Erratum: Optical parameters estimation in inhomogeneous turbid media using backscattered light: for transcutaneous scattering measurement of intravascular blood: erratum.

[This corrects the article on p. 237 in vol. 15, PMID: 38223194.].

Actual state of the diurnal masseteric electromyogram: Differences between awareness and non-awareness of awake bruxism.

PURPOSE: This study aimed to elucidate the relationship between diurnal masseter muscle activity and awareness of diurnal awake bruxism (d-AB) by conducting a comparative analysis of electromyographic (EMG) data from individuals with and without awareness of diurnal awake bruxism (d-AB), utilizing EMG data gathered from multiple subjects. METHODS: Unilateral masseter electromyography (EMG) recordings were performed during the daytime using an ultraminiature wearable EMG device. A total of 119 participants (59 with awareness of diurnal tooth clenching [d-TC] and 60 without awareness of d-TC) were included. Waveforms longer than 0.25 s with the two amplitude conditions, exceeding twice the baseline and >5% of maximum voluntary clenching, were extracted. In addition, the number of bursts and episodes (groups of bursts), burst duration, and burst peak amplitude were calculated for each participant. RESULTS: There were no significant differences in the EMG parameters between the groups with and without awareness of d-TC. Additionally, the frequency distribution of the number of EMG waveforms exhibited wide ranges and substantial overlap between the two groups. CONCLUSIONS: The variability in the number of bursts and episodes, burst peak amplitude, and burst duration among subjects suggests the need for an objective classification of d-AB severity based on EMG values. The absence of significant differences and large overlap in frequency distributions between the groups with and without awareness of d-TC indicate difficulty in predicting muscle activity solely based on awareness of d-AB.

Optical parameters estimation in inhomogeneous turbid media using backscattered light: for transcutaneous scattering measurement of intravascular blood.

In our earlier research, a technique was developed to estimate the effective attenuation coefficient of subcutaneous blood vessels from the skin surface using the spatial distribution of backscattered near-infrared (NIR) light. The scattering effect in surrounding tissues was suppressed through the application of a differential principle, provided that the in vivo structure is known. In this study, a new method is proposed enabling the separate estimation of both scattering and absorption coefficients using NIR light of different wavelengths. The differential technique is newly innovated to make it applicable to the subcutaneous structure without requiring explicit geometrical information. Suppression of the scattering effect from surrounding tissue can be incorporated into the process of estimating the scattering and absorption coefficients. The validity of the proposed technique can be demonstrated through Monte Carlo simulations using both homogeneous and inhomogeneous tissue-simulating models. The estimated results exhibit good coherence with theoretical values (r2 = 0.988-0.999). Moreover, the vulnerability and robustness of the proposed technique against different measurement errors are verified. Optimal conditions for practical measurement are specified under various light-detection conditions. Separate estimation of scattering and absorption coefficients improves the accuracy of turbidity measurements and spectroscopy in biomedical applications considerably, particularly for noninvasive measurements and analysis of blood, lipids, and other components in subcutaneous blood vessels.

Quantitative analyses of RBC movement in whole blood exposed to DC and ELF electric field.

For the study of biological effects of direct current (DC) and extremely low frequency (ELF) electric fields, we have quantitatively analyzed red blood cell (RBC) movement in whole blood. Considering the inhomogeneous distribution of electric fields in vivo, five different electric field distributions were generated under a microscope. For theoretical analyses, we assumed electrophoresis and dielectrophoresis as basic motive forces and obtained the spatial distribution of blood cell velocity. The RBC velocity was measured using video image analysis. The spatial dependence of the velocity showed good agreement with that predicted by theoretical analysis. This result suggests the validity of the theoretical model based on electrophoresis and dielectrophoresis for the study of ELF electric field exposure to inhomogeneous animal and human bodies. Next, using the same measurement system, we attempted to find the electric field strength at which these effects occur. The threshold values were found to be 0.40 and 1.6 kV/m, respectively, for DC and AC electric field exposures. Furthermore, we investigated the reproducibility of the field effects in more realistic conditions of human exposure. The RBCs in microchannels were exposed to the electric field generated in capacitive coupling using electrodes separated by an air gap. Even in the new condition, similar effects were observed, which also verified the validity of the analysis described above. These results will provide useful information for the safety assessment of field exposure and for the future biomedical applications of electric fields to manipulate RBCs in vivo.

