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Cushing's syndrome and Cushing's disease cause various metabolic disorders associated with high cortisol levels. Some reports have shown that Cushing's syndrome is complicated with dissecting aortic aneurysm and aortic dissection after long-term exposure to high cortisol levels. We herein report a rare case of aortic dissection complicated with Cushing's disease. Aortic dissection may occur even under relatively short periods of high cortisol conditions. This case suggests that hypercortisolemia should be treated as soon as possible in order to prevent aortic dissection in subjects with Cushing's disease.

This paper investigates the impacts of conventional and unconventional US monetary policies on global financial markets, using the global vector autoregressive (GVAR) model from 2004 through 2017. The impulse response results suggest unconventional easing had little effect on stock prices as in conventional easing while the responses of interest rates indicate liquidity was provided throughout the world. An unconventional US monetary tightening policy shock could effectively affect the stock prices of the world as is the case with a conventional US monetary tightening shock. Furthermore, the transmission of a US monetary policy shock to stock prices via exchange rates tends to attenuate the decrease in stock prices both in the conventional and unconventional tightening (the exit from a zero rate) phases. On the other hand, the transmission tends to push down stock prices in the conventional, unconventional monetary easing and the unconventional tightening (the shadow rate is negative) phases.

Using factor-augmented vector autoregressive (FAVAR) models, this study examines the effects of the Central Bank of Russia’s (CBR) monetary policy on economic indicators. The sample includes 39 monthly macroeconomic series and covers the period 2004 through 2019. The analysis revealed counter-intuitive results, with consumer prices often responding positively to a contractionary monetary policy shock, and vice versa; this is related to the impossible trinity. The ruble exchange devaluation was accompanied by price increases through an import price pass-through, so the CBR chose exchange stability and free capital flows out of the impossible trinity, temporarily subordinating monetary policy independence. Such independence was limited, possibly due to Russia’s high dependence on energy exports and the link between energy prices and the exchange rate. The findings indicate no direct evidence of an effect of monetary policy tightening on the decrease in consumer prices; rather, the attenuation of ruble depreciation may have helped to stabilize prices, even after the CBR adopted inflation targeting.

Background The association between C-reactive protein (CRP) level, symptoms, and activities of daily living (ADL) in advanced cancer patients is unclear. Methods Secondary data analysis of a multicenter prospective cohort study consisted of 2426 advanced cancer patients referred to palliative care settings was conducted to examine the cross-sectional relationships between CRP level, symptoms, and ADL disabilities. Laboratory data, symptoms, ADL, and manual muscle testing (MMT) results were obtained at baseline. Participants were divided into four groups: low (CRP

BACKGROUND Survival prediction systems such as the Palliative Prognostic Index (PPI), which includes the Palliative Performance Scale (PPS), are used to estimate survival for terminally ill patients. Oncologists are, however, less familiar with the PPS in comparison with the Eastern Cooperative Oncology Group (ECOG) performance status (PS). This study was designed to validate a simple survival prediction system for oncologists, the Performance Status–Based Palliative Prognostic Index (PS-PPI), which is a modified form of the PPI based on the ECOG PS. METHODS This multicenter, prospective cohort study enrolled all consecutive patients who were referred to 58 palliative care services in Japan. The primary responsible physicians rated the variables required to calculate the PS-PPI and the PPI. Patient survival in these risk groups was compared, and the sensitivity and specificity of the PS-PPI and the PPI were evaluated. Patients were subclassified as patients receiving care from in-hospital palliative care teams, palliative care units, or home-based palliative care services. Subsets of patients receiving chemotherapy were also analyzed. RESULTS This study included 2346 patients. Survival predictions based on the PPI and the PS-PPI differed significantly among the 3 risk groups (P 0.78 for predicting survival at all times, from 3 weeks to 180 days. CONCLUSIONS In predicting the prognosis of patients with advanced cancer, the PS-PPI was as accurate as the PPI. The PS-PPI was useful for short- and long-term survival prediction and for the prediction of survival for patients undergoing chemotherapy. Cancer 2017;123:1442–1452. © 2016 American Cancer Society.

