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Argonaute protein (AGO) in association with small RNAs is the core machinery of RNA silencing, an essential mechanism for precise development and defense against pathogens in many organisms. Here, we identified two AGOs in rice anthers, AGO1b and AGO1d, that interact with phased small interfering RNAs (phasiRNAs) derived from numerous long non-coding RNAs. Moreover, 3D-immunoimaging and mutant analysis demonstrated that rice AGO1b and AGO1d redundantly and cell type-specifically regulate anther development by acting as mobile carriers of these phasiRNAs from the somatic cell layers to the germ cells in anthers. Our study also highlights a new mode of reproductive RNA silencing via the specific nuclear and cytoplasmic localization of three AGOs, AGO1b, AGO1d, and MEL1, in rice pollen mother cells.

Small RNAs specifically expressed in reproductive tissues are key regulators of germline development in eukaryotes. Rice microRNA2118 (miR2118), which is enriched during reproduction in grasses, is a trigger to produce phased small interfering RNAs (phasiRNAs). These phasiRNAs demonstrate the temporal regulation with premeiotic phasiRNAs and meiotic phasiRNAs in anther development. Furthermore, the site-specific regulation via miR2118 and phasiRNAs is of importance in soma and germ development in anthers. Accordingly, histological imaging methods are essential tools for understanding spatiotemporal regulation during reproduction and elucidating the reproductive roles of miRNAs and phasiRNAs. We successfully developed a method to visualize the three-dimensional (3D) structure of entire rice anthers, which can also be used for distinguishing the internal structure of the anthers in other plants. Here, we describe the detailed methods of in situ hybridization for miR2118 localization and the visualization of the 3D structure of entire anthers of rice.

To assess the feasibility of a denoising approach with deep learning-based reconstruction (dDLR) for fast volume simultaneous multi-slice diffusion tensor imaging of the brain, noise reduction effects and the reliability of diffusion metrics were evaluated with 20 patients. Image noise was significantly decreased with dDLR. Although fractional anisotropy (FA) of deep gray matter was overestimated when the number of image acquisitions was one (NAQ1), FA in NAQ1 with dDLR became closer to that in NAQ5.

This study investigated the safety of bladder irrigation in patients with indwelling bladder catheter using Solution G prepared with tap water. Solution G was prepared using tap water and stored in a refrigerator for 1 week. The bacterial count range in the solution was estimated to be between 0 and 10 colony forming units/ml. The values were within the reference range in the Water Supply Act of Japan. Subsequently, bladder irrigation was performed with the prepared Solution G in six patients. The number of bacteria, leukocytes, and bacterial flora were evaluated before and 1 and 3 months after bladder irrigation. The results indicated no significant change in the values during this period. Therefore, bladder irrigation with Solution G prepared with tap water is safe.

[Purpose]: Asthma onset before the age of 40 years is associated with distinct clinical manifestations in chronic obstructive pulmonary disease (COPD) patients, but its morphologic features remain unestablished. This study aimed to explore airway morphology in COPD patients with asthma onset before 40 years of age using ultra–high-resolution computed tomography (U-HRCT), which allows a more accurate quantitation of the lumen and the wall in smaller airways than using conventional CT. [Materials and Methods]: Clinical data of 500 consecutive patients undergoing full inspiratory U-HRCT (1024×1024 matrix and 0.25 mm slice thickness) were retrospectively analyzed. COPD patients without asthma, COPD patients with asthma onset at age below or 40 years and above, and non-COPD smoker controls (N=137, 29, 34, and 22, respectively) were enrolled. The length, lumen area (LA), wall thickness and area (WA), and wall area percent (WA%) of the segmental (third-generation) to sub-subsegmental (fifth-generation) bronchus and the low attenuation volume percent (LAV%) were measured. [Results]: LA and WA were smaller in the fourth and fifth generation in COPD patients than in non-COPD controls, regardless of the age of asthma onset. LA was smaller and WA% was larger in the fourth-generation and fifth-generation airways in COPD with asthma onset before 40 years than COPD without asthma, whereas WA did not differ between them. In multivariate analyses, asthma onset before 40 years was associated with smaller LA in COPD patients independent of demographics, use of inhaled corticosteroids and long-acting bronchodilators, airflow limitation, and LAV%. [Conclusions]: Asthma onset before 40 years of age could be associated with greater lumen narrowing of the airways in COPD.

