Effects of the expansion of vascular plants in Sphagnum-dominated bog on evapotranspiration

Plant succession triggered by drainage, which results in the expansion or invasion of vascular plants, has been reported from many peatlands. However, the effects of the vascular plant's expansion on evapotranspiration (ET), which is a key component of the water balance of ombrotophic bog, are still contradictory. To investigate the effects, ET was measured at a Sphagnum-dominated bog and an adjacent transition peatland dominated by Sasa, dwarf bamboo, in Hokkaido Island, northern Japan, using the eddy covariance technique during the four growing seasons from 2007 through 2010. Cumulative gap-filled ET during a snow-free period of 6.5 months was 362(2008) and 374 mm (2010) at the Sphagnum site and 300 (2008) and 372 mm (2010) at the Sasa site. In the mid-growing season (late June to mid-September) with the highest leaf area index (LAI) at the Sasa site, ET was 2.14 +/- 0.03 (mean 1 standard deviation of the four years) and 1.92 +/- 0.19 mm d(-1), respectively, at the Sphagnum and Sasa sites. ET was smaller at the Sasa site, except for 2010 with an unusual hot wet summer; mean air temperature and precipitation were higher than their 30-year normal values by 1.75 degrees C and 172 mm, respectively. At the Sphagnum site, ET was stable despite such interannual variation in meteorological conditions. However, ET increased significantly at the Sasa site in 2010 probably because of LAI increase due to the enhanced growth of Sasa plants. The ET increase at the Sasa site suggests that ET will increase at the Sasa-dominated area, if the future warming environment accompanies more precipitation. (C) 2016 Elsevier B.V. All rights reserved

A case report of necrotizing soft tissue infection of the chest wall : Effective management with serial debridement

Introduction: Necrotizing soft tissue infection (NSTI) of the chest wall is a rare, rapidly spreading, highly lethal surgical disease. Radical debridement interferes with the important anatomical function of the chest wall. We re-port a case of chest wall NSTI that was successfully managed with early diagnosis and serial debridement. Presentation of case: A 43-year-old, previously healthy woman presented with severe malaise and worsening right axillary pain. She was severely lethargic and had a painful, large, pale lesion with surrounding erythema of the right chest and trunk. Computed tomography revealed NSTI, with diffuse soft tissue inflammation extending from the axilla to the lower abdomen. There was no obvious entry portal. Prompt surgical drainage was established. Group A streptococcus infection was diagnosed. During her 3-month postoperative course, she underwent four more surgeries, including two debridements. This treatment proved successful and avoided the need for complicated muscle flap reconstruction. She was discharged on postoperative day 109. Discussion: Group A streptococcus can cause NSTI even in immunocompetent patients without an entry portal. Radical debridement is recommended for infection control. Preserving anatomical chest wall function, however, is also important. Serial debridement with close follow-up solved the problem in this patient. Conclusions: Serial debridement with close follow-up enabled to avoid large tissue deficits and complicated re-construction in the case of NSTI of the chest wall. (C) 2021 The Author(s). Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd

Preoperative embolization strategy for the combined resection of replaced right hepatic artery in pancreaticoduodenectomy : a small case series

Background Replaced right hepatic artery (rRHA) is a common vascular variation, and combined resection of this vessel is sometimes needed for the curative resection of pancreatic head malignancy. Safe surgical management has not been established, and there is a small number of reported cases. Here, we reported five cases, wherein preoperative embolization of rRHA was performed for combined resection. Case presentation All patients had pancreatic head malignancies that were in contact with rRHA. We performed a preoperative embolization of the rRHA before the scheduled pancreaticoduodenectomy for the combined resection. Arterial embolization was safely accomplished, and the communicating arcade from the left hepatic artery via the hilar plate was clearly revealed in all cases. Four patients underwent the operative procedure, except for one patient who had liver metastasis at laparotomy. No patient suffered from a severe abnormal liver function during the management; however, one patient had multiple liver infarctions during the postoperative course. Conclusions Preoperative embolization for the combined resection of rRHA in pancreaticoduodenectomy can be a management option for the precise evaluation of hemodynamics after sacrificing rRHA. In our cases, arterial flow to the right liver lobe was supplied by the left hepatic artery via the bypass route, including the communicating arcade of the hilar plate

