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Objectives: We performed indocyanine green angiography (ICGA) in patients with peripheral arterial disease (PAD), and established a method for the quantitative measurement of appropriate parameters to assess peripheral perfusion and the applicability of ICGA tests. Methods: Twenty-one patients with PAD underwent revascularization procedures with pre- and postinterventional ICGA tests. The ICGA parameters, which included the magnitude of intensity of indocyanine green, the time to maximum intensity, and the time from fluorescence onset to half the maximum intensity (T1/2) were compared with the ankle-brachial pressure index, toe -brachial pressure index, and toe pressure. We evaluated these parameters for regions of interest (ROIs). Results: T1/2 was the strongest parameter among all parameters of the ICGA tests. ROI 3, which included the distal region of the first metatarsal bone, correlated more significantly with the traditional measurements than the other ROIs. A value of T1/2 >20 seconds for ROI 3 was significantly correlated with a toe pressure of <50 mmHg (sensitivity: 0.77, specificity: 0.80). Conclusions: ICGA can be used to assess peripheral tissue perfusion. By measuring the value of T1/2 in ROI 3, ICGA tests can be used to evaluate the outcomes of revascularization procedures. [Copyright &y& Elsevier]

Objectives: To detect emboli in the venous system using a Doppler ultrasound device with embolism detecting software. Methods: Pulmonary embolism (PE) was induced by injecting thrombus through the iliac vein of castrated swine under general anaesthesia. Data recorded from the Doppler system were analysed for high intensity transient signals (HITS) using receiver operating characteristic curves. Four different thrombi (5 or 10mm long and 3 or 5mm in diameter) were then injected to assess the quantitative analysis. Results: Thrombus could be detected in the venous system by the Doppler ultrasound device with an embolism detecting function. Appropriate confidence level was 60%. If thrombus were assumed to travel at the maximum flow rate (30cm/s) in the inferior vena cava, the estimated embolism size was 10.4 S.D. 2.8mm for 3mm and 10.8 S.D. 4.9mm for 5mm, both of which were close to 10mm. Conclusion: Thrombi could be detected as high intensity transient signals in the venous system. The appropriate confidence level was 60%. The size of emboli can be estimated if they are more than 3mm in diameter when the venous flow rate is 30cm/s or less. Our results suggest that it may be possible to detect emboli in the subclavian vein, axillary vein or inferior vena cava in clinical cases. [Copyright &y& Elsevier]

BACKGROUND: Narrow-band imaging (NBI) is a novel illumination technology for endoscopy that enhances vasculature of the GI tract. OBJECTIVE: The aim was to elucidate whether NBI colonoscopy can identify dysplasia in patients with ulcerative colitis (UC). DESIGN: Cross-sectional study of eligible patients. SETTING: Single center. PATIENTS: 46 patients with UC. INTERVENTIONS: Apparently flat mucosa at each segment and visible protruding lesions were observed by magnifying NBI colonoscopy. The surface structure was classified into honeycomb-like, villous, or tortuous pattern. The grade of dysplasia was determined in the specimens obtained from protrusions and from flat mucosa. MAIN OUTCOME MEASUREMENTS: The positive predictive value of conventional and NBI colonoscopy for the diagnosis of dysplasia. RESULTS: A total of 296 sites (20 protruding lesions and 276 flat areas) were examined by NBI colonoscopy. The surface pattern was determined to be honeycomb like in 161 sites, villous in 85 sites, and tortuous in 50 sites. Five dysplastic lesions were detected in 3 patients. A patient had 3 dysplastic lesions and the other 2 had a dysplastic lesion each. The positive rate of dysplasia was higher in protrusions (2/20 sites, 10%) than in flat mucosa (3/276 sites, 1.1%, P = .038; however, correction for the multiple testing of data removes this significance). When the surface pattern was taken into account, the rate of positive dysplasia was higher in the tortuous pattern (4/50 sites, 8%) than in the honeycomb-like or villous patterns (1/246 sites, 0.4%, P = .003). LIMITATIONS: Uncontrolled study. CONCLUSIONS: The tortuous pattern determined by NBI colonoscopy may be a clue for the identification of dysplasia during surveillance for UC. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To evaluate the characteristics of distal microembolic signals (MES) during iliac stenting using Doppler ultrasound monitoring. Design: Prospective clinical study. Methods: A 2-MHz probe was used to monitor continuously at the ipsilateral tibioperoneal trunks during technically and hemodynamically successful iliac stenting in 10 patients without infrainguinal occlusive lesion. MESs at guide-wire, balloon, or stent crossing (phase 1), predilatation (phase 2), stent deployment (phase 3), postdilatation (phase 4), and contrast medium or heparinized saline injection (at injection) were analyzed. Differentiation of gaseous emboli from particulate emboli was achieved by calculation of the sample volume length. Results: No distal embolic complications were observed. Five hundred and forty-one MESs were detected. The MES incidence and intensity in phase 3 were significantly higher than those in phase 1, phase 2, and phase 4 (p<0.05). The MES intensity at injection was significantly higher than that in each of four phases (p<0.0001). Conclusions: Both the MES incidence and intensity were highest at stent deployment. Further study is required of microembolism during endovascular procedures in the lower extremities. [Copyright &y& Elsevier]

