New constraint on the existence of the µ+ → e+ γ decay.

The analysis of a combined data set, totaling 3.6 × 10(14) stopped muons on target, in the search for the lepton flavor violating decay µ(+) → e(+)γ is presented. The data collected by the MEG experiment at the Paul Scherrer Institut show no excess of events compared to background expectations and yield a new upper limit on the branching ratio of this decay of 5.7 × 10(-13) (90% confidence level). This represents a four times more stringent limit than the previous world best limit set by MEG.

New limit on the lepton-flavor-violating decay µ+→e+γ.

We present a new result based on an analysis of the data collected by the MEG detector at the Paul Scherrer Institut in 2009 and 2010, in search of the lepton-flavor-violating decay µ(+)e(+)γ. The likelihood analysis of the combined data sample, which corresponds to a total of 1.8×10(14) muon decays, gives a 90% C.L. upper limit of 2.4×10(-12) on the branching ratio of the µ(+)→e(+)γ decay, constituting the most stringent limit on the existence of this decay to date.

Tracking of a bronchoscope using epipolar geometry analysis and intensity-based image registration of real and virtual endoscopic images.

This paper describes a method for tracking the camera motion of a flexible endoscope, in particular a bronchoscope, using epipolar geometry analysis and intensity-based image registration. The method proposed here does not use a positional sensor attached to the endoscope. Instead, it tracks camera motion using real endoscopic (RE) video images obtained at the time of the procedure and X-ray CT images acquired before the endoscopic examination. A virtual endoscope system (VES) is used for generating virtual endoscopic (VE) images. The basic idea of this tracking method is to find the viewpoint and view direction of the VES that maximizes a similarity measure between the VE and RE images. To assist the parameter search process, camera motion is also computed directly from epipolar geometry analysis of the RE video images. The complete method consists of two steps: (a) rough estimation using epipolar geometry analysis and (b) precise estimation using intensity-based image registration. In the rough registration process, the method computes camera motion from optical flow patterns between two consecutive RE video image frames using epipolar geometry analysis. In the image registration stage, we search for the VES viewing parameters that generate the VE image that is most similar to the current RE image. The correlation coefficient and the mean square intensity difference are used for measuring image similarity. The result obtained in the rough estimation process is used for restricting the parameter search area. We applied the method to bronchoscopic video image data from three patients who had chest CT images. The method successfully tracked camera motion for about 600 consecutive frames in the best case. Visual inspection suggests that the tracking is sufficiently accurate for clinical use. Tracking results obtained by performing the method without the epipolar geometry analysis step were substantially worse. Although the method required about 20 s to process one frame, the results demonstrate the potential of image-based tracking for use in an endoscope navigation system.

Binding evaluation of the combination between the superconductor and matrix by ultrasonic spectra.

Combination of the superconductor and high conductive normal metal is now indispensable in the practical use of superconducting magnet. And the binding property of both materials is one of the key points whether superconductive characteristics are fully attained or the current fails prematurely in the practical magnet. But this binding evaluation is not so easy, because even in the mechanically well-jointed conductor, it often appears poor in electric and magnetic joint in cryogenic temperature. Since we have examined and reported fundamental AE properties of superconductor from UI-91, UI-93, UI-95, and UI-97, we have found the simple but important discovery for getting new information about the binding evaluation. Here we report a new technique for evaluating these bindings by observing ultrasonic spectra when a normal transition is propagated along the superconductor. We have discovered that a good contacting conductor has an emission of this sound with sharp resonating frequency peak or peaks at around the highest spectrum area; from 0.5 to 1.0 MHz. Our interpretation of the evaluations are so simple that we can say that binding degrees are best, good or bad, according to the resonating Q-value at around the highest spectrum of the ultrasonic sound.

[Virtual bronchoscope system].

In this article, we describe the features of Virtual Bronchoscope System(VBS) and its practical use. VBS is constructed based on 3-D chest CT images. The bronchus region is automatically extracted from 3-D chest CT images by a three-dimensional region growing method. The surface rendering is employed for construction of virtualized tracheo-bronchial tree. It gives us an environment where we can observe inside the bronchi from an arbitrary viewpoint and a view direction. By mouse operation, the user can control the viewpoint and the view direction to fly through inside the airway in real time. VBS is applicable for a variety of purposes such as diagnosis, surgical planning, informed consent, education and training. One of extension of this system is a teaching tool for medical students. In the module for educational use, we have developed four functions for using the system as a teaching tool as follows: (a) automated display of bronchial anatomical names, (b) presenting questions about the currently observed branch in the endoscopic view, (c) display of the path which the user should follow, and (d) display of a question about the location of the artificially created tumor in the bronchus. These functions use the processed results of automated anatomical labeling. The method proposed here combines the knowledge based processing technique 'automated labeling of bronchial branch' and the novel visualization technique 'virtual bronchoscope'. This is one of new teaching tools of medical images. We conclude that this virtual bronchoscope system might have an important role in the medial students' education.

