Measurements of Strong-Interaction Effects in Kaonic-Helium Isotopes at Sub-eV Precision with X-Ray Microcalorimeters

We have measured the 3d→2p transition x rays of kaonic ^{3}He and ^{4}He atoms using superconducting transition-edge-sensor microcalorimeters with an energy resolution better than 6 eV (FWHM). We determined the energies to be 6224.5±0.4(stat)±0.2(syst)  eV and 6463.7±0.3(stat)±0.1(syst)  eV, and widths to be 2.5±1.0(stat)±0.4(syst)  eV and 1.0±0.6(stat)±0.3(stat)  eV, for kaonic ^{3}He and ^{4}He, respectively. These values are nearly 10 times more precise than in previous measurements. Our results exclude the large strong-interaction shifts and widths that are suggested by a coupled-channel approach and agree with calculations based on optical-potential models.

P1518 Relationship between post-operative asymptomatic status and reverse remodeling of large left atrium in patients with aortic stenosis who underwent aortic valve replacement

Introduction

Recently, we have reported that large left atrial volume (minimum left atrial volume index : LAVImin ≥30ml/m²) at end-diastole determined by direct exposure of left ventricular (LV) end-diastolic pressure can predict post-operative symptomatic status after aortic valve replacement (AVR) in aortic stenosis (AS) patients with high sensitivity and modest specificity. Reverse remodeling of large LAVImin after AVR may contribute to false positive for the prediction of post-operative symptomatic status in patients with AS.

Purpose

The purpose of this study was to evaluate relationship between post-operative symptomatic status and reverse remodeling of large LAVImin in patients with AS who underwent AVR.

Methods

The study population consisted of 75 patients with AS who underwent AVR and were followed up for 600 days after AVR, after the exclusion of the followings; atrial fibrillation, significant coronary artery disease, significant mitral valve disease, pacemaker rhythm, and inadequate echocardiographic images. We measured LAVImin by biplane Simpson"s method before and after AVR. Preoperative large LAVImin (≥30ml/m²) according to the previous study was observed in 32 (43%) of 75 patients. We divided these 32 patients into two groups according to the post-operative symptomatic status during the follow-up period.

Results

There was no significant difference in pre-operative LAVImin between patients with and without post-operative symptom (46.5 ± 13.4 vs 40.4 ± 8.6 ml/m²). On the other hand, post-operative LAVImin in patients without post-operative symptom was significantly smaller than that in patients with post-operative symptom (31.5 ± 8.6 vs 54.8 ± 14.0 ml/m², p < 0.01). While significant regression in LAVImin after AVR was observed in patients without post-operative symptom (40.4 ± 8.6 to 31.5 ± 8.6 ml/m², p < 0.05), no regression in LAVImin after AVR was observed in patients with post-operative symptom (46.5 ± 13.4 to 54.8 ± 14.0 ml/m²).

Conclusions

Reverse remodeling of large LAVmin in patients with AS who underwent AVR was observed in post-operative asymptomatic group, but not in symptomatic group. These results suggest that reverse remodeling of large LAVImin after AVR could contribute to the post-operative asymptomatic status in patients with AS who underwent AVR.

P3365Relationship between early diastolic intra-ventricular pressure gradient shortly after aortic valve closure estimated by vector flow mapping and left ventricular diastolic untwisting rate in humans

Background

Early diastolic suction is an important determinant of early diastolic function. Previous studies using color Doppler M-mode and speckle-tracking echocardiography have shown left ventricular (LV) early diastolic LV untwisting rate is directly related to LV intra-ventricular pressure gradient (IVPG) between LV base and apex during early diastole. Recent introduction of vector flow mapping (VFM) using combination of color Doppler and speckle-tracking echocardiography provides noninvasive and feasible assessment of early diastolic IVPG shortly after aortic valve closure including isovolmic relaxation period (ED-IVPG) in humans. However, relationship between VFM–derived ED-IVPG and early diastolic LV untwisting rate has not been well investigated.

