Hepatic infarction following abdominal interventional procedures.

To clarify the incidence, background, and progress of hepatic infarction following interventional procedures, cases of hepatic infarction following interventional procedures at our department during the last decade were identified by reviewing the clinical records of 1982 abdominal angiography and interventional procedures and records of abdominal CT. Nine episodes (0.5%) in 8 patients were identified as hepatic infarction following an interventional procedure. Five episodes were preceded by embolization of the hepatic or celiac artery at emergency angiography for postoperative bleeding with hemorrhagic shock. Three episodes followed the elected interventional procedure for hepatocellular carcinoma, and the remaining episode occurred after 12 months of chemoinfusion through an indwelling catheter in the hepatic artery and portal vein. Hepatic arterial occlusion in all episodes and portal venous flow abnormality in 5 episodes were observed on angiography. Four patients whose liver function was initially impaired died of hepatic infarction, although the extent of the disease on CT did not appear to be related to the mortality. Multiple risk factors, including arterial insufficiency, were observed in each patient. The incidence of hepatic infarction following interventional procedures in this series was low but sometimes fatal, and occurred most frequently in emergency embolization in hemorrhagic shock.</p

Four-dimensional lattice chiral gauge theories with anomalous fermion content

In continuum field theory, it has been discussed that chiral gauge theories with Weyl fermions in anomalous gauge representations (anomalous gauge theories) can consistently be quantized, provided that some of gauge bosons are permitted to acquire mass. Such theories in four dimensions are inevitablly non-renormalizable and must be regarded as a low-energy effective theory with a finite ultraviolet (UV) cutoff. In this paper, we present a lattice framework which enables one to study such theories in a non-perturbative level. By introducing bare mass terms of gauge bosons that impose ``smoothness'' on the link field, we explicitly construct a consistent fermion integration measure in a lattice formulation based on the Ginsparg-Wilson (GW) relation. This framework may be used to determine in a non-perturbative level an upper bound on the UV cutoff in low-energy effective theories with anomalous fermion content. By further introducing the St\"uckelberg or Wess-Zumino (WZ) scalar field, this framework provides also a lattice definition of a non-linear sigma model with the Wess-Zumino-Witten (WZW) term.Comment: 18 pages, the final version to appear in JHE

Quantum Exchange Algebra and Locality in Liouville Theory

Exact operator solution for quantum Liouville theory is investigated based on the canonical free field. Locality, the field equation and the canonical commutation relations are examined based on the exchange algebra hidden in the theory. The exact solution proposed by Otto and Weigt is shown to be correct to all order in the cosmological constant.Comment: 11 pages, LaTeX, no figure

Jejunal interposition reconstruction with a stomach preserving esophagectomy improves postoperative weight loss and reflux symptoms for esophageal cancer patients

Background: Conventional reconstruction after an esophagectomy uses a gastric tube, which commonly causes several postoperative complaints such as gastric acid reflux in long-term survival cases. Intestinal interposition between the remnant esophagus and the stomach is an option to reduce complaints, and in this study, the advantages of jejunal interposition reconstruction with a stomach preserving esophagectomy (SPE) were assessed. Materials and methods: Eleven cases of jejunal interposition with an SPE and 16 cases with gastric tube reconstruction as a control were subject to a comparison of operation time, amount of bleeding, postoperative quality of life, and endoscopic findings. Results: The SPE group had a longer operation time (SPE: 560 +/- 121 min, control 414 +/- 83 min, P = 0.038), whereas there was no significant difference in blood loss. Postoperative weight loss was significantly recovered in the SPE group (SPE versus control = 94.0 +/- 5.4% versus 87.5 +/- 4.7% at 3 mo, P = 0.017; 97.2 +/- 7.5% versus 85.0 +/- 5.2% at 6 mo, P = 0.010), and there was a significant decrease in the occurrence of reflux symptoms such as heartburn, odynophagia, and cough when jejunal interposition with an SPE was done. Furthermore, reflux esophagitis and Barrett's epithelium were found in six out of 12 cases (50%) of the control group by postoperative endoscopy, while no cases in the SPE group had either condition (P < 0.01). Conclusions: This reconstruction method is a promising option to improve postoperative quality of life, mainly due to the long-term elimination of reflux esophagitis, which assists in the recovery of postoperative weight loss

A New Navigation System for Minimally Invasive Total Knee Arthroplasty

A computer-assisted navigation system to be used for total knee arthroplasties (TKAs) was reported to improve the accuracy of bone resection and result in precise implant placement, but the concomitant surgical invasion and time consumption are clinical problems. We developed a computed tomography (CT)-based navigation system (NNS) to be used for minimally invasive TKA. It requires only the reference points from a small limited area of the medial femoral condyle and proximal tibia through a skin incision to obtain optical images. Here we evaluated the usefulness and accuracy of the NNS in comparison with the commercially available BrainLAB image-free navigation system (BLS). In a clinical experiment, the registration times obtained with the NNS tended to be shorter than those obtained with the BLS, but not significantly so. The NNS group tended to be in the extended position in the sagittal plane of the distal femur within 3 degrees, and the BLS group showed rather flexed deviation in the sagittal plane of the anterior femur

Solving the local cohomology problem in U(1) chiral gauge theories within a finite lattice

In the gauge-invariant construction of abelian chiral gauge theories on the lattice based on the Ginsparg-Wilson relation, the gauge anomaly is topological and its cohomologically trivial part plays the role of the local counter term. We give a prescription to solve the local cohomology problem within a finite lattice by reformulating the Poincar\'e lemma so that it holds true on the finite lattice up to exponentially small corrections. We then argue that the path-integral measure of Weyl fermions can be constructed directly from the quantities defined on the finite lattice.Comment: revised version, 35pages, using JHEP3.cl

Percutaneous sclerotherapy for venous malformations using polidocanol under fluoroscopy.

This retrospective study evaluated the safety and efficacy of using polidocanol with X-ray fluoroscopy for percutaneous sclerotherapy of venous malformations of the limbs, head, and neck. The subjects were 16 of 18 patients who presented to our department with venous malformations. Two patients were excluded because they were unlikely to benefit from the treatment. Of the 16 included in the study, 1 could not be treated because of inaccessibility, and another was lost to follow-up. Among the 14 cases that we were able to follow-up, 11 cases had had pain as their primary symptom. Following treatment, this symptom remained unchanged in 1 patient, was improved in 4, and had disappeared in 6; however, there was a recurrence of pain for 3 of these patients. Two patients had sought treatment for cosmetic purposes; following treatment, the lesion disappeared in one and showed a significant reduction in the other. The remaining patient presented with a primary symptom of mouth bleeding, which disappeared following treatment. There were no critical complications. Percutaneous sclerotherapy of venous malformations using polidocanol is safe and effective, and permits repeat treatments. The efficacy is especially good for resolving pain, and complications are minor. It is desirable to use fluoroscopy for these procedures</p