Case report: VA-ECMO for fulminant myocarditis in an infant with acute COVID-19

Fulminant myocarditis in children was rare during the coronavirus disease 2019 pandemic, but it had the potential for high morbidity and mortality. We describe the clinical course of a previously healthy 9-month-old young male infant who rapidly deteriorated into cardiogenic shock due to coronavirus disease 2019-related fulminant myocarditis. He developed severe heart failure and multiple organ dysfunction syndrome that were treated promptly with central venoarterial extracorporeal membrane oxygenation and continuous venovenous hemofiltration. He made a good recovery without significant morbidity

A Follow-up Study of Neonatal Interatrial Shunt with Echocardiography until Twelve to Fifteen Months of Age

ObjectiveTo assess the incidence and natural history of full-term neonates with interatrial shunt (IAS).MethodsA follow-up study of 1389 neonates who received screening echocardiography between 2003 and 2006. Babies with IAS at 2 to 4 days of life underwent follow-up echocardiography at 2 to 4 months, 6 to 9 months and 12 to 15 months of age until closure of IAS.ResultsThe ratio of IAS was 68.3% initially. No significant demographic differences were identified between infants with and without initial IAS. Among 949 neonates with initial IAS, 84.5% infants had a left-to-right interatrial shunt, 13.5% had bidirectional shunt and 2% had predominantly right-to-left shunt. The persistence rate of IAS at 12 to 15 months of age was 3.8% (44/1166). The initial size of IAS ranged from 1.2 to 7.7 mm (4.3 ± 1.1 mm) detected by color Doppler flow mapping and cases were divided into three groups: small (≦5 mm), medium (5 to 8 mm) and large group (≧8 mm). There were 74.6% infants in the small group and 25.4% in the medium group initially. The neonates in the initial small group would always see their IAS close or else they would remain in the small group. Those in the final medium and large size groups always came from the initial medium group. The late closure rate of IAS was 93.9% of infants with initial IAS. The closure curves of initial small and medium sized groups were significantly different, and their late closure rates were 95.1% and 90.4%, respectively.ConclusionsIAS was very common during early neonatal stage, but most cases would close after 1 year. The late closure rate of initial IAS was different if using a cutpoint of 5 mm

Mean structure and variability of the cold dome northeast of Taiwan

Author Posting. © The Oceanography Society, 2011. This article is posted here by permission of The Oceanography Society for personal use, not for redistribution. The definitive version was published in Oceanography 24 no. 4 (2011): 100–109, doi:10.5670/oceanog.2011.98.The "cold dome" off northeastern Taiwan is one of the distinctive oceanic features in the seas surrounding Taiwan. The cold dome is important because persistent upwelling makes the region highly biologically productive. This article uses historical data, recent observations, and satellite-observed sea surface temperatures (SST) to describe the mean structure and variability of the cold dome. The long-term mean position of the cold dome, using the temperature at 50 m depth as a reference, is centered at 25.625°N, 122.125°E. The cold dome has a diameter of approximately 100 km, and is maintained by cold ( 34.5) waters upwelled along the continental slope. The ocean currents around the cold dome, although weak, flow counterclockwise. The monsoon-driven winter intrusion of the Kuroshio current onto the East China Sea shelf intensifies the upwelling and carries more subsurface water up to the cold dome than during the summer monsoon season. On a shorter timescale, the cold dome's properties can be significantly modified by the passage of typhoons, which creates favorable physical conditions for short-term Kuroshio intrusions in summer. The surface expression of the cold dome viewed from satellite SST images is often not domelike but instead is an irregular shape with numerous filaments, and thus may contribute substantially to shelf/slope exchange. As a result of persistent upwelling, typhoon passage, and monsoon forcing, higher chlorophyll a concentrations, and thus higher primary productivity, are frequently observed in the vicinity of the cold dome.The National Science Council (NSC) of Taiwan sponsored this study under grant NSC98-2611-M-002-019-MY3. NSC supported C.-C. Chen under grant NSC98-2611-M-003-001-MY3

