Subendocardial Infarction in Severe Bicuspid Aortic Stenosis without Coronary Stenosis Confirmed by Contrast-enhanced Computed Tomography and Autopsy.

A 59-year-old man with aortic stenosis (AS) showed cardiopulmonary arrest requiring extracorporeal circulation. Although coronary angiography did not show coronary artery stenosis, he had an elevated creatine kinase-myocardial band value of 1,298 U/L. Echocardiography revealed severe AS and global hypokinesia of the thickened myocardium. Contrast-enhanced computed tomography (CT) detected a circumferential subendocardial perfusion defect of the left ventricular myocardium. Eventually, the patient died from brain anoxia. Autopsy revealed circumferential subendocardial infarction of the left ventricular myocardium. This is the first case of circumferential subendocardial defect on CT corresponding to circumferential subendocardial infarction on autopsy in severe AS without coronary stenosis.

Near-superhydrophobic silicone microcapsule arrays encapsulating ionic liquid electrolytes for micro-power storage assuming use in seawater.

Micro-energy storage, which is convenient for combination with energy harvesting, is known to be realized by microencapsulation with various shell materials, its application is limited to land. Here, we succeeded in fabricating a silicone microcapsule array encapsulating an ionic liquid electrolyte that can store minute power in NaCl solution as well as a minute power generation method. The ArF excimer laser-irradiated silicone rubber underneath silica microspheres was photochemically and periodically swelled by the photodissociation of silicone. Accompanied by the microswellings, the lower molecular weight silicones generated were ejected along a curvature of each the microsphere to enclose the microspheres. After the chemical etching, the silicone microcapsule arrays became hollow. Moreover, each the hollow silicone microcapsule could entrap an ionic liquid in a vacuum. In addition, the silicone microcapsules before and after the encapsulating ionic liquid showed a superhydrophobic or near-superhydrophobic property. As a result, the silicone microcapsule arrays could be confined in a uniform air gap of electrically insulated region in NaCl solution. This means that each the silicone microcapsule encapsulating ionic liquid as electrolytes enables to function as an electric double layer capacitor for micro-power storage, aiming to connect with Internet of Things devices that work under seawater.

Ventricular septal perforation naturally reduced in takotsubo cardiomyopathy.

An 80-year-old female was transferred to our hospital with dyspnea. Chest X-ray showed severe pulmonary congestion and electrocardiogram showed ST-segment elevation, abnormal Q, and negative T waves in leads V1-4. Transthoracic echocardiography demonstrated left ventricular apical akinesia with apical ventricular septal perforation. Emergent coronary angiography showed no coronary artery stenosis, and right-heart catheterization revealed a pulmonary to systemic flow ratio (Qp/Qs) of 2.2 on oximetry run. She was diagnosed with takotsubo cardiomyopathy with an associated complication of ventricular septal perforation. Her cardiac function gradually improved with nonsurgical treatment. An oximetry run performed 67 days later revealed that Qp/Qs decreased to 1.2. The size of ventricular septal perforation associated with takotsubo cardiomyopathy reduces naturally by conservative treatment, unlike that in acute myocardial infarction. .

O2 solvation cavity in voids of ionic liquids studied by the solvatochromic red shift of O2(1Δg) phosphorescence.

Phosphorescence spectroscopy of singlet oxygen [=O2(1Δg)] was applied to study the solvation properties of small solute molecule, O2, in ionic liquids. Unlike conventional molecular solvents, the spectral red shift of the O2(1Δg) phosphorescence in ionic liquids from the gas phase was found to depend not only on the refractive index of solvents but also on the vdW volume of anions. This unusual spectral shift of the O2(1Δg) luminescence is interpreted by considering the size of solvation cavities in voids, which is estimated by analyzing the free volume in ionic liquids. These results suggest the potential of the O2(1Δg) phosphorescence spectral shift measurement in the study of molecular-scale voids in ionic liquids.

Effect of jaw clenching on head acceleration during a predictable load impact.