Endoscopic ultrasonography of the esophagus.

Endoscopic ultrasonography (EUS) is a generally accepted technique for the preoperative staging of malignant tumors in the upper and lower gastrointestinal tracts. In particular, EUS has been considered the method of choice in diagnosing esophageal carcinoma due to the relative ease in performing the examination and the accuracy of staging based on high-resolution ultrasonic imaging from within the lumen of the esophagus. This comprehensive review covers currently available EUS instruments, image characteristics of esophageal carcinoma, and images by the recently introduced miniprobe scanner. The role of the method in diagnosing superficial esophageal carcinoma and the possible treatment by endoscopic mucosal resection of this particular disease entity are discussed.

Immunomodulatory constituents from three ascomycetes, Gelasinospora heterospora, G. multiforis, and G. longispora.

Three new 2-pyrones (2H-pyran-2-ones) called multiforisins G (3), H (1), and I (4), and a known hexaketide sordarial (2) have been isolated from an Ascomycete Gelasinospora heterospora. Among them, 1, 2, and 3 have been proved to be the immunosuppressive components of the fungus. Compounds 1, 3, and 4 have also been isolated from G. multiforis together with multiforisin A (5), which was formerly isolated from this fungus as its main immunosuppressive feature, and 1-5 have also been isolated from G. longispora. The absolute stereostructure of 2, which was not previously certain, has finally been determined to be (3'R,4'S). It has been found that the multiforisins 1, 3, and 5 in which one of the two substituents at positions 3 and 5 is a hydroxymethyl group and the other is a formyl or an acetoxymethyl group, show high immunosuppressive activity; the immunosuppressive activity of 3 does not seem to be due to inhibition of interleukin 2 (IL-2) production.

The value of endoscopic ultrasonography in preoperative evaluation of rectal cancer.

BACKGROUND: In rectal cancer, preoperative evaluation of the depth of cancer invasion and the presence of pararectal lymph node metastasis is essential to determine appropriate operative procedures, especially in autonomic nerve preserving operations. For this evaluation, endoscopic ultrasonography (EUS) was performed prospectively in the following cases. METHODS: During the past 5 years, 70 patients with rectal cancer underwent EUS examination by using 7.5MHz and 12MHz-EUS sonoprobe systems. RESULTS: The depth of cancer invasion was accurately predicted by EUS in 76% of cases (53/70). Seventeen cases were incorrectly estimated, 12 of those underestimated, and 5 overestimated. The evaluation of pararectal lymph node metastasis was accurate in 44 patients (69%). The sensitivity rate was 36% and specificity was 90%. CONCLUSIONS: EUS is a very useful technique for determining therapeutic procedures for rectal cancer, especially in deciding whether or not sphincter preserving and/or autonomic nerve preserving operations should be undertaken.

Carcinoma arising from ectopic pancreas in the stomach: endosonographic detection of malignant change.

We present a case of a submucosal tumor in the stomach that was suspicious for malignancy on preoperative endosonography. The resected tumor was histologically diagnosed as a ductal adenocarcinoma that originated in ectopic pancreatic tissue in the gastric wall. Although malignant transformation in ectopic pancreas is extremely rare, it remains an important consideration in the differential diagnosis of gastric submucosal masses.

A Case of Sclerosing Lymphocytic Lobulitis of the Breast Associated with Diabetes Mellitus.

BACKGROUND: The benign breast disease sclerosing lymphocytic lobulitis is thought to result from autoimmune diseases causing insulin-dependent diabetes mellitus (IDDM) due to insulinitis. In cases of sclerosing lymphocytic lobulitis accompanied by IDDM, the clinical term gdiabetic fibrous breast disease hhas been proposed. METHODS: A case of sclerosing lymphocytic lobulitis of the breast is described RESULTS: The patient was a 43-year-old woman diagnosed with non insulin-dependent diabetes mellitus (NIDDM) 8 years previously. Insulin therapy was thought to be necessary because treatment with glibenclamide was not effective. She visited our facility complaining of a lump in her right breast that was 5 cm in diameter, painless, rock-hard, discrete, and irregularly outlined. Biopsy was performed because breast cancer was strongly suggested by its hardness and its irregular internal echo on ultrasonography. Histopathological findings demonstrated marked stromal sclerosis and lymphocyte infiltration in the perivascular and perilobular areas. Sclerosing lymphocytic lobulitis was diagnosed. CONCLUSION: Referring physicians should avoid performing unnecessary repeated biopsies by recognizing this disease entity, which often occurs bilaterally.

