Interpersonal coordination analysis in bat-and-ball sports under a real game situation: Asymmetric interaction and delayed coupling.

This study investigated the interpersonal coordination between the pitcher and the batter in bat-and-ball sports. Although the importance of interpersonal coordination is widely accepted in many sports, no studies have investigated it in bat-and-ball sports because the dominant task constraints surrounding the interaction between pitcher and batter make it difficult to apply conventional analytic techniques. To address the issue, this study proposes a new analytical framework to investigate interpersonal coordination in bat-and-ball sports under a real game situation with two main characteristics: asymmetric interaction and delayed coupling. First, the dynamic time warping technique was used to evaluate the stability of the head movement pattern of the pitcher and batter, and cross-correlation analysis was used to quantify the temporal relationship between them. We found that the head movement pattern of batters was significantly more unstable than that of pitchers, and approximately 60% of the variance of the change in the head movement pattern of batters could be explained by that of the pitchers. Moreover, expert batters followed a pitcher's movements with a specific time delay of approximately 250 ms. These findings highlight the characteristics of interpersonal coordination in bat-and-ball sports: the pitcher can make a pre-patterned stable motion, whereas the batter needs to follow and adjust their movement to it. Although the effects of prediction ability need to be investigated to understand its detailed mechanism, the contribution of this study is that it revealed the existence of the interpersonal coordination between the pitcher and batter of bat-and-ball sports under a real game situation.

Relationships between the magnitude of representational momentum and the spatial and temporal anticipatory judgments of opponent's kicks in taekwondo.

For successful actions in a fast, dynamic environment such as sports, a quick successful anticipation of a forthcoming environmental state is essential. However, the perceptual mechanisms involved in successful anticipation are not fully understood. This study examined the relationships between the magnitude of representational momentum (RM) as a forward displacement of the memory representation of the final position of a moving object (which implies that observers perceptually "see" a near future forthcoming dynamic environmental state) and the temporal and spatial anticipatory judgments of the opponent's high or middle kicks in taekwondo. Twenty-seven participants (university taekwondo club members and non-members) observed video clips of taekwondo kicks that vanished at one of 10 frame positions prior to the kick impact and performed three tasks consecutively: anticipatory coincidence timing (CT) with the arrival of kick impact, judgment of the kick type (high and middle kicks) by forced choice, and judgment of the vanishing frame position (measuring RM). Our results showed significant group effects for the number of correct kick-type judgments and the judgment threshold for kick-type choice (kick-typeJT), which was estimated in terms of individual psychometric function curves. A significant correlation was found between the magnitude of RM (estimated at kick-typeJT) and kick-typeJT, but not between the CT errors (estimated at kick-typeJT) and kick-typeJT. This indicates that the magnitude of RM may play an influential role in quick kick-type judgments, but not in coincidence timing while observing an opponent's kick motion. These findings suggest that subjective anticipatory perception or judgment of the future spatial state is vital to anticipatory actions under severe time constraints.

Arginase-1 inhibition reduces migration ability and metastatic colonization of colon cancer cells.

BACKGROUND: Arginase-1 (ARG1), a urea cycle-related enzyme, catalyzes the hydrolysis of arginine to urea and ornithine, which regulates the proliferation, differentiation, and function of various cells. However, it is unclear whether ARG1 controls the progression and malignant alterations of colon cancer. METHODS: We established metastatic colonization mouse model and ARG1 overexpressing murine colon cancer CT26 cells to investigate whether activation of ARG1 was related to malignancy of colon cancer cells in vivo. Living cell numbers and migration ability of CT26 cells were evaluated in the presence of ARG inhibitor in vitro. RESULTS: Inhibition of arginase activity significantly suppressed the proliferation and migration ability of CT26 murine colon cancer cells in vitro. Overexpression of ARG1 in CT26 cells reduced intracellular L-arginine levels, enhanced cell migration, and promoted epithelial-mesenchymal transition. Metastatic colonization of CT26 cells in lung and liver tissues was significantly augmented by ARG1 overexpression in vivo. ARG1 gene expression was higher in the tumor tissues of liver metastasis than those of primary tumor, and arginase inhibition suppressed the migration ability of HCT116 human colon cancer cells. CONCLUSION: Activation of ARG1 is related to the migration ability and metastatic colonization of colon cancer cells, and blockade of this process may be a novel strategy for controlling cancer malignancy.

