Fogarty catheter for a difficult bronchial foreign body removal:.(case report)

Background: There are many methods for removal of tracheobronchial foreign bodies but there are many situations where removal of a foreign body seems impossible and may require a major surgical procedure. Familiarity with each method improves physician decision making.Case: A 17 months old baby with a history of foreign body aspiration suffered from long term pneumonia. There was a round shape foreign body in bronchoscopic view that could not be removed with standard methods, but was removed by application of Fogarty catheterConclusion: Removal of round, spherical foreign bodies may be performed by Fogarty Catheter preventing surgical intervention

Time-Sensitive Networking in automotive embedded systems: State of the art and research opportunities

The functionality advancements and novel customer features that are currently found in modern automotive systems require high-bandwidth and low-latency in-vehicle communications, which become even more compelling for autonomous vehicles. In a recent effort to meet these requirements, the IEEE Time-Sensitive Networking (TSN) task group has developed a set of standards that introduce novel features in Switched Ethernet. TSN standards offer, for example, a common notion of time through accurate and reliable clock synchronization, delay bounds for real-time traffic, time-driven transmissions, improved reliability, and much more. In order to fully utilize the potential of these novel protocols in the automotive domain, TSN should be seamlessly integrated into the state-of-the-art and state-of-practice model-based development processes for automotive embedded systems. Some of the core phases in these processes include software architecture modeling, timing predictability verification, simulation, and hardware realization and deployment. Moreover, throughout the development of automotive embedded systems, the safety and security requirements specified on these systems need to be duly taken into account. In this context, this work provides an overview of TSN in automotive applications and discusses the recent technological developments relevant to the adoption of TSN in automotive embedded systems. The work also points at the open challenges and future research directions

What is the appropriate aganglionic bowel length on contrast enema for attempting single stage transanal endorectal pull-through in Hirschsprung disease?

Purpose: To identify influence of different values of age and abnormal bowel length in HD patients selected for single stage TERPT which affects the technique of surgery. Methods: This observational study was carried out for over 2.5 years. All children younger than 14 years old with clinical suspicion for HD, typical transitional zone (TZ) on contrast enema (CE) distal to splenic flexure, preoperative diagnosis approved by full thickness biopsy, no previous surgical history and no urgency were included. The distance between the anus and TZ was considered as aganglionic length on CE. Biopsy was taken from distal to proximal of resected bowel to reach circumferentially normal innervated bowel. Paired sample Student's t-test, Pearson correlation test, receiver operating characteristic (ROC) analysis were performed. Results: Forty-eight patients were enrolled in this study. Measured mean for aganglionic bowel length on CE and pathology were 33.5 ± 17.1 cm and 56.8 ± 33.5 cm, respectively (p < 0.01). Correlation coefficient (R) and coefficient of determination (R2) were 0.632 and 40, respectively (p < 0.01). The difference between radiologic and pathologic measurements in females was higher than males (mean: 29.3 vs 21.9 cm) but was not statistically significant (p = 0.75). There was statistically significant difference between CE and pathologic results in the infants younger than 10 months (p =.004). Abnormal bowel length equal to 52 cm predicted requirement of laparoscopy assistance/laparotomy with 75 sensitivity and 85 specificity. Conclusion: Our investigation showed it is safe to attempt for single stage TERPT when aganglionic length on CE is less than 52 cm and the child with HD is older than 10 months. Chance of requiring additional laparotomy or laparoscopy assistance is low in these patients. Type of study: Study of diagnostic test. Level of evidence: Level II. © 2020 Elsevier Inc

Supplementary Material for: Differential T-Helper Cell Polarization after Allergen-Specific Stimulation of Autologous Dendritic Cells in Polysensitized Allergic Patients

<p><b><i>Background:</i></b> Dendritic cells (DCs) play an important role in the induction and regulation of adaptive immune responses by polarizing T-helper (Th) cells. In allergic disease this response is dominated by Th2 cells. It is still unclear whether the activation of Th cells by DCs in atopic individuals is allergen specific. <b><i>Methods:</i></b> Monocyte-derived DCs (MoDCs) obtained from polysensitized patients were stimulated with purified Bet v 1, Phl p 5 and Act d 10, and the surface marker expression was analysed. Proliferation and cytokine profiles of autologous naïve CD4+ T cells co-cultured with allergen-pulsed MoDCs were assessed. <b><i>Results:</i></b> The addition of either Bet v 1 or Phl p 5 did not further increase the expression of surface markers from matured MoDCs in all study groups. In co-cultures, autologous naïve CD4+ T cells proliferated when DCs obtained from individuals allergic to birch and grass pollen were stimulated with Bet v 1 and Phl p 5, respectively. In the co-culture supernatants, significantly increased levels of IL-5 and IL-13 were detected. This effect correlated with the sensitization background and was absent when applying an unspecific allergen, Act d 10. The levels of IL-10 in supernatants of MoDCs and the levels of IL-10 and IFN-γ in supernatants of T cells remained unchanged upon stimulation with allergens. <b><i>Conclusions:</i></b> In this study we observed that allergen-specific stimulation of MoDCs induces T-cell proliferation and upregulation of Th2-type cytokines. Interestingly, this Th2 polarization was only observed in cells stimulated with the allergen to which the patients were sensitized.</p