Purpose

The purpose of this study was to examine relationship between ED-IVPG estimated by VFM and LV untwisting rate by speckle-tracking echocardiography.

Methods

The study population consists of 66 patients without segmental wall motion abnormality, significant valvular diseases, and atrial fibrillation who underwent echocardiography for evaluation of LV function (age: 60±15 years, LVEF: 49±16%). From the apical long-axis views by color Doppler echocardiography, we analyzed peak ED-IVPG between LV base and apex just after aortic valve closure (figure) using commercially available VFM analysis software (DAS-RS1, Hitachi). We assessed peak early diastolic LV untwisting rate and LV torsion from LV basal and apical short-axis view by speckle-tracking echocardiography. We evaluated correlation between ED-IVPG and LV untwisting rate. We also evaluated correlation between ED-IVPG and peak systolic LV torsion, LV end-diastolic (EDV) and end-systolic volumes (ESV), ejection fraction (EF), early diastolic velocity (E) of LV inflow, average early diastolic velocity (e') of mitral annulus, and average E/e'.

Results

In all the study patients, ED-IVPG was successfully and quickly evaluated. 1) ED-IVPG correlated well with peak LV untwisting rate (r=0.64, p<0.0001). 2) ED-IVPG significantly correlated with LV torsion, LVEDV, LVESV, and LVEF (r=0.47, r=−0.48, r=−0.46, and r=0.48, respectively, p<0.001). 3) There were no significant correlations between ED-IVPG and other indexes including E, average e', and average E/e'. According to receiver operating characteristic analysis, the best cut-off value of ED-IVPG for determining impaired LV untwisting rate (<80 degrees/s) was found at 0.42 mmHg (sensitivity 81%, specificity 76%, and area under the curve 0.86)

ED-IVPG measurement by VFM

Conclusions

The present results showed that noninvasive VFM-derived peak ED-IVPG shortly after aortic valve closure is related to early diastolic peak LV untwisting rate. ED-IVPG easily and quickly estimated by VFM may be used as an additional index for LV diastolic function.

P4349Simple and rapid estimation of left ventricular longitudinal deformation by tissue-tracking mitral annular displacement in single apical view

Background

Noninvasive assessment of left ventricular (LV) deformation using global longitudinal strain (GLS) has prognostic value in patients with and without preserved ejection fraction (EF). Application of speckle-tracking technology to the mitral annulus provides rapid and easy assessment of displacement of septal and lateral mitral annulus and mid-point of mitral annular line in single apical view (TMAD) even in poor echo-image quality. TMAD may be used as a simple index of LV longitudinal deformation in patients with and without preserved EF (Figure).

Purpose

The purpose of this study was to examine whether TMAD can be used as a simple index of LV longitudinal deformation in patients with and without preserved EF.

Methods

The study population consists of 95 patients without segmental wall motion abnormality, significant valvular diseases, and atrial fibrillation in whom both TMAD and GLS measurements were applied by QLAB software (Philips). We estimated GLS from apical 4- and 2-chamber views and apical longitudinal views, and TMAD from apical 4-chamber view. TMAD was automatically and quickly evaluated as the base-to-apex displacement of septal (TMADsep), lateral (TMADlat), and mid-point of annular line (TMADmid) (Figure). The percentage of M-TMAD to LV length from the mid-point of mitral annuls to the apex at end-diastole (%TMADmid) was also calculated. We compared each TMAD values with GLS values by linear regression analysis, and evluated TMAD values by a receiver operating characteristic (ROC) analysis to detect impaired LV longitudinal deformation (|GLS|<12.0%).

Results

TMAD was successfully assessed in 94 of 95 patients (99%) while GLS was measured in 84 of 95 patients (87%, p=0.0082 vs TMAD). There were good correlations between each TMAD index and |GLS| (TMADsep:r=0.77, TMADlat:r=0.81, TMADmid:r=0.82, %TMADmid:r=0.87). According to ROC curve, the best cut-off values for TMADsep, TMADlat, TMADmid, and %TMADmid in determining LV longitudinal deformation were 6.8mm, 8.0mm, 7.8mm, and 9.5% respectively (Table).

