The autogenous saphenous venous bypass is accepted as an optimal procedure for distal arterial reconstruction. However, serious complications, including incomplete valvulotomy, laceration of the ...venous wall and persistent arteriovenous communications, are found in in situ bypasses. To avoid these complications, a new and simple technique using an angioscope in the in situ venous bypass has been developed. Angioscopy prevents tearing of the vein wall and avoids inaccurate incision of the valves.
To investigate the characteristics, risk factors, and prevention of methicillin-resistant Staphylococcus aureus (MRSA), a total of 3,627 patients were studied. Among these, 1,336 patients with ...various infections were used in a risk factor analysis of MRSA to determine the relationship between the use of antibiotics and the incidence of MRSA. Only 3.0% of infections were attributed to MRSA, the esophagus and colorectal region being highly involved, as anastomotic or pelvic abscesses, while the lung had a lower incidence. Almost half the patients with MRSA infections (47.6%) had concomitant infection. A univariate analysis revealed the following significant factors: The coexistence of gastrointestinal or metastatic malignancy, sepsis, tracheostomy, and the prior use of antibiotics such as the beta-lactam compounds or aminoglycosides. A multivariate analysis showed that gastrointestinal malignancy, sepsis, and the prior use of aminoglycosides, tetracycline, macrolides, and carbapenems were independently significant factors. To promote the education of doctors and nurses, regular in-service meetings on MRSA were held in the ward. Moreover, preventive approaches such as patient isolation, strategically placed hand washing equipment, and the use of disposable gloves and contaminated waste bags, have been initiated, and the incidence of MRSA has decreased significantly since then. Thus, to control MRSA, the following steps should be taken: (1) constant and careful surveillance, (2) regular risk factor analyses, (3) the optimal administration of antibiotics, and (4) the education of all hospital staff.
A multicenter study was done to assess the pathophysiology of malcirculation with portal hypertension.
Patients were admitted to 48 different institutes from 1990 to 1992.
Portal venous pressure was ...345.9 +/- 72.1 mmH2O in patients with portal hypertension. In patients with liver cirrhosis, the diameter of the splenic artery, of the proper hepatic artery, of the left gastric artery and of the splenic vein was significantly larger (p<0.05) than seen in the controls without portal hypertension. In patients with idiopathic portal hypertension, the diameter of the splenic artery and of the vein was significantly larger (p<0.05) and that of the proper hepatic artery was significantly smaller (p<0.05) than seen in the cirrhotic patients. In the cirrhotic patients, blood flow volume was significantly larger (p<0.05) in the splenic vein. In patient with idiopathic portal hypertension, blood flow volume in the portal vein and splenic vein were significantly larger (p<0.05) and that of superior mesenteric vein showed an increasing tendency to enlarge.
This study shows that a hyperdynamic state is present in patient with portal hypertension.
One of the most minimally invasive and promising medical treatments for early-stage breast cancer is radio frequency ablation (RFA). However, with RFA it is difficult to insert the needle into the ...cancer because of the needle deforms the organ and, therefore, displaces the cancer. To solve this problem, we have developed a novel approach called "palpation based needle insertion." to achieve precise needle insertion for the treatment of breast cancer. This paper focuses on the simulation validation of our novel approach. First, we explain how we use a palpation probe to develop our novel method of robot assisted needle insertion. Our assumption was that the palpation probe can detect the cancerous part from force information and, at the same time, reduce the displacement of the part by applying pressure on the breast tissues, which means that the palpation probe can be used to realize precise needle insertion. Next, we show how we developed the breast model and validated it by comparing the results of a numerical simulation and an in vitro experiment. Finally, we evaluated both "normal needle insertion" and "palpation based needle insertion" by carrying out numerical simulations. The simulation data showed that the needle insertion error L of "palpation based needle insertion" is smaller than that of ldquonormal needle insertion". In short, these simulations confirmed the effectiveness of ldquopalpation based needle insertion".
Thin-film electrodes were prepared from laser-ablated BiVO4 and BiZn2VO6 photocatalytic particulates, and the photocurrent action spectra were measured from 350 to 600 nm. The photocurrent of the ...electrodes prepared from laser-ablated particulates was increased compared to that from nonablated particulates. It is suggested that the increase of the photocurrents for the laser-ablated photocatalytic thin electrode should be attributed to the increase in the surface defect sites on the photocatalytic surface rather than the reduction of the particle size. 24 refs.
We describe herein the case of a 57-year-old man with thalassemia who developed acute liver failure after undergoing endoscopic injection sclerotherapy (EIS) to control hemorrhage from a ruptured ...esophageal varix. The patient, who had been confirmed as having liver cirrhosis due to chronic hepatitis C with thalassemia in 1989, was admitted to our department to undergo EIS for esophageal varices, at which time his serum total bilirubin level was 5.5 mg/dl. As a small amount of hematemesis occurred just after a percutaneous transhepatic portography was performed, emergency EIS was carried out, following which the serum total bilirubin level markedly increased, mainly with a direct fraction, until it reached 70 mg/dl. The patient eventually died from acute liver failure with extreme hyperbilirubinemia on the 27th day after experiencing hematemesis despite all treatment. This unfortunate case demonstrates that sclerotherapy could be an inappropriate method of treatment for patients with hemolytic disease.
Volcanic Eruptions of Cendres Island (1923) HASHIZUME, M.
SECOND SERIES BULLETIN OF THE VOLCANOLOGICAL SOCIETY OF JAPAN,
1987/10/15, Letnik:
32, Številka:
3
Journal Article
We examined the preventive effect of metoclopramide on the development of esophageal varices in a rat model. Thirty rats were divided into three groups: metoclopramide (7.5 mg/kg twice a day, ...intraperitoneally), control group I (saline 2 ml/kg twice a day, intraperitoneally), and control group II (incised lower esophageal sphincter and metoclopramide 7.5 mg/kg twice a day, intraperitoneally). On the 14th postoperative day, lower esophageal sphincter pressure in the metoclopramide group (8.6 +/- 1.4 cm H2O) increased more than in the control groups (5.4 +/- 0.5, 5.0 +/- 0.5 cm H2O, P < 0.01). Development of small collateral vessels from the spleen to the retroperitoneum was evident only in the metoclopramide group, as seen on the portography (P < 0.01). Histologically, the variceal area of the horizontal cross section of the esophagus in the metoclopramide group (0.62 +/- 0.26 mm2) was significantly smaller than in the controls (2.67 +/- 0.95, 2.78 +/- 0.82 mm2), determined using an image processor-analyzer for photographing histological specimens (P < 0.01). We also investigated the effect of metoclopramide on smooth muscle cells in the rat portal vein, using isometric-tension recording. Metoclopramide relaxed the smooth muscle precontracted with norepinephrine, in a concentration-dependent manner. Thus, metoclopramide inhibits the development of esophageal varices in this rat model due to both an increase in resistance of the lower esophagus and to development of small collaterals.