Accurate prognostic information in palliative care settings is needed for patients to make decisions and set goals and priorities. The Prognosis Palliative Care Study (PiPS) predictor models were presented in 2011, but have not yet been fully validated by other research teams.The primary aim of this study is to examine the accuracy and to validate the modified PiPS (using physician-proxy ratings of mental status instead of patient interviews) in three palliative care settings, namely palliative care units, hospital-based palliative care teams, and home-based palliative care services.This multicenter prospective cohort study was conducted in 58 palliative care services including 16 palliative care units, 19 hospital-based palliative care teams, and 23 home-based palliative care services in Japan from September 2012 through April 2014.A total of 2426 subjects were recruited. For reasons including lack of followup and missing variables (primarily blood examination data), we obtained analyzable data from 2212 and 1257 patients for the modified PiPS-A and PiPS-B, respectively. In all palliative care settings, both the modified PiPS-A and PiPS-B identified three risk groups with different survival rates (P0.001). The absolute agreement ranged from 56% to 60% in the PiPS-A model and 60% to 62% in the PiPS-B model.The modified PiPS was successfully validated and can be useful in palliative care units, hospital-based palliative care teams, and home-based palliative care services.

Serotonin, 5-hydroxytryptamine, is a systemic bioactive amine that acts in the gut and brain. As a substrate of myeloperoxidase in vitro, serotonin is oxidized to tryptamine-4,5-dione (TD), which is highly reactive with thiols. In this work, we successively prepared a monoclonal antibody to quinone-modified proteins and found that the antibody preferentially recognizes the TD–thiol adduct. Using the antibody, we observed that the chloride ion, the predominant physiological substrate for myeloperoxidase in vivo, is not competitive toward the enzyme catalyzed serotonin oxidation process, suggesting that serotonin is a plausible physiological substrate for the enzyme in vivo. Immunocytochemical analyses revealed that TD staining was observed in the cytosol of SH-SY5Y neuroblastoma cells while blot analyses showed that some cellular proteins were preferentially modified. Pull-down analyses confirmed that the cytoskeletal proteins tubulins, vimentin, and neurofilament-L were modified. When pure tubulins were exposed to micromolar levels of synthetic TD, self-polymerization was initially enhanced and then suppressed. These results suggest that serotonin oxidation by myeloperoxidase or the action of other oxidants could cause functional alteration of cellular proteins, which may be related to neurodegeneration processes or irritable bowel syndrome., Highlights • Antibody to quinone-modified protein was established and characterized. • Modification of protein by quinone was dependent on myeloperoxidase but independent of chloride ion concentration. • We immunochemically found that cellular proteins were preferentially modified. • Quinone modulated polymerization of tubulins in vitro.

This paper examines the effects of Russian foreign exchange and monetary policies under conditions of abundant natural resources during the period 1999–2011 using structural VAR models. The results suggest that monetary policy shocks, which are identified as money supply disturbances, have a persistent effect on real output, and more than half of the volatility in real output can be explained by changes in the money supply. Furthermore, the analysis reveals that stock prices are a more significant transmission channel of monetary policy than bank loans.

Survival prediction systems such as the Palliative Prognostic Index (PPI), which includes the Palliative Performance Scale (PPS), are used to estimate survival for terminally ill patients. Oncologists are, however, less familiar with the PPS in comparison with the Eastern Cooperative Oncology Group (ECOG) performance status (PS). This study was designed to validate a simple survival prediction system for oncologists, the Performance Status-Based Palliative Prognostic Index (PS-PPI), which is a modified form of the PPI based on the ECOG PS.This multicenter, prospective cohort study enrolled all consecutive patients who were referred to 58 palliative care services in Japan. The primary responsible physicians rated the variables required to calculate the PS-PPI and the PPI. Patient survival in these risk groups was compared, and the sensitivity and specificity of the PS-PPI and the PPI were evaluated. Patients were subclassified as patients receiving care from in-hospital palliative care teams, palliative care units, or home-based palliative care services. Subsets of patients receiving chemotherapy were also analyzed.This study included 2346 patients. Survival predictions based on the PPI and the PS-PPI differed significantly among the 3 risk groups (P .001). The PS-PPI was more sensitive, whereas the PPI was more specific. All areas under the receiver operating characteristic curves of both indices were0.78 for predicting survival at all times, from 3 weeks to 180 days.In predicting the prognosis of patients with advanced cancer, the PS-PPI was as accurate as the PPI. The PS-PPI was useful for short- and long-term survival prediction and for the prediction of survival for patients undergoing chemotherapy. Cancer 2017;123:1442-1452. © 2016 American Cancer Society.