BACKGROUND: Jaw clenching is considered to reduce head acceleration while receiving a strong impact on the body during sport activities. OBJECTIVE: The present study aimed to clarify the effect of jaw clenching on reduction of head acceleration during a predictable load impact to the body. METHODS: Seven healthy participants were exposed to a predictable load impact with and without jaw clenching. We recorded the electromyographic activity of the masseter (MA) and digastricus (DIG) muscles, occlusal pressure and head acceleration throughout the experiment. RESULTS: When participants were not instructed to clench their jaws, they naturally positioned their jaws without occlusal contact at the time of pendulum impact by co-contracting the jaw opener and closer muscles. When participants were instructed to clench their jaws, neither the activity of the jaw opener muscle nor the head acceleration differed at the time of pendulum impact when compared with when participants were not instructed to clench their jaws. CONCLUSIONS: A slightly distanced jaw position (co-contracting the jaw opener and closer muscles without occlusal contact) might serve inherently safety for reduction of head acceleration during predictable body impact, while jaw clenching does not contribute to reduction of head acceleration in response to pendulum impact more than the distanced jaw position does. Notably, DIG activation to minimise the head acceleration in response to pendulum impact was similar in clenching and no clenching positions. This suggests that DIG may play a crucial role in the reduction of head acceleration, regardless of MA muscle activity.

[A Case of Ramucirumab-Related Small Intestinal Perforation in Gastric Cancer].

A 54-year-old man underwent laparoscopic distal gastrectomy with D2 lymph node dissection and ante-colic Roux-en-Y reconstruction for gastric cancer. The histopathological diagnosis was pT2N3aM0, pStage ⅢA, HER2 negative. After 8 courses of S-1 plus oxaliplatin as adjuvant chemotherapy, he was diagnosed as peritoneal dissemination and treated with ramucirumab(RAM)plus paclitaxel(PTX). On the 12th day of course 10, he visited to our hospital with abdominal pain. CT showed free air and massive ascites. Emergent surgery was performed under the diagnosis of gastrointestinal perforation. A small intestinal perforation in front of the jejunal limb near gastric-jejunal anastomosis was identified and there was no peritoneal dissemination. We performed partial resection of remnant stomach and jejunal limb by linear stapler and reconstruction by end to side gastric-jejunal anastomosis. Because the gastric and intestinal wall were quite fragile and RAM impaired wound healing as adverse event, we feared about leakage, but he had no major postoperative complications and discharged on the 33th day after surgery. After 24 courses of nivolumab as third-line chemotherapy, the peritoneal dissemination disappeared. He has been alive without recurrence for about 1 year since then.

Usefulness of Repeat Angiography to Establish Spontaneous Coronary Artery Dissection in Small Vessels.

Background: Spontaneous coronary artery dissection (SCAD) is a rare disease that is often misdiagnosed, except in typical cases. Although intracoronary imaging and multislice coronary computed tomography angiography (CCTA) are useful in establishing dissection, they may not be feasible in all instances, especially in small vessels. Methods and Results: We describe a series of 7 patients with acute coronary syndrome secondary to small vessel SCAD that was detected only upon repeat coronary angiography (CAG). This cohort had a mean (±SD) age of 50±6 years, was predominantly female (n=6; 86%), and had few coronary risk factors. Three patients (43%) had dissection of the distal segment of the right coronary artery, 3 (43%) had distal left circumflex artery dissection, and 1 patient (14%) had a diagonal branch dissection. None of the patients required percutaneous coronary intervention, and received conservative therapy only, because the infarct area was sufficiently small. No definitive diagnosis of SCAD could be established in any of the patients at first admission because CAG alone or CCTA did not reveal the presence of a flap or intraluminal hemorrhage. However, in such patients without a definitive diagnosis, repeat CAG in the chronic stage showed enlargement of vessels, suggesting the healing of an SCAD. Conclusions: Repeat CAG may be useful for suggesting the occurrence of SCAD.

[A Case of Metastatic Colorectal Cancer with Hyperammonemic Encephalopathy Induced by mFOLFOX6 and SOX Therapy].

