BACKGROUND: Vision provides the most salient information with regard to stimulus motion, but audition can also provide important cues that affect visual motion perception. Here, we show that sounds containing no motion or positional cues can induce illusory visual motion perception for static visual objects. METHODOLOGY/PRINCIPAL FINDINGS: Two circles placed side by side were presented in alternation producing apparent motion perception and each onset was accompanied by a tone burst of a specific and unique frequency. After exposure to this visual apparent motion with tones for a few minutes, the tones became drivers for illusory motion perception. When the flash onset was synchronized to tones of alternating frequencies, a circle blinking at a fixed location was perceived as lateral motion in the same direction as the previously exposed apparent motion. Furthermore, the effect lasted at least for a few days. The effect was well observed at the retinal position that was previously exposed to apparent motion with tone bursts. CONCLUSIONS/SIGNIFICANCE: The present results indicate that strong association between sound sequence and visual motion is easily formed within a short period and that, after forming the association, sounds are able to trigger visual motion perception for a static visual object.

Background: It is well known that oxidative stress is enhanced in patients with end-stage renal disease. However, little is known about the relationship between serum antioxidant capacity and clinical outcome in hemodialysis (HD) patients. Methods: We examined the relationship between serum biomarkers of oxidative stress and clinical outcomes including all-cause mortality, hospitalization rate and incidence of cardiovascular events in HD patients. As biomarkers of oxidative stress, we measured serum levels of coenzyme Q10 (CoQ10) and biological antioxidant potential (BAP). Results: 108 patients were observed for 30 months as the follow-up periods. The survival group (n = 83) showed significantly higher BAP values compared with those in death groups (n = 25; p < 0.05). When serum BAP levels were divided into two groups by their median value, the group with higher BAP values had a better survival rate than that with lower BAP values on the Kaplan-Meier survival analysis (p = 0.05). Although serum levels of CoQ10 did not show any association with clinical outcomes, lower BAP was selected as an independent risk factor for all-cause mortality as well as the absence of angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers therapy by age-adjusted Cox regression analysis. Conclusions: This study indicated that BAP could predict the prognosis of HD patients.

BACKGROUND/PURPOSE: To prevent or reduce hepatic complications after hepatectomy, it is important to employ preoperative predictive parameters and to determine the indications for hepatectomy. In the present study, we evaluated risk parameters in patients who underwent hepatectomy between 1994 and 2003, and selected three parameters to modify the surgical indications. Using these indications before surgery in patients who underwent hepatectomy between 2004 and 2008, we compared the prevalences of postoperative complications in the the two groups of patients. METHODS: We examined 250 consecutive patients who underwent hepatectomy for liver disease [149 in 1994-2003 (termed the early period) and 101 in 2004 to 2008 (termed the later period)]. RESULTS: In the early period, uncontrolled ascites was observed in 55 patients and hepatic failure was observed in 15 of the 149 patients. Multivariate analysis identified volume of the resected liver (>/=50%), intraoperative blood loss (>/=1500 ml), prothrombin activity (<70%), hyaluronic acid level (>/=200 ng/ml), and LHL15 (hepatic uptake ratio of technetium-99m galactosyl human serum albumin ((99m)Tc-GSA) (<0.85) as risk factors; the latter three parameters were evaluated as predictors of outcome. From 2004, we used these three parameters, in addition to the indocyanine green retention rate at 15 min (ICGR15), as criteria for indications for hepatectomy. Despite the lower prevalence of normal liver in the later period, comparisons showed decreases in the rates of uncontrolled ascites (23 vs. 37%, P = 0.03), hepatic failure (4 vs. 10%, P = 0.12), and hepatic complications (25 vs. 44%, P = 0.003) in patients in the later period compared with these rates in the previous period. CONCLUSIONS: The use of prothrombin activity, and levels of hyaluronic acid and LHL15, as parameters of functional liver reserve in the selection of candidates for surgery reduced the incidence of hepatic complications after hepatectomy.

