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Background and purpose Fluorine-18-flurodeoxyglucose positron emission tomography (18FDG-PET) is a useful examination assessing active inflammatory myocardium noninvasively in patients with cardiac sarcoidosis (CS). Though immunosuppression like prednisolone (PSL) and Methotrexate (MTX) as alternative therapy is used to suppress the inflammation, little is known about the rate of response and efficacy of MTX for intolerance to PSL therapy. Methods From Aug 2016, we prospectively enrolled CS with positively accumulated of FDG in the heart. The initial dose of PSL was 30mg/day, wherefrom the dose was tapered down 5mg/month until 6 months. After 6 months, follow-up 18FDG-PET was performed. Using 18FDG-PET images, we calculated total lesion glycolysis (TLG; SUVmeam x metabolic volume) and calculated the reduction rate of TLG. In order to estimate the response rate to PSL therapy, responder group (R-group) was defined as TLG reduction rate ≥70% and poor-responder group (PR-group) was defined as TLG reduction rate Results In 64 CS patients, 55 patients had serial 18FDG-PET before and 6 months after PSL therapy. 18FDG-PET images were acquired following 7 day's carbohydrate limitation and after at least 18-h fasting (mean free fatty acid level right before 18FDG-PET acquisition was 1.05 mEq/L). The mean age was 63.4 years old and 42 (76.4%) patients were female. Because of 6 months PSL therapy, even though there were no significant difference in BNP (from 59.9 (26.2–137.6) to 60.4 (18.5–122.0) (P=0.593), LV-Dd (from 50.9 (44.5–59.5) to 49.7 (45.5–61.3) (P=0.666) and LV-EF (from 49.5 (34.4–62.5) to 49.9 (38.0–62.0) (P=0.792) at pre and post therapy, respectively, TLG were detected significant reduction from 216.4 (74.2–411.6) to 0.8 (0.0–8.2), (p Conclusions 1) By immunosuppression therapy using PSL for CS, about 86% patients showed significant reduction of myocardial FDG accumulation. 2) When detected intolerance for PSL therapy, MTX might be effective for reduction of inflammation of sarcoidosis in the heart, which might be effective as an alternate therapy in CS. The TLG level after randomization Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Grant-in-aid for scientific research

Background and purpose Fluorine-18-flurodeoxyglucose positron emission computed tomography (18FDG-PET CT) is the sole but time-consuming and expensive examination assessing active inflammatory myocardium noninvasively in patients with cardiac sarcoidosis (CS). Though immunosuppression is used to treat CS, little is known about the cardiac biomarkers for determining therapeutic effect to immunosuppression therapy other than 18FDG-PET. Methods From Aug 2016, we prospectively enrolled 50 sarcoidosis patients with positively accumulated of FDG in the heart. The initial dose of prednisolone was 30mg/day, wherefrom the dose was tapered down 5mg/month until 6 months. After 6 months, follow-up 18FDG-PET was performed. Using 18FDG-PET images, we calculated total lesion glycolysis (TLG; SUVmeam x metabolic volume) and compared it to various cardiac markers. Non-responder was defined as TLG reduction rate Results In 50 CS patients, 41 patients had serial 18FDG-PET before and 6 months after immunosuppression therapy. 18FDG-PET images were acquired following 7 day's carbohydrate limitation and after at least 18-h fasting (mean free fatty acid level right before 18FDG-PET acquisition was 1.03 mEq/L). The mean age and plasma brain natriuretic peptide (BNP) level were 61.9 years old, 184 pg/mL at baseline, respectively. Because of immunosuppression therapy, TLG was significantly reduced from 195.3 (38.6–339.6) to 1.1 (0.01–7.37), p Figure 1 Conclusions 1) By immunosuppression therapy using prednisolone for CS, about 85% patients showed significant reduction of increased myocardial FDG accumulation. 2) The sustained high level of serum TnT at post 6 months therapy indicates persistent inflammation of sarcoidosis in the heart, which could be an expedient marker for determining therapeutic effect.

