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Objective: The goal of our study was to evaluate the diagnostic performance of percutaneous lung biopsy under CT-fluoroscopic guidance for ground-glass opacity (GGO) lesions. Methods: 85 percutaneous needle lung biopsies were performed in 73 patients. Specimens were obtained by core biopsy utilising an automated cutting needle and were evaluated histologically. Final diagnosis was confirmed by independent surgical pathology, independent culture results or clinical follow-up. Results: Rates of adequate specimens obtained and of precise diagnosis by needle biopsy were 92.9% (79/85) and 90.6% (77/85) of evaluated lung lesions, respectively. Precise diagnosis was achieved in 87.1% (27/31) of lesions ≤10 mm in diameter, 90.0% (36/40) of lesions >10 mm to ≤20 mm and 100.0% (14/14) of lesions >20 mm. Precision in diagnosing GGO lesions according to the GGO component was 73.9% (17/23) for pure GGO lesions and 96.8% (60/62) for part-solid GGO lesions. Obtaining a precise diagnosis did not differ significantly according to the lesion size (p=0.3840), but differences were significant according to the GGO component (p=0.0047). Malignancy was accurately diagnosed in 35 of 36 malignant lesions for which surgery was later performed. The specific cell type determined from specimens obtained by needle biopsy was exactly the same as the final histological diagnosis obtained after surgery in 20 lesions. Conclusion: Tissue-core lung biopsy under CT-fluoroscopic guidance for a GGO lesion provides a high degree of diagnostic accuracy but is less reliable for determining the specific cell type. Advances in knowledge: Percutaneous lung biopsy under CT-fluoroscopic guidance for GGO is useful in differentiating malignancy [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to compare two different automated biopsy needles, a fully automated biopsy needle (Monopty; Bard, Covington, GA) and a semiautomated biopsy needle (Temno; Bauer Medical, Clearwater, FL), for lung biopsy. Methods: 50 consecutive percutaneous lung biopsies using the Monopty needle between June 2006 and January 2007 and 66 consecutive lung biopsies for 1 nodule in each session using the Temno needle between February 2007 and August 2008 were performed under CT fluoroscopic guidance followed by histopathological evaluation. Results: In 42/50 lung biopsies performed with the Monopty needle and 54/66 lung biopsies performed with the Temno needle, the final diagnosis was confirmed by independent surgical pathological findings or clinical follow-up. Sufficient samples for histopathological evaluation were obtained in all 50 (100%) biopsies using the Monopty needle and in 55 (83.3%) of the 66 biopsies using the Temno needle (p,0.01). Accurate diagnosis was achieved in 41 (97.6%) of 42 biopsies using the Monopty needle and in 45 (83.3%) of 54 biopsies using the Temno needle (p50.04). Biopsy-induced complications were pneumothorax, haemoptysis and haemothorax in 44.0%, 10.0% and 6.0% of biopsies, respectively, using the Monopty needle and in 48.3%, 8.3% and 3.3%, respectively, using the Temno needle. Conclusion: There is a possibility that a fully automated biopsy needle such as the Monopty is more useful for CT scan-guided lung biopsy than semi-automated biopsy needles. [ABSTRACT FROM AUTHOR]

Background: Reports on CT-guided percutaneous drainage within the intervertebral space for pyogenic spondylodiscitis with a secondary psoas abscess are limited. Purpose: To evaluate CT-guided percutaneous drainage within the intervertebral space for pyogenic spondylodiscitis and a secondary psoas abscess in which the two sites appear to communicate. Material and Methods: Eight patients with pyogenic spondylodiscitis and a secondary psoas abscess showing communication with the intradiscal abscess underwent CT-guided percutaneous drainage within the intervertebral space. The clinical outcome was retrospectively assessed. Results: An 8-French pigtail catheter within the intervertebral space was successfully placed in all patients. Seven patients responded well to this treatment. The one remaining patient who had developed septic shock before the procedure died on the following day. The mean duration of drainage was 32 days (13-70 days). Only one patient with persistent back pain underwent surgery for stabilization of the spine after the improvement of inflammation. Among seven patients responding well, long-term follow-up (91-801 days, mean 292 days) was conducted in six patients excluding one patient who died of asphyxiation due to aspiration unrelated to the procedure within 30 days after the procedure. In these six patients, no recurrence of either pyogenic spondylodiscitis or the psoas abscess was noted. Conclusion: CT-guided percutaneous drainage within the intervertebral space can be effective for patients with pyogenic spondylodiscitis and a secondary psoas abscess if the psoas abscess communicates with the intradiscal abscess. [ABSTRACT FROM AUTHOR]

Objective: This study evaluated the feasibility and safety of the transjugular intrahepatic portosystemic shunt (TIPS) procedure using the hepatic artery-targeting guidewire technique for the puncture step. Methods: We retrospectively reviewed 11 consecutive patients (5 men and 6 women, aged 46-76 years (mean 64 years)) with portal hypertension in whom the TIPS procedure was performed. As the first step in the TIPS procedure in all cases, a micro-guidewire was inserted into the hepatic arterial branch accompanying the portal venous branch through a microcatheter coaxially advanced from a 5-French catheter positioned in the coeliac or common hepatic artery. At the puncture step, the tip of the metallic cannula was aimed 1 cm posterior to the distal part of this micro-guidewire, after which the TIPS procedure was performed. Success rate, number of punctures and complications were evaluated. Results: The TIPS procedure was successfully performed in all 11 patients. Themean number of punctures until success in entering the targeted portal venous branchwas 5 (range 1- 14). In 3 patients (27%), the right portal venous branch was entered at the first puncture attempt. The hepatic artery was punctured once in one patient and the bile duct was punctured once in another patient. No serious procedure-induced complications occurred. Conclusion: The TIPS procedure can be accomplished safely, precisely and relatively easily using the hepatic artery-targeting guidewire technique. [ABSTRACT FROM AUTHOR]

