Current status of the medical expenses for the treatment of arteriosclerosis obliterans in Japan

AIM

We aimed to determine the current status of the medical expenses for the treatment of arteriosclerosis obliterans (ASO) and evaluate the cost effectiveness of the medical practices employed in ASO treatment in Japan.

METHODS

We performed a prospective observational study using 140 ASO patients. The cost of the medical practices comprised the costs of outpatient treatment, pharmacological agents, and hospitalization. To compare the average monthly costs, the patients were divided into preintervention, postintervention, or conservative-therapy groups. To compare the total costs and effectiveness of each treatment, the patients who had first visited our division during the study period were classified into surgery, endovascular-revascularization (EVR), or conservative-therapy groups. The adverse reactions of the 4 most popular agents for ASO were investigated, and bleeding events were assessed specifically.

RESULTS

The average monthly costs for outpatient treatment and pharmacological agents were yen 168,002 in conservative cases, yen 149,871 in preoperation cases, and yen 128,527 in postoperation cases. The mean total costs were yen 5,407,950 in conservative cases, yen 7,375,290 in surgical cases, and yen 2,631,650 in EVR cases. The average change of the gauge in clinical status was 0.57 in conservative cases, 2.13 in surgical cases, and 2.25 in EVR cases. Warfarin induced more bleeding complications than the other agents.

CONCLUSION

The costs of pharmacological agents represented much of the medical costs in any treatment groups.

Formation of H3O+ from alcohols and ethers induced by intense laser fields

The processes of H(3)O(+) production from alcohols (ethanol, 2-propanol, 1-propanol, 2-butanol) and ethers (diethyl ether and ethyl methyl ether), and their deuterium-substituted species, by intense laser fields (800 nm, 100 fs, approximately 1 x 10(14) W/cm) were investigated through time-of-flight (TOF) mass spectrometry. H(3)O(+) formation was observed for all these compounds except for ethyl methyl ether. From the analysis of TOF signals of H((3-n))D(n)O(+) (n = 0, 1, 2, and 3) that have expanding tails with increasing flight time, it has been confirmed that the reaction proceeds through metastable dissociation from the intermediate species C(2)H((5-m))D(m)O(+)(m = 0-5). The common shape of the H((3-n))D(n)O(+) signal profiles contains two major distributions in the time constant, i.e., fast and slow components of <50 ns and approximately 500 ns, respectively. The H((3-n))D(n)O(+) branching ratio is interpreted to be the result of complete scrambling of four hydrogen atoms at the C-C site in C(2)H(4)-OH(+), and partial exchange (18-38%) of a hydrogen atom in the OH group with four other hydrogen atoms within 1 ns prior to H((3-n))D(n)O(+) production. Ab initio calculations for the isomers and transition states of C(2)H(5)O(+) were also performed, and the observed H((3-n))D(n)O(+) production mechanism has been discussed. In addition, a stable isomer having a complex structure and two isomerization pathways were discovered to contribute to the H(3)O(+) formation process.

Extending the search for neutrino point sources with IceCube above the horizon

Point source searches with the IceCube neutrino telescope have been restricted to one hemisphere, due to the exclusive selection of upward going events as a way of rejecting the atmospheric muon background. We show that the region above the horizon can be included by suppressing the background through energy-sensitive cuts. This improves the sensitivity above PeV energies, previously not accessible for declinations of more than a few degrees below the horizon due to the absorption of neutrinos in Earth. We present results based on data collected with 22 strings of IceCube, extending its field of view and energy reach for point source searches. No significant excess above the atmospheric background is observed in a sky scan and in tests of source candidates. Upper limits are reported, which for the first time cover point sources in the southern sky up to EeV energies.

Limits on a muon flux from neutralino annihilations in the sun with the IceCube 22-string detector

A search for muon neutrinos from neutralino annihilations in the Sun has been performed with the IceCube 22-string neutrino detector using data collected in 104.3 days of live time in 2007. No excess over the expected atmospheric background has been observed. Upper limits have been obtained on the annihilation rate of captured neutralinos in the Sun and converted to limits on the weakly interacting massive particle (WIMP) proton cross sections for WIMP masses in the range 250-5000 GeV. These results are the most stringent limits to date on neutralino annihilation in the Sun.

