Ingestion of multiple magnets: The count does matter

AbstractIngestion of multiple magnets poses a particular risk for various intraabdominal complications in children. We herein report a case of ingestion of multiple magnets, of which 3 were spontaneously expelled, and the remaining magnets were surgically removed. Since the total amount of ingestion was unknown upon presentation and the remaining intraabdominal magnets failed to pass after 24 h, emergency surgery was performed. Two magnets sandwiched the bowel walls and formed a jejunoileal fistula. There was no peritoneal contamination. We found that not all the ingested multiple magnets attracted each other, and multiple magnets could appear as single material on a plain radiograph. Confirming the exact count of ingested magnets is important; if the count is in doubt or two or more attachments are evident, prompt surgical intervention is warranted

Infrared-Mediated Drug Elution Activity of Gold Nanorod-Grafted TiO 2

The purpose of this research was to prepare gold nanorod- (GNR-) grafted TiO2 nanotubes by thiolactic acid treatment and evaluate remote-controlled drug elution and antibacterial activity by infrared (IR) light irradiation. Tetracycline used as an antibiotic was loaded into GNR-grafted TiO2 nanotubes by using 2 w/v% polylactic acid solutions. A near-IR laser (830 nm) was used for remote-controlled IR light irradiation. Results of SEM, TEM, XRD, and EDX revealed that GNR chemically bonded to the whole surface of the TiO2 nanotubes. An antibiotic release test revealed that on-off drug elution was triggered effectively by the photothermal effect of GNR grafted on TiO2 nanotubes. Furthermore, an antibacterial agar zone test indicated that the annihilated zone of Streptococcus mutans in the experimental group with IR light irradiation was significantly larger than that of the corresponding group without IR light irradiation (P<0.05). Therefore, GNR-grafted TiO2 nanotubes would be expected to extend the limited usage of TiO2, which show photocatalytic activity only within the ultraviolet (UV) to IR region, thereby allowing the development of novel fusion technologies in the field of implant materials

Light-chain amyloidosis presenting with rapidly progressive submucosal hemorrhage of the stomach

SummaryThe gastrointestinal tract is frequently in involved light-chain (AL) amyloidosis, but significant hemorrhagic complications are rare. A 71-year-old man presented to our hospital with dyspepsia and heartburn for 1 month. Gastroscopy revealed a large submucosal hematoma at the gastric fundus. Two days later, a follow-up gastroscopy indicated extensive expansion of the hematoma throughout the upper half of the stomach. The hematoma displayed ongoing expansion during the endoscopic examination, suggesting that rupture was imminent. Emergency total gastrectomy was performed, and amyloidosis was confirmed after examining the surgical specimen. Bone marrow examination revealed multiple myeloma, and serum immunoglobulin assay confirmed the diagnosis of myeloma-associated AL amyloidosis. At manuscript submission, the patient was doing well and was undergoing chemotherapy

Numerical study on sequential period-doubling bifurcations of graphene wrinkles on a soft substrate

A compressed stiff film on a soft substrate may exhibit wrinkles and, under increased compressive strain, post-buckling instabilities as well. We numerically analyze wrinkling behaviors of graphene attached on a polydimethylsiloxane (PDMS) substrate under lateral compression. The finite element method is used to simulate the equilibrium shape of the wrinkles as a function of compressive strain. Two-dimensional stretching and bending properties of graphene are obtained by density functional theory analysis, which are then converted to equivalent elastic properties of a continuum film with finite effective thickness. The PDMS is described using an Ogden or a neo-Hookean material model. Wrinkles first appear at extremely small strain. As the lateral compression increases, due to the nonlinear elasticity of the PDMS, sequential period-doubling bifurcations of the wrinkle mode are activated until the bifurcation stops and the film folds. We show that the bifurcations are consequences of a delicate balance between the deformations of the film and the substrate to minimize the total energy.J.H.J., J.B., and J.I. were supported by the National Research Foundation of Korea through the MSIP Grant no. 2006-0093853 and the Korea Institute of Science and Technology. M.-W.M. was supported by the Korea Institute of Science and Technology (KIST), and K.-S.K. by the Institute for Molecular and Nanoscale Innovation (IMNI) at Brown University (GR260000.1001) and KIST (529243). Computations were performed through the support from the Korea Institute of Science and Technology Information

Desmoplastic small round cell tumor of the stomach mimicking a gastric cancer in a child

Intra-abdominal desmoplastic small round cell tumor (DSRCT) is a highly malignant tumor of uncertain histogenesis. Here we report a case of DSRCT involving the stomach, initially misdiagnosed as gastric cancer. A 12-year-old boy presented with upper abdominal pain developed 1 month prior. On gastroscopy, a 7-cm mass was noted involving the esophago-gastric junction to the fundus, and positron emission tomography showed multiple hot uptakes suggesting distant metastasis. Gastroscopic biopsy showed poorly differentiated malignant cells. We diagnosed as stage IV gastric cancer and treated with 6 cycles of chemotherapy. Laparotomy revealed a huge gastric mass along with peritoneal disseminations. Palliative proximal gastrectomy was performed. Pathological examination revealed transmural involvement of DSRCT, and t(11;22)(p12;q12) was demonstrated on fluorescence in situ hybridization test. The chemotherapeutic regimen was changed and the patient underwent 8 additional cycles of post-operative chemotherapy. The patient is now alive and the residual tumor shows no significant changes after chemotherapy