Stent implantation for a totally occluded right coronary artery in a six-year-old boy after Kawasaki disease: a case report

<p>Abstract</p> <p>Introduction</p> <p>Coronary stenting has previously been considered to be less feasible in children under 12 years old due to the limitation of vascular access. We report the case of a six-year-old boy who successfully underwent stent implantation for his totally occluded right coronary artery.</p> <p>Case presentation</p> <p>A Taiwanese boy aged six years and nine months old was found to have giant aneurysms after an acute episode of Kawasaki disease. An angiography revealed that his middle right coronary artery was totally occluded. A 0.014-inch guidewire was advanced to cross the totally occluded site. After pre-dilating the middle portion of his right coronary artery with a 1.5 mm balloon, stenting of his right coronary artery was accomplished using a 2.5 × 28 mm and a 2.5 × 18 mm bare metal stent. A final angiography demonstrated no residual stenosis or dissection.</p> <p>Conclusion</p> <p>Coronary stenting could be a therapeutic option for children as young as six years old. Close follow-up is mandatory because the long-term outcome is still unclear, especially in a small child.</p

Mass spectrometry-based lipidomics to explore the biochemical effects of naphthalene toxicity or tolerance in a mouse mode

Naphthalene causes mouse airway epithelial injury. However, repeated exposures of naphthalene result in mouse airway tolerance. Previous results showed that toxicity or tolerance was correlated with changes of phosphorylcholine-containing lipids. In this study, a mass spectrometry-based lipidomic approach was applied to examine the effects of naphthaleneinduced injury or tolerance in the male ICR mice. The injury model was vehicle x 7 plus 300 mg/kg naphthalene while the tolerant one was 200 mg/kg daily x 7 followed by 300 mg/kg naphthalene on day 8. The lung, liver, kidney, and serum samples were collected for profiles of phosphorylcholine-containing lipids including phosphatidylcholines (PCs) and sphingomyelins (SMs). A partial least-square-discriminate analysis model showed different lung phosphorylcholine-containing lipid profiles from the injured, tolerant, and control groups. Perturbation of diacyl-PCs and plasmenylcholines may be associated with enhanced membrane flexibility and anti-oxidative mechanisms in the lungs of tolerant mice. Additionally, alterations of lyso-PCs and SMs may be responsible for pulmonary dysfunction and inflammation in the lungs of injured mice. Moreover, serum PC(16:0/18:1) has potential to reflect naphthalene-induced airway injuries. Few phosphorylcholine-containing lipid alterations were found in the mouse livers and kidneys across different treatments. This study revealed the changes in lipid profiles associated with the perturbations caused by naphthalene tolerance and toxicity; examination of lipids in serum may assist biomarker development with the potential for application in the human population

Risk Stratification by Cross-Classification of Central and Brachial Systolic Blood Pressure

Background: Whether cardiovascular risk is more tightly associated with central (cSBP) than brachial (bSBP) systolic pressure remains debated, because of their close correlation and uncertain thresholds to differentiate cSBP into normotension versus hypertension.Methods: In a person-level meta-analysis of the International Database of Central Arterial Properties for Risk Stratification (n=5576; 54.1% women; mean age 54.2 years), outcome-driven thresholds for cSBP were determined and whether the cross-classification of cSBP and bSBP improved risk stratification was explored. cSBP was tonometrically estimated from the radial pulse wave using SphygmoCor software.Results: Over 4.1 years (median), 255 composite cardiovascular end points occurred. In multivariable bootstrapped analyses, cSBP thresholds (in mm Hg) of 110.5 (95% CI, 109.1-111.8), 120.2 (119.4-121.0), 130.0 (129.6-130.3), and 149.5 (148.4-150.5) generated 5-year cardiovascular risks equivalent to the American College of Cardiology/American Heart Association bSBP thresholds of 120, 130, 140, and 160. Applying 120/130 mm Hg as cSBP/bSBP thresholds delineated concordant central and brachial normotension (43.1%) and hypertension (48.2%) versus isolated brachial hypertension (5.0%) and isolated central hypertension (3.7%). With concordant normotension as reference, the multivariable hazard ratios for the cardiovascular end point were 1.30 (95% CI, 0.58-2.94) for isolated brachial hypertension, 2.28 (1.21-4.30) for isolated central hypertension, and 2.02 (1.41-2.91) for concordant hypertension. The increased cardiovascular risk associated with isolated central and concordant hypertension was paralleled by cerebrovascular end points with hazard ratios of 3.71 (1.37-10.06) and 2.60 (1.35-5.00), respectively.Conclusions: Irrespective of the brachial blood pressure status, central hypertension increased cardiovascular and cerebrovascular risk indicating the importance of controlling central hypertension.</p