Hypertrophic obstructive cardiomyopathy (HOCM) involves marked hypertrophy of cardiac muscle, resulting in myocardial ischemia and arrhythmia because of left ventricular diastolic dysfunction. In perioperative management of HOCM, hemodynamic stabilization is required, by prevention of arrhythmia and tachycardia and maintenance of preload and afterload. Here, we describe anesthesia management during cesarean section in a patient complicated by HOCM. The patient was a 27-year-old woman who underwent elective cesarean section scheduled at 36 weeks of pregnancy given her history of HOCM. She was managed with spinal anesthesia with monitoring of invasive blood pressure and arterial pressure cardiac output. Administration of landiolol hydrochloride was initiated, because of paroxysmal tachycardia after delivery. Approximately 5 min after initiation of administration, her heart rate decreased gradually and blood pressure rose. Circulatory dynamics stabilized and landiolol was discontinued 3 h after she was admitted to the intensive care unit. Her circulatory dynamics remained stable after discontinuation of landiolol, and she was moved to a general ward on the following day. She was discharged on postoperative day 14, with her child.

BACKGROUND/AIMS: Cancer death in the early period after hepatectomy remains problematic in patients with hepatocellular carcinoma (HCC). We examined the relationship between clinicopathological parameters' and survival periods in 234 HCC patients who underwent hepatectomy. METHODOLOGY: Patients were divided into four groups: Group 1, survival > 5 years; Group 2, survival for 2-5 years; Group 3, cancer death at 2-5 years; and Group 4, cancer death in < 2 years. RESULTS: Numbers of patients in each subgroup were: Group 1, n = 87 (37%); Group 2, n = 44 (19%); Group 3, n = 46 (20%); and Group 4, n = 57 (24%). Child-Pugh B status, blood loss > 1500 ml, multiple tumors, tumor size > 5 cm, not meeting Milan criteria, irregular macroscopic findings, invasion of Glissonian pedicle, invasion of hepatic vein, higher modified Japan Integrated Staging score (3-5), long-term ascites after hepatectomy and postoperative tumor recurrence within 12 months were frequent in Group 4 ( p < 0.05). Multivariate analysis revealed AFP level > or = 1000 ng/ml (hazard ratio (HR), 2.6) and early tumor relapse (HR, 8.1) as independently related parameters ( p < 0.05). CONCLUSIONS: Careful follow-up for early tumor relapse may be important for improving postoperative outcomes in HCC patients with high preoperative AFP levels.

We previously reported a strong positive correlation between syrup viscosity and the rate of syrup loss due to adhesion to a glass metering device. In this study, we examined differences in the surface free energies of metering devices made of different polymeric materials, since reducing adhesion loss to metering devices could improve the efficiency of drug preparation involving highly viscous syrups. Among metering devices made of glass only, glass with a silicone coating (SLC), polypropylene (PP), and polymethylpentene (PMP) the surface free energy of the glass-only metering device was the highest (49.2 mN/m). The adhesion loss obtained for highly viscous syrups in the PP and PMP metering devices was significantly lower than that of the glass metering device. Measurements of syrup contact angles suggested that in metering devices made of PP and PMP, which have low surface free energies, a decrease in the spreading wetting of syrups was a factor in reducing the rate of adhesion loss. Thus irrespective of the syrup viscosity being measured, metering devices produced from materials with low surface free energies can reduce the time required to prepare prescriptions without compromising the accuracy of drug preparation.

An abrupt change in a visual attribute (size) of apparently moving visual stimuli extends the time the changed stimuli is visible even after its physical termination (visible persistence). In this study, we show that elongation of visible persistence is enhanced by an abrupt change in an attribute (frequency) of the sounds presented along with the size-changed apparently moving visual stimuli. This auditory effect disappears when sounds are not associated with the visual stimuli. These results suggest that auditory attribute change can contribute to the establishment of a new object representation and that object-level audio-visual interactions can occur in motion perception.

The alternation of sounds in the left and right ears induces motion perception of a static visual stimulus (SIVM: Sound-Induced Visual Motion). In this case, binaural cues were of considerable benefit in perceiving locations and movements of the sounds. The present study investigated how a spectral cue - another important cue for sound localization and motion perception - contributed to the SIVM. In experiments, two alternating sound sources aligned in the vertical plane were presented, synchronized with a static visual stimulus. We found that the proportion of the SIVM and the magnitude of the perceived movements of the static visual stimulus increased with an increase of retinal eccentricity (1.875-30 degree), indicating the influence of the spectral cue on the SIVM. These findings suggest that the SIVM can be generalized to the whole two dimensional audio-visual space, and strongly imply that there are common neural substrates for auditory and visual motion perception in the brain.

