Metronidazole-induced encephalopathy in a patient with liver cirrhosis

Encephalopathy is a disorder characterized by altered brain function, which can be attributed to various causes. Encephalopathy associated with metronidazole administration occurs rarely and depends on the cumulative metronidazole dose, and most patients with this condition recover rapidly after discontinuation of therapy. Because metronidazole is metabolized in the liver and can be transported by the cerebrospinal fluid and cross the blood-brain barrier, it may induce encephalopathy even at a low cumulative dose in patients with hepatic dysfunction. We experienced a patient who showed ataxic gait and dysarthric speech after receiving metronidazole for the treatment of hepatic encephalopathy that was not controlled by the administration of lactulose. The patient was diagnosed as metronidazole-induced encephalopathy, and stopping drug administration resulted in a complete recovery from encephalopathy. This case shows that caution should be exercised when administering metronidazole because even a low dose can induce encephalopathy in patients with liver cirrhosis

Depolarization mitigated in ferroelectric Hf0.5Zr0.5O2 ultrathin films (< 5 nm) on Si substrate by interface engineering

(Hf,Zr)O2 offers considerable potential for next-generation semiconductor devices owing to its nonvolatile spontaneous polarization at the nanoscale. However, scaling this material to sub-5 nm thickness poses several challenges, including the formation of an interfacial layer and high trap concentration. In particular, a low-k SiO2 interfacial layer is naturally formed when (Hf,Zr)O2 films are directly grown on a Si substrate, leading to high depolarization fields and rapid reduction of the remanent polarization. To address these issues, we conducted a study to significantly improve ferroelectricity and switching endurance of (Hf,Zr)O2 films with sub-5 nm thicknesses by inserting a TiO2 interfacial layer. The deposition of a Ti film prior to Hf0.5Zr0.5O2 film deposition resulted in a high-k TiO2 interfacial layer and prevented the direct contact of Hf0.5Zr0.5O2 with Si. Our findings show that the high-k TiO2 interfacial layer can reduce the SiO2/Si interface trap density and the depolarization field, resulting in a switchable polarization of 60.2 μC/cm2 for a 5 nm thick Hf0.5Zr0.5O2 film. Therefore, we propose that inserting a high-k TiO2 interfacial layer between the Hf0.5Zr0.5O2 film and the Si substrate may offer a promising solution to enhancing the ferroelectricity and reliability of (Hf,Zr)O2 grown on the Si substrate and can pave the way for next-generation semiconductor devices with improved performance

A Case of Successful Treatment of Stomal Variceal Bleeding with Transjugular Intrahepatic Portosystemic Shunt and Coil Embolization

Variceal bleeding from enterostomy site is an unusual complication of portal hypertension. The bleeding, however, is often recurrent and may be fatal. The hemorrhage can be managed with local measures in most patients, but when these fail, surgical interventions or portosystemic shunt may be required. Herein, we report a case in which recurrent bleeding from stomal varices, developed after a colectomy for rectal cancer, was successfully treated by placement of transjugular intrahepatic portosystemic shunt (TIPS) with coil embolization. Although several treatment options are available for this entity, we consider that TIPS with coil embolization offers minimally invasive and definitive treatment

Flash Pulmonary Edema in a Patient With Unilateral Renal Artery Stenosis and Bilateral Functioning Kidneys

Flash pulmonary edema typically exhibits sudden onset and resolves rapidly. It generally is associated with bilateral renal artery stenosis or unilateral stenosis in conjunction with a single functional kidney. We describe a patient who presented with flash pulmonary edema treated by percutaneous therapy with stent implantation. Our case is unique in that the flash pulmonary edema occurred in the setting of unilateral renal artery stenosis with bilateral functioning kidneys

Changes in histopathology and tumor necrosis factor-α levels in the hearts of rats following asphyxial cardiac arrest

Objective Post cardiac arrest (CA) syndrome is associated with a low survival rate in patients who initially have return of spontaneous circulation (ROSC) after CA. The aim of this study was to examine the histopathology and inflammatory response in the heart during the post CA syndrome. Methods We induced asphyxial CA in male Sprague-Dawley rats and determined the survival rate of these rats during the post resuscitation phase. Results Survival of the rats decreased after CA: 66.7% at 6 hours, 36.7% at 1 day, and 6.7% at 2 days after ROSC following CA. The rats were sacrificed at 6 hours, 12 hours, 1 day, and 2 days after ROSC, and their heart tissues were examined. Histopathological scores increased at 12 hours post CA and afterwards, histopathological changes were not significant. In addition, levels of tumor necrosis factor-α immunoreactivity gradually increased after CA. Conclusion The survival rate of rats 2 days post CA was very low, even though histopathological and inflammatory changes in the heart were not pronounced in the early stage following CA

