Background-Endothelium-derived nitric oxide (EDNO) plays an important role in the regulation of angiogenesis, whereas hypercholesterolemia (HC) impairs EDNO release. We examined the hypothesis that HC may inhibit ischemia-induced angiogenesis by inhibition of EDNO in a rat model of unilateral hindlimb ischemia and that oral L-arginine supplementation, a substrate for NO synthase, may prevent HC-related impairment of angiogenesis. Methods and Results-Male Sprague-Dawley rats were fed (A) standard diet (control), (B) 2% high-cholesterol diet (HC group), or (C) high-cholesterol diet with oral L-arginine (2.25% in drinking water) (HCϩL-arg group). At 2 weeks of the dietary intervention, unilateral limb ischemia was surgically induced in all animals. Dietary HC groups (B and C) revealed elevated total and LDL cholesterol levels compared with control animals. Laser Doppler blood flow analyses showed significant decreases in the ischemic/normal limb blood flow ratio in the HC group compared with controls (PϽ0.05) when followed up until 4 weeks after surgery. Selective angiography and immunohistochemical analyses in the ischemic limb at postoperative day 14 revealed significantly lower angiographic scores (PϽ0.01) and capillary densities (PϽ0.01) in the HC group than controls, which were associated with decreased tissue contents of NO x and cGMP. Oral L-arginine supplementation (HCϩL-arg) significantly improved all parameters of the laser Doppler blood perfusion ratio, angiographic scores, and capillary densities (PϽ0.01 versus HC group), which were accompanied by significant elevations in serum L-arginine levels and tissue NO x and cGMP contents. Conclusions-Collateral vessel formation and angiogenesis in response to hindlimb ischemia were significantly attenuated in rats with dietary HC. The mechanism may be related to the reduced NO bioactivity in the ischemic tissues. Augmentation of the tissue NO activity by oral L-arginine supplementation restored the impaired angiogenesis in HC. (Circulation. 2000;102[suppl III]:III-370-III-376.)

Colorectal adenoma is linked to metabolic dysfunction. Metabolic dysfunction-associated fatty liver disease (MAFLD) has a precise definition and three subtypes, including non-obese MAFLD. We aimed to investigate the impact of MAFLD on the prevalence of colorectal adenoma by comparing it to non-alcoholic fatty liver disease (NAFLD) in health check-up examinees. This is a multicenter retrospective study. We enrolled 124 consecutive health check-up examinees who underwent colonoscopy. NAFLD and MAFLD were present in 58 and 63 examinees, respectively. Colorectal adenoma was diagnosed by biopsy. The impact of the MAFLD definition on the prevalence of colorectal adenoma was investigated by logistic regression, decision-tree, and random forest analyses. In logistic regression analysis, MAFLD was identified as the only independent factor associated with the presence of colorectal adenoma (OR 3.191; 95% CI 1.494–7.070; p = 0.003). MAFLD was also identified as the most important classifier for the presence of colorectal adenoma in decision-tree and random forest analyses (29 variable importance value). Among the three subtypes of MAFLD, non-obese MAFLD was the sole independent factor associated with the presence of colorectal adenoma (OR 3.351; 95% CI 1.589–7.262; p ≤ 0.001). Non-obese MAFLD was also the most important classifier for the presence of colorectal adenoma in decision-tree and random forest analyses (31 variable importance value). MAFLD, particularly non-obese MAFLD, is the most important factor associated with the presence of colorectal adenoma rather than NAFLD. Colonoscopy examination should be considered in patients with MAFLD, especially those who are non-obese.

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We evaluated an appropriate region of interest (ROI) size for the measurement of full width at half maximum (FWHM) in the bead method (0.1 mm and 0.5 mm diameter; lead) and the microdisk method (0.05 mm thickness and 1.0 mm diameter; tungsten) using multislice computed tomography (CT). The FWHM of preset slice thicknesses 0.625 mm, 1.25 mm, 5.0 mm and 7.5 mm were measured by varying helical pitch, location of measurement [center and off-center of scan field of view (SFOV)] and ROI size, and they were compared with the tolerance stated in the Japanese Industrial Standards (JIS). It was conlcuded that the appropriate ROI size was influenced by preset slice thickness in this study. At the center of SFOV, measurements of FWHM were enabled within the tolerance of the JIS with small variations in all preset slice thicknesses if the ROI sizes were set between 0.4 times and equal to the size of the bead or microdisk indicating the maximum CT value in the series of CT images. At the off-center of SFOV, the tendency of increasing FWHM was confirmed, but it was shown that variations of the off-center in thicker slice thickness were larger regardless of helical pitch when the orbital synchronized helical scan technique was not used.

Stereotactic radiosurgery (SRS) and radiotherapy (SRT) are intricate techniques that deliver a highly precise radiation dose to a localized target, usually a tumor. At our hospital, we perform SRS and SRT on brain tumors using a linear accelerator (linac) mounted with an external micro multi-leaf system. The Task Group TG-142 Report by the American Association of Physicists in Medicine recommends the coincidence of the radiation and mechanical isocenter to be within ±1 mm. The Winston-Lutz test is commonly used to verify the linac isocenter position: it has the advantages of being a simple method that uses a film or electronic portal imaging device (EPID). However, the film method requires a higher radiation dose, which makes it more time-consuming than the EPID method, and the results are highly dependent on the skills of the observer. The EPID method has certain advantages over the film method, but it has low resolution and can only be used for a few combinations of gantry and couch angles. This prompted us to develop an in-house-designed radiation receptor system based on digital radiography, using a photostimulable storage phosphor and automated analysis algorithm for Winston-Lutz test images using a template-matching technique based on cross-correlation coefficients. Our proposed method shows a maximum average absolute error of 0.222 mm (less than 2 pixels) for 0.5 mm and 1.0 mm displacement from the isocenter toward the inline and crossline directions. Our proposed method is thus potentially useful for verifying the Linac isocenter position with a small error and good reproducibility, as demonstrated by improved accuracy of evaluation.