Conclusions

The present results suggest that rapid and easy assessment of TMAD in single apical view may be used as a simple index of LV longitudinal deformation.

2,3-Dihydroxybenzoate meta-Cleavage Pathway is Involved in o-Phthalate Utilization in Pseudomonas sp. strain PTH10

Pseudomonas sp. strain PTH10 can utilize o-phthalate which is a key intermediate in the bacterial degradation of some polycyclic aromatic hydrocarbons. In this strain, o-phthalate is degraded to 2,3-dihydroxybenzoate and further metabolized via the 2,3-dihydroxybenzoate meta-cleavage pathway. Here, the opa genes which are involved in the o-phthalate catabolism were identified. Based on the enzymatic activity of the opa gene products, opaAaAbAcAd, opaB, opaC, and opaD were found to code for o-phthalate 2,3-dioxygenase, dihydrodiol dehydrogenase, 2,3-dihydroxybenzoate 3,4-dioxygenase, and 3-carboxy-2-hydroxymuconate-6-semialdehyde decarboxylase, respectively. Collectively, these enzymes are thought to catalyze the conversion of o-phthalate to 2-hydroxymuconate-6-semialdehyde. Deletion mutants of the above opa genes indicated that their products were required for the utilization of o-phthalate. Transcriptional analysis showed that the opa genes were organized in the same transcriptional unit. Quantitative analysis of opaAa, opaB, opaC, opaD, opaE, and opaN revealed that, except for opaB and opaC, all other genes were transcriptionally induced during growth on o-phthalate. The constitutive expression of opaB and opaC, and the transcriptional induction of opaD located downstream of opaB, suggest several possible internal promoters are existence in the opa cluster. Together, these results strongly suggest that the opa genes are involved in a novel o-phthalate catabolic pathway in strain PTH10.

Routine Referral by Urologists Increase Opportunities for Corneal Donation

BACKGROUND

The levels of corneal donation are insufficient to meet the demand for corneal transplantation in Japan. To overcome this problem, we started to routinely mention the possibility of corneal donation to the families of patients who died in our hospital's Urology Department in February 2008. In this study, we evaluated the effectiveness of this approach.

METHODS

We retrospectively reviewed the medical records of the patients who died in the Department of Urology, St. Marianna University School of Medicine Hospital, and analyzed the patients' characteristics and information about corneal donation.

RESULTS

In total, 211 patients died in our department between February 2008 and March 2017, and 155 patients were medically suitable corneal donors. We mentioned the possibility of corneal donation to 129 (83.2%) families, and 29 (18.7%) families agreed. Three families subsequently withdrew their consent. Finally, 26 (16.8%) of the families that were approached about corneal donation by urologists agreed to donate their relatives' corneas. Another 2 families voluntarily offered to donate their relatives' corneas. Thus, 28 (18.1%) of 155 medically suitable donors donated their corneas for transplantation. Twenty-six (92.8%) donors were 60 years or older and all donors were affected with malignant genitourinary tumors. Fifty-four (96.4%) corneas were successfully transplanted into recipients.

CONCLUSIONS

Even elderly patients who die of solid carcinoma can be an important source of corneal donors. In this study, we showed that routine referral by urologists increased corneal donation. If this approach were adopted by other departments, it might further increase the number of corneal donations.

Spectroscopy of Pionic Atoms in ^{122}Sn(d,^{3}He) Reaction and Angular Dependence of the Formation Cross Sections

We observed the atomic 1s and 2p states of π^{-} bound to ^{121}Sn nuclei as distinct peak structures in the missing mass spectra of the ^{122}Sn(d,^{3}He) nuclear reaction. A very intense deuteron beam and a spectrometer with a large angular acceptance let us achieve a potential of discovery, which includes the capability of determining the angle-dependent cross sections with high statistics. The 2p state in a Sn nucleus was observed for the first time. The binding energies and widths of the pionic states are determined and found to be consistent with previous experimental results of other Sn isotopes. The spectrum is measured at finite reaction angles for the first time. The formation cross sections at the reaction angles between 0° and 2° are determined. The observed reaction-angle dependence of each state is reproduced by theoretical calculations. However, the quantitative comparison with our high-precision data reveals a significant discrepancy between the measured and calculated formation cross sections of the pionic 1s state.