Background: Various treatments for hepatocellular carcinoma (HCC) beneath the diaphragm have been reported. Transpulmonary radiofrequency (TPRF) ablation for HCC beneath the diaphragm has been developed as a safe treatment, but pneumothorax has been reported as the most common complication of TPRF ablation. Purpose: To evaluate the relationship between the incidence of pneumothorax and various variables after TPRF ablation. Material and Methods: Seventy-six TPRF ablation sessions for unresectable HCC were performed in 66 patients (19 women, 47 men; mean age 69.6 years) under computed tomography (CT)-fluoroscopic guidance between November 2005 and April 2009. All patients had HCC beneath the diaphragm, not visible by ultrasonography. In 62 of the 76 sessions, the number of transpulmonary approaches was one as adequate, while multiple transpulmonary approaches were performed in 14 of the 76 sessions. The rate of pneumothorax and risk factors for pneumothorax were investigated. Results: Among the 76 sessions, pneumothorax was detected in 51 sessions (67.1%). Among the 14 sessions with multiple transpulmonary passages, pneumothorax was detected in 13 (92.9%), while in the 62 sessions with a single transpulmonary passage, pneumothorax occurred in 38 sessions (61.3%). Hence, the number of transpulmonary approaches was a significant factor (P=0.0232). Among 13 variables investigated for the 62 sessions with a single transpulmonary approach, the only significant factor correlated with the occurrence of pneumothorax was the length of the needle trajectory through the aerated lung (P=0.0014). The incidence of chest tube placement was 7.9%. Conclusion: Pneumothorax occurred frequently after TPRF ablation for HCC. The main risk factors for pneumothorax after TPRF ablation for HCC were increased length of needle trajectory through the aerated lung and multiple transpulmonary approaches in one session. Even if pneumothorax occurred, pneumothorax disappeared spontaneously or with simple treatment such as manual aspiration in most cases. [ABSTRACT FROM AUTHOR]

We used a retrospective non-randomised study to investigate the clinical effect of selective embolisation of the right gastric artery before hepatic arterial infusion chemotherapy (HAIC) using a port-catheter system. We evaluated whether the hepatic artery or the left gastric artery is the better approach for selecting the right gastric artery. A total of 367 patients (244 men and 123 women; mean age, 64.1 years) with unresectable advanced liver cancer underwent percutaneous implantation of a port-catheter system. In 294 of these patients, right gastric arterial embolisation with microcoils was attempted before placement of the port-catheter system to prevent gastric mucosal lesions. Approach was either through the hepatic artery (175 patients) or through the left gastric artery (119 patients), with success rates in catheterising the right gastric artery of 78.3% and 77.3%, respectively. If the attempt was unsuccessful, the catheter was redirected to the alternative approach, which increased the final success rate to 96.3%. Only seven patients experienced gastroduodenal mucosal lesions acutely after HAIC, as revealed by endoscopy. Embolisation of the right gastric artery is a feasible procedure that can reduce the incidence of gastric mucosal lesions associated with HAIC. Approach through either the hepatic artery or the left gastric artery is equally acceptable. [ABSTRACT FROM AUTHOR]

Background: Radiofrequency (RF) ablation of lung tumors has become a treatment of choice, especially for unresectable cases. However, RF ablation of small lung lesions located just beneath the rib is difficult. Purpose: To evaluate the efficacy and safety of gantry tilting for the performance of RF ablation of peripheral lesions located beneath the rib. Material and Methods: Our study was based on 18 of 293 lesions in the lung for which RF ablation was performed under CT scan fluoroscopic guidance at our institution between October 2004 and March 2009. For these 18 lesions, RF ablation was performed with gantry tilting because a rib blocked visualization of the RF ablation route even after other attempts had been made to change the relationship between the target and the rib. Results: All RF needles, with only one exception, were successfully advanced to hit the tumor. The commonest complication was a pneumothorax, which occurred in seven procedures. No serious complications occurred. The progression-free rates were 82.4% at 6 months, 62.5% at 12 months, and 30% at 24 months. Mean local progression-free duration was 17.6+/-11.6 months (range 4-36 months). Conclusion: RF ablation under CT scan fluoroscopic guidance with gantry tilt is a useful and safe technique for RF ablation of lung nodules located beneath the rib. [ABSTRACT FROM AUTHOR]

Background: Pneumothorax is the most common complication after computed tomography (CT)-guided lung biopsy. The presence of a pneumothorax per se does not complicate patient management, but an increasing pneumothorax, making chest tube placement necessary, is highly problematic. Purpose: To evaluate the efficacy and limitations of simple aspiration of air from the pleural space to prevent increased pneumothorax and avoid chest tube placement in cases of pneumothorax following CT-guided lung biopsy. Material and Methods: The subjects of our study were 642 consecutive lung lesions in 594 patients for which percutaneous needle lung biopsies were performed using CT guidance. While patients were on the CT scanner table, percutaneous manual aspiration was performed in all patients with a non-small pneumothorax demonstrated on post-biopsy chest CT images. The frequency of pneumothorax, management of each such case, and factors influencing the incidence of worsening pneumothorax that finally required chest tube placement were evaluated. Results: Post-biopsy pneumothorax occurred in 243 of 642 (38%) procedures. Of the 243 cases, 112 were treated with manual aspiration immediately after biopsy. In 210 (86.4%), the pneumothorax had resolved completely on follow-up chest radiographs without chest tube placement. Only 33 patients required chest tube placement. Requirement of chest tube insertion significantly increased in parallel with the degree of pneumothorax as shown on post-biopsy CT images. The rate of chest tube insertion was statistically higher in subjects with values for aspirated air above 543 ml. Conclusion: Percutaneous manual aspiration of biopsy-induced pneumothorax performed immediately after biopsy may prevent worsening of pneumothorax and avoid chest tube placement. The amount of aspirated air can be predictive of the requirement for chest tube placement. [ABSTRACT FROM AUTHOR]