Near-Infrared Transillumination for Macroscopic Functional Imaging of Animal Bodies.

The classical transillumination technique has been revitalized through recent advancements in optical technology, enhancing its applicability in the realm of biomedical research. With a new perspective on near-axis scattered light, we have harnessed near-infrared (NIR) light to visualize intricate internal light-absorbing structures within animal bodies. By leveraging the principle of differentiation, we have extended the applicability of the Beer-Lambert law even in cases of scattering-dominant media, such as animal body tissues. This approach facilitates the visualization of dynamic physiological changes occurring within animal bodies, thereby enabling noninvasive, real-time imaging of macroscopic functionality in vivo. An important challenge inherent to transillumination imaging lies in the image blur caused by pronounced light scattering within body tissues. By extracting near-axis scattered components from the predominant diffusely scattered light, we have achieved cross-sectional imaging of animal bodies. Furthermore, we have introduced software-based techniques encompassing deconvolution using the point spread function and the application of deep learning principles to counteract the scattering effect. Finally, transillumination imaging has been elevated from two-dimensional to three-dimensional imaging. The effectiveness and applicability of these proposed techniques have been validated through comprehensive simulations and experiments involving human and animal subjects. As demonstrated through these studies, transillumination imaging coupled with emerging technologies offers a promising avenue for future biomedical applications.

Reconstructing a Deblurred 3D Structure in a Turbid Medium from a Single Blurred 2D Image-For Near-Infrared Transillumination Imaging of a Human Body.

To provide another modality for three-dimensional (3D) medical imaging, new techniques were developed to reconstruct a 3D structure in a turbid medium from a single blurred 2D image obtained using near-infrared transillumination imaging. One technique uses 1D information of a curvilinear absorber, or the intensity profile across the absorber image. Profiles in different conditions are calculated by convolution with the depth-dependent point spread function (PSF) of the transillumination image. In databanks, profiles are stored as lookup tables to connect the contrast and spread of the profile to the absorber depth. One-to-one correspondence from the contrast and spread to the absorber depth and thickness were newly found. Another technique uses 2D information of the transillumination image of a volumetric absorber. A blurred 2D image is deconvolved with the depth-dependent PSF, thereby producing many images with points of focus on different parts. The depth of the image part can be estimated by searching the deconvolved images for the image part in the best focus. To suppress difficulties of high-spatial-frequency noise, we applied a noise-robust focus stacking method. Experimentation verified the feasibility of the proposed techniques, and suggested their applicability to curvilinear and volumetric absorbers such as blood vessel networks and cancerous lesions in tissues.

Analysis of Red Blood Cell Movement in Whole Blood Exposed to DC and ELF Electric Fields.

To evaluate hematological effects of direct current (DC) and alternating current (AC) extremely low frequency (ELF) electric field exposure, this study investigated red blood cell (RBC) movement in whole blood. Video images of RBCs were recorded under a microscope using specially designed electrode systems. Video analysis software was then used to measure the RBC velocity. The noise level and measurement system stability were confirmed based on results of a no-field exposure experiment. Using the electrode system to produce a non-homogeneous electric field, different movements were found to occur in DC and AC field exposure. The RBCs moved in the directions of the electric field and the gradient of field distribution, respectively, in the DC and AC fields. Dependences of the RBC velocity on the field strength were, respectively, linear and quadratic in the DC and AC fields. These results suggest that electrophoretic and dielectrophoretic movements were, respectively, dominant in the DC and AC fields. The magnitude of the electric field necessary to cause these effects was found to be 103 -105 times greater than the internationally publicized guideline for human safety. © 2022 Bioelectromagnetics Society.

A case of juvenile form of dilated cardiomyopathy in a 6-month-old Shiba Inu dog.

