In Vivo Sonoporation Effect Under the Presence of a Large Amount of Micro-Nano Bubbles in Swine Liver.

Objectives: Sonoporation as a method of intracellular drug and gene delivery has not yet progressed to being used in vivo. The aim of this study was to prove the feasibility of sonoporation at a level practical for use in vivo by using a large amount of carbon dioxide micro-nano bubbles.

Methods: The carbon dioxide micro-nano bubbles and 100 mg of cisplatin were intra-arterially injected to the swine livers, and ultrasound irradiation was performed from the surface of the liver under laparotomy during the intra-arterial injection.

Percutaneous Transsplenic Embolization of Gastric Varices in Left-sided Portal Hypertension.

An 81-year-old man with previously diagnosed cancer of the pancreatic body presented with melena and anemia. Upper gastrointestinal endoscopy showed gastric varices with bleeding in the entire stomach. Contrast-enhanced computed tomography identified a splenic vein occlusion resulting from invasion by the pancreatic body cancer and dilated collateral pathways from the splenic hilum to the gastric fundus.

Radiation Exposure and Protection in Computed Tomography Fluoroscopy.

Computed tomography (CT) fluoroscopy-guided procedures, such as those used for percutaneous biopsy, drainage, and radiofrequency ablation, are highly safe and quite often very successful due to the precision offered by the real-time, high-resolution tomographic images. Even so, international guidelines raised concerns regarding operator exposure to high doses of radiation during these procedures. In light of these concerns, operators conducting CT fluoroscopy-guided procedures not only need to be cognizant of the exposure risk but also exhibit sufficient knowledge of radiation protection.

Venous Rupture Following Transcatheter Arterial Embolization for Inferior Mesenteric Type II Arteriovenous Malformation.

We treated a 64-year-old man who had an inferior mesenteric arteriovenous malformation with multiple shunts. As multiple varicosities in the draining vein became enlarged, two dilated shunts on the superior rectal and sigmoid colon arteries were coil embolized. Two days after embolization, a varicosity near the shunt (65 mm diameter) ruptured, causing intra-abdominal hemorrhage and surgical hemostasis.

A Case of Percutaneous Transesophageal Jejunostomy after Subtotal Esophagectomy.

An 80-year-old woman who underwent subtotal esophagectomy with gastric tube reconstruction for esophageal cancer developed carcinoma of the left upper gingiva. The local recurrence of the gingival carcinoma resulted in trismus and prevented oral intake. Then she underwent a percutaneous transesophageal jejunostomy tube placement in the preserved cervical esophagus.

Percutaneous transhepatic obliteration for rupture of varices in the small intestine: a case report.

Rupture of ectopic varices is a rare but serious complication of portal hypertension. A 65-year-old woman with liver cirrhosis caused by primary biliary cholangitis visited the emergency department with several episodes of melena. Computed tomography revealed varices in the small intestine.

Congenital pulmonary varix: Two case reports.

Rationale: Patients with congenital pulmonary varix are asymptomatic and require no treatment, but the radiological characteristics of a pulmonary varix are similar to those of a pulmonary arteriovenous malformation, which requires treatment. Pulmonary angiography is useful for obtaining information about the dynamics of pulmonary blood flow to differentiate a pulmonary varix from a pulmonary arteriovenous malformation for the purpose of treatment planning. Two cases of congenital pulmonary varices that were differentiated from pulmonary arteriovenous malformations based on pulmonary angiography findings are presented.

Hemostasis radiotherapy for gastric cancer: Usefulness of the gastric cancer to spleen apparent diffusion coefficient ratio.

The hemostatic effect of radiation therapy on gastric cancer with bleeding is known. However, blood tests and endoscopes are mainly used to determine the therapeutic effect. Additionally, magnetic resonance imaging has been reported to be useful when needed because endoscopes are invasive.

The Impact of Sorafenib in Combination with Intermittent Hepatic Arterial Infusion Chemotherapy for Unresectable Hepatocellular Carcinoma with Major Vascular Invasion.

