RESUMO
The abundance of chlorine in the Earth's atmosphere increased considerably during the 1970s to 1990s, following large emissions of anthropogenic long-lived chlorine-containing source gases, notably the chlorofluorocarbons. The chemical inertness of chlorofluorocarbons allows their transport and mixing throughout the troposphere on a global scale, before they reach the stratosphere where they release chlorine atoms that cause ozone depletion. The large ozone loss over Antarctica was the key observation that stimulated the definition and signing in 1987 of the Montreal Protocol, an international treaty establishing a schedule to reduce the production of the major chlorine- and bromine-containing halocarbons. Owing to its implementation, the near-surface total chlorine concentration showed a maximum in 1993, followed by a decrease of half a per cent to one per cent per year, in line with expectations. Remote-sensing data have revealed a peak in stratospheric chlorine after 1996, then a decrease of close to one per cent per year, in agreement with the surface observations of the chlorine source gases and model calculations. Here we present ground-based and satellite data that show a recent and significant increase, at the 2σ level, in hydrogen chloride (HCl), the main stratospheric chlorine reservoir, starting around 2007 in the lower stratosphere of the Northern Hemisphere, in contrast with the ongoing monotonic decrease of near-surface source gases. Using model simulations, we attribute this trend anomaly to a slowdown in the Northern Hemisphere atmospheric circulation, occurring over several consecutive years, transporting more aged air to the lower stratosphere, and characterized by a larger relative conversion of source gases to HCl. This short-term dynamical variability will also affect other stratospheric tracers and needs to be accounted for when studying the evolution of the stratospheric ozone layer.
Assuntos
Dapsona/uso terapêutico , Subunidade p52 de NF-kappa B/genética , Síndrome de Sweet/genética , Síndrome de Sweet/patologia , Povo Asiático/etnologia , Povo Asiático/genética , Encefalopatias/complicações , Quimiocinas/metabolismo , Criança , Dapsona/administração & dosagem , Evolução Fatal , Glucocorticoides/uso terapêutico , Humanos , Hansenostáticos/uso terapêutico , Masculino , Insuficiência de Múltiplos Órgãos/complicações , Mutação , Prednisolona/administração & dosagem , Prednisolona/uso terapêutico , Síndrome de Sweet/complicações , Síndrome de Sweet/tratamento farmacológico , Sequenciamento do Exoma/métodosRESUMO
For developing and characterizing a novel compact D-T neutron spectrometer based on a single-crystal chemical vapor deposition diamond stack for plasma diagnostics toward future D-T fusion reactors, the initial measurement was performed using the accelerator-based D-T neutron sources OKTAVIAN at Osaka University. This neutron spectrometer was designed for the detection of 3-17 MeV neutrons and operated in the proton recoil telescope configuration by installing a polyethylene converter in front of the diamond stack. The measured neutron energy spectra were obtained by summing the energy of the recoil protons deposited in the diamond stack after the coincidence of the recoil protons identified by the time coincidence analysis. The neutron energy peaks measured by the compact D-T neutron spectrometer were almost in agreement with those obtained by the Monte Carlo N-Particle transport (MCNP) simulation. The energy resolution of the compact D-T neutron spectrometer was emulated to be about 4%-5% in D-T neutron measurement. In future work, the design of the compact D-T neutron spectrometer would be optimized to measure the fusion neutron for plasma diagnostics.
RESUMO
Glass dosimeters are very useful and convenient detection elements in radiation dosimetry. In this study, this glass dosimeter was applied to a BNCT treatment field. Boron Neutron Capture Therapy (BNCT) is a next-generation radiation therapy that can selectively kill only cancer cells. In the BNCT treatment field, both neutrons and secondary gamma-rays are generated. In other words, it is a mixed radiation field of neutrons and gamma-rays. We thus proposed a novel method to measure only gamma-ray dose in the mixed field using two RPLGD (Radiophoto-luminescence Glass Dosimeter) and two sensitivity control filters in order to control the dose response of the filtered RPLGD to be proportional to the air kerma coefficients, even if the gamma-ray energy spectrum is unknown. As the filter material iron was selected, and it was finally confirmed that reproduction of the air kerma coefficients was excellent within an error of 5.3% in the entire energy range up to 10 MeV. In order to validate this method, irradiation experiments were carried out using standard gamma-ray sources. As the result, the measured doses were in acceptably good agreement with the theoretical calculation results by PHITS. In the irradiation experiment with a volume source in a nuclear fuel storage room, the measured dose rates showed larger compared with survey meter values. In conclusion, the results of the standard sources showed the feasibility of this method, however for the volume source the dependence of the gamma-ray incident angle on the dosimeter was found to be not neglected. In the next step, it will be necessary to design a thinner filter in order to suppress the effect of the incident angle.
