Safety and efficacy of transarterial embolisation for treatment of dorsal pancreatic artery haemorrhage.

AIM: To evaluate the safety and efficacy of transarterial embolisation (TAE) of dorsal pancreatic artery (DPA) haemorrhage. MATERIALS AND METHODS: Nineteen consecutive patients (M:F = 16:3, mean age 59.6 years) who underwent TAE of DPA in three tertiary medical centres between January 2001 to January 2020 were reviewed retrospectively. Angiographic features and the technical and clinical outcomes of TAE were analysed. RESULTS: The clinical presentations were a bloody drain from the Jackson-Pratt drainage tube (n=8), melaena (n=7), abdominal pain (n=4), and haematochezia (n=3). Angiographic findings included pseudoaneurysm (n=14), contrast media extravasation (n=4), or abrupt cut-off of the arterial branch (n=1). The NBCA (N-butyl-cyanoacrylate; n=4), microcoils (n=4), and a combination of these agents (n=7) were used as embolic agents. The most common origin of the DPA in the present study cohort was the splenic artery (n=7), followed by the coeliac trunk (n=4), common hepatic artery (n=4), and superior mesenteric artery (n=4). Technical and clinical success rates were 100% and 84.2% (16/19), respectively. Of the three clinically unsuccessful cases, two patients were revealed to have newly developed bleeding from another artery. The other patient expired 1 day after the TAE procedure due to a progression of hepatic failure. In one patient, an asymptomatic non-target embolisation occurred in the right posterior tibial artery as a procedure-related complication. No major complications were observed. CONCLUSION: TAE is safe and effective for the management of bleeding from the DPA. It is important to be aware of the DPA as a potential bleeding source, including the relevant clinical characteristics.

Femtosecond Probing of Plasma Wakefields and Observation of the Plasma Wake Reversal Using a Relativistic Electron Bunch.

We show that a high-energy electron bunch can be used to capture the instantaneous longitudinal and transverse field structures of the highly transient, microscopic, laser-excited relativistic wake with femtosecond resolution. The spatiotemporal evolution of wakefields in a plasma density up ramp is measured and the reversal of the plasma wake, where the wake wavelength at a particular point in space increases until the wake disappears completely only to reappear at a later time but propagating in the opposite direction, is observed for the first time by using this new technique.

Arabidopsis thaliana Yellow Stripe1-Like4 and Yellow Stripe1-Like6 localize to internal cellular membranes and are involved in metal ion homeostasis.

Several members of the Yellow Stripe1-Like (YSL) family of transporter proteins are able to transport metal-nicotianamine (NA) complexes. Substantial progress has been made in understanding the roles of the Arabidopsis YSLs that are most closely related to the founding member of the family, ZmYS1 (e.g., AtYSL1, AtYSL2 and AtYSL3), but there is little information concerning members of the other two well-conserved YSL clades. Here, we provide evidence that AtYSL4 and AtYSL6, which are the only genes in Arabidopsis belong to YSL Group II, are localized to vacuole membranes and to internal membranes resembling endoplasmic reticulum. Both single and double mutants for YSL4 and YSL6 were rigorously analyzed, and have surprisingly mild phenotypes, in spite of the strong and wide-ranging expression of YSL6. However, in the presence of toxic levels of Mn and Ni, plants with mutations in YSL4 and YSL6 and plants overexpressing GFP-tagged YSL6 showed growth defects, indicating a role for these transporters in heavy metal stress responses.

Backward Raman amplification in a plasma waveguide.

Backward Raman amplification of a short laser pulse in a plasma waveguide is demonstrated. With a guided seed pulse of 0.8-microJ energy and a pump pulse of 345-mJ energy in a 9-mm-long optically preformed plasma waveguide, 910-fold energy amplification is achieved. Heating of the plasma by the long pump pulse is identified to be a key issue for plasma-waveguide-based backward Raman amplifiers.

Control of laser-beam propagation and absorption in a nanoplasma gas by programming of a transient complex refractive index with a prepulse.

By utilizing the intensity- and duration-dependent heating and expansion rate of nanoplasma to generate a transient transverse gradient of the refractive index, prepulse controlled laser-beam propagation is demonstrated. The dynamical response of the macroscopic optical refractive index is traced back to the microscopic polarizability of nanoplasmas experimentally, in accordance with hydrodynamic nanoplasma models. In particular, the delay between the prepulse and the main pulse for maximum Rayleigh scattering is found to be longer than that for maximum x-ray emission, supporting the more refined one-dimensional self-consistent hydrodynamic nanoplasma model.