Reproduction-specific small RNAs are vital regulators of germline development in animals and plants. MicroRNA2118 (miR2118) is conserved in plants and induces the production of phased small interfering RNAs (phasiRNAs). To reveal the biological functions of miR2118, we describe here rice mutants with large deletions of the miR2118 cluster. Our results demonstrate that the loss of miR2118 causes severe male and female sterility in rice, associated with marked morphological and developmental abnormalities in somatic anther wall cells. Small RNA profiling reveals that miR2118-dependent 21-nucleotide (nt) phasiRNAs in the anther wall are U-rich, distinct from the phasiRNAs in germ cells. Furthermore, the miR2118-dependent biogenesis of 21-nt phasiRNAs may involve the Argonaute proteins OsAGO1b/OsAGO1d, which are abundant in anther wall cell layers. Our study highlights the site-specific differences of phasiRNAs between somatic anther wall and germ cells, and demonstrates the significance of miR2118/U-phasiRNA functions in anther wall development and rice reproduction., MicroRNA2118 induces the production of phased small interfering RNAs (phaisRNAs) in plants. Here the authors show that rice miR2118 is required for both male and female fertility and supports the production of atypical U-rich 21 nt phasiRNAs that are abundant in anther walls.

To evaluate radiation dose and image quality of cervical spinal computed tomography scanned with low-radiation dose (LD-CT) utilizing model-based iterative reconstruction (MBIR). We retrospectively examined 14 patients (65.5 ± 13.9 years) who underwent both standard-radiation-dose CT (SD-CT) reconstructed with hybrid iterative reconstruction and LD-CT of cervical spine. The radiation dose, objective image quality indicator, which includes signal-to-noise and contrast-to-noise, and subjective image quality score of the anatomical landmarks in the SD-CT and LD-CT were statistically compared. In addition, the measurement errors of the length of C3 vertebrae (height, anteroposterior length, inner and outer pedicle diameters) between SD-CT and LD-CT were analyzed. Radiation dose of LD-CT was reduced to one-sixth of the dose of SD-CT. The objective image quality indicator of LD-CT was significantly better than that of SD-CT. The subjective image quality of LD-CT was relatively worse than that of SD-CT but generally graded as clinically accepted or higher. There was no remarkable difference between SD-CT and LD-CT in the measurement value of height and anteroposterior length. Inner pedicle diameter was significantly (0.21 ± 0.13 mm) smaller, and outer pedicle diameter was (0.24 ± 0.14 mm) larger on LD-CT than on SD-CT. Cervical spinal LD-CT that utilized MBIR enabled radical decrease in radiation dose and provided sufficient image quality for clinical use. This scanning protocol can be a good alternative for protecting patients from exposure to unnecessary radiation, especially when a patient requires multiple CT scans.

The full-iterative model reconstruction generates ultra-high-resolution computed tomography (U-HRCT) images comprising a 1024 × 1024 matrix and 0.25 mm thickness while suppressing image noises, allowing evaluating small airways 1–2 mm in diameter. However, this technique imposes huge computational burdens and requires a long reconstruction time. This study evaluated whether a recently-established deep learning-based reconstruction, Advanced intelligent Clear-IQ Engine (AiCE), allows quantitative morphological analyses of smaller airways with equal or better quality than the full-iterative model reconstruction while shortening the reconstruction time. In phantom tubes mimicking small airways, the measurement error of 0.5-mm-thickness wall was smaller on the AiCE-based than the full-iterative model-based U-HRCT. Moreover, in five patients with chronic obstructive pulmonary disease, the AiCE-based U-HRCT decreased the reconstruction time approximately by 90% with a modest improvement in image noise, contrast, and sharpness compared to the full-iterative model-based U-HRCT. Therefore, the AiCE-based U-HRCT can be readily used clinically for morphologically evaluating peripheral small airways.

