Degradation Analysis by X-ray Absorption Spectroscopy for LiNbO3 Coating of Sulfide-Based All-Solid-State Battery Cathode.

The surface coating of cathode active material in all-solid-state batteries using sulfide-based solid electrolytes is well-known to be a fundamental technology, and LiNbO3 is one of the most representative materials. The half cells using the cathode mixture of Li6PS5Cl/LiNbO3-coated LiNi0.5Co0.2Mn0.3O2 were exposed in harsh conditions at 60 °C and 4.25-4.55 V vs Li/Li+ and analyzed by transmission electron microscope/energy dispersive X-ray spectroscopy (TEM/EDS) and X-ray absorption spectroscopy (XAS). TEM/EDS observation shows that Nb element derived from LiNbO3 coating had remained at the interface, which means that Nb element had not migrated to the solid electrolyte and active material. On the other hand, the XAS spectra of Nb L3-edge changed corresponding to cell performance degradation. From the comparison with the spectra of the reference materials of the Li-Nb-O system, the XAS spectral changes were assigned to the decomposition reaction which released Li and O from the LiNbO3 coating. The side reaction is presumed to cause to the oxidization deterioration of sulfide electrolyte at the interface of Li6PS5Cl/LiNbO3-coated LiNi0.5Co0.2Mn0.3O2.

Design of Cathode Coating Using Niobate and Phosphate Hybrid Material for Sulfide-Based Solid-State Battery.

Coating the surface of the cathode active material of all-solid-state batteries with sulfide-based solid electrolytes is key for improving and enhancing the battery performance. Although lithium niobate (LiNbO3) is one of the most representative coating materials, its low durability at a highly charged potential and high temperature is an impediment to the realization of high-performance all-solid-state batteries. In this study, we developed new hybrid coating materials consisting of lithium niobate (Li-Nb-O) and lithium phosphate (Li-P-O) and investigated the influence of the ratio of P/(Nb + P) on the durability performance. The cathode half-cells, using a sulfide-based solid electrolyte Li6PS5Cl/cathode active material, LiNi0.5Co0.2Mn0.3O2, coated with the new hybrid coating materials of LiPxNb1-xO3 (x = 0-1), were exposed to harsh conditions (60 °C and 4.55 V vs Li/Li+) for 120 h as a degradation test. P substitution resulted in higher durability and lower interfacial resistance. In particular, the hybrid coating with x = 0.5 performed better, in terms of capacity retention and interfacial resistance, than those with other compositions of niobate and phosphate. The coated cathode active materials were analyzed using various analytical techniques such as scanning electron microscopy/energy-dispersive X-ray spectroscopy, transmission electron microscopy (TEM), X-ray photoelectron spectroscopy, and X-ray absorption spectroscopy (XAS) to elucidate the improvement mechanism. Moreover, the degraded cathodes were observed using time-of-flight secondary-ion mass spectrometry, TEM/electron diffraction, and XAS. These analyses revealed that the Nb-O-P coordination in the hybrid coating material captured O by P. The coordination suppressed the release of O from the coating layer as a decomposition side reaction to realize a higher durability than that of LiNbO3.

A rare case of eosinophilic gastrointestinal disorders with short bowel syndrome after strangulated bowel obstruction.

BACKGROUND: Short bowel syndrome (SBS) is a rare yet costly disease with an incidence rate of 3 per million people. Herein, we report a rare case of eosinophilic gastrointestinal disorders (EGIDs) with SBS after strangulated bowel obstruction. CASE PRESENTATION: A 5-year-old male had a necrotic intestine of 340 cm resected due to strangulated bowel obstruction caused by an intestinal mesenteric hiatal hernia. The length of the residual intestine was 51 cm. Bloody stools appeared 19 days postoperatively. Colonoscopy showed diffuse redness of the colonic mucosa, and pathological findings showed moderate chronic inflammatory cellular infiltration. On blood examination, the eosinophil count was > 30%. EGIDs with short bowel syndrome (SBS) were suspected. Because his symptoms did not improve with initial nutrition therapy, he was transferred to our hospital 5 months after the operation. Prednisolone was administrated at an initial dose of 1.4 mg/kg/day, 6 days after his transfer. Bloody stools disappeared after prednisolone administration. Seven months after discharge, he had no bloody stool recurrence. CONCLUSION: The risk of developing secondary EGIDs in children with SBS should be considered, and postoperative management should include attention to abdominal symptoms and elevated eosinophil counts on blood examination.

