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Port structure in the JT-60SA is designed to access vacuum vessel inside for vacuum exhausts, plasma heating systems and diagnostics etc. from cryostat outside. The port consists of a rectangular pipe, bellows and additional materials such as electrical insulations and connection parts for onsite assembly. The vacuum space as the thermal insulation for superconducting coils is penetrated by the port as the vacuum interfaces between the vacuum vessel and the cryostat so that port structure is required to be structurally integrated against plasma and baking operations and accidental events. This structure must be installed in narrow space, and electrical insulation is functionally designed to avoid the unexpected large eddy current loop. This paper reports the design of port connection structure for the assembly. Port connection parts “Port Extension” and “adjustable plate” are introduced to absorb vertical of 10 mm, toroidal of 8 mm, and port axial of 10 mm error due to the manufacturing and assembly. The bellows are expected to absorb relative displacement of 39 mm only between the vacuum vessel and the cryostat during the operation. The structure is confirmed to withstand the load conditions because stress is estimated to be lower than allowable level by FEM analysis.

The JT-60SA superconducting tokamak is being constructed under dual projects, the EU-JA international collaboration framework and Japanese national programme. To suppress magnetic field error to less than 0.01% with respect to the toroidal magnetic field for good confinement of plasma, QST has developed a precise onsite assembly technology of tokamak components such as vacuum vessel (VV) and toroidal magnetic field coils (TFC) with size of over 10-m scale. Prior to an onsite assembly, the assembly process is carefully simulated in a three dimension CAD model, through which the location and number of the reference points for the assembly are evaluated to determine each component position. In the onsite assembly, the tokamak components are positioned by measuring with the laser tracker of a 0.5 mm spatial resolution and assembled by adjusting with shims and splice plates. The onsite assembly of the VV 340° sector has been succeeded in an allowable accuracy of +8/−4 mm with the 10 m diameter by welding sectors, each of which was circumferentially segmented and manufactured by taking into account the deformation due to the welding. The remaining 20° sector will be installed after the TF coils installation. The metrology developed for the onsite assembly of the JT-60SA is expected to be applicable to ITER whose size is the double of JT-60SA.

In order to obtain information for control of JT-60SA plasma and physics research on the plasma, many types of magnetic sensors are developed. We have designed a new architecture of magnetic sensors and connection methods for JT-60SA taking installation and maintenance into account. The former include a newly designed Mirnov coil, a Rogowski coil and a diamagnetic loop. They enable us to make simple and robust sensors. The latter include a newly developed connector between a sensor and a mineral insulation cable, and a connection box. An unsealed connection box enables easy installation in a vacuum vessel; however, it should have a withstand voltage greater than 1 kV at intermediate gas pressures. We successfully achieved a high withstand voltage for the unsealed connection box in the gas pressure region around the Paschen minimum voltage. After R&D of JT-60SA magnetic sensors, almost all manufacturing steps are complete. This paper reports the manufacturing and tests of the magnetic sensors for JT-60SA.

Minimum sets of in-vessel components were installed for initial operation of JT-60SA in order to product and control the plasma and to know the plasma basic information, including inboard first wall, upper divertor, protection limiter, glow electrodes and magnetic sensors. All of magnetic sensors were installed within the required accuracy with in-situ measurement with laser tracker. The inboard first wall and the upper divertor were installed for the limiter configuration at the plasma initiation and the divertor configuration, respectively. They have carbon tiles as the first wall, which must be installed with accuracy of ± 1 mm in order to avoid the heat concentration. However, the vacuum-vessel wall had some deformation. Therefore, we measured in advance with laser tracker the position of the vacuum vessel where the bases of the inboard first wall and upper divertor would be welded. By using these position data and 3D CAD, we customized all bases. Owing to these procedures, we could install the first wall with required accuracy. Also, all other components were installed with required accuracy.

JT-60SA has been designed and is being constructed to demonstrate and develop steady-state high-beta operation. Resistive wall mode (RWM) control, error field correction, and edge-localized mode (ELM) control will be performed using in-vessel coils. For these controls, we have developed a biaxial magnetic sensor to determine 3D magnetic configuration of the plasma. Moreover, for obtaining basic information about JT-60SA plasma, magnetic sensors, in particular, one-turn loops, Rogowski coils, diamagnetic loops, and saddle coils have been developed. Because the length of the vacuum vessel in the poloidal direction of JT-60SA is 16 m and almost twice as long as that of JT-60U, the length of the Rogowski coil and the diamagnetic loop of JT-60SA are also twice as long as those on JT-60U. We have devised new types of sensors and a connector for the mineral-insulated cable because construction and installation of these sensors are much more difficult in JT-60SA. We will report the design and specification of the magnetic sensors for JT-60SA from the physics and engineering aspects.