Corals of the family Acroporidae are key structural components of reefs that support the most diverse marine ecosystems. Due to increasing anthropogenic stresses, coral reefs are in decline. Along the coast of Okinawa, Japan, three different color morphs of Acropora tenuis have been recognized for decades. These include brown (N morph), yellow green (G), and purple (P) forms. The tips of axial polyps of each morph exhibit specific fluorescence spectra. This attribute is inherited asexually, and color morphs do not change seasonally. In Okinawa Prefecture, during the summer of 2017, N and P morphs experienced bleaching, in which many N morphs died. Dinoflagellates (Symbiodiniaceae) are essential partners of scleractinian corals, and photosynthetic activity of symbionts was reduced in N and P morphs. In contrast, G morphs successfully withstood the stress. Examination of the clade and type of Symbiodiniaceae indicated that the three color-morphs host similar sets of Clade-C symbionts, suggesting that beaching of N and P morphs is unlikely attributable to differences in the clade of Symbiodiniaceae the color morphs hosted. Fluorescent proteins play pivotal roles in physiological regulation of corals. Since the A. tenuis genome has been decoded, we identified five genes for green fluorescent proteins (GFPs), two for cyan fluorescent proteins (CFPs), three for red fluorescent proteins (RFPs), and seven genes for chromoprotein (ChrP). A summer survey of gene expression profiles under outdoor aquarium conditions demonstrated that (a) expression of CFP and REP was quite low during the summer in all three morphs, (b) P morphs expressed higher levels of ChrP than N and G morphs, (c) both N and G morphs expressed GFP more highly than P morphs, and (d) GFP expression in N morphs was reduced during summer whereas G morphs maintained high levels of GFP expression throughout the summer. Although further studies are required to understand the biological significance of these color morphs of A. tenuis, our results suggest that thermal stress resistance is modified by genetic mechanisms that coincidentally lead to diversification of color morphs of this coral.

Human creative thinking is unique and capable of generating novel and valuable ideas. Recent research has clarified the contribution of different brain networks (default mode network, DN; executive control network; salience network) to creative thinking. However, the effects of brain stimulation on brain networks during creative thinking and on creative performance have not been clarified. The present study was designed to examine the changes in functional connectivity (FC) and effective connectivity (EC) of the large-scale brain network, and the ensuing changes in creative performance, induced by transcranial direct current stimulation (tDCS). Fourteen healthy male students underwent two tDCS sessions, one with actual stimulation and one with sham stimulation, on two separate days. Participants underwent tDCS (anode over the left dorsolateral prefrontal cortex, DLPFC; cathode over the right inferior parietal lobule, IPL) for 20 minutes. Before and after the tDCS session, electroencephalography signals were acquired from 32 electrodes over the whole head during the creative thinking task. On FC analysis, the delta band FC between the posterior cingulate cortex and IPL significantly increased only after real stimulation. We also found that the change of flexibility score was significantly correlated with the change in (i) delta band FC between mPFC and left lateral temporal cortex (LTC) and (ii) alpha band FC between IPL and right LTC. On EC analysis, decreased flow within the DN (from left LTC to right IPL) was observed. Our results reveal that tDCS could affect brain networks, particularly the DN, during creative thinking and modulate key FC in the generation of flexible creative ideas.

Corals of the family Acroporidae are key structural components of reefs that support the most diverse marine ecosystems. Due to increasing anthropogenic stresses, coral reefs are in decline. Along the coast of Okinawa, Japan, three different color morphs ofAcropora tenuishave been recognized for decades. These include brown (N morph), yellow-green (G) and purple (P) forms. The tips of axial coral polyps exhibit specific fluorescence spectra. This attribute is inherited asexually, and color morphs do not change seasonally. In Okinawa Prefecture, during the summer of 2017, the N and P morphs experienced bleaching, in which some N morphs died while P morphs recovered. In contrast, G morphs successfully withstood the stress. Symbiotic dinoflagellates are essential symbiotic partners of scleractinian corals. Photosynthetic activity of symbionts was reduced in July in N and P morphs; however, the three color-morphs host similar sets of Clade-C zoothanthellae, suggesting that beaching of N and P morphs cannot be attributed to differences in symbiont clades. The decodedAcropora tenuisgenome includes five genes for green fluorescent proteins (GFP), two for cyan fluorescent proteins (CFP), three for red fluorescent proteins (RFP), and seven genes for chromoprotein (ChrP). A summer survey of gene expression profiles demonstrated that (a) expression of CFP and REP was quite low in all three morphs, (b) P morphs expressed higher levels of ChrP, (c) both N and G morphs expressed GFP highly, and (d) GFP expression was reduced in N morphs, compared to G morphs, which maintained higher levels of GFP expression throughout the summer. Although further studies are required to understand the biological significance of these color morphs ofAcropora tenuis, our results suggest that thermal stress resistance is modified by genetic mechanisms that coincidentally lead to diversification of color morphs.