IFN-γ-STAT1-mediated NK2R expression is involved in the induction of antitumor effector CD8+ T cells in vivo.

The induction of antitumor effector T cells in the tumor microenvironment is a crucial event for cancer immunotherapy. Neurokinin receptor 2 (NK2R), a G protein-coupled receptor for neurokinin A (NKA), regulates diverse physiological functions. However, the precise role of NKA-NK2R signaling in antitumor immunity is unclear. Here, we found that an IFN-γ-STAT1 cascade augmented NK2R expression in CD8+ T cells, and NK2R-mediated NKA signaling was involved in inducing antitumor effector T cells in vivo. The administration of a synthetic analog of double-stranded RNA, polyinosinic-polycytidylic acid (poly I:C), into a liver cancer mouse model induced type I and type II IFNs and significantly suppressed the tumorigenesis of Hepa1-6 liver cancer cells in a STAT1-dependent manner. The reduction in tumor growth was diminished by the depletion of CD8+ T cells. IFN-γ stimulation significantly induced NK2R and tachykinin precursor 1 (encodes NKA) gene expression in CD8+ T cells. NKA stimulation combined with anti-CD3 monoclonal antibody (mAb) treatment significantly augmented IFN-γ and granzyme B production by CD8+ T cells compared with the anti-CD3 mAb alone in vitro. ERK1/2 phosphorylation and IκBα degradation in activated CD8+ T cells were suppressed under NK2R deficiency. Finally, we confirmed that tumor growth was significantly increased in NK2R-deficient mice compared with that in wild-type mice, and the antitumor effects of poly I:C were abolished by NK2R absence. These findings suggest that IFN-γ-STAT1-mediated NK2R expression is involved in the induction of antitumor effector T cells in the tumor microenvironment, which contributes to the suppression of cancer cell tumorigenesis in vivo. In this study, we revealed that IFN-γ-STAT1-mediated NK2R expression is involved in the induction of antitumor effector CD8+ T cells in the tumor microenvironment, which contributes to suppressing the tumorigenesis of liver cancer cells in vivo.

Optimal integration of kinematic and ball-flight information when perceiving the speed of a moving ball.

In order to intercept a moving target such as a baseball with high spatio-temporal accuracy, the perception of the target's movement speed is important for estimating when and where the target will arrive. However, it is unclear what sources of information are used by a batter to estimate ball speed and how those sources of information are integrated to facilitate successful interception. In this study, we examined the degree to which kinematic and ball-flight information are integrated when estimating ball speed in baseball batting. Thirteen university level baseball batters performed a ball-speed evaluation task in a virtual environment where they were required to determine which of two comparison baseball pitches (i.e., a reference and comparison stimuli) they perceived to be faster. The reference and comparison stimuli had the same physical ball speed, but with different pitching movement speeds in the comparison stimuli. The task was performed under slow (125 km/h) and fast (145 km/h) ball-speed conditions. Results revealed that the perceived ball-speed was influenced by the movement speed of the pitcher's motion, with the influence of the pitcher's motion more pronounced in the fast ball-speed condition when ball-flight information was presumably less reliable. Moreover, exploratory analyses suggested that the more skilled batters were increasingly likely to integrate the two sources of information according to their relative reliability when making judgements of ball speed. The results provide important insights into how skilled performers may make judgements of speed and time to contact, and further enhance our understanding of how the ability to make those judgements might improve when developing expertise in hitting.

