjunction with existing reports on 10 cases. Anisakis IgE was class 3 or higher in all cases. Analysis of 13 cases showed 2 cases sensitized to Ani s 4 and moderate or higher anaphylaxis, while Ani s 4-sensitized patients were reported to be more likely to develop severe disease. It is possible that the patients sensitized to Ani s 4 need to be careful about the severity of their allergic symptoms.

Low-Cost Electroencephalographic Recording System Combined with a Millimeter-Sized Coil to Transcranially Stimulate the Mouse Brain In Vivo.

A low-cost electroencephalographic (EEG) recording system is proposed here to drive transcranial magnetic stimulation (TMS) of the mouse brain in vivo, utilizing a millimeter-sized coil. Using conventional screw electrodes combined with a custom-made, flexible, multielectrode array substrate, multi-site recording can be carried out from the mouse brain. In addition, we explain how a millimeter-sized coil is produced using low-cost equipment usually found in laboratories. Practical procedures for fabricating the flexible multielectrode array substrate and the surgical implantation technique for screw electrodes are also presented, which are necessary to produce low-noise EEG signals. Although the methodology is useful for recording from the brain of any small animal, the present report focuses on electrode implementation in an anesthetized mouse skull. Furthermore, this method can be easily extended to an awake small animal that is connected with tethered cables via a common adapter and fixed with a TMS device to the head during recording.The present version of the EEG-TMS system, which can include a maximum of 32 EEG channels (a device with 16 channels is presented as an example with fewer channels) and one TMS channel device, is described. Additionally, typical results obtained by the application of the EEG-TMS system to anesthetized mice are briefly reported.

Weakened Grip Strength Over 40 Years in a Community-Dwelling Cohort in Tanushimaru, Japan.

BACKGROUND: An epidemiological survey has been periodically performed since 1977 among the adult population in Tanushimaru, a typical farming town in Japan. We aimed in this study to retrospectively investigate changes of grip strength (GS) and its correlates over 40 years in the same cohort of community-dwelling adults. We used pooled data from the survey to deduce essential correlates of GS in community-dwelling adults. METHODS: We retrospectively compared serial correlates of GS in the adult population in Tanushimaru between a population tested in 1977 and 1979 (Cohort A, n=2,452) and another population tested in 2016 and 2018 (Cohort B, n=1,505), to identify essential correlates of GS for investigating changes in GS during the past 40 years in community-dwelling adults. RESULTS: Age, height, weight, and the occupation of the subjects remained as correlates of GS in both genders during the past 40 years. In males, abdominal circumference also remained as a correlate of GS. Serum albumin levels in males and systolic blood pressure in females were identified as new correlates. GS after adjustment for the above correlates weakened in both genders, and the serial change in GS was particularly remarkable in subjects whose occupations were Class-1 and Class-2, which were defined as moderately hard work. CONCLUSIONS: From a periodically-performed epidemiological survey of a community-dwelling cohort in a Japanese typical farming town, age, height, weight, and occupation were deduced as essential correlates of GS. GS in the community dwelling cohort weakened in both genders over 40 years, possibly affected by their occupation.

Tocilizumab suppresses NF-kappa B activation via toll-like receptor 9 signaling by reducing cell-free DNA in rheumatoid arthritis.

Endogenous DNA is released into the bloodstream as cell-free DNA (cfDNA) following cell death and is associated with various pathological conditions. However, their association with therapeutic drugs against rheumatoid arthritis (RA) remains unknown. Therefore, we investigated the significance of cfDNA in RA treated with tocilizumab and tumour necrosis factor inhibitor (TNF-I). Biological DMARDs (bDMARDs), including tocilizumab and TNF-I, were administered to 77 and 59 RA patients, respectively. Plasma cfDNA levels were measured at weeks 0, 4, and 12 by quantitative polymerase chain reaction. Disease activity was evaluated at the same time point using DAS28ESR. cfDNA levels from RA synovial cells treated with tocilizumab or etanercept for 24 h were measured. Human toll-like receptor 9 (hTLR9)-expressing HEK293 cells, which release secreted embryonic alkaline phosphatase (SEAP) upon NF-κB activation, were stimulated by cfDNA from RA patients, and subsequently, SEAP levels were determined. NF-κB translocation was evaluated by immunofluorescence staining with or without tocilizumab. The DAS28ESR significantly improved in both bDMARD groups at week 12. However, plasma cfDNA levels significantly decreased in the tocilizumab group at week 12 compared to that in week 0. cfDNA levels correlated with DAS28ESR in biological treatment-naïve patients administered tocilizumab. cfDNA levels in synovial cells were significantly suppressed by tocilizumab treatment and unaltered with etanercept. HEK293 cells released SEAP upon cfDNA stimulation, and the observed NF-κB nuclear translocation was suppressed by tocilizumab. Tocilizumab suppressed inflammation via the TLR9 pathway by decreasing cfDNA levels. Regulation of cfDNA may be a therapeutic target for RA.

