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We show that the seasonal cycles of clouds over the mid‐latitude oceans in the Northern Hemisphere are predictors of the responses of clouds to increasing sea‐surface temperatures globally. These regions are therefore "natural laboratories" in which the processes responsible for low‐cloud feedbacks on global scales are observed as seasonal changes in local cloud properties. We use an ensemble of configurations of a global‐climate model to show that the sensitivities of cloud‐radiative anomalies to surface temperature and lower‐tropospheric stability in the "laboratory" regions predict the models' global cloud‐radiative feedbacks. Models with greater changes in low‐clouds between seasons are shown to have stronger negative feedbacks in the mid‐latitudes, and stronger positive feedbacks from the subtropical stratocumulus. The biases in the simulated seasonal cycles, compared to observations, imply that both feedbacks are too weak in the model. The consequences of this for configuring our model to have a lower climate sensitivity are discussed. Plain Language Summary: As the Earth's climate warms, feedbacks from changes in clouds are crucial for determining the rate of warming. In some climate models, positive cloud feedbacks are known to contribute to projected temperature increases which fall outside the range that is considered plausible given our current understanding of the Earth's climate. Methods are needed which directly relate present‐day model errors to projected cloud feedbacks so that we can understand how to improve models and simultaneously obtain plausible feedback strengths. We show that in the Met Office Hadley Centres' climate model, the seasonal cycles of clouds in a few key regions, specifically the poleward ocean basins in the Northern Hemisphere, can be used to predict cloud feedbacks, globally, across a wide range of configurations of the model. These regions, particularly the North‐west Pacific, are "natural laboratories" in which the same processes that are responsible for global, cloud‐feedbacks onto global‐warming rates, occur annually as part of the local seasonal cycle. Studying clouds in these regions and model biases in predictions of these clouds will allow us to directly improve estimates of global climate change. Key Points: Seasonal cycles of clouds constrain cloud feedbacksThe northern ocean basins are natural laboratories for low‐cloud feedbacksThe hot‐model problem in HadGEM3 will not easily be solved by tuning [ABSTRACT FROM AUTHOR]

The aim of this article is to review the published cases of nephrogenic systemic fibrosis (NSF) in Japan. The Japanese medical literature database and MedLine were searched using the keywords NSF and nephrogenic fibrosing dermopathy (January 2000 to March 2009). Reports in peer-reviewed journals and meeting abstracts were included, and cases with biopsy confirmation were selected. 14 biopsy-verified NSF cases were found. In seven of eight patients reported after the association between gadolinium-based contrast agent (GBCA) and NSF was proposed, GBCA administration was documented: five received only gadodiamide; two received both gadodiamide and gadopentetate dimeglumine. In four cases, the amounts of contrast agent were registered: two received only a single dose (0.1 mmol kg-1 body weight) whereas the other two received 7-15 ml (the body weight was not disclosed) for each MR examination. Five patients had multiple injections of GBCA before NSF developed. Except for one patient in whom renal assessment was not reported, none of the patients had an estimated glomerular filtration rate .30 ml min-1 1.73 m-2 and all received dialysis. 5 of the 8 patients (63%) in whom GBCA exposure was confirmed were treated with peritoneal dialysis. Skin lesion of the lower extremity was the first symptom in 12 patients (86%), whereas 2 patients had primarily symptoms from the upper extremity. In three cases, GBCA was administered even after onset of the NSF symptoms because of the physicians' lack of knowledge about the possible association between GBCA and NSF. NSF is found among Japanese end-stage renal failure patients even after examinations using a single dose. [ABSTRACT FROM AUTHOR]