A 6-month-old Shiba Inu dog was brought to the Veterinary Medical Teaching Hospital because of a cough, exercise intolerance, and pulmonary edema. The dog had a Levine 2/6 systolic murmur. Transthoracic echocardiography revealed left atrial and ventricular dilatation (left atrium to aortic ratio: 2.8), mitral and tricuspid valve regurgitation, and severe left ventricular myocardial hypokinesia (fractional shortening was 11.8%). Bubble contrast echocardiography did not reveal a congenital shunt; therefore, the dog was clinically diagnosed with early onset dilated cardiomyopathy. From the first visit, the dog was treated with pimobendan, taurine, torasemide, and isosorbide dinitrate. After 435 days, echocardiography revealed that systolic function had not improved. On Day 465, atrial fibrillation was confirmed via electrocardiogram, and treatment with diltiazem hydrochloride was initiated. The dog continued to appear clinically stable thereafter, until it died suddenly 1087 days after the initial visit. A postmortem histopathological examination identified severe enlargement of the left atrial and ventricular chambers as well as attenuated wavy fibers in the ventricular myocardium, which confirmed dilated cardiomyopathy in a juvenile. This is the first report of a juvenile form of dilated cardiomyopathy in a Shiba Inu dog. This case report provides evidence that the extended prognosis of this dog differed from that in previously reported cases of dilated cardiomyopathy in young dogs. Key clinical message: This is the first reported case of a juvenile form of dilated cardiomyopathy in a Shiba Inu dog. This report provides evidence that the prognosis of this dog differed from that in previously reported cases of dilated cardiomyopathy in young dogs.

Un cas de forme juvénile de cardiomyopathie dilatée chez un chien Shiba Inu de 6 mois. Un chien Shiba Inu de 6 mois a été amené à l'hôpital universitaire de médecine vétérinaire en raison d'une toux, d'une intolérance à l'exercice et d'un oedème pulmonaire. Le chien avait un souffle systolique Levine 2/6. L'échocardiographie transthoracique a révélé une dilatation auriculaire et ventriculaire gauche (rapport oreillette gauche sur aorte : 2,8), une régurgitation des valves mitrale et tricuspide et une hypokinésie myocardique ventriculaire gauche sévère (raccourcissement fractionnel de 11,8 %). L'échocardiographie de contraste par microbulles n'a pas révélé de shunt congénital; par conséquent, le chien a reçu un diagnostic clinique de cardiomyopathie dilatée d'apparition précoce. Dès la première visite, le chien a été traité avec du pimobendane, de la taurine, du torasémide et du dinitrate d'isosorbide. Après 435 jours, l'échocardiographie a révélé que la fonction systolique ne s'était pas améliorée. Au jour 465, la fibrillation auriculaire a été confirmée par électrocardiogramme et un traitement par le chlorhydrate de diltiazem a été instauré. Le chien a continué à apparaître cliniquement stable par la suite, jusqu'à ce qu'il meure subitement 1087 jours après la visite initiale. Un examen histopathologique post mortem a identifié une hypertrophie sévère des cavités auriculaire et ventriculaire gauche ainsi que des fibres ondulées atténuées dans le myocarde ventriculaire, ce qui a confirmé une cardiomyopathie dilatée chez un juvénile. Il s'agit du premier rapport d'une forme juvénile de cardiomyopathie dilatée chez un chien Shiba Inu. Ce rapport de cas fournit des preuves que le pronostic prolongé de ce chien différait de celui des cas précédemment rapportés de cardiomyopathie dilatée chez les jeunes chiens.Message clinique clé :Il s'agit du premier cas rapporté d'une forme juvénile de cardiomyopathie dilatée chez un chien Shiba Inu. Ce rapport fournit des preuves que le pronostic de ce chien différait de celui des cas précédemment rapportés de cardiomyopathie dilatée chez les jeunes chiens.(Traduit par Dr Serge Messier).

Clinical features of patients with pancreatic ductal adenocarcinoma with a history of other primary malignancies: A retrospective analysis.

Patients with pancreatic ductal adenocarcinoma (PDAC) that have a history of other primary malignancies are not well documented. The current study therefore aimed to evaluate the clinicopathological characteristics of patients with PDAC with or without a history of other primary malignancies. A total of 102 patients with surgically treated PDAC that presented with or without a history of other primary malignancies were retrospectively analyzed. A total of 25 patients (24.5%) had a history of other primary malignancies (age, with history of other primary malignancy vs. without, 74.2 vs. 68.9 years; P=0.005) and the reason for consultation (P<0.001) differed significantly between the groups with a history of other primary malignancies [HoM(+)] and without a history of other primary malignancies [HoM(-)]. Incidental indications during malignancy follow-up was the most common reason for the diagnosis of PDAC in the HoM(+) group. Conversely, there were no significant differences in the resectability (P=0.645), complete resection rate (P=0.774) and final stage (P=0.474) between the two groups. Disease-free survival was also not significantly different between the two groups (P=0.184). However, overall survival was significantly poorer in the HoM(+) group compared with the HoM(-) group (P=0.003). A history of other primary malignancies was also an independent predictor of poor overall survival (hazard ratio, 2.416; 95% confidence interval, 1.324-4.406; P=0.004). In conclusion, patients with PDAC and a history of other primary malignancies had significantly poorer overall survival than their counterparts, despite no differences in disease-free survival.

