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A key ingredient for realizing a magnetically confined tritium-deuterium plasma fusion reactor is plasma heating by fusion-born high-energy helium ions, as a chained cycle of "nuclear burning." Efficient collisionless plasma heating by high-energy particles is anticipated when their energy is directly transferred to the plasma through waves. Those processes often involve nonlinear structure formations in phase-space, spanned by real-space and velocity-space coordinates, that significantly influence heating efficiency. To date, experimental knowledge of phase-space structure formation physics is severely limited, due to lack of experimental diagnostic schemes. Here, state-of-the-art hardware and software approaches for phase-space perturbative structure detection are introduced. A bifurcation in the phase-space structure formation is found, which affects the plasma heating efficiency. A confinement magnetic field structure is shown to be a potential knob for nuclear-burning control through phase-space manipulation., Competing Interests: Competing interests statement:The authors declare no competing interest.

This paper presents an overview of recent hardware extensions and data analysis developments to the Wendelstein 7-X visible core spectroscopy systems. These include upgrades to prepare the in-vessel components for long-pulse operation, nine additional spectrometers, a new line of sight array for passive spectroscopy, and a coherence imaging charge exchange spectroscopy diagnostic. Progress in data analysis includes ion temperatures and densities from multiple impurity species, a statistical comparison with x-ray crystal spectrometer measurements, neutral density measurements from thermal passive Balmer-alpha emission, and a Bayesian analysis of active hydrogen emission, which is able to infer electron density and main ion temperature profiles., (© 2024 Author(s). All article content, except where otherwise noted, is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC) license (https://creativecommons.org/licenses/by-nc/4.0/).)

In this study, we discovered a turbulence transition in a large helical device. The turbulence level and turbulence-driven energy transport decrease to a specific transition density and increase above it. The ruling turbulences below and above the transition density were ion-temperature gradient (ITG) and resistive-interchange (RI) turbulences, consistent with the predictions of gyrokinetic theory and two-fluid MHD model, respectively. Isotope experiments on hydrogen (H) and deuterium (D) clarified the role of transitions. In the ITG regime, turbulence levels and energy transport were comparable in the H and D plasmas. In contrast, in the RI regime, they were clearly suppressed in the D plasma. The results provide crucial knowledge for understanding isotope effects and future optimization of stellarator and heliotron devices.

The experimental findings from the Large Helical Device have demonstrated a fast, nondiffusive behavior during the propagation of heat pulses, with an observed increase in speed with reduction in their temporal width. Concurrent propagation of the temperature gradient and turbulence, in a timeframe spanning from a few milliseconds to tens of milliseconds, aligned with the avalanche model. These results indicate that the more spatiotemporally localized the heat and turbulence pulses are, the greater the deviation of the plasma from its equilibrium state, coupled with faster propagation velocity. This insight is pivotal for future fusion reactors, which necessitate the maintenance of a steady-state, non-equilibrium condition., (© 2024. The Author(s).)

Doppler-backscattering (DBS) has been used in several fusion plasma devices because it can measure the perpendicular velocity of electron density perturbation v ⊥ , the radial electric field E r , and the perpendicular wavenumber spectrum S(k ⊥ ) with high wavenumber and spatial resolution. In particular, recently constructed frequency comb DBS systems enable observation of turbulent phenomena at multiple observation points in the radial direction. A dual-comb microwave DBS system has been developed for the large helical device plasma measurement. Since it is desirable to control the gain of each frequency-comb separately, a frequency-comb DBS system was developed with a function to adjust the gain of the scattered signal intensity of each channel separately. A correction processing method was also developed to correct the amplitude ratio and the phase difference between the in-phase and quadrature-phase signals of the scattered signals. As a result, the error in Doppler-shift estimation required to observe vertical velocity and the radial electric field was reduced, which enables more precise measurements.

The preceding propagation of turbulence pulses has been observed for the first time in heat avalanche events during the collapse of the electron internal transport barrier (e-ITB) in the Large Helical Device. The turbulence and heat pulses are generated near the foot of the e-ITB and propagate to the peripheral region within a much shorter time than the diffusion timescale. The propagation speed of the turbulence pulse is approximately 10 km/s, which is faster than that of the heat pulse propagating at a speed of 1.5 km/s. The heat pulse propagates at approximately the same speed as that in the theoretical prediction, whereas the turbulence pulse propagates one order of magnitude faster than that in the prediction, thereby providing important insights into the physics of non-local transport., (© 2022. The Author(s).)