Measurement of Excitation Spectra in the ^{12}C(p,d) Reaction near the η^{'} Emission Threshold

Excitation spectra of ^{11}C are measured in the ^{12}C(p,d) reaction near the η^{'} emission threshold. A proton beam extracted from the synchrotron SIS-18 at GSI with an incident energy of 2.5 GeV impinges on a carbon target. The momenta of deuterons emitted at 0° are precisely measured with the fragment separator (FRS) operated as a spectrometer. In contrast to theoretical predictions on the possible existence of deeply bound η^{'}-mesic states in carbon nuclei, no distinct structures are observed associated with the formation of bound states. The spectra are analyzed to set stringent constraints on the formation cross section and on the hitherto barely known η^{'}-nucleus interaction.

Fast Heating of Imploded Core with Counterbeam Configuration

A tailored-pulse-imploded core with a diameter of 70  μm is flashed by counterirradiating 110 fs, 7 TW laser pulses. Photon emission (>40  eV) from the core exceeds the emission from the imploded core by 6 times, even though the heating pulse energies are only one seventh of the implosion energy. The coupling efficiency from the heating laser to the core using counterirradiation is 14% from the enhancement of photon emission. Neutrons are also produced by counterpropagating fast deuterons accelerated by the photon pressure of the heating pulses. A collisional two-dimensional particle-in-cell simulation reveals that the collisionless two counterpropagating fast-electron currents induce mega-Gauss magnetic filaments in the center of the core due to the Weibel instability. The counterpropagating fast-electron currents are absolutely unstable and independent of the core density and resistivity. Fast electrons with energy below a few MeV are trapped by these filaments in the core region, inducing an additional coupling. This might lead to the observed bright photon emissions.

Abstract P1-10-26: Frozen glove could be a new hope for prevention of chemotherapy induced peripheral neuropathy

Introduction

Chemotherapy induced peripheral neuropathy (CIPN) is a major problem for patients who receive chemotherapy, and it sometimes deteriorate patients' QOL. Many CIPN prevention trials have been conducted, but no one succeeded to date.

Objectives

To investigate if frozen glove (FG) prevents peripheral neuropathy induced by nanoparticle albumin-bound paclitaxel (nab-PTX).

Methods

We conducted CIPN prevention study using FG, as part of multi-institutional phase II study which analyze efficacy and safety of nab-PTX (260mg/m2 q3w) followed by FEC (500/100/500 mg/m2, q3w) in pre-operative setting (KBCSG-TR 1213 trial). Each patient wore an FGs for a total of 60 minutes (15mins before and after nab-PTX treatment) on both hands. CIPN were assessed during treatment period with nab-PTX by the Patient Neurotoxicity Questionnaire (PNQ) and the FACT/GOG (Gynecologic Oncology Group) Neurotoxicity (Ntx) subscale. Patients were asked to access PNQ and FACT/GOG Ntx on a daily basis and recorded in the CIPN diary.

Results

Sixty two patients were registered for KBCSG-TR 1213 trial. And forty two pts (68%) who turned in the diary were analyzed. Median age and median body mass index (BMI) was 48 years old and 21.6 kg/m2, respectively. We analyzed following 6 categories, 1) symptoms of hands and arms, 2) symptoms of foots, 3) symptoms of general, 4) symptoms of ears 5) muscle weakness of hands and arms and 6) muscle weakness of foots. Median time to each event was 1) 25.5 days, 2) 5days, 3) 3days, 4) not available, 5) 46.5days, 6)4 days. By using FG, time to event of hands and arms was much longer compared with that of foots.