Sodium-glucose cotransporter 2 inhibitor-associated perioperative ketoacidosis: a systematic review of case reports.

Although the recommended preoperative cessation period for sodium-glucose cotransporter 2 inhibitors (SGLT2is) changed in 2020 (from 24 h to 3-4 days preoperatively) to reduce the risk of SGLT2i-associated perioperative ketoacidosis (SAPKA), the validity of the new recommendation has not been verified. Using case reports, we assessed the new recommendation effectiveness and extrapolated precipitating factors for SAPKA. We searched electronic databases up to June 1, 2022 to assess SAPKA (blood pH < 7.3 and blood or urine ketone positivity within 30 days postoperatively in patients taking SGLT2i). We included 76 publications with 99 cases. The preoperative SGLT2i cessation duration was reported for 59 patients (59.6%). In all cases with available cessation periods, the SGLT2is were interrupted < 3 days preoperatively. No SAPKA cases with > 2-day preoperative cessation periods were found. Many case reports lack important information for estimating precipitating factors, including preoperative SGLT2i cessation period, body mass index, baseline hemoglobin A1c level, details of perioperative fluid management, and type of anesthesia. Our study suggested that preoperative SGLT2i cessation for at least 3 days could prevent SAPKA. Large prospective epidemiologic studies are needed to identify risk factors for SAPKA.

Distinct role of tumor-infiltrating lymphocytes between synchronous and metachronous colorectal cancer.

PURPOSE: Tumor-infiltrating lymphocytes (TILs) may influence the prognosis of colorectal liver metastasis (CRLM). We assessed the prognostic value of evaluating TILs in the primary and metastatic sites of synchronous CRLM as well as metachronous CRLM. METHODS: We examined 90 patients who underwent curative primary and liver metastasis resection for colorectal cancer. CD8+ TILs (cytotoxic T cells) or CD45RO+ TILs (memory T cells) in both primary and metastatic sites were simultaneously evaluated by immunohistochemistry. RESULTS: Fifty-one patients had synchronous CRLM, and 39 patients had metachronous CRLM. In synchronous cases, the overall survival (OS) was significantly worse in patients with low CD8+ or CD45RO+ TILs in a metastatic site than in those with high CD8+ or CD45RO+ TILs (P = 0.017 and P = 0.005, respectively). Multivariate analysis showed that age ≥ 65 years (P = 0.043), maximum tumor size ≥ 30 mm (P = 0.003), primary N2-3 (P = 0.019), and low CD8+ TILs in metastatic site (P = 0.046) were independent poor prognostic factors. In contrast, in metachronous cases, OS was significantly worse in patients with low CD45RO+ TILs in a primary site than in those with high CD45RO+ TILs (P = 0.021). CD45RO+ TILs in a primary site (P = 0.044) were determined to be independent prognostic factor on multivariate analysis. CONCLUSIONS: The immune microenvironment between synchronous and metachronous CRLM might be different, and these differences may affect its prognosis.

RTA-dh404 decreased oxidative stress in mice ischemic limbs and augmented efficacy of therapeutic angiogenesis by intramuscular injection of adipose-derived regenerative cells in the limbs.

Although an intramuscular injection of angiogenic cells to ischemic limbs with peripheral artery disease is a therapeutic option to rescue patients by augmenting neovascularization in the limbs, oxidative stress in the limbs may accelerate apoptosis of the injected cells and thereby reduce the therapeutic effect. In this study involving mice with ischemic lower limbs, whether daily oral administration of RTA-dh404, which is an activator of nuclear factor erythroid 2-related factor 2 (Nrf2) with antioxidant activity, could reduce oxidative stress in the limbs and suppress apoptosis of adipose-derived regenerative cells (ADRCs) injected in the limbs, eventually augmenting neovascularization in the limbs, was evaluated. The tissue expression of Nrf2 and concentrations of total antioxidant capacity and superoxide dismutase in the mice ischemic limbs were higher in the RTA-dh404-treated mice than in the control treated mice, and oxidative stress in the limbs of the RTA-dh404 treated mice was decreased. The day after an intramuscular injection of human ADRCs into ischemic lower limbs of immunodeficient mice, the number of apoptotic ADRCs in the ischemic limbs was decreased by approximately 25% in the RTA-dh404-treated mice compared to the control mice. Fourteen days after cell injection, neovascularization and the salvage ratio were increased by approximately 10% and 63%, respectively, in the ischemic limbs in the RTA-dh404-treated mice compared to the control mice. Pretreatment of ischemic limbs by daily oral administration of RTA-dh404 may augment the effect of therapeutic angiogenesis using an intramuscular injection of ADRCs into the ischemic limbs.

