Successful embolization assisted by covered stents for a pseudoaneurysm following pancreatic surgery

Delayed intra-abdominal hemorrhage after pancreatic surgery is a potentially lethal complication.Transarterial coil embolization and/or the placing of an endovascular stent are minimally invasive and effective procedures.An artery that is extensively eroded and rendered friable due to operative skeletonization or postoperative inflammation sometimes contributes to delayed intra-abdominal hemorrhage or rebleeding after coil embolization.This report presents a case of successful management of postoperative hemorrhage in a-74-year-old Japanese male.He experienced bleeding from a pseudoaneurysm of the brittle hepatic artery following total pancreatectomy.Initially the pseudoaneurysm was successfully treated with covered coronary stent-grafts,but rebleeding occurred 1 mo later due to the brittleness of the artery.Rebleeding was definitively managed by the complete packing of the stent by coil embolization.He remains stable at 18 mo following the f inal embolization.A stent graft can be used for protecting a brittle artery to avoid injury by coil embolization.

HER2-positive adenocarcinoma arising from heterotopic pancreas tissue in the duodenum:A case report

BACKGROUND Adenocarcinoma originating from heterotopic pancreas tissue is a rare disease.Furthermore,to our knowledge,no HER2-positive cases in the duodenum have been reported in the scientific literature nor has the efficacy of trastuzumab treatment for the disease been reported.CASE SUMMARY A 65-year-old woman whose clinical diagnosis was unresectable advanced duodenal cancer with HER2 overexpression responded well to trastuzumab chemotherapy.The main tumor in the duodenum reduced drastically.The patient underwent pancreaticoduodenectomy and lymph node dissection.A small number of cancer cells remained in the submucosal layer of the duodenum and pancreas head.After histological and immunohistochemical examination,the patient was diagnosed with duodenal adenocarcinoma originating from heterotopic pancreas tissue.CONCLUSION Trastuzumab treatment is effective in HER2-positive adenocarcinoma originating from heterotopic pancreas tissue in the duodenum.

Differentiation of premacular hemorrhages with niveau formation

Dear Editor,W e present three anatomical forms of premacular hemorrhage with niveau formation:hemorrhage in posterior precortical vitreous pocket(intrapocket hemorrhage),sub-internal limiting membrane(ILM)hemorrhage,and premacular retrocortical hemorrhage.Niveau formation is the formation of a horizonal boundary between fluid and blood cells when they accumulate in a closed space,because blood cells with higher specific gravity settle in a standing position.

L-Serine Decreases Taurine Concentration in the Extracellular Fluid of Brain Slices

L-Serine is considered a functional amino acid in the central nervous system, and induces sedation and hypnotic effects in some animal models of acute and chronic stress. Accordingly, while L-serine is a candidate anti-stress factor, the central mechanism of L-serine is not clear. The present study clarifies the action of L-serine using acute chick brain slices. We investigated the changes in some extracellular fluid amino acid concentrations in response to L-serine perfusion. Taurine concentration decreased while L-alanine concentration increased following L-serine perfusion. To examine the involvement of the taurine transporter, the effect of L-serine on the taurine concentration in the presence and absence of Na+ was also investigated. Na+ had no effect on taurine concentration induced by L-serine perfusion. These results suggest that L-serine has an ability to promote L-alanine synthesis facilitating the catabolism of taurine. In conclusion, L-serine modifies the metabolism of taurine and L-alanine in the extracellular space in chick brain.

Bacteriostatic Effects of Hyaluronan-Based Bioresorbable Membrane

Purpose: The purpose of this study is to determine the presence of bacteriostatic effects of hyaluronan-based bioresorbable membrane (HA/CMC) on selected major bacterial strains in digestive organs. Methods: We firstly evaluated the growth inhibition effect of HA/CMC for E. coli and S. aureus by determining the optical density (OD)650 in the incubation medium. At second, to determine the viable counts of bacteria, total adenosine triphosphate (ATP) were measured with five groups;several concentrations of HA/CMC and control. Results: OD curve gradually elevated and reached to plateau at 4 hours in E. coli. and 6 hours in S. aureus. After reaching plateau, the growth inhibition of both strains was statistically significantly correlated to the concentrations of HA/CMC. The ATP productions had statistically significant differences at 6 hours after incubation and inhibited in dose-dependence of a well-dissolved HA/CMC. Conclusion: HA/CMC may have dose-dependently bacteriostatic effects on S. aureus and E. coli.

Correlation between Alzheimer’s Disease and Dementia with Lewy Bodies Scores Using VSRAD Advance

The objective of the study was to explore the relationship between the indicators of Alzheimer’s disease and dementia with Lewy bodies using the voxel-based specific regional analysis system for Alzheimer’s Disease (VSRAD) advance. Among 36 patients with suspected dementia, patients with Alzheimer’s disease and dementia with Lewy bodies were identified using VSRAD advance from March 1 to October 30, 2019. All patients underwent brain Magnetic Resonance Imaging (MRI). We diagnosed Alzheimer’s disease using Volume of Interest (VOI) in the Medial Temporal Lobe (MTL) atrophy ratio > 2 and dementia with Lewy bodies using both VOI in the MTL atrophy ratio ≤ 2 and gray/white matter atrophy ratio ≥ 0.2. The correlation between the indicators of Alzheimer’s disease and dementia with Lewy bodies was calculated. The number of patients classified as having Alzheimer’s disease and dementia with Lewy bodies was 25 and 11, respectively. In the Alzheimer’s disease group, the correlation coefficient between the extent of gray matter atrophy and the severity of atrophy in the dorsal brainstem gray matter was r = -0.40 (p = 0.045). In dementia with Lewy bodies group, the correlation coefficient between the extent of gray matter atrophy and the severity of atrophy in the dorsal brainstem white matter was r = -0.78 (p < 0.01). Using VSRAD advance, gray matter atrophy and dorsal brainstem grey/white matter atrophy were found to be negatively correlated in Alzheimer’s disease and dementia with Lewy bodies.