A 77-year-old man was given a diagnosis of pT4aN0M1a(PUL2), stage Ⅳ, RAS mutant type, after the operation for advanced ascending colon cancer. He was administered mFOLFOX6 plus Bmab as first-line chemotherapy. He showed consciousness disturbance on the 2nd day during the 6 cycles. Because of head computed tomography and magnetic resonance imaging showing no abnormal findings, we diagnosed convulsive seizure. His consciousness level gradually improved after intravenous infusion. He showed consciousness disturbance on the 2nd day during the 7 cycles again. Because blood ammonia level were high at 400µg/dL, he was diagnosed as hyperammonemic encephalopathy. His consciousness level rapidly recovered after branched chain amino acid(BCAA)infusion. SOX plus Bmab therapy was started as a post-treatment, he developed hyperammonemia(NH3 288µg/dL)again, on the 4th day during the 3 cycles. After taking of oral administration of BCAA and lactulose, the recurrence of hyperammonemic encephalopathy was not found. Therefore, 3 cycles of SOX plus Bmab therapy and 12 cycles of IRIS plus Bmab therapy were administered.

Effects of culling intensity on diel and seasonal activity patterns of sika deer (Cervus nippon).

Adaptive hunting management is commonly used for controlling the populations of overabundant large herbivores; however, induced behavioural changes can make the effective control of target populations difficult. However, few studies have compared the impact of different levels of hunting intensities on the activity patterns of ungulates before, during, and after a culling program. We investigated how different culling intensities affect the activity patterns of sika deer on Nakanoshima Island in Lake Toya, Hokkaido, Japan using camera-trap surveys comparing the period of treatment before, during, and after a culling program. We used the number of deer photographed per hour per camera as an index of activity. Sika deer showed consistent crepuscular activity patterns (i.e., dawn and dusk) during spring-summer and trimodal activity patterns (i.e., dawn, dusk, and midnight) in autumn throughout the study period. In response to increased culling intensity, the activity peaks shifted slightly towards the night. The shift towards nocturnal activity persisted during post-culling period. Understanding the changes in activity patterns in response to culling intensity could be used to facilitate population control and assist in establishing a night shooting program. Thus, wildlife managers should consider night shooting once hunting during day time has shifted the normal diurnal activity of deer to nocturnal activity.

Overhead-optimization of pilot-based digital signal processing for flexible high spectral efficiency transmission.

We present a low-complexity fully pilot-based digital signal processing (DSP) chain designed for high spectral efficiency optical transmission systems. We study the performance of the individual pilot algorithms in simulations before demonstrating transmission of a 51×24 Gbaud PM-64QAM superchannel over distances reaching 1000 km. We present an overhead optimization technique using the system achievable information rate to find the optimal balance between increased performance and throughput reduction from adding additional DSP pilots. Using the optimal overhead of 2.4%, we report 9.3 (8.3) bits/s/Hz spectral efficiency, or equivalently 11.9 (10.6) Tb/s superchannel throughput, after 480 (960) km of transmission over 80 km spans with EDFA-only amplification. Moreover, we show that the optimum overhead depends only weakly on transmission distance, concluding that back-to-back optimization is sufficient for all studied distances. Our results show that pilot-based DSP combined with overhead optimization can increase the robustness and performance of systems using advanced modulation formats while still maintaining state-of-the-art spectral efficiency and multi-Tb/s throughput.

Differences in edge artifacts between 68Ga- and 18F-PET images reconstructed using point spread function correction.

OBJECTIVE: Edge artifacts have been reported on in relation to F-PET using point spread function correction algorithms. The positron range of Ga is longer than F, and this difference is thought to result in different edge artifacts. The purpose of this study is to clarify the difference in edge artifacts in PET images using point spread function correction in Ga- and F-PET. METHODS: We used a National Electrical Manufacturers Association International Electrotechnical Commission body phantom. The phantom was filled severally with Ga and F solution. The PET data were obtained over a 90 minutes period using a True Point Biograph 16 scanner. The images were then reconstructed with the ordered subset expectation maximization with point spread function correction. The phantom image analyses were performed by a visual assessment of the PET images and profiles, and an absolute recovery coefficient, which was the ratio of the maximum radioactivity of any given hot sphere to its true radioactivity. RESULTS: The ring-like edge artifacts of Ga-PET were less prominent than those in F-PET. The relative radioactivity profiles of Ga-PET showed low overshoots of the maximum radioactivity although high overshoots did appear in F-PET. The absolute recovery coefficients of Ga-PET were smaller than those of F-PET. CONCLUSION: The edge artifacts of Ga-PET were less prominent than those of F-PET, and their overshoots were smaller. The difference in the positron range between Ga and F may possibly result in the difference in edge artifacts of images reconstructed using the point spread function correction algorithm.

