Background: Postoperative liver regeneration is essential for maintaining hepatic function. This study evaluated the rate, determinants, and volumetric patterns of early liver regeneration after hemihepatectomy. Methods: A retrospective review was conducted of 50 patients who underwent right or left hemihepatectomy between April 2019 and March 2025. Liver and spleen volumes (SV) were assessed preoperatively, at postoperative day (POD) 1 week, and at POD 3 months. Early liver regeneration rate (LRR) was defined as the percentage increase in remnant liver volume at POD 1 week relative to the preoperative future liver remnant (FLR), and patients were categorized into low (<50%) and high (≥50%) LRR groups. Clinical, biochemical, and volumetric variables were compared, and predictors of regeneration were identified using multivariable analyses. Regeneration patterns were also examined according to whether the FLR/standard liver volume (SLV) ratio was <50% or ≥50%. Results: FLR/SLV was the strongest independent predictor of rapid early liver regeneration (p<0.001). Remnants with FLR/SLV <50% exhibited rapid and sustained regeneration, whereas those with FLR/SLV ≥50% showed slower regrowth that plateaued after reaching approximately 90% of SLV. SV increased at POD 1 week in all patients; however, only the FLR/SLV ≥50% group showed a reduction by POD 3 months, whereas the <50% group maintained elevated volumes. Conclusions FLR/SLV reliably predicts early postoperative liver regeneration. Smaller remnants regenerate more rapidly, whereas persistent splenic enlargement suggests a sustained portal hemodynamic burden. Combined evaluation of FLR/SLV and SV may enhance perioperative risk assessment and surgical planning.

Purpose: Periprosthetic joint infections (PJIs) resulting from total hip arthroplasty (THA) pose significant challenges. Partial two-stage exchange arthroplasty (TSEA) retains either the femoral stem or acetabular cup by preserving bone stock and soft tissue and offers a potential alternative to total TSEA. Our meta-analysis evaluated the pooled success rate of partial TSEA in treating late chronic PJIs in THA. Our study also focused on the outcomes associated with retained prosthetic implant (stem or cup) and the type of prior surgery (primary vs. revision arthroplasty) performed. Materials and Methods: We analyzed data from 355 hips of patients with PJI following THA across 11 studies using a random-effects model to estimate the success rate of partial TSEA and spacer dislocation that occurs during the interval between the first and second stages of partial TSEA. The heterogeneity between the subgroups was also calculated. Results: The overall pooled success rate of partial TSEA in the study cohort was 87% (95% confidence interval [CI] 83-91).Lacking statistical significance (P=0.904), the success rates were 88% for stem-retained and 90% for cup-retained implant cases. The partial TSEA success rates were 88% for primary arthroplasty and 80% for revision arthroplasty, although this was not statistically significant (P=0.193). Spacer dislocation occurred in only 5% of the cases (95% CI 1-9). Conclusion Partial TSEA achieves high success rates comparable to those of total TSEA. Although revision arthroplasty cases carry a high risk of recurrence, partial TSEA remains a viable, tailored treatment option with a low complication rate.

Background: Posterior spinal fusion is performed for severe adolescent idiopathic scoliosis (AIS), with bone graft playing a critical role in achieving solid fusion. Iliac crest bone graft (ICBG) is the gold standard but has donor site morbidity, leading to increased use of non-ICBG. This study compared the effectiveness and safety of ICBG and non-ICBG bone grafts in AIS. Methods: This meta-analysis included 23 studies with 3,350 patients, categorized into ICBG and non-ICBG groups. The primary outcome was fusion rate; secondary outcomes were implant-related complication rate, infection rate, donor site pain, blood loss, and operation time. A proportion meta-analysis was conducted to estimate binary outcomes, and a weighted mean model was used to estimate continuous variables. Results: The fusion rate was 97% (95% confidence interval [CI], 93-99) in ICBG group and 97% (95% CI, 95-98) in non-ICBG group. Implant-related complications occurred in 5% (95% CI, 3-7) and 4% (95% CI, 2-6) of each group, while surgical site infections occurred in 3% (95% CI, 2-7) and 2% (95% CI, 1-3). Donor site pain was observed exclusively in ICBG group, with a prevalence of 49% (95% CI, 3–97). Estimated pooled blood loss was 1,461.10 mL (95% CI, 545.30-2,376.90) in ICBG group and 1,047.45 mL (95% CI, 666.92-1,427.99) in non-ICBG group. The estimated pooled operation time was 246.77 (95% CI, 221.74-271.80) and 232.37 (95% CI, 194.88-269.86) for each group. Conclusions Considering both ICBG and non-ICBG demonstrated high fusion rates and low complication rates, non-ICBG grafts may serve as an effective and safe alternative to ICBG, minimizing morbidity, donor site pain, and blood loss.