Compensatory enlargement in transplant coronary artery disease: an intravascular ultrasound study

Background It is unclear to what extent the ＂Glagov phenomenon＂ occurs in transplant coronary artery disease （TCAD）. The objective of this study was to evaluate the relationship between intimal hyperplasia and compensatory enlargement in TCAD. Methods Intravascular ultrasound imaging was performed on 190 cardiac transplant recipients at （1.4±0.6） months and again （12.1±0.7） months after cardiac transplantation. Studies 1 year apart were matched at 625 sites. There were 545 coronary artery sites that had an increase in intimal area 〉10% from baseline to one year, and this comprised the data set of the present study. Results At the first year, 91% of coronary artery sites with intimal growth had a total cross-sectional area stenosis ≤40%, but 38% of the sites showed a decrease of 〉10% in lumen area. Receiver operating characteristic curve demonstrated that the change in cross-sectional area stenosis cut-off level at year 1 was 8% with a sensitivity of 75% and a specificity of 82% in predicting lumen loss. At a total cross-sectional area stenosis of 20%, sensitivity was 65% with a specificity of 81% in predicting lumen loss. Conclusions In TCAD, vessel enlargement as a compensatory mechanism for plaque growth is generally inadequate. Instead of continued vessel expansion, luminal narrowing develops when there is more than 8% cross-sectional area filled with intimal hyperplasia. In distinction to native coronary artery atherosclerotic disease, the transition point in transplant vasculopathy where the lumen is diminished by increasing intimal growth, occurs at a lower threshold, 20% vs 40% of vessel crossectional area.

Low-temperature catalytic preparation of multi-wall MoS_(2)nanotubes

In the catalytic reduction atmosphere of H_2+CH_4+C_4H_4S, the ball-milledprecursor (NH_4)_2MoS_4 is heated to 300℃ for decomposition. The as-synthesized product ischaracterized by XRD, SEM, TEM, HRTEM, EDX, and BET. The results show that multi-wall MoS_2nanotubes are obtained. The length of the nanotubes is around 3 - 5 μm. The diameters of thenanotubes are homogeneous, with an inner diameter of ～15 nm, an outer diameter of ～ 30 nm, and aninterlayer (002) d-spacing of 0.63 nm. This catalytic thermal reaction occurring at low temperaturesis important for the large-scale preparation of similar transition-metal disulfide nanotubes.

锡金喜马拉雅地区的农业：保护与发展具有全球意义的传统农业系统

锡金喜马拉雅地区是全球重要的生物多样性热点地区之一,该地区的农业生产系统最近已经被推荐作为联合国粮农组织(FAO)全球重要农业文化遗产(GIAHS)保护的候选地。在这一地区,集中体现了被称为Demazong(稻米之谷)或香格里拉(消失的地平线)的神圣景观。这个神圣的、多样性的文化景观中,当地少数民族社区利用传统的生态知识对极为丰富的农业生物多样性进行适应和管理。多样化的农业生态系统,包括位于高山地区农牧复合系统Dokpas,位于温带地区的传统的农林复合系统(如桤木-草本混交农业系统),以及海拔较低的暖温带到亚热带农业气候区的梯田/谷地稻作系统。将富含文化多样性和生物多样性的土地利用系统与景观进行边缘化是一件十分荒谬的事情。但值得说明的是,尽管这里有着巨大的发展潜力,却长期存在着贫穷、进入市场困难、经济和生态较为脆弱等问题。锡金喜马拉雅地区的农业是一种典型的适应性管理系统,具有重要的生态系统服务功能,提供了具有重要经济价值的多样化的农作物品种,以及适应明显垂直分异农业生态区的多用途的植物物种。在那里生活着的不同的土著社区,依然保持着传统的生态知识,以适应、监测和响应生态系统的恢复能力与生态系统的服务功能。在本文中,我们探讨了传统农业在生物多样性保护中的作用,评估了从亚热带到高原农业生态区的多样性的生态系统管理途径,分析了对于农业生态系统的社会适应性与知识基础以及传统体制在促进该地区农业生产系统通过GIAHS在地区、国家和全球水平上获得更加广泛的认可的作用。我们认为,为减轻气候变化的可能影响和应对可能的新挑战,应当采用参与式的方式对传统农业进行监测,并制定科学的政策。锡金喜马拉雅地区的传统农业被认定为全球重要农业文化遗产,将有助于促进这一传统农业系统的保护,促进边际社区的环境健康和生计的可持续性,确保该地区的可持续发展。