Limits on the high-energy gamma and neutrino fluxes from the SGR 1806-20 giant flare of 27 December 2004 with the AMANDA-II detector

On 27 December 2004, a giant gamma flare from the Soft Gamma-Ray Repeater 1806-20 saturated many satellite gamma-ray detectors, being the brightest transient event ever observed in the Galaxy. AMANDA-II was used to search for down-going muons indicative of high-energy gammas and/or neutrinos from this object. The data revealed no significant signal, so upper limits (at 90% C.L.) on the normalization constant were set: 0.05(0.5) TeV-1 m;{-2} s;{-1} for gamma=-1.47 (-2) in the gamma flux and 0.4(6.1) TeV-1 m;{-2} s;{-1} for gamma=-1.47 (-2) in the high-energy neutrino flux.

Hemodynamic influence of peripheral vascular occlusive disease on abdominal aortic aneurysms

AIM

Clinical evidence indicates that hemodynamic conditions such as peripheral vascular occlusive disease (PVOD) influence abdominal aortic aneurysm (AAA) disease.

METHODS

We retrospectively analyzed 406 operated cases of AAA at our institute over the last 15 years, and compared 39 patients with PVOD to those without, to examine hemodynamic effects and risk factors. Aneurysm size at operation, rupture, shape, expansion rate and several preoperative risk factors were compared.

RESULTS

Mean aortic diameter in the AAA with PVOD patients (56.8+/-17.8 mm) showed no significant difference to that in the AAA without PVOD group (60.4+/-14.8 mm). However, the subgroup of AAA with PVOD in whom the aneurysm was found prior to PVOD diagnosis (67.8+/-18.1 mm) (n=19) showed a larger mean AAA diameter compared to the AAA (not followed up until operative indication/prior to operation) without PVOD group (60.4+/-14.8 mm), (n=340), (p=0.04). Smoking was the only preoperative risk factor to show a difference between AAA patients with and without PVOD. The aneurysm expansion rate was determined retrospectively in 13 patients with PVOD who had been followed for at least 1 year by CT scan and 17 patients without PVOD. The rate in the PVOD group was 8.1 mm/year, which was significantly faster than that in PVOD-free patients (4.6 mm/year), (p=0.03).

CONCLUSIONS

The findings of a large diameter and fast expansion rate in AAA patients with concomitant PVOD suggest that the hemodynamic effects of PVOD have a great influence on AAA development.

Evidence for direct CP violation in B0-->K+pi- decays

We report evidence for direct CP violation in the decay B0-->K+pi(-) with 253 fb(-1) of data collected with the Belle detector at the KEKB e(+)e(-) collider. Using 275x10(6) BB pairs we observe a B-->K+/-pi(-/+) signal with 2140+/-53 events. The measured CP violating asymmetry is A(CP)(K+pi(-))=-0.101+/-0.025(stat)+/-0.005(syst), corresponding to a significance of 3.9sigma including systematics. We also search for CP violation in the decays B+-->K+pi(0) and B+-->pi(+)pi(0). The measured CP violating asymmetries are A(CP)(K+pi(0))=0.04+/-0.05(stat)+/-0.02(syst) and A(CP)(pi(+)pi(0))=-0.02+/-0.10(stat)+/-0.01(syst), corresponding to the intervals -0.05<A(CP)(K+pi(0))<0.13 and -0.18<A(CP)(pi(+)pi(0))<0.14 at 90% confidence level.

Observation of B(0)-->D((*)0)pp

The B meson decay modes B-->Dpp; and B-->D(*)pp; have been studied using 29.4 fb(-1) of data collected with the Belle detector at KEKB. The B;(0)-->D(0)pp; and B;(0)-->D(*0)pp; decays have been observed for the first time with branching fractions B(B;(0)-->D(0)pp;)=(1.18+/-0.15+/-0.16)x10(-4) and B(B;(0)-->D(*0)pp;)=(1.20(+0.33)(-0.29)+/-0.21)x10(-4). No signal has been found for the B+-->D(+)pp; and B+-->D(*+)pp; decay modes, and the corresponding upper limits at 90% C.L. are presented.

