Imaging Gaseous Detector based on Micro Processing Technology

The development of gaseous detectors has been exciting again since the appearance of a MicroStrip Gas Chamber(MSGC) in 1988, which is made using a micro-electronics technology. These days lots of variations of the advanced gaseous detectors are being intensively studied in the world. We have developed the two-dimensional MSGC having a 10 cm square detection area and the ultra fast readout system for a real time X-ray imaging. The MSGC was made using Multi-Chip Module (MCM) technology, and has a very thin substrate of 17 $\mu$m, lots of thin anodes and back strips both with 200 $\mu$m pitches. This enables us to get fast digital X-ray images with recording both the timing and an energy of each X-ray photon. In addition, an intermediate gas multiplier has been realized using a capillary plate having a conductive surface of a capillary. The MSGC combined with the conductive capillary plate can be steadily operated with a high gain under intense irradiation. Here we also report new approaches of X-ray crystal structure analyses using timing information obtained by the MSGC.Comment: 14 papges, 10 figures, to appear in the proceedings of Solid State Detectors for 21st Century (Nucl. Instru. and Meth. A

Search for Tetraneutron by Pion Double Charge Exchange Reaction at J-PARC

Tetraneutron ($^4n$) has come back in the limelight, because of recent observation of a candidate resonant state at RIBF. We propose to investigate the pion double charge exchange (DCX) reaction, i.e. $^4\mathrm{He}({\pi}^- , {\pi}^+)$, as an alternative way to populate tetraneutron. An intense ${\pi}^-$ beam with the kinetic energy of ~850 MeV, much higher than that in past experiments at LAMPF and TRIUMF, will open up a possibility to improve the experimental sensitivity of the formation cross section, which will be much smaller than hitherto known DCX cross sections such as $^9\mathrm{Be}({\pi}^-, {\pi}^+)^9\mathrm{He}\ (g.s.)$.Comment: 4 pages, 1 figure; proceedings of the 14th International Conference on Meson-Nucleon Physics and the Structure of the Nucleon (MENU2016), Kyoto, Japan, 25-30 July 201

Group Chase and Escape with Conversion from Targets to Chasers

We are studying the effect of converting caught targets into new chasers in the context of the recently proposed `group chase and escape' problem. Numerical simulations have shown that this conversion can substantially reduce the lifetimes of the targets when a large number of them are initially present. At the same time, it also leads to a non-monotonic dependence on the initial number of targets, resulting in the existence of a maximum lifetime. As a counter effect for this conversion, we further introduce self-multiplying abilities to the targets. We found that the longest lifetime exists when suitable combination of these two effects is created.Comment: submitted for publicatio

Quantitative Estimation of Urate Transport in Nephrons in Relation to Urinary Excretion Employing Benzbromarone-Loading Urate Clearance Tests in Cases of Hyperuricemia

Background: A four-component system for urate transport in nephrons has been proposed and widely investigated by various investigators studying the mechanisms underlying urinary urate excretion. However, quantitative determinations of urate transport have not been clearly elucidated yet. Methods: The equation Cua = {Ccr(1 – R1) + TSR}(1 – R2) was designed to approximate mathematically urate transport in nephrons, where R1 = urate reabsorption ratio; R2 = urate postsecretory reabsorption ratio; TSR = tubular secretion rate; Cua = urate clearance, and Ccr = creatinine clearance . To investigate relationships between the three unknown variables (R1, R2, and TSR), this equation was expressed as contour lines of one unknown on a graph of the other two unknowns. Points at regular intervals on each contour line for the equation were projected onto a coordinate axis and the high-density regions corresponding to high-density intervals of a coordinate were investigated for three graph types. For benzbromarone (BBR)-loading Cua tests, Cua was determined before and after oral administration of 100 mg of BBR and CuaBBR(∞) was calculated from the ratio of CuaBBR(100)/Cua. Results: Before BBR administration, points satisfying the equation on the contour line for R1 = 0.99 were highly dense in the region R2 = 0.87–0.92 on all three graphs, corresponding to a TSR of 40–60 ml/min in hyperuricemia cases (HU). After BBR administration, the dense region was shifted in the direction of reductions in both R1 and R2, but TSR was unchanged. Under the condition that R1 = 1 and R2 = 0, urate tubular secretion (UTS) was considered equivalent to calculated urinary urate excretion (Uex) in a model of intratubular urate flow with excess BBR; CuaBBR(∞) = TSR was deduced from the equation at R1 = 1 and R2 = 0. In addition, TSR of the point under the condition that R1 = 1 and R2 = 0 on the graph agreed with TSR for the dense region at excess BBR. TSR was thus considered approximately equivalent to CuaBBR(∞), which could be determined from a BBR-loading Cua test. Approximate values for urate glomerular filtration, urate reabsorption, UTS, urate postsecretory reabsorption (UR2), and Uex were calculated as 9,610; 9,510; 4,490; 4,150, and 440 µg/min for HU and 6,890; 6,820; 4,060; 3,610, and 520 µg/min for normal controls (NC), respectively. The most marked change in HU was the decrease in TSR (32.0%) compared to that in NC, but UTS did not decrease. Calculated intratubular urate contents were reduced more by higher UR2 in HU than in NC. This enhanced difference resulted in a 15.4% decrease in Uex for HU. Conclusion: Increased UR2 may represent the main cause of urate underexcretion in HU

