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Background Aneurysmal subarachnoid hemorrhage is a rare but important cause of maternal death during pregnancy. Case description A 34-year-old primigravida (31 weeks of pregnancy) with acute headache but no neurological deficits or neck stiffness was prescribed medication and returned home. Four weeks later she presented with severe headache and consciousness disturbance. She was admitted to our hospital, where she fell into a deep coma. Brain CT and three-dimensional CT angiography showed subarachnoid hemorrhage and a 5-mm right internal carotid-posterior communicating artery aneurysm. Fetal heart rate was 60 beats per minute. Emergent cesarean section and surgical clipping were performed. Intraoperative examination revealed that the aneurysm originated at the right posterior communicating artery. There were no postoperative neurological focal deficits. On postoperative day 13 she developed delayed cerebral ischemia of the right temporo-parieto-occipital lobe. She was discharged home 36 days after surgery with left hemianopsia. The infant was free of complications and was discharged at age 17 days. Conclusions A pregnant woman with severe headache should undergo brain CT or magnetic resonance imaging to rule out subarachnoid hemorrhage.

OBJECTIVE Petrous internal carotid aneurysm (PA) concomitant with a mass lesion and cranial nerve palsy is relatively rare. Flow-diverter stent implantation is now widely used as an alternative treatment for PA. However, alternative treatments sometimes cannot be used because of tortuosity of the carotid artery, allergies to contrast material, and high costs. The outcomes of different treatment methods should therefore be assessed. Here, we review the available literature on treatments for PA. METHODS In a search using the terms "aneurysm", "carotid artery", and "petrous" on PubMed, MEDLINE, and databases such as OvidSP, 221 articles were identified. We also performed a literature review and discuss and compare the causes, symptoms, treatment methods, and clinical outcomes of PA. RESULTS AND CONCLUSIONS Onset of secondary aneurysm was generally heralded by bleeding (p

Background 5-Aminolevulinic Acid (5-ALA) Photodiagnosis (PD) is an effective method to detect residual tumors during glioma surgery. However, the strength of fluorescence differs in every case even in the most malignant glioma such as glioblastoma. Also, false-negative fluorescence may result in tumor residue. We investigated the effect of ultrasound on the intracellular level of protoporphyrin IX (PpIX) and the expression level of ATP-binding cassette transporter 2 (ABCG2), which is thought to act as a membrane efflux pump of PpIX from cytosol. Methods The malignant glioma established cell line, SNB19, U87MG and T98G were used for in vitro experiments. Ultrasound (1MHz, 3W/cm2, Duty cycle 10%) was irradiated on the cultured cells after administration of 5-ALA. The morphological changes of tumor cells were observed. The PpIX levels and the expression of ABCG2 were evaluated. Results The glioma tumor cells showed transient morphological changes and attachment to the culture dish, while most cells survived and were restored to their original morphology within 6 hours. The PpIX expression levels increased in glioma cells after ultrasound irradiation, earlier and higher than 5-ALA alone. Concurrently the expressions of ABCG2, that increased after 5-ALA administration, were relatively reduced in ultrasound irradiated glioma cells. Conclusions The ultrasound irradiation of the malignant gliomas contributes to the stronger 5-ALA induced fluorescence by elevating intracellular PpIX levels. The suppression of ABCG2 expression by ultrasound may be one of the factors which contributes to the PpIX accumulation in glioma cells.

SuperKEKB is an electron-positron double-ring asymmetric-energy collider at the High Energy Accelerator Research Organization (KEK) in Japan. It adopts a novel collision method named nano-beam scheme to avoid the so-called hourglass effect. In the nano-beam scheme, two beams are squeezed to extremely small sizes at the interaction point and are collided with a large crossing angle between them. Since staring the collision operation in April 2018, numerous machine tunings and beam studies have been performed to improve the machine performance. The highest peak luminosity so far is 4.65 x 10³⁴ cm⁻² s⁻¹ reached in June 8th, 2022. This record is the world’s highest instantaneous luminosity and is more than 2 times higher than that of the previous KEKB collider. This talk starts with a brief introduction to SuperKEKB ring lattice design. The talk then presents some important topics related to beam optics tuning in the actual machine operation. Major issues to be resolved to boost the machine performance further are also addressed., Proceedings of the 65th ICFA Advanced Beam Dynamics Workshop on High Luminosity Circular e+e- Colliders, eeFACT2022, Frascati, Italy

The SuperKEKB broke the world record of the luminosity in June 2020 in the Phase 3 operation. The luminosity has been increasing since then and the present highest luminosity is 4.65 x 10³⁴ cm⁻²s⁻¹ with β_{y}^{*} of 1 mm. The increase of the luminosity was brought with an application of crab waist, by increasing beam currents and by other improvements in the specific luminosity. In this paper, we describe what we have achieved and what we are struggling with. Finally, we mention a future plan briefly., Proceedings of the 13th International Particle Accelerator Conference, IPAC2022, Bangkok, Thailand

A mutation in RNF213 (c.14576G&gt, A), a gene associated with moyamoya disease (&gt, 80%), plays a role in terminal internal carotid artery (ICA) stenosis (&gt, 15%) (ICS). Studies on RNF213 and cerebral aneurysms (AN), which did not focus on the site of origin or morphology, could not elucidate the relationship between the two. However, a report suggested a relationship between RNF213 and AN in French-Canadians. Here, we investigated the relationship between ICA saccular aneurysm (ICA-AN) and RNF213. We analyzed RNF213 expression in subjects with ICA-AN and atherosclerotic ICS. Cases with a family history of moyamoya disease were excluded. AN smaller than 4 mm were confirmed as AN only by surgical or angiographic findings. RNF213 was detected in 12.2% of patients with ICA-AN and 13.6% of patients with ICS, patients with ICA-AN and ICS had a similar risk of RNF213 mutation expression (odds ratio, 0.884, 95% confidence interval, 0.199–3.91, p = 0.871). The relationship between ICA-AN and RNF213 (c.14576G&gt, A) was not correlated with the location of the ICA and bifurcation, presence of rupture, or multiplicity. When the etiology and location of AN were more restricted, the incidence of RNF213 mutations in ICA-AN was higher than that reported in previous studies. Our results suggest that strict maternal vessel selection and pathological selection of AN morphology may reveal an association between genetic mutations and ICA-AN development. The results of this study may form a basis for further research on systemic vascular diseases, in which the RNF213 (c.14576G&gt, A) mutation has been implicated.