Disassembly of the JT-60U torus was started in 2009 after 18 years of D2 operations and was completed in October 2012 for assembling the JT-60SA torus at the same position. The JT-60U torus was featured by the complicated and welded structure against the strong electromagnetic force, and by the radioactivation due to deuterium–deuterium (D–D) reactions. Since this work is the first experience of disassembling a large radioactivated fusion device in Japan, careful preparations of disassembly activities, including treatment of the radioactivated materials and safety work, have been made. During the disassembly period over 3 years, careful measures against exposure were taken and stringent control of exposure dose were implemented, and as a result, accumulated collective effective dose of ∼41,000 person-day to workers was only ∼22 mSv in total and no internal exposure was observed. About 13,000 components cut into pieces with measuring the contact dose were removed from the torus hall and stored safely in storage facilities. The total weight of the disassembly components reached up to ∼5400 tonnes. Most of the disassembly components will be treated as non-radioactive ones after the clearance level inspection under the Japanese regulations in the future. The assembly of JT-60SA has started in January 2013 after this disassembly of JT-60U torus.

The tokamak machine monitoring and control system has been developed to avoid machine damages in JT-60 safety operation. It monitors the JT-60 mechanical structures and other sub-components to maintain their conditions. The system adopts the CAMAC digitizers, the Signal Transfer Unit (STU), and the hard-wired interlocks. Over 20 year, it has never been affected by any major troubles except a water leakage in toroidal field coil (TFC). The TFC monitoring system has been developed for the TFC safety with the water leakage from a cooling water channel. It has improved the reliability and efficiency of the TFC operation.

Low- Z impurity ( 7 Be) on the JT-60U divertor tiles was analyzed to study the impurity behavior in the divertor region. The amount of the 7 Be increased approximately one hundred times after B 4 C-tile installation in the outer divertor. The 7 Be was probably produced by 10 B(p,α) 7 Be nuclear reaction on the divertor tiles in the hydrogen experiment with ion cyclotron range of frequency heating. The 7 Be was distributed asymmetrically in the poloidal and the toroidal direction. The highest 7 Be concentration was found at the inner divertor whose boron content (B/(B+C) ∼ 20%) was lower than the B 4 C tiles (B/(B+C) ∼ 80%) of the outer divertor. This result may imply impurity transport from the outer divertor to the inner divertor.

Modification of JT-60 as a full superconducting tokamak (JT-60SC) is planned. The objectives of the JT-60SC programme are to establish scientific and technological bases for steady-state operation of high performance plasmas and utilization of reduced-activation materials in an economically and environmentally attractive DEMO reactor. Advanced fusion technologies relevant to the DEMO reactor have been developed for the superconducting magnet technology and plasma facing components of the JT-60SC design. To achieve a high current density in a superconducting strand, Nb3Al strands with a high copper ratio of 4 have been newly developed for the toroidal field coils (TFCs) of JT-60SC. The R&D to demonstrate the applicability of the Nb3Al conductor to TFCs by a react-and-wind technique has been carried out using a full-size Nb3Al conductor. A full-size NbTi conductor with low ac loss using Ni-coated strands has been successfully developed. A forced cooling divertor component with high heat transfer using screw tubes has been developed for the first time. The heat removal performance of the carbon fibre composite target was successfully demonstrated on an electron beam irradiation stand.

A modification of the JT-60 is planned to be a superconducting tokamak (JT-60SC) in order to establish steady-state operation of high beta plasma for 100 s, and to ensure the applicability of ferri...

The design of the JT-60U tokamak, the configuration of the coil power supplies, and the operational experiences gained to date are reviewed. JT-60U is a large tokamak upgraded from the original JT-...

A centrifugal pellet injector and a guide tube for magnetic high-field side (HFS) injection were developed in JT-60U. The injector can eject trains of up to 40 cubic (1.9 mm) 3 deuterium pellets at frequencies of 1–10 Hz and velocities of 0.2–1.0 km/s. Pellet injection experiments into ohmic heating (OH) plasma were performed. From plasma density measurement, central fueling and enhanced fueling rate compared to gas puffing were observed for magnetic low-field side (LFS) injections. The results of HFS injection through the guide tube connected to the upper port of the vessel showed that the pellet velocity exceeding 220 m/s caused pellet destruction inside the tube.

Objective—To examine the eVect of transfection of oligodeoxynucleotides (ODNs) containing a CpG motif (CpG-ODN), of which the sequence was derived from circulating DNA in the sera of patients with systemic lupus erythematosus (SLE), on the expression of intercellular adhesion molecule-1 (ICAM-1) and synthesis of mRNA for proinflammatory cytokines and ICAM-1 in human umbilical vein endothelial cells (EC). Methods—A CpG-ODN or a control analogue, GpC-ODN, was transfected into EC. ICAM-1 expression was examined by flow cytometry, and expression of mRNA in EC encoding interleukin 1 (IL1), IL6, IL8, tumour necrosis factor AE (TNFAE), interferon a (IFNa), and ICAM-1 was examined by semiquantitative reverse transcriptase-polymerase chain reaction. Results—The CpG-ODN augmented the expression of ICAM-1 on EC determined by flow cytometry and increased mRNA levels of IL6, IL8, TNFAE, IFNa, and ICAM-1, but the GpC-ODN did not. Conclusion—Synthesised DNA, with a sequence corresponding to that of the fragment containing the CpG motif, in sera of patients with SLE was found to enhance ICAM-1 expression on EC, suggesting the participation of circulating DNA fragments in the pathogenesis of vasculitis in SLE. (Ann Rheum Dis 2001;60:685‐689)