Three-dimensional imaging through turbid media using deep learning: NIR transillumination imaging of animal bodies.

Using near-infrared (NIR) light with 700-1200 nm wavelength, transillumination images of small animals and thin parts of a human body such as a hand or foot can be obtained. They are two-dimensional (2D) images of internal absorbing structures in a turbid medium. A three-dimensional (3D) see-through image is obtainable if one can identify the depth of each part of the structure in the 2D image. Nevertheless, the obtained transillumination images are blurred severely because of the strong scattering in the turbid medium. Moreover, ascertaining the structure depth from a 2D transillumination image is difficult. To overcome these shortcomings, we have developed a new technique using deep learning principles. A fully convolutional network (FCN) was trained with 5,000 training pairs of clear and blurred images. Also, a convolutional neural network (CNN) was trained with 42,000 training pairs of blurred images and corresponding depths in a turbid medium. Numerous training images were provided by the convolution with a point spread function derived from diffusion approximation to the radiative transport equation. The validity of the proposed technique was confirmed through simulation. Experiments demonstrated its applicability. This technique can provide a new tool for the NIR imaging of animal bodies and biometric authentication of a human body.

The characteristics of the immune cell profiles in peripheral blood in cholangiocarcinoma patients.

BACKGROUND: Immune related cells are known to be closely related to the therapeutic effects and prognoses of cancer patients. In this study, we analyzed immune cell profiles (ICP) of cholangiocarcinoma patients (CCA). METHODS: To measure the frequency of immune cells, peripheral blood mononuclear cells of 41 CCA and 10 healthy volunteers (HV) were analyzed by FACS. RESULTS: There were significant differences between CCA and HV in ICP, and these differences were a consequence of tumor-bearing status, because many items in ICP before surgery were restored to levels in HV after surgery. Therefore, these changes were specifically attributable to cholangiocarcinoma, and we examined if they can function as biomarkers for therapeutic effects and prognoses. A shorter overall survival was associated with a lower frequency of helper T cells (HT) (p = 0.001), a higher frequency of effector regulatory T cells (eTregs) (p = 0.008), and a lower frequency of CD80 + eTregs (p = 0.024) in the best supportive care group, with a lower frequency of CD25 + naïve Tregs (nTregs) (p = 0.005) in the chemotherapy group, and with a lower frequency of OX40 + HT (p = 0.022), CD25 + CD8 + T cells (p = 0.017), and OX40 + CD8 + T cells (p = 0.032) in the surgery group. The recurrence factors were a higher frequency of CD4 + T cells (p = 0.009), CCR6 + nTregs (p = 0.014), and CXCR3 + nTregs (p = 0.012), and a lower frequency of PD-1 + HT (p = 0.006), OX40 + HT (p = 0.004), CD8 + T cells (p = 0.001), and CTLA-4 + CD8 + T cells (p = 0.036). CONCLUSIONS: The ICP in CCA are specifically attributable to cholangiocarcinoma, and may be biomarkers for therapeutic effects and prognoses.

[Laparoscopy Assisted Subtotal Gastrectomy(Billrothâ Reconstruction)for Gastric Cancer in the Upper Stomach-A Report of Three Cases].

We experienced 3 cases of upper gastric cancer who underwent BillrothⅠ reconstruction in laparoscopy assisted subtotal gastrectomy. Two cases were female and 1 was male. The postoperative course was uneventful in all cases without heartburn, and the surgical margin was negative. The body weight loss rate was 5.8-12.6%, and the short-term results were relatively acceptable. Although the number of cases in this study was small, reconstruction with BillrothⅠ/delta-shaped anastomosis after laparoscopy assisted subtotal gastrectomy were considered to be useful.

