Characteristics and treatments of large cystic brain metastasis: radiosurgery and stereotactic aspiration.

Brain metastasis represents one of the most common causes of intracranial tumors in adults, and the incidence of brain metastasis continues to rise due to the increasing survival of cancer patients. Yet, the development of cystic brain metastasis remains a relatively rare occurrence. In this review, we describe the characteristics of cystic brain metastasis and evaluate the combined use of stereotactic aspiration and radiosurgery in treating large cystic brain metastasis. The results of several studies show that stereotactic radiosurgery produces comparable local tumor control and survival rates as other surgery protocols. When the size of the tumor interferes with radiosurgery, stereotactic aspiration of the metastasis should be considered to reduce the target volume as well as decreasing the chance of radiation induced necrosis and providing symptomatic relief from mass effect. The combined use of stereotactic aspiration and radiosurgery has strong implications in improving patient outcomes

Development of Parametric Trend Life Cycle Assessment for marine SOx reduction scrubber systems

In response to the impending international maritime regulation, MARPOL Annex VI Reg. 14, to curb sulphur oxides (SOx) arising from shipping activities, this paper aimed to evaluate the environmental impacts of the entire life cycle of three different SOx reduction scrubber systems: (1) ‘wet open-loop’, (2) ‘wet closed-loop’, and (3) ‘wet hybrid’. To achieve this goal, the paper developed ‘the Parametric Trend Life Cycle Assessment (PT-LCA)’ which was introduced to proceed the extensive analysis for a number of case ship studies and quantify various emissions, such as greenhouse gases (GHG), sulphur oxides (SOx), nitrogen oxides (NOx), associated with the proposed systems from cradle to grave. A case study designed with the database consisting of 1,565 ocean-going Ro-Ro vessels based on Lloyd’s Register has revealed that, in terms of Global Warming Potential (GWP) and Acidification Potential (AP), closed-loop scrubbers were proven more environmentally friendly than open-loop scrubbers, but the opposite was true for Eutrophication Potential (EP). By identifying specific trends in scrubber systems in relation to various input parameters, the assessment contributed to improving environmental sustainability, as well as the total estimated amount of numerical environmental impacts that the scrubber systems have for the international fleets. The proposed framework enabled us not only to evaluate the different emission levels of systems applied to various ships but also to obtain the general trends of emission levels over ship parameters, which were expressed as formulae. The novelty of this paper can be placed on the provision of an insight into the optimal selection of scrubber systems depending on ship characteristics. It could also offer an insight into the improvement of current environmental regulations and guidelines by means of PT-LCA

Type 2 Myocardial Infarction Following Generalized Tonic-Clonic Seizure

Myocardial infarction is diagnosed when blood levels of biomarkers are increased in the clinical setting of acute myocardial ischemia. Among the biomarkers, troponin I is the preferred biomarker indicative of myocardial necrosis. It is tissue specific for the heart. Myocardial infarction is rarely reported following seizure. We report a case of elevated troponin I in a patient after an episode of generalized tonic-clonic seizure. The diagnosis was type 2 myocardial infarction

Collagen Immobilization on Ultra-thin Nanofiber Membrane to Promote In Vitro Endothelial Monolayer Formation

The endothelialization on the poly (epsilon-caprolactone) nanofiber has been limited due to its low hydrophilicity. The aim of this study was to immobilize collagen on an ultra-thin poly (epsilon-caprolactone) nanofiber membrane without altering the nanofiber structure and maintaining the endothelial cell homeostasis on it. We immobilized collagen on the poly (epsilon-caprolactone) nanofiber using hydrolysis by NaOH treatment and 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide/sulfo-N-hydroxysulfosuccinimide reaction as a cost-effective and stable approach. NaOH was first applied to render the poly (epsilon-caprolactone) nanofiber hydrophilic. Subsequently, collagen was immobilized on the surface of the poly (epsilon-caprolactone) nanofibers using 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide/sulfo-N-hydroxysulfosuccinimide. Scanning electron microscopy, Fourier transform infrared spectroscopy, transmission electron microscopy, and fluorescence microscopy were used to verify stable collagen immobilization on the surface of the poly (epsilon-caprolactone) nanofibers and the maintenance of the original structure of poly (epsilon-caprolactone) nanofibers. Furthermore, human endothelial cells were cultured on the collagen-immobilized poly (epsilon-caprolactone) nanofiber membrane and expressed tight junction proteins with the increase in transendothelial electrical resistance, which demonstrated the maintenance of the endothelial cell homeostasis on the collagen-immobilized-poly (epsilon-caprolactone) nanofiber membrane. Thus, we expected that this process would be promising for maintaining cell homeostasis on the ultra-thin poly (epsilon-caprolactone) nanofiber scaffolds.11Ysciescopu

Recurrent Infective Endocarditis Associated With Pyogenic Spondylodiskitis

Infective endocarditis is a life-threatening condition caused by microbial infection of the heart's endocardial surface. This condition can also be associated with bacterial infections of other organs. We experienced an unusual case of recurrent infective endocarditis associated with pyogenic spondylodiskitis. A 70-year-old man presented with persistent fever and lower back pain visited our hospital. The patient had a past history of recurrent infective endocarditis. He was diagnosed with infective endocarditis again based on clinical symptoms and echocardiographic findings. Magnetic resonance imaging was used to evaluate lower back pain, which showed acute spondylodiskitis on L3 and L4 vertebrae. The patient completely recovered following four weeks of antibiotic therapy

Determining the influence of ship hull deformations caused by draught change on shaft alignment application using FE analysis

This paper was to address the shortcomings of current design practice to evaluate the stability of the shaft alignment for a 300,000 DWT Very Large Crude Oil Carrier. An enhanced approach using FE was applied to identify the influence of hull deformation on the alignment of the shafting system. The effectiveness of this method was demonstrated in comparison with Jack up technique. Analysis results showed that the hull deformation could be a key factor affecting the offset distortion of each bearing supporting the shaft line. Moreover, it was confirmed that the deformation pattern of cargo hold was opposite to the deformation of engine room structure when hull deformation occurred due to draught change of the case ship. As new research findings, they are believed to contribute significantly to the prevention of shaft damage associated with hull deformations, thereby improving the reliability of shaft alignment for similar types of vessels

A Case of Traumatic Tricuspid Regurgitation Caused by Multiple Papillary Muscle Rupture

Traumatic tricuspid regurgitation is a rare complication of blunt chest trauma. With the increase in the number of automobile accidents, traumatic tricuspid regurgitation has become an important problem after blunt chest trauma. It has been reported more frequently because of better diagnostic procedures and a better understanding of the pathology. The early diagnosis of traumatic tricuspid regurgitation is important because traumatic tricuspid injury could be effectively corrected with reparative techniques, early operation is considered to relieve symptoms and to prevent right ventricular dysfunction. Echocardiography can reveal the cause and severity of regurgitation. We experienced a case of tricuspid regurgitation after blunt chest trauma early diagnosis and valve repair were performed. This case reminds the physicians in the emergency department should be aware of this potential complication following non-penetrating chest trauma and echocardiography is useful and should play an early role