Tension pneumopericardium after removal of pericardiocentesis drainage catheter

This image showed tension pneumopericardium caused by removing the pericardiocentesis catheter, which was inserted to drain malignant pericardial effusion. Tension pneumopericardium is a rare and potentially fatal event. Mortality from tension pneumopericardium can be as high as 50%. Therefore, it is important to suspect and detect early, if the patient complained of dyspnea after removing the pericardiocentesis drainage cathete

Exploratory Study of Functional Movement in Rope Climbing

PURPOSE This study aimed to explore the functional movement in rope climbing. METHODS The rope climbing experiment included 16 healthy young male participants, and the methods of hand, cross-leg, and foot-hooking climbing were employed. The muscle activity and joint range of motion were measured and analyzed using EMG (Electromyography) and IMU (Inertial Measurement Unit) sensors. One-way analysis of variance was conducted (α<.05). RESULTS The activity of the forearm and biceps muscle was lower in cross-leg and foot-hooking climbing compared to hand climbing (p<.01), and the rectus femoris muscle activity in cross-leg climbing was smaller than that in hand climbing (p<.05). Furthermore, the adductor muscle activity in cross-leg climbing was higher than that of other types (p<.01). The range of motion for the elbow and shoulder flexion was smaller in hand climbing than in other types (p<.05); furthermore, the range of motion in the pelvis, thigh, and knee joint was the smallest in cross-leg climbing (p<.05). CONCLUSIONS Because the pulling muscles such as the forearm, biceps, pectoralis major, and latissimus dorsi play an important role in the entire climbing motion, it is necessary to train the upper-body pulling-muscle group along with strengthening the core and lower body muscles

Evaluation of a Sodium–Water Reaction Event Caused by Steam Generator Tubes Break in the Prototype Generation IV Sodium-cooled Fast Reactor

AbstractThe prototype generation IV sodium-cooled fast reactor (PGSFR) has been developed by the Korea Atomic Energy Research Institute. This reactor uses sodium as a reactor coolant to transfer the core heat energy to the turbine. Sodium has chemical characteristics that allow it to violently react with materials such as a water or steam. When a sodium–water reaction (SWR) occurs due to leakage or breakage of steam generator tubes, high-pressure waves and corrosive reaction products are produced, which threaten the structural integrity of the components of the intermediate heat-transfer system (IHTS) and the safety of the primary heat-transfer system (PHTS). In the PGSFR, SWR events are included in the design-basis event. This event should be analyzed from the viewpoint of the integrities of the IHTS and fuel rods. To evaluate the integrity of the IHTS based on the consequences of the SWR, the behaviors of the generated high-pressure waves are analyzed at the major positions of a failed IHTS loop using a sodium–water advanced analysis method-II code. The integrity of the fuel rods must be consistently maintained below the safety acceptance criteria to avoid the consequences of the SWR. The integrity of the PHTS is evaluated using the multidimensional analysis of reactor safety-liquid metal reactor code to model the whole plant

Helical tomotherapy with concurrent capecitabine for the treatment of inoperable pancreatic cancer

<p>Abstract</p> <p>Background</p> <p>Helical tomotherapy, an advanced intensity-modulated radiation therapy with integrated CT imaging, permits highly conformal irradiation with sparing of normal tissue. Capecitabine, a pro-drug of 5-FU that induces thymidine phosphorylase can achieve higher levels of intracellular 5-FU when administered concurrently with radiation. We evaluated the feasibility as well as the clinical outcome of concurrent administration of capecitabine with tomotherapy in patients with advanced pancreatic cancer.</p> <p>Methods</p> <p>Nineteen patients with advanced pancreatic cancer including primarily unresectable disease and recurrence after curative surgery were included in the study. Two planning target volumes (PTV) were entered: PTV1 is gross tumor volume; and PTV2, the volume of the draining lymph nodes. The total doses to target 1 and target 2 were 55 and 50 Gy, respectively. Capecitabine at 1600 mg/m²/day was administered on each day of irradiation.</p> <p>Results</p> <p>Twenty six measurable lesions were evaluated. Overall in-field response rate was 42.3%; partial responses were achieved in 53.3% of the pancreatic masses, 28.6% of distant metastatic lesions and 25.0% of regional lymph nodes. The median duration of follow-up after tomotherapy was 6.5 months. None of the lesions showed in-field progression. Treatment was well tolerated with only minor toxicities such as grade 1 nausea (one patient), grade 1 hand-foot syndrome (one patient) and grade 1/2 fatigue (three patients).</p> <p>Conclusions</p> <p>Helical tomotherapy with concurrent capecitabine is a feasible option without significant toxicities in patients with advanced pancreatic cancer. We achieved excellent conformal distribution of radiation doses and minimal treatment-related toxicities with promising target volume responses.</p

Visceral Myopathy of Intestinal Pseudoobstruction

Intestinal pseudoobstruction is a syndrome complex caused by a variety of disorders of various etiology. It can be classified pathologically as visceral myopathy and visceral neuropathy. The sporadic form of visceral myopathy is characterized histologically by vacuolar degeneration and fibrosis of smooth muscle but differs from the familial form only by the absence of other affected family members. We studied 6 cases with intestinal pseudoobstruction classified as sporadic visceral myopathy. They were four boys and two girls, and were two neonates, two infants and two children. The duration of symptoms ranged from two days to two years. Two babies were dead from pneumonia and sepsis. Others were alleviated after surgical resection of the bowel. Both small and large intestines were found affected in autopsy cases. Histopathologic features were vacuolar degeneration of muscularis propria, disproportionate hypoplasia of outer muscle layer, abnormal muscle direction of muscularis propria, submucosal and/or interstitial fibrosis and extra muscle layering. It is presumed that a variety of histopathologic features accounts for visceral myopathy of intestinal pseudoobstruction