Colon Hypoperfusion After Artery Ligation

Background: Anastomotic leakage (AL) after colorectal surgery is associated with insufficient vascular perfusion of the anastomotic ends. This study aimed to evaluate the effect of high vs. low ligation of the ileocolic artery and inferior mesenteric artery, respectively, on the vascular perfusion of the bowel stumps during ileocecal resection (ICR) and anterior rectal resection (AR). Methods: We retrospectively evaluated patients who underwent ICR or AR between 2016 and 2020. Real-time indocyanine green fluorescence angiography was performed to measure the fluorescence time (FT) as a marker of the blood flow in the proximal and distal stumps before anastomosis. Results: Thirty-four patients with lower right-sided colon cancer underwent laparoscopic ICR. Forty-one patients with rectosigmoid colon or rectal cancer underwent robotic high AR (HAR) (n = 8), robotic low AR (LAR) (n = 6), laparoscopic HAR (n = 8), or laparoscopic LAR (n = 19). The FT was similar in the ileal and ascending colon stumps (p = 1.000) and did not differ significantly between high vs. low ligation of the ileocolic artery (p = 0.934). The FT was similar in the sigmoid colon and rectal stumps (p = 0.642), but high inferior mesenteric artery ligation significantly prolonged FT in the sigmoid colon during AR compared with low ligation (p = 0.004), indicating that the high ligation approach caused significant hypoperfusion compared with low ligation. The AL rate was similar after low vs. high ligation. Conclusions: Low vascular perfusion of the bowel stumps may not be an absolute risk factor for AL. High inferior mesenteric artery ligation could induce sigmoid colon stump hypoperfusion during anterior rectal resection

Intestinal hypoperfusion in patients with Crohn's disease revealed by intraoperative indocyanine green fluorescence imaging

Background: Anastomotic leakage has been reported as an independent risk factor for surgical recurrence at the anastomotic site in patients with Crohn's disease. An inadequate blood supply may contribute to this leakage. Real-time indocyanine green angiography has been useful for confirming vascular perfusion of the intestines. The aim of this study was to evaluate the use of intraoperative indocyanine green angiography to detect vascular perfusion of the intestines during ileocaecal resection in patients with Crohn's disease and colon cancer. Materials and methods: We retrospectively evaluated the medical records of 26 consecutive patients with colon cancer arising in the caecum or ascending colon and 3 consecutive patients with Crohn's disease without a history of disease-related surgery. The patients in the 2 cohorts had undergone ileocaecal resection at Tokushima University Hospital between January 2018 and January 2021. After ileocaecal resection, blood flow was evaluated in ileal (oral) and colon (anal) stapled stumps by indocyanine green fluorescence angiography. The fluorescence time was defined as the time from indocyanine green injection and flush of the injection route to the point when the stump showed the strongest fluorescent signal in the monitor. Results: The fluorescence time for the ileal and colon stumps in patients with Crohn's disease was 43.3 ± 8.8 s each and was significantly longer than the fluorescence time in the patients with colon cancer (29.4 ± 6.5 s and 29.6 ± 6.8 s, respectively) (P < 0.05). Conclusion: Intraoperative indocyanine green fluorescence imaging is safe and reproducible for assessing intestinal perfusion prior to anastomosis in patients with colon cancer and Crohn's disease