Developmental Changes in the Magnitude of Representational Momentum Among Nursery School Children: A Longitudinal Study.

Representational momentum (RM) is a well-known phenomenon that occurs when a moving object vanishes suddenly and the memory of its final or vanishing position is displaced forward in the direction of its motion. Many studies have shown evidence of various perceptual and cognitive characteristics of RM in various daily aspects, sports, development, and aging. Here we examined the longitudinal developmental changes in the displacement magnitudes of RM among younger (5-year-old) and older (6-year-old) nursery school children for pointing and judging tasks. In our experiments, the children were asked to point at by their finger (pointing task) and judge the spatial location (judging task) of the vanishing point of a moving stimulus. Our results showed that the mean magnitudes of RM significantly decreased from 5- to 6-year-old children for the pointing and judging tasks, although the mean magnitude of RM was significantly greater in the 5-year-old children for the pointing task but not for the judging task. We further examined the developmental changes in RM for a wide range of ages based on data from the present study (5-year-old children) and our previous study (7- and 11-year-old children and 22-year-old adults). This ad hoc examination showed that the magnitude of RM was significantly greater in 5-year-old children than in adults for the pointing and judging tasks. Our findings suggest that the magnitude of RM was significantly greater in young children than in adults and significantly decreased in young children through adults for the pointing and judging tasks.

Review: Sport Performance and the Two-visual-system Hypothesis of Vision: Two Pathways but Still Many Questions.

SIGNIFICANCE: The two-visual-system hypothesis (TVSH) provides a framework for understanding the nature of the visual information athletes are likely to rely on during competition. If valid, the framework provides a valuable means of evaluating the likely efficacy of different vision training tools that claim to improve the sport performance of athletes.The TVSH has been used to explain that many of the existing methods of testing and training vision may be ineffective to improve on-field sport performance. The TVSH suggests that the visual pathway used to control actions on-field may be different-and rely on different visual information-to the pathway often tested and trained off-field. However, the central claims of the TVSH are increasingly questioned, and this has implications for our understanding of vision and sport performance. The aim of this article is to outline the implications of the TVSH for the visual control of actions in sport. We first provide a summary of the TVSH and outline how the visual information used to control actions might differ from that usually tested. Second, we look at the evidence from studies of sports that are (and are not) consistent with the TVSH and the implications they have for training vision. Finally, we take a wider look at the impact of the TVSH on the sport sciences and other complementary theories that hold implications for training vision to improve sport performance.

Kinaesthetic cues when predicting the outcomes of the actions of others.

People can accurately predict others' action outcomes. To do so, recent studies have proposed that skilled athletes rely preferentially on sensorimotor resonance mechanisms that simulate-in their own motor system-the actions of others. However, little is known about which types of information are simulated for prediction. Here, we used a movement-illusion that selectively affected kinaesthetic sensation to investigate whether athletes use kinaesthetic information for simulation when predicting action outcomes. Nine skilled and 9 less-skilled right-handed basketball players predicted the outcomes of basketball shots when viewing an occluded video of another right-handed player's shots in each of 3 conditions: (a) observation alone (control), (b) observation + vibration-induced illusory kinaesthetic sensation in the right-wrist (effector vibration), and (c) observation + vibration in the left-wrist (noneffector vibration). Results revealed that the enhanced prediction of skilled players in the control condition was eliminated in the effector vibration condition but not in the noneffector condition. Additionally, when participants made correct predictions, their subjective feeling of wrist-flexion induced by vibration became larger when participants observed the longer shot in the effector condition but not the noneffector condition. The results suggest that skilled players use limb-specific kinaesthetic information, when it is available, as a means of predicting the action outcomes of others. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Effectiveness of Intraoperative Indocyanine Green Fluorescence-Navigated Surgery for Superior Mesenteric Vein Thrombosis that Developed During Treatment for Intravascular Lymphoma: A Case Report.