We report a case of Jaccoud’s arthropathy with forefoot plantar callosity. The lesser toe metatarsal heads were resected and Swanson’s double-stemmed flexible-hinge implant arthroplasty of the first metatarsophalangeal joint was performed. An osteolytic defect had formed around the implant after 2 years. Surgical revision comprised implant removal and synovectomy. Histology revealed a foreign-body reaction with birefringent material in multinucleated giant cells. Because the capsuloligamentous system is fragile in Jaccoud’s arthropathy, we recommend resection arthroplasty or arthrodesis of the first MP joint as an initial operative approach. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess the effectiveness of lymphangiography as a treatment for various chyle leakages. Pedal lymphangiography was performed in 9 patients (6 men and 3 women; mean age, 59 years) who were unlikely to be cured only by conservative treatment — a low-fat medium-chain triglyceride diet, total parenteral nutrition and insertion of a drainage tube and in whom chylothorax (n55), chylous ascites (n52) and lymphatic fistulae (n52) were refractory to conservative treatment. In 7 of these 9 patients (78%), we could detect the chyle leakage sites. In 8 of the 9 patients (89%), lymphatic leakage was stopped after lymphangiography, and surgical re-intervention was avoided. No cases had a recurrence of chyle leakage during follow-up (range, 1-54 months). Lymphangiography is effective not only for diagnosis but also as treatment for various chyle leakages. Early lymphangiography is therefore recommended for patients with chyle leakages who are unlikely to be cured by conservative treatment only. [ABSTRACT FROM AUTHOR]

Aim: To retrospectively investigate persistent hepatofugal blood flow in the gastroduodenal artery after implantation of a port-catheter system for repeated hepatic arterial infusion chemotherapy using a modified fixed catheter tip method. Materials and methods: A port-catheter system was percutaneously implanted in 150 patients (90 men and 60 women; mean age 64.6 years) with unresectable liver cancer. The persistence of blood flow beyond the end hole of the indwelling catheter via the port obtained immediately and 1–10 days after port-catheter placement was investigated using arteriography. Results: In all cases, port-catheter placement was successfully performed. In 64 (42.7%) of the 150 participants, the gastroduodenal artery was detected on arteriography just after implantation. However, arteriography obtained 1–10 days (mean 4.3 days) after implantation revealed the gastroduodenal artery in only two of the 64 participants. In these two patients, persistent blood flow disappeared spontaneously 12 and 15 days after implantation, respectively. Conclusion: Closure of the lumen of the distal tip of the catheter beyond the side hole most often occurs spontaneously just after implantation. However, the findings of the present study indicate that closure will occur within 15 days at the latest. This suggests that delaying chemotherapy for about 2 weeks after implantation may be advisable. [Copyright &y& Elsevier]

Background: In patients with two or more intrahepatic arteries, multiple intrahepatic arteries should be converted into a single intrahepatic artery before repeated hepatic arterial infusion chemotherapy. However, the number of reports investigating this has been scanty. Purpose: To evaluate the usefulness of the redistribution of multiple hepatic arteries into a single hepatic artery for repeated hepatic arterial infusion chemotherapy (HAIC) through an indwelling port-catheter system for unresectable liver malignancies. Material and Methods: In 76 patients with unresectable advanced liver cancer, redistribution of multiple hepatic arteries into one hepatic artery was performed prior to port-catheter system implantation. Investigated were distribution in the liver, as evaluated with computed tomography (CT) during arteriography via the port after implantation, and management of cases in which distribution in the entire liver was not achieved. Results: In 64 patients, good distribution in the entire liver was confirmed on CT arteriography via the port. In the remaining 12 patients, contrast material was heterogeneously distributed. The segments with poor distribution were segments VI, VII, VIII, and I. In the five patients with tumors in segments having poor distribution, the right inferior phrenic artery was successfully embolized and good distribution throughout the entire liver was thereafter achieved in all five. Conclusion: In cases with multiple hepatic arteries, redistribution procedures allow application of repeated HAIC through a single indwelling catheter while maintaining distribution over the entire liver. However, care regarding hepatopetal flow of the right inferior phrenic artery is necessary. [ABSTRACT FROM AUTHOR]

Background: There is strong controversy as to whether to use filters temporarily in the inferior vena cava (IVC) during endovascular therapies for deep venous thrombosis (DVT) in the lower extremity. Purpose: To evaluate the necessity of implantation of a retrievable inferior vena cava filter during treatment of DVT in the lower extremity using various endovascular techniques. Material and Methods: Studied were all 37 consecutive sessions of endovascular treatments performed in 34 patients with symptomatic lower-limb DVT between April 2001 and October 2006. In all sessions, a Gunther tulip retrievable vena cava filter (GTF) was implanted during the procedures. The degree of trapped thrombus in the filter was evaluated by repeated venocavography. Results: Implantation of a total of 66 GTFs was successfully performed in 37 sessions. Worsening of or new formation of pulmonary embolism was avoided in all patients. In 20 (54.1%) of the 37 sessions, a trapped thrombus in the filter was observed. In 14, the trapped thrombus was large, filling more than half the height of the filter. Conclusion: Temporary implantation of filters is effective in preventing pulmonary emboli during endovascular treatment of DVT in the lower extremities. [ABSTRACT FROM AUTHOR]