RESUMO
Boron neutron capture therapy (BNCT) is a high-dose-intensive radiation therapy that has gained popularity due to advancements in accelerator neutron sources. To determine the dose for BNCT, it is necessary to know the difficult-to-determine boron concentration and neutron fluence. To estimate this dose, we propose a method of measuring the prompt γ-rays (PGs) from the boron neutron capture reaction (BNCR) using a Compton camera. We performed a fundamental experiment to verify basic imaging performance and the ability to discern the PGs from 511 keV annihilation γ-rays. A Si/CdTe Compton camera was used to image the BNCR and showed an energy peak of 478 keV PGs, separate from the annihilation γ-ray peak. The Compton camera could visualize the boron target with low neutron intensity and high boron concentration. This study experimentally confirms the ability of Si/CdTe Compton cameras to image BNCRs.
Assuntos
Terapia por Captura de Nêutron de Boro , Compostos de Cádmio , Pontos Quânticos , Terapia por Captura de Nêutron de Boro/métodos , Boro/uso terapêutico , Telúrio , NêutronsRESUMO
Boron Neutron Capture Therapy (BNCT) is a cell-selective radiotherapy using a neutron capture reaction of 10B. In recent years, Accelerator Based Neutron Sources (ABNS) are under development instead of nuclear reactors for the next-generation neutron irradiation system for BNCT. However, ABNS as well as nuclear reactor usually generates unavoidable secondary gamma-rays by neutron-nuclear reactions such as capture reaction. In this research, we aimed to develop a separate measurement method of only gamma-rays in a mixed field of neutrons and gamma-rays using a fluorescent glass dosimeter (RPLGD), because most dosimeters have sensitivity to both radiation types. For this purpose, we proposed a lead filter method using two RPLGDs and lead filters. However, this method has a problem that the sensitivity to low energy gamma-rays (â¼100 keV) is very small. In order to improve the sensitivity to low energy gamma-rays, we devised a method using a specially shaped lead filter. From theoretical calculations, we have shown that it was possible to estimate the air dose rate of the field where the gamma-ray energy spectrum shape was known for energies up to 10 MeV. In addition, we produced the specially shaped lead filter and experimentally confirmed the validity of the lead filter method using several gamma-ray standard sources and by measurements in a nuclear fuel storage room.
RESUMO
Time-resolved triton burnup studies have been carried out to estimate the behavior of alpha particles in DD fusion experimental devices. In those studies, 14 MeV neutrons emitted through DT reactions in DD plasmas should be measured selectively in the backgrounds of DD neutrons and gamma rays. For this purpose, a scintillating-fiber (Sci-Fi) based fast-neutron detector has been adapted because of its advantages such as fast response, design flexibility in detection efficiency by changing the number of Sci-Fi, and discrimination property against 2.4 MeV neutrons produced through DD reactions and gamma rays. However, its length had conventionally been set to around 10 cm without an optimization study of its design parameters to meet the requirements as 14 MeV neutron detector. In the present study, we tested three types of Sci-Fi detectors with three different lengths and compared with the simulated results of energy deposition, through which we tried to understand the phenomena in the detection process of fast neutrons. From the results, it has been shown that, due to the self-shielding of neutrons by Sci-Fi and the attenuation of scintillation photons during the transmission process to the photomultiplier tube, the optimal length of Sci-Fi is concluded to be about 6 cm.
