Endoscopic retrograde cholangiopancretography in modified double tracks anastomosis with anastomotic stenosis

A 63-year-old man presented at our hospital with right upper abdomen pain and fever for 4 d.The patient's magnetic resonance cholangiopancreatography revealed dilated common bile duct and choledocholithiasis.In his past history,he received proximal gastrectomy and modified double tracks anastomosis.Endoscopic retrograde cholangiopancretography in modified double tracks anastomosis,especially accompanied with anastomotic stenosis,has been rarely reported.In the present case,the duodenoscope was successfully introduced over the guidewire and the stone taken out using a basket.The patient had good palliation of his symptoms after removal of the stone.

Three-Dimensional Structure and Low-Level Features of the North Pacific Storm Track from 1999 to 2005

A storm track is a region in which synoptic eddy activities are statistically most prevalent and intense. At daily weather charts, it roughly corresponds to the mean trajectories of cyclones and anticyclones. In this paper, the recent QuikSCAT （Quick Scatterometer） satellite sea winds data with a 0.5°×0.5° horizontal resolution, and the NCEP （National Centers for Environmental Prediction） 10-m height Gaussian grid wind data and pressure-level reanalysis data, are employed to document the spatial structure of the North Pacific storm track in winter （January） and summer （July） from 1999 to 2005. The results show that in winter the North Pacific storm track is stronger, and is located in lower latitudes with a distinct zonal distribution. In summer, it is weaker, and is located in higher latitudes. Based on the horizontal distributions of geopotential height variance at various levels, three-dimensional schematic diagrams of the North Pacific storm track in winter and summer are extracted and presented. Analyses of the QuikSCAT wind data indicate that this dataset can depict the low-level storm track features in detail. The double storm tracks over the Southern Oceans found by Nakamura and Shimpo are confirmed. More significantly, two new pairs of low-level storm tracks over the North Pacific and the North Atlantic are identified by using this high-resolution dataset. The pair over the North Pacific is focused in this paper, and is named as the ＂subtropical storm track＂ and the ＂subpolar storm track＂, respectively. Moreover, statistical analyses of cyclone and anticyclone trajectories in the winters of 1999 to 2005 reveal as well the existence of the low-level double storm tracks over the North Pacific.