BACKGROUND/AIMS: Thoraco-abdominal approach is a suitable choice for hepatectomy to secure good view for mobilization. The aim of this study was to assess efficacy of thoraco-abdominal approach (TAA) for hepatectomy. METHODOLOGY: There were compared clinicopathological data, surgical results and postoperative complications of 425 consecutive patients who underwent hepatectomy via abdominal (AA) (n = 147) or TAA (n = 278). RESULTS: Blood loss and operating time were significantly higher in TAA than AA group (970 vs. 830 ml and 408 vs. 372 min.) (p < 0.05). Prevalence of pleural effusion was significantly higher in TAA than AA group (24 vs. 9%) (p < 0.01). However, proportions of patients who developed hepatic complications such as biloma (14 vs. 23%), and wound infection (8 vs.25%) were significantly less in TAA than AA group (p < 0.05). Hospital stay after hepatectomy and mortality were similar between both groups. Presence of chronic viral hepatitis, lower platelet count, higher level of serum hyaluronic acid, larger blood loss and TAA correlated significantly with thoracic complications (p < 0.05). Multivariate analysis showed that increased blood loss (p = 0.011), but not TAA, was a significant determinant of thoracic complications (p = 0.08). CONCLUSIONS: TAA can be considered a relatively safe approach for hepatectomy with minimal abdominal complications nevertheless of frequent pleural effusion.

Carcinosarcoma is a rare malignant tumour composed of a mixture of carcinomatous and sarcomatous elements. Carcinosarcoma metastatic to the tongue is extremely rare. An 84-year-old woman presented with a rapidly growing mass on the tongue. She had a history of surgery for carcinosarcoma of the occipital skin 9 months before. An excisional biopsy of the tongue mass was performed, and the lesion was histopathologically diagnosed as carcinosarcoma. PET after diagnosis showed multiple hot uptakes in the whole body. The patient died of the disease 2 months after diagnosis. Therapies for patients with metastatic malignant tumours to the oral cavity are difficult, especially in aggressive case such as this. To the authors' knowledge, this is the first case of metastatic carcinosarcoma to the tongue.

This study reports the detection and genetic characterization of porcine kobuvirus, a new member of the genus Kobuvirus in the family Picornaviridae. Among 293 fecal specimens collected from healthy pigs in 2009, in Japan, 133 (45.4%) were positive for kobuvirus using RT-PCR screening method. Of the positive specimens, 124 were obtained from pigs </= 6 months old, while 9 samples were from pigs>6 months old. Fifty-two representative strains of kobuviruses detected in this study were randomly selected and analyzed for their phylogenetic relationships with those other kobuvirus reference strains. The phylogenetic tree confirmed that 51 strains belonged to porcine kobuvirus and formed the exclusive branch with other porcine kobuvirus reference strains. In addition, the nucleotide sequence of H023/2009/JP shared very low levels of sequence identity with those of other porcine kobuvirus strains, but showed the highest level of sequence identity with bovine kobuvirus U-1 prototype strain. Our study demonstrated clearly that, porcine kobuvirus infection was common in healthy pigs and high prevalence of this virus was found in younger age of less than 6 months old of porcine populations in Tokyo and Hokkaido, Japan.

The formation of an inclusion complex of amoxicillin (AMX) with beta-cyclodextrin (beta-CD) in aqueous solution was confirmed by a solubility method and proton nuclear magnetic resonance ((1)H-NMR) spectroscopy. The apparent stability constant for the inclusion complex was 10.72 M(-1) in water at 25 degrees C. The effect of alpha-CD, beta-CD, and gamma-CD on the degradation of AMX in a pH 1.2 solution at 37 degrees C was investigated. beta-CD and gamma-CD reduced the rate of degradation. alpha-CD had no effect. These results were consistent with those of (1)H-NMR spectroscopy. The effect of beta-CD on the degradation rate was studied in more detail. The apparent first order rate constant for the degradation of AMX in the pH 1.2 solution at 37 degrees C was 0.1121 h(-1) (t(1/2)=6.18 h), which decreased with the addition of beta-CD. The rate constants and t(1/2) values for the concentrations of beta-CD added, corresponding to molar ratios of AMX to beta-CD of 1:0.5, 1:1, 1:2, 1:5, and 1:10, were 0.1051 h(-1) and 6.59 h, 0.0992 h(-1) and 6.98 h, 0.0893 h(-1) and 7.76 h, 0.0697 h(-1) and 9.95 h, and 0.0509 h(-1) and 13.61 h, respectively. The activation energy for the degradation of AMX in the pH 1.2 solution was increased from 6.9x10(4) J/mol (AMX alone) to 8.0x10(4) J/mol (AMX:beta-CD=1:10).

