Gas Embolism Caused by Portal Vein Gas: Case Report and Literature Review

Introduction: We describe a case of pulmonary gas embolism caused by portal vein gas (PVG) observed using echocardiography. Echography revealed gas flowing through the hepatic vein, inferior vena cava, right atrium, and right ventricle, as well as pulmonary hypertension. The patient was diagnosed as having pulmonary gas embolism caused by PVG. Objective: We consider PVG routes to pulmonary circulation, diagnosis of gas embolism caused by PVG, and treatment of gas embolism caused by PVG.Methods: We reviewed reports of eight cases of gas embolism caused by PVG and compared these cases to cases of gas embolism without PVG. Results: Mortality of gas embolism caused by PVG was 67%, positive blood culture was observed in six cases, and pulmonary edema was seen in three cases. PVG initially excites microbubble formation, which causes tissue damage in the liver and liver abscess. A large volume of PVG causes portal obstruction. As a result, portal hypertension, a portosystemic shunt or gastrointestinal congestion can occur. PVG can travel to the systemic vein through the liver or portosystemic shunt without anomaly and cause pulmonary gas embolism, followed by arterial embolism. In this environment, sepsis easily occurs. Echocardiography is useful for diagnosis of gas embolism caused by PVG, but the gas can be seen intermittently. The view of pulmonary edema is important for pulmonary gas embolism caused by PVG. Conclusion: It is important to treat the underlying disease, but PVG must be considered and treated as the gas embolism’s source

Modeling complex flow dynamics of fluvial floods exacerbated by sea level rise in the Ganges-Brahmaputra-Meghna Delta

Global warming is likely to exacerbate future fluvial floods in the world’s mega-delta regions due to both changing climate and rising sea levels. However, the effects of sea level rise (SLR) on fluvial floods in such regions have not been taken into account in current global assessments of future flood risk, due to the difficulties in modeling channel bifurcation and the backwater effect.Weused a state-ofthe- art global river routing model to demonstrate how these complexities contribute to future flood hazard associated with changing climate and SLR in the world’s largest mega-delta region, the Ganges- Brahmaputra-Meghna Delta. The model demonstrated that flood water in the main channels flows into tributaries through bifurcation channels, which resulted in an increase in inundation depth in deltaic regions.Wefound that there were large areas that experienced an increase in inundation depth and period not directly from the SLR itself but from the backwater effect of SLR, and the effect propagated upstream to locations far from the river mouth. Projections under future climate scenarios as well as SLR indicated that exposure to fluvial floods will increase in the last part of the 21st century, and both SLR and channel bifurcation make meaningful contributions

ヘイセイ 24ネン 7ガツ キュウシュウ ホクブ ゴウウ ニ ヨル アソ チイキ ノ ドシャ サイガイ

We had a deluge in July 2012 in the northern Kyushu district with intense rainfall of 800mm and 108mm/hr. This intensity yielded countless traces of debris flow and slope failures that induced tremendous damage and causalities in the area. Hence, several field investigations and reconnaissance tasks were conducted by the society to delve into this sediment-related disaster. The various results and the information obtained through this investigation were reported as the primary report, mentioning the damage, geologic-geomorphologic features and hydraulic characteristics of the debris flows, vegetation effects, and the efficiency of Sabo facilities in other scenes of this disaster

ヘイセイ 24ネン 7ガツ キュウシュウ ホクブ ゴウウ ニ ヨル アソ チイキ ノ ドシャ サイガイ

We had a deluge in July 2012 in the northern Kyushu district with intense rainfall of 800mm and 108mm/hr. This intensity yielded countless traces of debris flow and slope failures that induced tremendous damage and causalities in the area. Hence, several field investigations and reconnaissance tasks were conducted by the society to delve into this sediment-related disaster. The various results and the information obtained through this investigation were reported as the primary report, mentioning the damage, geologic-geomorphologic features and hydraulic characteristics of the debris flows, vegetation effects, and the efficiency of Sabo facilities in other scenes of this disaster

Outcomes in Newly Diagnosed Atrial Fibrillation and History of Acute Coronary Syndromes: Insights from GARFIELD-AF

BACKGROUND: Many patients with atrial fibrillation have concomitant coronary artery disease with or without acute coronary syndromes and are in need of additional antithrombotic therapy. There are few data on the long-term clinical outcome of atrial fibrillation patients with a history of acute coronary syndrome. This is a 2-year study of atrial fibrillation patients with or without a history of acute coronary syndromes