Observation of double cć production in e+e- annihilation at squareroot[s] approximately 10.6 GeV

We report the observation of prompt J/psi via double cc; production from the e+e- continuum. In this process one cc; pair fragments into a J/psi meson while the remaining pair either produces a charmonium state or fragments into open charm. Both cases have been experimentally observed. We find cross sections of sigma[e+e- -->J/psieta(c)(gamma)]xB(eta(c)-->>or=4 charged)=(0.033(+0.007)(-0.006)+/-0.009) pb and sigma(e+e- -->J/psiD(*+)X)=(0.53(+0.19)(-0.15)+/-0.14) pb and infer sigma(e+e- -->J/psicc;)/sigma(e+e- -->J/psiX)=0.59(+0.15)(-0.13)+/-0.12. These results are obtained from a 46.2 fb(-1) data sample collected near the Upsilon(4S) resonance, with the Belle detector at the KEKB collider.

Study of CP-violating asymmetries in B0-->pi(+)pi(-) decays

We present a measurement of CP-violating asymmetries in B0-->pi(+)pi(-) decays based on a 41.8 fb(-1) data sample collected at the Upsilon(4S) resonance with the Belle detector at the KEKB asymmetric-energy e(+)e(-) collider. We fully reconstruct one neutral B meson as a B0-->pi(+)pi(-) CP eigenstate and identify the flavor of the accompanying B meson from its decay products. From the asymmetry in the distribution of the time intervals between the two B meson decay points, we obtain the CP-violating asymmetry parameters S(pipi)=-1.21(+0.38)(-0.27)(stat)+0.16-0.13(syst) and A(pipi)=+0.94(+0.25)(-0.31)(stat)+/-0.09(syst).

Observation of chi(c2) production in B meson decay

We report the first observation of chi(c2) production in B meson decays. We find an inclusive B-->chi(c2)X branching fraction of (1.80(+0.23)(-0.28)+/-0.26) x 10(-3). The data set, collected with the Belle detector at the KEKB e(+)e(-) collider, consists of 31.9 x 10(6) BB events. We also present branching fractions and momentum spectra for both chi(c1) and chi(c2) production.

Measurement of the lifetime difference in D0 meson decays

We report a measurement of the D0-D macro(0) mixing parameter y(CP) using 23.4 fb(-1) of data collected near the Upsilon(4S) resonance with the Belle detector at KEKB. y(CP) is measured from the lifetime difference of D0 mesons decaying into the K(-)pi(+) state and the CP-even eigenstate K(-)K(+). We find y(CP) = (-0.5+/-1.0(+0.7)(-0.8))x10(-2), where the first error is statistical and the second is systematic, corresponding to a 95% confidence interval -0.030<y(CP)<0.020.

Observation of the color-suppressed decay B( 0)-->D(0)pi(0)

We report the first observation of color-suppressed B( 0)-->D(0)pi(0), D(*0)pi(0), D0eta, and D0omega decays, and evidence for B( 0)-->D(*0)eta and D(*0)omega. The branching fractions are B(B( 0)-->D0pi(0)) = (3.1 +/- 0.4 +/- 0.5)x10(-4), B(B( 0) -->D(*0)pi(0)) = (2.7(+0.8+0.5)(-0.7-0.6))x10(-4), B(B( 0) --> D0eta) = (1.4(+0.5)(-0.4) +/- 0.3)x10(-4), B(B( 0) --> D0omega) = (1.8 +/- 0.5(+0.4)(-0.3))x10(-4), and we set 90% confidence level upper limits of B(B( 0) --> D(*0)eta)<4.6 x 10(-4) and B(B( 0)-->D(*0)omega)<7.9 x 10(-4). The analysis is based on a data sample of 21.3 fb(-1) collected at the Upsilon(4S) resonance by the Belle detector at the KEKB e(+)e(-) collider.