Intraoperative red cell salvage during obstetric surgery in 50 Japanese women.

OBJECTIVE: To determine the clinical usefulness of intraoperative cell salvage (ICS) in obstetrics. METHODS: A retrospective analysis was performed using data for 50 patients who had received ICS blood during obstetric surgery at 13 Japanese facilities between January 1, 2007 and December 31, 2013. The frequencies of ICS-associated adverse events, allogeneic blood transfusion (ABT), and preoperative autologous donation (PAD) were assessed. RESULTS: Placenta previa was the indication for ICS in 42 (84%) women. The ICS blood was reinfused in all women (median 366 mL; range 80 to at least 3715). No ICS-associated adverse events occurred. The median estimated blood loss (EBL) was 2171 mL (range 574-47 000); 27 (54%) women lost at least 2000 mL. ABT was not used in 33 (66%) women. Among 26 women who lost at least 2000 mL of blood and were included in analyses, 12 (44%) did not receive ABT. EBL was linearly correlated with the total volume of transfused blood (P<0.001). CONCLUSION: ICS caused no adverse events among women at elevated risk of peripartum hemorrhage and might be safe for use in obstetrics.

A case of lobulated and pedunculated duodenal hyperplastic polyp treated with snare polypectomy.

We report herein the case of a lobulated and pedunculated hyperplastic polyp in the third portion of the duodenum causing anemia and occult blood in stools, which was detected by capsule endoscopy (CE) and treated with snare polypectomy. A 71-year-old man was referred to our hospital because of anemia and occult blood in stools. Three months earlier, he had been admitted to another hospital because of hemorrhage from gastric antral vascular ectasia (GAVE). Despite being treated for GAVE, hemoglobin decreased gradually. Esophagogastroduodenoscopy (EGD) and colonoscopy revealed no source of bleeding. However, CE revealed a polyp at the distal duodenum. Barium meal and EGD revealed a lobulated and pedunculated polyp in the third portion of the duodenum. The polyp was treated with snare polypectomy. Histopathological examination of the polyp revealed hyperplasia. After treatment of the polyp, the anemia improved gradually. To our knowledge, there are only 6 reported cases of a duodenal hyperplastic polyp, including our case. The polyp was pedunculated in only 2 cases and lobulated only in our case. Moreover, our case was diagnosed by CE. When a patient presents with anemia or obscure gastrointestinal bleeding undiagnosed by EGD and colonoscopy, CE is useful for detecting the bleeding lesion.

Formation of large-scale flexible transparent conductive films using evaporative migration characteristics of Au nanoparticles.

To sustain the growing demand of transparent conductive films for wide applications, such as flat panel displays, a much more cost-effective film is required over the widely used indium tin oxide film. Here we developed a promising method to manufacture a cost-effective flexible transparent conductive film of high performance by first making grid-iron patterns of thin lines on a large scale using evaporative migration characteristics of gold nanoparticles, and then by burying the grid-iron pattern into a poly(ethylene terephthalate) film.

Pseudomembranous colitis complicating ulcerative colitis.

Clostridium difficile toxin (CD toxin) causes antibiotic-associated colitis, or pseudomembranous colitis (PMC). Although CD toxin is sometimes found in the stools of patients with ulcerative colitis (UC), UC is rarely complicated by PMC. We report herein a case of PMC complicating UC, and present a review of the literature. A 71-year-old woman was diagnosed as having UC of the left colon, and treated with prednisolone and mesalazine. Later, however, lumbar spinal stenosis was also detected. After surgery for lumbar spinal stenosis, she suffered postoperative infection of the lumbar region. After 3-week treatment with antibiotics, she developed diarrhea, bloody stools, and abdominal pain. Colonoscopy revealed PMC of the cecum, ascending colon, sigmoid colon, and rectum. Stools were positive for CD toxin. As cefotiam hydrochloride, levofloxacin hydrate (LVFX), and prednisolone were suspected as the causative agents, she was treated with 1.5 g vancomycin (VCM) daily for 2 weeks without ceasing LVFX. Her symptoms improved, and colonoscopy confirmed resolution of PMC. The possibility of PMC should be considered in UC patients treated with antibiotics, immunosuppressive agents or corticosteroids who complain of gastrointestinal symptoms. These patients should be thoroughly investigated by several modalities, including colonoscopy and CD toxin testing.

Molecular-scale change in the surface properties of silica and copper in pure water with time.