In this study, the use of a spatial heterodyne spectrometer (SHS) to measure the toroidal flow velocity (V f ) and the ion temperature (T C 6+ ) of the C 6+ impurity ion by charge exchange spectroscopy was explored. The instrumental width (IW) of the SHS (aperture size = 16.77 mm 2 , etendue = 2.9867 mm 2 sr) was extrapolated to be 0.09 nm, which is half of the 0.17 nm IW extrapolated for a conventionally used dispersive spectrometer (DS) (aperture size = 2.6 mm 2 , etendue = 0.2605 mm 2 sr). The resulting V f and T C 6+ measurements were found to be in good agreement with those measured using the DS.

We assess the magnetic field configuration in modern fusion devices by comparing experiments with the same heating power, between a stellarator and a heliotron. The key role of turbulence is evident in the optimized stellarator, while neoclassical processes largely determine the transport in the heliotron device. Gyrokinetic simulations elucidate the underlying mechanisms promoting stronger ion scale turbulence in the stellarator. Similar plasma performances in these experiments suggests that neoclassical and turbulent transport should both be optimized in next step reactor designs.

A new multi-tracer technique in the Tracer-Encapsulated Solid Pellet (TESPEL) method has been developed in order to acquire simultaneously the information about the behaviors of various impurities, i.e., to study concurrently the behaviors of low- and mid/high-Z impurities in magnetically confined high-temperature plasmas. In this new technique, an inorganic compound (for example, lithium titanate, Li 2 TiO 3 ) is proposed to be used as a tracer embedded in the core of the TESPEL, instead of pure elements. The results of the proof-of-principle experiment clearly demonstrate the applicability of the new multi-tracer technique in the TESPEL method for the simultaneous study of behaviors of low- and mid/high-Z impurities in high-temperature plasmas.

A bulk charge exchange spectroscopy (BCXS) system using a grism (grating prism) spectrometer has been applied to measure the profile of the deuterium (D) fraction in deuterium and hydrogen (H) mixture plasma in the Large Helical Device. The observed spectrum can be fitted with four Gaussian functions successfully by reduction of free parameters for the least-squares fit. The plasma flow velocity and ion temperature profile measured by charge exchange spectroscopy using carbon impurity are used for estimation of the wavelength shift of hot components to reduce the free parameter. The ion temperature is used to estimate the apparent wavelength shift due to the energy dependent emission cross section only and is not used to set the Doppler width for H and D in the fitting. The sensitivity of the evaluated D fraction on the velocity is increased for a higher D fraction. The error of the D fraction is calculated from the error in the fitted parameter and sensitivity on the velocity of the hot component. The difference in the profile and time trace of the D fraction with D pellet and H pellet injection was observed clearly by BCXS using a grism spectrometer.

The analysis method of the Motional Stark Effect (MSE) diagnostic to measure the rotational transform and current profiles in the Large Helical Device has been improved. This was done by using the Variational Moments Equilibrium Code to calculate an equilibrium database for various pressure profiles and current profiles. This method looks for the radial profile of the rotational transform in the equilibrium database that gives the best fit to the polarization angle profiles measured with the MSE diagnostic. This analysis improves the measurements of rotational transform, especially near the magnetic axis, where the sensitivity of the polarization angle measurements becomes low and the uncertainty due to error in the estimation of the Pfirsch-Schlüter current becomes large. The radial profiles of the rotational transform and current profiles for Electron Cyclotron Current Drive and Neutral Beam Current Drive are obtained in the new analysis method with a sufficiently high accuracy to discuss the discrepancy of the current density profiles between the measurements and the calculations.

A 90 GHz W-band millimeter-wave back-scattering system is designed and installed for measuring electron scale turbulence (k ⊥ ρ s ∼ 40). A metal lens relay antenna is used for in-vessel beam focusing, and a beam diameter of less than 40 mm is achieved in the plasma core region. This antenna can be steered at an angle of 159° ± 6°, which almost covers the plasma radius. The estimated size of the scattering volume is ∼105 mm at the edge and 135 mm at the core, respectively. A 60 m corrugated waveguide is used to achieve a low transmission loss of ∼8 dB. A heterodyne detection system for millimeter-wave circuits with probing power modulation can distinguish the scattered signal from background noise.