The sensitivity of the global climate is essentially determined by the radiative damping of the global mean surface temperature anomaly through the outgoing radiation from the top of the atmosphere (TOA). Using the TOA fluxes of terrestrial and reflected solar radiation obtained from the Earth radiation budget experiment (ERBE), this study estimates the magnitude of the overall feedback, which modifies the radiative damping of the annual variation of the global mean surface temperature, and compare it with model simulations. Although the pattern of the annually varying anomaly is quite different from that of the global warming, the analysis conducted here may be used for assessing the systematic bias of the feedback that operates on the CO2-induced warming of the surface temperature. In the absence of feedback effect, the outgoing terrestrial radiation at the TOA is approximately follows the Stefan-Boltzmann’s fourth power of the planetary emission temperature. However, it deviates significantly from the blackbody radiation due to various feedbacks involving water vapor and cloud cover. In addition, the reflected solar radiation is altered by the feedbacks involving sea ice, snow and cloud, thereby affecting the radiative damping of surface temperature. The analysis of ERBE reveals that the radiative damping is weakened by as much as 70% due to the overall effect of feedbacks, and is only 30% of what is expected for the blackbody with the planetary emission temperature. Similar feedback analysis is conducted for three general circulation models of the atmosphere, which was used for the study of cloud feedback in the preceding study. The sign and magnitude of the overall feedback in the three models are similar to those of the observed. However, when it is subdivided into solar and terrestrial components, they are quite different from the observation mainly due to the failure of the models to simulate individually the solar and terrestrial components of the cloud feedback. It is therefore desirable to make the similar comparison not only for the overall feedback but also for its individual components such as albedo- and cloud-feedbacks. Although the pattern of the annually-varying anomaly is quite different from that of global warming, the methodology of the comparative analysis presented here may be used for the identification of the systematic bias of the overall feedback in a model. A proposal is made for the estimation of the best guess value of climate sensitivity using the outputs from many climate models submitted to the Intergovernmental panel on Climate Change. [ABSTRACT FROM AUTHOR]

The purpose of this study is to evaluate the role of diffusion-weighted imaging (DWI) in combination with T1 and T2 weighted MRI for the characterisation of renal carcinoma. The institutional review board approved the study protocols and waived informed consent from all of the patients. 47 patients (32 male and 15 female; age range, 21-85 years; median age, 65 years) who had suspected renal lesions on abdominal CT underwent MRI for further evaluation and characterisation of the lesions from April 2005 to August 2007 in our university hospital. A region of interest was drawn around the tumour area on apparent diffusion coefficient (ADC) maps. Final diagnosis was confirmed by histological examination of surgical specimens from all patients. The ADC value was significantly higher in renal cell carcinoma (RCC) than in transitional cell carcinoma (2.71±2.35 × 10-3 mm2 s-1 vs 1.61±0.80 × 10-3 mm2 s-1; p=0.022). While analysing the histological subtypes of RCC, a significant difference in ADC values between clear cell carcinoma and non-clear cell carcinoma was found (1.59±0.55 × 10-3 mm2 s-1 vs 6.72±1.85 × 10-3 mm2 s-1; p=0.0004). Similarly, ADC values of RCC revealed a significant difference between positive and negative metastatic lesions (1.06±0.38 × 10-3 mm2 s-1 vs 3.02±2.44 × 10-3 mm2 s-1; p=0.0004), whereas intensity on T1 and T2 weighted imaging did not reach statistical significance. In conclusion, DWI has clinical value in the characterisation of renal carcinomas and could be applied in clinical practice for their management. [ABSTRACT FROM AUTHOR]

Objective: Recent studies have provided new insights into the role of lymph nodes (LNs) in rheumatoid arthritis (RA). The aim of this study was to evaluate the metabolic activity of the axillary LNs in relation to that of the upper limb joints and the clinical assessment of disease activity in RA patients treated with biologic therapies.Method: 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG-PET/CT) scans were acquired for 64 patients with RA at baseline and after 6 months of biologic therapy, and the patients' clinical status was evaluated. The maximum standardized uptake value (SUVmax), metabolic active volume, and total lesion glycolysis (TLG) were used to assess glucose metabolism in the LNs and 12 joints. Clinical evaluations included serum markers and the Disease Activity Score based on 28-joint count-erythrocyte sedimentation rate (DAS28-ESR).Results: Changes in the SUVmax and TLG for the axillary LNs correlated significantly with those of the ipsilateral wrist joints. There was a positive correlation between the changes in the three metabolic parameters of the axillary LNs and the changes in disease activity after treatment. After 6 months of biologic therapy, all metabolic parameters for the axillary LNs in patients with a DAS28-ESR < 3.2 were significantly lower than those of patients with a DAS28-ESR ≥ 3.2.Conclusion: A relationship between the glucose metabolism of the axillary LNs and the ipsilateral wrist joints was demonstrated by the 18F-FDG-PET/CT parameters. The metabolic activity and active volume of axillary LNs may reflect the therapeutic response to the biologic treatment of RA. [ABSTRACT FROM AUTHOR]