[Digital filing system for medical image data].

To establish practical, effective medical digital image filing systems, various problems remain to be solved. The authors focused on 2 such problems of great importance: image data compression and standard specifications for digital data storage. From a variety of image compression algorithms now available, 2D-Color Doppler image compression was clinically investigated using the Joint Photographic Expert Group (JPEG) method. In low grade compression, the images decompressed showed no significant alterations in image quality, however, in higher grades of compression attained through irreversible coding in the JPEG method, the images showed subtle but significant alterations: emergence of 2 kinds of artifact, i.e., borderline-artifact produced in the DCT procedures and pseudo color spots. The reproducibility of colors was found to be altered by changing the quantization table in the JPEG procedure. It was thought necessary to choose a proper quantization table and examine the DC coefficients (number of pixels) in the DCT procedure to attain practical 2D-Color Doppler image compression by the JPEG method. Although attempts in Japan are being made to establish common standards for electronic data storage, based on MEDIS, in an effort to promote standardization there are many problems to be solved before practical use is possible. To ensure common availability as required by the technical standards, it is necessary to organize minimum-required specifications into common standards and make them open to the public.

[Anemia due to chronic lead poisoning].

We report a case of anemia due to chronic lead poisoning. A 46-year-old female was admitted to our hospital because of general fatigue and anemia. A peripheral blood smear showed basophilic stippling. There was basophilic stippling and nuclear dysplasia of erythroblasts in the bone marrow. Laboratory findings were as follows: RBC 296 X 10(4)/microliter, Hb 8.5 g/dl, blood lead concentration 67 micrograms/dl, urinary lead concentration 309 micrograms/l, blood delta-ALA dehydrase 0.03 mumol/ml, urinary delta-ALA 25.2 mg/l, urinary coproporphyrin 8,810 micrograms/g.Cr, and blood protoporphyrin 612 micrograms/dl. Chronic lead poisoning was diagnosed and she was treated with Ca-EDTA.

[Soluble interleukin-2 receptor and macrophage colony-stimulating factor (M-CSF) in cerebrospinal fluid in patients with hematological malignancies: clinical significance in adult T-cell leukemia with meningeal infiltration].

We measured soluble interleukin-2 receptor (sIL-2R) and macrophage colony-stimulating factor (M-CSF) levels in the cerebrospinal fluid (CSF) of patients with hematological malignancies with or without meningeal infiltration and meningitis. Levels of sIL-2R and M-CSF in the CSF of adult T-cell leukemia (ATL) patients with meningeal infiltration were significantly higher than those of ATL patients without meningeal infiltration and non-ATL patients with meningeal infiltration. There was a significant positive correlation between sIL-2R levels and numbers of mononuclear cells in CSF of ATL patients with meningeal infiltration. However, M-CSF levels did not correlate with numbers of mononuclear cells. There was no correlation between CSF and serum levels of sIL-2R. There was also no correlation between sIL-2R and M-CSF in the CSF. Therefore, sIL-2R and M-CSF levels in the CSF may be useful in the diagnosis of meningeal infiltration in patients with ATL. In particular sIL-2R may be a sensitive marker.

[Clinical significance of soluble interleukin-2 receptor levels in the cerebrospinal fluid in patients with adult T-cell leukemia complicated with meningeal infiltration].

We measured soluble interleukin-2 receptor (sIL-2R) levels in the cerebrospinal fluid (CSF) of patients with hematological malignancies especially, adult T-cell leukemia (ATL) and non-Hodgkin's lymphoma (NHL) with or without meningeal infiltration. CSF levels of sIL-2R were significantly higher in patients with ATL and NHL with meningeal infiltration than in patients with both diseases without meningeal infiltration. The sIL-2R levels in CSF were elevated in 4/4 ATL patients (100%) and 3/13 NHL patients (23%) with meningeal infiltration. CSF levels of sIL-2R from ATL patients with meningeal infiltration had a tendency to elevate in correlation with numbers of mononuclear cells and lactic dehydrogenase (LDH) in CSF. However, these had no correlation with serum levels of sIL-2R. Therefore, sIL-2 levels in CSF may be useful in the diagnosis of meningeal infiltration in patients with ATL, are probably specific markers for meningeal infiltration of ATL.

Disintegration of the 'waterfall phenomenon' in the inferior vena cava due to right heart failure.