The transition between isotope-mixing and nonmixing states in hydrogen-deuterium mixture plasmas is observed in the isotope (hydrogen and deuterium) mixture plasma in the Large Helical Device. In the nonmixing state, the isotope density ratio profile is nonuniform when the beam fueling isotope species differs from the recycling isotope species and the profile varies significantly depending on the ratio of the recycling isotope species, although the electron density profile shape is unchanged. The fast transition from nonmixing state to isotope-mixing state (nearly uniform profile of isotope ion density ratio) is observed associated with the change of electron density profile from peaked to hollow profile by the pellet injection near the plasma periphery. The transition from nonmixing to isotope-mixing state strongly correlates with the increase of turbulence measurements and the transition of turbulence state from TEM to ion temperature gradient is predicted by gyrokinetic simulation.

The isotope effect, which has been a long-standing mystery in the turbulent magnetically confined plasmas, is the phenomena that the plasma generated with heavier hydrogen isotope show a mitigated transport. This is on the contrary to what is predicted with the simple scaling theory, in which the heavier ions easily diffuse because of its larger gyro-radius. Thanks to the newly developed analysis method and a comprehensive parameter scan experiment in the steady-state plasmas in the Large Helical Device (LHD), the isotope effect was clearly observed in the self-organized internal transport barrier (ITB) structure for the first time. Comparing the ITB intensity in deuterium (D) and hydrogen (H) plasmas, two distinct hydrogen isotope effects are found: stronger ITB is formed in D plasmas and a significant edge confinement degradation accompanied by the ITB formation emerges in H plasmas. This observation sheds light on a new aspect of the turbulent plasmas regarding how the basic properties of the fluid material affect the turbulent structure formation in the open-system.

The isotope effect on energy confinement time and thermal transport has been investigated for plasmas confined by a stellarator-heliotron magnetic field. This is the first detailed assessment of an isotope effect in a stellarator heliotron. Hydrogen and deuterium plasmas heated by neutral beam injection on the Large Helical Device have exhibited no significant dependence on the isotope mass in thermal energy confinement time, which is not consistent with the simple gyro-Bohm model. A comparison of thermal diffusivity for dimensionally similar hydrogen and deuterium plasmas in terms of the gyroradius, collisionality, and thermal pressure has clearly shown robust confinement improvement in deuterium to compensate for the unfavorable mass dependence predicted by the gyro-Bohm model.

A bulk charge exchange spectroscopy system has been applied to measure the radial profiles of the hydrogen (H) and deuterium (D) density ratio in the isotope mixture plasma in a large helical device. Charge exchange lines of H α and D α are fitted by 4 Gaussian of H and D cold components and H and D hot components with 5 parameters by combining the measurement of plasma toroidal rotation velocity with carbon charge exchange spectroscopy. The radial profiles of the relative density of hydrogen and deuterium ions are derived from H and D hot components measured and the beam density calculated from beam attenuation calculation. A proof-of-principle experiment is performed by the H pellet and the D pellet injections into the H-D mixture plasma.

Interaction between a quasi-stable stationary MHD mode and a tongue-shaped deformation is observed in the toroidal plasma with energetic particle driven MHD bursts. The quasi-stable stationary 1/1 MHD mode with interchange parity appears near the resonant rational surface of q = 1 between MHD bursts. The tongue-shaped deformation rapidly appears at the non-resonant non-rational surface as a localized large plasma displacement and then collapses (tongue event). It curbs the stationary 1/1 MHD mode and then triggers the collapse of energetic particle and magnetic field reconnection. The rotating 1/1 MHD mode with tearing parity at the q = 1 resonant surface, namely, the MHD burst, is excited after the tongue event.

A new Motional Stark Effect (MSE) analysis routine has been developed for improved spatial resolution in the core of the Large Helical Device (LHD). The routine was developed to reduce the dependency of the analysis on the Pfirsch-Schlüter (PS) current in the core. The technique used the change in the polarization angle as a function of flux in order to find the value of diota/dflux at each measurement location. By integrating inwards from the edge, the iota profile can be recovered from this method. This reduces the results' dependency on the PS current because the effect of the PS current on the MSE measurement is almost constant as a function of flux in the core; therefore, the uncertainty in the PS current has a minimal effect on the calculation of the iota profile. In addition, the VMEC database was remapped from flux into r/a space by interpolating in mode space in order to improve the database core resolution. These changes resulted in a much smoother iota profile, conforming more to the physics expectations of standard discharge scenarios in the core of the LHD.

