Balloon-occluded retrograde transvenous obliteration for gastric varices: the relationship between the clinical outcome and gastrorenal shunt occlusion

<p>Abstract</p> <p>Background</p> <p>The rupture of gastric varices is associated with high mortality rate. Balloon-occluded retrograde transvenous obliteration (B-RTO), a minimally invasive procedure that was introduced in the mid-1990s, has been widely accepted in Japan. Several reports have indicated that B-RTO yields satisfactory results; however, few reports have discussed the recurrence of gastric varices after this therapy. The purpose of this study is to retrospectively evaluate the technical aspects of B-RTO and the recurrence of gastric varices after treatment with this procedure.</p> <p>Methods</p> <p>B-RTO was performed in 47 patients with gastric varices, who were at a risk of variceal ruptures and who may or may not have had a history of variceal bleeding. We injected a sclerosing agent into the gastric varices for 30-60 minutes. To evaluate the therapeutic efficacy of the technique, we obtained contrast-enhanced computed tomography (CT) scans 5 days after B-RTO. As a general rule, if the gastric varices did not appear thrombosed, we repeated the procedure 7 days after the first procedure.</p> <p>Results</p> <p>B-RTO was a technical success in 37 patients. It was performed once in 26 patients, twice in 6 patients, thrice in 2 patients, and 4 times in 3 patients. Contrast-enhanced CT scans obtained after B-RTO showed thrombosed gastrorenal shunts in 29 patients and patent gastrorenal shunts in 8 patients. The gastric varices recurred in 2 patients who had patent gastrorenal shunts. The overall cumulative relapse-free rate of gastric varices was 90% at 5 years after B-RTO.</p> <p>Conclusions</p> <p>B-RTO is an effective treatment modality for gastric varices. Moreover, obliteration of the gastrorenal shunt as well as the gastric varices appears to be important for the treatment of gastric varices.</p

Characteristics of Forming Human Relationships and Social Development Abilities in Special Needs Class in Junior High School: Based on an Analysis of Narrative of Students in “Discussion Activities”

本研究は、中学校特別支援学級生徒を対象として、人間関係形成・社会形成能力の特徴を「話合い活動」での生徒の発話分析を用いて検討した。その結果、第Ⅰ期は、教師の支援や評価を受けながら、「利己的発話とそれに対する反証型の発話」並びに「特定の生徒への利他的発話」から、「全員を意識した発話」並びに「新たな提案を行う共有型の発話」に移行するという特徴、第Ⅱ期は、「継続的な利他的発話」並びに「生徒同士の話合いによる集団的発話」が生起し始めるという特徴、第Ⅲ期は、利他・集団的視点に立つ「提案に対する反証・共有型の発話」や「反復される共有型の発話」、「共有型の発話に対して納得する発話」が生起し、共有型の発話が連なるという特徴があった。これらの結果から、友達や学級集団のためを志向する発話に移行する傾向や、生徒同士で課題を発見し、課題解決のための提案や友達の提案に納得する発話が生起することが示唆された。Characteristics of forming human relationships and social development ability were examined for students in special needs classes in junior high school in the current study based on a speech analysis of students in “Discussion activity”. As a result, such characteristics have been revealed in each stage, i.e., a shift from “selfish speech and counter-evidence type speech” to “speech in awareness of all students” and “sharing type speech to make new proposal” while receiving assistance and evaluation by teachers in the first stage, fledgling of “continuous altruistic speech” and “collective speech based on discussion between students” in the second stage, and arising of “counter-evidence /sharing type speech for proposals”, “repeated sharing type speech” and “agreed speech with sharing type speech” from an altruistic and collective perspective in the third stage followed by continued sharing type speeches. From these outcomes, it has been suggested that such speeches arise that agree with proposals for problem solving and those made by friends while discovering problems by discussion between students along with a trend shifting to speeches focused on friends and groups in the class as well

Digital data arrangement and accumulation on the stud y of the ancient Japanese wooden tablets

2013年度～2017年度科学研究費補助金基盤研究(S) 研究成果報告書（課題番号25220401

Macroscopic findings for breast VAB specimens

Purpose : Ultrasound-guided breast tissue biopsy is an essential technique for diagnosing breast disease, but sample errors reduce its accuracy. This study investigated whether the histopathological results can be inferred from the macroscopic findings for Ultrasound-guided breast Vacuum Assisted Biopsy (VAB) specimens. Methods: Biopsy specimens from 101 patients who underwent mammary gland VAB were photographed with a smartphone, and the relationships between the macroscopic findings and the pathological results were examined. Results : A significant difference was observed with regard to the presence / absence of turbidity: malignancy was detected in 33 / 37 (89%) specimens with turbidity and in 2 / 47 (4%) cases without turbidity (p < 0.001). A significant difference was also observed regarding the surface properties : malignancy was detected in 14 / 70 (19%) smooth specimens and in 24 / 29 (83%) rough specimens (p < 0.001). Also, malignancy was detected in 11 / 13 (85%) specimens with white spots, and the difference was significant (p < 0.001). In addition, the characteristics of intraductal papilloma, fibroadenoma, and mastopathy could be confirmed by macroscopic findings. Conclusions : When needle–biopsy of a lesion that is targeted for resection yields macroscopic findings that match the predicted histopathological findings, it can be thought that the biopsy had been properly performed. This means that false–negatives due to poor specimens can be prevented

Development of a Combined Real Time Monitoring and Integration Analysis System for Volatile Organic Compounds (VOCs)

A combined integration analysis and real time monitoring (Peak Capture System) system was developed for volatile organic compounds (VOCs). Individual integration analysis and real time monitoring can be used to qualitatively and quantitatively analyze VOCs in the atmosphere and in indoor environments and determine the variation in total VOC (TVOC) concentration with time, respectively. In the Peak Capture System, real time monitoring was used to predict future elevations in the TVOC concentration (peak), and this was used an indicator of when to collect (capture) ambient air samples for integration analysis. This enabled qualitative and quantitative analysis of VOCs when the TVOC concentration was high. We developed an algorithm to predict variation in the TVOC concentration, and constructed an automatic system to initiate air sampling for integration analysis. With the system, auto-sampling and analysis of VOCs in a conventional house were conducted. In comparison with background concentrations, the results of peak analysis enabled identification of compounds whose concentration rose. This also enabled an evaluation of possible VOC emission sources