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Hepatic tissue repair plays a critical role in determining the outcome of hepatic ischemia–reperfusion (I/R) injury. Hepatic lymphatics participate in the clearance of dead tissues and contribute to the reparative process after acute hepatic injury; however, it remains unknown whether lymphangiogenesis in response to hepatic inflammation is involved in liver repair. Herein, we determined if hepatic lymphangiogenesis improves liver repair after hepatic I/R injury. Using a mouse model of hepatic I/R injury, we investigated hepatic lymphatic structure, growth, and function in injured murine livers. Hepatic I/R injury enhanced lymphangiogenesis around the portal tract and this was associated with increased expression of pro-lymphangiogenic growth factors including vascular endothelial growth factor (VEGF)-C and VEGF-D. Recombinant VEGF-D treatment facilitated liver repair in association with the expansion of lymphatic vessels and increased expression of genes related to the reparative macrophage phenotype. Treatment with a VEGF receptor 3 (VEGFR3) inhibitor suppressed liver repair, lymphangiogenesis, drainage function, and accumulation of VEGFR3-expressing reparative macrophages. VEGF-C and VEGF-D upregulated expression of genes related to lymphangiogenic factors and the reparative macrophage phenotype in cultured macrophages. These results suggest that activation of VEGFR3 signaling increases lymphangiogenesis and the number of reparative macrophages, both of which play roles in liver repair. Expanded lymphatics and induction of reparative macrophage accumulation may be therapeutic targets to enhance liver repair after hepatic injury.

PurposeTo demonstrate how artificial intelligence (AI) can expand radiologists’ capacity, we visualized the features of invasive ductal carcinomas (IDCs) that our algorithm, developed and validated for basic pathological classification on mammograms, had focused on.Materials and methodsIDC datasets were built using mammograms from patients diagnosed with IDCs from January 2006 to December 2017. The developing dataset was used to train and validate a VGG-16 deep learning (DL) network. The true positives (TPs) and accuracy of the algorithm were externally evaluated using the test dataset. A visualization technique was applied to the algorithm to determine which malignant findings on mammograms were revealed.ResultsThe datasets were split into a developing dataset (988 images) and a test dataset (131 images). The proposed algorithm diagnosed 62 TPs with an accuracy of 0.61–0.70. The visualization of features on the mammograms revealed that the tubule forming, solid, and scirrhous types of IDCs exhibited visible features on the surroundings, corners of the masses, and architectural distortions, respectively.ConclusionWe successfully showed that features isolated by a DL-based algorithm trained to classify IDCs were indeed those known to be associated with each pathology. Thus, using AI can expand the capacity of radiologists through the discovery of previously unknown findings.

Macrophage polarization is critical for liver tissue repair following acute liver injury. However, the underlying mechanisms of macrophage phenotype switching are not well defined. Invariant natural killer T (iNKT) cells orchestrate tissue inflammation and tissue repair by regulating cytokine production. Herein, we examined whether iNKT cells played an important role in liver repair after hepatic ischemia-reperfusion (I/R) injury by affecting macrophage polarization. To this end, we subjected male C57BL/6 mice to hepatic I/R injury, and mice received an intraperitoneal ( ip ) injection of α-galactosylceramide (α-GalCer) or vehicle. Compared with that of the vehicle, α-GalCer administration resulted in the promotion of liver repair accompanied by acceleration of macrophage differentiation and by increases in the numbers of Ly6C high pro-inflammatory macrophages and Ly6C low reparative macrophages. iNKT cells activated with α-GalCer produced interleukin (IL)-4 and interferon (IFN)-γ. Treatment with anti-IL-4 antibodies delayed liver repair, which was associated with an increased number of Ly6C high macrophages and a decreased number of Ly6C low macrophages. Treatment with anti-IFN-γ antibodies promoted liver repair, associated with reduced the number of Ly6C high macrophages, but did not change the number of Ly6C low macrophages. Bone marrow-derived macrophages up-regulated the expression of genes related to both a pro-inflammatory and a reparative phenotype when co-cultured with activated iNKT cells. Anti-IL-4 antibodies increased the levels of pro-inflammatory macrophage-related genes and decreased those of reparative macrophage-related genes in cultured macrophages, while anti-IFN-γ antibodies reversed the polarization of macrophages. Cd1d -deficient mice showed delayed liver repair and suppressed macrophage switching, compared with that in wild-type mice. These results suggest that the activation of iNKT cells by α-GalCer facilitated liver repair after hepatic I/R injury by both IL-4-and IFN-γ-mediated acceleration of macrophage polarization. Therefore, the activation of iNKT cells may represent a therapeutic tool for liver repair after hepatic I/R injury.