BACKGROUND Superior mesenteric vein thrombosis (SMVT) is a relatively rare form of acute abdominal disease; less than 0.1% of laparotomy surgeries are performed for SMVT. In the presence of severe intestinal ischemia or necrosis caused by SMVT, immediate surgical intervention is required. Macroscopic diagnosis of intestinal viability is sometimes difficult; its over-resection may carry the risk of short bowel syndrome. A near-infrared fluorescence imaging system with indocyanine green (ICG) has recently been developed for intraoperative, real-time evaluation of intestinal perfusion. This is the first report on the use of ICG fluorescence imaging during surgery for intestinal ischemia caused by venous thrombosis. CASE REPORT A 70-year-old man presented with a general feeling of weariness. On examination, he was diagnosed with intravascular large B cell lymphoma. R-CHOP therapy was initiated. On day 3 of initial R-CHOP therapy, the patient experienced sudden severe abdominal pain while in the hospital. Contrast-enhanced computed tomography revealed SMVT and loss of contrast effect in the small intestine. We diagnosed small bowel necrosis caused by SMVT, and exploratory laparotomy was performed, which revealed a continuous ischemia of 150 cm. Intraoperative ICG fluorescence imaging was utilized, and the color boundary was consistent with the ischemic area detected by visualization. The necrotic small intestine was excised and anastomosed. The patient was transferred to the hematology department on postoperative day 10 with no severe complications such as anastomotic leakage or re-thrombosis, and re-embolization was not observed 6 months later. CONCLUSIONS Venous thrombosis should be listed as a differential diagnosis when acute abdominal disease presents during chemotherapy for malignant lymphoma. ICG fluorescence imaging may be useful in the evaluation of intestinal blood flow for venous thrombosis.

A Benign Appendiceal-Colonic Fistula, Diagnosed and Managed Laparoscopically: A Case Report.

BACKGROUND Treatment methods for appendiceal-colonic fistulas differ greatly depending on whether lesions are benign or malignant. If the tumor is malignant, appendectomy with lymph node resection (ileocecal resection or right hemicolectomy) should be performed. There is no consensus on the method of surgery for organs infiltrated by appendiceal cancer. Furthermore, there are no reported laparoscopic cases that could be prevented from over-surgery by laparoscopy examination or rapid intraoperative pathological examination. CASE REPORT A 76-year-old man presented with positive fecal occult blood. Lower endoscopy revealed a 10-mm tumor in the rectosigmoid colon accompanied by white moss. A biopsy showed inflammatory granulation and no malignancy. Fluorodeoxyglucose-positron emission tomography showed highly increased accumulation at the tip of the appendix, and the standardized uptake value max was 7.3. We suspected a benign lesion rather than appendiceal cancer with infiltration into the rectosigmoid colon; therefore, we performed laparoscopic appendectomy and wedge-shaped resection of the rectum of the sigmoid colon. An intraoperative rapid pathological examination showed no appearance of malignancy; therefore, additional resection was omitted, and an ileostomy was created in the right lower quadrant. A permanent pathological examination showed complicated appendicitis, with no appearance of malignancy. The ileostomy was closed on postoperative day 25, and the patient was discharged on postoperative day 32. CONCLUSIONS In cases where there is difficulty in identifying whether the appendiceal-colonic fistula lesion is benign or malignant, laparoscopy and intraoperative rapid pathological examination may be useful in avoiding excessive treatment.

Difficult Diagnosis and Surgical Procedure for Scirrhous Gastric Cancer Complicated by Upside-Down Stomach: A Case Report.