Background Although veno-arterial extracorporeal oxygenation (VA-ECMO) is widely used as mechanical circulatory support, it reduces native left ventricular (LV) stroke volume through the cardiac preload decrease and afterload increase. Therefore some patients with severe cardiac dysfunction present persistently closed aortic valve (AV). The closed AV is considered to increase the risk of pulmonary edema or intracardiac thrombosis. However, little is known about the variables that contribute to persistently closed AV under the management of VA-ECMO. Purpose We investigated the factors that could predict persistently closed AV at the time of VA-ECMO initiation. Methods This was a retrospective chart review. We investigated the patients who received the management of VA-ECMO due to cardiogenic shock from April 2011 to December 2018, and analyzed 18 patients (43±16 years, 50% female) who presented closed AV immediately after the introduction of VA-ECMO. We obtained the hemodynamic data at the time of VA-ECMO initiation (baseline) and 24h after. The patients who presented persistently closed AV during 24h were defined as Close-group (n=8). The patients whose AV was opened within 24h were defined as Open-group (n=10). The status of AV was investigated by the echocardiogram. Results All patients were managed by concomitant use of intra-aortic balloon pumping. The etiologies were myocarditis (56%), cardiomyopathy (33%), and acute myocardial infarction (11%). Nine patients experienced in-hospital death (6 were Close-group and 3 were Open-group, p=0.15). At baseline, there were no significant differences between mean arterial blood pressure (mABP) (p=0.07), central venous pressure (CVP) (p=0.71), and left ventricular ejection fraction (p=0.44). However, Close-group had significantly lower mean pulmonary artery pressure (MPAP) and pulmonary artery pulse pressure (PAPP) than Open-group (Close-group versus Open-group; MPAP, 15±6 mmHg versus 27±11 mmHg, p=0.01; PAPP, 3±2 mmHg versus 8±3 mmHg, p=0.01). Logistic regression analyses revealed the lower MPAP and PAPP had the predictive value of closed AV within 24-h after VA-ECMO initiation [MPAP: odds ratio (OR) 0.78, 95% confidence interval (95% CI) 0.62–0.99, P=0.003; PAPP: OR 0.18, 95% CI 0.02–1.13, P Conclusion At the time of VA-ECMO initiation, lower MPAP and PAPP had the predictive value for persistently closed AV. LV preload derived from right heart function would have major impact on AV status.

Two-proton relative momentum ($q_{pp}$) and opening angle ($\theta_{pp}$) distributions from the three-body decay of two excited proton-rich nuclei, namely $^{23}$Al $\rightarrow$ p + p + $^{21}$Na and $^{22}$Mg $\rightarrow$ p + p + $^{20}$Ne, have been measured with the projectile fragment separator (RIPS) at the RIKEN RI Beam Factory. An evident peak at $q_{pp}\sim20$ MeV/c as well as a peak in $\theta_{pp}$ around 30$^\circ$ are seen in the two-proton break-up channel from a highly-excited $^{22}$Mg. In contrast, such peaks are absent for the $^{23}$Al case. It is concluded that the two-proton emission mechanism of excited $^{22}$Mg is quite different from the $^{23}$Al case, with the former having a favorable diproton emission component at a highly excited state and the latter dominated by the sequential decay process.

We measured the reaction cross sections of the two-neutron halo nucleus 14Be with proton and carbon targets at about 41 and 76 MeV/nucleon. Based on a Glauber model calculation, we deduced the matter density distribution of 14Be in which previously measured interaction cross sections at relativistic energies were also included. An s-wave dominance in 14Be has been confirmed, although the halo tail of 14Be is not distributed as much as that of 11Li. Significant mixing of the p-wave in addition to the s- and d-wave is also suggested.

The proton-proton momentum correlation functions ($C_{pp}(q)$) for kinematically complete decay channels of $^{23}$Al $\rightarrow$ p + p + $^{21}$Na and $^{22}$Mg $\rightarrow$ p + p + $^{20}$Ne have been measured at the RIKEN RI Beam Factory. From the very different correlation strength of $C_{pp}(q)$ for $^{23}$Al and $^{22}$Mg, the source size and emission time information were extracted from the $C_{pp}(q)$ data by assuming a Gaussian source profile in the correlation function calculation code (CRAB). The results indicated that the mechanism of two-proton emission from $^{23}$Al was mainly sequential emission, while that of $^{22}$Mg was mainly three-body simultaneous emission. By combining our earlier results of the two-proton relative momentum and the opening angle, it is pointed out that the mechanism of two-proton emission could be distinguished clearly.

