C hronic thromboembolic pulmonary hypertension (CTEPH) is defined as a progressive disease of increasing pulmonary vascular resistance because of chronic thromboembolism in the pulmonary arteries that leads to pulmonary hypertension (PH), right-sided heart failure, and a grave prognosis. [1][2][3][4][5][6][7][8][9] Several studies have demonstrated the efficacy of medical therapies using anticoagulation and pulmonary vasodilators, including several newly developed agents. 1,10,11 The most powerful conventional therapeutic strategy for CTEPH is invasive surgical pulmonary endarterectomy (PEA).12-16 Surgical therapy is indicated when the thromboembolic lesions are located in the proximal pulmonary arteries or lobar branches.9 Thus, there are some patients in whom PEA is not indicated; furthermore, some patients continue to suffer from severe PH despite treatment with PEA. Editorial see p 744A few reports have demonstrated the efficacy of balloon pulmonary angioplasty. In 1988, 1 case report demonstrated the efficacy of pulmonary angioplasty after acute pulmonary embolism.17 In 2001, Feinstein et al 18 showed that pulmonary hemodynamics were markedly improved by pulmonary angioplasty in 18 patients with CTEPH, and that 11 of 18 patients developed reperfusion pulmonary edema. However, this therapy has not been developed further since then, and is rarely performed now. Thus, it is important to take into account the experiences of this therapy and the data regarding its complications, to consider the possibility of pulmonary angioplasty as an alternative therapy for selected patients with CTEPH.Therefore, the objectives of this study were (1) to investigate the clinical efficacy of percutaneous transluminal pulmonary Background-Chronic thromboembolic pulmonary hypertension leads to pulmonary hypertension and right-sided heart failure. The purpose of this study was to investigate the efficacy of percutaneous transluminal pulmonary angioplasty (PTPA) for the treatment of chronic thromboembolic pulmonary hypertension. Methods and Results-Twenty-nine patients with chronic thromboembolic pulmonary hypertension underwent PTPA. One patient had a wiring perforation as a complication of PTPA and died 2 days after the procedure. In the remaining 28 patients, PTPA did not produce immediate hemodynamic improvement at the time of the procedure. However, after follow-up (6.0 ± 6.9 months), New York Heart Association functional classifications and levels of plasma B-type natriuretic peptide significantly improved (both P<0.01). Hemodynamic parameters also significantly improved (mean pulmonary arterial pressure, 45.3 ± 9.8 versus 31.8 ± 10.0 mm Hg; cardiac output, 3.6 ± 1.2 versus 4.6 ± 1.7 L/min, baseline versus followup, respectively; both P<0.01). Twenty-seven of 51 procedures in total (53%), and 19 of 28 first procedures (68%), had reperfusion pulmonary edema as the chief complication. Patients with severe clinical signs and/or severe hemodynamics at baseline had a high risk of reperfusion pulmonary edema. Conclusions-PTPA imp...

Highly dispersed Ru nanoparticles loaded on a TiO 2 support (Ru/TiO 2 (B)), which affects the hydrogenation of CO 2 to CH 4 (methanation), were prepared by employing a ''dry'' modification method using a barrel-sputtering instrument. The loaded Ru nanoparticles exhibited a narrow particlesize distribution with a mean diameter of ca. 2.5 nm. Methanation of CO 2 on the Ru/TiO 2 (B) catalyst produced a 100% yield at ca. 160 C, which is more than 200 C below that required for Ru/TiO 2 prepared by a conventional ''wet'' impregnation method. In addition, the methanation reaction over Ru/TiO 2 (B) proceeded at temperatures as low as room temperature with a reaction rate of 0.04 mmol min À1 g À1 .

In a randomized, placebo-controlled trial, we found 8 weeks of IN (0.5-2.0 g per day) to be effective in inducing a clinical response in patients with UC. However, IN should not yet be used because of the potential for adverse effects, including pulmonary arterial hypertension. Clinical Trials Registry no: UMIN000021439 (http://www.umin.ac.jp/ctr/).

The results of this study showed that warfarin therapy and lower serum albumin levels are significant and strong risk factors for the development of calciphylaxis in chronic hemodialysis patients in Japan.

BackgroundAn anti-programmed cell death protein 1 monoclonal antibody, nivolumab, is one of the most effective drugs for advanced melanoma. Tumor cell-derived or immune cell-derived markers and clinical predictors such as serum lactate dehydrogenase (LDH) and cutaneous adverse events, have already been described as prognostic factors for advanced melanoma treated with nivolumab. We sought to identify further clinical predictors that can be determined in routine clinical practice.MethodsWe retrospectively analyzed clinical findings of 98 consecutive patients with unresectable stage III or IV melanoma treated with nivolumab, at the National Cancer Center Hospital or at Keio University Hospital, in Tokyo, Japan, between July 2014 and July 2016. These patients had been administered nivolumab at a dose of 2mg/kg every 3 weeks.ResultsAs for pretreatment prognostic factors, ECOG performance status (PS) ≥1, maximum tumor diameters of ≥30mm, elevated LDH and elevated C-reactive protein were significantly associated with poor overall survival (OS) (hazard ratio [HR] 0.29 [P<0.001], HR 0.40 [p=0.003], HR 0.29 [P<0.001], HR 0.42 [P=0.004], respectively) on univariate analysis. Among these factors, PS and LDH were identified as independent variables by multivariate analysis. As for early markers examined during therapy, patients with absolute lymphocyte count (ALC) ≥ 1000/μl (Week3: HR 0.40 [P=0.004], Week6: HR 0.33 [P=0.001]) and absolute neutrophil count (ANC) <4000/μl (Week3: HR 0.46 [P=0.014], Week6: HR 0.51 [P=0.046]) had significantly better OS.ConclusionALC≥1000/μl and ANC<4000/μl during treatment appear to be early markers associated with OS. Nivolumab might have minimal efficacy in patients with a massive tumor burden.