Postanesthetic torsade de pointes in a patient with unrecognized long QT syndrome -A case report-

Torsade de pointes (TdP) is a devastating form of polymorphic ventricular arrhythmia associated with corrected QT (QTc) interval prolongation. TdP usually terminates spontaneously but frequently recurs and may degenerate to ventricular fibrillation. The present report describes a case of TdP in a patient being transferred to the postanesthetic care unit following an emergency laparoscopic appendectomy. The patient had undergone open heart surgery 1 week before. Retrospective electrocardiogram analysis revealed the patient had QTc and Tpeak-Tend interval prolongation that had gone unrecognized. We believe TdP may have been induced by accentuation of sympathetic nervous system during emergence from general anesthesia

Direct measurement of mechanical vibrations of the 4-rod RFQ at the HLI

In this paper, we present a new haptic interface, called active skin , which is configured with a tactile sensor and a tactile stimulator in single haptic cell, and multiple haptic cells are embedded in a dielectric elastomer. The active skin generates a wide variety of haptic feel in response to the touch by synchronizing the sensor and the stimulator. In this paper, the design of the haptic cell is derived via iterative analysis and design procedures. A fabrication method dedicated to the proposed device is investigated and a controller to drive multiple haptic cells is developed. In addition, several experiments are performed to evaluate the performance of the active skin

Granulocyte colony-stimulating factor treatment ameliorates lupus nephritis through the expansion of regulatory T cells

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.Abstract Background Granulocyte colony-stimulating factor (G-CSF) can induce regulatory T cells (Tregs) as well as myeloid-derived suppressor cells (MDSCs). Despite the immune modulatory effects of G-CSF, results of G-CSF treatment in systemic lupus erythematosus are still controversial. We therefore investigated whether G-CSF can ameliorate lupus nephritis and studied the underlying mechanisms. Methods NZB/W F1 female mice were treated with G-CSF or phosphate-buffered saline for 5 consecutive days every week from 24 weeks of age, and were analyzed at 36 weeks of age. Results G-CSF treatment decreased proteinuria and serum anti-dsDNA, increased serum complement component 3 (C3), and attenuated renal tissue injury including deposition of IgG and C3. G-CSF treatment also decreased serum levels of BUN and creatinine, and ultimately decreased mortality of NZB/W F1 mice. G-CSF treatment induced expansion of CD4+CD25+Foxp3+ Tregs, with decreased renal infiltration of T cells, B cells, inflammatory granulocytes and monocytes in both kidneys and spleen. G-CSF treatment also decreased expression levels of MCP-1, IL-6, IL-2, and IL-10 in renal tissues as well as serum levels of MCP-1, IL-6, TNF-α, IL-10, and IL-17. When Tregs were depleted by PC61 treatment, G-CSF-mediated protective effects on lupus nephritis were abrogated. Conclusions G-CSF treatment ameliorated lupus nephritis through the preferential expansion of CD4+CD25+Foxp3+ Tregs. Therefore, G-CSF has a therapeutic potential for lupus nephritis

WSES guidelines for management of Clostridium difficile infection in surgical patients

In the last two decades there have been dramatic changes in the epidemiology of Clostridium difficile infection (CDI), with increases in incidence and severity of disease in many countries worldwide. The incidence of CDI has also increased in surgical patients. Optimization of management of C difficile, has therefore become increasingly urgent. An international multidisciplinary panel of experts prepared evidenced-based World Society of Emergency Surgery (WSES) guidelines for management of CDI in surgical patients.Peer reviewe

Surgical and Clinical Outcomes Associated With the Use of Barbed Sutures and Self-Adhering Mesh System and Polymeric Glue for Wound Closure in Multilevel or Revision Spinal Surgery: A Matched Cohort Comparative Study With Conventional Wound Closure Procedure

Objective Multilevel or revisional posterior spinal surgery is prone to infection and delayed wound healing, related with the wound closure time and suture strength. Knotless barbed suture is an innovative self-locking, multianchor suture. This study aims to evaluate the safety and efficacy of the knotless barbed suture and self-adhering mesh with polymeric glue in multilevel or revisional posterior spinal surgery. Methods This is a single-center retrospective matched cohort study. Patients were divided into 2 groups based on the wound closure method: barbed suture group with novel wound closure, and conventional suture group with conventional wound closure, 1:1 matched by the level of surgery and sex, resulting in 120 subjects each. Total operation time and wound closure time were measured intraoperatively, and perioperative clinical outcome parameters including postoperative wound complication were investigated for the first 3 months postoperatively. The distribution of continuous variables was assessed for normality by Shapiro-Wilk test, then parametric or nonparametric tests were applied accordingly (paired t-test or Wilcoxon signed-rank test). Results Wound closure time was significantly shorter with the novel barbed suture than with conventional suture in all subgroups divided by the level of spinal surgery: 3–5, 6–9, ≥ 10 levels (p < 0.001). The 2 groups showed no significant differences in surgical complications (p = 1.000). Specially, total operation time and wound-closing time were significantly shorter in revisional subgroup. Conclusion Absorbable knotless barbed suture and self-adhering mesh with polymeric glue can shorten spinal wound closure time with noninferiority in complications for multilevel or revisional spinal surgery

Spatial and temporal changes in moth assemblages along an altitudinal gradient, Jeju-do island

Abstract Montane species on islands attract attention due to their small and isolated populations and limited dispersal potential, making them vulnerable to extinction. We investigated the diversity pattern of moth assemblages over the 12-years-period (2009–2020) at 11 study plots on an island mountain (Mount Hallasan, Jeju-do Island, South Korea) to assess the changes in the moth assemblages in terms of species composition, richness, and abundances. We expected to find a decline in the number of species at these sites, given the reported decline in similar taxa in other temperate regions, such as Europe and North America. In contrast, we found that the numbers of species and individuals of moth populations on the island mountain have not significantly changed, except at the high-elevation sites, where the number of species has increased. Our results also show that the numbers of species and individuals are closely related to energy availability, actual evapotranspiration. Moreover, we found that the species composition during the study period has not been greatly changed, except at the lowermost and uppermost elevations. The mechanism driving this high dissimilarity of moth assemblages differed: the low-elevation site experienced high temporal turnover, and the high elevation sites also experienced high temporal turnover and nestedness resulting from active species replacement due to a recent forest fire and vegetation changes and the geographic and ecological constraints of the high elevations. To date, the moth species diversity of the temperate forests of the island mountain is not showing a drastic change. However, we observed that the moth assemblages had changed the number of species and individuals at low and high elevations. Given the biological and ecological limitations of moths (ectothermic organisms with limited habitat range) and considering the results of our study, we infer that climate change has impacted the diversity and species composition of moths on the island mountain