RESUMO
In time-resolved measurement for triton burnup in Korea Superconducting Tokamak Advanced Research (KSTAR) deuterium plasmas, an NE213 liquid scintillation detector was installed and operated during the 2017 KSTAR campaign. The detector is composed of an NE213 scintillator (50 mm in diameter and 10 mm in thickness) and a photomultiplier tube (PMT). The PMT anode signal was processed under a data acquisition system which contains a field programmable gate array circuit and pulse processing software that is capable of discriminating gamma-ray and neutron pulse signals. In order to determine an appropriate threshold level for the 14 MeV neutron signal resulting from triton burnup, the NE213 scintillation detector was calibrated by using d-d and d-t neutron generators at the National Fusion Research Institute and Intense 14 MeV Neutron Source Facility, OKTAVIAN, Osaka University, Japan. The detector was installed on KSTAR with a 10 mm thick soft-iron stray magnetic field shield and a radiation shield which consists of 100 mm thick lead blocks and 200 mm thick borated polyethylene blocks. A discrimination range for d-t neutron was determined based on test results from neutron generators and KSTAR. Data points selected from the discrimination range were consistent with the classical triton confinement characteristics. In conclusion, under condition of an input counting rate of 1.9 × 105 counts per second (CPS), the detector is able to measure triton burnup signals up to 500 CPS for various plasma parameters.
RESUMO
Neutrons generated by accelerators have various energy spectra. However, only limited methods are available to measure the whole neutron energy spectrum, especially when including the epithermal region that is normally used in BNCT. In the present study, we carried out the design study on a new neutron spectrometer that can measure such a neutron spectrum more accurately, precisely and with higher energy resolution, using an unfolding technique and a liquid moderator.
Assuntos
Terapia por Captura de Nêutron de Boro , Estudos de ViabilidadeRESUMO
Liquid lithium (Li) is a candidate material for a target of intense neutron source, heat transfer medium in space engines and charges stripper. For a medical application of BNCT, epithermal neutrons with least energetic neutrons and γ-ray are required so as to avoid unnecessary doses to a patient. This is enabled by lithium target irradiated by protons at 2.5 MeV range, with utilizing the threshold reaction of (7)Li(p,n)(7)Be at 1.88 MeV. In the system, protons at 2.5 MeV penetrate into Li layer by 0.25 mm with dissipating heat load near the surface. To handle it, thin film flow of high velocity is important for stable operation. For the proton accelerator, electrostatic type of the Schnkel or the tandem is planned to be employed. Neutrons generated at 0.6 MeV are gently moderated to epithermal energy while suppressing accompanying γ-ray minimum by the dedicated moderator assembly.
Assuntos
Terapia por Captura de Nêutron de Boro , Lítio/química , NêutronsRESUMO
Mock-up experiment for development of accelerator based neutron source for Osaka University BNCT project was carried out at Birmingham University, UK. In this paper, spatial distribution of neutron flux intensity was evaluated by foil activation method. Validity of the design code system was confirmed by comparing measured gold foil activities with calculations. As a result, it was found that the epi-thermal neutron beam was well collimated by our neutron moderator assembly. Also, the design accuracy was evaluated to have less than 20% error.
Assuntos
Terapia por Captura de Nêutron de Boro , Ouro/química , NêutronsRESUMO
To clarify whether patients with schizophrenia still show EEG slowing in the absence of psychopharmacological treatment, EEG was analyzed in 20 acute never-treated schizophrenics and 20 age-matched healthy controls using the computerized wave-form recognition method. Compared to controls, schizophrenics had more fast theta (6-8 Hz) and slow alpha (8-9 Hz) activity, and less fast alpha activity (9-13 Hz). The average EEG frequency at O1 correlated negatively with total and positive symptom scores on the BPRS in the schizophrenic group. These findings confirm that the frequency of alpha rhythm is slowed in schizophrenia and that this slowing is possibly related to the expression of psychopathology in this disorder.
Assuntos
Nível de Alerta/fisiologia , Eletroencefalografia/instrumentação , Esquizofrenia/fisiopatologia , Psicologia do Esquizofrênico , Processamento de Sinais Assistido por Computador , Adulto , Ritmo alfa , Córtex Cerebral/fisiopatologia , Feminino , Análise de Fourier , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Valores de Referência , Esquizofrenia/diagnóstico , Ritmo TetaRESUMO
Proton magnetic resonance spectroscopy (1H-MRS) was performed in a group of 18 adult patients with Down's syndrome (DS) aged 20-46 years, and the peak area ratios (NAA/Cr, Cho/Cr, NAA/Cho) of N-acetylaspartate (NAA), total creatine (Cr), and choline-containing compounds (Cho) calculated separately in the patients in their 20's, 30's, and 40's. In age-matched healthy control groups, there were no significant age-related changes in any of the peak area ratios. In contrast, in the DS group, although the relative amount of NAA (NAA/Cr) showed no significant change with increasing age, the relative amount of Cho (Cho/Cr and NAA/Cho) was significantly increased in the 40's group. At least as judged by MRI, few age-related general morphological changes such as brain atrophy were apparent in the third, fourth, and fifth decade groups. However, the MRI findings considered together with the age-related changes in the peak area ratios suggest that in DS patients in the fifth decade metabolic abnormalities such as degradation and/or rapid synthesis of brain cell membrane may occur prior to neuronal loss and degeneration.