A new method for measuring density fluctuation profiles near the edge of plasmas in the Large Helical Device (LHD) has been developed utilizing reflectometry combined with pellet-induced fast density scans. Reflectometer cutoff location was calculated by proportionally scaling the cutoff location calculated with fast far infrared laser interferometer (FIR) density profiles to match the slower time resolution results of the ray-tracing code LHD-GAUSS. Plasma velocity profile peaks generated with this reflectometer mapping were checked against velocity measurements made with charge exchange spectroscopy (CXS) and were found to agree within experimental uncertainty once diagnostic differences were accounted for. Measured density fluctuation profiles were found to peak strongly near the edge of the plasma, as is the case in most tokamaks. These measurements can be used in the future to inform inversion methods of phase contrast imaging (PCI) measurements. This result was confirmed with both a fixed frequency reflectometer and calibrated data from a multi-frequency comb reflectometer, and this method was applied successfully to a series of discharges. The full width at half maximum of the turbulence layer near the edge of the plasma was found to be only 1.5-3 cm on a series of LHD discharges, less than 5% of the normalized minor radius.

The resistive interchange mode destabilized by the resonant interaction with the trapped energetic ions is fully suppressed when the injected power of electron cyclotron heating exceeds a certain threshold. It is shown for the first time that the complete stabilization of the energetic-particle-driven mode without relaxing the energetic particle (EP) pressure gradient is possible by reducing the radial width of the eigenmodes δ_{w}, especially when δ_{w} narrows to a small enough value relative to the finite orbit width of EP.

Beam emission spectroscopy is widely used as local density fluctuation measurement of fusion plasmas. We have installed a beam emission spectroscopy system in the large helical device (LHD) with radially and poloidally elongated optical configuration to enhance both signal-to-noise ratio and wavenumber sensitivity in radial and poloidal directions. The calculation considering the integral effect of the line of sight showed the radially and poloidally elongated sightlines have increased sensitivity compared with the square shaped bundle design of the same sampling area.

This paper describes the development study of the beam emission spectroscopy (BES) for the turbulent transport study in Heliotron J. Modification of the sightlines (10 × 4 for edge and 10 × 2 for edge) enables us to obtain 2-dimensional BES imaging. The cooling effect on the reduction in the electrical noise of avalanche photodiode (APD) assembly has been investigated using a refrigerant cooling system. When the temperature of the APD element has set to be -20 °C, the electrical noise can be reduced more than 50%. The measurement error of the phase difference in the case of low signal level has been tested by two light-emitting diode lamps. The APD cooling has an effect to improve the measurement error at the low signal level of APD.

An abrupt onset of the new tongue-shaped deformation of magnetic surface in magnetized plasmas, which was conjectured in since the 1960s but has not been observed, is experimentally identified just before an abrupt onset of a large-scale collapse event. Two novel properties of the event are identified. First, the transition of symmetry of perturbation (rather than a growth of linearly unstable MHD modes) was found to be a key for the onset of abrupt collapse, i.e., the transition of symmetry gives a new route to the collapse from stable state. Second, as a phase-space response of ions, the distortion from Maxwell-Boltzmann distribution of epithermal ions was observed for the first time.

This paper provides a software application of the sampling scope concept for fusion research. The time evolution of Thomson scattering data is reconstructed with a high temporal resolution during a modulated electron cyclotron resonance heating (MECH) phase. The amplitude profile and the delay time profile of the heat pulse propagation are obtained from the reconstructed signal for discharges having on-axis and off-axis MECH depositions. The results are found to be consistent with the MECH deposition.

Radial profiles of density ratio of helium to hydrogen ions are measured using the charge exchange spectroscopy technique with the two-wavelength spectrometer system in the large helical device. The two-wavelength spectrometer system consists of a dichroic mirror box, a spectrometer with two grating and two camera lenses, and one CCD detector. The dichroic mirror box is used to divide the light of one fiber from the plasma to two fibers, one for HeII (λ = 468.6 nm) and the other for H(α) (λ = 656.3 nm), that are connected to the entrance slit of the spectrometer to eliminate the interference between the HeII and the H(α) spectra on the CCD. This system provides a simultaneous measurement of helium and hydrogen ion density ratio at 8 exact same locations (8 spatial channels) with a time resolution of >40 ms in the wide range of the density ratio of 0.05-5.

