Esophageal stricture occurs at a high rate after endoscopic submucosal dissection, especially after entire circumferential dissection, leading to poor quality of life. This retrospective cohort study ...evaluated the stricture rate in circumferential mucosal defect cases following modified steroid administration. We enrolled 22 consecutive patients who underwent entire circumferential endoscopic submucosal dissection for superficial esophageal cancer between April 2010 and April 2015 at our hospital. Until January 2013, a systemic steroid-prednisolone-was administered at 30 mg/day and tapered over 8 weeks in the original method group (original group). From February 2013, 30 mg of prednisolone was administered orally for 3 weeks and then the dose was reduced in 5 mg decrements every 3 weeks. This group was classified as the modified method group (modified group). We retrospectively compared the stricture rates between the two groups. The postoperative stricture rate was significantly lower in the modified group (36.4%; 4/11 patients) than in the original group (82%; 9/11 patients; P = 0.04). The mean number of endoscopic balloon dilatation procedures was significantly lower in the modified group (6.2 ± 11.3) than in the original group (19.4 ± 15.3; P = 0.023). Pneumonia and oral herpes infection, which are adverse events potentially associated with steroid administration, were observed in the original group. Candida esophagitis, arthritis, and steroid-related myopathy were observed in the modified group. This modified systemic steroid administration was effective for patients with entire circumferential mucosal defect. The safety of this method was also demonstrated.
Full text
Available for:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Summary
There have been several reports that steroid administration is effective at preventing strictures after endoscopic submucosal dissection (ESD). However, adverse events after steroid use are ...of great concern. We have reported that shielding with a polyglycolic acid (PGA) sheet and fibrin glue can be useful for prevention of stricture after ESD. We conducted a retrospective analysis of efficiency of shielding with a PGA sheet and fibrin glue for prevention of esophageal stricture compared with intralesional steroid injection. ESD was performed on a total of 489 lesions in 400 patients for superficial esophageal cancer from January 2012 to July 2016. Of these, 39 lesions were enrolled in the study group (PGA sheet and fibrin glue) and 31 lesions were enrolled in the control group. The incidence of postoperative stricture at 6 weeks and the number of sessions of endoscopic balloon dilatation (EBD) required to resolve any strictures were evaluated. The post-ESD stricture rate was 9.1% in the study group (3/33 patients), which was not significantly lower than the stricture rate of 10.3% in the historical control group (3/29 patients; p = 1.00). The mean number of EBD was 0.057 ± 0.24 in the study group and 1.9 ± 5.1 in the control group, which was not significant (P = 0.95). PGA sheet and fibrin glue appear to be a promising option for the prevention of esophageal stricture similar to the effect of intralesional steroid injection.
Full text
Available for:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
We report a study on the threshold voltage (Formula Omitted) description for dual-gate MOSFETs with independent gate control, which provides the major contribution for multigate MOSFETs. ...Specifically, we focus on the understanding of the control mechanisms with two gates, leading to the derivation of an appropriate Formula Omitted description. The results demonstrate that Formula Omitted-linear extrapolation (GMLE) method can extract a Formula Omitted value, which reflects the device physics in the best way. Both front- and back-gate charges are found to induce important contributions to the threshold condition. The newly developed Formula Omitted equation includes only device parameters and accurately predicts Formula Omitted value for any back-gate bias conditions. Based on this Formula Omitted model, a further analytical equation is derived for the situation, where the back-gate charge becomes comparable and starts to exceed the front-gate charge. The independent gate control induces two Formula Omitted values if the back-gate control becomes strong enough in comparison to that of the front gate. It is further shown that the developed model can be applied for device performance optimization to meet circuitry requirements.
The strength decrease in magnesium implants was studied in vitro and in vivo, with and without a protective plasmaelectrolytic coating. In vivo, degradation was examined by implanting rectangular ...plates on top of the nasal bone of miniature pigs. The presence of gas pockets in the soft tissue surrounding the implants was evaluated with intermediate X-rays and computed X-ray tomography scans before euthanasia. After 12 and 24weeks of in vivo degradation, the large rectangular plates were removed and mechanically tested in three-point bending. In vitro, identical plates were immersed in simulated body fluid for 4, 8 and 12weeks. In vitro and in vivo results showed that onset of gas release can be delayed by the plasmaelectrolytic coating. Mass loss and strength retention during in vivo degradation is about four times slower than during in vitro degradation for the chosen test conditions. Despite the slow degradation of the investigated WE43 alloy, the occurrence of gas pockets could not be completely avoided. Nevertheless, uniformity of degradation and reliable strength retention make this alloy a prime candidate for the use of magnesium in cranio-maxillofacial surgery.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
A large portion of Earth's crust is formed at convergent plate boundaries that are accompanied by the subduction of sediments that can contain evolved crust-derived detritus. Partial melting of such ...sediments can strongly affect the trace element and isotope geochemistry of new arc rocks. Here, we present high-precision Lu–Hf–Zr concentration data and Hf isotope compositions for a series of volcanic rocks from the Banda arc, East Indonesia, to quantify the transfer of subducted Hf to the Banda arc crust and address the influence of recycled Hf in subduction zones on the Hf isotope systematics of arc rocks.
