Complete Remission of Pancreatic Pseudoaneurysm Rupture with Arterial Embolization in a Patient with Poor Risk for Surgery: A Case Report

Pancreatic pseudoaneurysm is a rare vascular complication of chronic pancreatitis resulting from erosion of the pancreatic or peripancreatic artery into a pseudocyst that is identified as a pulsating vascular malformation which may lead to lethal complications if left untreated. Many publications in the literature consider angiography as the first step in the management of pancreatic pseudoaneurysm to stabilize the patient's critical condition; it should be followed by surgical intervention as the definite treatment. We report a rare case of pancreatic pseudoaneurysm rupture with hemodynamic embarrassment in a critical patient with multiple comorbid conditions and poor risk for surgery who responded dramatically to angiographic management as a single therapeutic modality without further surgical intervention. The results observed in our patient suggest that pancreatic pseudoaneurysm may be successfully managed with angiography only and that not all cases require surgical intervention. This is particularly relevant in critically ill patients in whom surgical intervention would be unfeasible

Sox10+ adult stem cells contribute to biomaterial encapsulation and microvascularization.

Implanted biomaterials and biomedical devices generally induce foreign body reaction and end up with encapsulation by a dense avascular fibrous layer enriched in extracellular matrix. Fibroblasts/myofibroblasts are thought to be the major cell type involved in encapsulation, but it is unclear whether and how stem cells contribute to this process. Here we show, for the first time, that Sox10+ adult stem cells contribute to both encapsulation and microvessel formation. Sox10+ adult stem cells were found sparsely in the stroma of subcutaneous loose connective tissues. Upon subcutaneous biomaterial implantation, Sox10+ stem cells were activated and recruited to the biomaterial scaffold, and differentiated into fibroblasts and then myofibroblasts. This differentiation process from Sox10+ stem cells to myofibroblasts could be recapitulated in vitro. On the other hand, Sox10+ stem cells could differentiate into perivascular cells to stabilize newly formed microvessels. Sox10+ stem cells and endothelial cells in three-dimensional co-culture self-assembled into microvessels, and platelet-derived growth factor had chemotactic effect on Sox10+ stem cells. Transplanted Sox10+ stem cells differentiated into smooth muscle cells to stabilize functional microvessels. These findings demonstrate the critical role of adult stem cells in tissue remodeling and unravel the complexity of stem cell fate determination

Periampullary Diverticulum Perforation Following Endoscopic Retrograde Cholangiopancreatography (ERCP); a Case Report

Endoscopic Retrograde Cholangiopancreatography (ERCP) is widely used for the diagnosis and treatment of biliary and pancreatic tract disease. Perforation is a rare complication of it, but it is associated with high rate of mortality, an overall mortality rate of 1.0-1.5%. Here, a case of massive subcutaneous emphysema following ERCP was reported without an obvious retroperitoneal or peritoneal perforation

A 52-Year-Old Woman with a Palpable Abdominal Mass

A 52-year-old woman presented with a history of diabetes mellitus under medical treatment and a surgical history of a cesarean section 20 years ago. The patient was referred to our emergency department because of a 2-week hypermenorrhea and unspecific abdominal pain without nausea and vomiting, fever, or other symptoms. She did not complain of weight loss

Vibration of fast trains, palindromic eigenvalue problems and structure-preserving doubling algorithms

AbstractThe vibration of fast trains is governed by a quadratic palindromic eigenvalue problem (λ2A1T+λA0+A1)x=0, where A0,A1∈Cn×n and A0T=A0. Accurate and efficient solution can only be obtained using algorithms which preserve the structure of the eigenvalue problem. This paper reports on the successful application of the structure-preserving doubling algorithms