Preventing Dementia Using Saffron, The Kampo Medicine, Kamiuntanto, and Their Combination, Kamiuntantokabankoka.

The objective of this review is to evaluate the anti-dementia activities of saffron and its combination with Kampo medicine. The Kampo formula Kamiuntanto composed of 13 crude drugs is well known for its anti-dementia activity. A significant increase in choline acetyltransferase activity and mRNA levels were observed. Polygala radix was identified as the most essential component drug in Kamiuntanto, probably due to the saponins, tenuifolin, and sinapinic acid. Ginseng was also identified as an essential Kamiuntanto component in terms of its synergistic functions with Polygala radix. Saffron, which was recommended in the Bencao Gangmu for memory and dementia, and is used as an anti-spasmodic, anti-catarrhal, and sedative herbal drug. Saffron and its major constituent, crocin were shown to enhance learning-memory, non-rapid eye movement (rem) sleep, and inhibit depression and neuronal cell death due to strong anti-oxidant and anti-inflammation activities. In addition based on the epidemiological studies such as the treatment of sleeping disorders and the clinical trials of saffron for Alzheimer patients, we demonstrated the indirect and direct anti-dementia activities of crocin and saffron.

Overview of Cannabis including Kampo Medicine and Therapy for Treatment of Dementia: A Review.

Cannabis sativa L. is an annual herb oldest cultivated plants as a source of fiber since about 5000 B.C. On the other hand, the cannabis flower and seed are listed in Shennong's classic Materia Medica approximately 2000 years ago. The formulas prescribed with cannabis in Kampo medicine have been summarized. Cannabidiol (CBD) and tetrahydrocannabinol (THC) are the major neurological and psychiatric cannabinoids, and develop to drugs. It becomes evident that the therapeutic CBD and/or THC are the important candidate of anti-dementia drugs having different mechanism for Alzheimer's patients. Two receptors and endocannabinoids are also discussed for underlying mechanism of action. In order to promote the breeding of cannabis plant containing higher concentration of target cannabinoid the biosynthetic enzymes were isolated, cloning and the tertiary structure of THCA synthase determined by x-ray analysis resulting in the possibility of molecular breeding for cannabinoids.

Comparison of three fistula risk scores after pancreatoduodenectomy: A single-institution retrospective study.

BACKGROUND: Postoperative pancreatic fistula (POPF) after pancreatoduodenectomy greatly influences patients' postoperative course. Several evaluation methods have been used to assess the risk of clinically relevant POPF (CR-POPF) after pancreatoduodenectomy namely, the original, alternative, and updated alternative fistula risk scores (o-FRS, a-FRS, and ua-FRS, respectively). METHODS: We enrolled 106/179 patients who underwent pancreatoduodenectomy in our institution between April 2013 and Mar 2018. CR-POPF was defined as grade B and C POPF according to the 2016 definitions of the International Study Group on Pancreatic Surgery. RESULTS: Pancreatic gland texture was the only significant risk factor for CR-POPF (p = 0.007). The CR-POPF incidence increased significantly according to the risk groups defined by both o-FRS (p = 0.004) and a-FRS (p = 0.004). The area under the curve for o-FRS, a-FRS, and ua-FRS was 0.693, 0.693, and 0.671, respectively. CONCLUSION: o-FRS, a-FRS, and ua-FRS were almost equally useful for risk evaluation for CR-POPF after pancreatoduodenectomy. Further studies, especially for preoperative objective evaluation of pancreatic gland texture, are needed for more useful and accurate risk evaluation.

[A Case of a Huge Gastrointestinal Stromal Tumor with Extraluminal Growth Arising in the Small Intestine Diagnosed as an Ovarian Tumor].

We report a case of a gastrointenstinal stromal tumor(GIST)of the small intestine with extraluminal growth that was difficult to distinguish from an ovarian tumor. A 73-year-old woman presented to a nearby hospital for lower abdominal pain. A computed tomography(CT)scan showed a 17 cm ovarian tumor in the pelvis, and she was referred to the gynecology department of our hospital. Following examinations(enhanced CT and magnetic resonance imaging), she was referred to our department in suspicion of a small intestinal GIST in which the superior mesenteric artery/vein was the feeding blood vessel, and intraperitoneal tumor resection was performed. A large cystic tumor occupied the abdominal cavity and was in contact with the small intestinal wall. As the tumor was not in contact with the uterus or bilateral adnexa, only partial resection of the small intestine was performed. Histopathological examination showed c-kit positivity and she was diagnosed with small intestinal GIST; as a result, a course of imatinib was started.