Assuntos
Doença de Alzheimer/fisiopatologia , Ácido Aspártico/análogos & derivados , Encéfalo/fisiopatologia , Senescência Celular/fisiologia , Colina/metabolismo , Creatinina/metabolismo , Síndrome de Down/fisiopatologia , Espectroscopia de Ressonância Magnética , Adulto , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/genética , Ácido Aspártico/metabolismo , Encéfalo/patologia , Senescência Celular/genética , Síndrome de Down/diagnóstico , Síndrome de Down/genética , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Membranas Sinápticas/fisiologiaRESUMO
BACKGROUND: Therapy for the relief of symptoms of functional dyspepsia is unpredictable. AIM: To identify which patients may benefit from antisecretory therapy. METHODS: Twenty-seven patients with functional dyspepsia were selected to receive H2-receptor antagonist (H2RA) treatment for 4 weeks. Serum pepsinogen A, pepsinogen C and gastrin were measured, and Helicobacter pylori status was determined. Symptoms were assessed at baseline and after H2RA treatment. RESULTS: Fourteen patients were identified as H2RA responders and the remaining patients were non-responders. No differences were found between responders and non-responders with regard to serum pepsinogen A, pepsinogen C, gastrin and H. pylori status. However, the pepsinogen A/C ratio was significantly higher in responders than in non-responders. Ten of the 13 functional dyspepsia patients (77%) with a high value of the pepsinogen A/C ratio (> or = 4.5) achieved symptom resolution by H2RA, compared with only one of the eight patients (13%) with a low value of the pepsinogen A/C ratio (< or = 3.0). CONCLUSIONS: The serum pepsinogen A/C ratio seems to identify those functional dyspepsia patients for whom acid control provides benefit. This ratio may be a practical tool for the management of functional dyspepsia patients.
Assuntos
Antiulcerosos/uso terapêutico , Dispepsia/tratamento farmacológico , Antagonistas dos Receptores H2 da Histamina/uso terapêutico , Pepsinogênio A/sangue , Piperidinas/uso terapêutico , Adulto , Idoso , Biomarcadores/sangue , Dispepsia/sangue , Dispepsia/microbiologia , Feminino , Gastrinas/sangue , Helicobacter pylori/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , Seleção de Pacientes , Pepsinogênio C/sangue , Resultado do TratamentoRESUMO
AIM: To determine whether a 5-day regimen with rabeprazole, clarithromycin and amoxicillin (RCA) was as effective as a 7-day regimen. METHODS: A total of 139 H. pylori-infected patients were randomized to receive either a 5-day or 7-day course of rabeprazole 10 mg b.d., clarithromycin 400 mg b.d. and amoxicillin 750 mg b.d. Eradication was assessed by CLO test, histology and 13C-urea breath test. RESULTS: On the intention-to-treat basis, eradication rates were 66% (46 out of 70) and 84% (58 out of 69) for the 5- and 7-day regimens, respectively (P < 0.05). Using per protocol analysis, eradication rates were 70% (46 out of 66) and 91% (58 out of 64) for the 5- and 7-day regimens, respectively (P < 0.01). Adverse events, which were observed in 14 patients from each group, caused discontinuation of treatment in only two patients, resulting in excellent compliance. CONCLUSIONS: Our 5-day regimen of RCA yielded inferior results, whereas the 7-day regimen achieved an eradication rate exceeding 90% on the per protocol basis. Therefore, treatment regimens of less than 7 days for proton pump inhibitor-clarithromycin-amoxicillin therapies cannot be recommended.
