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Competing Interests: T. Fujita is a consultant for Terumo Corporation. The other authors have no conflicts of interest to declare.

Objectives: To examine the safety, efficacy, and efficiency of the PlasmaWire TM System to recanalize coronary chronic total occlusions (CTO) using controlled ablation inside the CTO., Background: The PlasmaWire TM System is a new bipolar radiofrequency (RF) wire system utilizing plasma-mediated ablation to facilitate wire crossing in CTOs. Two independent PlasmaWire TM wires are used in tandem for channel creation by applying RF energy between the tips so as to localize the ablation., Methods: Prospective, nonrandomized, single-arm, multicenter study in seven patients with CTOs indicated for percutaneous coronary intervention (PCI)., Results: In this study, both wires were antegradely delivered to the distal end of CTO for antegrade re-entry in two cases and bidirectionally (antegrade and retrograde) delivered to the CTO for retrograde re-entry in five cases. In all cases, channel creation was achieved within a few seconds and was confirmed on angiogram or intravascular ultrasound (IVUS) and CTO recanalization was successfully achieved without any major adverse cardiac and cerebrovascular events (MACCE) or other minor complications. The clinical follow-up showed no clinical event at 1 month., Conclusions: The PlasmaWire TM System was shown to be safe and effective in obtaining CTO recanalization through a re-entry channel utilizing plasma-mediated ablation while reducing procedure time. The PlasmaWire™ System is a new bi-polar RF wire system utilizing plasma-mediated ablation for channel creation to facilitate CTO recanalization. This first-in-human study in which seven patients were enrolled was conducted to demonstrate the safety, efficacy, and efficiency of this system for CTO recanalization. Channels through the CTOs were successfully created within a few seconds by applying RF energy between the tips of two independent PlasmaWire TM wires and recanalization was achieved in all cases without any complication. The PlasmaWire TM System may safely facilitate CTO recanalization with less vessel injury and improve initial results of CTO PCI while reducing procedure time., (© 2017 Wiley Periodicals, Inc.)

Objectives: The aim of this study was to evaluate the clinical outcomes of rotational atherectomy (RA) followed by new-generation drug-eluting stent (DES) implantation in patients with an extensive amount of calcified and fibrotic plaque., Background: RA followed by new-generation DES implantation for complex lesions has not been thoroughly evaluated., Methods: A total of 744 consecutive patients (770 lesions) treated with new-generation DES implantation following RA for de novo lesions between January 2013 and November 2015 were retrospectively identified using our institutional database. Clinical outcomes at 12 months were evaluated and the independent predictors of all-cause death and target vessel failure (TVF) were assessed using Cox regression models., Results: Target lesion revascularization occurred in 22 lesions (2.9%) and TVF occurred in 51 lesions (6.6%). In a multivariate analysis, hemodialysis, non-ST-segment elevation acute coronary syndrome, low ejection fraction, and HbA1c ≧ 7% were associated with 12-month mortality. Hemodialysis and right coronary artery were identified as independent predictors of TVF (hazard ratio (HR) 4.107, 95% confidence interval (CI) 2.194-7.685, P < .001; HR 2.491, 95% CI 1.023-6.062, P = .044, respectively)., Conclusions: A good debulking with RA followed by new-generation DES implantation is recommended for patients with an excessive amount of calcified and fibrotic plaque, as this will likely improve the clinical outcomes., (© 2017 Wiley Periodicals, Inc.)

Although performing rotational atherectomy (RA) requires guidewire exchange for the dedicated guidewire, RotaWire guidewire (Boston Scientific) exhibits much lower performance than conventional guidewire. Consequently, there are times when RotaWire cannot be advanced past the lesion independently or using a microcatheter exchange technique, rendering RA impossible. We present a case of a heavily calcified, device-uncrossable, and non-expansible chronic total occlusion lesion successfully revascularized with RA over RG3 guidewire (Asahi Intecc), which has a length of 330 cm, hydrophilic coating, and a 0.010-inch-long shaft. RG3 provided excellent cross-ability and RA could also be performed over RG3 without guidewire exchange for the RotaWire.

The dependence of the C-C hydrogenolysis activity on reaction parameters and the structure of the substrate alkanes was investigated for Ru/CeO 2 catalyst with very small (dispersion: H/Ru=0.89) Ru particles. The substrate concentration and reaction temperature did not have a significant effect on the selectivity pattern, except that methane production was promoted at high temperatures. However, the hydrogen pressure had a marked effect on the selectivity pattern. C tertiary -C bond dissociation, terminal C secondary -C primary bond dissociation, and fragmentation to form excess methane had negative reaction order with respect to hydrogen partial pressure, whereas C secondary -C secondary bond dissociation had an approximately zero reaction order. Therefore, a high hydrogen pressure is essential for the regioselective hydrogenolysis of C secondary -C secondary bonds in squalane. Ru/SiO 2 catalyst with larger Ru particles showed similar changes in the product distribution during the change in hydrogen pressure. The reaction mechanism for each type of C-C bond dissociation is proposed based on reactivity trends and DFT calculations. The proposed intermediate species for the internal C secondary -C secondary dissociation, terminal C secondary -C primary dissociation, and C tertiary -C dissociation is alkyls, alkylidynes, and alkenes, respectively., (© 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.)

The unbound nucleus ^{26}O has been investigated using invariant-mass spectroscopy following one-proton removal reaction from a ^{27}F beam at 201  MeV/nucleon. The decay products, ^{24}O and two neutrons, were detected in coincidence using the newly commissioned SAMURAI spectrometer at the RIKEN Radioactive Isotope Beam Factory. The ^{26}O ground-state resonance was found to lie only 18±3(stat)±4(syst)  keV above threshold. In addition, a higher lying level, which is most likely the first 2^{+} state, was observed for the first time at 1.28&#95;{-0.08}^{+0.11}  MeV above threshold. Comparison with theoretical predictions suggests that three-nucleon forces, pf-shell intruder configurations, and the continuum are key elements to understanding the structure of the most neutron-rich oxygen isotopes beyond the drip line.

Squalane, C30 algae-derived branched hydrocarbon, was successfully converted to smaller hydrocarbons without skeletal isomerization and aromatization over ruthenium on ceria (Ru/CeO2 ). The internal CH2 CH2 bonds located between branches are preferably dissociated to give branched alkanes with very simple distribution as compared with conventional methods using metal-acid bifunctional catalysts., (© 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

A woman was admitted to the hospital with joint pain. She was also found to have pericardial effusion, renal dysfunction, pancytopenia, and positive antinuclear antibody; a diagnosis of systemic lupus erythematosus (SLE) was made. Although she had neither neurological symptoms nor fever, laboratory tests showed microangiopathic hemolytic anemia, thrombocytopenia, and renal dysfunction. Therefore, we diagnosed her illness as SLE complicated by thrombotic microangiopathy (TMA). Plasmapheresis was performed in addition to immunosuppressive therapy. TMA improved rapidly and renal function improved gradually. The number of patients with SLE complicated by TMA is relatively small and the mortality rate is extremely high. A diagnosis of TMA is difficult to determine in patients with SLE because of the overlapping clinical symptoms. The data suggest that prompt induction of plasmapheresis in addition to immunosuppressive therapy is necessary in SLE patients having symptoms suspicious of TMA even before they fulfill the 5 symptoms typical of TMA.