The crevice corrosion behaviour of stainless steels containing 25 mass% Cr, 3 mass% Mo and various amounts of Ni was investigated in natural seawater. The results showed that ferritic steels containing nickel were more resistant to corrosion than both ferritic steels without nickel and austenitic steels. The superiority of the Ni bearing ferritic steel over the other steels was in close agreement with the depassivation pH of those steels in acidic chloride solutions. The results showed that the addition of Ni to ferritic steel was effective in decreasing the depassivation pH and the dissolution rate in acidic chloride solutions at crevices. [Copyright &y& Elsevier]

High rate intercalation electrode performance of V2O5 gel/carbon composites has been demonstrated. A V2O5 sol was prepared by a reaction of metallic vanadium with a hydrogen peroxide solution. Acetylene black powder was added into the sol with acetone to yield a homogeneous suspension. A composite of amorphous V2O5 and carbon was loaded on a macroporous nickel current collector, and heat-treated at 120 °C to obtain a sample electrode. Electrochemical measurements were performed in some organic electrolytes like LiClO4/PC or LiPF6/γ-butyrolactone (γ-BL) at room temperature. It was confirmed that a composite electrode with the V2O5/carbon ratio of 0.7 in weight showed 54% of the ideal capacity, 360 mA h/g (4.2–2.0 V) based on V2O5, even at a very high rate discharge at 150 C or 54 A/g V2O5. The diffusion length of this host–guest system was estimated as 30–50 nm by means of a simulation of the discharge curves using a diffusion model assuming D˜=10−12 cm2/s. The reversibility was also satisfactory and no capacity loss was observed after thousands of times of discharge/charge cycles between 4.2 and 3.0 V at the rate of 20 C. A prototype electrode was fabricated by coating a thin layer of the composite on an Al sheet current collector using an applicator. It showed the capacity of 40 mA h/g electrode at a current density as high as 30 mA/cm2. [Copyright &y& Elsevier]

Abstract: Introduction: Infection of a prosthetic graft is still associated with considerable morbidity and mortality. Conventionally, this vascular complication is treated by excising the infected graft, although prosthetic graft preservation is possible in selected cases. Report: We report the successful treatment of prosthetic graft infection caused by methicillin-resistant Staphylococcus aureus (MRSA) in three patients, by performing drainage surgery with postoperative irrigation using gentian violet. Discussion: The combination of drainage surgery and irrigation with gentian violet solution provides an alternative option to graft excision for prosthetic graft infection. [Copyright &y& Elsevier]

A purpose of cancer treatment for advanced and metastatic pancreatic cancer (AMPC) is to improve survival and quality of life. In Japan, S-1 is one of treatment regimens applied as a first-line therapy and no economic evaluation including these regimens have not been conducted. We conducted cost-utility analysis based on a network meta-analysis of the first-line therapy for AMPC under Japanese clinical environment. [Extracted from the article]

Abstract: Introduction: Due to their anatomic location, internal iliac artery aneurysms are difficult to treat surgically. An endovascular approach can be helpful, even in ruptured cases. Report: We report a 71-year-old male with ruptured isolated bilateral internal iliac artery aneurysms. The aneurysms were treated with embolisation of the branching arteries of the bilateral internal iliac arteries followed by placement of a stent graft covering the orifice of the bilateral internal iliac arteries. The patient tolerated this procedure well. Discussion: Even in patients with ruptured aneurysms, endovascular treatment for internal iliac artery aneurysms can be a good treatment option. [Copyright &y& Elsevier]

We measured the total concentration of nitrite and nitrate, metabolites of nitric oxide, in vaginal secretions from pregnant women at 22 to 32 weeks' gestation. Total nitrite and nitrate concentrations in patients with preterm premature rupture of membranes and in those with preterm labor and subsequent premature delivery were significantly higher than concentrations in patients who were delivered at term. Elevated total nitrite and nitrate concentration may predict premature delivery. [ABSTRACT FROM AUTHOR]