The modification of 5-hydroxyindoleacetic acid (5HIAA) by myeloperoxidase with a xanthine oxidase system was investigated by chromatographic analyses. Two major products were identified as a dimer and quinone (indoleacetate dione) of 5HIAA. The formation of a quinone moiety was also confirmed by chemical trapping with o-phenylenediamine. In the presence of N-acetyl-cysteine (NAC), a quinone-NAC adduct was formed. When glyceraldehyde 3-phosphate dehydrogenase was exposed to the myeloperoxidase system with 5HIAA, quinone adducts were formed on the protein molecule. A monoclonal antibody was prepared using a quinone-modified protein as an immunogen to immunochemically detect the quinone on a protein. The established antibody recognized the quinone-NAC adduct, quinone-modified poly-L-lysine, and quinone-modified low-density lipoprotein. Quinone-modified proteins in human atherosclerotic lesions were immunohistochemically observed using the established antibody to the quinone and also a monoclonal antibody to tryptamine dione-modified protein, suggesting an occurrence of in vivo oxidation of serotonin and 5HIAA, accompanied by covalent adduction to biomolecules.

This article examines the relationship between financial development and economic growth. Money supply and loans relative to Gross Domestic Product (GDP) are used as indicators of financial development. The empirical results, that money supply leads economic growth while economic growth leads loans, reflect the characteristics of the Russian economy. Oil price increases and the appreciation of the ruble increased money supply under insufficient sterilisation instruments, which, in turn, fostered economic growth. On the other hand, the Russian economic boom provided an incentive for banks to increase loans and their role in initiating economic growth is limited.

Object The authors report their investigation on the current status of neuroendoscopic biopsy for ventricular and paraventricular tumors as well as treatment for associated hydrocephalus in Japan. Methods Patients who had undergone therapeutic neuroendoscopy between 2005 and 2009 were included in this study. The main items examined were age; sex; localization of tumor; pathological diagnosis using biopsy; the presence, treatment, and efficacy of treatment of associated hydrocephalus; perioperative complications; activities of daily living (ADL) before and after therapeutic neuroendoscopy; and the presence of dissemination during the postoperative course. Results Seven hundred fourteen patients from 123 sites (462 male and 252 female patients, mean age 33.3 years) were enrolled. Localization of the tumor was mainly classified into the lateral ventricle in 91 patients, the third ventricle in 339, the fourth ventricle in 18, the suprasellar region in 75, and other paraventricular areas in 191 patients. The most commonly observed tumors were germ cell tumors in the third ventricle (177 cases [39%]), cystic lesions in the suprasellar region (56 cases [75%]), and astrocytic tumors in the thalamus-basal ganglia (71 cases [38%]). Although 641 (92.8%) of 691 patients could receive neuroendoscopic diagnosis using biopsy, the diagnosis obtained with endoscopic biopsy differed from the final diagnosis based on subsequent craniotomy in 18 patients and clinical course in 3 patients. Of these 21 patients, 7 had astrocytic tumors, 4 had pineal tumors, 6 had germ cell tumors, and 4 had other tumors. The final diagnostic accuracy rate was 89.7%. Associated hydrocephalus was observed in 517 patients (72.4%), of whom 316 and 39 underwent third ventriculostomy and fenestration of the septum, respectively. The response rates were 96.2% and 89.7%, respectively. Third ventriculostomy was required for recurrence of hydrocephalus in 41 patients (13.0%), and the long-term response rate was therefore 83.2% (263 of 316 patients). Perioperative complications other than fever, such as new onset of or progressive hydrocephalus, infection due to CSF leakage, and bleeding in the ventricle or tumor, were found in 81 patients (11.3%). The median Karnofsky Performance Scale score before endoscopic surgery was 80, but it increased to 90 after surgery. The score was thus significantly increased after surgery (p < 0.0001, Mann-Whitney U-test). Activities of daily living after surgery decreased due to perioperative complications in 15 patients (2.1%). The incidence of new dissemination after endoscopic biopsy was 6.8% and not high compared with routine surgical treatment. Conclusions The authors concluded that neuroendoscopic diagnosis using biopsy for ventricular and paraventricular tumors is adequately accurate and safe. It was demonstrated that endoscopic procedures play important roles not only in the treatment of hydrocephalus associated with intra- and paraventricular tumors but also in significantly improving ADL. Furthermore, the long-term outcome of endoscopic third ventriculostomy was clearly favorable.

