Bilateral tension pneumothorax caused by an abrupt increase in airway pressure during cervical spine surgery in the prone position -A case report-

Elevated peak inspiratory airway pressure (PIP) can occur during general anesthesia and is usually easily rectified. In rare circumstances it can lead to potentially fatal conditions such as tension pneumothorax. We report on a 77-year-old male patient admitted for a cervical laminoplasty. The preoperative chest radiograph showed normal findings and there was no medical history of allergy or underlying airway inflammation. Anesthesia induction and maintenance progressed uneventfully. However, 5 minutes after prophylactic antibiotic administration, PIP suddenly increased and blood pressure dropped. The operation was abandoned and the patient was moved to a supine position to perform chest radiography. Cardiac arrest occurred, and cardiopulmonary resuscitation was performed. The radiograph showed bilateral tension pneumothorax. Needle aspiration was immediately performed, and chest tubes were inserted. Ventilation rapidly improved and the vital signs normalized. The patient was discharged without sequelae on postoperative day 36

Correction to: Metagenomic analysis of isolation methods of a targeted microbe, Campylobacter jejuni, from chicken feces with high microbial contamination

Following publication of the original article [1], the authors reported an error in Fig. 2. The correct figure is shown below

Dairy Cattle, a Potential Reservoir of Human Campylobacteriosis: Epidemiological and Molecular Characterization of Campylobacter jejuni From Cattle Farms

Campylobacter jejuni is a major foodborne pathogen that is increasingly found worldwide and that is transmitted to humans through meat or dairy products. A detailed understanding of the prevalence and characteristics of C. jejuni in dairy cattle farms, which are likely to become sources of contamination, is imperative and is currently lacking. In this study, a total of 295 dairy cattle farm samples from 15 farms (24 visits) in Korea were collected. C. jejuni prevalence at the farm level was 60% (9/15) and at the animal level was 23.8% (68/266). Using the multivariable generalized estimating equation (GEE) model based on farm-environmental factors, we estimated that a high density of cattle and average environmental temperature (7 days prior to sampling) below 24°C affects the presence and survival of C. jejuni in the farm environment. Cattle isolates, together with C. jejuni from other sources (chicken and human), were genetically characterized based on analysis of 10 virulence and survival genes. A total of 19 virulence profile types were identified, with type 01 carrying eight genes (all except hcp and virB11) being the most prevalent. The prevalence of virB11 and hcp was significantly higher in isolates from cattle than in those from other sources (p < 0.05). Multilocus sequence typing (MLST) of C. jejuni isolates from three different sources mainly clustered in the CC-21 and CC-48. Within the CC-21 and CC-48 clusters, cattle isolates shared an indistinguishable pattern with human isolates according to pulsed-field gel electrophoresis (PFGE) and flaA-restriction fragment length polymorphism (RFLP) typing. This suggests that CC-21 and CC-48 C. jejuni from dairy cattle are genetically related to clinical campylobacteriosis isolates. In conclusion, the farm environment influences the presence and survival of C. jejuni, which may play an important role in cycles of cattle re-infection, and dairy cattle represent potential reservoirs of human campylobacteriosis. Thus, environmental management practices could be implemented on cattle farms to reduce the shedding of C. jejuni from cattle, subsequently reducing the potential risk of the spread of cattle-derived C. jejuni to humans through the food chain

Pure Sensory Deficit at the T4 Sensory Level as an Isolated Manifestation of Lateral Medullary Infarction

In rare cases restricted sensory deficits along the somatotopic topography of the spinothalamic tract can develop from a lateral medullary infarction. To our knowledge, isolated dermatomal sensory deficit as a single manifestation of a lateral medullary infarction has not been reported previously. A 58-year-old man presenting with sudden left-sided paresthesia complained of sensory deficit of pain and temperature below the left T4 sensory level without other neurologic deficits. Diffuse- and T2-weighted magnetic resonance imaging (MRI) of the brain showed high signal intensities in the right lower medulla oblongata, whereas thoracic-spine MRI and somatosensory evoked potentials produced normal findings

Reproduction of Gastric Cancer Prognostic Score by real-time quantitative polymerase chain reaction assay in an independent cohort

Purpose Addition of molecular markers to the American Joint Committee on Cancer (AJCC) staging system would allow further refinements in predicting recurrence and help individualize treatment decisions. We aimed to validate the Gastric Cancer Prognostic Score (GCPS) in an independent cohort using an easy and cost effective quantitative real-time polymerase chain reaction (qRT-PCR) assay. Methods We performed qRT-PCR using 48 samples from our previous study and expanded to 128 independent patients. The GCPS was recalculated using Cox regression estimates and the performance of cutoff values for GCPS was reassessed. Results The qRT-PCR results showed a similar pattern to nanostring data by scale function data comparison. Using a new cutoff value, GCPS stratified 95 stage IB–III patients who received adjuvant chemotherapy into 74 high-risk patients and 21 low-risk patients with significantly different recurrence-free survival (P< 0.0001). The survival difference remained significant (P= 0.028) in 27 patients who did not receive adjuvant chemotherapy. Among stage I and II patients who were treated with surgery only, one AJCC stage IIA patient was defined as low-risk and showed long-term survival. Nine of 12 high-risk patients showed recurrence less than 67 months after operation. Conclusion We reproduced the GCPS with an easily applicable qRT-PCR assay and successfully predicted recurrence in patients with gastric cancer

Preparation of Multilayered Core–Shell Fe3O4-SnO2-C Nanoparticles via Polymeric/Silane–Amino Functionalization

Multilayered core–shell Fe3O4-SnO2-C nanoparticles were prepared via surface treatment and carbonization at atmospheric pressure. Fe3O4-SnO2 nanoparticles were prepared by the carboxylation of the pivotal particles (Fe3O4) with an anionic surfactant to immobilize SnO2 nanoparticles. A method was proposed to externally surround hydrophilic carbon with amine-forming materials, polyethyleneimine (PEI), and (3-Aminopropyl) triethoxysilane (APTES). The synthesis strategy was based on the electrostatic bonding of the introduced amine group with the hydroxyl group on the carbon precursor and the carbonization of the coating layer by the catalytic reaction of sulfuric acid

An Optimization-Based Intentional Islanding Scheme for Service Restoration in Distribution Systems Considering Anti-Parallel Operation of Distributed Generations

An islanding operation of distributed generations (DGs) in emergencies due to a fault in distribution systems can be a means of power supply for important loads in outage areas by facilitating the self-sufficient capability of DGs forming microgrids. This paper presents an optimization-based intentional islanding scheme to derive a near-optimal service restoration (SR) plan. The anti-parallel operation of DGs is considered a new constraint that avoids more than two DGs in an island thereby, enabling simpler control and operation of the distribution system in an emergency. Each island is created by an island partitioning scheme based on the tree representation of the network and fast searching scheme for the tree structure considering load importance, and a genetic algorithm (GA) is utilized to explore possible SR solutions. Case studies on IEEE 69-bus distribution system according to various fault locations are conducted, and the simulation results show that the proposed scheme can restore more loads with higher priority in outage areas by the intentional islanding of DGs. Furthermore, the time for deriving the optimal solution can be reduced since the evaluations for infeasible solutions are not performed