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Yasuhiro Morimoto Department of Anesthesia, Ube Industries Central Hospital, Ube, Yamaguchi, JapanCorrespondence: Yasuhiro MorimotoDepartment of Anesthesia, Ube Industries Central Hospital, Ube, Yamaguchi, Japan, Tel +81-836-51-9221, Email yasumorimo@gmail.comAbstract: Sedation for short-term procedures is increasingly being used in clinical practice. Selection of appropriate drugs is important for effective and safe sedation; however, an ideal sedative remains unavailable. Remimazolam is a novel, ultrafast-acting benzodiazepine with a shorter duration of action than other agents in this class. It is currently expected to become a popular agent for short-term procedural sedation. Remimazolam shows higher clearance, a smaller volume of distribution, and a shorter half-life than midazolam. It showed dose-dependent sedative action, with onset of sedation within 60s of administration. The results of clinical trials indicate that remimazolam is more useful than midazolam for short procedural sedation such as in patients who undergo colonoscopy and that its safety profile is comparable with that of midazolam. Anesthesia-induced vascular pain is lesser and reduction in blood pressure is lesser with remimazolam than with propofol. Moreover, the availability of flumazenil (a benzodiazepine antagonist) is a specific advantage of remimazolam. These characteristics and the results of clinical trials suggest that remimazolam will be a safer alternative to previous sedative drugs for sedation during the short surgical procedures. Although short-acting agents are useful, they might lead to immediate hyper-sedation. Remimazolam is a promising agent for short-term procedural sedation; however, clinicians should be mindful of the risks of this agent.Keywords: sedation, propofol, midazolam, remimazolam

This study conducted an analysis of muons, protons, and charged pions emitted from νμ charged-current interactions on iron using a nuclear emulsion detector. The emulsion detector with a 65 kg iron target was exposed to a neutrino beam corresponding to 4.0×1019 protons on target with a mean neutrino energy of 1.49 GeV. The measurements were performed at a momentum threshold of 200 (50) MeV/c for protons (pions), which are the lowest momentum thresholds attempted up to now. The measured quantities are the multiplicities, emission angles, and momenta of the muons, protons, and charged pions. In addition to these inclusive measurements, exclusive measurements such as the muon-proton emission-angle correlations of specific channels and the opening angle between the protons of CC0π2p events were performed. The data were compared to Monte Carlo predictions and some significant differences were observed. The results of the study demonstrate the capability of detailed measurements of neutrino-nucleus interactions using a nuclear emulsion detector to improve neutrino interaction models.

This study conducted an analysis of muons, protons, and charged pions emitted from $\nu_{\mu}$ charged-current interactions on iron using a nuclear emulsion detector. The emulsion detector with a 65$\,$kg iron target was exposed to a neutrino beam corresponding to 4.0$\times$10$^{19}$ protons on target with a mean neutrino energy of 1.49$\,$GeV. The measurements were performed at a momentum threshold of 200 (50)$\,$MeV/$c$ for protons (pions), which are the lowest momentum thresholds attempted up to now. The measured quantities are the multiplicities, emission angles, and momenta of the muons, protons, and charged pions. In addition to these inclusive measurements, exclusive measurements such as the muon-proton emission-angle correlations of specific channels and the opening angle between the protons of CC0$\pi$2$p$ events were performed. The data were compared to Monte Carlo (MC) predictions and some significant differences were observed. The results of the study demonstrate the capability of detailed measurements of neutrino-nucleus interactions using a nuclear emulsion detector to improve neutrino interaction models., Comment: 21 pages, 25 figures

This study conducted an analysis of muons, protons, and charged pions emitted from $ν_μ$ charged-current interactions on iron using a nuclear emulsion detector. The emulsion detector with a 65$\,$kg iron target was exposed to a neutrino beam corresponding to 4.0$\times$10$^{19}$ protons on target with a mean neutrino energy of 1.49$\,$GeV. The measurements were performed at a momentum threshold of 200 (50)$\,$MeV/$c$ for protons (pions), which are the lowest momentum thresholds attempted up to now. The measured quantities are the multiplicities, emission angles, and momenta of the muons, protons, and charged pions. In addition to these inclusive measurements, exclusive measurements such as the muon-proton emission-angle correlations of specific channels and the opening angle between the protons of CC0$π$2$p$ events were performed. The data were compared to Monte Carlo (MC) predictions and some significant differences were observed. The results of the study demonstrate the capability of detailed measurements of neutrino-nucleus interactions using a nuclear emulsion detector to improve neutrino interaction models., 21 pages, 25 figures