A new bursting m=1/n=1 instability (m,n: poloidal and toroidal mode numbers) with rapid frequency chirping down has been observed for the first time in a helical plasma with intense perpendicular neutral beam injection. This is destabilized in the plasma peripheral region by resonant interaction between helically trapped energetic ions and the resistive interchange mode. A large radial electric field is induced near the edge due to enhanced radial transport of the trapped energetic ions by the mode, and leads to clear change in toroidal plasma flow, suppression of microturbulence, and triggering an improvement of bulk plasma confinement.

The driving and damping mechanism of plasma flow is an important issue because flow shear has a significant impact on turbulence in a plasma, which determines the transport in the magnetized plasma. Here we report clear evidence of the flow damping due to stochastization of the magnetic field. Abrupt damping of the toroidal flow associated with a transition from a nested magnetic flux surface to a stochastic magnetic field is observed when the magnetic shear at the rational surface decreases to 0.5 in the large helical device. This flow damping and resulting profile flattening are much stronger than expected from the Rechester-Rosenbluth model. The toroidal flow shear shows a linear decay, while the ion temperature gradient shows an exponential decay. This observation suggests that the flow damping is due to the change in the non-diffusive term of momentum transport.

In order to measure the poloidal rotation velocity, a Doppler reflectometer has been developed in Large Helical Device (LHD). A remotely controlled antenna tilting system has been installed in an LHD vacuum vessel. A synthesizer is used as the source, and the operation microwave frequency ranges are ka-band and V-band. In LHD last experimental campaign we obtained the Doppler shifted signal, which was consistent with CXRS measurements.

A tangential Fast Ion Charge eXchange Spectroscopy is newly applied on a Large Helical Device (LHD) for co/countercirculating fast ions, which are produced by high energy tangential negative-ion based neutral beam injection. With this new observation geometry, both the tangential-neutral beam (NB) and a low-energy radial-NB based on positive ions can be utilized as probe beams of the measurement. We have successfully observed Doppler-shifted H-alpha lights due to the charge exchange process between the probing NB and circulating hydrogen ions of around 100 keV in LHD plasmas.

Reversed-shear Alfvén eigenmodes were observed for the first time in a helical plasma having negative q₀'' (the curvature of the safety factor q at the zero shear layer). The frequency is swept downward and upward sequentially via the time variation in the maximum of q. The eigenmodes calculated by ideal MHD theory are consistent with the experimental data. The frequency sweeping is mainly determined by the effects of energetic ions and the bulk pressure gradient. Coupling of reversed-shear Alfvén eigenmodes with energetic ion driven geodesic acoustic modes generates a multitude of frequency-sweeping modes.

A beam emission spectroscopy (BES) system was developed for density gradient and fluctuation diagnostics in the Large Helical Device (LHD). In order to cover the large Doppler shift of the Hα beam emission because of the high-energy negative-ion-based neutral beam atom (acceleration voltage V(acc)=90-170 kV) and the large motional Stark splitting due to the large v×B field (magnetic field B=3.0 T), a grating spectrometer was used instead of a conventional interference filter system. The reciprocal linear dispersion is about 2 nm/mm, which is sufficient to cover the motional Stark effect spectra using an optical fiber with a diameter of 1 mm.

A system of beam emission spectroscopy (BES) for density fluctuation measurements having the sightlines passing through the plasma in the poloidal direction was developed in the Large Helical Device (LHD). Even though the angle between the beam and the sightline is slightly larger than a right angle, Doppler-shifted beam emission can be distinguished from background emission because of the high energy (120-170 keV) of the neutral beam for heating with negative ion sources. Spatial resolution is about 0.1-0.2 in the normalized radius. Compared with the prototype BES system with toroidal sightlines, the BES system with poloidal sightlines showed improved spatial resolution.

Energy resolved soft x-ray imaging system using a charge coupled device camera and a multifilter disk has recently been installed to the Large Helical Device for the measurements in the long pulse discharges. Eight images with different cutoff energies are measured sequentially during a single discharge by rotating a filter disk mounting eight beryllium filters with different thicknesses. A tangential line-integrated profile for a specific photon energy range can be obtained by taking intensity difference between two images measured with a filter pair of adjacent thicknesses. The typical photon energy corresponding to each difference ranges from 1.9 to 4.8 keV with the bandwidth of 2-3 keV. In the initial results, the difference in the line-integrated soft x-ray profile by the energy range has been clearly observed. This diagnostic method can possibly be applied to the observation of the dependence of two dimensional soft x-ray profile on photon energy range especially if local non-Maxwellian component appears in electron energy distribution function.

