Cap-assisted hemoclip application with forward-viewing endoscope for hemorrhage induced by endoscopic sphincterotomy: a prospective case series study.

BACKGROUND: Endoscopic sphincterotomy (ES) is a therapeutic technique developed as an advanced application of endoscopic retrograde cholangiopancreatography (ERCP). An important adverse event associated with this procedure is hemorrhage, which may sometimes be uncontrollable. We sought to examine whether cap-assisted hemoclip application is effective in controlling ES-induced hemorrhage. METHODS: In this prospective study, we investigated the outcomes in 10 patients who had uncontrolled ES-induced hemorrhage and were treated by cap-assisted application of hemoclip with a forward-viewing endoscope. RESULTS: Nine of the 10 investigated patients were successfully treated using the cap-assisted hemoclip technique with forward-viewing endoscope, yielding a success rate of 90 %. The patient with hemorrhage non-responsive to hemoclipping required catheter embolization of the bleeding artery after its identification by digital subtraction angiography. One of the 10 patients developed mild pancreatitis after the procedure, but was successfully managed conservatively. CONCLUSIONS: Cap-assisted hemoclip application with a forward-viewing endoscope appears to be an effective therapeutic modality for achieving hemostasis in cases of ES-induced hemorrhage, without the occurrence of any severe adverse events; we believe that this method should be considered as an option in the management of ES-induced hemorrhage.

High-throughput discovery of chloroplast and mitochondrial DNA polymorphisms in Brassicaceae species by ORG-EcoTILLING.

BACKGROUND: Information on polymorphic DNA in organelle genomes is essential for evolutionary and ecological studies. However, it is challenging to perform high-throughput investigations of chloroplast and mitochondrial DNA polymorphisms. In recent years, EcoTILLING stands out as one of the most universal, low-cost, and high-throughput reverse genetic methods, and the identification of natural genetic variants can provide much information about gene function, association mapping and linkage disequilibrium analysis and species evolution. Until now, no report exists on whether this method is applicable to organelle genomes and to what extent it can be used. METHODOLOGY/PRINCIPAL FINDINGS: To address this problem, we adapted the CEL I-based heteroduplex cleavage strategy used in Targeting Induced Local Lesions in Genomes (TILLING) for the discovery of nucleotide polymorphisms in organelle genomes. To assess the applicability and accuracy of this technology, designated ORG-EcoTILLING, at different taxonomic levels, we sampled two sets of taxa representing accessions from the Brassicaceae with three chloroplast genes (accD, matK and rbcL) and one mitochondrial gene (atp6). The method successfully detected nine, six and one mutation sites in the accD, matK and rbcL genes, respectively, in 96 Brassica accessions. These mutations were confirmed by DNA sequencing, with 100% accuracy at both inter- and intraspecific levels. We also detected 44 putative mutations in accD in 91 accessions from 45 species and 29 genera of seven tribes. Compared with DNA sequencing results, the false negative rate was 36%. However, 17 SNPs detected in atp6 were completely identical to the sequencing results. CONCLUSIONS/SIGNIFICANCE: These results suggest that ORG-EcoTILLING is a powerful and cost-effective alternative method for high-throughput genome-wide assessment of inter- and intraspecific chloroplast and mitochondrial DNA polymorphisms. It will play an important role in evolutionary and ecological biology studies, in identification of related genes associated with agronomic importance such as high yield and improved cytoplasmic quality, and for identifying mitochondrial point mutations responsible for diseases in humans and other animals.

[Influence of visual attention in visual evoked potential examination].

OBJECTIVE: To explore the influence of visual attention in visual evoked potential (VEP) examination. METHODS: The pattern visual evoked potential (PVEP) and flash visual evoked potential (FVEP) were used to examine 110 normal subjects whose visual acuity or corrected visual acuity is in the range of 4.8-5.2, and age between 20 to 30 years old. In PVEP inspection, subjects were asked to watch with three ways, to stare at the central screen (at the same time count silently the number of alternating of black and white squares to improve the subjects' attention), to stare at the central screen at the same time thinking other things, to look sideways (the left eye stared at the left bottom corner of the screen or the right eye stared at the right one). In FVEP inspection, subjects were checked with eyes open and closed respectively. The latency and amplitude of P100 wave were recorded. The data were statistically analyzed by SPSS 13.0 software. RESULTS In PVEP inspection, the latency and amplitude of P100 wave were statistically different among three watching ways. In FVEP inspection, latency and amplitude of P100 wave were statistically different between eyes open and closed group. CONCLUSION: Although the visual evoked potential test is an objective electrophysiological visual function test, it is susceptible to the influence of various subjective factors such as visual attention. It should arise the attention of forensic experts.