In JT-60U, the modification to a W-shaped pumped divertor will be completed in May 1997, aiming to realize sufficient reduction in heat flux to the targets and good H-mode confinement simultaneously. W-shaped geometry is optimized not only for forming radiative divertor plasmas and reducing the back flow of neutral particles but also for allowing various experimental configurations. Toroidally and poloidally segmented divertor plates, dome and baffles are arranged in a W-shaped poloidal configuration. The pumping speed can be changed during a shot by variable shutter valves in the three pumping ports under the outer baffle. The net throughput is enough for particle control in the steady radiative operations with high power NBI heating. Carbon fiber composite (CFC) tiles are used for the divertor targets and the divertor throat where large heat flux is expected. Gaps between two adjacent segments are carefully sealed to suppress the leak of neutral gas from the exhaust duct below the divertor and baffles. The strength of the whole structure is confirmed by an electromagnetic force analysis and structural analysis carried out for disruptions of 3 MA discharges with a halo current.

Fusion performance of reversed shear discharges with an {ital L}-mode edge has been significantly improved in a thermonuclear dominant regime with up to 2.8 MA of plasma current in the JT-60U tokamak. The core plasma energy is efficiently confined due to the existence of persistent internal transport barriers formed for both ions and electrons at a large minor radius of r/a{approximately}0.7 near the boundary of the reversed shear region. In an assumed deuterium-tritium fuel, the peak fusion amplification factor defined for transient conditions involving the dW/dt term would be in excess of unity. {copyright} {ital 1997} {ital The American Physical Society}

B 4 C conversion-coated carbon fiber composites (B 4 C-converted CFC) have been installed on the outboard strike point of the divertor plate in JT-60U to form a complete toroidal ring. The plasma-surface interactions of the B 4 C-converted CFC have been investigated in high power divertor operation with neutral beam (NB) heating power of - 30 MW for 2 s. It is found that the carbon impurity is reduced without a significant increase of the boron impurity using a 100 μm thick B 4 C layer with a B /C ratio of 2.7. The oxygen impurity is reduced significantly by the evaporation of a 300 μm thick B 4 C layer with a B /C ratio of 3.8. A reduction in the detrimental effects on plasma-surface interactions with carbon-based materials has been demonstrated for more than 1000 shots by the use of surface-boronized carbon tiles in JT-60U

The mechanical fracture of three carbon fiber composite (CFC) first wall tiles was observed. This damage was probably caused by the electromagnetic force due to halo current during disruption. The required current to break the CFC tile is estimated to be 25 kA. The broken tile was rotated poloidally around the plasma with a speed of about 10 m/s during the following discharge. A possible driving force of this rotation might be the electromagnetic force due to the scrape-off layer (SOL) current. The required current to rotate the piece of the broken tile is 1 kA. These results indicate that electromagnetic interaction between SOL plasma and the plasma facing component is important in the research on the plasma wall interactions in fusion devices.

Hepatocyte growth factor is a potent angiogenic agent. This study investigated the efficacy and safety of intramuscular injection of naked plasmid DNA encoding the human hepatocyte growth factor gene in Japanese patients with Buerger's disease and critical limb ischemia.An open-label clinical study was performed at eight hospitals in Japan from May 2004 to April 2008. Ten patients were enrolled. They had Buerger's disease with ischemic ulcers, were not candidates for revascularization, and were unresponsive to conventional drug therapy. Treatment consisted of 8 injections (total dose: 4 mg) of hepatocyte growth factor plasmid, which were administered into the calf muscles and/or distal thigh muscles of the ischemic limbs under ultrasound guidance. Administration was done twice at an interval of 4 weeks. If there was no improvement after 2 doses, a 3rd dose could be administered. The response to treatment was evaluated from the reduction of ischemic ulcer size.The size of ischemic ulcers showed a decrease in 6/9 (66.7%) patients and the ulcers healed completely in 5/9 (55.6%) patients after gene therapy. Major amputation was not required. There were no deaths and no major safety concerns.Hepatocyte growth factor gene therapy is safe and effective for critical limb ischemia in patients with Buerger's disease.

The approach that should be used for an anterior apical tumor still remains controversial. Since a modified open door method was very useful for the widening of the surgical field in a recent patient with an anterior apical tumor, an outline of this case is reported. The patient was a 66-year-old male with squamous cell carcinoma of the anterior apical region of the right lung (suspected to be invading the thoracic wall, cT3N1M0). After a midline sternal incision with a right unilateral collar incision, the medial half of the right clavicle and a few cm of the right 1st rib on the sternal side were resected to sufficiently expose the area from the right brachiocephalic trunk to around the subclavicular artery and vein, where invasion was suspected. This treatment facilitated widening of the visual field around the site of tumor invasion and made safe right upper lobectomy + combined thoracic wall resection + ND2a possible. In this patient, anterolateral incision at the 4th intercostal level, which is made using the original open door method, could be avoided, probably minimizing surgical invasion.

We report a case of a solitary fibrous tumor (SFT) of the pleura which is suspected of chest wall tumor. A 52-year-old female was admitted to our hospital because of epigastralgia and body weight loss. Chest X-ray and computed tomography showed a circumscribed mass of 35 x 22 mm in diameter arising from the parietal pleura. Positron emission tomography showed uptake valve of 1.5. SFT of chest wall origin was suspected and performed video-assisted thoracic surgery. The pedunculated tumor attached to the visceral pleura. The tumor was diagnosed as a benign SFT in intraoperative diagnosis. Long term clinical follow-up is recommended for patients with SFT, because the tumor recurrence and malignant transformation may occur in tumors with benign histological features.