Objective: To identify CT findings of massive venous invasion (MVI) in colorectal cancer, compare them to pathological findings and evaluate its clinical implications. Methods: Among 423 patients who received surgical resection of colorectal cancer, pre-operative CT of 26 patients (15 males, 11 females; mean age, 63.0 ± 12.1 years) with histopathologially proven MVI and 26 patients (14 males, 12 females; mean age, 71.1 ± 9 .6 years) with histopathologically proven lymph node (LN) metastases were reviewed and compared with histopathological findings. We evaluated CT detectability of MVI and the morphologic differences between MVI and LN metastasis. All cases were followed up for at least 6 months after surgery. Results: Pre-operative CT correctly diagnosed only one case as tumour thrombus. 9 lesions were not detected on CT, and others were misdiagnosed pre-operatively as regional LN metastasis (14 cases) and juxtatumoural abscess (2 cases). Afte r reviewing these cases, MVIs were identifiable in 20 of 26 cases. MVI was depicted on CT as nodules (oval, lobulated), abscess-like or intravenous tumour thrombus. MVI was significantly larger than LN metastasis ( p < 0.05), while contrast enhancement was significantly lower (p < 0 .0 5 ), and MVI often had an enhanced rim. Ten patients had synchronous metastases, and six patients had metachronous distant metastases within 5 years. Conclusion: Many cases of MVI were distinguishable from LN metastases on pre-operative CT of colorectal cancer, but their appearances were varied, reflecting their histopathological behaviours. The distant metastatic rate was much higher in cases with MVI. Advances in knowledge: Radiologists should be aware of CT findings of MVI in colorectal cancer as a sentinel sign of distant metastasis. [ABSTRACT FROM AUTHOR]

Purpose: (18)F-FAMT as an amino-acid tracer for positron emission tomography (PET) is useful for detecting human neoplasms. (18)F-FAMT is accumulated in tumour cells solely via L-type amino-acid transporter 1 (LAT1). This study was conducted to investigate the biological significance of (18)F-FAMT uptake in patients with oesophageal cancer.Methods: From April 2008 to December 2011, 42 patients with oesophageal cancer underwent both (18)F-FAMT PET/CT and (18)F-FDG PET/CT before surgical treatment. The immunohistochemical analysis of LAT1, CD98, Ki-67, CD34, p53, p-Akt and p-mTOR was performed on the primary lesions. In vitro experiments were performed to examine the mechanism of (18)F-FAMT uptake.Results: High uptake of (18)F-FAMT was significantly associated with advanced stage, lymph node metastasis and the expression of LAT1, CD98, Ki-67 and CD34. LAT1 expression yielded a statistically significant correlation with CD98 expression, cell proliferation, angiogenesis and glucose metabolism. In vitro experiments revealed that (18)F-FAMT was specifically transported by LAT1.Conclusions: The uptake of (18)F-FAMT within tumour cells is determined by the LAT1 expression and correlated with cell proliferation and angiogenesis in oesophageal cancer. The present experiments also confirmed the presence of LAT1 as an underlying mechanism of (18)F-FAMT accumulation. [ABSTRACT FROM AUTHOR]