The side effects that occur in the central nervous system and circulatory system due to medicines are expected to be prevented by research and development. However, many of the compounds in medicines have the possibility of causing arrhythmia, and methods developed to detect this problem at the early stage of drug development are not always successful. In the present study, we classified drug compounds according to their activity using only structural information. To classify compounds, we used a self-organizing map (SOM), which is a nonlinear unsupervised classification method. We first analyzed a small-scale dataset, and an excellent classification result was obtained. We then applied our method to a large-scale dataset containing numerous inert compounds and were again able to classify the compounds according to their activity. Both classifications showed some compound activity, although a few differences between the two SOM maps were seen.

Food contains components that may either increase or decrease the bioavailability of a drug. In particular, it is known that grapefruit juice and St. John's Wort induce drug interactions via an effect on the drug-metabolizing enzyme cytochrome P450 (CYP). However, interactions with membrane transporters, such as P-glycoprotein and multidrug resistance-related protein (MRP), may also influence drug bioavailability. The objective of the present study was to investigate the effects of kaempferol, a flavonoid present in food, on the cytotoxicity of anticancer drugs and the mechanisms of drug resistance in the human glioblastoma cell line T98G. Acute exposure to kaempferol inhibited the efflux of calcein, a substrate of MRP; however, chronic exposure caused no apparent effect on calcein efflux. The cytotoxicity of doxorubicin was not influenced by chronic exposure of cells to kaempferol, although that of cisplatin was significantly reduced. Multidrug resistance is often associated with increased levels of MRP1, glutathione S-transferase (GST) and activity by chronic exposure to kaempferol, although MRP2 protein levels are decreased. Accordingly, we hypothesized that the cytotoxicity of anticancer drugs that conjugate with glutathione and the substrate of MRPs may be influenced by long-term intake of drugs such as kaempferol, which are substrates of MRPs and GST.

Naloxone, a potent and specific opioid antagonist, has been shown in previous studies to have an influx clearance across the rat blood-brain barrier (BBB) two times greater than the efflux clearance. The purpose of the present study was to characterize the influx transport of naloxone across the rat BBB using the brain uptake index (BUI) method. The initial uptake rate of [(3)H]naloxone exhibited saturability in a concentration-dependent manner (concentration range 0.5 microM to 15 mM) in the presence of unlabeled naloxone. These results indicate that both passive diffusion and a carrier-mediated transport mechanism are operating. The in vivo kinetic parameters were estimated as follows: the Michaelis constant, K(t), was 2.99+/-0.71 mM; the maximum uptake rate, J(max), was 0.477+/-0.083 micromol/min/g brain; and the nonsaturable first-order rate constant, K(d), was 0.160+/-0.044 ml/min/g brain. The uptake of [(3)H]naloxone by the rat brain increased as the pH of the injected solution was increased from 5.5 to 8.5 and was strongly inhibited by cationic H(1)-antagonists such as pyrilamine and diphenhydramine and cationic drugs such as lidocaine and propranolol. In contrast, the BBB transport of [(3)H]naloxone was not affected by any typical substrates for organic cation transport systems such as tetraethylammonium, ergothioneine or L-carnitine or substrates for organic anion transport systems such as p-aminohippuric acid, benzylpenicillin or pravastatin. The present results suggest that a pH-dependent and saturable influx transport system that is a selective transporter for cationic H(1)-antagonists is involved in the BBB transport of naloxone in the rat.