Assuntos
Amoxicilina/administração & dosagem , Benzimidazóis/administração & dosagem , Claritromicina/administração & dosagem , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori/efeitos dos fármacos , 2-Piridinilmetilsulfinilbenzimidazóis , Adulto , Idoso , Amoxicilina/efeitos adversos , Benzimidazóis/efeitos adversos , Claritromicina/efeitos adversos , Quimioterapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Omeprazol/análogos & derivados , Estudos Prospectivos , RabeprazolRESUMO
BACKGROUND: There is currently no optimal second-line treatment after failure of Helicobacter pylori triple therapy. AIM: To determine effective salvage therapy after failure of lansoprazole-amoxicillin-clarithromycin. METHODS: After failure of lansoprazole-amoxicillin-clarithromycin 123 out-patients were randomized to receive either 2-week rabeprazole (20 mg b.d.) + amoxicillin (1000 mg b.d.) (RA group) or 1-week rabeprazole (10 mg b.d.) + amoxicillin (750 mg twice b.d.) + metronidazole (250 mg b.d.) (RAM group). Eradication was assessed by the 13C-urea breath test. We also evaluated cytochrome p450 (CYP) 2C19 genotype status, determined by polymerase chain reaction - restriction fragment length polymorphism, and susceptibility to clarithromycin and metronidazole. RESULTS: On an intention-to-treat basis, H. pylori infection cure was achieved in 37 of 63 (59%) patients in the RA group and in 49 of 60 (82%) patients in the RAM group. Per protocol-based eradication rates in the RA and RAM groups were 66% (37/56) and 88% (49/56), respectively. In both analytic sets there were significant differences between the treatment groups (P < 0.01 in each). Mild adverse events were observed in eight and five patients from the RA and RAM groups, respectively. Genetic predisposition of CYP2C19 and antibiotic resistance did not influence the treatment outcome either regimen. CONCLUSIONS: The rabeprazole + amoxicillin + metronidazole therapy yielded satisfactory results. In contrast, the cure rate in high-dose rabeprazole + amoxicillin was below an acceptable level.
Assuntos
Amoxicilina/administração & dosagem , Antibacterianos/administração & dosagem , Antiulcerosos/administração & dosagem , Benzimidazóis/administração & dosagem , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori , Metronidazol/administração & dosagem , 2-Piridinilmetilsulfinilbenzimidazóis , Adulto , Idoso , Farmacorresistência Bacteriana , Quimioterapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Omeprazol/análogos & derivados , Penicilinas/administração & dosagem , Estudos Prospectivos , Rabeprazol , Resultado do TratamentoRESUMO
Despite rapid progress in methods for analyzing radiation effects, much remains to be learned about the mechanisms and processes of radiation-induced immunological dysfunction. Among 17,899 sera obtained from atomic bomb survivors in Nagasaki, Japan, sera from 484 participants who complied with a reexamination for alkaline phosphatase (ALP) were tested for antimitochondrial antibody (AMA) by indirect immunofluorescence, and autoantibodies against 2-oxo-acid dehydrogenase complex (2-OADC) by immunoblotting to investigate the prevalence of primary biliary cirrhosis (PBC). Of these 484 sera, 28 (5.8%) were seropositive for AMA. The 484 participants were divided into three groups according to distance from the hypocenter: 72 who were exposed within 1999 m (closest group), 368 from 2000 to 5999 m (intermediate distant group), and 44 outside 6000 m (distant group). The positivity rates for AMA in these three groups were 6/72 (8.3%), 22/368 (6.0%), and 0/44 (0%), respectively (P =.08). Furthermore, high titers ( > 1:320) of AMA were observed in 3/6 (50%) AMA-positive sera from the closest group, in contrast to 4/22 (18%) from the intermediate distant group, although there was no significant correlation between AMA titer and distance from the hypocenter (P =.07). Of these 28 AMA-positive sera, 11 (39%) were from participants who had already been diagnosed with PBC, and 25 (89%) contained antibodies against at least one component of 2-OADC enzymes by immunoblotting. Therefore, the prevalence of PBC was estimated to be at least 615 cases per million (792 per million women). Our results suggest that the prevalence of PBC in atomic bomb survivors in Nagasaki is higher than that reported for the general population in Japan, and a further survey of the environmental factors, including radiation exposure, that predispose to PBC would be needed for understanding this disease of unknown etiology.