Conclusions

CIPN could be prevented or lessened by FG. Randomized phase II CIPN prevention study has been just launched.

Citation Format: Nakayama T, Yasojima H, Morimoto T, Yoshidome K, Mizutani M, Takashima T, Matsunami N, Enami A, Kagawa M, Nomura T, Shiba E, Nishi T, Kamigaki S, Kozuma Y, Yoshinami T, Masuda N. Frozen glove could be a new hope for prevention of chemotherapy induced peripheral neuropathy. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-10-26.

Candidate Resonant Tetraneutron State Populated by the ^{4}He(^{8}He,^{8}Be) Reaction

A candidate resonant tetraneutron state is found in the missing-mass spectrum obtained in the double-charge-exchange reaction ^{4}He(^{8}He,^{8}Be) at 186  MeV/u. The energy of the state is 0.83±0.65(stat)±1.25(syst)  MeV above the threshold of four-neutron decay with a significance level of 4.9σ. Utilizing the large positive Q value of the (^{8}He,^{8}Be) reaction, an almost recoilless condition of the four-neutron system was achieved so as to obtain a weakly interacting four-neutron system efficiently.

Treatment of pressure ulcers in patients with declining renal function using arginine, glutamine and ß-hydroxy-ß-methylbutyrate

The aim of this study is to examine the efficacy on healing pressure ulcers (PU) of using a supplement combination containing arginine, glutamine and ß-hydroxy-ß-methylbutyrate, which was given to two elderly patients with renal dysfunction. The PU was surgically opened, decompressed and treated by drugs. A half quantity of the defined dose of the supplement combination, with an enteral nutrition product, was administered to the patients twice a day. This combination improved the PUs, with no effect on renal function. This novel finding may provide a nutritional rationale of arginine, glutamine and ß-hydroxy-ß-methylbutyrate for PUs associated with renal dysfunction.

Clinicopathological significance of laminin-5γ2 chain expression in superficial esophageal cancer

The glycoprotein laminin 5γ2 chain (LN-5γ2) has recently become a focus of increased interest and investigation as a marker of invasion in gastrointestinal malignancies. We investigated the significance of LN-5γ2 expression as a prognostic factor in superficial esophageal cancer. The study population consisted of 87 patients who had undergone a transthoracic esophagectomy and three-field lymphadenectomy for the treatment of superficial esophageal cancer at Tokai University Hospital. Formalin-fixed, paraffin-embedded sections of the resected specimens were examined using immunohistochemical staining and hematoxylin and eosin staining to assess the correlations between the LN-5γ2 expression pattern and the clinicopathological factors (age, sex, T-factor, N-factor, ly-factor, v-factor, degree of differentiation, infiltrative growth pattern, tumor node metastasis classification of malignant tumors [TNM] stage, etc.) and the patient outcome. The expression pattern of LN-5γ2 was classified into an extracellular type (E type), characterized by the staining of extracellular matrix such as the basement membrane and the stroma (31 cases, 35.6%), and a cytoplasmic type (C type), characterized by the staining of the cytoplasm in the cancer cells (56 cases, 64.6%). The expression pattern was not correlated with any of the clinicopathological factors that were assessed. However, univariate analyses of the survival analysis data showed that the N-factor (P = 0.011), TNM stage (P = 0.011), and LN-5γ2 C type (P = 0.017) were prognostic factors. A multivariate analysis revealed that the N-factor (P = 0.049) and LN-5γ2 C type (P = 0.048) were prognostic factors. In the survival analysis, a univariate analysis of the 75 T1b cases also showed that the N-factor (P = 0.048), TNM stage (P = 0.048), and LN-5γ2 C type (P = 0.029) were prognostic factors, while a multivariate analysis showed that the LN-5γ2 C type (P = 0.035) was a prognostic factor. The C type expression of LN-5γ2, i.e. confined to the cytoplasm, was correlated with an unfavorable outcome among the patients with superficial esophageal cancer in the present series. Observation of the LN-5γ2 expression pattern may be useful for the diagnosis of highly malignant tumors.