The right internal thoracic artery to the right coronary artery bypass with ligation of the proximal native vessel is a simple and reliable option for the treatment of an anomalous aortic origin of the right coronary artery arising from the left sinus of Valsalva without an intramural course. Coronary artery bypass grafting is an uncomplicated option for elderly patients, those with connective tissue diseases, and those for whom combined aortic valve procedures are planned. Herein, we present four cases of this anomaly that underwent right internal thoracic artery anastomosis to the distal right coronary artery along with proximal right coronary artery ligation using a surgical clip. There was no occurrence of complications such as hypoperfusion syndrome, graft occlusion, recurrent symptoms, or late cardiac events.

Invariant natural killer T (iNKT) cells are involved in the initiation and resolution of inflammatory responses. We previously reported that activated iNKT cells facilitate liver repair after hepatic ischemia reperfusion (I/R) injury by accelerating macrophage polarization during the early phase of hepatic I/R injury. Upon activation with α-galactosylceramide (α-GalCer), iNKT cell numbers transiently decrease before increasing within 72 h of stimulation. In the present study, we examined the role of expanded hepatic iNKT cells in the late phase of hepatic I/R injury. iNKT cells were activated by intraperitoneal injection of α-GalCer in male C57/BL6 mice at the induction of hepatic ischemia followed by reperfusion. Numbers of activated hepatic iNKT cells immediately diminished after hepatic I/R and reached minimal levels at 24 h and 48 h post-reperfusion. Numbers of hepatic iNKT cells then increased at 72 h and 96 h post-reperfusion to levels approximately 2-fold higher than in mice that underwent a sham operation. Liver repair as demonstrated by decreased necrotic area and increased expression of proliferating cell nuclear antigen (PCNA) was enhanced in α-GalCer-treated mice at 96 h post-reperfusion. Interleukin (IL)-13 production by proliferating iNKT cells was observed at 96 h post-reperfusion, which was associated with enhanced liver repair and increased numbers of reparative macrophages. Repopulation of hepatic iNKT cells promotes liver repair by stimulating macrophage phenotype switching in the late phase of hepatic I/R injury.

Background/Aim: Although the pathology of sinusoidal obstruction syndrome (SOS) is characterized by damage to liver sinusoidal endothelial cells (LSECs), the processes underlying LSEC repair are incompletely understood. The angiopoietin (Ang)/Tie system contributes to angiogenesis. The present study aimed to examine the processes of LSEC repair and the involvement of the Ang/Tie pathway in LSEC recovery. Materials and Methods: Experimentally, SOS was induced by intraperitoneal injection of monocrotaline (MCT) to C57/BL6 mice. Results: Levels of LSEC markers were up-regulated during the repair phase of MCT-induced hepatotoxicity. The damaged LSECs recovered from the injury by expanding LSECs expressing lymphatic vessel endothelial hyaluronan receptor-1 (LYVE-1) in the peri-central area of MCT-injured livers, while LSECs in the same area of uninjured livers lacked LYVE-1 expression. Bone marrow (BM)-derived cells did not incorporate into the restored LSECs. Tie2 expression was related to LSEC recovery in MCT-injured liver tissue. Conclusion: The resident LSECs neighboring uninjured tissue replace damaged LSECs in MCT-injured livers. Tie2 is involved in LSEC recovery from MCT-induced hepatotoxicity.

Background Advances in diagnostic and surgical techniques have improved survival rates for gastric cancer patients. However, gastrectomy involving ghrelin‐secreting regions of the upper gastric greater curvature can lead to long‐term endocrine and metabolic disturbances, including reductions in serum ghrelin and insulin‐like growth factor‐1 (IGF‐1), potentially contributing to skeletal muscle and bone mineral loss. Methods This prospective observational study included 35 gastric cancer patients who underwent gastrectomy between 2016 and 2018, with follow‐up for 3–5 years. Patients were categorized into ghrelin‐depleted (total or proximal gastrectomy) and ghrelin‐preserved (distal gastrectomy) groups. Serum desacyl‐ghrelin, IGF‐1, and insulin‐like growth factor‐binding protein‐3 (IGFBP‐3) levels were measured, and skeletal muscle mass and bone mineral content were assessed. Results The ghrelin‐depleted group exhibited significantly lower serum desacyl‐ghrelin (56.9 ± 27.9 vs. 111.2 ± 54.8 fmol/mL, p = 0.0006), skeletal muscle mass (87.7% ± 2.1% vs. 95.1% ± 2.4%, p = 0.0229), and bone mineral content (90.9% ± 13.0% vs. 99.5% ± 6.3%, p = 0.0249). Additionally, IGF‐1 levels showed a significant positive correlation with skeletal muscle mass (r = 0.53, p = 0.020). While the correlation between IGF‐1 and bone mineral content did not reach statistical significance, a positive trend was observed (r = 0.44, p = 0.062). Conclusion Gastrectomy involving resection of ghrelin‐rich regions leads to long‐term reductions in serum desacyl‐ghrelin levels, adversely affecting skeletal muscle mass and bone mineral content. These findings highlight the importance of considering the endocrine consequences when selecting surgical procedures. This study investigates the long‐term endocrine and metabolic consequences of ghrelin‐depleted gastrectomy, with a focus on skeletal muscle mass and bone mineral content. Sustained reductions in serum desacyl‐ghrelin were linked to lower IGF‐1 levels, resulting in significant loss of muscle and bone. These findings underscore the importance of preserving ghrelin‐rich regions during gastric cancer surgery to maintain long‐term metabolic health.