Interaction cross sections (sigma(1)) for Me isotopes from the stability line to the vicinity of the neutron drip line have been measured at around 240 MeV/nucleon using BigRIPS at RIBF, RIKEN, The sigma(1) for Ne27-32 in every case exceed the systematic mass-number dependence of sigma(1) for stable nuclei, which can be explained by considering the nuclear deformation. In particular the sigma(1) for Ne-29 and Ne-31 are significantly greater than those of their neighboring nuclides. These enhancements of sigma(1) for Ne-29 and Ne-31 cannot be explained by a single-particle model calculation under the assumption that the valence neutron of Ne-29 (Ne-31) occupies the 0d(3/2) (0f(7/2)) orbital, as expected from the standard spherical shell ordering. The present data suggest an s dominant halo structure of Ne-29 and s- or p-orbital halo in Ne-31. (C) 2011 Elsevier B.V. All rights reserved.

A thick and large solid hydrogen target (SHT) for radioisotope (RI) beams was developed. A target with 100 mm thickness and 50 mm diameter equipped with thin Kapton windows (25 μm) was achieved. We developed a new method to fill solid hydrogen into a large target cell by eliminating any void or porous regions. The expansion of thin Kapton windows and the real thickness of SHT were measured by a laser distance meter and an energy-loss of RI beams, respectively. They gave the same thickness confirming the complete solidification of hydrogen in the cell. We obtained a window expansion of about 2.5 mm (about 1.25 mm for each side).

The total charge-changing, charge pick-up, and partial charge-changing cross sections of very neutron-rich nuclei (Ne-30, Na-32,Na-33) with a proton target have been measured at similar to 240A MeV for the first time. We introduced the phenomenological correction factor in Glauber-model calculations for the total charge-changing cross sections with the proton target, and applied it to deduce the proton radii of these nuclei. For 30Ne and Na-32, the neutron skin thicknesses of the nuclei were deduced by comparing the proton radii with the matter radii deduced from the interaction cross-section measurements. A significant thick neutron-skin has been observed for the nuclei. We also found that the charge pick-up cross sections are much larger than those in the systematics of stable nuclei.

The differential cross sections of the 9 Be + α inelastic scattering at 30 MeV were measured at the tandem of Tsukuba University. All the known states of 9 Be up to energies ~ 12 MeV were observed and decomposed into three rotational bands, each of them having a cluster structure consisting of a 8 Be core plus a valence neutron in one of the sub-shells: p3/2-, s1/2+ and p1/2-. Existence of a neutron halo in the positive parity states was confirmed.

We measured the reaction cross sections of the two-neutron halo nucleus ${}^{11}$Li with solid hydrogen and carbon targets at around 31 and 41 MeV/nucleon. The neutron density distribution of ${}^{11}$Li was deduced for the first time by the Glauber model calculation based on the optical limit approximation. The uncertainty of the matter density of ${}^{11}$Li was improved, compared with earlier measurements. The present root-mean-square radius of the proton distribution agrees with the previous one derived from an optical isotope shift measurement. The present root-mean-square radii reproduce theoretical calculations by the tensor optimized shell model by assuming core excitation. This consistency suggests the possibility that ${}^{9}$Li in ${}^{11}$Li is excited and the disappearance of the $N=8$ shell gap of ${}^{11}$Li is caused by correlations originating from the nucleon force, such as the tensor and the pairing.

Recent studies have shown that dexamethasone inhibits gelatinases. We investigated the effect of dexamethasone on the invasiveness of a human pancreatic cancer cell line. Tumor cells were treated with dexamethasone at various concentrations for 24 h. Cells were examined in an invasion assay. The expression and activity of MMP-9 in culture media were quantitated by Western blotting and gelatin zymogram. The invasiveness of cancer cells and expression of MMP-9 were decreased by dexamethasone in a dose-dependent manner. Dexamethasone may be a useful therapeutic agent in the treatment of pancreatic cancer.

The structure of proton-unbound {sup 30}S states strongly determines the thermonuclear {sup 29}P(p,{gamma}){sup 30}S reaction rate at temperatures characteristic of explosive hydrogen burning in classical novae and type I x-ray bursts. Specifically, the rate had been previously predicted to be dominated by two low-lying, unobserved, levels in the E{sub x}= 4.7-4.8 MeV region, with spin and parity assignments of 3{sup +} and 2{sup +}. In recent experimental work, two candidate levels were observed with energies of 4.699 MeV and 4.814 MeV, but no experimental information on their spins and parities was obtained. We have performed an in-beam {gamma}-ray spectroscopy study of {sup 30}S with the {sup 28}Si({sup 3}He, n{gamma}){sup 30}S reaction. By constructing the decay schemes of proton-unbound states with a {gamma}-{gamma} coincidence analysis of their decay {gamma} rays, their J{sup {pi}} values were inferred from a comparison to the known decay schemes of the corresponding mirror states in {sup 30}Si. For the two aforementioned states, our results strongly corroborate the spin-parity assignments assumed in recent evaluations of the {sup 29}P(p,{gamma}){sup 30}S reaction rate.

