Bronchial artery embolization (BAE) is an effective and minimally invasive procedure for managing massive or medically refractory hemoptysis. Despite its overall safety, BAE can be associated with complications, including nontarget embolization, with cerebral infarction being a rare but severe adverse event. We report a case of posterior circulation infarction, caused by unintended embolization of trisacryl gelatin microspheres via anastomosis between the left bronchial and left subclavian arteries, following BAE in a 45-year-old man with massive hemoptysis. After the BAE, the patient complained of nausea and vomiting. Magnetic resonance imaging (MRI) revealed multifocal bilateral posterior circulation infarctions. The patient was initially treated with aspirin. However, follow-up MRI the next day showed hemorrhagic transformation of the right thalamic infarct along with right lateral intraventricular hemorrhage. Consequently, aspirin was discontinued, and blood pressure was carefully managed. Seven days later, the patient’s symptoms improved without any neurological sequelae. This case highlights the importance of superselective catheterization, meticulous angiographic assessment, and repeat angiography during embolization to minimize neurological complications. Anticoagulation therapy may be beneficial for the management of such complications.

In this study, the effect of particle size of genistein-loaded solid lipid particulate systems on drug dissolution behavior and oral bioavailability was investigated. Genistein-loaded solid lipid microparticles and nanoparticles were prepared with glyceryl palmitostearate. Except for the particle size, other properties of genistein-loaded solid lipid microparticles and nanoparticles such as particle composition and drug loading efficiency and amount were similarly controlled to mainly evaluate the effect of different particle sizes of the solid lipid particulate systems on drug dissolution behavior and oral bioavailability. The results showed that genistein-loaded solid lipid microparticles and nanoparticles exhibited a considerably increased drug dissolution rate compared to that of genistein bulk powder and suspension. The microparticles gradually released genistein as a function of time while the nanoparticles exhibited a biphasic drug release pattern, showing an initial burst drug release, followed by a sustained release. The oral bioavailability of genistein loaded in solid lipid microparticles and nanoparticles in rats was also significantly enhanced compared to that in bulk powders and the suspension. However, the bioavailability from the microparticles increased more than that from the nanoparticles mainly because the rapid drug dissolution rate and rapid absorption of genistein because of the large surface area of the genistein-solid lipid nanoparticles cleared the drug to a greater extent than the genistein-solid lipid microparticles did. Therefore, the findings of this study suggest that controlling the particle size of solid-lipid particulate systems at a micro-scale would be a promising strategy to increase the oral bioavailability of genistein.
Absorption* ; Animals ; Biological Availability* ; Drug Liberation ; Genistein* ; Nanoparticles* ; Particle Size* ; Powders ; Rats

PURPOSE: Before laparoscopic gastrectomy for gastric cancer can be planned, it is very important to know the precise location of the tumor. The aim of this study was to evaluate 3 methods of predicting the exact location of the tumor: preoperative gastrofibroscopy (GFS), preoperative computed tomography gastroscopy (CT), and intraoperative gastroscopy-guided laparoscopy (Lap). METHODS: In this study, 15 patients were prospectively identified, and endoscopic clips were preoperatively placed on the proximal 1 cm of the tumor, at the angle on the greater curvature and opposite the angle on the greater curvature. The distances between the pylorus and the proximal tumor clip (PT), the angle clip (PA), the greater curvature clip (PG), and the gastroesophageal junction were measured by preoperative GFS, preoperative CT, intraoperative Lap, and visual inspection (Vis). RESULTS: PT, PA, and PG values measured by preoperative GFS differed significantly from the Vis values (P < 0.01). However, preoperative CT measurements of PT, PA, and PG did not differ from the Vis values (P = 0.78, P = 0.48, and P = 0.53, respectively). Intraoperative Lap and Vis PT values differed by only 1.1 cm on an average (P = 0.10), but PA and PG values varied by 1.9 and 3.4 cm, respectively (P = 0.01 for both). CONCLUSION: Endoscopic clipping combined with preoperative CT gastroscopy is more useful than preoperative GFS for preoperatively predicting the location of early gastric cancers and will be helpful for planning laparoscopic gastrectomy.
Esophagogastric Junction ; Gastrectomy ; Gastroscopy ; Humans ; Laparoscopy ; Prospective Studies ; Pylorus ; Stomach Neoplasms ; Tomography, X-Ray Computed

A trocar site hernia is a rare complication. We report a patient who had an abdominal wall mass at a previous trocar site after laparoscopic distal gastrectomy. It was diagnosed as omental herniation and fat necrosis. We conclude that patients with trocar site masses exhibiting fat density on a computed tomography scan could be followed up without surgery, and that fascial defects located at 10-mm or larger trocar sites should be closed whenever possible to prevent hernia formation.
Abdominal Wall ; Fat Necrosis ; Gastrectomy ; Hernia ; Humans ; Laparoscopy ; Omentum ; Stomach Neoplasms ; Surgical Instruments

Intussusception is rare in adults accounting for 5% of all cases. It can be caused by various lesions but is rarely the result of trauma. Recently we encountered a case of adult intussusception after blunt abdominal trauma without any other leading causes. We report this case with a review of the relevant literatures.
Abdomen, Acute ; Adult* ; Humans ; Intussusception*