Along-arc from NE to SW, the 176Hf/177Hf decreases from 0.28314 to 0.28268 ranging from predominantly mantle-like ratios towards more crustal signatures. Hf–Nd isotope co-variations require low Nd/Hf in the arc magma source, inconsistent with fluid addition to the arc melts, but in agreement with the involvement of partial sediment melts. The systematic decrease in Hf–Nd isotopes infers a NE–SW along-arc increase in the involvement of subducted continental material (SCM) in the arc magma source, consistent with δ18O and Nd–Sr–Pb isotope constraints. The along-arc decrease in Hf isotopes coupled with increasing Zr/Hf (from 31.9 to 36.1) and decreasing Lu/Hf suggests that the newly produced arc lavas contain crustal-derived Hf as a result of partial melting of SCM associated with the breakdown of zircon. Based on recent experimental estimates of temperatures required to achieve zircon breakdown, we infer that slab surface temperatures in the Banda arc region need to be as high as 925°C.
As a consequence of the inheritance of non-radiogenic Hf from SCM, the juvenile Banda arc crust exhibits Hf isotope model ages biased by hundreds of millions of years. We conclude that crust-formation ages derived from Hf isotope ratios of convergent margin rocks and their constituent minerals (such as zircon) can be geologically meaningless mixing ages, even when they readily preserve low δ18O values (i.e., <6.5). These findings are discussed with respect to the inferred origin of Hadaean zircons at convergent plate boundaries, which appear consistent with an origin in a convergent margin setting.
► Hf isotopes in Banda arc rocks decrease from an Indian-type mantle towards crustal signature. ► Along-arc variations in Hf isotopes are caused by sediment melting. ► Hf model ages are significantly biased for rocks with δ18O values <6.5. ► Hadaean zircons may have formed in similar convergent margin settings.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
We present major and trace element analyses and U–Pb zircon intrusion ages from I-type granitoids sampled along a crustal transect in the vicinity of the Chilas gabbronorite of the Kohistan ...paleo-arc. The aim is to investigate the roles of fractional crystallization of mantle-derived melts and partial melting of lower crustal amphibolites to produce the magmatic upper crust of an island arc. The analyzed samples span a wide calc-alkaline compositional range (diorite–tonalite–granodiorite–granite) and have typical subduction-related trace element signatures. Their intrusion ages (75.1 ± 4.5–42.1 ± 4.4 Ma) are younger than the Chilas Complex (~85 Ma). The new results indicate, in conjunction with literature data, that granitoid formation in the Kohistan arc was a continuous rather than punctuated process. Field observations and the presence of inherited zircons indicate the importance of assimilation processes. Field relations, petrographic observations and major and trace element compositions of the granitoid indicate the importance of amphibole fractionation for their origin. It is concluded that granitoids in the Kohistan arc are derivative products of mantle derived melts that evolved through amphibole-dominated fractionation and intra crustal assimilation.
Full text
Available for:
DOBA, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, SIK, UILJ, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Atoms moving in a static periodic field experience a time-dependent oscillating field in their own rest frame. By tuning the frequency, an atomic transition can be induced. So far, this type of ...transition has been demonstrated in the EUV region or at higher frequencies by crystalline fields and in the microwave region by artificial fields. Here, we present the observation of the transition of positronium (Ps) in the sub-THz region by using an energy-tunable Ps beam with a multilayered magnetic grating. This grating produces a microsized periodic field, whose amplitude corresponds to a huge energy flux of ∼100 MW cm^{-2}, resulting in the efficient magnetic dipole transition.