BACKGROUND The upper stomach can be involved in 1 type of esophageal hiatal hernia in which the degree of stomach insertion is considerable and accompanied by a twist in the shaft of the stomach. The diagnostic accuracy of upper endoscopy or barium meal examination decreases in patients with upside-down stomach, thus making diagnosis of stomach lesions very difficult. No previous reports have described scirrhous gastric cancer in a patient with upside-down stomach. CASE REPORT An 85-year-old woman presented with loss of appetite and vomiting after eating oxalic acid-containing food 2 months previously. Computed tomography revealed an upside-down stomach, and upper endoscopy revealed loss of distensibility and superficial gastritis of the entire stomach. Upside-down stomach was diagnosed; accordingly, laparoscopic hernia repair was planned. Laparoscopic exploration revealed retention of serous fluid (i.e., ascites) containing gastric carcinoma cells (pathologically identified intraoperatively) and induration of the entire stomach. After converting to laparotomy, induration of the stomach was confirmed, continuing to the adjacent 4 cm of the distal esophagus. The patient was diagnosed with scirrhous gastric cancer. Esophageal hiatus hernia repair was performed due to the patient's age and the risks associated with esophagojejunostomy. Preoperative complaints of symptoms disappeared. The patient was transferred to the medical hospital on postoperative day 52 with no complications. CONCLUSIONS Specific symptoms of gastric cancer can mimic those of esophageal hiatal hernia in patients with hernia. In cases of upside-down stomach with loss of distensibility and increased wall thickness, physicians should be aware of the possibility of scirrhous gastric cancer.

The Effect of Choice on Motor Learning for Learners With Different Levels of Intrinsic Motivation.

This study examines whether the positive effect of choice on motor learning in a dart-throwing task varies by intrinsic motivation. Participants were allocated to a highly motivated or less-motivated group based on measured task motivation and randomly to a Choice or No Choice group. In Experiment 1, participants in the Choice group chose their dart color. In Experiment 2, they chose when to observe a model demonstration. Results showed that the effect of choice on motor learning differed between highly and less-motivated participants in Experiment 1 (i.e., interaction between motivation and choice) but not Experiment 2 (i.e., main effects of motivation and choice). Specifically, motor learning was enhanced in less-motivated but not highly motivated participants when choosing dart color, while it was enhanced regardless of initial intrinsic motivation when choosing model-demonstration time. Therefore, external provision of choice in a motor-learning situation may not be equally effective across learners.

The Development of Evidence-Based Classification of Vision Impairment in Judo: A Delphi Study.

Objective: Most para-sports group athletes into "classes" to compete against others with similar activity limitations. Judokas with vision impairment (VI) instead all compete in the same class irrespective of their level of impairment. There is considerable controversy whether this approach represents a legitimate way to structure judo competition. The aim of this study was to establish expert opinion on the requirements for an evidence-based classification system for VI judo. Methods: A panel of 18 athletes, coaches, and administrators participated in a three-round Delphi review process. Expert opinions were canvased for a large range of issues related to classification in judo. Between rounds, results were summarized and further questions were asked on topics where consensus was not reached across experts. Results: The panel expressed that: (i) blind and partially sighted athletes should not compete against each other in the same class; (ii) additional measures of visual function might be needed to accurately evaluate an athlete's impairment; (iii) the minimum impairment criteria (MIC) should represent a more severe level of impairment to ensure that all those included possess a level of VI that indeed decreases performance in judo; and (iv) legitimate competition could be undermined by some athletes intentionally underperforming on classification tests. The panel identified six additional measures of visual function which are not currently measured but are likely to impact judo performance, and six aspects of judo performance which are most likely impacted by VI. Conclusion: Experts in the field of VI judo expressed a need to change the manner in which VI judokas are classified. This study outlines a model for establishing the impairment-performance relationship and guides the development of evidence-based classification for VI judo.

Simultaneous Laparoscopic Cholecystectomy and Combined Endoscopic and Laparoscopic Surgery for an Endoluminal Tumor of the Sigmoid Colon: A Case Report.

