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

Unilateral Epileptic Negative Myoclonus Following Focal Lesion of the Postcentral Cerebral Cortex Due to Acute Middle Cerebral Infarction

Here we report a patient who suffered an acute infarction of the contralateral postcentral cerebral cortex and subsequently developed unilateral partial epilepsy with negative myoclonus. The findings of brain magnetic resonance imaging, polygraphic recordings of the postcentral somatosensory area, and response to anticonvulsant treatment support the presence of a cause-and-effect relationship, thereby providing evidence for a pathophysiological substrate for epileptic negative myoclonus

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

Subchronic inhalation toxicity of gold nanoparticles

<p>Abstract</p> <p>Background</p> <p>Gold nanoparticles are widely used in consumer products, including cosmetics, food packaging, beverages, toothpaste, automobiles, and lubricants. With this increase in consumer products containing gold nanoparticles, the potential for worker exposure to gold nanoparticles will also increase. Only a few studies have produced data on the <it>in vivo </it>toxicology of gold nanoparticles, meaning that the absorption, distribution, metabolism, and excretion (ADME) of gold nanoparticles remain unclear.</p> <p>Results</p> <p>The toxicity of gold nanoparticles was studied in Sprague Dawley rats by inhalation. Seven-week-old rats, weighing approximately 200 g (males) and 145 g (females), were divided into 4 groups (10 rats in each group): fresh-air control, low-dose (2.36 × 10⁴particle/cm³, 0.04 μg/m³), middle-dose (2.36 × 10⁵particle/cm³, 0.38 μg/m³), and high-dose (1.85 × 10⁶particle/cm³, 20.02 μg/m³). The animals were exposed to gold nanoparticles (average diameter 4-5 nm) for 6 hours/day, 5 days/week, for 90-days in a whole-body inhalation chamber. In addition to mortality and clinical observations, body weight, food consumption, and lung function were recorded weekly. At the end of the study, the rats were subjected to a full necropsy, blood samples were collected for hematology and clinical chemistry tests, and organ weights were measured. Cellular differential counts and cytotoxicity measurements, such as albumin, lactate dehydrogenase (LDH), and total protein were also monitored in a cellular bronchoalveolar lavage (BAL) fluid. Among lung function test measurements, tidal volume and minute volume showed a tendency to decrease comparing control and dose groups during the 90-days of exposure. Although no statistically significant differences were found in cellular differential counts, histopathologic examination showed minimal alveoli, an inflammatory infiltrate with a mixed cell type, and increased macrophages in the high-dose rats. Tissue distribution of gold nanoparticles showed a dose-dependent accumulation of gold in only lungs and kidneys with a gender-related difference in gold nanoparticles content in kidneys.</p> <p>Conclusions</p> <p>Lungs were the only organ in which there were dose-related changes in both male and female rats. Changes observed in lung histopathology and function in high-dose animals indicate that the highest concentration (20 μg/m³) is a LOAEL and the middle concentration (0.38 μg/m³) is a NOAEL for this study.</p

Regression of esophageal varices and splenomegaly in two patients with hepatitis-C-related liver cirrhosis after interferon and ribavirin combination therapy

Some recent studies have found regression of liver cirrhosis after antiviral therapy in patients with hepatitis C virus (HCV)-related liver cirrhosis, but there have been no reports of complete regression of esophageal varices after interferon/peg-interferon and ribavirin combination therapy. We describe two cases of complete regression of esophageal varices and splenomegaly after interferon-alpha and ribavirin combination therapy in patients with HCV-related liver cirrhosis. Esophageal varices and splenomegaly regressed after 3 and 8 years of sustained virologic responses in cases 1 and 2, respectively. To our knowledge, this is the first study demonstrating that complications of liver cirrhosis, such as esophageal varices and splenomegaly, can regress after antiviral therapy in patients with HCV-related liver cirrhosis