A Time Projection Chamber (TPC) for use as an active target has been developed. The TPC is used for nuclear experiments using unstable nuclear beam and is intended to measure a recoil nucleus in forward scattering whose energy is very small. It is designed to have two field cages and beams pass between the cages in order to decrease distortion of the electric field inside the TPC due to the ions created along the beam track. A Gas Electron Multiplier (GEM) is utilized for signal amplification. A performance test was carried out using 4 He2+ with 7.5 MeV/u in 12UD Pelletron tandem accelerator at the University of Tsukuba Tandem Accelerator Center. From the test, energy resolution of 4%, position resolution of 80 μm in the drift direction and of less than 700 μm in the transverse direction were obtained.

The purpose of this study was to evaluate the effect of endovascular treatment with Guglielmi detachable coils (GDC) on the outcome of severe subarachnoid hemorrhage (SAH) caused by acute rupture of a cerebral aneurysm and on the incidence of symptomatic vasospasm. Thirty-five patients with aneurysmal SAH were treated in the acute stage using GDC. Fifteen out of 17 patients in Hunt & Kosnik grades I, II, and III showed good recovery (GR) at discharge, while one was moderately disabled (MD) and one was severely disabled (SD). Among 16 patients in poor neurological condition (GCS was ⩽ 9 on admission), the outcome was GR in 5 cases (31%), MD in 2 (13%), and SD in 9 (56%). These results were better than those for surgically treated patients with the same neurological status. The difference in outcome between endovascular treatment and surgery may have been related to the difference in the insult to the brain caused by each modality. The incidence of symptomatic vasospasm was lower in the GDC group (5.7%) than in the surgical group (12%). In the patients treated with GDC and intrathecal administration of urokinase, subarachnoid clots were cleared more rapidly than in those treated surgically with continuous cisternal irrigation. The accelerated clearance of subarachnoid clots in the GDC group might have helped to prevent delayed vasospasm. The long-term efficacy of GDC embolization in preventing subsequent bleeding has not yet been determined. However, this method seems to be less traumatic for the brain and may be suitable for treatment of patients with severe SAH.

An anomalous junction of the pancreaticobiliary duct (AJPBD) was thought to be an important risk factor for gallbladder carcinoma in Japan. In this report, we compared K-ras and p53 mutations in Stage I gallbladder carcinomas (GC) of patients with AJPBD with those in patients without AJPBD:We examined 6 GC of patients with AJPBD and 20 GC of patients without AJPBD: Immunohistochemistry was performed for p53 protein. K-ras and p53 mutations were examined using genomic DNA extracted from the cancer regions. The methods of polymerase chain reaction (PCR) single strand conformation polymorphism analysis were performed for mutations in exons 5-8 of p53. The methods of PCR restriction fragment length polymorphism were performed for mutation in codon 12 of K-ras.p53 positivity was 67% in GC of patients with AJPBD and 65% in GC of patients without AJPBD: p53 mutations were found in exons 7 and 8 in GC of patients with AJPBD and in exons 5, 6, and 7 in GC of patients without AJPBD: The incidence of K-ras mutation in GC of patients with AJPBD (50%) was greater than that in patients without AJPBD (6%) (P0.05).These results suggest that K-ras mutation may be important in the early stage of carcinogenesis of the gallbladder mucosa with AJPBD, and that p53 mutations may also contribute to the early stage of carcinogenesis of the gallbladder mucosa, regardless of AJPBD

The interaction cross-sections (σI) of neutron-rich Na isotopes, 23-35Na, on C target have been measured at 250A MeV using the RI beam factory (RIBF) at RIKEN. Mass dependence of σI for 27-35Na suggests monotonic growth of the skin thickness. The root-mean-square nuclear matter radii (rm) of 23-35Na were deduced from observed σI via a Glauber-type calculation. These rm are in a good agreement with the theoretical prediction by relativistic mean field model (RMF). rm of 33-35Na were determined for the first time.