Background: Quantitative measurement of airway dimensions using computed tomography (CT) is performed in relatively larger airways due to the limited resolution of CT scans. Nevertheless, the small airway is an important pathological lesion in lung diseases such as chronic obstructive pulmonary disease (COPD) and asthma. Ultra-high resolution scanning may resolve the smaller airway, but its accuracy and limitations are unclear. Methods: Phantom tubes were imaged using conventional (512 × 512) and ultra-high resolution (1024 × 1024 and 2048 × 2048) scans. Reconstructions were performed using the forward-projected model-based iterative reconstruction solution (FIRST) algorithm in 512 × 512 and 1024 × 1024 matrix scans and the adaptive iterative dose reduction 3D (AIDR-3D) algorithm for all scans. In seven subjects with COPD, the airway dimensions were measured using the 1024 × 1024 and 512 × 512 matrix scans. Results: Compared to the conventional 512 × 512 scan, variations in the CT values for air were increased in the ultra-high resolution scans, except in the 1024×1024 scan reconstructed through FIRST. The measurement error of the lumen area of the tube with 2-mm diameter and 0.5-mm wall thickness (WT) was minimal in the ultra-high resolution scans, but not in the conventional 512 × 512 scan. In contrast to the conventional scans, the ultra-high resolution scans resolved the phantom tube with ≥ 0.6-mm WT at an error rate of < 11%. In seven subjects with COPD, the WT showed a lower value with the 1024 × 1024 scans versus the 512 × 512 scans. Conclusions: The ultra-high resolution scan may allow more accurate measurement of the bronchioles with smaller dimensions compared with the conventional scan.

This study aimed to investigate the effects of parameter presets of the forward projected model-based iterative reconstruction solution (FIRST) on the accuracy of pulmonary nodule volume measurement. A torso phantom with simulated nodules [diameter: 5, 8, 10, and 12 mm; computed tomography (CT) density: - 630 HU] was scanned with a multi-detector CT at tube currents of 10 mA (ultra-low-dose: UL-dose) and 270 mA (standard-dose: Std-dose). Images were reconstructed with filtered back projection [FBP; standard (Std-FBP), ultra-low-dose (UL-FBP)], FIRST Lung (UL-Lung), and FIRST Body (UL-Body), and analyzed with a semi-automatic software. The error in the volume measurement was determined. The errors with UL-Lung and UL-Body were smaller than that with UL-FBP. The smallest error was 5.8% ± 0.3 for the 12-mm nodule with UL-Body (middle lung). Our results indicated that FIRST Body would be superior to FIRST Lung in terms of accuracy of nodule measurement with UL-dose CT.

The purpose of this study is to clarify the degree of impregnation resulting from treatment of internal waterlogged wood samples using MRI. On a 1.5T MR scanner, T1 and T2 measurements were performed using inversion recovery and spin-echo sequences, respectively. The samples were cut waterlogged pieces of wood treated with various impregnation techniques which were divided into different concentrations of trehalose (C12H22O11) and polyethylene glycol (PEG; HO-(C2H4O)n-H) solutions. Then these samples underwent impregnation treatment every two weeks. From the results, we found that the slope of the T1-concentration curve using linear fitting showed the value of the internal area for PEG to be higher than the external area; internal, -2.73ms/wt% (R2=0.880); external, -1.50ms/wt% (R2=0.887). Furthermore, the slope of the T1-concentration curve using linear fitting showed the values for trehalose to have almost no difference when comparing the internal and the external areas; internal, -2.79ms/wt% (R2=0.759); external, -3.02ms/wt% (R2=0.795). However, the slope of the T2-concentration curve using linear fitting for PEG showed that there was only a slight change between the internal and the external areas; internal, 0.26ms/wt% (R2=0.642); external, 0.18ms/wt% (R2=0.920). The slope of the T2-concentration curve did not show a change in linear relationship between the internal and the external areas; internal, 0.06ms/wt% (R2=0.175); external, -0.14ms/wt% (R2=0.043). In conclusion, using visualization of relaxation time T1, it is possible to obtain more detail information noninvasively concerning the state of impregnation treatment of internal waterlogged wood.