BACKGROUND One treatment for colon endoluminal tumors is endoscopic resection, i.e., endoscopic mucosal resection (EMR). In this report we describe a case of an endoluminal tumor resected safely and completely by combined endoscopic and laparoscopic surgery (CELS). CASE REPORT A 70-year-old female was admitted to our hospital for cholelithiasis, and we planned a cholecystectomy. She had a surgical history for endometrial cancer, and she was taking amlodipine 2.5 mg/day for hypertension. A preoperative colonoscopy for screening revealed an 18-mm endoluminal tumor in the sigmoid colon. We tried to resect it by EMR, but flexion of the colon, which was considered to be due to adhesion from the former surgical treatment, was severe, so it was difficult to resect the endoluminal tumor by endoscopy. We conducted laparoscopic cholecystectomy and sigmoid colon mobilization. Sigmoid colon flexion was released, enabling us to conduct EMR to the endoluminal tumor. No intraoperative or postoperative complications were observed. CONCLUSIONS CELS can make an endoluminal tumor resectable by EMR without colon resection, and performing simultaneous CELS and laparoscopic cholecystectomy is less invasive.

Predictive eye movements when hitting a bouncing ball.

Predictive eye movements targeted toward the direction of ball bounce are a feature of gaze behavior when intercepting a target soon after it has bounced. However, there is conjecture over the exact location toward which these predictive eye movements are directed, and whether gaze during this period is moving or instead "lies in wait" for the ball to arrive. Therefore, the aim of this study was to further examine the location toward which predictive eye movements are made when hitting a bouncing ball. We tracked the eye and head movements of 23 novice participants who attempted to hit approaching tennis balls in a virtual environment. The balls differed in time from bounce to contact (300, 550, and 800 ms). Results revealed that participants made predictive saccades shortly before the ball bounced in two-thirds of all trials. These saccades were directed several degrees above the position at which the ball bounced, rather than toward the position at which it bounced or toward a position the ball would occupy shortly after the bounce. After the saccade, a separation of roles for the eyes and head ensured that gaze continued to change so that it was as close as possible to the ball soon after bounce. Smooth head movements were responsible for the immediate and ongoing changes in gaze to align it with the ball in the lateral direction, while eye movements realigned gaze with the ball in the vertical direction from approximately 100 ms after the ball changed its direction of motion after bounce. We conclude that predictive saccades direct gaze above the location at which the ball will bounce, presumably in order to facilitate ball tracking after the bounce.

Why does the Quiet Eye improve aiming accuracy? Testing a motor preparation hypothesis with brain potential.

The purpose of the present study was to determine whether the Quiet Eye (QE) acquired over time is associated with motor preparation processes by using movement-related cortical potentials (MRCPs). Eighteen male, right-handed college students voluntarily participated in this study. Participants performed a dart throw while wearing an eye-tracking system and electrode cap to measure electroencephalogram waveforms (EEG). After performing the dart task, participants were randomly assigned to a Quiet Eye training group (QET) or control training group (CT). Six subjects were excluded due to incomplete electroencephalography (EEG) data. MRCPs were analysed separately within 4 QE categories: High performance score and Long fixation time (HL), High performance score and Short fixation time (HS), Low performance score and Long fixation time (LL), and Low performance score and Short fixation time (LS). Results revealed that although the QET group acquired QE characteristics, MRCPs did not differ between the two groups. Thus, a longer-term experimental design may be necessary to observe EEG changes. Furthermore, QE durations may relate to not only motor programming but also online control.

Laparoscopic abdominoperineal resection with lateral lymph node dissection for advanced rectal and prostate cancer with synchronous lateral lymph node metastases.

Here we report a case of advanced rectal and prostate cancer with synchronous lateral lymph node (LLN) metastases that was treated with laparoscopic surgery. A 71-year-old man presented with fecal occult blood and was diagnosed with rectal cancer. A metastatic right LLN was suspected after CT examination of a 19-mm lymph node (proximal internal iliac artery region) and a 13-mm lymph node (distal internal iliac artery region) in the right lateral region. We planned neoadjuvant chemotherapy to suppress local and distant recurrence. This treatment decreased the size of the primary rectal tumor. We performed laparoscopic abdominoperineal resection and right LLN dissection. The histopathological diagnosis was LLN metastases from the rectal and prostate cancers. It is rare for synchronous metastases from rectal and prostate cancers to be observed in the LLN. It may be difficult to determine an appropriate treatment strategy in cases like this.