Full text
Available for:
CMK, CTK, FMFMET, IJS, NUK, PNG, UL, UM
The thermal fluidity and injection moldability of oven-dry steam-treated bamboo powder were investigated with control of the temperature. Thermal analysis, such as differential thermal analysis and ...thermogravimetry, indicated that the steamed powder underwent degradation at lower temperatures, and the weight loss of the steamed powder was larger than that for the untreated powder. Thermal flow tests of the steamed powder at several temperatures revealed the flow rate was high at 180 and 200°C. Injection molding was attempted while controlling the temperature of the injection part and metal mold. It was possible to obtain products with a surface similar to plastic via injection molding and the range of metal mold temperature that resulted in a successfully molded product increased with the injection temperature. The four-point bending strength and Rockwell superficial hardness of the product increased with the mold temperature at each injection temperature. Both characteristics were high when the injection temperature was 180°C, and the highest values obtained were 36MPa and HR15w 78. Observation of the fracture part of the molded product confirmed that the fiber strength of the product molded at an injection temperature of 180°C was maintained, while that molded at an injection temperature of 200°C was not.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
To report the definitive diagnosis of anti-NMDA receptor (NMDAR) encephalitis in four Japanese women previously diagnosed with "juvenile acute nonherpetic encephalitis" of unclear etiology, and to ...describe their long-term follow-up in the absence of tumor resection.
We extensively reviewed the case histories with current clinical and laboratory evaluations that include testing for antibodies to NR1/NR2 heteromers of the NMDAR in serum/CSF available from the time of symptom onset (4 to 7 years ago) and the present.
All patients sequentially developed prodromal symptoms, psychosis, hypoventilation, severe orofacial dyskinesias, and bizarre immunotherapy-resistant involuntary movements that lasted 1 to 12 months. Two patients required mechanical ventilation for 6 and 9 months. Initial tests were normal or unrevealing, including the presence of nonspecific CSF pleocytosis, and normal or mild changes in brain MRI. Eventually, all patients had dramatic recovery of cognitive functions, although one had bilateral leg amputation due to systemic complications. Antibodies to NR1/NR2 heteromers were found in archived serum or CSF but not in long-term follow-up samples. An ovarian teratoma was subsequently demonstrated in three patients (all confirmed pathologically).
1) These findings indicate that "juvenile acute nonherpetic encephalitis" or a subset of this disorder is mediated by an antibody-associated immune response against NR1/NR2 heteromers of the NMDA receptor (NMDAR). 2) Our patients' clinical features emphasize that anti-NMDAR encephalitis is severe but potentially reversible and may precede by years the detection of an ovarian teratoma. 3) Although recovery may occur without tumor removal, the severity and extended duration of symptoms support tumor removal.
The efficacy of early enteral nutrition after esophageal cancer surgery has been reported. However, the choice of formula and management of diarrhea are important to achieve the goal of enhanced ...recovery after surgery. The aim of this study is to assess the frequency of diarrhea/completion rate of enteral nutrition regimen as primary endpoints and the postoperative nutritional status/body composition analysis/operative morbidity as secondary endpoints was compared between the two nutrition groups. Among the 122 patients who underwent esophagectomy for esophageal cancer between December 2015 and September 2017, 67 patients who met the eligibility criteria were randomly assigned to receive enteral nutrition with either HINE E-GEL® (HINE group; n = 33) or MEIN® (MEIN group; n = 34). The incidence of diarrhea was significantly lower in the HINE group (18.2 % vs. 64.7 %, P < 0.001). The score of Bristol scale of POD 6/7 was significantly lower in the HINE group (P = 0.019/P = 0.006, respectively). The completion rate of enteral nutrition regimen was significantly higher in the HINE group (97.4 % vs. 86.6 %, P = 0.002). The Controlling Nutritional Status scores and total protein levels at 6 months after surgery were significantly better in the HINE group (P = 0.030 and P = 0.023, respectively), indicating improved tendency in nutritional status in the HINE group. However, there were no significant differences in Prognostic Nutritional Index values, blood test results, rapid turnover proteins, body mass index, or body composition between the two groups. HINE E-GEL compared with MEIN may reduce the frequency of diarrhea, enabling patients to adhere to the scheduled enteral nutrition plan. Also, maintenance of nutritional status with HINE E-GEL was comparable or potentially better in some nutrition components to that with MEIN, indicating that HINE E-GEL can be an option for enteral nutrition following esophageal surgery to achieve the goal of successful completion of scheduled enteral nutrition and smooth transition to the normal diet.
Full text
Available for:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
PDF