The aim of this study is to evaluate the feasibility and safety of CT fluoroscopic-guided needle biopsy with the use of the "I-I device", which was developed to assist in precisely advancing the needle while avoiding irradiation to the operator's hand. Using the "I-I device" under CT fluoroscopic guidance, 131 percutaneous needle lung biopsies were performed followed by histopathological evaluation. The final diagnosis was confirmed by independent surgical pathological findings or clinical follow-up. The rate of success in obtaining specimens adequate for histopathological analysis was 100% (131/13 1). For the 104 lesions that we were able to follow up, sensitivity, specificity and accuracy in diagnosing malignancy were 93.8%, 100% and 95.2%, respectively. In 51 lesions for which surgery was performed, the specific cell type was characterized in 98.0% (50/51; malignant, n=38; benign, n=12). The specific cell type was precisely diagnosed and confirmed after surgery in 36 malignant lesions and 8 benign lesions. Biopsy-induced complications were pneumothorax in 34.0% (44/131) and haemoptysis in 9.9% (13/131). None of the patients had serious complications. In conclusion, CT fluoroscopic-guided lung biopsy with use of the "I-I device" provides a high degree of diagnostic accuracy, allows specific characterization of lung nodules and can be performed safely. [ABSTRACT FROM AUTHOR]

The feasibility of infusion of 50% glucose solution before balloon-occluded retrograde transvenous obliteration (BRTO) to occlude collateral vessels draining gastric varices other than gastrorenal shunt was evaluated. In five patients with such collateral vessels, 50% glucose solution was infused from the balloon catheter inflated within the gastrorenal shunt. The degree of collateral vessels had decreased when BRTO was carried out so that sclerotic agents sufficiently occupied the gastric varices in all patients. In three patients, embolization of collateral vessels with coils was unnecessary. There were no complications. In conclusion, retrograde infusion of 50% glucose solution assists in effectively carrying out BRTO. [ABSTRACT FROM AUTHOR]

Purpose: To retrospectively evaluate results of selective embolization of the accessory left gastric artery prior to repeated hepatic arterial infusion chemotherapy using a port-catheter system. Material and Methods: Of 22 patients with unresectable advanced liver cancer who underwent percutaneous implantation of a port-catheter system, an accessory left gastric artery was revealed by arteriography in 16 patients before and in six patients after port-catheter implantation. The right gastric artery was embolized to prevent gastric mucosal lesions in all 22 patients. In addition, the accessory left gastric artery was selectively embolized for the same purpose using from one to six microcoils, which were from 3 to 5 mm in diameter. Within 10 days after implantation, arteriography was performed while contrast material was infused via the port. Results: Selective embolization of the accessory left gastric artery was successful in all 22 patients. No complication related to embolization of this artery occurred in any patient. A gastrointestinal mucosal lesion developed in only one case during hepatic arterial infusion chemotherapy, but was unrelated to the accessory left gastric artery. Conclusion: Prophylactic embolization of the accessory left gastric artery is useful to avoid development of a gastrointestinal mucosal lesion resulting from hepatic arterial infusion chemotherapy. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine management guidelines for biopsy-induced pneumothorax with the assistance of manual aspiration, mainly based on the duration of complicated pneumothorax. Data from 388 consecutive percutaneous needle lung biopsies were examined. Patients with pneumothorax on postbiopsy chest CT images underwent percutaneous manual aspiration with an 18-G i.v. catheter. Frequency and management of biopsy-induced pneumothorax and period to its disappearance were reviewed. Postbiopsy pneumothorax occurred in 133 of 388 (34.3%) procedures. Manual aspiration in 72 of these 133 patients was carried out immediately after biopsy. The pneumothorax had resolved completely on follow-up chest radiographs without chest tube placement in 121 of the 133 pneumothoraces (91.0%). In cases requiring chest tube, the mean period from biopsy until resolution of the pneumothorax was 6.0 ± 5.3 days, but was only 2.4 ± 2.9 days when chest tube placement was not needed. Specifically, time until recovery was short both in those not requiring manual aspiration (2.1 ± 3.4 days) and in those with a pneumothorax that disappeared completely or almost completely after manual aspiration (1.9 ± 2.0 days). The almost equally short recovery periods in patients not requiring manual aspiration and those requiring immediate manual aspiration indicates the value of rapid management. [ABSTRACT FROM AUTHOR]

This is the study of a 52-year-old man with oesophageal, rectal and anal varices caused by portal hypertension with complete obstruction of the superior mesenteric vein. Treatment by two sessions of interventional radiological procedures was successful. The first was a catheter-directed thrombolysis using the transmesenteric approach. The second was percutaneous transluminal angioplasty and stent implantation for the obstructed segment of the superior mesenteric vein and the creation of a transjugular intrahepatic portosystemic shunt. In the second session, devices were advanced over a guidewire inserted from the right jugular vein and pulled out of the ileocolic vein using the pull-through technique. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the efficacy of hepatic port‐catheter system placement without distal catheter tip occlusion or gastroduodenal artery embolization distal to the catheter tip.Material and Methods: A port‐catheter system was percutaneously implanted in 29 patients (16 men, 13 women; mean age 65.6 years) with unresectable liver cancer. Persistent blood flow through the end hole of the catheter was verified immediately and 1–10 days after catheter placement.Results: In all cases, percutaneous port‐catheter placement was successfully performed. In seven of 29 (24.1%) patients, flow through the end hole of the catheter was verified immediately after the procedure. However, no flow was seen 1–10 days after the procedure.Conclusion: It is not necessary to occlude the end hole of the catheter tip and embolize the gastroduodenal artery beyond the catheter tip when placing a port‐catheter system for repeated hepatic arterial infusion chemotherapy. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: This study was initiated to examine if exposure to cadmium (Cd) was high also outside of the previously identified Itai-itai disease endemic region in the Jinzu River basin in Toyama prefecture in Japan. Methods: Morning spot urine samples were collected in June–August 2004 from 651 adult women (including 535 never-smokers) in various regions in Toyama prefecture, and subjected to urinalyses for cadmium (Cd), α1-microglobulin (α1-MG), β2-microglobulin (β2-MG), N-acetyl-β-d-glucosaminidase (NAG), specific gravity (SG or sg) and creatinine (CR or cr). Three months later, the second urine samples were collected from those with elevated Cd in urine (e.g., ≧4 μg/g cr), together with answers to questionnaires on shellfish consumption. Results: The geometric mean (GM) Cd, α1-MG, β2-MG and NAG (after correction for CR) for the total participants were 2.0 μg/g cr, 2.4 mg/g cr, 104 μg/g cr and 2.8 units/g cr, respectively; further analysis with never-smoking cases only did not induce significant changes in these parameters. Analyses of the second urine samples from the high Cd subjects showed that there was substantial decrease (to about a half) in Cd in the 3-month period, and that the decrease was accompanied by reduction in α1-MG and NAG (β2-MG did not show elevation even in the first samples). The urinalysis results in combination with the results of the questionnaire survey suggest that the high urinary Cd was temporary and might be induced by intake of shellfish that is edible whole. Conclusions: The overall findings appear to suggest that Cd exposure in Toyama populations (outside of the Itai-itai disease endemic region) was at the levels commonly observed on the coast of the Sea of Japan, and that the Cd level in urine might be modified by the intake of some types of seafood. Further studies are necessary to elucidate the relation of urinary Cd with seafood intake. [Copyright &y& Elsevier]

