Atrial fibrillation-induced cardiomyopathy presenting with bilateral intermittent claudication associated with intracardiac thrombi.

Systemic thromboembolism associated with atrial fibrillation (AF) is usually caused by thrombi in the left atrial appendage and acute onset. We experienced an unusual case of a woman in her 60s who presented to the outpatient district having bilateral intermittent claudication for more than 1 month, which turned out to be multiple thromboembolism from asymptomatic AF with tachycardia. She was also complicated with non-ischaemic dilated cardiomyopathy with reduced ejection fraction, consistent with arrhythmia-induced cardiomyopathy (AiCM), along with left atrial and left ventricular thrombi and thromboembolism in multiple organs. Rate control with beta-blockers was not effective. With the administration of amiodarone after adequate anticoagulation therapy, she returned to sinus rhythm, and the ejection fraction was restored. This case is instructive in that AiCM with AF can cause thrombosis in the left ventricle, and the patient may present with worsening intermittent claudication as a result of systemic embolism.

Wavelength-Conversion-Material-Mediated Semiconductor Wafer Bonding for Smart Optoelectronic Interconnects.

A new concept of semiconductor wafer bonding, mediated by optical wavelength conversion materials, is proposed and demonstrated. The fabrication scheme provides simultaneous bond formation and interfacial function generation, leading to efficient device production. Wavelength-converting functionalized semiconductor interfacial engineering is realized by utilizing an adhesive viscous organic matrix with embedded fluorescent particles. The bonding is carried out in ambient air at room temperature and therefore provides a cost advantage with regard to device manufacturing. Distinct wavelength conversion, from ultraviolet into visible, and high mechanical stabilities and electrical conductivities in the bonded interfaces are verified, demonstrating their versatility for practical applications. This bonding and interfacial scheme can improve the performance and structural flexibility of optoelectronic devices, such as solar cells, by allowing the spectral light incidence suitable for each photovoltaic material, and photonic integrated circuits, by delivering the respective preferred frequencies to the optical amplifier, modulator, waveguide, and detector materials.

Endoscopic band ligation for control of nonvariceal upper GI hemorrhage: comparison with bipolar electrocoagulation.

BACKGROUND: Despite advances in endoscopic treatment methods for upper GI hemorrhage, hemostasis is often difficult to achieve. This study evaluated the usefulness of endoscopic band ligation for upper GI hemorrhage exclusive of hemorrhage from chronic gastroduodenal ulcer and varices. METHODS: This prospective study included 27 patients who underwent endoscopic band ligation and 31 patients in whom bipolar electrocoagulation was performed for upper GI hemorrhage. In both groups, the causes of hemorrhage included Dieulafoy's ulcer, Mallory-Weiss tear, gastric ulcer after polypectomy, and gastric angiodysplasia. Patients with esophageal varices and those with chronic gastroduodenal ulcer were excluded. RESULTS: Hemostasis was achieved in all 27 patients in the endoscopic band ligation group and in 26 of 31 patients (83.9%) in the bipolar electrocoagulation group. The median procedure time required for achieving hemostasis was 17.0 minutes (interquartile range: 11.5-23.5) in the endoscopic band ligation group versus 27.0 minutes (interquartile range: 20.5-40.0) in the electrocoagulation group. No major complications occurred in either group. CONCLUSION: Endoscopic band ligation is efficient, simple, and safe. Therefore, this technique should be considered as a treatment option for nonvariceal, nonchronic gastroduodenal ulcer upper GI hemorrhage.