This paper reports the track multiplicity and kinematics of muons, charged pions, and protons from charged-current inclusive ν¯μ and νμ interactions on a water target, measured using a nuclear emulsion detector in the NINJA experiment. A 3-kg water target was exposed to the T2K antineutrino-enhanced beam corresponding to 7.1×1020 protons on target with a mean energy of 1.3 GeV. Owing to the high granularity of the nuclear emulsion, protons with momenta down to 200 MeV/c from the neutrino-water interactions were detected. We find good agreement between the observed data and model predictions for all kinematic distributions other than the number of charged pions and the muon kinematics shapes. These results demonstrate the capability of measurements with nuclear emulsion to improve neutrino interaction models.

This paper reports the track multiplicity and kinematics of muons, charged pions, and protons from charged-current inclusive ¯νμ and νμ interactions on a water target, measured using a nuclear emulsion detector in the NINJA experiment. A 3-kg water target was exposed to the T2K antineutrino-enhanced beam corresponding to 7.1×1020 protons on target with a mean energy of 1.3 GeV. Owing to the high granularity of the nuclear emulsion, protons with momenta down to 200 MeV/c from the neutrino-water interactions were detected. We find good agreement between the observed data and model predictions for all kinematic distributions other than the number of charged pions and the muon kinematics shapes. These results demonstrate the capability of measurements with nuclear emulsion to improve neutrino interaction models., 精密測定により素粒子ニュートリノの謎の解明を目指すNINJA実験の物理解析が開始. 京都大学プレスリリース. 2020-10-21.

This paper reports the track multiplicity and kinematics of muons, charged pions, and protons from charged-current inclusive $\bar{\nu}_{\mu}$ and $\nu_{\mu}$ interactions on a water target, measured using a nuclear emulsion detector in the NINJA experiment. A 3-kg water target was exposed to the T2K antineutrino-enhanced beam with a mean energy of 1.3 GeV. Owing to the high-granularity of the nuclear emulsion, protons with momenta down to 200 MeV/$c$ from the neutrino-water interactions were detected. We find good agreement between the observed data and model predictions for all kinematic distributions other than the number of charged pions. These results demonstrate the capability of measurements with nuclear emulsion to improve neutrino interaction models., Comment: 22 pages, 20 figures

Introduction: The digital artery perforator (DAP) flap, which was first reported by Koshima, is useful in the reconstruction of a soft tissue defect of the finger. Recently, many studies using the DAP flap have been published. However, to adequately close the donor site, Koshima recommended that the[for full text, please go to the a.m. URL], 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

Objectives/Interrogation: APTUS Adaptive 2 Distal Radius Plate (Adaptive 2, Medartis AG, Basel, Switzerland) is a poly-axial locking plate (PLP) with a variable angle of 15° and is suitable for use in the double-tiered subchondral support procedure. However, it can be also used with an [for full text, please go to the a.m. URL], 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

This paper reports the track multiplicity and kinematics of muons, charged pions, and protons from charged-current inclusive $\bar��_��$ and $��_��$ interactions on a water target, measured using a nuclear emulsion detector in the NINJA experiment. A 3-kg water target was exposed to the T2K antineutrino-enhanced beam with a mean energy of 1.3 GeV. Owing to the high-granularity of the nuclear emulsion, protons with momenta down to 200 MeV/$c$ from the neutrino-water interactions were detected. We find good agreement between the observed data and model predictions for all kinematic distributions other than the number of charged pions. These results demonstrate the capability of measurements with nuclear emulsion to improve neutrino interaction models., 22 pages, 20 figures