Influence of region-of-interest determination on measurement of signal-to-noise ratio in liver on PET images.

OBJECTIVE: On 18F-fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography (PET), signal-to-noise ratio in the liver (SNRliver) is used as a metric to assess image quality. However, some regions-of-interest (ROIs) are used when measuring the SNRliver. The purpose of this study is to examine the different ROIs and volumes of interest (VOIs) to obtain a reproducible SNRliver. METHODS: This study included 108 patients who underwent 18F-FDG-PET/CT scans for the purpose of cancer screening. We examined four different ROIs and VOIs; a 3-cm-diameter and a 4-cm-diameter circular ROI and a 3-cm-diameter and a 4-cm-diameter spherical VOI on the right lobe of the patients' livers. The average of SUV (SUVmean), standard deviation (SD) of SUV (SUVSD), SNRliver and SD of the SNRliver obtained using ROIs and VOIs were then compared. RESULTS: Although the SUVmean was not different among the ROIs and VOIs, the SUVSD was small with a 3-cm-diameter ROI. The largest SUVSD was obtained with a 4-cm-diameter spherical VOI. The SNRliver and the SD of the SNRliver with a 4-cm-diameter spherical VOI were the smallest, while those with a 3-cm-diameter circular ROI were the largest. These results suggest that a small ROI may be placed on a relatively homogeneous region not representing whole liver unintentionally. CONCLUSION: The SNRliver varied according to the shape and size of ROIs or VOIs. A 4-cm-diameter spherical VOI is recommended to obtain stable and reproducible SNRliver.

Seasonal and year-round use of the Kushiro Wetland, Hokkaido, Japan by sika deer (Cervus nippon yesoensis).

The sika deer (Cervus nippon yesoensis) population in the Ramsar-listed Kushiro Wetland has increased in recent years, and the Ministry of the Environment of Japan has decided to take measures to reduce the impact of deer on the ecosystem. However, seasonal movement patterns of the deer (i.e., when and where the deer inhabit the wetland) remain unclear. We examined the seasonal movement patterns of sika deer in the Kushiro Wetland from 2013 to 2015 by analyzing GPS location data for 28 hinds captured at three sites in the wetland. Seasonal movement patterns were quantitatively classified as seasonal migration, mixed, dispersal, nomadic, resident, or atypical, and the degree of wetland utilization for each individual was estimated. The area of overlap for each individual among intra-capture sites and inter-capture sites was calculated for the entire year and for each season. Our results showed that the movement patterns of these deer were classified not only as resident but also as seasonal migration, dispersal, and atypical. Approximately one-third of the individuals moved into and out of the wetland during the year as either seasonal migrants or individuals with atypical movement. Some of the individuals migrated to farmland areas outside the wetland (the farthest being 69.9 km away). Half of the individuals inhabited the wetland all or most of the year, i.e., 81-100% of their annual home range was within the wetland area. Even among individuals captured at the same site, different seasonal movement patterns were identified. The overlap areas of the home ranges of individuals from the same capture sites were larger than those for individuals from different capture sites (e.g., mean of annual home range overlap with intra-capture sites: 47.7% vs. inter-sites: 1.3%). To achieve more effective ecosystem management including deer management in the wetland, management plans should cover inside and outside of the wetland and separate the population into multiple management units to address the different movement patterns and wetland utilization of the population.

[A Case of Gallbladder Carcinoma Producing Alpha-Fetoprotein(AFP)with Metastatic Liver Tumor].

