Accuracy of brain perfusion single-photon emission computed tomography for detecting misery perfusion in adult patients with symptomatic ischemic moyamoya disease

OBJECTIVE

The purpose of the present study was to determine how accurately relative cerebral blood flow (RCBF) and relative cerebrovascular reactivity (RCVR) to acetazolamide assessed using brain perfusion single-photon emission computed tomography (SPECT) detected misery perfusion identified on positron emission tomography (PET) in adult patients with ischemic moyamoya disease (MMD).

METHODS

Oxygen extraction fraction (OEF), RCBF, and RCVR were assessed using ¹⁵O gas PET and N-isopropyl-p-[¹²³I]-iodoamphetamine SPECT without and with acetazolamide challenge, respectively, in 45 patients. Regions of interest (ROIs) were automatically placed in the five middle cerebral artery (MCA) territories in the symptomatic cerebral hemisphere and in the ipsilateral cerebellar hemisphere using a three-dimensional stereotaxic ROI template. For RCBF and RCVR to acetazolamide, the ratio of the MCA ROI to cerebellar ROI was calculated. Of the five MCA ROIs in the symptomatic cerebral hemisphere in each patient, the ROI with the highest and lowest OEF value (two ROIs per patient) was selected for analyses.

RESULTS

A significant square or linear correlation was observed between the OEF and RCBF (correlation coefficient, 0.780) or RCVR (correlation coefficient, - 0.345), respectively. The area under the receiver operating characteristic curve for detecting misery perfusion (OEF > 51.3%) was significantly greater for the RCBF than for the RCVR (difference between areas, 0.221; p < 0.0001). Sensitivity, specificity, and positive- and negative-predictive values for the RCBF for detecting misery perfusion were 100, 91, 67, and 100%, respectively. The specificity and positive-predictive value did not differ between the combination of the RCBF and RCVR and the CBF ratio alone.

CONCLUSIONS

RCBF assessed using brain perfusion SPECT detects misery perfusion with high sensitivity, a high negative-predictive value, and a low positive-predictive value in adult patients with ischemic MMD. The accuracy of RCVR to acetazolamide assessed using brain perfusion SPECT is lower than that of RCBF.

Microbes Culture System Using Cellulose Tubes and Photocatalyst-Coated Glass Balls

Currently, microbes are utilized in many fields, such as medicine, food and environment etc. For more application of microbes, we need a new culture system, which can culture target microbes in large quantities at low cost. Thereupon, we propose a culture system using cellulose tubes. Target microbes are encapsulated inside the cellulose tubes, where they acquire nutrients and oxygen through nano pores of the tubes and are protected from competitive microbes even in open environment. To further increase the amount of oxygen and nutritions available for the target microbes, we propose photocatalyst-coated glass balls (PCGB) to sterilize competing microbes outside the tubes. We experimentally verified the effectiveness of the proposed culture system by culturing Coryne gultamicum as the target microbes.

Rikkunshito simultaneously improves dyspepsia correlated with anxiety in patients with functional dyspepsia: A randomized clinical trial (the DREAM study)

BACKGROUND

Functional dyspepsia (FD), a heterogeneous disorder, involves multiple pathogenetic mechanisms. Developing treatments for FD has been challenging. We performed a randomized, placebo-controlled, double-blind clinical trial to determine the efficacy of rikkunshito, a Japanese herbal medicine, in FD patients.

METHODS

FD patients (n = 192) who met the Rome III criteria without Helicobacter pylori infection, predominant heartburn, and depression were enrolled at 56 hospitals in Japan. After 2 weeks of single-blind placebo treatment, 128 patients with continuous symptoms were randomly assigned to 8 weeks of rikkunshito (n = 64) or placebo (n = 61). The primary efficacy endpoint was global assessment of overall treatment efficacy (OTE). The secondary efficacy endpoints were improvements in upper gastrointestinal symptoms evaluated by the Patient Assessment of Upper Gastrointestinal Disorders-Symptom Severity Index (PAGI-SYM), the Global Overall Symptom scale (GOS), and the modified Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease (m-FSSG), and psychological symptoms evaluated by the Hospital Anxiety and Depression Scale (HADS).

KEY RESULTS

Rikkunshito increased OTE compared to placebo at 8 weeks (P = .019). Rikkunshito improved upper gastrointestinal symptoms (PAGI-SYM, GOS, and m-FSSG) at 8 weeks, especially postprandial fullness/early satiety (P = .015 and P = .001) and bloating (P = .007 and P = .002) of the PAGI-SYM subscales at 4 weeks and 8 weeks. Improvement of HADS at 8 weeks (P = .027) correlated with those of PAGI-SYM (r = .302, P = .001), GOS (r = .186, P = .044), and m-FSSG (r = .462, P < .001), postprandial fullness/early satiety (r = .226, P = .014), dyspepsia (r = .215, P = .019), and PDS (r = .221, P = .016).

CONCLUSION & INFERENCES

Rikkunshito may be beneficial for FD patients to simultaneously treat gastrointestinal and psychological symptoms.