Takemasa Matsumoto,1 Masaki Fujita,1 Ryosuke Hirano,1 Junji Uchino,1 Yukari Tajiri,2 Satoru Fukuyama,2 Yasuo Morimoto,3 Kentaro Watanabe1 1Department of Respiratory Medicine, Faculty of Medicine, Fukuoka University, 2Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 3Department of Occupational Pneumology, Institute of Industrial and Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan Abstract: The club cell secretory protein (CCSP) is a regulator of lung inflammation following acute respiratory infection or lung injury. Recently, the relationship between CCSP and COPD has been reported. Since COPD results from an abnormal inflammatory response, we hypothesized that CCSP could have a protective role against chronic inflammation-induced lung damage. To address this issue, the pathophysiology of chronic lung inflammation induced by Pseudomonas aeruginosa in CCSP-deficient mice was determined. A tube of 5 mm in length was soaked in a fluid containing P. aeruginosa (PAO01 strain) for 1 week and inserted into the trachea of CCSP-deficient mice. One week later, P. aeruginosa was administered into the trachea. Five weeks after insertion of tube, the mice were sacrificed. Bronchoalveolar lavage fluids were collected to determine the bacterial growth, and the lung histology and physiology were also examined. P. aeruginosa was continuously detected in bronchoalveolar lavage fluids during the study. Neutrophils were increased in the bronchoalveolar lavage fluids from the CCSP-deficient mice in comparison to wild-type mice. A histological study demonstrated chronic inflammation around bronchus, serious bronchial stenosis, and alveolar enlargement in the CCSP-deficient mice. The lung physiology study demonstrated an increase in the lung compliance of the CCSP-deficient mice. Chronic P. aeruginosa inflammation resulted in chronic bronchitis and emphysematous changes in the CCSP-deficient mice. CCSP could play an important role in protecting the host from the chronic inflammation-induced lung damage. Keywords: chronic bronchitis, animal models, emphysema, inflammation&nbsp

Chronic hepatitis B (CHB) leads to cirrhosis and hepatocellular carcinoma (HCC). With a cohort of 1,206 CHB patients who visited Okayama University Hospital and related hospitals in 2011 and 2012, we compared the incidence rates of HCC among the patients grouped by age, hepatitis B virus (HBV) DNA, hepatitis B e antigen (HBeAg), and treatment. HCCs were observed in 115 patients with the median observation period of 1,687 days. Among the HCC patients aged ≥ 35 years, HBV DNA ≥ 4 log copies/mL and positive HBeAg at diagnosis (n=184), the HCC incidence rate was 8.4% at 5 years in the entecavir (ETV)-treated patients, 21.8% in the lamivudine (LVD)-treated patients, and 26.4% among the patients not treated with drugs. The cumulative HCC incidence was significantly reduced in the ETV-treated patients compared to those treated with LVD or not treated (p=0.013). Among the patients aged ≥ 35 years with HBV DNA ≥ 4 log copies/mL and negative HBeAg (n=237), the cumulative HCC incidence was 14.6% in 5 years in ETV group and 13.9% among those not treated with a drug (p>0.05). Only small numbers of HCCs occurred in other patients. In CHB patients aged≥35 years with HBV DNA ≥4 log copies/mL and positive HBeAg, ETV treatment is recommended for the suppression of HCC development.

Monitoring utility-scale solar arrays was shown to minimize cost of maintenance and help optimize the performance of the array under various conditions. In this paper, we describe the design of an 18 kW experimental facility that consists of 104 panels fitted with smart monitoring devices. Each of these devices embeds sensors, wireless transceivers, and relays that enable continuous monitoring, fault detection, and real-time connection topology changes. The facility enables networked data exchanges via the use of wireless data sharing with servers, fusion and control centers, and mobile devices. Research planned at this stage includes developing machine learning methods for fault detection. Preliminary simulation results on fault detection using machine learning are given in this paper.

We used a Kerr microscope, image processing, and photo editing to clarify magnetization reversal and its propagation in a sintered Nd-Fe-B magnet. Magnetic domain change was observed when a dc field from +20 to 20 kOe was applied to a sintered Nd-Fe-B magnet. Simultaneous magnetization reversal in several grains along the easy axis direction and its propagation to neighboring grains occurred. This indicates that the nucleation field in a grain and magnetic interaction between grains are important controlling factors of the coercivity of sintered Nd-Fe-B magnets.

We performed waveform analysis of the efferent signal detected within early hepatocellular carcinomas and borderline lesions, in which portal flow was demonstrated. Continuity of this flow with the surrounding vessels was also analyzed. Nine nodules in 7 patients with early hepatocellular carcinomas and borderline lesions were included in this study. Tumor diameter ranged from 1.2 to 3.5 cm; average, 2.1 cm. Waveform of the efferent flow signal from within these nodules was continuous in 5 nodules and biphasic venous in 4 nodules. Outside the nodules, the waveform of the efferent flow signal was that of a biphasic venous wave. All efferent signals were confirmed to continue in the hepatic vein. These findings thus suggest that the draining vessel in early hepatocellular carcinomas and their borderline lesions is the hepatic vein.