Falciform Ligament Abscess after Omphalitis: Report of a Case

A falciform ligament abscess is a rare type of intra-abdominal abscess. A 2-yr-old male, who had omphalitis two months previously, presented with a fever and right upper quadrant abdominal pain. The ultrasound and CT scan showed an abdominal wall abscess located anterior to the liver, which was refractory to conservative management with percutaneous draninage and antibiotics. On the third recurrence, surgical exploration was performed and revealed an abscess arising from the falciform ligament; the falciform ligament was excised. A follow up ultrasound confirmed complete resolution of the abscess with no further recurrence

Difference in the Cobb Angle Between Standing and Supine Position as a Prognostic Factor After Vertebral Augmentation in Osteoporotic Vertebral Compression Fractures

Objective We retrospectively analyzed patients with osteoporotic vertebral compression fracture (OVCF) undergoing vertebral augmentation to compare the Cobb angle changes in the supine and standing positions and the clinical outcomes. Methods We retrospectively extracted the data of OVCF patients who underwent vertebral augmentation. Back pain was assessed using a visual analogue scale (VAS). Supine and standing radiographs were assessed before treatment to determine the Cobb angle and compression ratio. Receiver operating characteristic curve analysis was performed to determine the optimal cutoff to predict favorable outcomes after vertebral augmentation. Results A total of 249 patients were included. We observed a statistically significant increase in the VAS score change with increasing Cobb angle and compression ratio (p < 0.001), and multivariate logistic regression analysis showed that a difference in the Cobb angle (odds ratio [OR], 1.27) and compression ratio (OR, 1.12) were the independent risk factors for predicting short-term favorable outcomes after vertebral augmentation. In addition, we found that the difference in the Cobb angle (OR, 1.05) was the only factor for predicting midterm favorable outcomes after vertebral augmentation. The optimal cutoff value of the difference in the Cobb angle for predicting midterm favorable outcomes was 35.526°. Conclusion We found that the midterm clinical outcome after vertebral augmentation was better when there was a difference of approximately 35% or more in the Cobb angle between the standing and supine positions. Surgeons should pay attention to the difference in the Cobb angle depending on the posture when deciding to perform vertebral augmentation in patients with OVCFs

Predictive value of progression-related gene classifier in primary non-muscle invasive bladder cancer

<p>Abstract</p> <p>Background</p> <p>While several molecular markers of bladder cancer prognosis have been identified, the limited value of current prognostic markers has created the need for new molecular indicators of bladder cancer outcomes. The aim of this study was to identify genetic signatures associated with disease prognosis in bladder cancer.</p> <p>Results</p> <p>We used 272 primary bladder cancer specimens for microarray analysis and real-time reverse transcriptase polymerase chain reaction (RT-PCR) analysis. Microarray gene expression analysis of randomly selected 165 primary bladder cancer specimens as an original cohort was carried out. Risk scores were applied to stratify prognosis-related gene classifiers. Prognosis-related gene classifiers were individually analyzed with tumor invasiveness (non-muscle invasive bladder cancer [NMIBC] and muscle invasive bladder cancer [MIBC]) and prognosis. We validated selected gene classifiers using RT-PCR in the original (165) and independent (107) cohorts. Ninety-seven genes related to disease progression among NMIBC patients were identified by microarray data analysis. Eight genes, a progression-related gene classifier in NMIBC, were selected for RT-PCR. The progression-related gene classifier in patients with NMIBC was closely correlated with progression in both original and independent cohorts. Furthermore, no patient with NMIBC in the good-prognosis signature group experienced cancer progression.</p> <p>Conclusions</p> <p>We identified progression-related gene classifier that has strong predictive value for determining disease outcome in NMIBC. This gene classifier could assist in selecting NMIBC patients who might benefit from more aggressive therapeutic intervention or surveillance.</p

Protective actions of Rubus coreanus ethanol extract on collagenous extracellular matrix in ultraviolet-B irradiation-induced human dermal fibroblasts

Solar ultraviolet (UV) irradiation leads to distinct changes in the skin connective tissues by degradation of collagen, which is a major structural component in the extracellular matrix. UV irradiation induces the production of matrix metalloproteinases (MMP) capable of attacking native fibrillar collagen and responsible for inhibiting the construction of collagenous extracellular matrix. In this study, we attempted to investigate the protective actions of Rubus coreanus ethanol extract (RCE) on the MMP production and the consequent procollagen/collagen degradation in UV-B-irradiated human dermal fibroblasts. The analytical data showed that Rubus coreanus ethanol extract was mostly comprised of cyanidin 3-rutinoside. Pre-treatment of fibroblasts with this extract inhibited UV-B-induced production of MMP-1, MMP-8 and MMP-13 in dose-dependent manners. In addition, Western blot analysis and immunocytochemical staining assay revealed that RCE markedly augmented the cellular levels of procollagen/collagen declined in UV-B-exposed dermal fibroblasts. These results demonstrate that RCE blocks UV-B-induced increase of the collagen degradation by inhibiting MMP production. Thus, RCE may act as an agent inhibiting excessive dermal collagen degradation leading to the skin photoaging