Case of chronic pain after laparoscopic percutaneous extraperitoneal closure in an adolescent girl with inguinal hernia in which open repair was effective.

Chronic pain after laparoscopic percutaneous extraperitoneal closure is very rare. Here, we report a case of chronic pain after laparoscopic percutaneous extraperitoneal closure in an adolescent patient with inguinal hernia who underwent open repair. A 15-year-old girl was diagnosed with a left indirect inguinal hernia, and laparoscopic percutaneous extraperitoneal closure was performed. However, 6 months later, after strenuous exercise, she developed localized pain around the hernia site. Her pain was well controlled by internal treatment but failed to completely resolve. The pain type was somatic, Tinel's sign was negative, and there was no recurrence of the inguinal hernia. Because she strongly wished to undergo surgery, the Potts procedure with removal of the ligature and excision of the round ligament was performed. Her pain improved after surgery, and further medical treatment was not required. The Potts procedure may be an effective treatment for chronic pain such as in this case.

Endoscopic Retrograde Cholangiopancreatography (ERCP) with Laparotomic Small-Intestinal Incision Approach for Extraction of a Common Bile Duct (CBD) Stone Following Total Gastrectomy and Roux-en-Y (R-Y) Anastomosis: A Case Report.

BACKGROUND Endoscopic retrograde cholangiopancreatography for common bile duct stone in patients who underwent gastrectomy and Roux-en-Y anastomosis is challenging. We report a case in which we performed endoscopic retrograde cholangiopancreatography through a small-intestinal incision approach for a common bile duct stone, which had developed after total gastrectomy and Roux-en-Y anastomosis. CASE REPORT An 86-year-old woman with a history of laparoscopic-assisted total gastrectomy and R-Y anastomosis and incision of the common bile duct and cholecystectomy for common bile duct stone by open surgery 3 years ago presented with abdominal pain. Examination revealed a 10-mm stone in the lower part of common bile duct. We planned a combined endoscopic and open surgical approach. An incision on the Y limb of the Roux-en-Y anastomosis 20 cm from the jejunojejunal anastomosis and insertion of an endoscope through this opening were performed to extract the common bile duct stone. The patient was discharged on postoperative day 22 without complications. CONCLUSIONS For a patient with a common bile duct stone, who underwent gastrectomy and Roux-en-Y anastomosis, with firm adhesions at the porta hepatis, combined endoscopy and open surgery using a small-intestinal incision approach can be effective when small-bowel endoscopes are unavailable or the cannulation to Vater's papilla by them is difficult.

The inhibition of motor contagion induced by action observation.

In sports, success and failure are believed to be contagious. Yet it is unclear what might cause contagion. This study investigated whether motor contagion is associated with the active observation of the kinematic actions of others. In Experiment 1, six skilled hammer throwers threw a hammer after watching a video of a model throwing toward the left, center, or right. The video included two types of action kinematics which resulted in throw directions that were either easy or difficult to predict based on the model's kinematics. In Experiment 2, the athletes threw hammers after watching the same stimuli as Experiment 1, but while engaging in one of two types of focus (self-focus or non-self-focus) to determine whether motor contagion could be diminished. Results demonstrated that the direction of each participant's throw was more influenced by the videos that contained easy action kinematics, supporting a critical role for the meaningfulness of the link between an action and its outcome in producing motor contagion. Motion analysis revealed that motor contagion was not likely to be a result of the observer imitating the model's action kinematics. The contagion observed in Experiment 1 disappeared when participants engaged in self-focus. These results suggest that motor contagion is influenced by the predictability of an action outcome when observing an action, and that motor contagion can be inhibited through self-focus when observing.