Unruptured Saccular Aneurysm Arising from the Fenestrated A1 Segment of the Anterior Cerebral Artery: Report of 2 Cases

Some cases of aneurysms originating from the fenestrated A1 segment of the anterior cerebral artery (ACA) have been reported, but the pitfalls of the surgical procedure have not been well determined. We herein report 2 cases of a saccular aneurysm arising from the fenestrated A1 segment. Case 1 was a 72-year-old man incidentally diagnosed with an unruptured left ACA aneurysm on magnetic resonance imaging (MRI). Cerebral angiography revealed a saccular aneurysm arising from the proximal end of the left A1 segment. He underwent surgical clipping via the left pterional approach. The aneurysm originated from the proximal bifurcation of the fenestrated left A1 segment. A fenestrated ring clip was applied to obliterate the aneurysmal neck and one small fenestrated trunk, preserving the other fenestrated trunk and perforators around the fenestration. Case 2 was a 73-year-old man incidentally diagnosed with an unruptured ACA aneurysm on MRI. Cerebral angiography revealed a saccular aneurysm arising from the proximal end of the fenestrated left A1 segment. He underwent surgical clipping via the interhemispheric approach. The aneurysm originated from the proximal bifurcation of the fenestrated left A1 segment. A fenestrated ring clip was applied to obliterate the aneurysmal neck and one hypoplastic fenestrated trunk, preserving the other fenestrated trunk and perforators around the aneurysm. Detailed intraoperative evaluations of the anatomical structure and hemodynamics around the fenestration are important. The intentional obliteration of a fenestrated trunk and application of fenestrated clips need to be considered in difficult cases in order to expose the aneurysmal neck.

Baseline biomarkers of connectome disruption and atrophy predict future processing speed in early multiple sclerosis

The development of accurate prognoses in multiple sclerosis is difficult, as the disease is characterized by heterogeneous patterns of brain abnormalities that relate in an unclear way to future impairments. Here, we use a statistical modeling approach to determine if the baseline pattern of connectome disruption due to T2-FLAIR lesions could predict a patient's future processing speed, as measured using the Symbol Digits Modality Test scores. Imaging data, demographics and Symbol Digits Modality Test scores were collected from 61 early relapsing remitting multiple sclerosis patients. The Network Modification Tool was used to estimate damage to the connectome by quantifying white matter abnormalities' effects on 1) global network properties, 2) regional connectivity and 3) connectivity between pairs of regions. MS subjects showed significant improvement of processing speed between baseline and follow-up (t = −2.6, p = 0.0096); however, both baseline (t = −4.01, p = 0.00012) and follow-up (t = −2.10, p = 0.038) processing speed were significantly lower than age-matched healthy controls. Partial Least Squares Regression was used to create models that predict future processing speed from between baseline imaging metrics and demographics. The model based on region-pair disconnection and gray matter atrophy had the lowest AIC and highest prediction accuracy (R² = 0.79) compared to models based on global (R² = 0.41) or regional (R² = 0.66) disconnection and gray matter atrophy, overlap with an ROI-based atlas and gray matter atrophy (R² = 0.73) or gray matter atrophy alone (R² = 0.71). We found that baseline measures of connectivity disruption in various parietal, temporal, occipital and subcortical regions and atrophy in the putamen were important predictors of future processing speed. We conclude that information about disruptions to pairwise brain connections is more informative of future processing speed than regional or global metrics or gray matter atrophy alone. The combination of quantitative disconnectome metrics, gray matter atrophy and statistical modeling approaches could enable clinicians in developing more accurate, individualized prognoses of future cognitive status in multiple sclerosis patients.

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Atrophy and structural disconnection estimates via NeMo Tool were collected in MS.

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Future cognitive functioning in MS patients was predicted by baseline MRI measures.

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Measures of atrophy and disconnection between region-pairs had best goodness-of-fit.

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More caudate atrophy was significantly predictive of worse future cognition.

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Disconnections in parietal/temporal/occipital areas predicted worse future cognition.

Evolution of spall-damage in iron caused by repeated plate impacts: Ultrasonic evaluation

This paper focuses on the developed of spall-damage that occurs in pure iron as a result of repeated impact. The employed low-frequency scanning acoustic microscopy (LF-SAM) observations combined with the measurements of ultrasonic wave velocity, attenuation, backscattering intensity and amplitude spectrum of the reflected wave, enabled us to provide a nondestructive evaluation. The spall-damage distribution was analyzed in the C-scan images, and we found the spall-damage increase with impact stress when the latter exceeds the characteristic spall-threshold stress. Moreover, we recorded the decreased sound velocity, amplitude ratio, and the increase of backscattering intensity, significant attenuation (the high frequency component of the reflected wave) for enhanced impact stress. It was also demonstrated that the tiny cracks generated in iron develop significantly during subsequent impacts either with lower or higher impact stress. Since the presented results concern for the first time the multiple-impact experiments, we contend that the applied ultrasonic investigations constitute the effective method of nondestructive spall-damage evaluation.