Fecoflowmetric profiles in postoperative patients with Hirschsprung's disease.

PURPOSE: The objective of this study is to evaluate the anorectal function from the viewpoint of fecoflowmetry in postoperative patients with Hirschsprung's disease (HD). METHODS: This study evaluated 23 long-term follow-up patients who had undergone a radical operation for HD. Their mean age was 11 years. The types of HD included rectosigmoid colon type, 18 cases, and entire colon type, 5 cases. An anorectal manometric study was performed before fecoflowmetry. After normal saline solution was administrated as an imitation stool into the rectal cavity under pressure monitoring, the patients defecated on a fecoflowmeter. After discussing the maximum defecation flow (Flow-max), fecoflow pattern (FFP), tolerance rate (TR), anal canal pressure (AP), and Kelly's clinical scores (Kelly-Scores), the significant parameters were identified to elucidate the anorectal activity. RESULTS: (1) A close relationship was observed between the FFP and Kelly-Scores (P = .0027). (2) Flow-max, TR, and AP in patients with good Kelly-Scores were significantly higher than those in patients with fair Kelly-Scores (P < .05). (3) The Flow-max accurately reflected the TR, Kelly-Scores, and AP. Flow-max >45 mL per second, TR >70%, or AP >30 mm Hg was statistically regarded as a borderline level of fecal continence (P < .002). CONCLUSIONS: The Flow-max and FFP are considered to be useful parameters for postoperative patients with HD.

Effects of the herbal medicine Inchinko-to on liver function in postoperative patients with biliary atresia--a pilot study.

BACKGROUND/PURPOSE: A continuation of liver fibrosis after undergoing successful Kasai operation has become the important clinical issue in the long-term follow-up of patients with biliary atresia (BA). The aim of this study is to evaluate the efficacy of the herbal medicine Inchinko-to (TJ-135) on the treatment of liver fibrosis in patients with BA without jaundice, especially from the viewpoint of the long-term effects of TJ-135. METHODS: Six postoperative patients with BA ranging between 3 and 13 years of age with normal serum total bilirubin levels (total bilirubin < 1.0 mg/dL [17 micromol/L]) received TJ-135 from 2 to 4 years. The liver enzyme (glutamic oxaloacetic transaminase [GOT], glutamic pyruvic transaminase [GPT], gamma glutamyl transpeptidase[gamma-GTP]transpeptidase[gamma-GTP] levels and hyaluronic acid (HA) levels were compared before and after the administration of TJ-135. The monthly collected data were averaged on a 1-year basis. The record of one postoperative patient with BA and a normal serum total bilirubin level was incorporated as a control. This patient showed portal hypertension and did not receive TJ-135. RESULTS: Five of the six patients who showed abnormal values for liver enzymes, exhibited a significant decrease in serum GOT, gamma-GTP, or GPT levels after a 1 to 3-year administration of TJ-135, and the improvement in these parameters persisted thereafter. Furthermore, one patient who had an abnormally high value of HA also showed a significant decrease in the serum level of HA. In the remaining patient with normal liver enzyme values, no significant change was observed during the administration of TJ-135. The control patient exhibited a chronological decrease in the serum GOT and GPT levels by 5 years of age, but the serum gamma-GTP and HA levels remained stable throughout the postoperative period. CONCLUSIONS: The long-term effectiveness of TJ-135 was only found in those patients with abnormal liver enzyme levels and HA, thereby suggesting that TJ-135 has a protective and antifibrotic effect on the liver.

Long-term follow-up status of patients with neuroblastoma after undergoing either aggressive surgery or chemotherapy--a single institutional study.