The aim of the current study was to investigate the efficacy and safety of sorafenib and intermittent hepatic arterial infusion chemotherapy with cisplatin for unresectable hepatocellular carcinoma (HCC) with severe portal vein invasion. The antitumor effect was a complete response in 1 of 38 patients, a partial response in 12 patients, stable disease in 16 patients, and progressive disease in 9 patients, for a 34.2% response rate and a 76.

The percutaneous tandem drainage technique for radical treatment of intractable hepaticojejunostomy leakage.

The principal concept of the percutaneous tandem drainage procedure for an intractable hepaticojejunostomy (HJ) leakage is to decrease the amount of fluid and divide the fluid-filled cavity into several small cavities, which can then be drained individually. Percutaneous abscess drainage (PAD) has a role in drainage of the fluid cavity, whereas percutaneous trans-anastomotic jejunum drainage (PTAJD) has a role in drainage to reduce the bile fluid and digestive juices. A decrease in fluid induces effective drainage of the fluid cavity by PAD.

Subcapsular hepatic hematoma: a case of chronic expanding hematoma of the liver.

Background: A chronic expanding hematoma (CEH) enlarges as a result of slight bleeding over several months, and the tissue shows a mixture of blood breakdown products, granulation tissue with capillary ingrowth, and inflammatory tissue. This report presents a case of a subcapsular hepatic CEH that was treated with transarterial embolization (TAE) and hepatectomy.

Case Presentation: A 56-year-old man presented with vomiting and right-sided abdominal pain.

The Impact of Sorafenib in Combination with Transarterial Chemoembolization on the Outcomes of Intermediate-Stage Hepatocellular Carcinoma.

Background: We investigated the treatment outcomes and hepatic reserve of transarterial chemoembolization (TACE)-refractory patients with recurrent advanced hepatocellular carcinoma (HCC) treated with TACE plus sorafenib.

Methods: Forty-one patients with intermediate-stage HCC defined as being TACE refractory on imaging were treated with sorafenib and TACE between 2009 and 2012 and comprised the combination treatment group. Twenty-nine patients who received repeated TACE after becoming refractory to TACE between 2005 and 2008 comprised the TACE continuation group.

Evaluation of the antithrombogenicity of poly-2-methoxyethylacrylate-coated catheters.

Background And Objectives: The blood compatibility of indwelling intravascular catheters is facilitated by the use of antithrombogenic materials. Heparin has typically been used for this purpose; however, since heparin-coated catheters are considered combination products, difficulties meeting the relevant Food and Drug Administration safety recommendations have disrupted commercialization. Other issues include coating durability and the occurrence of heparin-induced thrombocytopenia.

Clinical results of transarterial embolization for post-partum hemorrhage in 62 patients.

Aim: The pathology of post-partum hemorrhage (PPH) differs depending on its cause, background and timing of bleeding, and the effectiveness of transarterial embolization (TAE) is thought to vary based on these characteristics. The aim of this study is to evaluate the treatment outcomes of TAE for PPH.

Methods: Technical success, initial clinical success (hemostasis without repeat TAE or surgical treatment after initial TAE) and final clinical success (hemostasis with or without repeat TAE, but without surgical treatment) were assessed in 62 Japanese patients.

Assessment of the Antithrombogenicity of a Poly-2-Methoxyethylacrylate-Coated Central Venous Port-Catheter System.

Purpose: The purpose of this study was to evaluate the antithrombogenic effects of poly-2-methoxyethylacrylate (PMEA) coating applied to the internal surfaces of the port-catheter system to prevent thrombotic occlusion.

Materials And Methods: PMEA coating was applied to the inner surfaces of the entire system, including the chamber, catheter, and connecting stem. PMEA-coated and uncoated port-catheter systems were each filled with fresh human blood for 1 or 3 h and then flushed with saline.

Simultaneous Drainage of the Abscess Cavity and Intestinal Tract for an Intra-abdominal Abscess Secondary to Major Leakage: A Case Report.

This case report describes a 72-year-old man who developed an intra-abdominal abscess and major postoperative anastomotic leakage. He reported a history of pancreaticoduodenectomy, partial hepatectomy, and segmental colectomy for hepatic and colonic invasion of extrahepatic cholangiocarcinoma. Three catheters, (one in the transverse colon and two in the abscess cavity) were placed simultaneously through the drainage tract formed by the intraoperatively placed Pleats drain.