The preoperative SOFA score and remnant small intestine length are postoperative risk factors for mortality in patients with non‐occlusive mesenteric ischemia: a case–control study

Aim Non‐occlusive mesenteric ischemia (NOMI) is a fatal condition with a low survival rate in most cases. The risk factors for perioperative mortality in NOMI cases are unclear. The purpose of this study was to define the risk factors for mortality in patients with NOMI undergoing surgery. Methods Thirty‐eight consecutive patients who underwent surgery for NOMI at Teine Keijinkai Hospital between 2012 and 2020 were included in the study. Patient information, including age, sex, physical findings, comorbidities, laboratory data, and computed tomography and surgical findings were retrospectively analyzed. Results Of the 38 patients, 18 (47%) died before discharge. Significant univariate predictors of mortality were a high Sequential Organ Failure Assessment (SOFA) score, high lactate level, low blood pH, and short intestinal length after surgery. In the multivariate analysis, a high SOFA score (odds ratio 1.33, P = 0.036) and short intestine length after surgery (odds ratio 34.7, P = 0.003) were identified as independent risk factors for perioperative mortality. Conclusion The preoperative SOFA score and postoperative residual intestinal length may be predictors of death in NOMI surgical patients, not age and the content of comorbidities

A case report of necrotizing soft tissue infection of the chest wall : Effective management with serial debridement

Introduction: Necrotizing soft tissue infection (NSTI) of the chest wall is a rare, rapidly spreading, highly lethal surgical disease. Radical debridement interferes with the important anatomical function of the chest wall. We re-port a case of chest wall NSTI that was successfully managed with early diagnosis and serial debridement. Presentation of case: A 43-year-old, previously healthy woman presented with severe malaise and worsening right axillary pain. She was severely lethargic and had a painful, large, pale lesion with surrounding erythema of the right chest and trunk. Computed tomography revealed NSTI, with diffuse soft tissue inflammation extending from the axilla to the lower abdomen. There was no obvious entry portal. Prompt surgical drainage was established. Group A streptococcus infection was diagnosed. During her 3-month postoperative course, she underwent four more surgeries, including two debridements. This treatment proved successful and avoided the need for complicated muscle flap reconstruction. She was discharged on postoperative day 109. Discussion: Group A streptococcus can cause NSTI even in immunocompetent patients without an entry portal. Radical debridement is recommended for infection control. Preserving anatomical chest wall function, however, is also important. Serial debridement with close follow-up solved the problem in this patient. Conclusions: Serial debridement with close follow-up enabled to avoid large tissue deficits and complicated re-construction in the case of NSTI of the chest wall. (C) 2021 The Author(s). Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd

The preoperative SOFA score and remnant small intestine length are postoperative risk factors for mortality in patients with non-occlusive mesenteric ischemia : a case-control study

AimNon-occlusive mesenteric ischemia (NOMI) is a fatal condition with a low survival rate in most cases. The risk factors for perioperative mortality in NOMI cases are unclear. The purpose of this study was to define the risk factors for mortality in patients with NOMI undergoing surgery. MethodsThirty-eight consecutive patients who underwent surgery for NOMI at Teine Keijinkai Hospital between 2012 and 2020 were included in the study. Patient information, including age, sex, physical findings, comorbidities, laboratory data, and computed tomography and surgical findings were retrospectively analyzed. ResultsOf the 38 patients, 18 (47%) died before discharge. Significant univariate predictors of mortality were a high Sequential Organ Failure Assessment (SOFA) score, high lactate level, low blood pH, and short intestinal length after surgery. In the multivariate analysis, a high SOFA score (odds ratio 1.33, P = 0.036) and short intestine length after surgery (odds ratio 34.7, P = 0.003) were identified as independent risk factors for perioperative mortality. ConclusionThe preoperative SOFA score and postoperative residual intestinal length may be predictors of death in NOMI surgical patients, not age and the content of comorbidities