Abstract: Launching a large balloon in a limited launching field is a long standing problem in Japan. The largest balloon ever launched successfully was 200,000m3 in volume. It was launched in 1973. A larger balloon with a volume of 500,000m3 was tried later, but it burst during the ascending phase. For launching balloons with a large lift exceeding 500kg, the conventional static launching method had the most serious problem with possible damage to the polyethylene film of the balloon caused by the holding mechanism. After that, we had developed a new static launching method to launch balloons with a total lift of 1.0ton. For launching a large balloon with a total lift above 1.5ton, the new static launching method had a weak point in that if there was an air bubble in the folded part of the balloon, it may puncture the balloon as it is pushed by a spool. To avoid this problem, we developed a semi-dynamic launching method in 1999 using a launcher fixed to the ground leaving a freedom of rotation around the vertical axis. We have launched some balloons using the method and have gradually enriched our experience in using this system. In 2003, we successfully launched a balloon with a volume of 500,000m3 by using the method. This balloon was made of polyethylene films with a thickness of 20μm and it is the largest balloon ever launched in Japan. [Copyright &y& Elsevier]

We report a case in which hepatic arterial occlusion developed during repeated hepatic arterial infusion chemotherapy through an implanted port-catheter system for advanced malignant hepatic neoplasia. After successful recanalization of the hepatic artery by using percutaneous transluminal angioplasty, another port-catheter system was placed percutaneously by interventional radiology techniques, allowing the continuation of hepatic arterial infusion chemotherapy. [ABSTRACT FROM AUTHOR]

We present a patient with gastric varices complicating portal hypertension caused by liver cirrhosis related to hepatitis C virus. The patient underwent balloon-occluded retrograde transvenous obliteration. The gastric varices almost completely disappeared, without any sclerotic agent being used, after iatrogenic injury of the gastrorenal shunt at the time of the interventional procedure. [ABSTRACT FROM AUTHOR]

The authors report a case in which catheter-related difficulties occurred with a port-catheter system implanted to perform repeated hepatic arterial infusion chemotherapy for advanced hepatocellular carcinomas. The port-catheter system had been percutaneously implanted with the catheter tip fixation method, and a side hole had been created in the indwelling catheter for placement in the common hepatic artery. Four months after port-catheter placement, however, the indwelling catheter became bent at the location of the side hole in the proper hepatic artery. Subsequently, the side hole moved into the left hepatic artery, resulting in a lack of distribution of chemotherapeutic agents to the tumours in the segments of the liver supplied by the right hepatic artery. This situation was easily corrected with a simple interventional radiological method so that hepatic arterial infusion chemotherapy could be resumed with sufficient distribution over the entire liver. To our knowledge, such a problem involving a port-catheter system implanted with the catheter tip fixation method and its management thereafter has not been reported in the published literature. [ABSTRACT FROM AUTHOR]

The CdTe and the CdZnTe detectors are considered to be promising detectors for the future of astronomical hard X-ray observations due to their high stopping power and high energy resolution. For the preparation of future experiments, we have performed a simple balloon experiment using a small CdTe detector (2 mm cubic) as a piggy-back mission in 2000. Its energy range was 20–140 keV band with an energy resolution of 3.0 keV at 60 keV. The balloon reached an altitude of 36.9 km, and then gradually descended. During the 10-h flight, we successfully observed the background spectrum. The flux of the background was ∼1.5 × 10-2 s-1 cm-2 keV-1 at 50 keV, being comparable to those of the past observations measured by CdZnTe detectors. We also found that the count-rate increases as the atmospheric pressure increases. No apparent line emission was observed. [Copyright &y& Elsevier]

Development of a balloon flying at higher altitude is one of the most attractive trials for balloon technology. We, the balloon group at the Institute of Space and Astronautical Science (ISAS), have been engaged in the development of a light balloon to go to higher altitudes since 1991. We have developed light equipment for house keeping modules and an ultra-thin film with a thickness of only 3.4 μm. Using the equipment and film, we have made and launched some balloons from 1000 m3 in volume. We gradually enlarged the balloon volume, and on May 23, 2002, we launched a 60,000 m3 balloon. The balloon reached the altitude of 53.0 km, which is the highest altitude ever reached by a balloon. This event opened a new era for scientific observations at high altitude. [Copyright &y& Elsevier]