Summary Cells modify the migration mechanism in response to their surroundings, which sets the challenge for cancer therapy targeting metastasis through signaling pathways. To cope with the diversity and complexity of molecular self-assembled nanofibrils, we have developed a mechanical approach that captures membrane dynamicity to suppress cancer cell migration and invasion. We designed and synthesized a ruthenium (Ru)-complex-based peptidic molecule that selectively initiates self-assembly into extracellular nanofibrils on lipid rafts of cervical cancer cells by reacting with glycosylphosphatidylinositol-anchored placental alkaline phosphatase (GPI-anchored PLAP). The growing nanofibrils glue the lipid rafts and chain them into large clusters, leading to reinforced focal adhesion suppressing cell migration. The molecular self-assembly constantly exerts mechanical stimuli to raft-associated protein receptors, provoking opposing cell migration against focal adhesion with enhanced motility. The contradictory motions generate a mechanical force transferred through the actin cytoskeleton. When the force increases, the restricted cervical cancer cell is ruptured.

Head-up displays (HUDs), which present information on windshields of vehicles, have attracted attention as a method for presenting varied information to drivers while they are driving. The advantage of a HUD is that the amount of eye movement involved when confirming the presented information is smaller in comparison with conventional in-vehicle information devices, thereby enabling the driver to concentrate on driving while taking cognizance of the information. However, a large cognitive load could distract the driver. Therefore, quantitative evaluation of the cognitive load is necessary to develop a presentation method that is less distracting. In this study, we focused on the P300 component of eye-fixation related potentials as an evaluation index of the cognitive load to confirm whether the P300 latency could be used as a quantitative evaluation index of the cognitive load. The results suggested that the peak latency of P300 could be used as a quantitative indicator of the driver’s cognitive load.

Background: The optimal cutoff value of fractional flow reserve (FFR) derived from coronary computed tomography angiography (FFR CT ) remains unclear. Methods: The current study population consisted of 93 patients with 139 vessels, who had suspected coronary artery disease by computed tomography angiography and underwent invasive FFR. We evaluated diagnostic performance of FFR CT according to different FFR CT cutoff values and FFR CT ranges with invasive FFR ≤0.80 as the reference standard. Results: In per-vessel analysis, median invasive FFR was 0.85 (interquartile range, 0.75–0.90), and 57 out of 139 vessels (41%) showed hemodynamically significant stenosis (≤0.80). Median FFR CT was 0.77 (interquartile range, 0.66–0.84; mean difference [invasive FFR-FFR CT ], 0.06±0.11). Per-vessel accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were 73%, 95%, 59%, 61%, and 94% for the cutoff value of FFR CT ≤0.80, 81%, 86%, 78%, 73%, and 89% for FFR CT ≤0.75, and 83%, 74%, 89%, 82%, and 83% for FFR CT ≤0.70, respectively. Per-vessel accuracy across the different ranges of FFR CT ≤0.60, 0.61 to 0.70, 0.71 to 0.80, 0.81 to 0.90, and >0.90 with the cutoff value of FFR CT ≤0.80 were 95%, 74%, 32%, 93%, and 100%, respectively. Setting a gray zone of FFR CT 0.71 to 0.80 provided high positive predictive value (82%; n=42/51) in the range of FFR CT ≤0.70 and high negative predictive value (94%; n=48/51) in FFR CT >0.80. Conclusions: This study suggested that referral to invasive coronary angiography should be considered individually in the range of FFR CT 0.71 to 0.80, whereas dichotomous decision could be made in FFR CT ≤0.70 and >0.80. Future prospective studies evaluating clinical outcomes are needed to establish optimal FFR CT -based diagnostic algorithm.

