CT減弱補正を用いて構築した123I-iodoamphetamine脳血流SPECT統計解析用正常データベースの臨床応用についての多施設研究

藤田医科大

Evaluation of therapeutic effects and serious complications following endoscopic obliterative therapy with Histoacryl

Takahiro Sato, Katsu YamazakiDepartment of Gastroenterology, Sapporo Kosei General Hospital, Sapporo, JapanBackground and aims: Our aim was to evaluate the utility of endoscopic obliterative therapy with Histoacryl for gastric varices and to investigate the incidence of serious complications.Methods: Endoscopic obliterative therapy with Histoacryl was performed on 129 gastric variceal patients. Sixty-five patients had cardiofornical varices, and 64 had fundal varices. Forty-five of 129 patients were emergency cases and the other 84 patients were prophylactic cases. Endoscopic therapy was performed under fluoroscopy using 70% Histoacryl (Histoacryl diluted with 5% Lipiodol).Results: Endoscopic hemostasis of gastric varices was successful in 45/45 (100%) emergency cases. The recurrence rate of gastric varices was 17/120 (14.2%) among patients whose variceal eradication was achieved. Additional treatment was successfully performed in all recurrent cases. The incidence of serious complications was 4/129 (3.1%), including two cases of splenic infarction, one case of pulmonary embolism, and one case of an inflammatory tumor of pancreatic tail. The two patients with splenic infarction improved with conservative medical treatment. The patient with pulmonary embolism showed no respiratory symptoms, and died of liver failure. The patient with the pancreatic tumor, which was diagnosed as an inflammatory tumor, was treated surgically.Conclusions: Endoscopic obliterative therapy with Histoacryl is a useful and relatively safe method for treatment of bleeding gastric varices. Nonetheless, careful attention must be paid to avoid potentially serious complications.Keywords: cyanoacrylate, endoscopic obliterative therapy, gastric varices, Histoacry

Availability of a remote online hemodynamic monitoring system during treatment in a private dental office for medically high-risk patients

The importance of systemic management to prevent accidents is increasing in dentistry because co-morbid illnesses in an aging society and invasive surgical procedures are increasing. In this prefecture, a new medical system called the remote online hemodynamic monitoring system (ROHMs) was started in 2001. Eight private dental offices participated in this trial. When dental practitioners feel the risk of a dental procedure, they can contact via ROHMs to this hospital. Then, the hemodynamic data (blood pressure, heart rate, ECG, SpO2, and RPP) of the patient in the clinic can be transmitted here via the internet, and the images and the voice can be transmitted as well. The availability of this system was assessed in 66 patients (98 cases). The most frequent complications were hypertension, heart disease, and diabetes mellitus. Systemic management included monitoring during the dental procedure (71.4%), checking vital signs after an interview (15.3%), and monitoring under sedation (13.3%). There were 35.7% of all cases where an unscheduled procedure was necessary for the systemic management. Based on a questionnaire, the majority of the patients felt relieved and safe. This system creates a situation where a specialist is almost present during the procedure. This system will provide significant assistance for future medical cooperation for risk management

High-pressure phase equilibria of tertiary-butylamine hydrates with and without hydrogen

Thermodynamic stability boundaries of the simple tertiary-butylamine (t-BA) hydrate and t-BA+hydrogen (H2) mixed hydrate were investigated at a pressure up to approximately 100 MPa. All experimental results from the phase equilibrium measurement, in situ Raman spectroscopy, and powder X-ray diffraction analysis arrive at the single conclusion that the t-BA hydrates, under pressurization with H2, are transformed from the structure VI simple t-BA hydrate into the structure II t-BA+H2 mixed hydrate. The phase transition point on the hydrate stability boundary in the mother aqueous solutions with the t-BA mole fractions (xt-BA) of 0.056 and 0.093 is located at (2.35 MPa, 267.39 K) and (25.3 MPa, 274.19 K), respectively. On the other hand, in the case of the pressurization by decreasing the sample volume instead of supplying H2, the simple t-BA hydrate retains the structure VI at pressures up to 112 MPa on the thermodynamic stability boundary.Tomohiro Tanabe, Takeshi Sugahara, Kazuma Kitamura et al. High-Pressure Phase Equilibria of Tertiary-Butylamine Hydrates with and without Hydrogen, Journal of Chemical & Engineering Data, 60 (2), 222–227, February 12, © 2015 American Chemical Society. https://doi.org/10.1021/je500301