A sequence of 11 consecutive arginine residues (11R) is one of the best protein transduction domains for introducing proteins into cell membranes. Heme-oxygenase-1 (HO-1) is involved in heme catabolism and reduces the contractile effect of hemoglobin after subarachnoid hemorrhage (SAH). Therefore, we constructed 11R-fused HO-1 protein to achieve successful transduction of the protein into the cerebral arteries and examined the therapeutic effect of the 11R-HO-1 protein for cerebral vasospasm (CV) after SAH. We injected the 11R-HO-1 protein into the cisterna magna of male rats and, several hours after the injection, performed immunofluorescence staining and western blotting analysis of the rat basilar arteries (BAs) to determine transduction efficacy. We also assessed intraarterial HO-1 activity as cGMP (cyclic guanosine 3′, 5′-cyclic monophosphate) accumulation in SAH and determined whether protein transduction of 11R-HO-1 quantified the therapeutic effect in a rat double-hemorrhage model of SAH. The BAs expressed significantly more HO-1 in the group injected with 11R-HO-1 (3.56±0.54 (11R-HO-1) versus control (saline)), and transduction of 11R-HO-1 resulted in higher activity (>3.25-fold) in rat BAs with SAH. Moreover, the results of the rat double-hemorrhage model showed that the 11R-HO-1 protein significantly attenuated CV after SAH (317.59±23.48 μm (11R-HO-1) versus 270.08±14.66 μm (11R-fused enhanced green fluorescent protein), 252.05±13.95 μm (saline), P

This paper examines the impact of oil prices on real stock returns for Brazil, China, India and Russia over 1999:1-2009:9 using VAR models. The results suggest that whereas real stock returns positively respond to some of the oil price indicators with statistical significance for China, India and Russia, those of Brazil do not show any significant responses. In addition, statistically significant asymmetric effects of oil price increases and decreases are observed in India. The analysis of variance decomposition shows that the contribution of oil price shocks to volatility in real stock returns is relatively large and statistically significant for China and Russia.

Background There are significant differences in the postoperative morphological and hemodynamic conditions of the carotid arteries between carotid artery stenting (CAS) and endarterectomy (CEA). Objective To compare the postoperative rheological conditions after CAS with those after CEA with patch angioplasty (patch CEA) through the use of computational fluid dynamics (CFD) based on patient-specific data. Methods The rheological conditions in the carotid arteries were simulated in 2 patients after CAS and in 2 patients after patch CEA by CFD calculations. Three-dimensional reconstruction of the carotid arteries was performed with the images obtained with computed tomography angiography. The streamlines and wall shear stress (WSS) were calculated by a supercomputer. Adequate boundary conditions were determined by comparing the simulation results with ultrasound flow data. Results CFD was successfully calculated for all patients. The differences between the flow velocities of ultrasound data and those of the simulation results were limited. In the streamline analysis, the maximum flow velocities in the internal carotid artery after patch CEA were around two-thirds of those after CAS. Rotational slow flow was observed in the internal carotid artery bulb after patch CEA. WSS analysis found regional low WSS near the outer wall of the bulb. High WSS was observed at the distal end of the arteriotomy after patch CEA and at the residual stenosis after CAS. Conclusion CFD of postoperative carotid arteries disclosed the differences in streamlines and WSS between CAS and patch CEA. CFD may allow us to obtain adequate rheological conditions conducive to achieving the best clinical results.

