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To investigate the safety and efficacy of intrathecal injection as an alternative to epidural injection for analgesia. Seventy consecutive outpatients with chronic low back and lower extremity pain received lumbar intrathecal injection of low-dose isobaric bupivacaine using a 25-gauge pencil-point needle. The patients received 0.5, 1.0, and 1.5 mg of bupivacaine at 1-week intervals to determine the optimal dose. Thereafter, they received two more weekly injections with the optimal dose. The safety and efficacy of the treatment were assessed over a 1-year period. No serious adverse events were encountered. The optimal dose of bupivacaine (1.0 mg in 60% of patients) alleviated pain and disability (both, p

The current method for in vitro immunization (IVI) uses several antigens including toxins, food allergens, pathogenic bacteria, and self-antigen-derived peptides that induce an antigen-specific immune response in peripheral blood mononuclear cells (PBMCs). This protocol, however, requires donor blood collection and preparation of PBMCs before every IVI. In the present study, we aimed to design a more efficient system utilizing B cells immortalized with Epstein–Barr virus (EBV-B) as host cells for IVI to make antigen-specific antibodies. Results showed that previously antigen-sensitized, EBV-B cells exposed to the antigen along with IL-6, CpG oligonucleotides, and CD40 ligand signal produced antigen-specific antibodies. These results provide evidence for a novel and easy method to expand memory-type B cells and produce antigen-specific antibodies.

Introduction Hepatic encephalopathy is an important underlying cause of consciousness disorders. Possible causes of hepatic encephalopathy include hepatic failure and shunt encephalopathy resulting from a portosystemic venous shunt. Balloon-occluded retrograde transvenous obliteration is generally an effective treatment for hepatic encephalopathy. Case presentation A 73-year-old Japanese woman was referred to our department because of disturbance of consciousness. Hepatic venous angiography disclosed a shunt between her left hepatic vein and her portal vein. The shunt was closed with the use of coils and N-butyl 2-cyanoacrylate. One hour after the procedure, she lost consciousness. The bleeding was ascribed to catheter-induced vascular injury. Emergency angiography was performed, and hemostasis was achieved with coils. Conclusion Although bleeding is relatively rare after balloon-occluded retrograde transvenous obliteration, postoperative intraperitoneal bleeding is a serious complication.