A minimally invasive multiple percutaneous drainage technique for acute necrotizing pancreatitis

BACKGROUND: In approximately 20% of patients, necrotizing pancreatitis is complicated with severe acute pancreatitis, with high morbidity and mortality rates. Minimally invasive step-up approach is both safe and effective, but sometimes requires multiple access sites.METHODS: A 62-year-old woman was admitted with diabetic ketoacidosis, and initial computed tomography(CT) revealed no evidence of acute pancreatitis. She was clinically improved with insulin therapy, fl uid administration, and electrolyte replacement. However, on the 14 th day of admission, she developed a high-grade fever, and CT demonstrated evidence of acute necrotizing pancreatitis with a large collection of peripancreatic fl uid. Percutaneous transgastric drainage was performed and a 14 French gauge(Fr) pigtail catheter was placed 1 week later, which drained copious pus. Because of persistent high-grade fever and poor clinical improvement, multiple 8 and 10 Fr pigtail catheters were placed via the initial drainage route, allowing the safe and effective drainage of the extensive necrotic tissue that was occupying the bilateral anterior pararenal space.RESULTS: After drainage, the patient recovered well and the last catheter was removed on day 123 of admission.CONCLUSIONS: Multiple percutaneous drainage requires both careful judgment and specialist skills. The perforation of the colon and small bowel as well as the injury of the kidney and major vessels can occur. The current technique appears to be safe and minimally invasive compared with other drainage methods in patients with extended, infected necrotic pancreatic pseudocysts.

Survival from cardiac arrest due to sushi suffocation

BACKGROUND: Sushi suffocation is relatively uncommon, and it is an unignorable cause of sudden death; however, no reports on sushi suffocation have been published.METHODS: A 60-year-old man was referred to our hospital for post resuscitative intensive care. He had choked on sushi and collapsed in the dining room of a mental hospital. A nursing assistant summoned a physician who attempted to extract the sushi. External cardiac massage was initiated after 7 minutes had elapsed and followed by endotracheal intubation. Return of spontaneous circulation was achieved after 7 minutes of resuscitation. A bronchoscopy demonstrated a large amount of shari in the trachea and right bronchus, which was removed with alligator forceps and a wire basket.RESULTS: Neurological recovery was evident on day 2 of admission. He was transferred back to the mental hospital with no neurological complications.CONCLUSION: Emergency physicians should consider sushi suffocation, including its clinical features and management.

Beat-to-Beat Variability in Field Potential Duration in Human Embryonic Stem Cell-Derived Cardiomyocyte Clusters for Assessment of Arrhythmogenic Risk, and a Case Study of Its Application

We established a QT interval assessment system that uses human embryonic stem cell-derived cardiomyocyte clusters (hES-CMCs) in which the field potential duration (FPD) or corrected FPD (FPDc) was measured as an indicator of drug-induced QT interval prolongation. To investigate the applicability of the hES-CMC system to drug safety assessment, we investigated short-term variability in FPDc (STVFPDc) (beat rate rhythmicity) as a marker of torsadogenic risk. We investigated the FPDc and STVFPDc of hES-CMCs treated with hERG channel blockers (E-4031 or cisapride) or with our proprietary compounds X, Y, and Z. We also evaluated the electrocardiograms and hemodynamics of dogs treated with compound X, Y, or Z. The torsadogenic hERG channel blockers increased STVFPDc and prolonged FPDc. Compounds X, Y, and Z had hERG inhibitory activity. Compound X prolonged FPDc with increased STVFPDc, whereas compounds Y and Z tended to shorten FPDc in the hES-CMC system. In the in vivo canine study, compound X prolonged corrected QT (QTc), and compounds Y and Z tended to shorten QTc, showing a good correlation with the results in hES-CMCs. These findings suggest that combined assessment of FPDc and STVFPDc in the hES-CMC system increases the predictability of torsadogenic risk.

Cultivation Features Using Meteorological and Satellite Data from 2001 to 2010 in Dakhla Oasis, Egypt

The differences between the oasis region and the regions of the Nile delta and Nile valley in Egypt are due mainly to the regions’ access to water. The oasis region depends on underground water, while the other regions rely on the Nile River. Numerous studies on cultivation in the Nile delta have been accumulated. However, few studies have addressed cultivation in the oasis region. This study examines cultivation throughout the government and local well districts using meteorological and satellite data from 2001 to 2010, and the interview in Rashda Village, Dakhla Oasis. Since the reference evapotranspiration (ET0) is lower in winter than in summer, cultivation in winter makes sense from the viewpoint of saving irrigation water. Evapotranspiration is highest in the order of date palm, rice paddy, winter wheat, and clover hay under sufficient wet conditions in Rashda Village. Cultivation features and water requirements were examined using the Normalized Difference Vegetation Index (NDVI) and Normalized Difference Water Index (NDWI). Results indicated a distinct difference in cultivation systems between the summer and winter seasons in the government well district. Water requirements for date palm in the local well district were 2.6 times those for winter plants in the government well district, using the accumulated NDWI value.

Thyroid hormone alterations in trauma patients requiring massive transfusion: An observational study

BACKGROUND: Although non-thyroidal illness syndrome(NTIS) is considered a negative prognostic factor, the alterations in free triiodothyronine(f T3) levels in trauma patients requiring massive transfusion have not been reported.METHODS: A prospective observational study comparing 2 groups of trauma patients was conducted. Group M comprised trauma patients requiring massive transfusions(>10 units of packed red blood cells) within 24 hours of emergency admission. Group C comprised patients with an injury severity score >9 but not requiring massive transfusions. Levels of f T3, free thyroxine(f T4), and thyroidstimulating hormone(TSH) were evaluated on admission and on days 1, 2, and 7 after admission. The clinical backgrounds and variables measured including total transfusion amounts were compared and the inter-group prognosis was evaluated. Results are presented as mean±standard deviation.RESULTS: Nineteen patients were enrolled in each group. In both groups, 32 were men, and the mean age was 50±24 years. In group C one patient died from respiratory failure. The initial f T3 levels in group M(1.95±0.37 pg/m L) were signifi cantly lower than those in group C(2.49±0.72 pg/m L; P<0.01) and remained low until 1 week after admission. Initial inter-group f T4 and TSH levels were not significantly different. TSH levels at 1 week(1.99±1.64 μIU/m L) were higher than at admission(1.48±0.5 μIU/m L) in group C(P<0.05).CONCLUSION: Typical NTIS was observed in trauma patients requiring massive transfusions. When initial resuscitation achieved circulatory stabilization, prognosis was not strongly associated with NTIS.

利用丹宁酸处理生丝制造异收缩纱

通过赋予纱线不规则的卷缩,使得蚕丝具有柔软的手感和蓬松性,并且,如果这种材料具有极好的拉伸弹性和可纺性能,那么,蚕丝的用途将延伸到西服面料领域。在热和硝酸钙溶液作用下,家蚕丝和野蚕丝的缩率不同。家蚕丝表现出明显的收缩和膨化而野蚕丝则没有。将纤度相同的家蚕丝和野蚕丝并合,加捻,制成混合纱,然后再经盐缩,分纤处理,发现纱线具有柔软的手感、良好的弹性模量、挠曲性能和优良的回弹性。这是由于家蚕丝和野蚕丝缩率不同造成的。最近。