Comparison of Three-Dimensional T1-Weighted Magnetic Resonance and Contrast-Enhanced Ultrasound Plaque Images for Severe Stenosis of the Cervical Carotid Artery

BACKGROUND AND PURPOSE

Magnetic resonance (MR) and contrast-enhanced ultrasound assess characteristics and neovascularization, respectively, of the carotid plaque. The purpose of the present study was to clarify how findings of contrast-enhanced ultrasound plaque imaging are related to those of 3-dimensional (3D) fast spin echo (FSE) T1-weighted MR plaque imaging (WI) in severe stenosis (≥70%) of the cervical carotid artery.

METHODS

Fifty-three patients underwent 3D FSE T1-WI and contrast-enhanced ultrasound. For each patient, the averaged contrast ratio on MR (CR_MR) was calculated by dividing the averaged internal carotid artery plaque signal intensity by the sternocleidomastoid muscle signal intensity; maximally enhanced intensities on the intraplaque and lumen time-intensity curves were obtained from contrast-enhanced ultrasound data, and the ratio of the maximal intensity of the intraplaque curve to that of the lumen curve was calculated and defined as contrast effect (CE_US).

RESULTS

A linear correlation (r = .702; P <.0001) was observed between CR_MR and CE_US. Receiver operating characteristic curve analyses to evaluate the ability of the CE_US to differentiate each category of CR_MR from the other 2 categories showed that the sensitivity was significantly lower for category II (1.30 ≤ CR_MR ≤ 1.60) than for category I (CR_MR < 1.30) or III (1.60 < CR_MR). The CE_US was lower in plaques with higher CR_MR than in those with lower CR_MR in a subgroup of category III (P = .0196).

CONCLUSION

Findings of contrast-enhanced ultrasound plaque imaging are related to those of 3D FSE T1-WI MR plaque imaging according to the life history of arterial plaque and its neovascularization.

Development of Fe-based Catalysts for Purification of Coke Oven Gases

<p>Fe-based catalysts of different geometry are developed for the purification of coke oven gases: bulk, supported on alumina and supported on alumina silicate monoliths. Adsorption and decomposition of H₂S on the catalysts developed are studied. Influence of active component content, type of support material and modification by Mn and Mo on the catalyst activity in de-H₂S process is elucidated. Supported monolith catalysts show superior activity over bulk and supported spherical catalysts in H₂S decomposition reaction and demonstrate stable operation in ammonia decomposition process during 2 hours at 900 °C giving 100% ammonia conversion.</p>

Micro-tube mass production device for microbial culture

This paper describes mass production system of micro-tubes for microbial culture in an open environment. Microbes are used in many fields, such as food, medicine, environmental and energy. We proposed a microbe culture system using hydrogel micro-tubes, which can protect the target microbes inside from competitive microbes outside of the tubes while allow oxygen and nutrition to diffuse through. The hydrogel micro-tubes can be produced by a microfluidic device, which can precisely control the flow and therefore, the tube geometry. For practical applications of the micro-tube-based microbial culture, one of the biggest challenges is the scale-up of the micro-tube-based culture system, or mass production of the tubes. We developed a fluidic system that can produce multiple micro-tubes in parallel. We characterized the mass-produced micro channels and verified the effectiveness of the system.

Development of 19F-NMR chemical shift detection of DNA B–Z equilibrium using 19F-NMR

The DNA conformational changes such as B-formed, Z-formed, and single stranded DNA, were detected in one of ¹⁹F-NMR measurements using a fluorine-labeled nucleobase.

Simple 40K removal by acidified water leaching for estimating low levels of radiocesium in fishery products following Fukushima Dai-ichi Nuclear Power Plant accident

We developed a simple method for ⁴⁰K removal by acidified water leaching combined with ammonium phosphomolybdate coprecipitation, for estimating low levels of radiocesium in Japanese flounder. ⁴⁰K removal from ashed samples was approximately 98%, with the radiocesium yield of ~98%. The treatment reduced the γ-spectral baseline to ~1/5 at ground and ~3/100 at underground levels (1.04 and 0.11 cph/keV, respectively). Faint signal of ¹³⁴Cs, which is embedded in the Compton continuum of ⁴⁰K in an untreated sample, was detected.

Allosteric Inhibitors against HIV-1 Reverse Transcriptase: Design and Synthesis of MKC-442 Analogues Having an Ω-Functionalized Acyclic Structure

Based on X-ray crystallographic analysis of MKC-442/human immunodeficiency virus type 1 reverse transcriptase (HIV-1 RT) complex, analogues in which the N1-substituent is replaced with ω-functionalized alkyl groups were designed to improve the affinity for the enzyme. Synthesis of these compounds was carried out starting from MKC-442 by a sequence of reactions (N3-protection, removal of N1-ethoxymethyl group, alkylation, and N3-deprotection). The compounds were evaluated for anti-HIV activity. Structure–activity relationships are discussed in terms of the possible interaction with the enzyme.