A novel cell culture model to study ischemia-reperfusion injury in lung transplantation

grantor: University of TorontoLung transplantation has emerged as a therapeutic modality for patients with end-stage lung disease. However ischemia reperfusion injury remains a significant clinical problem, occurring in 20% of patients. Many cell culture models have been developed to study ischemia-reperfusion (I/R) injury, however none are specific to the conditions of lung preservation and transplantation. We designed a cell culture model that mimics the conditions of clinical lung transplantation, where preservation is aerobic and hypothermic. Human pulmonary epithelial cells (A549 cell line), were preserved in 100% O2 at 4°C for varying periods in Low Potassium Dextran Glucose solution, simulating ischemia, followed by the reintroduction of warm (37°C) Dulbecco's Modified Eagle Medium plus 10% fetal bovine serum to simulate reperfusion. Cultures were assayed for cell attachment and viability. Sequential extension of ischemic times to 24 h showed a time-dependent loss of cells. There was a further decrease in cell number following simulated reperfusion. Cell detachment was due mainly to cell death, as determined by cell viability assays. The effects of chemical components in the preservation solution and various gas mixtures during ischemia. were examined using this model system. Because this model closely mimics I/R injury in lung transplantation, it could be used to study cellular and molecular mechanisms related to this clinical situation.M.Sc

How We Do It: A Multicenter National Experience of Virtual Vascular Surgery Rotations.

ObjectiveTo describe the development and implementation of virtual vascular surgery rotations among 6 integrated vascular surgery programs.DesignA collaborative teleconference retrospectively discussing 6 independently developed virtual vascular surgery rotations to make a framework for future use.SettingUniversity of California Davis initiated a joint teleconference among the various integrated vascular surgery programs.ParticipantsVascular surgery faculty and residents from 6 programs participated in the teleconferences and drafting of a framework for building a virtual vascular surgery rotation.ResultsFour specific domains were identified in discussing the framework to build a virtual vascular surgery rotation: planning, development, curriculum, and feedback. Each domain has specific aspects in making a virtual rotation that has applicability to other surgical rotations that seek to do the same.ConclusionVirtual vascular surgery rotations are feasible and important; these electives can be established and implemented successfully with appropriate planning and consideration. This work hopes to help programs navigate this new space in education by making it more transparent and highlighting potential pitfalls

Emergent percutaneous chimney endovascular aortic repair of a secondary aortoenteric fistula in the setting of a solitary kidney

Secondary aortoenteric fistula is a potentially lethal complication after aortic surgery. Traditional treatment consists of open graft excision with extra-anatomic bypass or in situ reconstruction. Patients who present in extremis, however, are generally poor candidates for re-do open aortic surgery. Endovascular repair has emerged as an alternative treatment modality for patients who would otherwise be unable to tolerate an extended operation. We report here a case of urgent endovascular repair of a juxtarenal secondary aortoenteric fistula via endovascular aneurysm repair with a renal artery chimney in a patient with a solitary kidney who presented in hemorrhagic and septic shock

Prevalence of Cardiovascular Disease Risk Factors by Key Demographic Variables Among Mid-South Church Leaders from 2012 to 2017

Cardiovascular disease (CVD) risk factors were examined among church leaders (n = 2309) who attended Mid-South United Methodist Church annual meetings between 2012 and 2017 using repeated cross-sectional data. There was a significant increase in body mass index (BMI) (b = 0.24, p = 0.001) and significant decreases in blood pressure (systolic: b = − 1.08, p \u3c 0.001; diastolic: b = − 0.41, p = 0.002), total cholesterol (b = − 1.76, p = 0.001), and blood sugar (b = − 1.78, p = 0.001) over time. Compared to Whites, a significant increase was seen in BMI (b = 1.14, p = 0.008) among participants who self-identified as “Other,” and a significant increase was seen in blood pressure (systolic: b = 1.36, p = 0.010; diastolic: b = 1.01, p = 0.004) among African Americans over time. Results indicate BMI and blood pressure are important CVD risk factors to monitor and address among church leaders, especially among race/ethnic minority church leaders

Repair of a mycotic abdominal aortic aneurysm in a neonate using an everted jugular vein patch

A 43-day-old boy presented with bacteremia after umbilical artery catheterization. Duplex ultrasound examination revealed a 1.1- × 1.6-cm mycotic infrarenal aortic aneurysm and an incidental asymptomatic occluded right common iliac artery. Resection and repair were completed by creating an everted, double-layered internal jugular vein patch. Screening ultrasound examination 10 months postoperatively demonstrated successful repair