Secretory origin and temporal appearance of the porcine beta-microseminoprotein (sperm motility inhibitor) in the boar reproductive system.

A specific antiserum against the porcine sperm motility inhibitor (SMI) was used in Western blotting analysis of tissue homogenates to reveal the possible origin of SMI in the boar reproductive system at different ages. The ages of the boar used were day 0, day 15, day 30, day 60, day 100, day 120, day 135, day 150, and day 210. The tissue homogenates of the day 60 and older showed immunoreaction. The results were further checked by indirect immunohistochemical staining and observed under light microscope. The SMI antigen appeared in the epithelial cells and in the lumen of the secretory ducts of the prostate gland. These results indicate that porcine SMI is synthesized only by the postnatal prostate gland. The homogenate of the prostate gland of day 100 was also used for the purification of SMI. The prostatic SMI was co-eluted with the seminal SMI in the reversed phase HPLC. Mass spectrometric analysis of the prostatic SMI revealed a molecular weight of 10,066. These results indicate that the prostatic SMI is identical to that purified from seminal plasma (Jeng et al., 1993; Biochem Biophys Res Communi 191:435-440).

Proton beam irradiation of subfoveal choroidal neovascularisation in age-related macular degeneration.

PURPOSE: To assess the safety and potential toxicity of proton beam radiation in the treatment of subfoveal choroidal neovascular membrane (CNVM) due to age-related manner degeneration (ARMD) in a prospective, non-randomised study. METHODS: Forty-eight eyes of 46 consecutive patients with subfoveal CNVM due to ARMD, not amenable to laser photocoagulation, were treated prospectively with a single proton beam exposure. Two dose regimens were evaluated: 8 CGE (Cobalt Gray Equivalent) and 14 CGE. Patients were followed for an average of 22.1 months after proton beam treatment. RESULTS: At the 12 month follow-up, 44% of eyes in the 8 CGE group and 75% of the eyes in the 14 CGE group had stabilized or improved visual acuity. Complex size in the 8 CGE group as measured on standard fluorescein angiography (FA), decreased or had no change initially but showed less effect over time, while the eyes treated with 14 CGE maintained decreased leakage over the follow-up period of 12 months. However, 11 eyes in the 14 CGE group experienced radiation retinopathy, with the onset between 3 and 30 months. Seven of these 11 eyes have demonstrated some visual loss but only 1 eye developed severe visual loss at 15 months after proton treatment. CONCLUSIONS: To date, 14 CGE has suggested a favourable influence on visual function and growth inhibition of CNVM. Proton beam irradiation appears to inhibit CNVM growth. The 14 CGE dose regimen appears to have a longer effect of CNVM growth than does 8 CGE, with overall stabilisation of visual function and growth inhibition. Radiation retinopathy has developed over time, but severe visual loss has been limited. On the basis of the incidence of radiation retinopathy, adjustments in the total radiation dosage and/or fractionation of the dosage should be considered.

[Effect of early intervention on the interaction of developmentally delayed infants and their mothers].

The purpose of this study was (1) to examine the interaction patterns of mothers and their developmentally delayed infants during free play and instructional episodes; (2) to investigate the influence of an early intervention program on the interaction patterns of mothers and their developmentally delayed infants; and (3) to investigate to what extent the maternal perceptions and expectations, perceived stress and involving motivation were associated with maternal behavior while interacting with their developmentally delayed infants. The participants of this study were twenty-one developmentally delayed infants and their mothers. Each mother-child dyad was videotaped in a laboratory playroom for 10-minutes of free play and a 5-minute instructional session. Mental and psychomotor development of the child were measured by Bayley scale. The perception of child development, expectation, and the stress of mothers were measured by a self-report questionnaire which was designed by a researcher in this study. The mothers' motivation of involvement was evaluated by teachers. On year after early intervention, it was found that (1) developmentally delayed infants increased locomotion, (2) mothers demonstrated more positive emotional expression during mother-child interaction, and (3) the score of HOME, mother's involvement, and the quality of mother-child interaction which was evaluated by teachers were significantly increased. Furthermore, the differences between situations indicated that the developmentally delayed infants were more toy-oriented during play than instruction. The mothers tended to be more helpful in attitude while they instructed their children. The mother's perception of child development and stress were found to be the critical factors affecting maternal teaching, controlling, and caring behavior.

Mortality of Mexican Americans with NIDDM. Retinopathy and other predictors in Starr County, Texas.