Effects of digital phase-conjugate light intensity on time-reversal imaging through animal tissue.

For transillumination imaging of animal tissues, we have attempted to suppress the scattering effect in a turbid medium using the time-reversal principle of phase-conjugate light. We constructed a digital phase-conjugate system to enable intensity modulation and phase modulation. Using this system, we clarified the effectiveness of the intensity information for restoration of the original light distribution through a turbid medium. By varying the scattering coefficient of the medium, we clarified the limit of time-reversal ability with intensity information of the phase-conjugate light. Experiment results demonstrated the applicability of the proposed technique to animal tissue.

Postoperative changes in neutrophil-to-lymphocyte ratio and platelet count: A simple prognostic predictor for adult-to-adult living donor liver transplantation.

BACKGROUND/OBJECTIVE: The neutrophil-to-lymphocyte ratio (NLR) is a simple index that represents systemic inflammatory change. The number of platelets is also known to reflect both post-transplant graft regeneration and dysfunction. Thus, we aimed to investigate the usefulness of NLR and platelet number in predicting the clinical course after adult-to-adult living donor liver transplantation (AA-LDLT) in the acute postoperative period in recipients. METHODS: Between January 1999 and December 2013, 61 patients underwent their first AA-LDLT at our institute. We retrospectively analyzed their clinical data, including NLR and number of platelets, until postoperative day 14, and evaluated their ability to predict prognosis after AA-LDLT. RESULTS: The optimal cutoff values of postoperative maximum NLR and maximum platelets to predict prognosis were 50 and 80 × 103/µL, respectively. The 1- and 5-year survival rates were 87.5% and 79.1% in the normal maximum NLR group, respectively, and 46.2% for both in the high maximum NLR group (p = 0.0033). The 1- and 5-year survival rates, respectively, were 90.9% and 84.1% in the high maximum platelets group and 47.1% and 41.2% in the low maximum platelets group (p < 0.0001). In multivariate analysis, maximum NLR ≥ 50 and maximum platelets < 80 × 103/µL were independently associated with 1-year mortality. CONCLUSION: A high NLR and a low platelet count during acute postoperative period might correlate with poor prognosis after AA-LDLT.

A cat with suspected laryngeal metastasis with mucosal irregularity resulting from apocrine/salivary gland adenocarcinoma in the head.

A 16-year-old castrated male mongrel cat presented with swelling under the left pinna and a 3 -month history of voice change. Laryngeal endoscopy revealed circumferential oedema around the arytenoid cartilages and hypersecretion of saliva. Histopathological examination of the mass around the left ear canal was considered the primary lesion that originated from cutaneous apocrine adenocarcinoma or parotid gland adenocarcinoma, and it metastasized to the larynx, lung and medial retropharyngeal lymph nodes. This report provides new insights into feline laryngeal diseases which could result in laryngeal metastasis with slight mucosal irregularity alone and without obvious radiographic abnormalities. Therefore, histopathological examination should be performed when a cat presents clinical signs such as stridor, dysphonia or voice change without any mass-forming laryngeal lesion.

Thoracoscopic Surgery in a Patient with Multiple Esophageal Carcinomas after Surgery for Esophageal Achalasia.

We present a case in which we used a thoracoscopic approach for resection of multiple esophageal carcinomas diagnosed 33 years after surgery for esophageal achalasia. A 68-year-old Japanese man had been diagnosed with esophageal achalasia and underwent surgical treatment 33 years earlier. He was examined at our hospital for annual routine checkup in which upper gastrointestinal endoscopy showed a "0-IIb+IIa" lesion in the middle esophagus. Iodine staining revealed multiple irregularly shaped iodine-unstained areas, the diagnosis of which was esophageal carcinoma. Thoracoscopic subtotal esophagectomy was performed. Esophageal carcinoma may occur many years after surgery for esophageal achalasia, even if the passage symptoms have improved. So, long-term periodic follow-up is necessary for detection of carcinoma at an earlier stage.