Increased prevalence of aortic and mitral valve calcification has been reported in patients on hemodialysis, but it remains unknown whether aortic and mitral valve calcification arise from similar pathogenesis. We detected heart valve calcification using two-dimensional echocardiography, and we related valve calcification to various clinical parameters in patients treated with hemodialysis three times a week for more than 1 year. In 112 patients (77 men and 35 women, age 67+/-10 years, duration on hemodialysis 95+/-67 months), aortic and mitral valve calcification were observed in 84 (75.0%) and 58 (51.7%) patients, respectively. Aortic valve calcification was associated with increased age, higher serum calcium, lower serum albumin, lower total cholesterol and higher high-sensitivity C-reactive protein. Multivariate analysis showed that increased age and higher serum calcium were independently associated with aortic valve calcification. Conversely, mitral valve calcification was associated with increased age, higher high-sensitivity C-reactive protein and higher serum beta(2)-microglobulin, but not with higher serum calcium. In multivariate analysis, increased age and higher serum beta(2)-microglobulin were independently associated with mitral valve calcification. Serum beta(2)-microglobulin was associated with longer duration on hemodialysis, malnutrition inflammation (lower serum albumin and higher high-sensitivity C-reactive protein) and dyslipidemia. Considering the results in previous studies showing that the distribution of beta(2)-microglobulin amyloid deposition was consistent with that of tissue calcification in patients on hemodialysis, beta(2)-microglobulin may have pathogenic roles in valve calcification.Hypertension Research advance online publication, 9 April 2010; doi:10.1038/hr.2010.44.

Multiple liver metastatic lesions were shown by computed tomography and scintigraphy with 123I- metaiodobenzylguanidine (MIBG) in a 76-year-old woman 2 years after resection of a pheochromocytoma of the right adrenal gland. Transcatheter arterial chemo-embolization (TACE) was performed for the liver metastasis, with blood pressure strictly controlled by administration of doxazosin and phentolamine for the prevention of hypertensive crisis after TACE. There were no severe adverse events associated with the treatment, and the number and size of the lesions were decreased. TACE with strict blood pressure control was an effective and safe therapy for multiple liver metastatic lesions related to malignant pheochromocytoma.

Abstract The risk factors of coronary artery calcification (CAC) and the impact of CAC on cardiovascular events, cardiovascular deaths, and all-cause deaths in hemodialysis (HD) patients have not been fully elucidated. We examined the CAC score (CACS) in 74 HD patients using electron-beam computed tomography. Fifty-six patients underwent a second electron-beam computed tomography after a 15-month interval to evaluate CAC progression. We evaluated (1) the risk factors for CAC and its progression and (2) the impact of CAC on the prognosis. In the cross-sectional study, HD vintage and high-sensitive C-reactive protein (hsCRP) were the independent risk factors for CAC. In the prospective cohort study, delta CACS (progression of CAC) was significantly correlated with hsCRP, fibrinogen, and serum calcium level in the univariate analysis. Stepwise multiple regression analysis revealed that only hsCRP was the independent risk factor for CAC progression in HD patients. Kaplan-Meier survival analysis revealed that cardiovascular events (P<0.0001), cardiovascular deaths (P=0.039), and all-cause deaths (P=0.026) were significantly associated with CACS. In conclusion, CAC had significantly progressed in HD patients during the 15-month observation period. Microinflammation was the only independent risk factor for CAC progression in HD patients. The advanced CAC was a significant prognostic factor in HD patients, i.e., which was strongly associated with future cardiovascular events, cardiovascular deaths, and all-cause deaths.

BACKGROUND: It is difficult to diagnose lymph node metastasis in biliary and pancreas carcinomas before surgery. AIM: The aim of this study was to assess the utility of the combination of multi-detector computed tomographic (MDCT) findings and serum carbohydrate antigen (CA)19-9 level in the diagnosis of lymph node metastasis in biliary and pancreas carcinomas. METHODS: The subjects were 139 patients with biliary and pancreas carcinomas who underwent surgical resection. We calculated the positive predictive values (PPV), sensitivities, specificities, positive likelihood ratios (PLR) and accuracies of diagnosis by MDCT alone, serum CA19-9 level alone, and their combination. RESULTS: The PPV and sensitivity were higher for node metastasis in hepatoduodenal ligament than in common hepatic artery (CHA) or para-aortic region (PAR). Specificity, accuracy and PLR were highest for CHA in biliary carcinoma. With pancreatic carcinoma, PLR was slightly higher in PAR compared to other regions. The sensitivity of CA19-9 for node metastasis was higher than that of MDCT, while the PPV, specificity, accuracy and PLR were low for both biliary and pancreas carcinoma. The combination of positive CT findings and high CA19-9 level had the highest positive rate for node metastasis for both types of carcinomas. Nodes around the supra-mesenteric vein could not be fully observed on CT. CONCLUSION: The combination of high-resolution MDCT and CA19-9 is useful for the diagnosis of lymph node metastasis in biliary and pancreas carcinomas.