Interrupted aortic arch diagnosed with loss of femoral pulse in a patient undergoing patent ductus arteriosus ligation -A case report-

A 12-year-old boy with ventricular septal defect and patent ductus arteriosus was presented to the operating room. Upon clamping the patent ductus arteriosus, the femoral arterial pressure curve was lost; however, it returned upon unclamping. Upon further dissection, an interrupted aortic arch was found between the left subclavian artery and patent ductus arteriosus. The surgery was discontinued for further evaluation

Application of Ganz Surgical Hip Dislocation Approach in Pediatric Hip Diseases

Ganz surgical hip dislocation is useful in the management of severe hip diseases, providing an unobstructed view of the femoral head and acetabulum. We present our early experience with this approach in pediatric hip diseases. Twenty-three hips of 21 patients with pediatric hip diseases treated using the Ganz surgical hip dislocation approach were the subjects of this study. The average age at the time of surgery was 15.7 years. There were 15 male and 6 female patients who were followed for an average of 15.1 months (range, 6 to 29 months). Diagnoses included hereditary multiple exostoses in 9 hips, slipped capital femoral epiphysis in 7, Legg-Calvé-Perthes disease in 4, osteoid osteoma in 1, pigmented villonodular synovitis in 1, and neonatal septic hip sequelae in 1. Medical records were reviewed to record diagnoses, principal surgical procedures, operative time, blood loss, postoperative rehabilitation, changes in the range of hip joint motion, and complications. Femoral head-neck osteochondroplasty was performed in 17 patients, proximal femoral realignment osteotomy in 6, open reduction and subcapital osteotomy for slipped capital femoral epiphysis (SCFE) in 2, core decompression and bone grafting in 2, hip distraction arthroplasty in 2, and synovectomy in 2. Operative time averaged 168.6 minutes when only osteochondroplasty and/or synovectomy were performed. Hip flexion range improved from a preoperative mean of 84.7 degrees to a mean of 115.0 degrees at the latest follow-up visit. Early continuous passive motion and ambulation were stressed in rehabilitation. No avascular necrosis of the femoral head was noted up to the time of the latest follow-up visit, except for in one SCFE patient whose surgical intervention was delayed for medical reasons. Ganz surgical hip dislocation provides wide exposure of the femoral head and neck, which enables complete and precise evaluation of the femoral head and neck contour. Hence, the extensive impinging bump can be excised meticulously, and the circulation of the femoral head can be monitored during surgery. The Ganz procedure was useful in severe pediatric hip diseases and allowed for quick rehabilitation with fewer complications.Y

Comparative Genomic Analysis of the 2016 Vibrio cholerae Outbreak in South Korea

In August 2016, South Korea experienced a cholera outbreak that caused acute watery diarrhea in three patients. This outbreak was the first time in 15 years that an outbreak was not linked to an overseas source. To identify the cause and to study the epidemiological implications of this outbreak, we sequenced the whole genome of Vibrio cholerae isolates; three from each patient and one from a seawater sample. Herein we present comparative genomic data which reveals that the genome sequences of these four isolates are very similar. Interestingly, these isolates form a monophyletic Glade with V. cholerae strains that caused an outbreak in the Philippines in 2011. The V. cholerae strains responsible for the Korean and Philippines outbreaks have almost identical genomes in which two unique genomic islands are shared, and they both lack SXT elements. Furthermore, we confirm that seawater is the likely source of this outbreak, which suggests the necessity for future routine surveillance of South Korea's seashore.

Evaluation of functional outcome of bilateral kidney tumors after sequential surgery

Background There are limited data concerning patients treated with sequential bilateral kidney surgery. Current guidelines still lack an optimal surgical sequencing approach. We evaluated renal functional outcomes after sequential partial nephrectomy (PN) and radical nephrectomy (RN) in patients with bilateral renal cell carcinoma (RCC). Methods A propensity score matched cohort of 267 patients (synchronous bilateral RCCs, N = 44 [88 lesions]; metachronous bilateral, N = 45 [90 lesions]; unilateral, N = 178) from two tertiary institutions were retrospectively analyzed. Synchronous bilateral RCCs were defined as diagnosis concomitantly or within 3 months of former tumor. Renal functional outcomes were defined as estimated glomerular filtration rate (eGFR) changes and de novo chronic kidney disease (CKD, stage ≥3) after surgery. Renal functional outcomes and clinical factors predicting de novo CKD were assessed using descriptive statistics and Cox regression analysis. Results In subgroup of bilateral RCCs, patients underwent sequential PN (N = 48), PN followed by RN (N = 8), or RN followed by PN (N = 25). Final postoperative estimated glomerular filtration rates (eGFRs) were 79.4, 41.4, and 61.2 ml/minute/1.73 m2, respectively (p = 0.003). There were significant differences in eGFR decline from baseline and de novo chronic kidney disease (CKD stage ≥ III) among groups, with PN followed by RN group showing the worst functional outcomes (all p <  0.05). Moreover, sequential PN subgroup in bilateral RCC showed significantly higher rate of de novo CKD than unilateral RCC group (13.8% vs. 6.9%, p = 0.016). On multivariate analysis, hypertension (p = 0.010) and surgery sequence (PN followed by RN, p <  0.001) were significant predictors of de novo CKD. Conclusions The surgery sequence should be prudently determined in bilateral renal tumors. PN followed by RN showed a negative impact on renal functional preservation. Nephron-sparing surgery should be considered for all amenable bilateral RCCs

