Hemostasis of Gastric Variceal Hemorrhage by Transileocoecal and Transhepatic Obliteration

Obliteration for gastric or duodenal variceal hemorrhage was performed via transileocoecal or transhepatic portal catheterization in 8 patients with portal hypertension. The patients were 6 men and 2 women, whose average age was 59 years. All of the patients had cirrhosis of the liver. The obliteration was performed as an emergency procedure in 6 cases, and 2 patients were electively treated. Transileocoecal obliteration (TIO) and transhepatic obliteration (PTO) were selected for 6, and 2 patients, respectively. Variceal bleeding was successfully controlled in all patients after completion of the therapy. One patient died after 3 months when duodenal variceal bleeding recurred. Elective surgical operations were performed on 2 patients after the initial therapy, because the vein feeding toward the varices remained. Six of the patients have survived to date without bleeding. Transient oliguria and jaundice after the therapy were noticed in 2 patients. Histological examination revealed cast formation of polymerized cyanoacrylate in the obliterated gastric varices of 2 patients. TIO and PTO seem to be safe, effective procedures to stop bleeding from ectopic varices, gastric or duodenal. This therapy is useful either to obtain accurate information about the varices or to obliterate the collateral veins in patients with ruptured ectopic varices.</p

Bispectral index-guided propofol sedation during endoscopic ultrasonography

Background/Aims Bispectral index (BIS) monitors process and display electroencephalographic data are used to assess the depth of anesthesia. This study retrospectively evaluated the usefulness of BIS monitoring during endoscopic ultrasonography (EUS). Methods This study included 725 consecutive patients who underwent EUS under sedation with propofol. BIS monitoring was used in 364 patients and was not used in 361. The following parameters were evaluated: (1) median dose of propofol; (2) respiratory and circulatory depression; (3) occurrence of body movements; (4) awakening score >8 at the time; and (5) awakening score 2 hours after leaving the endoscopy room. Results The BIS group received a significantly lower median dose of propofol than the non-BIS group (159.2 mg vs. 167.5 mg; p=0.015) in all age groups. For patients aged ≥75 years, the reduction in heart rate was significantly lower in the BIS group than in the non-BIS group (1.2% vs. 9.1%; p=0.023). Moreover, the occurrence of body movements was markedly lower in the BIS group than in the non-BIS group (8.5% vs. 39.4%; p<0.001). Conclusions During EUS examination, BIS monitoring is useful for maintaining a constant depth of anesthesia, especially in patients 75 years of age or older

Enhanced hole injection in a hybrid organic-inorganic light-emitting diode

The operating mechanism, particularly the carrier injection mechanism, of a hybrid organic-inorganic light-emitting diode (HOILED) is reported. Asymmetric hole injection has been observed in a symmetric hole-only device, which has two identical interfaces between a conducting polymer and a metal oxide. A HOILED having a layer of molybdenum oxide (MoO3) deposited on a layer of poly(dioctylfluorene-alt-benzothiadiazole) (F8BT) demonstrated a markedly enhanced hole injection, four orders of magnitude higher on one side of the structure than on the other side. This enhanced hole injection is the considered to initiate the operation of the HOILED. X-ray photoelectron spectra (XPS) analysis revealed that Mo deposited on the surface of F8BT was reduced compared to that deposited Mo below the film of F8BT. It is suggested that a chemical interaction between the metal oxide and the organic material affects carrier injection

Synthesis of Amphiphilic Blockcopolymer Using Mechanically Produced Macromonomers Possessing Anhydrate as a Terminal Group and Its Application to Polymeric Micelles

We have synthesized macromonomers by mechanochemical reaction of poly(benzyl methacrylate) (PBzMA) and maleic anhydride (MA). The ESR spectrum of the fractured sample of PBzMA and MA showed a broad singlet, which was apparently different from the spectrum of PBzMA mechanoradical. The amphiphilic blockcopolymer was synthesized with macromonomer of PBzMA and amino-terminated polyethyleneglycol (a-methyl-w-aminopropoxy polyoxyethylene, MEPA). The number average molecular weight of the produced amphiphilic blockcopolymer was 33,000. Polymeric micelles were readily prepared from the present amphiphilic blockcopolymer by a dialysis method. The mean diameter of the micelles measured by dynamic light scattering was about 146 nm. It was shown that the present macromonomer mechanically produced can be used for the synthesis of amphiphilic bockcopolymer to form polymeric micelles