BACKGROUND/PURPOSE: Before adopting a national protocol of aggressive chemotherapy for patients with advanced neuroblastoma in 1985, the treatment strategies in use varied considerably among the institutions in Japan. An aggressive surgical resection was the treatment of choice at the authors' institution before 1985. To better understand treatment-related complications, the authors retrospectively investigated the long-term morbidity of patients who had reached adulthood. METHODS: Sixteen patients with neuroblastoma currently 18 years of age or older were incorporated into the study. All were non-mass screening cases, and 13 of the patients had undergone aggressive surgery, whereas the remaining 3 cases had received aggressive chemotherapy. RESULTS: In the 13 patients who had undergone aggressive surgical treatment, a unilateral atrophy of the kidney was noted in 2 cases of adrenal and retroperitoneal neuroblastomas, respectively. Dry ejaculation was noted in one case of a giant presacral neuroblastoma. A maldevelopment of the unilateral lower extremity was also noted in another case with a presacral tumor, which had been resected by abdominal and sacral approaches. In the 3 patients who had undergone aggressive chemotherapy, severe hearing loss occurred in 2 cases. However, social adaptation was well preserved in all 16 cases. CONCLUSIONS: Treatment-specific complications were found in both the aggressive surgery and chemotherapy groups. These results should, therefore, be taken into account when developing future treatment protocols.

Effect of postoperative chemotherapy on the serum alpha-fetoprotein level in hepatoblastoma.

PURPOSE: It is generally accepted that postoperative chemotherapy does not affect the serum alpha-fetoprotein (AFP) level. The authors report on 3 patients who supposedly showed chemotherapy-related changes in their AFP levels after operation. METHODS: This study included 3 patients with hepatoblastoma (1 case of PRETEXT III and 2 cases of PRETEXT IV). RESULTS: One patient with PRETEXT III underwent a complete tumor resection, and the postoperative AFP level decreased until it reached the normal range. However, he consistently exhibited a transient, 2- to 3-fold increase in the AFP after each course of chemotherapy for 3 courses. The chemotherapy regimen had to be stopped because of drug-induced encephalopathy, but he has been followed up for 5 years without any evidence of recurrence, and his AFP level has also remained stable and in the normal range. Two patients with PRETEXT IV, who underwent a curative tumor resection, also showed similar chemotherapy-related changes in AFP levels. Both of these cases were observed only after the administration of routine postoperative chemotherapy instead of administering further high-dose chemotherapy. The AFP level remained stable for 17 months and 7 months after the cessation of chemotherapy in 2 cases, respectively. CONCLUSIONS: Regarding the postoperative chemotherapy of hepatoblastoma, we have to pay close attention to both the AFP status during chemotherapy as well as the absolute AFP level.

Whole-blood manganese levels and brain manganese accumulation in children receiving long-term home parenteral nutrition.

Recent reports attribute neurological and cerebral disorders to the accumulation of manganese (Mn) in the brain in patients receiving home parenteral nutrition (HPN). It is desirable to control the amount of Mn delivered to these patients, but a suitable method for monitoring an individual's Mn status and assessing Mn accumulation remains debatable. The aim of this study was to evaluate whether whole-blood manganese levels (WB-Mn) correlate with the accumulation of Mn in the brains of children who receive long-term HPN, using magnetic resonance imaging (MRI) of the brain. Six patients who had received HPN (duration of HPN, 18-137 months) were included in this study. The daily parenteral doses of Mn were calculated while on HPN. WB-Mn was measured and T1-weighted MRI of the brain was obtained for each patient with a 1.5-T MR imager. Twelve months after the withdrawal of Mn from HPN, measurements of WB-Mn and brain MRI were repeated in all patients except for one who was lost after initial examination. The same examinations were performed on an additional patient who had been successfully weaned off a 179 month course of HPN 20 months prior to the initial examination. The parenteral dose of Mn while receiving HPN ranged from 15.7 to 91.5 micro g/kg/day. Initially, MRI showed hyperintensity in the globus pallidus in all patients and in the anterior pituitary in one patient. WB-Mn was elevated in four patients, but was in the normal range in the remaining three. Following subsequent measurements 12 months later, WB-Mn was normal in all patients and MRI hyperintensity remained in the globus pallidus in one patient. One patient was lost after the initial examinations. WB-Mn does not necessarily correlate with the accumulation of Mn in the brain. Periodic MRI should be performed in patients receiving long-term NPN to monitor for excessive Mn accumulation in the brain.