Germline variation at 8q24 and prostate cancer risk in men of European ancestry

Chromosome 8q24 is a susceptibility locus for multiple cancers, including prostate cancer. Here we combine genetic data across the 8q24 susceptibility region from 71,535 prostate cancer cases and 52,935 controls of European ancestry to define the overall contribution of germline variation at 8q24 to prostate cancer risk. We identify 12 independent risk signals for prostate cancer (p < 4.28 × 10−15), including three risk variants that have yet to be reported. From a polygenic risk score (PRS) model, derived to assess the cumulative effect of risk variants at 8q24, men in the top 1% of the PRS have a 4-fold (95%CI = 3.62–4.40) greater risk compared to the population average. These 12 variants account for ~25% of what can be currently explained of the familial risk of prostate cancer by known genetic risk factors. These findings highlight the overwhelming contribution of germline variation at 8q24 on prostate cancer risk which has implications for population risk stratification

Fine-mapping of prostate cancer susceptibility loci in a large meta-analysis identifies candidate causal variants

Prostate cancer is a polygenic disease with a large heritable component. A number of common, low-penetrance prostate cancer risk loci have been identified through GWAS. Here we apply the Bayesian multivariate variable selection algorithm JAM to fine-map 84 prostate cancer susceptibility loci, using summary data from a large European ancestry meta-analysis. We observe evidence for multiple independent signals at 12 regions and 99 risk signals overall. Only 15 original GWAS tag SNPs remain among the catalogue of candidate variants identified; the remainder are replaced by more likely candidates. Biological annotation of our credible set of variants indicates significant enrichment within promoter and enhancer elements, and transcription factor-binding sites, including AR, ERG and FOXA1. In 40 regions at least one variant is colocalised with an eQTL in prostate cancer tissue. The refined set of candidate variants substantially increase the proportion of familial relative risk explained by these known susceptibility regions, which highlights the importance of fine-mapping studies and has implications for clinical risk profiling. © 2018 The Author(s).Prostate cancer is a polygenic disease with a large heritable component. A number of common, low-penetrance prostate cancer risk loci have been identified through GWAS. Here we apply the Bayesian multivariate variable selection algorithm JAM to fine-map 84 prostate cancer susceptibility loci, using summary data from a large European ancestry meta-analysis. We observe evidence for multiple independent signals at 12 regions and 99 risk signals overall. Only 15 original GWAS tag SNPs remain among the catalogue of candidate variants identified; the remainder are replaced by more likely candidates. Biological annotation of our credible set of variants indicates significant enrichment within promoter and enhancer elements, and transcription factor-binding sites, including AR, ERG and FOXA1. In 40 regions at least one variant is colocalised with an eQTL in prostate cancer tissue. The refined set of candidate variants substantially increase the proportion of familial relative risk explained by these known susceptibility regions, which highlights the importance of fine-mapping studies and has implications for clinical risk profiling. © 2018 The Author(s).Peer reviewe

Penilaian Kinerja Keuangan Koperasi di Kabupaten Pelalawan

This paper describe development and financial performance of cooperative in District Pelalawan among 2007 - 2008. Studies on primary and secondary cooperative in 12 sub-districts. Method in this stady use performance measuring of productivity, efficiency, growth, liquidity, and solvability of cooperative. Productivity of cooperative in Pelalawan was highly but efficiency still low. Profit and income were highly, even liquidity of cooperative very high, and solvability was good