This paper investigates the spillovers of US conventional and unconventional monetary policies to Russian financial markets using VAR-X models. Impulse responses to an exogenous Federal Funds rate shock are assessed for all the endogenous variables. The empirical results show that both conventional and unconventional tightening monetary policy shocks decrease stock prices whereas an easing monetary policy shock does not increase stock prices. Moreover, the results suggest that an unconventional tightening monetary policy shock increases Russian interest rates and decreases oil prices, implying reduced liquidity in international financial markets.

Parkinsonism related to brain tumor is reviewed with the presentation of our case. Neurosurgeons or neurolo- gists know that some patients with brain tumor present parkinsonism, although further enlightenment is required. The mechanisms are divided into 6 subgroups, 1. direct oppression to the basal ganglia; 2. distortion and stress to the mid- brain; 3. neuronal loss in the substantia nigra; 4. involvement of the basal ganglia; 5. damage of the fiber connection be- tween the basal ganglia and supplementary motor area; 6. old age. In the recent 11 years, 16 cases were reported. Pediatric cases, localized cases with relatively small lesion and post-irradiation cases were increasingly reported. The prognoses of brain tumor-related parkinsonism varied and independent of the pathology, location, and therapies of the tumor. All we can do is to select the appropriate therapy including surgical removal of the tumor by the correct estimation of the dam- aged region.

Many studies have shown that a motif of 11 consecutive arginines (11R) is one of the most effective protein transduction domains (PTD) for introducing proteins into the cell membrane. By conjugating this "11R", all sorts of proteins can effectively and harmlessly be transferred into any kind of cell. We therefore examined the transduction efficiency of 11R in cerebral arteries and obtained results showing that 11R fused enhanced green fluorescent protein (11R-EGFP) immediately and effectively penetrated all layers of the rat basilar artery (BA), especially the tunica media. This method provides a revolutionary approach to cerebral arteries and ours is the first study to demonstrate the successful transductionof a PTD fused protein into the cerebral arteries. In this review, we present an outline of our studies and other key studies related to cerebral vasospasm and 11R, problems to be overcome, and predictions regarding future use of the 11R protein transduction method for cerebral vasospasm (CV).

Objective Hypoxia-inducible factor (HIF)-1 is a transcription factor that regulates the expression of various neuroprotective genes. The goal of this study was to clarify the relationship between HIF-1 expression and subarachnoid hemorrhage (SAH) and to characterize the effects of deferoxamine (DFO)-induced increases in HIF-1 protein levels on the brainstem and the basilar artery (BA) after experimental SAH. Methods Rat single- and double-hemorrhage models (injected on Days 0 and 2) of SAH were used. We assessed the time courses for HIF-1 protein levels in the brainstems and the BA diameters within 10 minutes and 6 hours on Days 1 and 2 in the single-SAH model, and also on Day 7 in the double-SAH model. After induction of double hemorrhage in rats, DFO was injected intraperitoneally. We then evaluated HIF-1 protein expression and brainstem activity, BA diameter, and brainstem blood flow. Results After the rats experienced SAH, HIF-1 protein expression was significantly greater at 10 minutes in the single-injection model and at 7 days in the double-injection model than at similar time points in the control group, and these increases correlated with degrees of cerebral vasospasm. DFO injection resulted in significant increases in HIF-1 protein expression and activity in the brainstems of rats with SAH, compared with the rats with SAH that were given placebos, and the rats without SAH in the double-hemorrhage model. Cerebral vasospasm and reduction of brainstem blood flow were significantly attenuated in the rats that were administered DFO. Conclusion These results show that a DFO-induced increase in HIF-1 protein level and activity exerts significant attenuation of BA vasospasm and reduction of brainstem blood flow in the rat model of SAH. DFO may be a promising agent for treating clinical SAH.