The concept of the waterfall phenomenon in Zone 2 in the pulmonary vasculature is well known from West's lung model. It is believed that the flow through this zone is determined by the pressure difference between the pulmonary artery and alveoli, and the left atrial pressure is not transmissible to the alveolar capillaries. However, it is impossible to see whether alveolar capillaries are really displaying the waterfall phenomenon or not. In this review, the interrelation between the flow and geometry of the alveolar capillaries in the waterfall phenomenon is analyzed based on physiological studies using a model system and isolated lung lobe experiments. Further, extending the concept to the analysis of ventilatory changes of the inferior vena cava (IVC) configuration, it is ascertained that the waterfall phenomenon normally occurs in the IVC during inspiration just before it enters the thorax and the waterfall phenomenon in the IVC disintegrates with elevation of the central venous pressure. Because these configurations of the IVC in normal and abnormal conditions are visible with ultrasonography, the technique is very useful as a noninvasive approach to diagnose right heart failure.

Expression of the MAGE gene family in human lymphocytic leukemia.

The MAGE gene family, encoding tumor-rejection antigens recognized by cytotoxic T lymphocytes, is frequently expressed in human solid cancers. However, its expression in leukemia has not been well studied. We have investigated MAGE gene expression at the mRNA level in human leukemia. The MAGE gene family was expressed in 17 of 34 (50%) examples of T cell leukemia (12/21 patients' peripheral blood mononuclear cells and 5/13 cell lines), in 7 of 16 (44%) cases of B cell leukemia (1/8 and 6/8 respectively), but in none of 23 myelomonocytic leukemia cases (0/16 and 0/7), as evaluated by the primers common to the MAGE-1, -3, -4 (-4a and/or -4b), and -6 genes and the semi-quantificative reverse transcription/polymerase chain reaction method. None of a panel of normal lymphoid cells expressed the MAGE gene family. As revealed by the primers specific for each of the MAGE genes, the MAGE-1, -2, -3, -4 or -6 gene was expressed in 8, 8, 6, 2, or 6 respectively out of 23 types of leukemia cell lines. Expression of the MAGE-1 protein in both the cell lines and patients' cells was confirmed by immunoblot analysis with the polyclonal antibody to recombinant MAGE-1 protein. Cellular MAGE-4 protein in the cell lines was measured by an enzyme-linked immunosorbent assay with the polyclonal and monoclonal antibodies to recombinant MAGE-4b protein. In summary, the MAGE gene family was found to be expressed in the substantial proportion of T cell leukemias, but in no case of myelomonocytic leukemia. Antigens coded by the MAGE gene family could be important molecules for understanding specific immunity against lymphocytic leukemia.

[Digital analysis of pulmonary nodules--potential usefulness of computer-aided diagnosis for differentiation of benign from malignant nodules].

Digital analysis of 80 plain chest radiographs was done to differentiate benign from malignant pulmonary nodules. Each of 80 radiographs had a solitary pulmonary nodule, of which 40 were benign and the other 40 were malignant. Radiographic features of nodules were visually evaluated. Frequencies of the radiographic features described below were significantly different between benign and malignant nodules: irregular shape, vague density, well-defined contour, spicular formation, and vascular convergene. To digitally evaluate the density characteristics, two kinds of concentric circular windows were used, to allow analysis of intra-nodular, marginal and surrounding regions of the nodules. Seventeen digital parameters were obtained by computerized analysis with the windows. There were significant differences in six digital parameters; three of density gradient (one of intra-nodular and two of marginal regions), one DCF-N (directional contrast filter for nodule) output of intra-nodular region, and two of density entropy values of intra-nodular and surrounding regions. Density gradient parameters of marginal regions are believed to represent the features of nodular shape and spicula formation. With these six parameters, 70% of benign nodules and 85% of malignant nodules were correctly discriminated. These results suggest that computer-aided diagnosis may be used to differentiate benign from malignant nodules.

[Treatment of cancer and counter-measures for MRSA infections].

Patients with malignancy, especially those with hematological malignancy, are well known to be very susceptible to infection in general, because of bone marrow suppression induced by anticancer chemotherapy in addition to the nature of the disease itself. Accordingly, the risk of MRSA infection is very high in these patients, and the infection is often fatal. In an attempt to establish effective measures to prevent MRSA infection, we investigated the nosocomial spread of strains of MRSA and studied the characteristics of patients from the clinical standpoint. We found that strict isolation of patients with MRSA infection is an urgent necessity to prevent the intrahospital spread of MRSA strains and that disinfection of the hands of medical staff and sterilization of the environment are extremely important. In addition, due care must be taken to select an adequate antimicrobial agent and to determine the optimal dose and period for treatment of the infection in patients with malignancy to avoid selecting MRSA strains or inducing resistance in mecA positive strains of S. aureus. For treatment of MRSA infections in patients with malignancy, a combination chemotherapy with vancomycin (VCM), or arbekacin (ABK) plus beta-lactam antibiotic is recommended, and granulocyte colony stimulating factor (G-CSF) is clinically useful when the granulocytopenia was induced by chemotherapy.