Purpose: Metabolic diseases share common risk factors, requiring the development of therapeutic agents with multi-target effects. Although the ameliorating effects of Porphyra tenera ethanol extract (PTE) have been reported on some individual metabolic disorders, studies addressing various other metabolic diseases are still limited. This study investigated the ameliorating effects of PTE supplementation for 12 weeks on obesity, dyslipidemia, and hepatic lipid metabolism in high-fat diet (HFD)-induced obese mice and its molecular mechanisms. Methods: Male C57BL/6 mice (n = 12/in each group) were divided into six groups for 12 weeks: control, HFD, chow diet + 1% porphyran, chow diet + 4% porphyran, HFD + 1% porphyran (HPYP-L), and HFD + 4% porphyran (HPYP-H). To confirm the attenuation of metabolic disease in vivo, mice in the HFD, HPYP-L and HPYP-H groups were fed 60% HFD to induce obesity. PTE was prepared using ethanol and dissolved in drinking water to concentrations of 1% and 4% porphyran. After 12 weeks of free PTE intake, body weight measurement, serum analysis, histopathological analysis, real-time quantitative polymerase chain reaction, and Western blot analysis of liver tissues were performed for comparative evaluation. Results: After 12 weeks, the HPYP-L and HPYP-H groups showed a decreased body weight, improved blood lipids, and reduced hepatic lipid droplet accumulation vs. the HFD group.Liver acetyl-CoA carboxylase, was suppressed in the HPYP-L group vs. the HFD group.The B-cell lymphoma 2 (Bcl-2)-associated X protein/Bcl-2 protein and messenger RNA (mRNA) level ratio in the liver decreased after PTE intake, indicating inhibition of apoptosis.Interleukin-1 beta mRNA expression in the liver was reduced in the HPYP-L group vs. the HFD group. In the liver, lower protein carbonylation levels in the HPYP-H group indicated reduced oxidative stress, while the increased mitochondrial DNAuclear DNA ratio indicated improved mitochondrial function. Conclusion PTE protects against diet-induced metabolic disorders and could be a potential agent for the prevention and treatment of metabolic diseases.

Purpose: Metabolic diseases share common risk factors, requiring the development of therapeutic agents with multi-target effects. Although the ameliorating effects of Porphyra tenera ethanol extract (PTE) have been reported on some individual metabolic disorders, studies addressing various other metabolic diseases are still limited. This study investigated the ameliorating effects of PTE supplementation for 12 weeks on obesity, dyslipidemia, and hepatic lipid metabolism in high-fat diet (HFD)-induced obese mice and its molecular mechanisms. Methods: Male C57BL/6 mice (n = 12/in each group) were divided into six groups for 12 weeks: control, HFD, chow diet + 1% porphyran, chow diet + 4% porphyran, HFD + 1% porphyran (HPYP-L), and HFD + 4% porphyran (HPYP-H). To confirm the attenuation of metabolic disease in vivo, mice in the HFD, HPYP-L and HPYP-H groups were fed 60% HFD to induce obesity. PTE was prepared using ethanol and dissolved in drinking water to concentrations of 1% and 4% porphyran. After 12 weeks of free PTE intake, body weight measurement, serum analysis, histopathological analysis, real-time quantitative polymerase chain reaction, and Western blot analysis of liver tissues were performed for comparative evaluation. Results: After 12 weeks, the HPYP-L and HPYP-H groups showed a decreased body weight, improved blood lipids, and reduced hepatic lipid droplet accumulation vs. the HFD group.Liver acetyl-CoA carboxylase, was suppressed in the HPYP-L group vs. the HFD group.The B-cell lymphoma 2 (Bcl-2)-associated X protein/Bcl-2 protein and messenger RNA (mRNA) level ratio in the liver decreased after PTE intake, indicating inhibition of apoptosis.Interleukin-1 beta mRNA expression in the liver was reduced in the HPYP-L group vs. the HFD group. In the liver, lower protein carbonylation levels in the HPYP-H group indicated reduced oxidative stress, while the increased mitochondrial DNAuclear DNA ratio indicated improved mitochondrial function. Conclusion PTE protects against diet-induced metabolic disorders and could be a potential agent for the prevention and treatment of metabolic diseases.