Objective Dural arteriovenous fistulae involving the transverse-sigmoid sinus, which is occluded at its proximal and distal ends (i.e., an isolated sinus), carry a high risk of intracranial hemorrhage or progressive neurological deficits. Although transvenous coil embolization is a useful and safe treatment for such lesions, it is often difficult to reach into the isolated sinus through the occluded sinus using the percutaneous catheter approach. Methods We report the successful treatment of two patients with transverse-sigmoid dural arteriovenous fistulae with isolated sinus using the percutaneous transvenous triple-catheter technique. A 6-French guiding catheter was placed at the internal jugular vein followed by a second 4-French catheter positioned at the end of the occluded sinus. A third microcatheter was then navigated into the isolated sinus with support of the second catheter. Results Although initial attempts to reach into the isolated sinus without the second catheter failed, insertion of the second catheter resulted in successful navigation of the third microcatheter into the affected sinus in both cases. Complete cure was obtained in both cases by coil packing of the affected sinus. Conclusion Although careful maneuvering is required, this triple-catheter technique is useful for treatment of dural arteriovenous fistulae with isolated sinus.

Object Inflammation in the subarachnoid space and apoptosis of arterial endothelial cells have been implicated in the development of delayed cerebral vasospasm after subarachnoid hemorrhage (SAH). The authors investigated mechanisms of possible antivasospastic effects of N-benzyl-oxycarbonyl-Val-Ala-Asp-fluoromethylketone (Z-VAD-FMK), a caspase inhibitor that can inhibit both inflammatory and apoptotic systems, in animal models of SAH. Methods Rabbits were assigned to three groups of eight animals each and were subjected to SAH by injection of blood into the cisterna magna. The experiments were performed in the following groups: SAH only, SAH + vehicle, and SAH + Z-VAD-FMK. The Z-VAD-FMK (1 mg) or vehicle (5% dimethyl sulfoxide) was intrathecally administered before SAH induction. Diameters of the basilar artery (BA) were measured on angiograms obtained before and 2 days after SAH. The BA diameter on Day 2 was expressed as a percentage of that before SAH. Interleukin (IL)–1β in the cerebrospinal fluid (CSF) was examined using Western blotting, and brains were immunohistochemically examined for caspase-1 and IL-1β. In a separate experiment, 20 rats were subjected to SAH and their brains were immunohisto-chemically assessed for caspase-1, IL-1β, and macrophages. Results In rabbits, Z-VAD-FMK significantly attenuated cerebral vasospasm (the BA diameter on Day 2 in SAH-only, SAH + vehicle, and SAH + Z-VAD-FMK groups was 66.6 ± 3.2%, 66.3 ± 3.7%, and 82.6 ± 4.9% of baseline, respectively), and suppressed IL-1β release into the CSF and also suppressed immunoreactivities of caspase-1 and IL-1β in macrophages infiltrating into the subarachnoid space. Immunoreactivities for caspase-1 and IL-1β were observed in immunohistochemically proven infiltrating macrophages in rats. Conclusions These results indicate that caspase activation may be involved in the development of SAH-induced vasospasm through inflammatory reaction.

After endovascular coil embolization of cerebral aneurysms, coil compaction and late aneurysm recanalization have been ever observed. The HydroCoil Embolic System (HES) was developed to improve the packing efficacy of endovascular treatment of cerebral aneurysms. In this study, we evaluate the packing efficacy of HES using a silicone model of ruptured cerebral aneurysm. This silicone model was connected to a pulsatile flow pump and embolized with the initial framing coils followed by hydro coils (n = 3) or bare platinum coils (n = 3). The coils used in the two groups were identical to each other in size and length. In the hydro coil group, continuous outflow from ruptured aneurysm ceased in two out of three cases. On the other hand, in the bare platinum coil group, outflow from the ruptured point slightly decreased but did not stop in all cases. The hydro coil could result in a higher initial occlusion rate of silicone model. In addition, expanded hydrogel possibly sealed the ruptured point directly. Changes in the size of aneurysms were not detected, from which the risk of over-expansion seemed extremely low. The hydro Coil is a safe and feasible device for improving the packing efficacy in endovascular coil embolization.

