Anomalies of the tracheobronchial tree in patients with esophageal atresia

Bone marrow examination revealed a lipid-laden histiocytosis in seven patients undergoing long-term total parenteral nutrition necessitated by extensive short-bowel surgical resection. Clinical abnormalities occurred during this treatment which required bone marrow examination. These included hepatosplenomegaly and peripheral blood cytopenia; the median time to the detection of these abnormalities was 64 months. The most striking change within the bone marrow was the presence of many pigment-laden histiocytes which had the typical morphology of sea-blue histiocytes seen in the so-called idiopathic sea-blue histiocyte syndrome. The occurrence of sea-blue histiocytosis in the bone marrow in association with long-term parenteral nutrition for short-bowel syndrome has not, to our knowledge, been reported previously and should now be considered in the differential diagnosis of bone marrow sea-blue histiocytosis.     

A novel therapeutic approach for rectal varices: a case report of rectal varices treated with double balloon-occluded embolotherapy

We present a patient with continuous melena, diagnosed as rectal varices bleeding. She had a history of esophageal varices, which was treated by endoscopic ligation therapy. Eight years after the treatment of esophageal varices, the continuous melena began. Colonoscopic examination showed that the melena was caused by rectal varices, which were so severe that they could not be treated by either endoscopic sclerotherapy or surgical devascularization. Taking into considering the overall risk of treating rectal varices, we chose the approach of double balloon-occluded embolotherapy (DBOE) with 5% ethanolamine oleate with iopamodol as a liquid embolic material. DBOE is one of the interventional radiology techniques (Morita et al., Acta Hepatol Jpn 1994;35:109-120), but in this case was a completely new and novel clinical procedure for rectal varices. After the DBOE therapy, the condition of rectal varices was markedly improved. Thus, DBOE might be a new tool for treating inoperable rectal varices.     

Electrotunable Non‐reciprocal Laser Emission from a Liquid‐Crystal Photonic Device

A liquid crystal (LC) photonic device with an anisotropic optical heterojunction structure has been fabricated. The device has a phase‐retarding nematic LC (NLC) layer sandwiched between two polymer cholesteric LC films with right‐handed helices of different pitches. Electrotunable non‐reciprocal light transmittance and unidirectional circularly polarized (CP) lasing emission have been successfully demonstrated for this device structure. Two left CP (LCP) lasing emission peaks are observed at the edges of the overlapping region between the two photonic bands in the structure and are shifted upon the application of a voltage. In contrast, a non‐reciprocal right CP (RCP) lasing emission peak emerges at one of the band edges and diminishes upon the application of a voltage. These phenomena are interpreted based on the selective reflection of RCP light and the reorientation of the NLC molecules by the application of a voltage.     

TRVs and fault clearing stresses in extra-high-voltage radial networks

To cope with the high rate of increase of power demand in the main industrialized districts in Japan, 550-kV transmission systems covering the districts have been reinforced, with most of the main power plants connected directly to these systems. Through 550-/300-kV substations, the majority of power to the districts is supplied by 300-kV systems. To limit the excess short-circuit capacity in the 300-kV systems, they tend to be reconstructed as so-called radial networks. In radial networks with high short-circuit capacity and relatively small number of transmission lines connected to the substation busbars, the rate of rise of TRV can be far higher than standard value. This paper analyzes the transient recovery voltages (TRV) in such extra-high-voltage radial networks in Japan, together with the relevant stresses to circuit-breakers during fault clearings. Future system conditions have also been introduced. As the typical rate of rise of the TRV values, more than twice that of today's standard ones are probable.     