Objectives: To evaluate the efficacy of simple aspiration of air from the pleural space to prevent increased pneumothorax and to avoid chest tube placement in cases of pneumothorax following CT-guided lung biopsy.Design: Observational.Materials and Methods: One hundred thirty-four consecutive percutaneous needle lung biopsies using real-time CT fluoroscopy guidance formed the basis of our study. All patients that demonstrated moderate or severe pneumothorax on postbiopsy chest CT images underwent percutaneous manual aspiration regardless of symptoms while on the CT scanner table. Correlation between the incidence of pneumothorax after biopsy and many factors (i.e., gender, age, number of pleural passes, presence of emphysema, lesion size, and lesion depth) were determined, and management of each case of biopsy-induced pneumothorax was reviewed.Results: Postbiopsy pneumothorax occurred in 46 of 134 procedures (34.3%). Twenty of the 46 patients were treated by manual aspiration, while 26 patients were simply observed. In 43 of the 46 pneumothoraces (93.5%), the pneumothorax resolved completely on follow-up chest radiographs without requiring tube placement. Only three patients (2.2% of the entire series; 6.5% of those who had pneumothorax develop) required chest tube placement. The risk of pneumothorax significantly increased with lesion size and depth.Conclusion: Results of our nonprospective, nonrandomized study suggest that percutaneous manual aspiration of biopsy-induced pneumothorax performed immediately after biopsy may prevent progressive pneumothorax and subsequent chest tube placement. [ABSTRACT FROM AUTHOR]

BACKGROUND: Short sleeping hours could cause obesity through increased sympathetic activity, elevated cortisol secretion and decreased glucose tolerance. The aim of this study was to clarify parental and lifestyle factors, particularly sleeping habits, associated with obesity in Japanese children. METHODS: Between June and July 1996, 8274 children (4194 males and 4080 females) aged 6-7 years living in Toyama prefecture, Japan, were investigated by questionnaire survey and the collection of anthropometric data. Subjects with a body mass index (BMI; weight in kg divided by square of height in m) greater than the age- and sex-specific cut-off points linked to adulthood overweight (BMI of 25 kg/m2 or more) were defined as obese subjects. Parental obesity was defined as a BMI of 25 kg/m2 or more. Logistic regression analysis was performed to evaluate the strength of the relationships between parental obesity or lifestyle factors and childhood obesity, adjusted for possible confounding factors. RESULTS: Parental obesity, long hours of TV watching and physical inactivity were significantly associated with childhood obesity. Although wake-up time was not related to obesity, there was a significant dose-response relationship between late bedtime or short sleeping hours and childhood obesity. Compared with children with 10 or more hours of sleep, the adjusted odds ratio was 1.49 (95% confidence interval 1.08-2.14) for those with 9-10 h sleep, 1.89 (1.34-2.73) for those with 8-9 h sleep and 2.87 (1.61-5.05) for those with <8 h sleep, after adjustment for age, sex, parental obesity and other lifestyle factors. CONCLUSION: A strong inverse association was observed in the relationship between sleeping hours and childhood obesity. Longitudinal research will be required to confirm this causality. [ABSTRACT FROM AUTHOR]

Purpose: To investigate nontumorous abnormalities in the liver around the falciform ligament as revealed by arteriography and helical CT arterial portography (CTAP) and helical CT during hepatic arteriography (CTHA).Material and Methods: One hundred and seventeen patients simultaneously underwent hepatic arteriography and CTAP and CTHA of the common hepatic artery. The number, size, and shape of nontumorous defects of portal perfusion in the liver adjacent to the falciform ligament on CTAP as well as the nontumorous contrast enhancement in the same area on CTHA were determined. In 1 case, in which nontumorous enhancement was observed on CTHA, selective arteriography from the gastric arteries was performed.Results: On CTAP a nontumorous area of decreased portal perfusion of the liver around the falciform ligament was detected in 18 (15.4%) of the 117 patients, while nontumorous enhancement on CTHA was seen in 7 (6.0%). In 4 patients, both of these nontumorous abnormalities were observed. In the patient undergoing selective gastric arteriography, nonportal venous inflow to the liver in the direction to the liver adjacent to the falciform ligament was seen.Conclusion: One cause of nontumorous vascular abnormalities adjacent to the falciform ligament as shown on angiographic helical CT is aberrant gastric venous inflow to this region. [ABSTRACT FROM AUTHOR]

Summary It has been observed that obese children receive genetic and environmental effects that are associated with them being overweight. With regard to the latter, lifestyles such as eating habits and physical activity have been focused on. In the present study, the social characteristics which would dominate their lifestyles were investigated as background variables. For this purpose, 9668 Japanese children aged three years who were all born in Toyama prefecture, Japan, in 1998, served as birth cohort subjects. For the comparison between obese (Kaup index; mass in kg/(height in m)2 >=18) and nonobese (Kaup index 18) children, irregular snack intake, physical inactivity and reduced sleeping hours were chosen as statistically significant obesity-related lifestyle indicators for the children. For social characteristics, family construction (expanded family with grandparents/nonexpanded family), main caregiver (mother/other), attending a nursery school (yes/no) and mother’s employment (full-time worker/other) were chosen. These were significantly associated with the obesity-related lifestyles mentioned above using multiple logistic regression analysis adjusted for other variables of social characteristics as well as for gender and birth month (July–December/January–June). The two greatest population-attributable risk percentages were observed for mother as main caregiver (-36.5%) and attending a nursery school (-28.9%) for irregular snack intake. Therefore, these two social characteristics substantially reduced the number of children with irregular snack intake. On the other hand, the two social characteristics were reversed in children with reduced sleeping hours (population-attributable risk percentage of mother as main caregiver: 15.4%; attending a nursery school: 17%). In contrast with favourable effects on snack intake these social characteristics showed an adverse influence on the sleeping habits of children. [ABSTRACT FROM AUTHOR]

