Immune-related aseptic meningitis diagnosed by Cube FLAIR on enhanced magnetic resonance imaging for a lung cancer patient administered atezolizumab: A case report

Immune checkpoint inhibitors (ICIs) can cause immune-related adverse events (irAEs), such as neurological toxicity. A 46-year-old man was diagnosed with squamous cell lung cancer. Lung cancer recurred 3 years after he experienced left segmental lung rejection. Therefore, he received atezolizumab as fourth-line chemotherapy. He experienced fever, headache, and decreased consciousness 10 days after the first dose of atezolizumab. Plain head computed tomography and cerebrospinal fluid examination showed no significant findings. Magnetic resonance imaging (MRI) with a Gadolinium (Gd)-enhanced Cube fluid-attenuated inversion recovery (FLAIR) sequence showed nodular abnormalities with contrast enhancement. Thus, aseptic meningitis caused by ICIs was suspected. His consciousness level gradually improved with glucocorticoid therapy. Moreover, most nodular abnormalities observed on cerebral MRI disappeared concurrently. Thus, Gd-enhanced Cube FLAIR sequence has the unique ability to reveal immune-related aseptic meningiti

Analysis of the Cesium Distribution in the JT-60SA Negative Ion Sources for Steady Long-Pulse Operation

To realize stable negative ion beams for 100 s required in the neutral beam injector of JT-60SA, a physical model to control cesium (Cs) distribution inside the negative ion source has been developed in order to maintain the stable negative ion production at the plasma grid (PG) surface with Cs. In this work, to quantitatively evaluate Cs coverage on the PG, a three-dimensional Cs transportation code was introduced to consider the spatial Cs distribution in the source. The spatial temperature distribution of the chamber wall was also introduced in this model. As a result, the reasonable variation of the Cs coverage for 100 s was obtained, compared to that in the initial model. Based on the modified model, the operational temperature of the chamber wall was proposed to be less than 60 ℃ to suppress the desorption of Cs in the chamber wall and to sustain the stable negative ion production. In addition, it was also suggested that a slightly higher wall temperature before the operation leads to a decrease in the amount of Cs stored at the chamber wall, resulting in suppression of Cs consumption in the ion source