Background Lung hyperinflation in chronic obstructive pulmonary disease (COPD) is closely associated with emphysema and non-emphysematous gas trapping, termed functional small airway disease (fSAD), on inspiratory and expiratory computed tomography (CT). Because the cranial-caudal emphysema distribution affects pulmonary function and fSAD may precede emphysema on CT, we tested the hypothesis that lobar fSAD distribution would affect lung hyperinflation differently in COPD with minimal and established emphysema. Methods The volume percentages of fSAD and emphysema (fSAD% and Emph%) over the upper and lower lobes were measured using inspiratory and expiratory CT in 70 subjects with COPD. Subjects were divided into those with minimal and established emphysema (n = 36 and 34) using a threshold of 10% Emph% in the whole lung. Results In the minimal emphysema group, fSAD% in the upper and lower lobes was positively correlated with functional residual capacity (FRC) and residual volume to total lung capacity ratio (RV/TLC), and the correlation of fSAD% with RV/TLC was greater in the lower lobes. Conversely, in the established emphysema group, fSAD% in the upper and lower lobes was correlated with RV/TLC, but not with FRC. In multivariate analysis, fSAD% in the lower lobes, but not in the upper lobes, was associated with RV/TLC in subjects with minimal emphysema after adjusting for age, smoking status, and bronchodilator use. Conclusion Non-emphysematous gas trapping in the upper and lower lobes has a distinct physiological effect, especially in COPD with minimal emphysema. This local evaluation might allow sensitive detection of changes in lung hyperinflation in COPD.

Retrospective.To evaluate the image quality of low-radiation-dose computed tomography (LD-CT) of the thoracolumbar spine, using model-based iterative reconstruction (MBIR) for measuring pedicle diameter.MBIR can drastically reduce radiation dose but its utility in spine surgery planning is unknown.We identified patients (mean age, 70.5 ± 13.3 yrs) who incidentally underwent both standard-radiation-dose CT (SD-CT) with hybrid iterative reconstruction and LD-CT with MBIR of the thoracolumbar spine within 2 years. We compared radiation dose, subjective image sharpness, signal-to-noise ratio, and contrast-to-noise ratio for the two tests. Additionally, inner pedicle diameters were measured on SD-CT (DSD) and LD-CT (DLD), and statistically compared.We included 24 CT and 84 pedicles for each CT group. The radiation dose of LD-CT estimated by volume CT dose index was 1.21 ± 0.42 mGy, one-sixth the dose of SD-CT. The effective dose of LD-CT was 0.58 ± 0.31 mSv, equivalent to or less than that of a one-time lumbar X-ray in a previous report. LD-CT was significantly inferior in subjective image sharpness for the contour of vertebrae and trabecular structure, but superior for signal-to-noise ratio and contrast-to-noise ratio. The intra-rater reliability (intra-RR) and inter-RR for DLD were 0.985 and 0.892, respectively, comparable to those of DSD. DLD was consistently 0.30 mm smaller than DSD when compared within the same pedicle, regardless of pedicle diameter.LD-CT with MBIR produced a radiation dose equivalent to a one-time lumbar X-ray and provided excellent images for measuring pedicle diameter. LD-CT can be a substitute for SD-CT when planning spine surgery if the relationship between DSD and DLD is sufficiently understood.3.

To visualize the condition of impregnation of polyethylene glycol (PEG) in waterlogged wood, we demonstrated magnetic transfer (MT) magnetic resonance imaging (MRI) through a series of process of PEG impregnation. Three different samples were examined; reference wood, 10 cm cut wood, and 5 cm cut wood. During this study, the upper section sample was kept immersed in water, for the middle and lower sections the concentration of PEG solution was changed at 20 wt% intervals from 20 to 100 wt%. The impregnated periods of each PEG solution concentration were 14 days. Then, MR imaging were performed with/without MT pulse. The MTR value for both 10 cm- and 5 cm-samples were shown to decrease at 20 wt% PEG at peak concentration. When the sample volume was large, e.g., 10 cm-sample, the MTR value decreased to 100 wt% PEG concentration. In contrast, when a sample volume was small, e.g., 5 cm-sample, MTR value decreased to 60 wt% PEG concentration. In conclusion, MTR analysis makes it possible to nondestructively visualize and evaluate the inner condition concerning the PEG impregnation method for waterlogged wood.