Paxlovid is the first approved oral treatment for coronavirus disease 2019 and includes nirmatrelvir, a protease inhibitor targeting the main protease (Mpro ) of SARS-CoV-2, as one of the key components. While some specific mutations emerged in Mpro were revealed to significantly reduce viral susceptibility to nirmatrelvir in vitro, there is no report regarding resistance to nirmatrelvir in patients and animal models for SARS-CoV-2 infection yet. We recently developed xenograft tumors derived from Calu-3 cells in immunodeficient mice and demonstrated extended replication of SARS-CoV-2 in the tumors. In this study, we investigated the effect of nirmatrelvir administration on SARS-CoV-2 replication. Treatment with nirmatrelvir after virus infection significantly reduced the replication of the parental SARS-CoV-2 and SARS-CoV-2 Omicron at 5 days post-infection (dpi). However, the virus titers were completely recovered at the time points of 15 and 30 dpi. The virus genomes in the tumors at 30 dpi were analyzed to investigate whether nirmatrelvir-resistant mutant viruses had emerged during the extended replication of SARS-CoV-2. Various mutations in several genes including ORF1ab, ORF3a, ORF7a, ORF7b, ORF8, and N occurred in the SARS-CoV-2 genome; however, no mutations were induced in the Mpro sequence by a single round of nirmatrelvir treatment, and none were observed even after two rounds of treatment. The parental SARS-CoV-2 and its sublineage isolates showed similar IC50 values of nirmatrelvir in Vero E6 cells. Therefore, it is probable that inducing viral resistance to nirmatrelvir in vivo is challenging differently from in vitro passage.

Purpose: Metabolic diseases share common risk factors, requiring the development of therapeutic agents with multi-target effects. Although the ameliorating effects of Porphyra tenera ethanol extract (PTE) have been reported on some individual metabolic disorders, studies addressing various other metabolic diseases are still limited. This study investigated the ameliorating effects of PTE supplementation for 12 weeks on obesity, dyslipidemia, and hepatic lipid metabolism in high-fat diet (HFD)-induced obese mice and its molecular mechanisms. Methods: Male C57BL/6 mice (n = 12/in each group) were divided into six groups for 12 weeks: control, HFD, chow diet + 1% porphyran, chow diet + 4% porphyran, HFD + 1% porphyran (HPYP-L), and HFD + 4% porphyran (HPYP-H). To confirm the attenuation of metabolic disease in vivo, mice in the HFD, HPYP-L and HPYP-H groups were fed 60% HFD to induce obesity. PTE was prepared using ethanol and dissolved in drinking water to concentrations of 1% and 4% porphyran. After 12 weeks of free PTE intake, body weight measurement, serum analysis, histopathological analysis, real-time quantitative polymerase chain reaction, and Western blot analysis of liver tissues were performed for comparative evaluation. Results: After 12 weeks, the HPYP-L and HPYP-H groups showed a decreased body weight, improved blood lipids, and reduced hepatic lipid droplet accumulation vs. the HFD group.Liver acetyl-CoA carboxylase, was suppressed in the HPYP-L group vs. the HFD group.The B-cell lymphoma 2 (Bcl-2)-associated X protein/Bcl-2 protein and messenger RNA (mRNA) level ratio in the liver decreased after PTE intake, indicating inhibition of apoptosis.Interleukin-1 beta mRNA expression in the liver was reduced in the HPYP-L group vs. the HFD group. In the liver, lower protein carbonylation levels in the HPYP-H group indicated reduced oxidative stress, while the increased mitochondrial DNAuclear DNA ratio indicated improved mitochondrial function. Conclusion PTE protects against diet-induced metabolic disorders and could be a potential agent for the prevention and treatment of metabolic diseases.