Recent lower hybrid current drive (LHCD), and heating (LHH) experiments on JT-60 are reported. The current drive product of neRpIRF approximately 12.5*1019 m-2 MA was achieved at the LH power of approximately 4.5 MW, and the CD efficiency, the energy confinement, the global power balance and the heat load on divertor plates were investigated in high power LHCD plasmas. Nearly steady state H-mode discharges were found during LHCD with two different frequency injections. Sawtooth suppression in NB heated plasmas by LHCD have shown an improvement in confinement near the plasma center. Parametric instabilities in LH heating experiments were significantly reduced by increasing the plasma current, and the stored energy increased linearly with heating power of up to approximately 9 MW at ne approximately 7*1019 m-3 and Ip=2.75 MA. Parametric instabilities near the plasma edge in the ion heating regime were also reduced in peaked density plasmas produced by pellet injection and LH waves increased the central plasma pressure at ne(0) > 1.4*1020 m-3.

We herein present a case who underwent vacuum-assisted wound closure (VAC) therapy for post-sternotomy mediastinitis. A 71-year-old female with chronic renal failure on dialysis underwent a graft replacement of the ascending aortic aorta for the treatment of an acute aortic dissection. After she was discharged from the hospital, a purulent discharge was noted to occur from the median sternal wound. The wound was therefore reopened and all sternal wires were removed. Thereafter, polyurethane foam which was shaped to fit the defect was placed within the cavity. The area was covered with adhesive drape and suction drainage was carried out at -100 mmHg. The polyurethane foam was replaced every few days. The wound was finally closed using a muscle flap at 49 days after surgery. VAC therapy is therefore considered to be a useful treatment modality for deep sternal wound infections.

We previously reported intercostal duplex scanning ultrasonography to be a reliable technique for the evaluation of the internal thoracic artery (ITA). The purpose of this study was to determine the flow characteristics of the ITA graft using this technique.We evaluated the flow characteristics of 69 ITA grafts who underwent coronary artery bypass grafting by this technique. The internal diameter, mean systolic and diastolic velocity, total flow volume and diastolic fraction were all thus obtained.One occluded graft was found during the follow-up. The mean systolic velocity significantly decreased after the operation (P=0.0001) and the mean diastolic velocity significantly increased both just after the operation (P=0.0002) and 1 year later (P=0.0283). The average diameter of the ITA graft after the operation (1.70+/-0.39), at 1 year (1.73+/-0.29) and at 2 years thereafter (1.66+/-0.27 mm) all significantly decreased in comparison to the preoperative value (2.30+/-0.35 mm) (P=0.0001). The average total flow volume after the operation (35.8+/-22.2), and at 1 year (29.4+/-16.5) and 2 years thereafter (23.4+/-12.7), respectively, were significantly decreased in comparison to the preoperative value (59.4+/-28.6 mL/min) (P=0.0001). However, the average diastolic fraction which was 25.1+/-10.5% before the operation significantly increased after the operation (54.5+/-12.0, 53.2+/-11.2 at 1 year and 50.4+/-9.3 at 2 years) (P=0.0001).This technique is thus considered to be a useful noninvasive for the postoperative follow-up of the graft function. A significant increase in the diastolic fraction is thought to be important for maintaining long term graft patency.

Vein graft stenosis due to intimal hyperplasia (IH) is the main cause of graft failure. We examined possibilities of nuclear factor-kB (NF-kB) expression in vein grafts, and inhibitive effects of NF-kB decoy on the gene expression and subsequent vein graft IH.Fifteen mongrel dogs underwent femoral artery replacement with autogenous vein grafts. Group I: grafts were retrieved at a predetermined time and subjected to NF-kB binding activity assay; Groups II and III: grafts were transfected with scrambled (II-a, III-a) or NF-kB (II-b, III-b) decoy using hemagglutinating virus of Japan envelope before implantation. Grafts were retrieved 7 days after implantation for evaluation of intercellular adhesion molecule-1 (ICAM-1) mRNA expression (Group II) and 4 weeks after implantation for comparison of IH by morphometric analysis (Group III).NF-kB binding activity was increased in a time-dependent manner, with a peak 2 days after implantation. The ratio between ICAM-1 and glyceraldehyde-3-phosphate dehydrogenase mRNA expression in II-b was significantly lower than that in II-a (0.347 +/- 0.07 versus 0.612+/-0.08; P = 0.047). The ratio of intimal cross-section area to luminal cross-section area of III-b was significantly lower than that of the III-a (0.096+/-0.03 versus 0.461+/-0.11; P = 0.048).NF-kB binding activity in vein grafts increases after implantation, and transfection of NF-kB decoy before implantation may reduce IH through the inhibition of ICAM-1 expression.