The effect of tetrastarch on the endothelial glycocalyx layer in early hemorrhagic shock using fluorescence intravital microscopy: a mouse model.

PURPOSE: To investigate vascular endothelial dysfunction based on glycocalyx impairment in massive hemorrhage and to evaluate fluid therapy. METHODS: In this randomized controlled animal study, we withdrew 1.5 mL blood and administered 1.5 mL resuscitation fluid. Mice were divided into six groups according to the infusion type and administration timing: NS-NS (normal saline), NS-HES ([hydroxyethyl starch]130), HES-NS, NS-ALB (albumin), ALB-NS, and C (control) groups. RESULTS: The glycocalyx index (GCXI) of a 40-µm artery was significantly larger in group C than in other groups (P < 0.01). Similarly, the GCXI for a 60-µm artery was significantly higher in group C than in NS-NS (P ≤ 0.05), NS-HES (P ≤ 0.01), and NS-ALB groups (P ≤ 0.05). The plasma syndecan-1 concentration, at 7.70 ± 5.71 ng/mL, was significantly lower in group C than in group NS-NS (P ≤ 0.01). The tetramethylrhodamine-labeled dextran (TMR-DEX40) fluorescence intensity in ALB-NS and HES-NS groups and the fluorescein isothiocyanate-labeled hydroxyethyl starch (FITC-HES130) fluorescence intensity in NS-HES and HES-NS groups were not significantly different from those of group C at any time point. FITC-HES130 was localized on the inner vessel wall in groups without HES130 infusion but uniformly distributed in HES130-treated groups in intravital microscopy. FITC-FITC-HES130 was localized remarkably in the inner vessel walls in group HES-NS in electron microscopy. CONCLUSIONS: In an acute massive hemorrhage mouse model, initial fluid resuscitation therapy with saline administration impaired glycocalyx and increased vascular permeability. Prior colloid-fluid administration prevented the progression of glycocalyx damage and improve prognosis. Prior HES130 administration may protect endothelial cell function.

Safety and Efficacy of a Bodyweight Exercise Training Program in Symptomatic Patients With Severe Aortic Valve Stenosis.

Conventional exercise therapy including aerobic and resistance training is desirable for cardiovascular disease, whereas it is generally considered contraindicated for symptomatic severe aortic valve stenosis (AS). This study aimed to evaluate the safety and efficacy of bodyweight resistance exercise training (BRET), which is low-intensity exercise training in symptomatic patients with severe AS. A BRET program consisting of 8 exercises was performed 3 times a week by patients with AS with physical therapists. For the 78 symptomatic patients with severe AS, the median aortic valve area and mean transaortic valve pressure gradient were 0.56 cm2 and 48.9 mm Hg, respectively; none showed any harmful changes in blood pressure or heart rate in 11 sessions of the BRET program. There were no adverse events during hospitalization. Meanwhile, Barthel's Index score significantly improved at the time of hospital discharge. In conclusion, the BRET program in this study did not appear to cause harmful changes in hemodynamics during the program or adverse events during hospitalization, and it improved activities of daily living in symptomatic patients with severe AS, allowing doctors and physical therapists to conduct it safely, with less emotional stress, for cardiac rehabilitation for such patients.

Short- and long-term outcomes of laparoscopic versus open repeat liver resection for hepatocellular carcinoma: A multicenter study.