We encountered a patient with a gastric varix that drained through the left inferior phrenic vein, which directly entered the inferior vena cava at the point just inferior to the diaphragm. In this patient, gastrorenal shunt was not seen. Balloonoccluded retrograde transvenous obliteration of the gastric varix was performed, in which 50% glucose and 5% ethanolamine oleate-iopamidol were injected as sclerosing agents while the balloon was inflated in the left inferior phrenic vein. 1 week after the procedure, the disappearance of enhancement in the gastric varix was confirmed on contrast-enhanced multidetector row CT. Furthermore, a significant reduction in the size of the varix was confirmed on endoscopic examination 4 months later. [ABSTRACT FROM AUTHOR]

This paper reviews the development of behavior therapy, its applications, and the characteristics that make this form of therapy unique and applicable to a wide range of problems. Behavior therapy started from learning theory. It has adopted other theoretical bases and produced numerous techniques as a result of efforts to apply its principles to clinical problems. Recently, cognitive techniques of behavior therapy have been growing. The characteristics of behavior therapy are: (i) problem oriented and practical; (ii) emphasis on real life and living skills; and (iii) concrete viewpoint and techniques. These characteristics enable wide application. Today, many studies show the superior efficacy of behavior therapy for various mental and physical problems. Some well-documented techniques can be performed by non-professionals. The techniques and the viewpoint of behavior therapy would be accepted widely in Pacific Rim countries in the future. [ABSTRACT FROM AUTHOR]

Presents a study which investigated the hot workability of R-iron-boron alloys and their magnetic properties. Experimental details; Results and discussion; Conclusion.

Abstract: Cosmic-ray electrons have been observed in the energy region from 10GeV to 1TeV with the PPB-BETS by a long duration balloon flight using a Polar Patrol Balloon (PPB) in Antarctica. The observation was carried out for 13 days at an average altitude of 35km in January 2004. The PPB-BETS detector is an imaging calorimeter composed of scintillating-fiber belts and plastic scintillators inserted between lead plates. In the study of cosmic-ray electrons, there have been some suggestions that high-energy electrons above 100GeV are a powerful probe to identify nearby cosmic-ray sources and search for particle dark matter. In this paper, we present the energy spectrum of cosmic-ray electrons in the energy range from 100GeV to 1TeV at the top of atmosphere, and compare our spectrum with the results from other experiments. [Copyright &y& Elsevier]

There are few reports of unmanipulated HLA-haploidentical nonmyeloablative stem cell transplantation (NST) using only pharmacological acute graft-vs.-host disease (GVHD) prophylaxis. We present here a successful case of unmanipulated HLA-haploidentical NST for mediastinal large B cell lymphoma that was resistant to autologous peripheral blood stem cell transplantation (PBSCT). The conditioning regimen consisted of fludarabine, busulfan and rabbit anti-T-lymphocyte globulin (ATG) in addition to rituximab. GVHD prophylaxis was performed using tacrolimus and methylprednisolone 1 mg/kg. The patient had rapid engraftment, with 100% donor chimaerism in the lineages of both T cells and granulocytes on day +12, but developed no GVHD clinically. The patient is still in complete remission past day +1020, with no sign of chronic GVHD without receiving immunosuppressive agents. HLA-haploidentical NST may be performed without utilizing mixed chimaerism. [ABSTRACT FROM AUTHOR]

Describes a process for the development of high-energy bulk praseodymium-iron-boron magnets directly from the melt without the handling of magnetic powder or powderlike ribbons. Processes in the preparation of anisotropic rare-earth element magnets with full density; Production steps of cast magnets and hot-pressed magnets; Effects of copper addition on the magnets.

Abstract: The Balloon-borne Experiment with a Superconducting Spectrometer (BESS) was flown from Lynn Lake, Manitoba, Canada in August, 2000, during the maximum solar modulation period, with an average residual atmospheric overburden of 4.3g/cm2. Precise spectral measurements of cosmic ray hydrogen isotopes from 0.178GeV/n to 1.334GeV/n were made during the 28.7h of flight. This paper presents the measured energy spectra and their ratio, 2H/1H. The results are also compared with previous measurements and theoretical predictions. [Copyright &y& Elsevier]

Abstract: Development of a balloon to fly at higher altitudes is one of the most attractive challenges for scientific balloon technologies. After reaching the highest balloon altitude of 53.0km using the 3.4μm film in 2002, a thinner balloon film with a thickness of 2.8μm was developed. A 5000m3 balloon made with this film was launched successfully in 2004. However, three 60,000m3 balloons with the same film launched in 2005, 2006, and 2007, failed during ascent. The mechanical properties of the 2.8μm film were investigated intensively to look for degradation of the ultimate strength and its elongation as compared to the other thicker balloon films. The requirement of the balloon film was also studied using an empirical and a physical model assuming an axis-symmetrical balloon shape and the static pressure. It was found that the film was strong enough. A stress due to the dynamic pressure by the wind shear is considered as the possible reason for the unsuccessful flights. A 80,000m3 balloon with cap films covering 9m from the balloon top will be launch in 2011 to test the appropriateness of this reinforcement. [Copyright &y& Elsevier]

Abstract: Since 1971, numerous balloons have been launched from the Japanese balloon base, the Sanriku Balloon Center (SBC). Through these years, balloon technologies have been developed continuously and many scientific achievements have resulted. Recently, however, because of the limited area of the launching pad of the SBC, we have been faced with the difficulty of safely launching large balloons. To solve this issue, we decided to move the balloon base from the SBC to the Taiki Aerospace Research Field (TARF) in northern Japan. The TARF had an existing huge hanger and a paved launch pad capable of being utilised for balloon operations. To evolve the TARF into a new balloon base, new balloon facilities have been constructed at the TARF and equipment was transferred from the SBC to the TARF during July 2007 and March 2008. The SBC was closed in September 2007, and the new base became operational in May 2008. The new base at the TARF is designed to launch larger balloons with greater safety and to perform balloon operations more effectively than ever before. In the summer of 2008, we carried out the first series of the balloon campaign at the TARF, and succeeded in two engineering flights of stratospheric balloons. By the success of these flights, we have verified that the whole system of the new balloon base is well established. [Copyright &y& Elsevier]