Gallbladder carcinoma producing alpha-fetoprotein(AFP)is rare.We report a case of AFP producing carcinoma of the gallbladder with huge metastatic hepatic tumor.A 81-year-old female with a hepatitis B virus(HBV)had a fever and right hypochondralgia.Abdominal CT showed an enlarged gallbladder with gallbladder stones, a huge tumor in the right lobe of liver, and swelling paraaortic lymph nodes.Acute cholecystitis was treated by percutaneous transhepatic gallbladder drainage (PTGBD).The hepatic tumor was diagnosed as hepatocellular carcinoma for HBV carrier and the high level of AFP and PIVKA- II .We performed right lobectomy, cholecystectomy and the resection of paraaortic lymph nodes.In the resected gallbladder, the papillary tumor was detected.Histopathological diagnosis was moderately to poorly differentiated adenocarcinoma of the gallbladder.The liver tumor and paraaortic lymph nodes were metastases of the gallbladder carcinoma.The both of gallbladder and liver tumor immunohistochemically stained positive to AFP.It was difficult to diagnose the hepatic tumor because of HBV carrier, the high level of AFP and the unnoticed gallbladder tumor.Gallbladder carcinoma with the high level of AFP might have relation to liver metastases.

Improved 68 Ga-labeling method using ethanol addition: Application to the α-helical peptide DOTA-FAMP.

We examined the 68 Ga labeling of the α-helical peptide, DOTA-FAMP, and evaluated conformational changes during radiolabeling. 68 Ga-DOTA-FAMP is a positron emission tomography probe candidate for atherosclerotic plaques. The labeling yield achieved by Zhernosekov's method (using acetone for 68 Ga purification) was compared with that achieved by the original and 2 modified Mueller's methods (using NaCl solution). Modified method I involves desalting the 68 Ga prior to labeling, and modified method II involves the inclusion of ethanol in the labeling solution. The labeling yield using Zhernosekov's method was 62% ± 5.4%. In comparison, Mueller's original method gave 8.9% ± 1.7%. Modified method I gave a slight improvement of 32% ± 2.1%. Modified method II further increased the yield to 66% ± 3.4%. Conformational changes were determined by circular dichroism spectroscopy, revealing that these differences could be attributed to conformational changes. Heat treatment affects peptide conformation, which leads to aggregation and decreases the labeling yield. Mueller's method is simpler, but harsh conditions preclude its application to biomolecules. To suppress aggregation, we included a desalting process and added ethanol in the labeling solution. These changes significantly improved the labeling yield. Before use for imaging, conformational changes of biomolecules during radiolabeling should be evaluated by circular dichroism spectroscopy to ensure the homogeneity of the labeled product.

Phase I/II study of the oral retinoid X receptor agonist bexarotene in Japanese patients with cutaneous T-cell lymphomas.

Safety, tolerability, pharmacokinetics and efficacy of bexarotene, a novel retinoid X receptor (RXR)-selective retinoid, were evaluated in Japanese patients with stage IIB-IVB and relapsed/refractory stage IB-IIA cutaneous T-cell lymphomas (CTCL). This study was conducted as a multicenter, open-label, historically controlled, single-arm phase I/II study. Bexarotene was p.o. administrated once daily at a dose of 300 mg/m2 for 24 weeks in 13 patients, following an evaluation of safety and tolerability for 4 weeks at a dose of 150 mg/m2 in three patients. Eight of 13 patients (61.5%) with an initial dose of 300 mg/m2 met the response criteria using the modified severity-weighted assessment tool (mSWAT) at 24 weeks or discontinuation. Dose-limiting toxic effects (DLT) were present in four of 13 patients (31%) at a dose of 300 mg/m2 : two neutropenia, one abnormal hepatic function and one hypertriglyceridemia. No DLT was observed in patients received 150 mg/m2 bexarotene. In the 13 patients at 300 mg/m2 , common drug-related adverse events (AE) included hypothyroidism (92%), hypercholesterolemia (77%), leukopenia or neutropenia (39%), nasopharyngitis or anemia (31%). The treatment-related grade 3 AE included hypertriglyceridemia (4/16 patients, 25%), increased alanine aminotransferase, increased aspartate aminotransferase, dyslipidaemia, leukopenia and neutropenia (1/16 patients, 6%), and one of 16 patients experienced grade 4 hypertriglyceridemia. No patients discontinued bexarotene due to the AE during the study, but dose reduction or suspension was required. Bexarotene was shown to be well tolerated at 300 mg/m2 once daily and effective in Japanese patients with CTCL.

Seasonal and Diel Activity Patterns of Eight Sympatric Mammals in Northern Japan Revealed by an Intensive Camera-Trap Survey.