An experimental technique to investigate fast ion confinement based on charge exchange spectroscopy of H(alpha)-light was applied to evaluate the confinement property of perpendicular fast ions in large helical device (LHD). Sensitivities of the H(alpha) spectra to the pitch angles of injected neutral beams (NBs) and these to the angle between the sight line of the measurement and NB injection path are examined. The energy dependence of the charge exchange cross section significantly affects the observed spectra since the driving NB is injected perpendicular to the magnetic field lines in the geometry of LHD. The measured spectra are compared to the spectra of GNET simulation results and the simulated spectra agreed well with the experimental measurement when we take into account the contribution of halo neutrals. Although it is difficult to obtain the fast ion distribution functions directly, this technique provides useful experimental data in benchmarking simulation codes.

A spontaneous transition phenomena between two states of a plasma with an internal transport barrier (ITB) is observed in the steady-state phase of the magnetic shear in the negative magnetic shear plasma in the JT-60U tokamak. These two ITB states are characterized by different profiles of the second radial derivative of the ion temperature inside the ITB region (one has a weak concave shape and the other has a strong convex shape) and by different degrees of sharpness of the interfaces between the L mode and the ITB region, which is determined by the turbulence penetration into the ITB region.

A new technique to measure the first and second derivatives of the ion temperature profile has been developed by using a charge exchange spectroscopy system with space modulation optics. The space observed is scanned up to +/-3 cm with a cosine wave modulation frequency up to 30 Hz by shifting the object lens in front of the optical fiber bundle by 0.5 mm with a piezoelement. The first and second derivatives of ion temperature are derived from the modulation component of the ion temperature measured by using Fourier series expansion.

Three states of a magnetic island are observed when the magnetic shear at the rational surface is modified using inductive current associated with the neutral beam current drive in the Large Helical Device. One state is the healed magnetic island with a zero island width. The second state is the saturated magnetic island with partial flattening of the T(e) profile. The third state is characterized by the global flattening of the T(e) profile in the core region. As the plasma assumes each of the three states consecutively through a bifurcation process a clear hysteresis in the relation between the size of the magnetic island and the magnetic shear is observed.

Associated with the transition from ion root to electron root, an electron internal transport barrier (ITB) appears in the large helical device, when the heating power of electron cyclotron resonance heating exceeds the threshold power. The incremental thermal diffusivity of electron heat transport chi(inc)(e) in the ITB plasma is much lower than that in the plasma with the heating power below the threshold, and the thermal diffusivity chi(e) decreases with increasing of heating power [dchi(e)/d(P/n(e))<0] in helical ITB plasmas.

In preheparin serum, there exists lipoprotein lipase (LPL) mass with little activity. The clinical significance of this preheparin serum LPL mass (preheparin LPL mass) is unclear. We studied the levels of preheparin LPL mass in patients with coronary atherosclerosis, comparing the results with those in healthy men. We also evaluated the correlation between preheparin LPL mass and the severity of coronary atherosclerosis by comparing with other risk factors such as age, smoking, family history, hypertension, hyperuricemia, diabetes mellitus, total cholesterol, triglyceride, high density lipoprotein-cholesterol and body mass index. The subjects, 70 men presenting with symptoms of coronary artery disease, underwent coronary angiographic examination. Significant narrowness was defined as > or = 75%. Control group comprised 77 men who had annual health checks and showed no abnormal findings. Preheparin LPL mass in the stenosis group was lower than normal coronary group and also than the control group. Multivariate analysis showed that preheparin LPL mass had the highest t-value (-2.53) for the number of lesions among the risk factors listed above. These results suggest that low preheparin LPL mass may be deeply involved in the progression of coronary atherosclerosis.