OBJECTIVE: This multicenter study aimed to compare the short- and long-term outcomes of laparoscopic (LRLR) versus open repeat liver resection (ORLR) for recurrent hepatocellular carcinoma (HCC) using propensity score matching (PSM). Despite the expanding indications for laparoscopic liver resection, limited data regarding the outcomes of LRLR have previously been reported. METHODS: This study included patients who underwent repeat liver resection for recurrent HCC. Patients were divided into the LRLR and ORLR groups, and their short- and long-term outcomes were compared via PSM. RESULTS: There were 256 and 130 patients in the ORLR and LRLR groups, respectively. After PSM, 64 patients were included in each group. Intraoperative blood loss was significantly less in LRLR than in ORLR (56 vs 208 ml, P < .001). Postoperative complications of Clavien-Dindo IIIa or more were significantly less in LRLR than in ORLR (3.1% vs 15.6%, P = .030). The length of hospital stay was notably shorter in LRLR than in ORLR (9 vs 12 days, P < .001). Survival rates after repeat liver resection at 1, 3, and 5 years, respectively, were comparable at 93.4%, 81.9%, and 63.5% for ORLR and at 94.8%, 80.7%, and 67.3% for LRLR (P = .623). Subgroup analysis of patients who underwent wedge resection in repeat liver resection revealed that the postoperative complication rate was notably lower in LRLR than in ORLR (7.2% vs 21.8%, P = .030). CONCLUSION: LRLR for recurrent HCC is a viable option due to its better short-term outcomes and comparable long-term outcomes compared to ORLR.

Association between eating behavior and the immediate neural activity caused by viewing food images presented in and out of awareness: A magnetoencephalography study.

Obesity is a serious health problem in modern society. Considering the fact that the outcomes of treatments targeting appetitive behavior are suboptimal, one potential reason proposed for these poor outcomes is that appetitive behavior is driven more by unconscious decision-making processes than by the conscious ones targeted by traditional behavioral treatments. In this study, we aimed to investigate both the conscious and unconscious decision-making processes related to eating behavior, and to examine whether an interaction related to eating behavior exists between conscious and unconscious neural processes. The study was conducted on healthy male volunteers who viewed pictures of food and non-food items presented both above and below the awareness threshold. The oscillatory brain activity affected by viewing the pictures was assessed by magnetoencephalography. A visual backward masking procedure was used to present the pictures out of awareness. Neural activity corresponding to the interactions between sessions (i.e., food or non-food) and conditions (i.e., visible or invisible) was observed in left Brodmann's areas 45 and 47 in the high-gamma (60-200 Hz) frequency range. The interactions were associated with eating behavior indices such as emotional eating and cognitive restraint, suggesting that conscious and unconscious neural processes are differently involved in eating behavior. These findings provide valuable clues for devising methods to assess conscious and unconscious appetite regulation in individuals with normal or abnormal eating behavior.

Temporal and spatial profiles of evoked activity induced by magnetic stimulation using millimeter-sized coils in the mouse auditory cortex in vivo.

Transcranial magnetic stimulation (TMS), a minimally/non-invasive method of electromagnetic stimulation of brain tissue, has been shown to be beneficial in clinical therapy for specific neurological diseases and disorders. Magnetic stimulation is also used to modulate human and animal brain activity in basic neuroscience studies. Among experimental animal models, mouse models are particularly popular and uniquely representative of brain disorders in basic neuroscience research. TMS in mouse models may play a substantial role in understanding TMS-induced changes in neural networks and plasticity. Although TMS techniques are widely used to examine rodent disease models, techniques specific for mice using small magnetic stimulators have not been intensively developed. Here, we provide a numerical simulation and a practical method of applying TMS to mice by constructing millimeter-sized TMS coils to deliver a low stimulation intensity while maintaining focality. Our results indicate the TMS coils can produce an electrical field with sufficient magnitude to activate the anesthetized mouse cortex in the presence or absence of the skull in vivo. Our results also show that, immediately after magnetic stimulation, local field and action potentials were reliably observed in a manner that depended on the distance between the coil and the brain, implying even a small coil could reliably evoke cortical activity. Therefore, our results show our millimeter-sized coils could produce electric fields sufficient to alter cortical excitability in mice. These coils could be useful in future preclinical studies to examine detailed mechanisms underlying TMS-induced changes in neural activity of the auditory cortex and other cortical regions.

Neural effects of viewing children's faces on mental fatigue: a magnetoencephalography study.

We examined whether the recovery from fatigue could be facilitated by viewing the children's faces. Seventeen healthy mothers with child or children over 6 years old participated in our experiment. After performing a 2-back task for 40 min, they viewed the pictures of children's and adult's faces in the target and control conditions, respectively. The target and control conditions were performed on the separate days in a two-crossover design. Neural activity caused by viewing the children's faces was recorded using magnetoencephalography and electrocardiography was performed to assess the index of heart rate variability (low-frequency component power/high-frequency component power ratio, LF/HF) reflecting fatigue. The subjective level of mental fatigue sensation and LF/HF ratio was decreased after viewing the children's faces and the overactivation of the visual cortex caused by performing the 2-back task, assessed by the alteration of alpha band power in the visual cortex, was attenuated by viewing the children's faces, suggesting that viewing the children's faces affected the time course of mental fatigue after performing the 2-back task.