One of the possible causes of bone cement implantation syndrome during total hip arthroplasty is pulmonary embolism, as has been suggested by a characteristic image seen during transoesophageal echocardiography, the so-called 'Snow Flurry'. However, the nature of the embolic material has not been definitively determined. We studied seven patients undergoing cemented or uncemented total hip arthroplasty. 'Snow Flurry' images were detected in all patients. Blood was aspirated from the right atrium during 'Snow Flurries' and was subjected to pathological examination. Amorphous, eosinophilic, fine granular material was seen in all specimens. The material did not originate from cement. Fat and bone marrow were not detected. The material seen may consist of fine particles of bone ('bone dust') originating from reamed bone.

PURPOSE Prenatal detection of congenital hydronephrosis has raised new questions with regard to the need of management and the indications for operation. Moreover, there is considerable controversy whether or not pyeloplasty improves long-term renal function. We evaluated the operative results of this entity under the setting of well defined indications for surgery. MATERIALS AND METHODS The indications for pyeloplasty included Society for Fetal Urology-grade (SFU-grade) 3 and grade 4 hydronephrosis on ultrasonogram together with obstructive pattern on modified "Well Tempered" diuretic renogram. We analysed the postoperative changes of ultrasonographic findings, differential renal function, and renogram patterns in 28 children with unilateral hydronephrosis detected prenatally. RESULTS Of the patients, 27 had grade-4 hydronephrosis on preoperative ultrasonogram. Pyeloplasty was effective in decreasing the grade of dilatation in all kidneys except one. Of the involved renal units, 14 (50%) had reduced differential renal function less than 45% on the preoperative renogram. Differential renal function increased significantly by absolute value of 5% or greater in 8 kidneys (29%), but decreases in 5 kidneys (18%). In the remaining 15 kidneys (54%) there was no significant differences between pre- and post-operative differential renal function. Postoperative diuretic renogram changed to non-obstructive pattern in 26 kidneys (93%). Another 2 kidneys showed hypofunctioning pattern. CONCLUSIONS The results suggest that, although pyeloplasty decreases ultrasonographic dilatation of hydronephrosis and improves excretory pattern of diuretic renogram, significant increase of differential renal function is expected in only one third of the involved kidneys.

The purpose of this study was to investigate whether fatty sparing adjacent to the gallbladder fossa is related to efferent blood flow from the gallbladder wall.Color and power Doppler sonography were performed in 80 patients with a fatty liver that appeared as a fine echogenic pattern with considerable deep attenuation on sonography. We analyzed whether color signal appeared around the spared area, the gallbladder wall, or both. Subsequently, when such signal was detected, pulse Doppler analysis of the signal was performed.Color signal indicating efferent blood flow from the gallbladder wall was detected in 25 (64%) of 39 patients with a focal spared area at the gallbladder fossa and in two (5%) of 41 patients without a focal spared area. This difference was statistically significant (p.05). The waveform of efferent blood flow signals (n = 25) that were seen within spared areas was continuous in 23 (92%) of 25 patients and was pulsatile in the remaining two patients (8%).Blood flow from the gallbladder wall to areas of the spared liver was frequently revealed by color and power Doppler sonography; therefore, this blood flow may be associated with focal fatty sparing.

X-ray diffraction and domain observation were performed to evaluate an effect of Nd-rich phase on the c-axis orientation of the Nd–Fe–B melt-spun ribbon. It was found that adequate addition of Nd-rich phase promotes the c-axis orientation of the Nd–Fe–B ribbon. The (Nd2Fe14B1)95(Nd-rich phase)5 ribbon has c-axis orientation in the entire body from bottom to top when melt-spun at wheel speed of 10.0 m/s.

Recently, there has been growing interest in the impact of beverage consumption on dental health because changes have occurred in the types and quantities of beverage consumed. This cross-sectional study investigated the relationship between consumption frequencies of various beverages and the prevalence of tooth loss among young adult women. Study subjects were 1002 pregnant Japanese women. Tooth loss was defined as previous extraction of one or more teeth. Dietary habits were evaluated by a validated dietary history questionnaire. Logistic regression analysis was used to estimate the odds ratios and their 95% confidence intervals of tooth loss. Adjustment was made for age, gestation, parity, cigarette smoking, passive smoking at home and at work, family income, education, changes in diet in the previous one month, season when data were collected and body mass index. Of the 1002 subjects, 256 women had lost one or more teeth. Coffee consumption was independently associated with an increased prevalence of tooth loss. When subjects were divided according to consumption of coffee with or without sugar, an increased prevalence of tooth loss was found only in subjects who consumed coffee without addition of sugar. Compared with the lowest consumption of green tea, the intermediate but not the highest consumption of green tea was associated with an increased prevalence of tooth loss. There was no measurable association of intake of milk, black tea, cola, or 100% fruit juice with the prevalence of tooth loss. The findings suggest that coffee consumption might be associated with an increased prevalence of tooth loss among young adult women.