An 81-year-old male appealed against a feeling of dyspnea, and consulted the hospital. The giant tumor discovered in the thorax and it was enlarging gradually for 7 years. The tumor shadow with a diameter of about 15 cm was noted in right lower lung field on the chest X-ray. A definite diagnosis was not obtained by the needle biopsy. The tumor was found to exist between upper lobe and lower lobe and pressed lower lobe at surgery. The tumor was completely excised with partial resection of the collapsed lower lobe. The tumor was 1,050 g in weight and 18 cm in maximum diameter. Pathological examination showed the irregular and plan-like arrangement of the spindle-shape cell. Immunohistochemical study revealed positive findings for bcl-2 and CD34, negative findings for desmin, ketatin, and alpha-actin. The tumor was diagnosed as malignant solitary fibrous tumor of the pleura due to highly atypical nuclear finding with an abundant nuclear fission or histology.

A field observation of dynamic behavior of full-scaled test gravity type of quay wall during earthquakes is under action in the Port of Kushiro, Hokkaido, Japan. This project aims to reveal the mechanism of the damage to quay wall associated with the liquefaction of the backfill ground, and provide information for the evaluation of seismic earth pressure on retaining structure and the development of rational earthquake resistant design method for gravity type quay wall. Some records of the dynamic behavior of the test quay wall have been obtained since the observation was started in April 2001. In the 2003 Tokachi-oki Earthquake, the test quay wall was shook with

The aim of this paper was to examine effectiveness of maintaining venous blood flow through dissected, but not harvested, grafts on prostaglandin I2 production and endothelial cell regeneration after implantation.Using 10 dogs, 8-cm-long bilateral jugular veins were dissected; 1 was harvested, and immersed in heparinized blood for 60 or 120 min. The other was left in situ with retained blood flow until harvest after 60 or 120 min. Two 1-cm-long specimens were obtained from these 4 graft types and subjected to PGI2 assay or silver nitrate staining for measurement of endothelial cell coverage area. The remaining 6-cm portions of the 120-min grafts were autogenously implanted into the abdominal aorta, retrieved after 7 days and assayed and measured.Comparisons between groups suggested beneficial effects of preserving venous blood flow until implantation on endothelial coverage and PGI2 production (p0.05).Venous blood flow through dissected vein grafts effectively helps preserve PGI2 production.

We have experienced a case of acute pulmonary embolism after lung cancer operation. The case was a 74-year-old male. He underwent left upper lobectomy due to squamous cell carcinoma. He fell into shock state suddenly on the 6th day postoperatively. We diagnosted acute pulmonary embolism, performed urgent embolectomy under percutaneous cardiopulmonary support (PCPS). Postoperative course was smooth, and he has returned to normal daily life. Urgent diagnosis and management are indispensable for acute pulmonary embolism after lung cancer operation from the aspect of residual among of pulmonary vascular bed.

The modification of JT-60 is planned as a fully superconducting tokamak (JT-60SC). The mission of JT-60SC program is to establish scientific and technological bases for an advanced operation in an economically and environmentally attractive DEMO reactor and ITER. The research objectives are to accomplish high performance steady state operation with high beta and non-inductive full current drive, with high bootstrap current fraction, and demonstrate the plasma applicability of reduced-activation material for a plasma of break-even class relevant to the reactor plasma. Basic design of JT-60SC has been completed and the detailed design is under way. The engineering design for main components of JT-60SC is described.

In JT-60U, an outer divertor pumping slot was added to the W-shaped divertor with an inner pumping slot during the maintenance period, November to December 1998, in order to improve plasma performance especially in a detached state with no or inverse in-out particle flux asymmetry. This modification was already planned at the beginning of W-shaped divertor design activity. Hence, the previous W-shaped divertor had adaptable structure to the in-out pumping slots. The modified components, especially armor tiles, may be exposed to high heat load and high electromagnetic load in an extreme plasma configuration. Thermal analyses showed that peak surface temperatures exceeded 2000/spl deg/C. The maximum induced thermal stress, however, was below an acceptable level. Furthermore, each armor tile size and position of the tile attachment were optimized to avoid fracture due to halo current. Therefore, high power operations are possible without tile fracture in an extreme condition. With the modified W-shaped divertor, it was observed that the efficiency of He pumping was improved, and that the L-H transition threshold power was reduced. The integrated plasma performance has also been improved. These results indicate efficient divertor pumping of the modified W-shaped divertor.

Wall damages of the JT-60U plasma facing components in the recent operation are more serious than in the previous one. Erosion of carbon fiber composite (CFC) divertor tiles due to field ripple of the toroidal coil is observed. Several bolt-loosening divertor tiles are eroded or disconnected. Mechanical fracture of CFC first wall tiles is found. The first application of B/sub 4/C-converted CFC tiles (surface-boronized ones using conversion method) is also shown. The B/sub 4/C-converted tiles have been installed to the outboard striking zone of the divertor plate and in use satisfactorily in the high power heating divertor operation.