The activity patterns of mammals are generally categorized as nocturnal, diurnal, crepuscular (active at twilight), and cathemeral (active throughout the day). These patterns are highly variable across regions and seasons even within the same species. However, quantitative data is still lacking, particularly for sympatric species. We monitored the seasonal and diel activity patterns of terrestrial mammals in Hokkaido, Japan. Through an intensive camera-trap survey a total of 13,279 capture events were recorded from eight mammals over 20,344 camera-trap days, i.e., two years. Diel activity patterns were clearly divided into four categories: diurnal (Eurasian red squirrels), nocturnal (raccoon dogs and raccoons), crepuscular (sika deer and mountain hares), and cathemeral (Japanese martens, red foxes, and brown bears). Some crepuscular and cathemeral mammals shifted activity peaks across seasons. Particularly, sika deer changed peaks from twilight during spring-autumn to day-time in winter, possibly because of thermal constraints. Japanese martens were cathemeral during winter-summer, but nocturnal in autumn. We found no clear indication of predator-prey and competitive interactions, suggesting that animal densities are not very high or temporal niche partitioning is absent among the target species. This long-term camera-trap survey was highly cost-effective and provided one of the most detailed seasonal and diel activity patterns in multiple sympatric mammals under natural conditions.

Comparison of Drive Counts and Mark-Resight As Methods of Population Size Estimation of Highly Dense Sika Deer (Cervus nippon) Populations.

Assessing temporal changes in abundance indices is an important issue in the management of large herbivore populations. The drive counts method has been frequently used as a deer abundance index in mountainous regions. However, despite an inherent risk for observation errors in drive counts, which increase with deer density, evaluations of the utility of drive counts at a high deer density remain scarce. We compared the drive counts and mark-resight (MR) methods in the evaluation of a highly dense sika deer population (MR estimates ranged between 11 and 53 individuals/km2) on Nakanoshima Island, Hokkaido, Japan, between 1999 and 2006. This deer population experienced two large reductions in density; approximately 200 animals in total were taken from the population through a large-scale population removal and a separate winter mass mortality event. Although the drive counts tracked temporal changes in deer abundance on the island, they overestimated the counts for all years in comparison to the MR method. Increased overestimation in drive count estimates after the winter mass mortality event may be due to a double count derived from increased deer movement and recovery of body condition secondary to the mitigation of density-dependent food limitations. Drive counts are unreliable because they are affected by unfavorable factors such as bad weather, and they are cost-prohibitive to repeat, which precludes the calculation of confidence intervals. Therefore, the use of drive counts to infer the deer abundance needs to be reconsidered.

Physicochemical and biological characterizations of Pxt peptides from amphibian (Xenopus tropicalis) skin.

Pxt peptides (Pxt-1 through Pxt-12) have been isolated from amphibian, Xenopus tropicalis Pxt-related peptides (Pxt-2, Pxt-5, Pxt-12, reverse Pxt-2, reverse Pxt-5 and reverse Pxt-12) with significant foaming properties were further characterized. In the physicochemical experiments, all Pxt-related peptides formed significant amphiphilic α-helices in 50% 2,2,2-trifluoroethanol by circular dichroism measurements. Among Pxt-related peptides, both Pxt-5 and reverse Pxt-5 were the most effective in reducing their surface tensions. Moreover, Pxt-2, Pxt-5 and reverse Pxt-5 produced constant surface tensions above their critical association concentrations, suggesting the micelle-like assemblies. In the biological experiments, Pxt-5 possessed the most potent hemolytic activity, while reverse Pxt-5 exhibited the most remarkable gene expression of interleukin 8 and heme oxygenase 1 and the most potent cytotoxicity in HaCaT cells. In contrast, Pxt-12 and reverse Pxt-12 were much weaker in antimicrobial assays for Gram-negative bacteria, Gram-positive bacteria and yeasts, as well as in hemolytic, cell viability and cytotoxicity assays in HaCaT cells. All Pxt-related peptides exhibited about 20-50% of the total cellular histamine release at 10(-5) M, as well as mastoparan and melittin in mast cells. Real-time polymerase chain reaction analysis confirmed the gene expressions of Pxt-5 in testis and Pxt-12 in muscle, in addition to skin, while Pxt-2 was only in skin.