Some experimental findings in compression-after-impact (CAI) tests of CF/PEEK (APC-2) and conventional CF/epoxy flat plates

Compression-after-impact (CAI) tests have been conducted for quasi-isotropic thick plates with 48 plies by using the NASA method and on plates with 32 plies by using the SACMA method. Specimens are made of CF/PEEK (APC-2) and conventional CF/epoxy for the NASA plates and CF/epoxy for the SACMA plates. In the NASA CAI tests, the sequence of delamination buckling and its propagation is clearly revealed through various experimental techniques. One major technique is moiré topography, and the other is thermo-mechanical stress analysis with a high-accuracy infrared sensor. The arrest of delamination propagation just before catastrophic failure due to high fracture toughness is clearly captured by the moiré camera. This behavior provides good CAI values of CF/PEEK. The initial buckling properties of the delaminated region by the impact are then extensively discussed. Numerical predictions of initial buckling stress have been obtained by modelled geometry of the delaminated region simplified from its precise structure clarified by ultrasonic C-scanning. They agree fairly well with the experimental results. The in-plane stress distribution in the delaminated region before initial buckling is measured by an infrared stress graphic system. This compared favorably with finite element predictions. Two types of symmetric buckling modes with respect to the central plate surface, twin and single peak ones, are experimentally captured.     

Can EC-IC bypass prevent brain ischemia from recurring?

The effectiveness of extracranial-intracranial arterial bypass (EC-IC bypass) surgery for patients with hemodynamic compromise still remains controversial. In the present study, we evaluated the correlation between the pre- and post-surgical cerebral hemodynamics and long-term prognosis. 28 patients and a subsequent 21 patients (41 men, eight women: mean age 59.9 [S.D. 8.6] years) with reduced cerebrovascular reserve due to steno-occlusive disease of the cerebral major arteries formed the study groups 1 and 2, respectively. Measurement of the mean hemispheric cerebral blood flow (mCBF) and the cerebral vasoreactivity (%mCVR) with an intravenous acetazolamide injection were performed by a 133Xe inhalation method and SPECT. Patients were treated with EC-IC bypass surgery and measurement of mCBF and %mCVR were made again about one month after surgery. The patients were observed for a long period (mean 44.3 months). During the follow-up period, 6 patients experienced recurrent ischemic strokes. The annual incidence of recurrent ischemic stroke was 4.4%. The patients with significantly reduced pre- and post-surgical resting mCBF of the affected hemisphere were at significantly higher risk of recurrent ischemic stroke than the patients with normal mCBF (p < 0.01). The %mCVR of the affected hemisphere rose after surgery.     

Disaccharide analysis of human skin glycosaminoglycans in sun-exposed and sun-protected skin of aged people

The negative conduction effect of quinidine on each of the successive phases of the ventricular depolarization was investigated using an original noninvasive method: the spatial velocity electrocardiogram of the QRS complex (SVECG-QRS). We performed a randomized placebo-controlled trial in 10 healthy subjects with a single oral dose of quinidine (330 mg) or placebo. Electrocardiographic acquisition and processing (220 recordings for the complete trial) were performed using the Lyon vectorcardiographic program. For each SVECG-QRS curve, the position of seven specific points from A (onset of QRS) to G (end of QRS) were determined precisely. The six successive time intervals between these points (AB-FG) and five velocity values (B-F) were then calculated. The QRS complex was longer under quinidine than placebo (102.4 +/- 1.6 vs. 100.3 +/- 1.5 ms). The difference was at the periphery of statistical significance (p = 0.05), and this lack of statistical difference may be mainly due to the low serum levels of quinidine obtained at the peak of the concentration (1.46 +/- 0.4 mg/1). All six QRS time intervals were longer under quinidine, but only the BC interval was significantly different (9.3 +/- 1.1 vs. 18.8 +/- 1.1 ms; p < 0.05) suggesting a more pronounced negative conduction effect at the onset of ventricular depolarization. No significant modifications were observed for the velocity values. We conclude that (1) the negative conduction effect of quinidine is heterogeneous, but a further study with a higher dose of quinidine (concentration-dependent effect) is required to confirm this hypothesis and (2) the spatial velocity electrocardiogram of the QRS complex allows a detailed analysis of the ventricular conduction phases. The results of the measurement were found to be reproducible. This noninvasive tool could be used in clinical practice to assess effects of antiarrhythmic drugs on successive ventricular depolarization phases.