We aimed to understand one of the fundamentals of how silica and copper surfaces are flattened on the molecular scale by the chemical mechanical polishing (CMP) method, which is used in the fabrication of semiconductors. In particular, we examined whether even pure water affects the properties of silica and copper surfaces. This study used the atomic force microscope to detect how the morphologies, normal interaction, and friction forces of the silica and copper surfaces changed with their exposure time to water. We found that the surface properties of even the silica surfaces changed on the molecular scale when the surfaces were exposed to water for a sufficiently long time. In the case of copper, the surface properties were observed to undergo rapid changes. Gel-like layers were detected on the copper surface within a few minutes, even though copper surfaces oxidized by ambient air are considered to be rather stable to water.

Growth mechanism of soap-free polymerization of styrene investigated by AFM.

To clarify the growth mechanism of polystyrene (PSL) particles in the soap-free polymerization, characteristics of not only particles but also polymeric materials floating in the bulk were investigated on the molecular scale by using atomic force microscope (AFM), where a cationic initiator V-50 is used to make the formed polymeric materials transfer on the mica plate in sampling. Our main attention here is to know the reason why the particle size increases with increasing initiator concentration in the production of PSL particles. The following are found. (1) As far as the initiators and monomers remain in the bulk solution, the polymeric materials are born in the bulk continuously, because of the slow decomposition rate of initiators. (2) The growth of particles at the early stage of t(r) > or = 0.75 h is considered to be attributable mainly to the particle swelling by absorbing monomers from the bulk. The rapid growth at the intermediate stage is due to the deposition of polymeric materials in the bulk on the particle surface and their simultaneous swelling by monomers in the bulk. (3) The reason why the particle size increases with increasing concentration of initiator is that the growth process is controlled by the deposition rate of polymeric materials in the bulk whose amount increases with the initiator concentration. (4) The particle size and the smoothness of particle surface depend on the relative concentration of initiators and monomers remained.

Assessing the efficacy of famotidine and rebamipide in the treatment of gastric mucosal lesions in patients receiving long-term NSAID therapy (FORCE--famotidine or rebamipide in comparison by endoscopy).

BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDs) and Helicobacter pylori infection are major causes of gastric mucosal lesions. In Japan, histamine-2 receptor antagonists are frequently prescribed, but the literature regarding their efficacy is limited. In this study, we compare the effects of famotidine and rebamipide on NSAID-associated gastric mucosal lesions using upper gastrointestinal endoscopy. METHODS: This study examined 112 patients taking NSAIDs for either gastric hemorrhage or erosion. Before treatment, the patients were assessed by endoscopy. Using blind randomization, patients were divided into two groups: group F (famotidine, 20 mg/day) and group R (rebamipide, 300 mg/day). Efficacy was examined 4 weeks later using endoscopy. RESULTS: After treatment, the Lanza score decreased significantly in group F (P < 0.001) but not in group R (P = 0.478). The change in the Lanza score in group F was significantly greater (P = 0.002) than that in group R. CONCLUSIONS: Famotidine was superior to rebamipide in treating NSAID-associated mucosal lesions.

Ero1-L, an ischemia-inducible gene from rat brain with homology to global ischemia-induced gene 11 (Giig11), is localized to neuronal dendrites by a dispersed identifier (ID) element-dependent mechanism.

Many changes in neuronal gene expression occur in response to ischemia, and these may play a role in determining the fate of ischemic neurons. To identify genes induced in the rat brain following cerebral ischemia, a strategy was used that combines subtractive hybridization and differential screening. Among the genes identified was one referred to as global ischemia-inducible gene 11(Giig11). Sequence analysis indicated that Giig11 exhibited 97% and 91% identity to the known Ero1-L (S. cereviseae ero1-like oxidoreductase) of mouse and human origin, which is involved in oxidative endoplasmic reticulum protein folding. Rat Ero1-L/Giig11 also contains a l07-bp sequence that is nearly identical (> 95%) to the known dispersed repetitive identifier (ID), but which is lacking in mouse and human Ero1-L. Northern blotting showed that expression of the ID element and Ero1-L/Giig11 mRNA increased after global cerebral ischemia. In situ hybridization demonstrated increased expression of Ero1-L/Giig11 in the brain following ischemic injury, with the highest levels in the vulnerable hippocampal CA1 pyramidal neurons. Transfection of cultured primary hippocampal neurons with a plasmid containing green fluorescent protein (gfp) and Ero1-L/Giig11 cDNA (with and without the ID element) produced a gfp-Ero1-L/Giig11 fusion protein, and more fusion protein was localized into dendrites in the presence of the ID element, suggesting that the ID element promotes Ero1-L/Giig11 protein localization to dendrites. Therefore, Ero-1L/Giig11 may have a role in ischemia-induced neuronal repair or survival mechanisms directed at counteracting abnormalities in protein folding, maturation and distribution.