OBJECTIVE: To determine the rate and risk factors of mortality in a cohort of Mexican Americans with NIDDM. RESEARCH DESIGN AND METHODS: A cohort of 353 Mexican Americans with NIDDM were identified between 1981 and 1986. All individuals underwent extensive evaluations that included physical, historical, ophthalmological, and laboratory assessments. This cohort was followed prospectively for a mean of 8 yr. Follow-up included mortality surveillance, death certificate extraction, and a combination of annual and intermediate examinations. RESULTS: The cohort experienced 67 mortality events. One-third of all deaths were premature < 65 yr of age) and most often were attributed to diseases of the heart (60.0%). In no case was diabetes listed as the cause of death, although it was listed as a contributing cause in 25.5% of cases. Men had a higher mortality rate than women. In both sexes, baseline retinopathy was identified as an important predictor of subsequent mortality. Mortality was significantly elevated in those with nonproliferative retinopathy and even further elevated in those with proliferative disease (relative risks of > or = 4 for proliferative disease). CONCLUSIONS: Mexican Americans with NIDDM are experiencing premature and excessive mortality compared with the general population. The results clearly link microvascular complications with macrovascular disease, but this link is not explained by a more untoward profile of traditional cardiovascular risk factors. Retinopathy appears to serve as an important monitor of the progression of diabetes and when identified would warrant aggressive action to inhibit or slow the processes leading to subsequent mortality.

The pattern electroretinogram in diabetes.

In 27 normal subjects and 64 insulin-dependent diabetic patients, we evaluated the pattern electroretinogram, which may reflect the neural activity of the spatially sensitive retinal ganglion cells. The amplitude of the pattern electroretinogram was reduced in diabetic patients who had no observable retinal changes. The amplitude was further reduced with increasing retinopathy. The pattern electroretinogram amplitude change was a more sensitive indicator of retinal change among the diabetic subpopulations than the statistically significant changes in latency. A significant correlation between pattern electroretinogram amplitude and the duration of diabetes were found in diabetic patients with either no observable retinopathy or minimal background retinopathy. The pattern electroretinogram may be useful as a quantitative, dependent variable to establish and monitor short-term metabolic and physiologic changes in diabetic patients.

Enzyme-assisted vitrectomy with bacterial collagenase. Time course and toxicity studies.

Electron microscopic analysis of intravitreal strands produced by the injection of autogenous fibroblasts showed thin, immature collagen after two weeks and the mature banded variety after four weeks. With the use of this intravitreal strand model, it was found that highly purified bacterial collagenase caused extensive digestion of scar tissue after incubation periods of 10, 15, and 30 minutes. There was no morphologic damage to cicatricial cellular elements or to the inner limiting membrane of the retina. A 45-minute exposure of retinas previously injured by photocoagulation to collagenase also did not result in morphologic evidence of damage. The use of collagenase as an adjunct to vitrectomy in cases of extreme vitreal scarring or retinal traction may decrease the complication rate of a procedure that is still extremely hazardous.

The use of vitreous fluorophotometry to distinguish between diabetics with and without observable retinopathy: effect of vitreous abnormalities on the measurement.

Ten age-matched normals, diabetics with retinopathy, and diabetics without observable retinopathy were evaluated by vitreous fluorophotometry (VFL) using a 0.15 mm and a 0.45 fiberoptic probe in a photomultiplier system as well as a commercially available photodiode instrument to determine whether differences in intraocular sodium fluorescein levels could be detected among the three groups. Each subject was injected in the antecubital vein with 7 mg/kg of sodium fluorescein (25% solution) and measurements were taken 1 hr postinjection at 4.5 mm and 7.5 mm from the retina. The influence of choroidal fluorescein and ocular pigmentation are reduced at these locations. We found that a breakdown in the blood-ocular barrier may not be present early in the course of diabetes. Furthermore, no significant difference was found between normals and diabetics without retinopathy. Although the mean value for vitreous fluorescein was significantly higher in diabetics with retinopathy compared to normals, several of the diabetics with retinopathy had values in the normal range. These results differ from those previously reported in the literature. However, our studies took into consideration several factors not considered by other investigators, such as ocular pigmentation, choroidal fluorescence, slit width, and vitreous changes, that may have significant effects on the fluorophotometry values.

The influence of vitreous change on vitreous fluorophotometry.

Thirteen patients with retinitis pigmentosa were graded in terms of vitreous change and compared by vitreous fluorophotometry to an equal number of normal patients. A highly significant difference was found between groups. A high correlation was also noted between severity of vitreous change and midvitreous fluorophotometry values. Certain types of vitreous detachments appear to produce a characteristic "cancer hump" in the resultant data. A possible explanation for the increased values is discussed.