Superior Mesenteric Artery Syndrome Treated with Percutaneous Radiologic Gastrojejunostomy

Superior mesenteric artery (SMA) syndrome is a rare condition that must be differentiated from other gastrointestinal diseases manifesting as upper abdominal pain, nausea, or vomiting. The description of SMA syndrome is compression of the third portion of the duodenum by the SMA and the abdominal aorta. SMA syndrome is managed with nasoenteral nutrition or surgical strategies such as laparoscopic duodenojejunostomy. However, SMA syndrome treated using enteral nutrition by percutaneous radiologic gastrojejunostomy has not been reported. Here, we report our experience of successfully managing a case of SMA syndrome with percutaneous radiologic gastrojejunostomy. (Korean J Gastroenterol 2016;67:321-326

Experiments and performances of strain-hardening fiber low cementitious composites

The ordinary Portland cement is a main binding material in normal concrete or high-performance fiber cementitious composites. However, the carbon dioxide (CO 2 ) emission during the ordinary Portland cement manufacturing process is up to about 7.0% of global manmade CO 2 . The ordinary Portland cement is also known to have toxic substances. The purpose of current research is to develop a near-environmental and strain-hardening fiber low cementitious composite in which the binder is mixed by replacing 60% of the amount of cement with ground granulated blast-furnace slag with or without using alkali activators, or replacing with fly ash. Five mixture proportions with proper fluidity and viscosity of the composites in order to easily mix fibers and to uniformly disperse fibers were determined according to reducing the amount of cement and replacing it with ground granulated blast-furnace slag with or without alkali activators, or replacing with fly ash. The mechanical characteristics of the strain-hardening fiber low cementitious composite were evaluated experimentally by the slump flow, compression, and direct tension tests. The strain-hardening fiber low cementitious composite exhibited the slump flow of 520–670 mm and the tensile strain capacity of 2.3%−4.8% with multiple micro-cracks

Investigation of Strength Properties for Concrete Containing Fine-Rubber Particles Using UPV

Since the early 1990s, many studies were conducted to utilize waste tires as a replacement for natural coarse and fine aggregates in concrete, known as rubberized concrete or rubber-concrete. In this paper, an experimental study was performed on the strength properties of concrete containing fine-rubber particles as a replacement of fine aggregate, using destructive and non-destructive tests. Ultrasonic pulse velocity (UPV) tests were used to evaluate the strength property of rubber-concrete as a non-destructive test. Compressive and splitting tensile strengths were determined for four different volume contents of fine-rubber particles and exponential equations were proposed for the relationship between compressive, splitting tensile strength and the UPV of rubber-concrete, respectively. With the limited conditions in this paper, it found that UPV tests could also be used to estimate the compressive and tensile strengths of rubber-concrete, that are used in other types of concrete

Mechanical Properties of Alkali-Activated Slag Fiber Composites Varying with Fiber Volume Fractions

The mechanical properties of alkali-activated slag fiber composites (ASFC) were investigated with varying volume fractions of PVA (Polyvinyl alcohol) fibers. Ground granulated blast furnace slag (GGBS) and alkali-activators were used as the main binders instead of cement, which emits a large amount of carbon dioxide during the manufacturing process. The measured slump flow of ASFC showed a high fluidity at a fiber content of 1.5 vol.% or less. The tensile, flexural, and shear strength of ASFC showed higher values as the amount of fiber increased. Compared to the existing high ductility fiber composites showing strain hardening behaviors with a fiber content of 2.0 vol.%, ASFC proved that it could exhibit high ductility characteristics due to multi-microcracks even at low fiber mixing rates of 1.0% and 1.25%. ASFC could be expected to lower the manufacturing cost with a low fiber content and provide improved workability with high fluidity. In addition, when manufacturing structural components using the developed ASFC, it is expected that the amount of fiber could be selected and used according to the required performance