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Contains fulltext : 42462.pdf (Publisher’s version ) (Open Access) Cambridge, MA, Workshop "Recent Developments in OT Syntax & Semantics"

Item does not contain fulltext [Leiden] Going Romance 2004, 11 december 2004 Leiden : [s.n.]

To compare the depth of the maxillary sinus floor on panoramic radiographs between the edentulous and dentate patients. Thirty panoramic radiographs of edentulous female patients and 47 panoramic radiographs of female dentate patients were used for the sample. To measure the depth of the maxillary sinus floor, the outline of the maxillary sinus on the panoramic radiograph was traced on transparent paper. An apparent difference in depth of the maxillary sinus floor was recognized only in comparing the left sides of the edentulous and dentate jaws(P < 0.05). However, there was no statistical difference in the depth of the maxillary sinus floor between the right and left sides in the edentulous and dentate jaws. In this study there seems to be no difference in the depth of maxillary sinus floor between the right and left sides of either the edentulous or dentate jaws. It is not clear as to why, on the other hand, there is a statistical difference in between only the left maxillary sinus floor of the edentulous and dentate jaws, this apparent contradiction might be further investigated statistically.

Magnetization reversal and its propagation in sintered Nd–Fe–B magnets were clearly observed at elevated temperatures up to 150 °C using a Kerr microscope, image processing, and photo editing. Simultaneous magnetization reversal in several grains along the easy axis direction occurred at elevated temperature, and the extent of simultaneous magnetization reversal increased with temperature. This indicates that reduction in the coercivity of Nd–Fe–B sintered magnets at elevated temperatures is attributable to decrease in anisotropy and insufficient pinning of domain walls at grain boundaries.

Due to recent increases in the number of cases of embedded mandibular third molars, the Department of Dental Radiology, Kyushu Dental College decided to investigate generational differences in their occurrence. For the purpose of investigation, 670 panoramic radiographs, obtained from two different generations (1970s and 1999s) of Kyushu Dental College students, wer used. There were significant statistical differences in the angle of eruption of the third molar between the 1970s and 1990s groups. The mandibular third molars in the 1990s group were growing at an abnormal angle (P < 0.05) and were closer to the mandibular canal (P < 0.05) than those in the 1970s group.

A Kerr microscope that uses ultraviolet (UV) light for high-resolution domain observation was built, and the domain structure and magnetization process of hydrogenation disproportionation desorption recombination (HDDR) powder were examined. The UV Kerr microscope could observe nanometer-sized domain patterns. Applying a dc field of 1.0 kOe to HDDR powder at a desorption recombination (DR) time of 12 min produced abrupt wall motion. The pinning force exerted by the grain boundaries is inadequate for producing high coercivity because the Nd-rich phase layers along these boundaries are absent at a DR time of 12 min. For HDDR powder at a DR time greater than 14 min, changing the magnetic field by up to 1.0 kOe produced no observable wall motion. It follows that the high coercivity of HDDR powder is due to domain wall pinning at the grain boundaries.

Using a commercially available h-TSH RIA kit (Daiichi), a sensitive RIA method was developed. When pooled serum from patients with active Graves' disease was used as a carrier, combined applications of a delayed addition of 125-I TSH and utilization of X2 diluted anti-TSH antibody resulted in the consistent detection of 0.156 microunits/ml level of serum TSH. Further, 0.078 microunits/ml level could also be detected when 200 microliter of serum samples were applied. However, usage of 200 microliter sample volume should be determined after further studies concerning possible non specific effects of human serum. Assay results of 29 patient sera by the sensitive assay correlated quite well (r = 0.953, Y = 0.97X-0.06) with those by the regular assay. Serum TSH in all of the 20 normal subjects were detectable and ranged from 0.31 to 3.2 microunits/ml giving mean values of 1.48 +/- 0.65 (s.d.) microunits/ml. Values less than 0.156 microunits/ml were observed in patients with untreated Graves' disease, acute stage of subacute thyroiditis, and panhypopituitarism, and in postoperative cancer patients under suppressive doses of T-4. In conclusion, this sensitive TSH RIA made clear discrimination of low and normal serum TSH possible, and the clinical application of this method was considered quite useful.