Association of Plasma Retinol-Binding Protein 4, Adiponectin, and High Molecular Weight Adiponectin with Insulin Resistance in Non-Diabetic Hypertensive Patients

∙The authors have no financial conflicts of interest. Purpose: The aim of this study was to determine whether retinol-binding protein 4 (RBP4), adiponectin and high molecular weight (HMW) adiponectin are associated with insulin resistance (IR) and metabolic parameters in non-diabetic hypertensive patients. Also, we sought to compare the predictive values of these adipocytokines for IR in non-diabetic hypertensive patients. Materials and Methods: Analyses of RBP4, adiponectin, and HMW adiponectin were performed on 308 non-diabetic hypertensives (148 males, age 58 ± 10 years, 189 non-metabolic syndrome and 119 metabolic syndrome). The homeostasis model assessment (HOMA) index for IR, lipid profiles, and anthropometric measure-ments were assessed. Results: There was no significant difference in RBP4 levels according to the presence of metabolic syndrome, although adiponectin and HMW adiponectin were significantly lower in metabolic syndrome. Correlation analysis of log RBP4 with IR and metabolic indices revealed that there was no significant correlation of RBP4 with wais

Clinical Outcomes of Single-level Posterior Percutaneous Endoscopic Cervical Foraminotomy for Patients with Less Cervical Lordosis

Objective Posterior percutaneous endoscopic cervical foraminotomy (P-PECF) is a minimally invasive surgical technique for treatment of cervical radiculopathies. Application of P-PECF to patients with preexisting loss of cervical curvature (<10°) is still controversial because violation to facet joint may lead to kyphotic change. Clinical outcomes of P-PECF was analyzed and compared according to preoperative cervical curvature. Methods In this retrospective nested case-control study, 71 patients who underwent P-PECF due to foraminal soft disc herniation or bony stenosis were reviewed. P-PECF was performed by a single senior surgeon, and surgical methods were as previously described. Visual analogue pain scale on arm (Arm-VAS) was assessed preoperatively and postoperatively (1, 3, 6, 12 month and yearly thereafter). All patients were clinically followed for 24.5±20.0 months. The minimal clinically important difference of the Arm-VAS was set at 2.5. Patients with preoperative cervical curvature ≥10° were included in group I (n=32) and cervical curvature <10° or kyphosis were included in the group II (n=39). Results At the last follow up, 68/71 (96%) patients showed significant reduction of arm pain (Pre-operation, 7.4±2.0; post-operation, 1.5±2.0) after 1.74±0.29 months (95% CI; 1.18-2.31). The preoperative cervical curvature did not influence the outcome (p=0.4, T-test) and time to reach the clinical endpoint (p=0.34, Cox-logistic regression analysis). Conclusion P-PECF effectively reduced radicular pain due to foraminal soft disc herniation or stenosis. Preexisting loss of lordosis is not a risk factor for outcomes of P-PECF

Potential Usefulness of Streptococcus pneumoniae

The secretion of extracellular membrane vesicles (EMVs) is a common phenomenon that occurs in archaea, bacteria, and mammalian cells. The EMVs of bacteria play important roles in their virulence, biogenesis mechanisms, and host cell interactions. Bacterial EMVs have recently become the focus of attention because of their potential as highly effective vaccines that cause few side effects. Here, we isolated the EMVs of Streptococcus pneumoniae and examined their potential as new vaccine candidates. Although the S. pneumoniae bacteria were highly pathogenic in a mouse model, the EMVs purified from these bacteria showed low pathological activity both in cell culture and in mice. When mice were injected intraperitoneally with S. pneumoniae EMVs and then challenged, they were protected from both the homologous strain and another pathogenic serotype of S. pneumoniae. We also identified a number of proteins that may have immunogenic activity and may be responsible for the immune responses by the hosts. These results suggest that S. pneumoniae EMVs or their individual immunogenic antigens may be useful as new vaccine agents

Pathological Classification of the Intramedullary Spinal Cord Tumors According to 2021 World Health Organization Classification of Central Nervous System Tumors, a Single-Institute Experience

According to the new 2021 World Health Organization (WHO) classification of tumors of the central nervous system (CNS) the classification of the primary intramedullary spinal cord tumors (IM-SCT) follows that of CNS tumors. However, since the genetics and methylation profile of ependymal tumors depend on the location of the tumor, the ‘spinal (SP)’ should be added for the ependymoma (EPN) and subependymoma (SubEPN). For an evidence-based review, the authors reviewed SCTs in the archives of the Seoul National University Hospital over the past decade. The frequent pathologies of primary IM-SCT were SP-EPN (45.1%), hemangioblastoma (20.0%), astrocytic tumors (17.4%, including pilocytic astrocytoma [4.6%] and diffuse midline glioma, H3 K27-altered [4.0%]), myxopapillary EPN (11.0%), and SP-subEPN (3.0%) in decreasing order. IDH-mutant astrocytomas, oligodendrogliomas, glioneuronal tumors, embryonal tumors, and germ cell tumors can occur but are extremely rare in the spinal cord. Genetic studies should support for the primary IM-SCT classification. In the 2021 WHO classifications, extramedullary SCT did not change significantly but contained several new genetically defined types of mesenchymal tumors. This article focused on primary IM-SCT for tumor frequency, age, sex difference, pathological features, and genetic abnormalities, based on a single-institute experience