To develop an effective way to produce hydrogen continuously by means of partial oxidation of natural gas methane, we experimentally studied a Ni catalytic‐permeable‐membrane‐tube reactor. When a mixture of CH4 and O2 was introduced into a Ni tube, H2 was produced by a partial oxidation reaction and permeated through the Ni‐tube reactor to separate from another product of CO. The dependence of the partial oxidation rate on the inlet CH4/O2 molar ratio, temperature, flow rate, and total pressure were determined experimentally. The rate constants of the complete oxidation reaction, the steam‐reforming one and the CO2‐reforming one were simultaneously determined at temperatures of 400 to 750°C from fitting analytical calculations to experimental ones. Although complete separation between CO and H2 was not achieved within a limited surface area in the present experiment, it was analytically proved that H2 and CO can be effectively separated in a long Ni‐tube reactor.

●Abstract● The authors report initial clinical experience of new detachable coils in the treatment of cerebral aneurysms. Micrusphere coils and Microplex complex coils were introduced in Japan in 2006. These coils have a unique three-dimensional shape, suitable for framing the aneurysm. We mainly used these coils for the purpose of initial frame formation in the aneurysmal dome and evaluated their characteristics in this study. Over the last 8 months, 58 patients with intra-cranial aneurysm were treated using detachable coils at our institution. Of them, 14 patients were treated using Micrusphere, and 11 using Microplex. The Micrusphere coil was suitable for initial frame formation into a global shape with a relatively broad neck. The Microplex coil was able to produce a nice basket even in multi-lobulated or spindly aneurysms. It is imperative that all operators have precise understanding of the new coils prior to clinical use.

This paper examines whether a bank lending channel exists in monetary policy transmission in Russia, employing Russian bank-level data from 2005 through 2012. The results of specifications suggest that banks with less capital tend to react more sensitively to changes in monetary policy. Furthermore, this study finds that smaller, more liquid and/or better-capitalized banks were likely to have more rapidly growing loan portfolios, and larger banks tended to attenuate the crisis shock.

The International Commission on Radiological Protection recommends diagnostic reference levels (DRL) in each radiological examination for justification and optimization of patients' dose in medicine. The aim of our study was to propose the dose management system by utilizing dose information in diagnostic X-ray radiation dose structured report (Dose SR) in The Digital Imaging and Communications in Medicine to optimize radiation dose in institutions. Our dose management system is able to organize dose information obtained from various angiography systems and CTs. It is possible to provide this information to operators for justification and optimization of patient dose. Our system would be useful for the estimation of organ dose and could be used for the determination of local DRL (LDRL) for each radiological practice. In addition, the optimization became possible to compare LDRL with national DRL.

The overall mass-transfer process of methane decomposition on Ni surfaces and hydrogen permeation through a Ni tube was experimentally investigated to design a catalytic-permeable Ni tube reactor. This is a basic study of an impurity detritiation system to decompose tritiated methane and continuously recover tritium in a gas mixture exhaustedfrom fusion plasma. The mass-transfer process was comparatively studied under the two conditions of an open Ni tube without any packing and a Ni tube packed with 200-240 mesh Ni particles. Results were discussed in terms of a CH 4 decomposition ratio η decomp and a H 2 permeation ratio η perm . The η decomp values depended on temperature and were almost independent of the flow rate. The η decomp value was correlated to the first-order reaction-rate constant. On the contrary, the η perm values were in reverse proportion to the flow rate and were almost independent of temperature. The η perm value was related to diffusion through a H 2 concentration boundary layer formed in the vicinity of the Ni tube wall. The degradation of catalytic performance due to carbon deposition on Ni was discussed based on our experiments.

A 6-year-old boy presented with a large supratentorial ependymoma with massive calcification and central cyst formation manifesting as generalized convulsion and right hemiparesis. Computed tomography and magnetic resonance imaging showed a large, poorly enhanced, left frontal mass with massive calcification and a central cyst. Angiography revealed no extracranial blood supply to the tumor, which was supplied by branches of the left middle cerebral artery. The patient underwent total resection of the tumor, which was located in the parenchyma with no dural attachment. The tumor was clearly demarcated and dissected subpially from the surrounding brain parenchyma. The surgical findings suggested no relationship with the lateral ventricular system. Histological examination of the tumor demonstrated perivascular pseudorosette formation and mitosis with massive calcification, and immunocytochemical reactivity for glial fibrillary acidic protein and epithelial membrane antigen, but not synaptophysin. These findings were compatible with ependymoma, World Health Organization grade 2. Postoperative magnetic resonance imaging clearly showed that the tumor was located in the intradural, intraaxial space with no relationship to the ventricles.