Goodpasture (GP) antigens, protein components reactive with human autoantibodies against glomerular basement membrane (GBM), were identified in human alveolar basement membrane (ABM) using an enzyme-linked immunoassay (ELISA), Western blotting and immunoprecipitation. All six anti-GBM antisera studied, three obtained from patients with glomerulonephritis and pulmonary haemorrhages (i.e. GP syndrome), and three from patients with glomerulonephritis alone, distinctively reacted with collagenase-digested (CD) ABM. Very cationic 22-28 kD and 40-48 kD components were detected by blot analysis combined with two-dimensional gel electrophoresis. These proteins showed some similarities to GP antigens in human GBM with respect to the monomer-dimer composition and charge distribution. Inhibition ELISA revealed that the binding of anti-GBM antisera to CDGBM decreased when they were pre-incubated with CDABM, suggesting that the anti-GBM antisera recognized the same epitope(s) on the GBM and ABM. Heterogeneity of the GP antigens in human ABM was demonstrated by blotting; monomeric antigens were absent or at low levels in the CDABM of three out of 10 normal individuals. In immunoprecipitation, anti-GBM antisera from patients with and without pulmonary haemorrhage showed different reactivities with CDABM. The former antisera precipitated both monomeric and dimeric components, but the latter did not. The observations of variation in monomer-dimer composition of ABM, and the different binding of anti-GBM antisera to it may explain why only some patients with anti-GBM nephritis have lung involvement.

Daclatasvir (DCV) + asunaprevir (ASV) combination therapy has become available for patients with hepatitis C virus (HCV) serogroup 1 infection. We studied the efficacy of this therapy by focusing on the factors associated with sustained virological responses (SVR) including resistance-associated variants (RAVs) and mixed infection of different HCV genotypes. We enrolled 951 HCV serogroup 1-positive patients who received this combination therapy at our hospital or affiliated hospitals. The presence of RAVs in non-structural (NS) regions 3 and 5A was analyzed by direct sequencing. HCV genotypes were determined by PCR with genotype-specific primers targeting HCV core and NS5B regions. SVR was achieved in 91.1% of patients. Female sex, age > 70 years, and RAVs were significantly associated with non-SVR (p

It has generally been held that each portal branch is always accompanied by a single arterial branch in the liver. During Doppler ultrasound examination, however, we sometimes encounter a portal branch that appears to be associated with two arterial branches, a phenomenon referred to below asthis finding orthis phenomenon. Here we attempt to confirm that this finding is based on a correct interpretation of the image and to disclose its basic mechanism.Five cases of chronic liver disease in which this phenomenon appeared were analyzed with B-flow imaging. Videotapes obtained from 30 patients who had chronic liver disease and had undergone ultrasound angiography (USAG) with arterial infusion of CO2 micro bubbles were reviewed in order to look for similar findings. Sixty-nine healthy controls were also examined with Doppler sonography for this purpose. Histopathologic specimens from 7 patients who had undergone hepatectomy (3 with hepatocellular carcinoma, 3 with metastatic tumor, and 1 with focal nodular hyperplasia) were examined to study the basic structure of the hepatic vessels.Three parallel color signals (two pulsatile and one of a constant waveform) observed on Doppler examination were confirmed by the B-flow method to be three independent vessels in all five cases in which both Doppler sonography and B-flow imaging were used. In 13 (43%) of the 30 cases of USAG, two vessels along a portal branch were visualized by the inflow of micro bubbles, indicating that the two vessels were arteries. The trio of one portal and two arterial branches was also detected with Doppler sonography in 12 (17%) of the 69 healthy controls. In 10 (59%) of the 17 cases (5 of liver disease and 12 normal) that showed this finding on Doppler examination, bifurcations of the hepatic artery and portal vein were both visualized. Hepatic arterial branches were found to bifurcate slightly more proximal to the hepatic hilus than the accompanying portal branch. Histopathologic study revealed Glisson's areas that contained one portal branch and two arterial vessels in nontumorous parts of specimens from all 7 patients with hepatectomy.Two arterial branches can be demonstrated along a portal branch as a result of a more-proximal bifurcation of the hepatic artery than of the portal vein.