Impact of laparoscopic liver resection on liver regeneration.

BACKGROUND: Liver regeneration after liver resection plays an important role in preventing posthepatectomy liver failure. In this study, we aimed to evaluate and compare the impact of laparoscopic liver resection (LLR) and open liver resection (OLR) on liver regeneration. METHODS: Patients who underwent curative anatomical liver resection for hepatocellular carcinoma, cholangiocellular carcinoma, and colorectal liver metastases at our institution between January 2010 and December 2018 were included in this study. The patients were divided into the OLR and LLR groups. Preoperative liver volume (PLV), future remnant liver volume, resected liver volume (RLV), liver volume at 1 month after the surgery, and liver volume at 6 months after the surgery were calculated. The liver regeneration rate was defined as the increase in the rate of RLV, and the liver recovery rate was defined as the rate of return to the PLV. RESULTS: The study included 72 patients. Among them, 43 were included in the OLR group and 29 were included in the LLR group. No differences were observed in the baseline characteristics and surgical procedures between the two groups. Moreover, no significant difference was observed in the liver regeneration rate at 1 month after the surgery (OLR vs. LLR: 68.9% vs. 69.0%, p = 0.875) and at 6 months after the surgery (91.8% vs. 93.2%, p = 0.995). Furthermore, the liver recovery rates were not significantly different between the two groups at 1 month after the surgery (90.3% vs. 90.6%, p = 0.893) and at 6 months after the surgery (96.9% vs. 98.8%, p = 0.986). CONCLUSION: Liver regeneration after liver resection is not affected by the type of surgical procedure and both laparoscopic and open procedures yield similar regeneration and recovery rates.

Advantages of skin closure with subcuticular suture for liver resection on postoperative and cosmetic outcomes: a propensity matched analysis.

PURPOSE: The effects of subcuticular sutures on postoperative and cosmetic outcomes in patients who underwent liver resection have not been well studied. Here, we investigated the advantages of subcuticular suture compared to skin stapler regarding open liver resection. METHODS: We assessed 342 patients who underwent liver resection at Nara Medical University between 2008 and 2015. They were divided into two groups: subcuticular suture and staple groups. Baseline characteristics and perioperative outcomes were retrospectively compared using one-to-one propensity score matching analysis. RESULTS: In this period, 179 patients underwent skin closure with subcuticular sutures and 163 patients underwent skin closure with staples. After propensity matching, 85 pairs of cases were matched. The incidence of wound infection was similar in the two groups (3.5% in the subcuticular suture group and 9.4% in the staple group; p = 0.119). The length of hospital stay was significantly shorter in the subcuticular suture group than in the staple group (10 days vs 15 days; p < 0.001). In addition, the rate of patients who were discharged within 7 days after surgery was statistically higher in the subcuticular group (21.1% vs 3.5%, p = 0.001). Hypertrophic scar 6 months after surgery was significantly less frequent in the subcuticular group (9.4% vs 25.9%, p = 0.010). CONCLUSION: Subcuticular sutures might be advantageous for liver surgery reducing length of hospital stay and proportion of hypertrophic scar.

Neural mechanism by which physical fatigue sensation suppresses physical performance: a magnetoencephalography study.

The right dorsolateral prefrontal cortex (DLPFC) has been proposed to be the brain region regulating performance through fatigue sensation in fatigue, but direct evidence has been lacking for right DLPFC activation when physical performance is suppressed in the presence of fatigue sensation. We examined whether the right DLPFC is activated when physical performance is suppressed by remembering a physical fatigue sensation. Eighteen healthy male volunteers participated. They performed a rest session followed by a handgrip session to induce physical fatigue sensation. Then, they were instructed to remember the state of the right hand with (i.e., the target condition) and without (i.e., the control condition) fatigue sensation as experienced in the handgrip and rest sessions, respectively while performing motor imagery of maximum handgrip of the right hand. Neural activity during both conditions was recorded using magnetoencephalography. The level of fatigue sensation was higher in the target condition than in the control condition. Decreases of handgrip strength and beta band power in the right Brodmann's area 46 were observed in the target condition, suggesting that the right DLPFC is involved in the regulation of physical performance through fatigue sensation. These findings may help elucidate the neural mechanisms regulating performance under fatigue conditions.