Spectroscopic observation of solar flares in the hard X-ray energy range, particularly the 20 ∼ 100 keV region, is an invaluable tool for investigating the flare mechanism. This paper describes the design and performance of a balloon-borne hard X-ray spectrometer using CdTe detectors developed for solar flare observation. The instrument is a small balloon payload (gondola weight 70 kg) with sixteen 10×10×0.5 mm CdTe detectors, designed for a 1-day flight at 41 km altitude. It observes in an energy range of 20−120 keV and has an energy resolution of 3 keV at 60 keV. The second flight on 24 May 2002 succeeded in observing a class M1.1 flare. [ABSTRACT FROM AUTHOR]

Abstract: Historically, there are been many searches for fractionally charged particles in the cosmic radiation. However, few searches have been performed near the top of the atmosphere. We performed a search for relativistic charged particles in cosmic rays using data collected during four BESS balloon flights from 1997 to 2000 carried out in northern Canada. The data were analyzed by examining energy deposition in the time-of-flight scintillator hodoscopes. No candidate was found. We derive an upper limit of 4.5×10−7 (cm2 ssr)−1 for the flux of charged particles, at the 90% confidence level. [Copyright &y& Elsevier]

We report a 78-year-old woman who presented with repeated tarry stools, and having lower duodenal variceal bleeding caused by portal hypertension. Endoscopic therapy had been attempted, but was impossible because the endoscope could not be inserted into the lower duodenum. Thus, the lower duodenal variceal bleeding was treated with balloon-occluded retrograde transvenous obliteration in combination with embolization using microcoils. Complete hemostasis was achieved without complications, and neither the recurrence of varices nor rebleeding has occurred for the last 3 years. A review of the English-language literature reveals only 11 such cases. The world literature is reviewed. [ABSTRACT FROM AUTHOR]

We have been developing an instrument named "PHENEX (Polarimetry for High ENErgy X rays)" to measure polarization in the hard X-ray region. The PHENEX polarimeter consists of detector modules called "unit counters". We have investigated the performance of the unit counter, using a highly polarized beam in KEK-PF BL14A. From these measurements, we obtained a detection efficiency of 20% and a modulation factor (analyzing power for polarization) of 53% for 80 keV X rays. Assembling four unit counters, a balloon-flight version was constructed and a preliminary observation of the Crab Nebula was carried out on Jun. 13th, 2006. During this flight, the PHENEX polarimeter observed the Crab for about one hour and detected its hard X rays with a significance of 9σ. From this result, we expect that a PHENEX polarimeter with nine "unit counters" would achieve a 17% minimum detectable polarization of the Crab Nebula with 3σ significance in a 3-hour observation. [ABSTRACT FROM AUTHOR]

Abstract: The Emulsion Cloud Chamber (ECC) has played important role for the cosmic-ray research. The Micro Segment Chamber (MSC) is a new generation detector evolved from the ECC, which has maximized and extended advantages of ECCs as well as overcome difficulties in the analysis of the events that occur inside the detector. The essential parts of MSC and its application to a balloon experiment for cosmic-ray electron observations are described. [Copyright &y& Elsevier]

Abstract: We have observed cosmic-ray electrons from 10 to 1000GeV by a long duration balloon flight using Polar Patrol Balloon (PPB) in Antarctica. The observation was carried out for 13 days at an altitude of 35km in January 2004. The detector is an imaging calorimeter composed of scintillating-fiber belts and plastic scintillators inserted between lead plates. The geometrical factor of detector is about 600cm2sr and the total thickness of lead absorber is 9 radiation lengths. The performance of the detector has been confirmed by the CERN-SPS beam test and also investigated by Monte-Carlo simulations. New telemetry system using a commercial satellite of iridium, power supply by solar batteries, and automatic level control using CPU have successfully been developed and operated during the flight. We have collected 5.7×103 events over 100GeV including nearly 100 candidates of primary electrons. [Copyright &y& Elsevier]

Abstract: Development of a balloon to fly at higher altitudes is one of the most attractive challenges in scientific balloon technologies. After reaching the highest record setting balloon altitude of 53.0km using the 3.4μm film in 2002, we tried to make a thinner balloon film. In 2003, we developed a forming die and an air-ring and succeeded in forming a film with a thickness of 3.0μm and a width of 220cm. Using this film, we manufactured a balloon with a volume of 5000m3 and succeeded in flying the balloon up to an altitude of 46.0km. We then searched for a good combination of resins to make a thinner and wider film and obtained films with widths of 280cm, and a thickness of 3.0μm at first, and then 2.8μm. In 2004, we performed balloon experiments making a 30,000m3 balloon with the 3.0μm film and a 5000m3 balloon with the 2.8μm film. Both balloons were well manufactured and reached the highest altitudes of 50.7 and 42.6km, respectively. [Copyright &y& Elsevier]

Abstract: Polar patrol balloon experiments were carried out at Syowa Station in Antarctica from 2002 to 2004. Two balloons were launched for the purpose of observing phenomena in the polar atmosphere and one was done for the observation of high energy cosmic electrons. We developed a new housekeeping system including communication device using the Iridium satellite network, an auto-level controller driven by a new program for keeping the flight altitude, and a power management system for solar cells combined with secondary batteries. Two balloons for studying phenomena in the Antarctic atmosphere launched on January 13, 2003 made flights for 18 days and 25 days, respectively. All the housekeeping system worked well during the flights as we expected. Based on these experiments, we adjusted parameters for the altitude control system and the power management system. We launched a balloon for the cosmic electron observation on January 4, 2004. It flew 13 days around the Antarctica with the perfect operation of the onboard housekeeping system. We hope that fruitful scientific results will be obtained from these long-duration flights. [Copyright &y& Elsevier]