Safety and Feasibility of a Pancreaticoduodenectomy with Total Meso-Pancreatoduodenum Excision: Analysis in Various Periampullary Disorders

BACKGROUND/AIMS

This study aimed to evaluate the safety and feasibility of a pancreaticoduodenectomy with total meso-pancreatoduodenum excision (tMPDe) as an new anatomical concept.

METHODOLOGY

A total of 90 patients underwent PD for various periampullary diseases. Of these, 52 patients received a conventional PD (cPD), while 38 patients underwent a tMPDe. Surgical outcomes were compared between the two study groups.

RESULTS

Operative time was equivalent in the two groups; however, the estimated blood loss (cPD, 1360 ml; tMPDe, 995 ml; median, P = 0.026) and blood transfusion rate (cPD, 63%; tMPDe, 31% ; P = 0.001) were significantly decreased in tMPDe. Morbidity had no significant difference between cPD and tMPDe, and tMPDe showed no characteristic complications. With regard to oncological aspects, tMPDe was superior to cPD. Risk factors analysis revealed the operative time (P = 0.003), estimated blood loss (P < 0.001), and blood transfusion (P < 0.001) to be significant predictive risk factors for postoperative morbidity but not tMPDe procedure (P = 0.794).

CONCLUSIONS

tMPDe is safe and superior to cPD because it is a bloodless operation with a good oncological outcome: We concluded that tMPDe should be adaptable to various periampullary diseases, including benign and low-grade malignant disorders.

Neurofibromatosis 2 gene has novel alternative splicings which controls intracellular protein binding

Three novel isoforms of the neurofibromatosis 2 (NF2) gene transcripts generated from alternative splicing were identified from normal human brain, schwannoma and glioma tissues. The 3 novel transcripts lack exon 2, exons 2 and 3, exons 2-4, respectively. Recombinant isoform proteins encoded by those new transcripts have lost the previously reported ability to bind S-35-methionine labeled cellular proteins. Two of seven glioblastoma tissues expressed significantly high levels of the shorter transcripts whereas low grade astrocytomas expressed levels similar to those found in normal brain, suggesting that genomic mutation or aberrant alternative splicing of the NF2 gene may contribute to the progression of malignant gliomas.

Increased monocyte chemoattractant protein-1 expression by tumor necrosis factor-alpha can mediate macrophage infiltration in gliomas

We compared the in vitro effects of various cytokines on the expression of monocyte chemoattractant protein-1 (MCP-1) in glioma cell lines and found that MCP-1 expression was highly induced by tumor necrosis factor-alpha (TNF alpha) and interleukin-1 beta. The intra-tumoral injection of TNF alpha in rat glioma model increased the in vivo expression of MCP-1 at 1 to 12 h after the injection and induced macrophage infiltration into tumor tissue. The injection of TNF alpha into post-operative tumor cavity of human malignant glioma also increased the concentration of MCP-1 in the cavity fluid at 24 to 38 h after injection. These data, together with the previous finding that the growth of transplanted MCP-1-transfected cells was significantly inhibited by infiltrated macrophages, suggest that injection of TNF alpha inhibits turner growth via the induction of MCP-1 expression.

Run-up to participation in ATACH II in Japan

Intracerebral hemorrhage (ICH) is a major cause of morbidity and mortality in Japan. Seventeen Japanese institutions are participating in the Antihypertensive Treatment for Acute Cerebral Hemorrhage (ATACH) II Trial (ClinicalTrials.gov no. NCT01176565; UMIN 000006526). This phase III trial is designed to determine the therapeutic benefit of early intensive systolic blood pressure (BP) lowering for acute hypertension in ICH patients. This report explains the long run-up to reach the start of patient registration in ATACH II in Japan, including our preliminary study, a nationwide survey on antihypertensive treatment for acute ICH patients, a multicenter study for hyperacute BP lowering (the SAMURAI-ICH study), revision of the official Japanese label for intravenous nicardipine, and construction of the infrastructure for the trial.