Background Since long-term administrations of anti-hyperlipidemic agents result in reduction in % stenosis or increase in minimum lumen diameter (MLD) of stenotic coronary segments, it is generally believed that anti-hyperlipidemic agents stabilize vulnerable coronary plaques. However, recent pathologic and angioscopic studies revealed that vulnerability of coronary plaques is not related to severity of stenosis and the rims rather than top of the plaques disrupt, and therefore, angiography is not adequate for evaluation of vulnerability.Angioscopy enables macroscopic pathological evaluation of the coronary plaques. Therefore, we carried out a prospective angioscopic open trial for evaluation of the stabilizing effects of bezafibrate on coronary plaques.Methods From April, 1997 to December, 1998, 24 patients underwent coronary angioscopy of the plaques in the non-targeted vessels during coronary interventions and 6 months later. The patients were divided into control (10 patients, 14 plaques) and bezafibrat (14 patients, 21 plaques) groups. Oral administration of bezafibrate (Bezatol SR, 400mg/day) was started immediately after the interventions and was continued for 6 months. The vulnerability score was determined based on angioscopic characteristics of plaques and it was compared before and 6 months later.Results Six months later, vulnerability score was reduced (from 1.6 to 0.8;p < 0.05) in bezafibrate group and unchanged (from 1.4 to 1.3; NS) in control group. In bezafibrate group, the changes in vulnerability score was not correlated with those in % stenosis or MLD. Conclusion The results indicate that bezafibrate can stabilize coronary plaques.

Endocardial lesions are caused not only by inflammatory processes but also by myocardial ischemia, resulting in endocardial thrombosis and cerebral embolism. We deviced a method for direct visualization of endocardial damages by a novel dye image cardioscopy with Evans blue and examined its feasibility in patients with heart disease. The dye was injected into the left ventricle before and after endomyocardial biopsy. Endocardial surface was stained in dark blue in 63% of patients with angina pectoris before biopsy. After biopsy, the biopsied portions were stained in blue in all. The results indicate that endocardium is damaged even in apparently intact LV in patients with ischemic heart disease and that endomyocardial biopsy causes severe endocardial damages.

Pemirolast potassium, an antiallergic agent, has preventive effects against restenosis after percutaneous transluminal coronary angioplasty (PTCA). This study investigated the mechanism of the preventive effects of pemirolast on restenosis using serial intravascular ultrasound (IVUS). Initial elective PTCA was performed in consecutive 106 patients from March 1996 through August 1997. Patients with type C lesions or graft stenosis were excluded from the study. A total of 97 patients with 110 lesions, 48 patients (56 lesions) in the pemirolast treated group and 49 patients (54 lesions) in the control group were analyzed. Restenosis was defined as a diameter stenosis of > or = 50% at follow-up study. Patients in the pemirolast group received 20 mg/day from the morning after angioplasty until the time of follow-up (mean 6 months). The lumen cross-sectional area, vessel area, plaque area, and % plaque area were measured by quantitative coronary ultrasound and compared after PTCA and at follow-up between the patients without restenosis in the pemirolast (28 lesions) and control (27 lesions) groups. There was no significant change in baseline characteristics between the 2 groups. Restenosis rate per lesion was significantly lower in the pemirolast group than in the control group (23.2% vs 44.4%, p < 0.05, respectively). After angioplasty and at follow-up study, there was no difference in lumen and vessel cross-sectional areas between the 2 groups. However, plaque and % plaque area in the pemirolast group were smaller than in the control group at follow-up study (8.9 +/- 2.3 vs 11.8 +/- 3.5 mm2, p < 0.005, 56.0 +/- 9.0% vs 64.0 +/- 10.4%, p < 0.005, respectively). These results suggest that suppression of neointimal hyperplasia is the preventive mechanism of pemirolast against restenosis after angioplasty. Pemirolast may be more effective against restenosis after coronary stenting.

Background: We recently confirmed that pemirolast potassium, an antiallergic agent, markedly inhibits migration and proliferation of vascular smooth muscle cells. It has also been reported that pemirolast inhibits intimal hyperplasia in animal experiments., Methods and Results: To elucidate the preventive effects of pemirolast on restenosis after percutaneous transluminal coronary angioplasty (PTCA), 227 patients were enrolled in this prospective, randomized trial. A total of 205 patients who were compatible with the protocol were analyzed (pemirolast group, 104 patients with 140 lesions; control group, 101 patients with 133 lesions). Patients in the pemirolast group received 20 mg/d of pemirolast from 1 week before PTCA until the time of follow-up angiography (4 months after PTCA). Angiographic restenosis was defined as diameter stenosis >/=50% at follow-up. Restenosis rates were significantly lower in the pemirolast group than in the control group (24.0% vs 46.5% of patients, 18.6% vs 35.3% of lesions, P <.01, respectively). During 8 months of follow-up, there were no coronary events (death, myocardial infarction, coronary artery bypass surgery, or repeated PTCA) in 81.7% of the pemirolast group and in 63.4% of the control group (P =.013)., Conclusions: This study suggested that pemirolast would be useful in the clinical setting to prevent restenosis after PTCA.