Enhancement of re-endothelialization inhibits the progression of intimal hyperplasia. We investigated uptake of Lipoprostaglandin E(1) (LPGE(1)) by endothelial cells (ECs) and vascular smooth muscle cells (VSMCs), and effects of the LPGE(1) on re-endothelialization of vein grafts.Primary cultured ECs and VSMCs were obtained from mongrel dogs, and incubated in mediums containing 0.5, 5, 50, and 250 ng/ml of DiI-LPGE(1) (DLPGE(1)); its uptake was visualized by the standard rhodamine excitation, and assessed by flow cytometry. In an implantation study, the bilateral femoral veins of 18 animals were implanted into the femoral artery, and the animals were given 0.2 microg/kg LPGE(1) for 2 weeks. Percentages of EC coverage area of the grafts (%EC) were measured by silver nitrate staining at intervals of 3, 7, and 21 days after implantation.VSMCs showed significant uptake in all of the mediums containing DLPGE(1), whereas the ECs revealed no fluorescence. In flow cytometry, histograms of VSMCs showed a specific notch of DLPGE(1), which increased the height according to the grade of the concentrations. The notch did not appear in the histograms of the ECs incubated with any concentration nor in the VSMCs incubated in control medium. These results suggested that LPGE(1) is predominantly absorbed by the VSMCs and exuded PGE(1) then acts on the VSMCs itself and on ECs alike. The %EC at 7 days was 58.4+/-1.9% in the DLPGE(1) group and 31.6+/-6.8% in controls (p0.05) showing a significant enhancing effect of DLPGE(1) on re-endothelialization of the vein grafts.In an animal model, daily administration of LPGE(1) resulted in significant enhancement of vein graft re-endothelialization. LPGE(1) was absorbed by the VSMCs, whereas the ECs showed no uptake, therefore the enhancement is probably due to a paracrine effect of VSMCs.

In JT-60U, the modification from the open divertor to the W-shaped divertor with pumps was conducted from February to May in 1997. To install a new divertor in the vessel, pre-inspection of the vacuum vessel, test of installation procedure with mock-ups of the divertor components being designed were carried out, and information obtained from these procedures was taken into the installation procedure as well as the design. The actual installation works such as determination of datum lines, adjustment of new divertor components and the preparations concerning with working environment are described. The status of initial operations is also shown.

We report herein the case of a 66-year-old man with basaloid squamous cell carcinoma (BSCC) of the esophagus. There are only 60 cases of BSCC of the esophagus previously reported in Japan. In our patient, endoscopic findings revealed a type 2 in the lower intrathoracic esophagus (Lt), and the tumor was intact with the aorta (T2). A biopsy suggested that it was adenosquamous cell carcinoma. An operation was done on June 11, 1996. With open thoracotomy, esophagectomy was performed with mediastinal lymphnode dissection by posterior mediastinal esophagogastrostomy. Histologically, the lesion of the tumor with ulceration was composed of BSCC, and other lesion was composed of typical squamous cell carcinoma (SCC). The immunohistochemical findings of the respected specimens led us to suspect that the basal-layer-type SCC had transformed into BSCC by undergoing differentiation and expansive proliferation. According to the prognosis, eventually the patient died of pneumonia due to methicillin resistant Staphylococcus aureus (MRSA) and candida 4 years and 9 months after the surgery.

A patient with Moyamoya-like vessels after radiation therapy for treatment of a tumor in the basal ganglia is reported. He was diagnosed as Down syndrome at birth. He had a tumor in the left basal ganglionic region at 12 years of the age. The tumor increased in size at age 14. He underwent cerebral angiography, which did not show a stenosis nor occlusion of the internal carotid artery, anterior cerebral artery, nor the middle cerebral artery. He received radiation therapy with a total dose of 56 Gy. He presented a dressing apraxia at age 19. MRI showed cerebral infarction in the left temporo-occipital region. Right internal carotid angiography revealed a severe stenosis of the internal carotid artery and anterior cerebral artery as well as a severe stenosis of the middle cerebral artery on the right side. Moyamoya-like vessels were seen in the basal ganglionic region. Left internal carotid angiography also showed a stenosis of the internal carotid artery and anterior cerebral artery as well as a severe stenosis of the middle cerebral artery on the left side. Moyamoya-like vessels were seen in the basal ganglionic region. Leptomeningeal anastomose and transdural anastomose were bilaterally seen. These arterial occlusion and stenotic phenomenon corresponded to a previous radiation field. These Moyamoya-like vessels with arterial stenosis and occlusion were thought to be due to radiation-induced vasculopathy, because a previous cerebral angiography showed a normal caliber of cerebral arteries. This patient showed that patients with radiation therapy in their early childhood should be carefully observed considering the possibility of this phenomenon.

We report a case involving leakage of cyanoacrylate (CA) to the inferior vena cava (IVC) through a gastrorenal shunt and left renal vein. A 72-year-old man with liver cirrhosis was admitted to our hospital to undergo emergency treatment for massive hemorrhage of gastric varices. Endoscopic injection sclerotherapy (EIS) using CA was performed on the varices. Radiographic fluoroscopy revealed that most of the injected CA had adhered firmly to the gastric varices, but a certain portion of the CA had flowed to the IVC through the gastrorenal shunt and left renal vein. At that point, the patient did not complain of any symptoms. However, 6 months later, he died of hepatic failure and an autopsy was performed. Histopathologic examination of the wall of the IVC and renal vein, to which CA had adhered, revealed that the CA was covered with endothelial cells of the vessel and no nearby thrombus was present. Long-term anticoagulant therapy may not be indicated in cases of leakage of CA from the gastric varices to other veins, since the leaked CA may be readily covered with endothelium without thrombus formation as in our patient. It is possible for CA to flow to the IVC and have a fatal impact. Our patient was fortunate, and for safe EIS it is important that these complications are prevented.