Background: Highly pathogenic avian influenza viruses (HPAIVs) is an extremely contagious and high mortality rates in chickens resulting in substantial economic impact on the poultry sector. Therefore, it is necessary to elucidate the pathogenic mechanism of HPAIV for infection control. Objective: Gene set enrichment analysis (GSEA) can effectively avoid the limitations of subjective screening for differential gene expression. Therefore, we performed GSEA to compare HPAI-infected resistant and susceptible Ri chicken lines. Methods: The Ri chickens Mx(A)/BF2(B21) were chosen as resistant, and the chickens Mx(G)/ BF2(B13) were selected as susceptible by genotyping the Mx and BF2 genes. The tracheal tissues of HPAIV H5N1 infected chickens were collected for RNA sequencing followed by GSEA analysis to define gene subsets to elucidate the sequencing results. Results: We identified four differentially expressed pathways, which were immune-related pathways with a total of 78 genes. The expression levels of cytokines (IL-1β, IL-6, IL-12), chemokines (CCL4 and CCL5), type interferons and their receptors (IFN-β, IFNAR1, IFNAR2, and IFNGR1), Jak-STAT signaling pathway genes (STAT1, STAT2, and JAK1), MHC class I and II and their co-stimulatory molecules (CD80, CD86, CD40, DMB2, BLB2, and B2M), and interferon stimulated genes (EIF2AK2 and EIF2AK1) in resistant chickens were higher than those in susceptible chickens. Conclusions Resistant Ri chickens exhibit a stronger antiviral response to HPAIV H5N1 compared with susceptible chickens. Our findings provide insights into the immune responses of genetically disparate chickens against HPAIV.

Background: Highly pathogenic avian influenza virus (HPAIV) is considered a global threat to both human health and the poultry industry. MicroRNAs (miRNA) can modulate the immune system by affecting gene expression patterns in HPAIV-infected chickens. Objectives: To gain further insights into the role of miRNAs in immune responses against H5N1 infection, as well as the development of strategies for breeding disease-resistant chickens, we characterized miRNA expression patterns in tracheal tissues from H5N1-infected Ri chickens. Methods: miRNAs expression was analyzed from two H5N1-infected Ri chicken lines using small RNA sequencing. The target genes of differentially expressed (DE) miRNAs were predicted using miRDB. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analysis were then conducted. Furthermore, using quantitative real-time polymerase chain reaction, we validated the expression levels of DE miRNAs (miR-22-3p, miR-146b-3p, miR-27b-3p, miR-128-3p, miR-2188-5p, miR-451, miR-205a, miR-203a, miR-21-3p, and miR-200a-3p) from all comparisons and their immune-related target genes. Results: A total of 53 miRNAs were significantly expressed in the infection samples of the resistant compared to the susceptible line. Network analyses between the DE miRNAs and target genes revealed that DE miRNAs may regulate the expression of target genes involved in the transforming growth factor-beta, mitogen-activated protein kinase, and Toll-like receptor signaling pathways, all of which are related to influenza A virus progression. Conclusions Collectively, our results provided novel insights into the miRNA expression patterns of tracheal tissues from H5N1-infected Ri chickens. More importantly, our findings offer insights into the relationship between miRNA and immune-related target genes and the role of miRNA in HPAIV infections in chickens.

BACKGROUND/OBJECTIVES: A dietary restriction on the intake of fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) has been reported to be effective in the treatment of gastrointestinal (GI) tract complications. Enteral nutrition (EN) is widely used for patients who cannot obtain their nutritional requirements orally, but many studies have reported EN complications, especially diarrhea, in up to 50% of patients. SUBJECTS/METHODS: We performed a single-center, non-randomized, controlled trial to determine the effects of a low-FODMAP enteral formula on GI complications in patients in intensive care units (ICUs). Patients in the ICU who needed EN (n = 66) were alternately assigned to the low-FODMAP group (n = 33) or the high-FODMAP group (n = 33). RESULTS: Anthropometric and biochemical parameters were measured, and stool assessment was performed using King's Stool Chart. We excluded patients who received laxatives, GI motility agents, proton pump inhibitors, antifungal agents, and antibiotics other than β-lactams. There were no differences in GI symptoms during 7 days of intervention, including bowel sound, abdominal distension, and vomiting between the 2 groups. However, diarrhea was more frequent in the high-FODMAP group (7/33 patients) than the lowFODMAP group (1/33 patients) (P = 0.044). CONCLUSIONS Our results suggest that a low-FODMAP enteral formula may be a practical therapeutic approach for patients who exhibit enteral formula complications. Our study warrants further randomized clinical trials and multicenter trials.