Non-invasive fractional flow reserve measured by coronary computed tomography angiography (FFRCT) has demonstrated a high diagnostic accuracy for detecting coronary artery disease (CAD) in selected patients in prior clinical trials. However, feasibility of FFRCT in unselected population have not been fully evaluated. Among 60 consecutive patients who had suspected significant CAD by coronary computed tomography angiography (CCTA) and were planned to undergo invasive coronary angiography, 48 patients were enrolled in this study comparing FFRCT with invasive fractional flow reserve (FFR) without any exclusion criteria for the quality of CCTA image. FFRCT was measured in a blinded fashion by an independent core laboratory. FFRCT value was evaluable in 43 out of 48 (89.6 %) patients with high prevalence of severe calcification in CCTA images [calcium score (CS) >400: 40 %, and CS > 1000: 19 %). Per-vessel FFRCT value showed good correlation with invasive FFR value (Spearman’s rank correlation = 0.69, P 1000), per-vessel FFRCT value showed a diagnostic performance similar to that in patients with CS ≤ 1000 (Spearman’s rank correlation = 0.81, P

Left atrial contrast computed tomography (LA-CT) as well as transesophageal echocardiography (TEE) can exclude left atrial appendage (LAA) thrombus, but is sometimes unable to evaluate LAA due to incomplete LAA filling. The aim of the current study was to validate the utility of real-time approach of LA-CT with real-time surveillance of LAA-filling defect (FD). We enrolled consecutive 894 patients with LA-CT studies acquired for catheter ablation and compared the diagnostic accuracy in demonstrating LAA-FD between conventional protocol (N = 474) and novel protocol with real-time surveillance of LAA-FD immediately after the initial scanning and, when necessary, adding delayed scanning in the supine or prone position (N = 420). Primary endpoint was severity of LAA-FD classified into the 3 groups: “Grade-0” for complete filling of contrast, “Grade-1” for incomplete filling of contrast, and “Grade-2” for complete FD of contrast. The prevalence of Grade-1 and Grade-2 FD was 17.3% and 11.2% in conventional protocol, whereas there was no patient with Grade-2 FD, and only 1 patient with Grade-1 FD after the additional scanning in novel protocol. In 5 patients with suspected LAA thrombus both by TEE and Grade-2 FD in LA-CT by the conventional protocol, ablation procedure was canceled due to diagnosis of LAA thrombus. Conversely, 4 patients with suspected LAA thrombus by TEE in novel protocol group was proved to have intact LAA by LA-CT with and without additional scanning. This novel approach with real-time surveillance improved the diagnostic accuracy of LA-CT in detecting LAA-FD, suggesting potential superiority of LA-CT over TEE in excluding LAA thrombus.

Aims: It is well documented that maternal morbidity and neonatal morbidity and mortality increase alike in high‐order multiple (HOM) births. There have, however, been few reports concerning the costs of maternal and neonatal medical care associated with HOM births. This is the first such report on the situation in Japan.

STUDY DESIGN Prospective descriptive study. OBJECTIVE To verify the feasibility and utility of evaluating venous sinuses (VSs) using computed tomography venography (CTV) concomitant with preoperative CT angiography (CTA) for safe occipital screw fixation. SUMMARY OF BACKGROUND DATA Preoperative evaluation of the vertebral artery by CTA is indispensable in occipitocervical spinal instrumentation surgery. Despite accumulating evidence showing the potential of CTV, no studies have reported the usefulness of concomitant use of CTV and CTA before placement of occipital plate-screw constructs. METHODS We analyzed 30 consecutive patients who underwent CTV simultaneously with CTA. First, we investigated VS anatomy in individual cases and classified the continuity patterns of relevant VSs. Subsequently, we evaluated the probable risk zones for VS injury, from the viewpoint of occipital screw insertion. RESULTS VSs can be clearly visualized using CTV simultaneously with CTA examination without significant increase of radiation exposure or extra workload for radiographical technicians. VS continuity was classified into 4 categories: the confluence type (n = 9), bifurcation type (n = 8), transverse type (n = 11), and others (n = 2). The confluence of sinuses and their relevant VSs were greatly variable between individuals, and occasionally, some cases with high-risk morphology for VS injury in occipital screw placement were observed. CONCLUSION Our findings indicate that there is no universal position for safe insertion of occipital screws that is applicable to all individuals. It is risky to determine optimal screw placement, only on the basis of traditional cadaveric information such as occipital bone thickness and several external bony landmarks. Spine surgeons must recognize that VS injury may occasionally lead to life-threatening complications. The detailed information on VSs obtained by preoperative CTV examination combined with CTA in individual cases can be useful in preoperative planning and can contribute greatly to the improvement of surgical safety. LEVEL OF EVIDENCE 2.