Protective Effect of Sauchinone Against Regional Myocardial Ischemia/Reperfusion Injury: Inhibition of p38 MAPK and JNK Death Signaling Pathways

Sauchinone has been known to have anti-inflammatory and antioxidant effects. We determined whether sauchinone is beneficial in regional myocardial ischemia/reperfusion (I/R) injury. Rats were subjected to 20 min occlusion of the left anterior descending coronary artery, followed by 2 hr reperfusion. Sauchinone (10 mg/kg) was administered intraperitoneally 30 min before the onset of ischemia. The infarct size was measured 2 hr after resuming the perfusion. The expression of cell death kinases (p38 and JNK) and reperfusion injury salvage kinases (phosphatidylinositol-3-OH kinases-Akt, extra-cellular signal-regulated kinases [ERK1/2])/glycogen synthase kinase (GSK)-3β was determined 5 min after resuming the perfusion. Sauchinone significantly reduced the infarct size (29.0% ± 5.3% in the sauchinone group vs 44.4% ± 6.1% in the control, P < 0.05). Accordingly, the phosphorylation of JNK and p38 was significantly attenuated, while that of ERK1/2, Akt and GSK-3β was not affected. It is suggested that sauchinone protects against regional myocardial I/R injury through inhibition of phosphorylation of p38 and JNK death signaling pathways

Gold Nanoparticle-Enhanced and Roll-to-Roll Nanoimprinted LSPR Platform for Detecting Interleukin-10

Localized surface plasmon resonance (LSPR) is a powerful platform for detecting biomolecules including proteins, nucleotides, and vesicles. Here, we report a colloidal gold (Au) nanoparticle-based assay that enhances the LSPR signal of nanoimprinted Au strips. The binding of the colloidal Au nanoparticle on the Au strip causes a red-shift of the LSPR extinction peak, enabling the detection of interleukin-10 (IL-10) cytokine. For LSPR sensor fabrication, we employed a roll-to-roll nanoimprinting process to create nanograting structures on polyethylene terephthalate (PET) film. By the angled deposition of Au on the PET film, we demonstrated a double-bent Au structure with a strong LSPR extinction peak at ~760 nm. Using the Au LSPR sensor, we developed an enzyme-linked immunosorbent assay (ELISA) protocol by forming a sandwich structure of IL-10 capture antibody/IL-10/IL-10 detection antibody. To enhance the LSPR signal, we introduced colloidal Au nanocube (AuNC) to be cross-linked with IL-10 detection antibody for immunogold assay. Using IL-10 as a model protein, we successfully achieved nanomolar sensitivity. We confirmed that the shift of the extinction peak was improved by 450% due to plasmon coupling between AuNC and Au strip. We expect that the AuNC-assisted LSPR sensor platform can be utilized as a diagnostic tool by providing convenient and fast detection of the LSPR signal. © Copyright © 2020 Baek, Song, Lee, Kim, Kim, Wi, Ok, Park, Hong, Kwak, Lee and Nam.1

Importance of Fe-Zn Reaction in Zn-assisted Liquid Metal Embrittelement during Resistance Spot Welding: Si Effect in TWIP Steels

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Characteristics and trends of published adult hip research over the last decade

Purpose: We designed this study to demonstrate recent trends in the proportion of adult hip research in orthopedics, to identify countries leading the adult hip research, and to evaluate the relationship between the economic power of the countries and their contributions. Materials and Methods: Studies published in seven select orthopedic journals were retrieved from PubMed. Among them, we determined the number of adult hip studies. The countries-of-origin of adult hip studies, and the economic power of the countries were investigated. Results: A total of 7218 orthopedic publications and 1993 (27.6%) addressed adult hip research were identified. Adult hip studies increased from 313 (23.7%) in 2000 to 555 (27.9%) in 2011. Twenty-five countries accounted for 97.6% of the total number of adult hip studies, and gross domestic product correlated with publication volume (Spearman&apos;s rho, 0.723; p=0.000). Conclusion: Researchers from a limited number of developed countries have published their studies in the adult hip discipline.Y