[Endoscopic variceal ligation and percutaneous transhepatic obliteration difficulty in esophageal variceal bleeding: a case report].

A 48-year-old male patient with a history of alcoholic cirrhosis was admitted to our hospital due to hematemesis with a 7-day history of melena. Emergency esophagogastroduodenoscopy revealed esophageal variceal bleeding. We attempted hemostasis with endoscopic variceal ligation (EVL). The esophageal mucosa was not aspirated into the EVL device although the patient had no history of endoscopic injection sclerotherapy or EVL. Percutaneous transhepatic obliteration (PTO) was performed and esophageal variceal bleeding was successfully hemostasis. PTO is a viable option for refractory esophageal bleeding.

[A case of refractory ascites due to splenic arteriovenous fistula appeared during the course of observation and cured by embolization therapy].

This is a case of a 61-year-old female who presented to our hospital with liver dysfunction without any symptoms. She was diagnosed with splenic arteriovenous fistula. About 8 months later, she visited the hospital again due to abdominal distention and diarrhea. Computerized tomography (CT) revealed splenic aneurysm, dilated splenic vein enhanced in the arterial phase, ascites, and intestinal edema. We considered that these findings were caused by portal hypertension due to splenic arteriovenous fistula. The splenic aneurysm was managed with coil embolization. Completion arteriography revealed the absence of flow into the splenic arteriovenous fistula. Surveillance CT scans at 2 months post-procedure confirmed complete occlusion of the aneurysm and arteriovenous fistula. There was no evidence of splenic infarction. The patient remained asymptomatic 1 year post-procedure. Asymptomatic splenic arteriovenous fistula is rare and needs immediate treatment due to the high probability of deterioration.

Design and Synthesis of Non-peptide RGD Mimics for Evaluation of Their Utility as Anti-platelet Agents.

Arg-Gly-Asp (RGD) mimics were synthesized and their anti-platelet activity was evaluated. A concise method was developed for the synthesis of the target compounds from dehydroepiandrosterone and Wieland-Miescher and Hajos-Parrish ketones, which are suitable for readily available platform. Among the synthesized compounds, the perhydronaphthalene framework with a 3-(4-piperidinyl)propoxyl structure 3e possessed the highest anti-aggregative activity. The IC50 values of 3e were 0.91 mM (ADP initiation) and 0.54 mM (collagen initiation).

[Comparison of activity expression between PET using 68Ge-68Ga line source attenuation correction and PET-CT using CT attenuation correction: impact on emission images].

OBJECTIVES: CT data can be used for both anatomical image and attenuation correction (CTAC) of PET data in PET-CT scanners. The CTAC method is useful for attenuation correction, because the CT scan time is much shorter than the external radionuclide (e.g., (68)Ge) transmission scan time. However, the energy of the X-rays from CT is not monoenergetic and is much lower than that of the external radionuclide source. In this study, we evaluated the differences between emission PET images reconstructed with CT-based and (68)Ge-based attenuation correction. METHODS: CT scans and (68)Ge-Transmission scans were acquired and used for attenuation correction (CTAC, MAC, and SAC). The PET emission scan time was 4 min. CT scans were acquired at 10, 20, 40, 80, and 160 mA. (68)Ge-Transmission scans were acquired at 1, 3, 5, 10, 20, 40, 60, and 300 min. The attenuation-corrected emission image using MAC on a 300 min transmission scan was defined as the reference image. Seven cylinders (30 mm diameter) were filled with (18)F-FDG placed in a heart-liver phantom with simulated pulmonary mass lesions. The PET value [counts/cc] was measured in circular regions of interest (ROI) over the cylindrical mass lesion. Averages [counts/cc], coefficients of variation [C.V.(%)], and ratios of difference [%Diff] from the reference value were calculated for all conditions. RESULTS: In the CT-Transmission, analysis of variance revealed no significant effect of CT current on the average and the C.V. In the (68)Ge-Transmission, the average and the C.V. changed in dependence on the acquisition time. All %Diff using CT-Transmission were small. It was shown that CT-Transmission is more appropriate than (68)Ge-Transmission.