A 33-year-old Man with Abdominal Pain

A 33-year-old man presented to the emergency department ED) with complaint of 2-day history of abdominal pain. His pain developed with gradual onset prominently in epigastric area after eating dried mushrooms. The pain was diffuse, persistent, radiating to the back and aggravated by meal. He had been tolerating only liquids and had complaints of nausea and vomiting. He had no history of diabetes mellitus, hypertension, alcohol consumption, malignancy, or prior surgery. On arrival his blood pressure was 128/72 mmHg, with a heart rate of 101 beats/minute and a respiratory rate of 20 breaths/minute. He was afebrile. Physical examination revealed diffuse abdominal distention, hyper-pitched bowel sounds, and tenderness more marked over the umbilicus with no guarding or rebound tenderness. A complete blood cell count showed the following: leukocyte count 12600 /mm3; segmented neutrophils 90%; hemoglobin level of 14 mg/dl; hematocrit 30%; and platelet 420000/µL. Other laboratory studies included: glucose 101 mg/dL; serum urea nitrogen 45 mg/dL; serum creatinine 2.0 mg/dL; sodium 148 mEq/L; potassium 3.1 mEq/L; serum glutamic oxaloacetic transaminase (SGOT) 38 U/L and lipase 30 U/L. Figure 1 shows patient’s plain upright abdominal X-ray as well as coronal and axial cuts of abdominal CT scan

A 5-Month-Old Infant with Right Scrotum Swelling

Case presentation:A five-month-old male infant (gestational age 28 weeks, birthweight 1020 gm) with posthemorrhagic hydrocephalus subsequent to prematurity had a left sided ventriculoperitoneal shunt 3 months after birth. Frontal radiography of the chest and abdomen check-up after operation are shown in figure 1. He was referred to our emergency department with a history of right scrotal swelling for several days. Physical examination, he appeared malnourished. He was afebrile. The right scrotum was found to be distended. Bilateral testicles were palpable on both sides. There were no features of shunt malfunction. A complete blood cell count showed the following: leukocyte count, 7900/mm3; segmented neutrophils, 65%; hemoglobin level of 9.3 mg/dL; hematocrit, 25.9%; and platelet, 190000/uL. Other laboratory studies included: glucose, 92 mg/dL; serum urea nitrogen, 10 mg/dL; serum creatinine, 0.2 mg/dL; sodium, 140 mEq/L; potassium, 3.9 mEq/L; C-reactive protein, 2.9mg/L; and prothrombin time with an international normalized ratio of 1.2. His abdomen x-ray is shown in figure 2. 

Trends in Research about COVID-19 Vaccine Documented through Bibliometric and Visualization Analysis

Due to COVID-19, people’s lives have changed greatly. In accordance with former experience, an efficacious vaccine is the most effective way to curb the pandemic; thus, many researchers have published related publications in the short term. Hence, this study aims at using bibliometric analysis and visualization to document research trends regarding COVID-19 vaccines, and offer some directions and suggestions for future research. Initially, all eligible publications were downloaded from Web of Science on 1 January 2022. Subsequently, some publications published before December 2019 were removed since COVID-19 did not occur before that date. Finally, Microsoft Excel is used for bibliometric analysis to analyze publication date, author, affiliation, country, publication title, publisher, research area, document type, and language, and visualized software (VOSviewer) is used to visualize author, affiliation, country, and keywords. After analyzing a total of 17,392 publications, the results show that the overall research trend was upward. Moreover, the prominent authors, institutions, and countries inclined towards regional cooperation instead of international cooperation. Furthermore, the most popular research areas were immunology and medicine (general and internal). Ultimately, COVID-19, vaccine, and SARS-CoV-2 were the top 3 keywords. In conclusion, this study shows the approximate research trend for COVID-19 vaccine during the completely first two years of the pandemic. The research focuses moved from safety, effectiveness, and immunology at the early stage to the optimal allocation strategies for COVID-19 vaccine, and eventually to public attitudes and acceptance towards COVID-19 vaccination

Leo: A Programming Language for Formally Verified, Zero-Knowledge Applications

Decentralized ledgers that support rich applications suffer from three limitations. First, applications are provisioned tiny execution environments with limited running time, minimal stack size, and restrictive instruction sets. Second, applications must reveal their state transition, enabling miner frontrunning attacks and consensus instability. Third, applications offer weak guarantees of correctness and safety. We design, implement, and evaluate Leo, a new programming language designed for formally verified, zero-knowledge applications. Leo provisions a powerful execution environment that is not restricted in running time, stack size, or instruction sets. Besides offering application privacy and mitigating miner-extractable value (MEV), Leo achieves two fundamental properties. First, applications are formally verified with respect to their high-level specification. Second, applications can be succinctly verified by anyone, regardless of the size of application. Leo is the first known programming language to introduce a testing framework, package registry, import resolver, remote compiler, formally defined language, and theorem prover for general-purpose, zero-knowledge applications