To minimize the recharge time of EVs, Level 3 charging stations utilizing DC fast charging systems have become increasingly prevalent. Additionally, these systems offer bidirectional functionality, aiding in stabilizing the DC grid during peak hour. As a result, the DC–DC converters utilized in such systems must be capable of bidirectional energy transfer. Among existing typologies, DAB converters are preferred due to their simplicity and sustainability. The three-phase DAB (DAB3) is favored because the output ripple is lower compared to the single-phase structure. This characteristic assists in mitigating the negative effects on the battery caused by high-frequency current ripple. However, the input to DAB3 converters typically originates from AC–DC stages, leading to the inclusion of low harmonic frequency ripples (e.g., multiples of 360 Hz). These ripples are then transferred to the battery, increasing its temperature. To address this issue, this paper proposes a technique to mitigate negative effects by attenuating these low frequencies in the charging current. Simulations were conducted to demonstrate the effectiveness of the proposed technique. Scaled-down experiments utilizing a DAB3 prototype were conducted to corroborate the simulations. The findings demonstrated a reduction in ripple from 8.66% to below 2.67% when compared to the original controller. This reduction enabled the solution to meet the limiting current ripple criteria outlined in the CHAdeMO standard.

Graphene, a single layer of graphite, has recently attracted a large amount of attention because of its extremely high electronic and thermal properties, as many nanoscale materials are based on individual graphene. Graphene oxide (GO), which is the intermediate during the chemical processing of graphene, consists of graphene functionalized with oxygen-containing functional groups that imparts the desirable solution-processability to the neat graphene. Herein, poly(vinyl alcohol) (PVA), a hydrophilic polymer, was selected as the matrix, and PVA/GO nanocomposites were prepared by a simple and environment friendly process using water as the proceeding medium. In the PVA matrix, GO was exfoliated and nanodispersed. We found that the nanocomposites constructed by the incorporation of GO up to 1% by weight possess remarkable properties, such as significantly high mechanical and thermal properties. These excellent reinforcement effects were achieved not only by the rigid structure and high aspect ratio of the exfoliated GO but also by the strong interaction between PVA and GO. Furthermore, owing to the sheet-like structure of GO, the barrier properties of the nanocomposites were found to be dramatically increased. The graphene oxide (GO)-reinforced poly(vinyl alcohol) (PVA) nanocomposites were prepared using a simple and environment friendly process using aqueous medium. GO was revealed to be nanodispersed in the PVA matrix. The Young’s modulus of the nanocomposites largely exceeded the predicted value with only a low content of GO. We also revealed the increase in the thermal resistance and the barrier properties. As a result, not only the excellent properties but also the advantageous effects derived from the sheet-like structure of GO were successfully imparted to the nanocomposites.

The complex nature of tetraplegia in individuals with incomplete cervical spinal cord injury (ICSCI) significantly impacts activities of daily living, with few interventions comprehensively addressing upper and lower limb and trunk dysfunction due to tetraplegia. This study aimed to investigate the effectiveness of intensive task-oriented training incorporating bimanual movement and postural control in individuals with ICSCI. This study included two cases: a man in his 30s (neurological level of injury (NLI) C5; American Spinal Injury Association Impairment Scale (AIS) grade D) and a man in his 50s (NLI C3; AIS grade D). The intervention consisted of 50-h task-oriented training over 15 days and a diary-based transfer package. Both cases demonstrated improvements in upper limb function and balance ability. Several goals were improved or achieved. This report indicates the efficacy of intensive task-oriented training for ICSCI. Bimanual activities in various postures, including standing, enhanced upper limb function, and balance ability. This indicates that interventions targeting upper limb function in ICSCI should consider both bimanual movement and postural control. This study highlights the ability of this comprehensive training to improve functional outcomes in individuals with ICSCI and provides valuable insights into spinal cord injury rehabilitation.