The effects of repetitive myocardial ischemia on collateral circulation, ST deviation and epicardial wall motion were examined in 12 patients undergoing percutaneous transluminal coronary angioplasty (PTCA) for single left anterior descending artery disease. Rentrop collateral filling grade was assessed using contrast injection to the contralateral artery during the first and final episodes of coronary occlusion. ST deviation was measured by intracoronary electrocardiography. Epicardial wall motion (%pre PTCA) was measured by guide wire motion analysis according to the centerline method. Collateral filling grade was assessed 30 sec after balloon inflation. The ST segment and the epicardial wall motion were measured 60 sec after balloon inflation and deflation, respectively. There was no change in the collateral filling grade between the first and final episode of coronary occlusion. Patients with collateral filling grade I (R-I group, n = 4), II (R-II group, n = 3) and III (R-III group, n = 5) during coronary occlusion showed mean ST segment shifts of 13.2, 9.4, and 0.9 mm, respectively, and mean epicardial wall motion of 41.4%, 67.2%, and 78.5%, respectively. The collateral filling grade correlated with ST deviation and epicardial wall motion, and there was a significant correlation between epicardial wall motion and ST deviation (r = -0.67). Comparison of the R-I group or severe ischemia (n = 4) and the R-III group or slight ischemia (n = 4) during coronary occlusion for the fourth time showed the effect of preconditioning was obtained in R-I group. More R-III group patients than R-I group had hyperkinetic epicardial wall motion during coronary reperfusion. Stunned myocardium was demonstrated in both R-I group and R-III group patients. Epicardial wall motion was poorer in the R-I group than R-III group. We concluded the following: There is no change in the grade of collaterals during repetitive coronary occlusion, and there is a relationship between the grade of collateral and degree of myocardial protection; there is good correlation between ST segment and epicardial wall motion; ischemic preconditioning is obtained during repetitive severe myocardial ischemia; recovery from brief episodes of slight myocardial ischemia is associated with hyperkinesia of epicardial wall motion; the reduction of stunned myocardium is related to the degree of premyocardial ischemia; preconditioning is sufficient to cause myocardial stunning, but myocardial stunning is insufficient to cause preconditioning.

Left ventricular systolic function in patients with acute myocardial infarction was assessed by Doppler echocardiographic measurement of left ventricular ejection flow velocity and maximum acceleration in 20 patients with initial acute anteroseptal myocardial infarction (group A) and 15 age-matched normal subjects. All patients underwent emergency reperfusion therapy by direct percutaneous transluminal coronary angioplasty (direct PTCA). Pulsed Doppler echocardiograms were obtained from sample volume immediately below the aortic valve in the apical long-axis view. Three parameters, peak velocity, ratio of acceleration time to ejection time (AT/ET) and maximum acceleration, were measured by the Doppler analysis program. Changes in the 3 parameters from the day of admission to the 3rd post-admission day were also observed in 15 patients. Although no significant difference was observed in AT/ET in the 2 groups, peak velocity and maximum acceleration in the patient group were significantly lower than those in the normal group (peak velocity: 90.8 +/- 13.1 vs 99.4 +/- 9.7 cm/sec, p < 0.05, maximum acceleration: 2,692.4 +/- 604.5 vs 3,410.2 +/- 712.5 cm/sec2, p < 0.01, respectively). Between the admission and 3rd day, peak velocity and AT/ET did not change significantly, but maximum acceleration increased significantly (2,720.5 +/- 676.7, 1st day vs 3,313.9 +/- 947.5 cm/sec2, 3rd day, p < 0.05). These results indicate that the maximum acceleration measured by pulsed Doppler echocardiography is useful for assessing global left ventricular systolic function in acute myocardial infarction. Direct PTCA results in improved ventricular systolic function on the 3rd post-operative day.

A mass-fusion splicer for single-mode four-fiber ribbon has been developed with an accurate splice loss estimation function capability. Measurements in two orthogonal directions are used to obtain a high axis offset resolution of 0.3 microm. An average splice loss of 0.05 dB and an average splice loss estimation error of -0.002 dB are achieved.