Synthesis of Amphiphilic Blockcopolymer Using Mechanically Produced Macromonomers Possessing Anhydrate as a Terminal Group and Its Application to Polymeric Micelles

We have synthesized macromonomers by mechanochemical reaction of poly(benzyl methacrylate) (PBzMA) and maleic anhydride (MA). The ESR spectrum of the fractured sample of PBzMA and MA showed a broad singlet, which was apparently different from the spectrum of PBzMA mechanoradical. The amphiphilic blockcopolymer was synthesized with macromonomer of PBzMA and amino-terminated polyethyleneglycol (a-methyl-w-aminopropoxy polyoxyethylene, MEPA). The number average molecular weight of the produced amphiphilic blockcopolymer was 33,000. Polymeric micelles were readily prepared from the present amphiphilic blockcopolymer by a dialysis method. The mean diameter of the micelles measured by dynamic light scattering was about 146 nm. It was shown that the present macromonomer mechanically produced can be used for the synthesis of amphiphilic bockcopolymer to form polymeric micelles

New endoscopic ultrasonography techniques for pancreaticobiliary diseases

Endoscopic ultrasonography (EUS) is widely used to evaluate pancreaticobiliary diseases, especially pancreatic masses. EUS has a good ability to detect pancreatic masses, but it is not sufficient for the differential diagnosis of various types of lesions. In order to address the limitations of EUS, new techniques have been developed to improve the characterization of the lesions detected by EUS. EUS-guided fine needle aspiration (EUS-FNA) has been used for diagnosing pancreatic tumors. In order to improve the histological diagnostic yield, a EUS-FNA needle with a core trap has recently been developed. Contrast-enhanced harmonic EUS is a new imaging modality that uses an ultrasonographic contrast agent to visualize blood flow in fine vessels. This technique is useful in the diagnosis of pancreatic solid lesions and in confirming the presence of vascularity in mural nodules for cystic lesions. EUS elastography analyzes several different variables to measure tissue elasticity, color patterns, and strain ratio, using analytical techniques such as hue-histogram analysis, and artificial neural networks, which are useful for the diagnosis of chronic pancreatitis and pancreatic cancer

Electrically Stimulated Antagonist Muscle Contraction Increased Muscle Mass and Bone Mineral Density of One Astronaut - Initial Verification on the International Space Station.

BackgroundMusculoskeletal atrophy is one of the major problems of extended periods of exposure to weightlessness such as on the International Space Station (ISS). We developed the Hybrid Training System (HTS) to maintain an astronaut's musculoskeletal system using an electrically stimulated antagonist to resist the volitional contraction of the agonist instead of gravity. The present study assessed the system's orbital operation capability and utility, as well as its preventative effect on an astronaut's musculoskeletal atrophy.MethodsHTS was attached to the non-dominant arm of an astronaut staying on the ISS, and his dominant arm without HTS was established as the control (CTR). 10 sets of 10 reciprocal elbow curls were one training session, and 12 total sessions of training (3 times per week for 4 weeks) were performed. Pre and post flight ground based evaluations were performed by Biodex (muscle performance), MRI (muscle volume), and DXA (BMD, lean [muscle] mass, fat mass). Pre and post training inflight evaluations were performed by a hand held dynamometer (muscle force) and a measuring tape (upper arm circumference).ResultsThe experiment was completed on schedule, and HTS functioned well without problems. Isokinetic elbow extension torque (Nm) changed -19.4% in HTS, and -21.7% in CTR. Isokinetic elbow flexion torque changed -23.7% in HTS, and there was no change in CTR. Total Work (Joule) of elbow extension changed -8.3% in HTS, and +0.3% in CTR. For elbow flexion it changed -23.3% in HTS and -32.6% in CTR. Average Power (Watts) of elbow extension changed +22.1% in HTS and -8.0% in CTR. For elbow flexion it changed -6.5% in HTS and -4.8% in CTR. Triceps muscle volume according to MRI changed +11.7% and that of biceps was +2.1% using HTS, however -0.1% and -0.4% respectively for CTR. BMD changed +4.6% in the HTS arm and -1.2% for CTR. Lean (muscle) mass of the arm changed only +10.6% in HTS. Fat mass changed -12.6% in HTS and -6.4% in CTR.ConclusionsThese results showed the orbital operation capability and utility, and the preventive effect of HTS for an astronaut's musculoskeletal atrophy. The initial flight data together with the ground data obtained so far will be utilized in the future planning of human space exploration