Assuntos
Cirrose Hepática Biliar/epidemiologia , Guerra Nuclear , Sobreviventes , Idoso , Idoso de 80 Anos ou mais , Fosfatase Alcalina/sangue , Relação Dose-Resposta à Radiação , Feminino , Técnica Indireta de Fluorescência para Anticorpo , Humanos , Japão/epidemiologia , Cirrose Hepática Biliar/etiologia , Masculino , PrevalênciaRESUMO
BACKGROUND: Previous studies on pulmonary hypertension (PH) in systemic sclerosis and related disorders used differing patient populations, and defined PH according to different criteria. We have attempted to determine the prevalence and cause of PH in these disorders using a mainly noninvasive cardiopulmonary evaluation. PATIENTS AND METHODS: One-hundred thirty-five Japanese patients with systemic sclerosis and related disorders were divided into proximal and distal scleroderma groups, with or without overlapping features of systemic lupus erythematosus (SLE) and polymyositis. They underwent multiple cardiopulmonary tests, including chest radiography, pulmonary function tests, and echocardiography to screen for pulmonary fibrosis and PH. RESULTS: The pulmonary artery systolic pressure was estimated by Doppler echocardiography in 80 patients (59%). PH (systolic pressure > or = 40 mm Hg) was diagnosed in 28 patients by the Doppler method and in two patients by right heart catheterization (mean pressure > or = 20 mm Hg). Doppler-estimated pulmonary artery pressures were significantly higher in patients with proximal scleroderma (p < 0.05), and in those with an SLE/polymyositis overlap (p < 0.01). The FVC was significantly reduced in the proximal scleroderma group (p < 0.0005), but not in the overlap group. PH was attributable to pulmonary fibrosis in nine patients who had proximal scleroderma without overlap. Pulmonary arteriopathy was the probable cause of PH in seven patients with overlap and in four patients who had proximal scleroderma without overlap. CONCLUSIONS: These findings suggest that proximal scleroderma predisposes patients to PH mainly because of pulmonary fibrosis, but occasionally because of pulmonary arteriopathy. An overlap of SLE/polymyositis predisposes patients to PH due to the occurrence of arteriopathy.
Assuntos
Ecocardiografia Doppler , Hipertensão Pulmonar/etiologia , Escleroderma Sistêmico/complicações , Povo Asiático , Pressão Sanguínea , Feminino , Humanos , Hipertensão Pulmonar/diagnóstico por imagem , Hipertensão Pulmonar/etnologia , Hipertensão Pulmonar/fisiopatologia , Japão , Masculino , Pessoa de Meia-Idade , Artéria Pulmonar/fisiologia , Testes de Função Respiratória , Escleroderma Sistêmico/diagnóstico por imagem , Escleroderma Sistêmico/etnologia , Escleroderma Sistêmico/fisiopatologiaRESUMO
BACKGROUND: Using Doppler color flow imaging, abnormal flow patterns were reported to occur with pulmonary artery (PA) dilation. We have frequently observed red signals in the main PA, suggesting reversed flow (RF) in patients without overt pulmonary hypertension. The clinical implication of these signals has not been extensively studied. PATIENTS AND METHODS: We studied 191 of 412 patients referred for echocardiography (99 men and 92 women; mean +/- SD age, 62 +/- 13 years), in whom the main PA diameter had been adequately measured. If a red signal was observed by color flow imaging, a pulsed Doppler echocardiogram of the red signal was recorded simultaneously. The presence of the red signal was correlated with the PA diameter and the PA systolic pressure determined using the modified Bernoulli equation. In 54 patients who also underwent cardiac catheterization studies, the red signal was correlated with PA and pulmonary capillary wedge (PCW) pressures, and with pulmonary vascular resistance. RESULTS: Red signals adjacent to the medial PA border were detected in parallel with systolic blue signals in 127 patients (66%). Pulsed Doppler recordings revealed that they were caused by RF occurring immediately after the forward systolic signal and persisted in diastole. The PA diameter (28 +/- 4.8 mm) and the estimated PA systolic pressure (34 +/- 16 mm Hg) of patients with the RF signal were significantly greater (p < 0.001 and p < 0.05, respectively) than those of patients without the signal (22 +/- 2.5 mm and 28 +/- 6.0 mm Hg, respectively). Among patients who had hemodynamic studies, PA and PCW pressures were significantly higher (p < 0.05) in the 41 patients with the RF signal (22 +/- 12 mm Hg vs 15 +/- 2.6 mm Hg and 11 +/- 5.5 mm Hg vs 8 +/- 3.1 mm Hg, respectively). CONCLUSION: : RF signals in the main PA occur mostly as a result of PA dilation, which may be caused by primary pulmonary hypertension or chronic elevation of left atrial pressure in left-sided cardiac abnormalities.