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We report two patients for whom the proximal balloon protection (PBP) method was used during transradial carotid artery stenting (TR-CAS). Case Presentations: Case 1 was a 79-year-old male. TR-CAS for acute occlusion of the internal carotid artery was performed. A 6 Fr balloon guiding catheter was introduced into a 6 Fr guiding sheath, and CAS was conducted by passing through the lesion under PBP. Case 2 was an 83-year-old male. TR-CAS was performed to treat marked stenosis of the internal carotid artery. It was difficult to pass the catheter through the lesion, but PBP with a balloon guiding catheter enhanced the supporting power, facilitating lesion passage, and CAS was successful. Conclusion: No study has reported PBP during TR-CAS, but we were able to perform PBP during TR-CAS by adopting this method, and the support for lesion passage may be enhanced. This method may be useful for patients at risk of distal embolism or for those in whom lesion passage is difficult. Keywords▶ carotid artery stenting, transradial approach, lesion cross, proximal balloon protection, flow reversal method

This paper studies the structural design of the wireless-electrodeless quartz crystal microbalance (QCM) sensor, which has a rectangular AT-cut quartz oscillator installed in the microchannel fabricated by nanoimprint lithography. The quartz oscillator was supported by the micropillars in the microchannel, and by optimizing the micropillar arrangement, it was found that the structural damping could be significantly reduced by performing the finite elemental piezoelectric analysis. This behavior was then confirmed by the experiments using the evaluation chips. By supporting the four corners of the quartz oscillator with the micropillars, the structural damping could be reduced, achieving a high-quality factor (Q-factor) of about 24700. This high Q-factor was also realized in the experiments, and we investigated its application to a hydrogen-gas sensor. We succeeded in detecting hydrogen gas with an extremely low concentration of 10 ppm.

Background: Although glioblastoma has been shown to be able to disseminate widely in the intracranially after treatment with bevacizumab without any significant radiological findings, reports on such cases with subsequent autopsy findings are lacking. Case Description: A 36-year-old man presented with a general seizure and a mass of the right frontal lobe, which was diagnosed as diffuse astrocytoma (WHO Grade II). The patient underwent a total of four surgeries from 2005 to 2017. He showed tumor recurrence, progression, and malignant transformation to glioblastoma (GBM) (WHO Grade IV) despite repeated tumor resections, radiotherapy, and chemotherapies with temozolomide and carmustine wafers. Bevacizumab (10 mg/kg body weight) was started following the fourth surgery. After bevacizumab administration, the patient’s clinical condition improved to a Karnofsky performance status (KPS) score of 50–60, and he was stable for several months before finally deteriorating and passing away. Although sequential magnetic resonance imaging (MRI) showed shrinkage of the lesion and a reduction of edema, an autopsy showed widespread tumor invasion that was not revealed on MRI. Neoplastic foci were identified extensively in the cerebral cortex, basal ganglia, pituitary gland, cerebellum, and brainstem, imposing as gliomatosis cerebri. Conclusion: Imaging follow-up of malignant gliomas needs to be interpreted with caution as marked improvement in radiological response after bevacizumab treatment may not be indicating tumor regression. Despite the notable lack of evidence to increase overall survival in GBM patients with bevacizumab, the increase in progression-free survival and the observed relief of symptoms due to a decrease in edema should be considered relevant for patient management.