In this report, we examined whether corrosion cast method is also applicable for the measurement and estimation of the rat major arteries in which subarachnoid hemorrhage (SAH) is produced. Additionally, we have examined the diameters of the rat major arteries following SAH. A total of 0.3 ml autologous blood was injected into the cisterna magna of male Sprague-Dawley rats for the SAH model. A perfusion of a semi-polymerized casting medium was performed, 10 min, 30 min, 1 h, 4 h, 8 h, 1 day, 2 days, 3 days, 5 days, and 7 days after SAH. The brains were corroded in a 10% NaOH solution. The BA and the other major arteries were then measured using scanning electron microscopy (SEM). Macroscopic observation and hematoxylin-eosin (HE) staining were also performed. Using the corrosion cast method, the biphasic contractile response was observed in the BA; 8.3% and 11.6% contractions were observed 30 min and 1 day after SAH, respectively. In addition, there was almost no smooth muscle or adventitial thickening in the chronic stage. In contrast, the dilative response was observed in the internal carotid artery and middle cerebral artery 10 min after SAH. Macroscopic findings and HE staining revealed that the extensive basal subarachnoid hematoma had almost disappeared by day 2. These results indicate that in this model, the minimal spasm, which occurs one day after SAH, can be explained by the small capacity of the rat subarachnoid space and the rapid cerebrospinal fluid washout around major vessels at the cerebral base. Moreover, the present data also show the compensatory dilatation in the ICA and MCA in the early stage after SAH.

Object. Hemoglobin causes contraction of cerebral arteries and is also believed to cause vasospasm after subarachnoid hemorrhage (SAH). The goal in this study was to determine if overexpression of heme oxygenase-1 (HO-1), the principal enzyme involved in the metabolism of hemoglobin, would reduce contractions of cerebral arteries brought on by hemoglobin and decrease vasospasm after experimental SAH. Methods. Injection of adenovirus expressing HO-1 (Ad5HO-1) into the cisterna magna of rats produced a significant increase in expression of HO-1 messenger RNA, and protein and HO-1 activity in the basilar artery ([BA]; p < 0.05 for each measure compared with vehicle and/or control virus, according to analysis of variance or unpaired t-test). Injection of adenovirus expressing β-galactosidase (Ad-βGal) produced only mild, statistically nonsignificant increases. The HO-1 immunoreactivity was localized to the BA adventitia after injection of Ad5HO-1 or Ad-βGal. Injection of Ad5HO-1 and Ad-βGal increased the baseline diameter of the BA (measured directly via a transclival window) and brainstem cerebral blood flow (CBF), measured by laser Doppler flowmetry, compared with vehicle. Contraction of the BA after addition of hemoglobin was significantly inhibited, reduction in brainstem CBF was significantly prevented, and carboxyhemoglobin concentration was significantly increased in rats injected with Ad5HO-1 compared with Ad-βGal and vehicle. Vasospasm was significantly ameliorated in rats in which Ad5HO-1 was injected into the cisterna magna at the time of SAH in a double-hemorrhage model. Conclusions. These results show that overexpression of HO-1 inhibits arterial contractions induced by hemoglobin and can reduce vasospasm after experimental SAH.

Short acting opioids, such as morphine, are recommended for the management of predictable breakthrough pain in cancer patients. However, it has been reported that prophylactic fentanyl rescue medication, which is more effective and has a shorter duration of action, is more suitable for some patients depending on their symptoms and the characteristics of their breakthrough pain. Herein, we report the case of a 68-year-old man with prostate cancer who received high-quality analgesic treatment by prophylactic administration of fentanyl buccal tablets before meals. It is hoped that fentanyl rescue medication can be used as a prophylactic for predictable breakthrough pain in other cancer patients.