Provocative angiography for lower gastrointestinal bleeding.

Purpose: This study evaluated the results of provocative angiography performed to identify the site of hemorrhage in lower gastrointestinal bleeding to enable transcatheter arterial embolization.

Materials And Methods: The subjects of this study were 11 patients with acute lower gastrointestinal bleeding who underwent provocative angiography, after contrast agent extravasation could not be identified during conventional angiography. One patient underwent provocative angiography twice, making 12 cases of provocative angiography that were analyzed in this study.

Percutaneous Balloon Plasty for Thoracic Duct Occlusion in a Patient with Chylothorax and Chylous Ascites.

A patient developed abdominal distension, dyspnea, and nausea due to chylothorax and chylous ascites 1 month after bruising her back. Lymphangiography was unable to identify the site of lymph leakage, and lymphatic duct embolization was impractical. However, lymphangiography showed occlusion of the thoracic duct.

Central venous access port placement by translumbar approach using angio-CT unit in patients with superior vena cava syndrome.

Purpose: To evaluate the clinical results of central venous access port (CV port) placement by translumbar inferior vena cava cannulation using angio-CT unit for cancer patients with superior vena cava syndrome.

Materials And Methods: A CV port was placed by translumbar inferior vena cava cannulation using an angio-CT unit, in 14 consecutive patients. All patients had occlusion or advanced stenosis of the superior vena cava due to cancer progression.

A body mass index ≥25 kg/m is associated with a poor prognosis in patients with acute pancreatitis: a study of Japanese patients.

Background: In Asian population, there is limited information on the relevance between obesity and poor outcomes in acute pancreatitis (AP). The objective of this study was to examine the clinical impact of obesity based on body mass index (BMI) on prognosis of AP in Japanese patients.

Methods: A total of 116 patients with AP were enrolled in this study.

Transvenous Retrograde Thoracic Ductography: Initial Experience with 13 Consecutive Cases.

Purpose: To report the feasibility and findings of transvenous retrograde thoracic duct cannulation.

Materials And Methods: The subjects were 13 patients who had undergone retrograde transvenous thoracic ductography. Despite conservative treatment, all required drainage for chylothorax, chylous ascites, or a chylous pericardial effusion.

Sclerotherapy for Rectal Varices by a Small-Bore Needle Puncture Through the Greater Sciatic Foramen.

Purpose: To report a sclerotherapy technique for rectal varices consisting of direct puncture of the superior rectal vein with a small-bore sheathed needle via the greater sciatic foramen without insertion of a sheath or catheter.

Materials And Methods: The subjects of this retrospective study were three consecutive patients who underwent embolization of rectal varices, two for rupture of rectal varices and one for hepatic encephalopathy and hyperammonemia. A 5% solution of ethanolamine oleate with iodinated contrast agent (5% EOI) was injected through puncture of the superior rectal vein and carried in the blood flow, after which n-butyl cyanoacrylate mixed with lipiodol (NBCA-Lip) was immediately injected to stop the blood flow.

[Postoperative Chylotholax;Intraoperative Prevention and Postoperative Management].

Postoperative chylothorax is a relatively rare but potentially fatal complication caused by iatrogenic injury to thoracic duct system, with an incidence ranging from 2 to 4% after major lung surgery or esophagectomy. The pathophysiologic features of chylothorax include dehydration, loss of nutrients and immunological components. Intraopreative prevention is the first step for the management, and treatment options include conservative therapy, percutaneous intervention, and redo-operation.

Validation of the efficacy of the prognostic factor score in the Japanese severity criteria for severe acute pancreatitis: A large multicenter study.

Background: The Japanese severity criteria for acute pancreatitis (AP), which consist of a prognostic factor score and contrast-enhanced computed tomography grade, have been widely used in Japan.

Objective: This large multicenter retrospective study was conducted to validate the predictive value of the prognostic factor score for mortality and complications in severe AP patients in comparison to the Acute Physiology and Chronic Health Evaluation II (APACHE II) score.

Methods: Data of 1159 patients diagnosed with severe AP according to the Japanese severity criteria for AP were retrospectively collected in 44 institutions.