Purpose:18F-FAMT as an amino-acid tracer for positron emission tomography (PET) is useful for detecting human neoplasms. 18F-FAMT is accumulated in tumour cells solely via L-type amino-acid transporter 1 (LAT1). This study was conducted to investigate the biological significance of 18F-FAMT uptake in patients with oesophageal cancer.Methods:From April 2008 to December 2011, 42 patients with oesophageal cancer underwent both 18F-FAMT PET/CT and 18F-FDG PET/CT before surgical treatment. The immunohistochemical analysis of LAT1, CD98, Ki-67, CD34, p53, p-Akt and p-mTOR was performed on the primary lesions. In vitro experiments were performed to examine the mechanism of 18F-FAMT uptake.Results:High uptake of 18F-FAMT was significantly associated with advanced stage, lymph node metastasis and the expression of LAT1, CD98, Ki-67 and CD34. LAT1 expression yielded a statistically significant correlation with CD98 expression, cell proliferation, angiogenesis and glucose metabolism. In vitro experiments revealed that 18F-FAMT was specifically transported by LAT1.Conclusions:The uptake of 18F-FAMT within tumour cells is determined by the LAT1 expression and correlated with cell proliferation and angiogenesis in oesophageal cancer. The present experiments also confirmed the presence of LAT1 as an underlying mechanism of 18F-FAMT accumulation. [ABSTRACT FROM AUTHOR]

Background: Vaporization around the radiofrequency (RF) electrode after RF application (RFA) limits the RF ablation area. Purpose: To determine whether saturated saline injected into the area of vaporization after initial RFA extends ablation area after further RFA. Material and Methods: RFA was performed in 18 ex vivo porcine livers and four in vivo rabbit erector spinae muscles. An RF electrode was used to ablate an area with 40W of parallel current for 15 min. The ablation margin was determined using a thermocouple, and the radius of the ablated area was measured. After RF electrode removal, saturated saline was infused through a percutaneous ethanol injection needle into the site of the original RFA in 11 liver samples and two erector spinae muscles. Three minutes later, RFA was resumed for 15 min. The remaining seven control liver samples and two spinae muscles received RFA without saline injection. The radius of the final ablated area was then measured. Results: In the ex vivo study, injection of saturated saline significantly decreased tissue impedance (87.7±9.4 to 51.1±9.7Ω, P<0.0001), and increased the mean radius of the ablated area (15.9±3.0 to 25.0±3.6 mm, P<0.0001). These significant changes were not observed without injection of saturated saline. Similar trends were found in the in vivo study. Conclusion: Injection of saturated saline into the area of vaporization around the RF electrode, followed by additional RFA, caused concentric expansion of the final ablation area, facilitating more efficient tumor ablation. [ABSTRACT FROM AUTHOR]

Global and local feedback analysis techniques have been applied to two ensembles of mixed layer equilibrium CO2 doubling climate change experiments, from the CFMIP (Cloud Feedback Model Intercomparison Project) and QUMP (Quantifying Uncertainty in Model Predictions) projects. Neither of these new ensembles shows evidence of a statistically significant change in the ensemble mean or variance in global mean climate sensitivity when compared with the results from the mixed layer models quoted in the Third Assessment Report of the IPCC. Global mean feedback analysis of these two ensembles confirms the large contribution made by inter-model differences in cloud feedbacks to those in climate sensitivity in earlier studies; net cloud feedbacks are responsible for 66% of the inter-model variance in the total feedback in the CFMIP ensemble and 85% in the QUMP ensemble. The ensemble mean global feedback components are all statistically indistinguishable between the two ensembles, except for the clear-sky shortwave feedback which is stronger in the CFMIP ensemble. While ensemble variances of the shortwave cloud feedback and both clear-sky feedback terms are larger in CFMIP, there is considerable overlap in the cloud feedback ranges; QUMP spans 80% or more of the CFMIP ranges in longwave and shortwave cloud feedback. We introduce a local cloud feedback classification system which distinguishes different types of cloud feedbacks on the basis of the relative strengths of their longwave and shortwave components, and interpret these in terms of responses of different cloud types diagnosed by the International Satellite Cloud Climatology Project simulator. In the CFMIP ensemble, areas where low-top cloud changes constitute the largest cloud response are responsible for 59% of the contribution from cloud feedback to the variance in the total feedback. A similar figure is found for the QUMP ensemble. Areas of positive low cloud feedback (associated with reductions in low level cloud amount) contribute most to this figure in the CFMIP ensemble, while areas of negative cloud feedback (associated with increases in low level cloud amount and optical thickness) contribute most in QUMP. Classes associated with high-top cloud feedbacks are responsible for 33 and 20% of the cloud feedback contribution in CFMIP and QUMP, respectively, while classes where no particular cloud type stands out are responsible for 8 and 21%. [ABSTRACT FROM AUTHOR]