The timing and extent of cell division is particularly important for the growth and development of multicellular organisms. Roots of the model organism Arabidopsis thaliana have been widely studied as a paradigm for organ development in plants. In the Arabidopsis root, the plant-specific GRAS family transcription factors SHORT-ROOT (SHR) and SCARECROW (SCR) are key regulators of root growth and of the asymmetric cell divisions that separate the ground tissue into two separate layers: the endodermis and cortex. To elucidate the role of SHR in root development, we identified 17 SHR-interacting proteins. Among those isolated was At5g24740, which we named SHRUBBY (SHBY). SHBY is a vacuolar sorting protein with similarity to the gene responsible for Cohen syndrome in humans. Hypomorphic alleles of shby caused poor root growth, decreased meristematic activity and defects in radial patterning that are characterized by an increase in the number of cell divisions in the ground tissue that lead to extra cells in the cortex and endodermis, as well as additional cell layers. Analysis of genetic and molecular markers indicates that SHBY acts in a pathway that partially overlaps with SHR, SCR, PLETHORA1 and PLETHORA2 (PLT1 and PLT2). The shby-1 root phenotype was partially phenocopied by treatment of wild-type roots with the proteosome inhibitor MG132 or the gibberellic acid (GA) synthesis inhibitor paclobutrazol (PAC). Our results indicate that SHBY controls root growth downstream of GA in part through the regulation of SHR and SCR.

In contrast to development in animals, much of the patterning of plants occurs post-embryonically in specialized structures called meristems. The root apical meristem of Arabidopsis thaliana is a readily accessible structure that has been extensively studied to uncover the factors that control root growth and cellular patterning. Recently we showed that one of the key factors in patterning the root, the mobile transcription factor SHORT-ROOT (SHR), acts in a concentration-dependent manner to initiate or suppress asymmetric divisions in the endodermis. The amount of SHR varies dynamically in the endodermis with the age of the root. Here we show that this variation is controlled in part through the activity of the transcription factor, SCARECROW (SCR), which regulates SHR movement and therefore its effective concentration and function in the endodermis.

A key question in developmental biology is how cellular patterns are created and maintained. During the formation of the Arabidopsis root, the endodermis, middle cortex (MC), and cortex are produced by periclinal cell divisions that occur at different positions and at different times in root development. The endodermis and cortex arise continuously from the periclinal divisions of cells that surround the quiescent center (QC) at the tip of the root. The MC arises between days 7 and 14 from periclinal divisions of the endodermis. The divisions that produce the middle cortex begin in the basal region of the root meristem away from the QC and then spread apically and circumferentially around the root. Although the transcription factor SHORT-ROOT (SHR) is required for both of these divisions, the mechanism that determines where and when SHR acts to promote cell division along the longitudinal axis of the root is unknown; SHR is present along the entire length of the root tip, but only promotes periclinal divisions at specific sites. Here we show that the abundance of the SHR protein changes dynamically as the root develops, and that the pattern of cell division within the endodermis is sensitive to the dose of this protein: high levels of SHR prevent the formation of the MC, whereas intermediate levels of SHR promote MC formation. These results provide a mechanism for the longitudinal patterning of the endodermis, and represent the first example in plants of a mobile transcription factor whose function (activator or repressor) depends upon concentration.

Fetal brain tumors are very rare, and fetal survival is generally poor. Here we present a congenital intracranial immature teratoma, which was prenatally diagnosed. Prenatal ultrasonography and fetal magnetic resonance imaging detected the presence of a massive, heterogeneous intracranial tumor at 26 weeks gestational age. An intracranial tumor lacking normal intracranial structures was detected. The biparietal diameter was 13.1 cm, which is abnormally long. Fetal death occurred at 27 weeks of gestation due to cranial perforation. Postmortem histologic examination revealed the presence of an immature teratoma. Ultrasonography and magnetic resonance imaging are helpful in the prenatal diagnosis and evaluation of intracranial tumors. In conclusion, some cases of giant immature congenital teratoma develop antenatal cranial perforation.