Mitral aneurysm is commonly associated with infectious endocarditis of the aortic valve. In rare instances, it is associated with other underlying inflammatory or metabolic disorders. A 62-year-old man with mitral valve insufficiency with moderate aortic valve insufficiency underwent operation. Operative findings were the ruptured aneurysm of the mitral valve in association with the calcified quadricuspid aortic valve. There was no evidence of infection in the mitral valve and the aortic valve. The mitral valve was repaired, the aortic valve replaced, and Cox Maze procedure added. A rare combination of mitral and aortic valve lesions without endocarditis suggested that mechanical stress alone may induce mitral valve aneurysm.

To investigate the therapeutic efficacy as well as the immunological effects of inoculation of an expression vector encoding interleukin 10 (IL-10) in murine type II collagen induced arthritis (CIA).CIA was induced in DBA/1 Lac/J mice by immunization with bovine type II collagen (CII) in Freund's complete adjuvant (FCA), followed by immunization of CII in Freund's incomplete adjuvant (FIA) 3 weeks later (CIA mice). The plasmid cytomegalovirus (pCMV) vector encoding IL-10 (pCMV-IL-10) was inoculated intradermally into DBA/1 Lac/J mice (pCMV-IL-10 CIA mice) one week prior to first immunization with CII. CIA mice inoculated with the backbone pCMV vector instead of pCMV-IL-10(pCMV CIA mice), mice inoculated with the pCMV vector alone, without subsequent immunization with CII (pCMV-C mice), and mice not subjected to any treatment (C mice) were examined as controls. At the 3rd and 5th week after 2nd immunization with CII, booster injections of CII in FIA were administered. Foot pad thicknesses were measured weekly and the histopathological changes in the ankle joints and the titers of IgG1 (Th2 type) and IgG2a (Th1 type) isotype antibodies to CII were examined at the 10th week.pCMV-IL-10 CIA mice showed lesser foot pad thicknesses (p0.01 except at Weeks 1-3), less severe histopathological changes (p0.01 or 0.05) and lower IgG2a/IgG1 ratios of antibodies to CII (p0.01) than CIA mice.Inoculation of pCMV-IL-10 suppressed CIA through suppression of the Th 1 type immune response in CIA, and offers promise as a potential therapeutic strategy for rheumatoid arthritis.

Mitral valve aneurysm is a rare disease and in Japan, cases of perforation which is considered to be mainly caused by infectious endocarditis is usually only encountered through case reports. We experienced a case who received aortic valve replacement and mitral valve annuloplasty for combined valvular heart disease of aortic insufficiency and mitral insufficiency followed by mitral valve replacement for severe mitral valve regurgitation subsequent to perforation of the anterior mitral cusp, leading to recovery.

The possibility of safe implementation of neoadjuvant chemotherapy using nedaplatin (254-S) was investigated with the aim of improving the therapeutic results in advanced esophageal cancer patients. The subjects had usually undergone two courses of 254-S, 80 or 100 mg/m2, preoperatively, at intervals of 4 weeks. After chemotherapy, responses were evaluated, and resection was undertaken 4 weeks after the final administration. The subjects were 10 patients with untreated esophageal cancer. As a result of evaluation of responses of main lesions to chemotherapy, a partial response (PR) was observed in 3 patients, and a minor response 3, showing an efficacy rate of 30%. Pathological findings before treatment were determined by staining of a cell cycle marker (Ki-67). The 3 patients who were evaluated as PR (clinical efficacy) showed high rates of positivity for Ki-67 of 47.4%, 52.7%, and 86%, respectively. There were no serious complications and no death related to operation. The observations suggested that 254-S, which has little or no side effects including nephrotoxicity, can become the standard remedy for esophageal cancer instead of CDDP in future.

We have experienced a case of mediastinal abscess and tracheal fistula after operation for esophageal cancer and successfully closed by using intercostal muscle pedicle flap. A 61-year-old male underwent esophagectomy for advanced esophageal cancer. On the 12th postoperative day, mediastinal abscess caused by leakage was detected, and drainage of the mediastinal and thoracic cavity was performed. On the 29th postoperative day, tracheal fistula was detected, and operation was performed in order to close the fistula by using of intercostal muscle pedicle flap. His postoperative course was fair and general condition was improvement, esophageal reconstruction using of free jejunal graft was performed and oral ingestion was started.

Twenty-four patients with chest wall tumors underwent resection during the past twenty years. There were 12 female and 12 male patients with ages ranging from 7 months to 78 years (mean 44 years). Five patients had primary malignant neoplasms, 7 had metastases, and 12 had benign tumors. The tumor was located in the soft tissue in 14 patients and in the ribs and the sternum in 10. Ninety-two percent of tumors were diagnosed correctly if they were benign or malignant before resection, however the final diagnosis was made in only 25% of benign tumors and 54% of malignant tumors before surgery. Thirty-one operations were performed in 24 patients and 10 reconstruction with prosthetic materials were done. Concerning malignant neoplasms patients with primary tumors had better prognosis than those with metastases and patients underwent reconstruction had better prognosis than those underwent resection only. We conclude that wide resection with reconstruction is potentially curative treatment.