MicroRNA-133 regulates the expression of GLUT4 by targeting KLF15 and is involved in metabolic control in cardiac myocytes

GLUT4 shows decreased levels in failing human adult hearts. We speculated that GLUT4 expression in cardiac muscle may be fine-tuned by microRNAs. Forced expression of miR-133 decreased GLUT4 expression and reduced insulin-mediated glucose uptake in cardiomyocytes. A computational miRNA target prediction algorithm showed that KLF15 is one of the targets of miR-133. It was confirmed that over-expression of miR-133 reduced the protein level of KLF15, which reduced the level of the downstream target GLUT4. Cardiac myocytes infected with lenti-decoy, in which the 3′UTR with tandem sequences complementary to miR-133 was linked to the luciferase reporter gene, had decreased miR-133 levels and increased levels of GLUT4. The expression levels of KLF15 and GLUT4 were decreased at the left ventricular hypertrophy and congestive heart failure stage in a rat model. The present results indicated that miR-133 regulates the expression of GLUT4 by targeting KLF15 and is involved in metabolic control in cardiomyocytes

Effects of periodic robot rehabilitation using the Hybrid Assistive Limb for a year on gait function in chronic stroke patients

Using a robot for gait training in stroke patients has attracted attention for the last several decades. Previous studies reported positive effects of robot rehabilitation on gait function in the short term. However, the long-term effects of robot rehabilitation for stroke patients are still unclear. The purpose of the present study was to investigate the long-term effects of periodic gait training using the Hybrid Assistive Limb (HAL) on gait function in chronic stroke patients. Seven chronic stroke patients performed 8 gait training sessions using the HAL 3 times every few months. The maximal 10-m walk test and the 2-minute walking distance (2MWD) were measured before the first intervention and after the first, second, and third interventions. Gait speed, stride length, and cadence were calculated from the 10-m walk test. Repeated one-way analysis of variance showed a significant main effect on evaluation time of gait speed (F = 7.69, p < 0.01), 2MWD (F = 7.52, p < 0.01), stride length (F = 5.24, p < 0.01), and cadence (F = 8.43, p < 0.01). The effect sizes after the first, second, and third interventions compared to pre-intervention in gait speed (d = 0.39, 0.52, and 0.59) and 2MWD (d = 0.35, 0.46, and 0.57) showed a gradual improvement of gait function at every intervention. The results of the present study showed that gait function of chronic stroke patients improved over a year with periodic gait training using the HAL every few months

Impact of a learning health system on acute care and medical complications after intracerebral hemorrhage

Introduction: Patients with stroke often experience pneumonia during the acute stage after stroke onset. Oral care may be effective in reducing the risk of stroke‐associated pneumonia (SAP). We aimed to determine the changes in oral care, as well as the incidence of SAP, in patients with intracerebral hemorrhage, following implementation of a learning health system in our hospital. Methods: We retrospectively analyzed the data of 1716 patients with intracerebral hemorrhage who were hospitalized at a single stroke center in Japan between January 2012 and December 2018. Data were stratified on the basis of three periods of evolving oral care: period A, during which conventional, empirically driven oral care was provided (n = 725); period B, during which standardized oral care was introduced, with SAP prophylaxis based on known risk factors (n = 469); and period C, during which oral care was risk‐appropriate based on learning health system data (n = 522). Logistic regression analysis was performed to evaluate associations between each of the three treatment approaches and the risk of SAP. Results: Among the included patients, the mean age was 71.3 ± 13.6 years; 52.6% of patients were men. During the course of each period, the frequency of oral care within 24 hours of admission increased (P < .001), as did the adherence rate to oral care ≥3 times per day (P < .001). After adjustment for confounding factors, a change in the risk of SAP was not observed in period B; however, the risk significantly decreased in period C (odds ratio 0.61; 95% confidence interval 0.43‐0.87) compared with period A. These associations were maintained for SAP diagnosed using strict clinical criteria or after exclusion of 174 patients who underwent neurosurgical treatment. Conclusions: Risk‐appropriate care informed by the use of learning health system data could improve care and potentially reduce the risk of SAP in patients with intracerebral hemorrhage in the acute stage