Case 1 was a 75-year-old woman. Her chest X-ray showed a 3 cm solitary nodule in the right S4, and biopsy obtained by fiberoptic bronchoscopy revealed epithelioid cell granuloma. Four weeks later, Mycobacterium avium complex (MAC) was detected on culture of the bronchial lavage fluid. She was treated with INH, RFP and EB for 12 months and recovered with no relapse. Case 2 was a 75-year-old man with mild diabetes mellitus and hypertension. Chest X-ray showed a 4 cm solitary nodule in the right S9. Percutaneous pulmonary aspiration revealed numerous acid-fast bacilli on smear, and he was treated with INH, RFP and EB. Culture proved M. avium complex. The patient was unable to continue his medications because of gastrointestinal side effects, so right lower lobectomy was performed. Cases of M. avium complex infection presenting as solitary pulmonary nodule are very rare. We found only 12 reported cases in Japan and in other countries. The most usual site of cavitary lesions in M. avium complex infections is both upper lobes, in contrast to the relatively even distribution of solitary pulmonary nodules of the 14 cases (12 reported cases and our 2 cases).

We report a case of malignant lymphoma with bronchial involvement in a 35-year-old male patient. On admission, chest X-ray revealed enlargement of bilateral hilar lymph nodes and expansion of the superior mediastinal space. CT and MR images showed that the tumor shadow appeared to wrap around the left and right main bronchi. Bronchoscopy revealed that the entire periphery of the left main bronchus was constricted. Transbronchial biopsy specimens, which revealed findings consistent with non-Hodgkin's lymphoma, were positive for surface markers of CD2, CD4, and CD8 and negative for those of CD19 and CD20. After MACOP-B treatment, the patient entered complete remission. He received 41.4 Gy radiotherapy thereafter, and has shown no signs of recurrence during continuing follow-up.

The authors have developed new devices for stereotactic radiosurgery using a conventional linear accelerator (LINAC). The system of devices consists of a rotatory chair with a base ring holder, a Brown Robert Well's stereotactic apparatus (BRW's apparatus) with a double set of base rings and a number of precise collimators which eliminate penumbra to the greatest extent. A study rotatory chair was manufactured, whose vertical axis of rotation is always set and stable. A strongly built, adjustable holder for the BRW's base ring is attached to the chair. The principle and flow of procedures step by step is as follows; 1). The rotatory chair is carried in under the linear accelerator and the vertical rotatory axis of the chair is precisely adjusted to align with the vertical center of the photon beam from the LINAC. 2) A base ring and a locator of BRW's apparatus are mounted on a patient's head and three coordinates of a target are determined by CT scans. 3) The target indicator of the dummy set of BRW's apparatus is positioned according to X, Y, Z coordinates of the target. The tip of a rod indicator fixed on an instrument bloc on the arc device is precisely adjusted to touch at the tip of the target indicator. 4) The base ring and arc device with rod indicator are transferred together from the BRW's dummy set to the rotatory chair and fixed to the base ring holder. The tip of the rod indicator is precisely adjusted to be positioned at the isocenter of the LINAC. 5) The base ring and arc device are removed and replaced by another base ring mounted on the head of a patient, who is made to sit on the rotatory chair. The target in the brain is now located at the isocenter of the LINAC. Stereotactic radiation is started with rotation of the chair and circular movement of the gantry of the LINAC. The chair is rotated at a speed of 100 degrees per second, and the gantry of the LINAC is moved slowly on a circular trajectory from +115 degrees to -115 degrees. Fourteen cases, including AVM, cavernous angioma, acoustic tumor and glioma have been treated so far. Three cases of large AVM were treated by a combination of artificial embolization and stereotactic radiosurgery.(ABSTRACT TRUNCATED AT 400 WORDS)

An analysis was performed of 2,168 consecutive stroke patients who were examined by computed tomography and entered into a hospital-based stroke registry in Akita Prefecture, Japan. The occurrence of cerebral hemorrhage, cerebral infarction, and subarachnoid hemorrhage was 30, 55, and 14%, respectively. Age-specific rates of subarachnoid hemorrhage were higher in women than men; other types of stroke showed a preponderance in men. Total strokes increased in the winter; this seasonal difference was confined to cerebral hemorrhage. Putaminal hemorrhages predominated in the younger age groups; thalamic hemorrhage and cerebellar hemorrhage were predominant in the older age groups. The increased accuracy of the diagnosis of stroke subtypes by the use of computed tomography in this study is in contrast to other community-based epidemiologic studies that have relied solely on clinical diagnosis. This increased accuracy is seen to be the reason that new ratios of stroke subtype incidence have been identified.