We report a series of studies that assess the feasibility and sensitivity of imaging of herpes virus type one thymidine kinase (HSV1-tk) gene transfer and expression with [124I]-5-iodo-2'-fluoro-1-beta-D-arabinofuranosyluracil ([124I]-FIAU) and positron emission tomography (PET) and the ability of [124I]-FIAU-PET imaging to discriminate different levels of HSV1-tk gene expression. Studies were performed in rats bearing multiple s.c. tumors derived from W256 rat carcinoma and RG2 rat glioma cells. In the first set, we tested the sensitivity of [124I]-FIAU-PET imaging to detect low levels of HSV1-tk gene expression after retroviral-mediated gene transfer. HSV1-tk gene transduction of one of preestablished wild-type W256 tumor in each animal was accomplished by direct intratumoral injection of retroviral vector-producer cells (W256--W256TK* tumors). Tumors produced from W256 and W256TK+ cells served as the negative and positive control in each animal. Highly specific images of [124I]-FIAU-derived radioactivity were obtained in W256TK* tumors (that were transduced in vivo) and in W256TK+ tumors but not in nontransduced wild-type W256 tumors. The level of "specific" incorporated radioactivity in transduced portions of both W256TK* and W256TK+ tumors was relatively constant between 4 and 50 h. In the second set, we tested whether [124I]-FIAU and PET imaging can measure and discriminate between different levels of HSV1-tk gene expression. Multiple s.c. tumors were produced from wild-type RG2 cells and stably transduced RG2TK cell lines that express different levels of HSV1-tk. A highly significant relationship between the level of [124I]-FIAU accumulation [% injected dose/g and incorporation constant (Ki)] and an independent measure of HSV1-tk expression (sensitivity of the transduced tumor cells to ganciclovir, IC50) was demonstrated, and the slope of this relationship was defined as a sensitivity index. We have demonstrated for the first time that highly specific noninvasive images of HSV1-tk expression in experimental animal tumors can be obtained using radiolabeled 2'-fluoro-nucleoside [124I]-FIAU and a clinical PET system. The ability to image the location (distribution) of gene expression and the level of expression over time provides new and useful information for monitoring clinical gene therapy protocols in the future.

Vascular endothelial growth factor (VEGF), also known as vascular permeability factor, has been investigated as a potent mediator of brain tumor angiogenesis and tumor growth. We evaluated the effect of VEGF expression on the pathophysiology of tumor growth in the brain. Human SK-MEL-2 melanoma cells, with minimal VEGF expression, were stably transfected with either sense or antisense mouse VEGF cDNA and used to produce intracerebral xenografts. Vascular permeability, blood volume, blood flow, and tumor fluorodeoxyglucose metabolism were assessed using tissue sampling and quantitative autoradiography. Tumor proliferation was assessed by measuring bromodeoxyuridine labeling indices. Tumor vascular density and morphological status of the blood-brain barrier were evaluated by immunohistochemistry. SK-MEL-2 cells transfected with sense VEGF (V+) expressed large amounts of mouse and human VEGF protein; V+ cells formed well-vascularized, rapidly growing tumors with minimal tumor necrosis. V+ tumors had substantial and significant increases in blood volume, blood flow, vascular permeability, and fluorodeoxyglucose metabolism compared to wild-type and/or V- (antisense VEGF) tumors. VEGF antisense transfected V- expressed no detectable VEGF protein and formed minimally vascularized tumors. V- tumors had a very low initial growth rate with central necrosis; blood volume, blood flow, vascular permeability, and glucose metabolism levels were low compared to wild-type and V+ tumors. A substantial inhibition of intracerebral tumor growth, as well as a decrease in tumor vascularity, blood flow, and vascular permeability may be achieved by down-regulation of endogenous VEGF expression in tumor tissue. VEGF-targeted antiangiogenic gene therapy could be an effective component of a combined strategy to treat VEGF-producing brain tumors.

A 53-year-old man with left lung cancer underwent left upper lobectomy and extended mediastinal lymphadenectomy. Shortly before the end of the operation, electrocardiogram showed elevation of ST wave and multiple ventricular premature contractures first, then ventricular fibrillations, and finally cardiac arrest. Coronary artery spasm was strongly suspected. The patient was resuscitated by cardiac massage and countershock immediately, however, such attacks repeated several times. As medication and cardiac pacing were not effective, percutaneous cardiopulmonary support (PCPS) was established. The hemodynamics was stabilized with PCPS. He was weaned off PCPS the next day. He was discharged and has had no attack so far. PCPS is an excellent modality for intraoperative coronary spasm which is uncontrollable by medicines and other methods.

Twelve patients who suffered from low grade malignant tumors arisen in the trachea and the bronchus (6 of carcinoid, 4 of mucoepidermoid carcinoma, and 2 of adenoid cystic carcinoma) underwent surgical treatment from 1977 to 1996 in our department. Operations included 1 sleeve resection of the trachea, 1 patch plasty of the trachea, 3 sleeve lobectomies, and 7 lobectomies. Lymph node dissection was performed in 9 of 12 cases. Metastases in lymph nodes were not found in all 12 cases. Five year survival rate of low grade malignant tumors arisen in the trachea and the bronchus was 78.8% and better than that of stage I lung cancers.