Effectiveness of Embolization for Pulmonary Arteriovenous Malformations from Distal of the Last Normal Branch of the Pulmonary Artery.

Purpose: This retrospective study of patients with pulmonary arteriovenous malformations aims to assess the efficacy of embolization distal to the origin of the last normal branch of the pulmonary artery. Material and Methods: A total of 30 consecutive patients with 38 untreated pulmonary arteriovenous malformations underwent coil embolization distal to the origin of the last normal branch of the pulmonary artery between September 2015 and October 2021. The median (interquartile range) age of patients (5 males, 25 females) was 59 years (50-68 years old), and the median (interquartile range) sizes of the feeding artery and sac were 2.9 mm (2.3-3.8 mm) and 6.7 mm (5.4-9.7 mm), respectively. The technical success rate, persistence rate, and treatment-related complications were evaluated. Technical success was defined as the inability to identify the draining vein on feeding arteriography after coil embolization. Persistence was assessed using time-resolved magnetic resonance angiography. Results: Coil embolization was successful in all patients (100%). There was no persistence during a median (interquartile range) follow-up period of 23 months (10-45 months) for the 38 pulmonary arteriovenous malformations embolized with coils. No major complications were reported. Only minor complications following embolization occurred in 4 of 36 sessions, including local pain in 2 sessions (6%) and hemosputum in 2 sessions (6%). Conclusions: Embolization distal to the origin of the last normal branch of the pulmonary artery is effective in preventing the persistence of pulmonary arteriovenous malformations.

Mechanism simulation of polar and nonpolar organic solvent vapor adsorption on a multiwall carbon nanotubes paper gas sensor.

We investigate the adsorption behavior of polar and nonpolar molecules on carbon nanotube interfaces through computational simulations. Gaussian 16 was utilized to calculate the total energy of each possible molecular structure and analyze the adsorption mechanisms in stacked and inline configurations. The study reveals that nonpolar molecules favor stacked adsorption on two graphene interfaces, while polar molecules prefer inline adsorption. The findings suggest that inline adsorption of polar molecules results in minimal changes to the local dielectric constant, which may explain the absence of multi-step adsorption isotherms. The research examines the stability and energetics of molecular adsorption on graphene layers simulating CNT interfaces. Different types of molecules (polar and nonpolar) exhibit distinct adsorption behaviors, with nonpolar molecules aligning with the IUPAC type VI isotherm model and polar molecules following the Langmuir isotherm model (IUPAC type I). This study provides insight into how molecules are likely to adsorb on CNT surfaces and the impact on the local dielectric constant. This understanding has implications for the design and optimization of CNT-based sensors, particularly in detecting organic solvents and gases in various environments.

A facile technique to develop conductive paper based bioelectrodes for microbial fuel cell applications.

Electronic devices with multifunctional capabilities is forever an attractive area with diverse scope including towards developing solutions to sustainable energy technology. Microbial biofuel cells (MiBFCs) are one such sustainable energy technology based electronic device which can not only harvest energy, but can perform biosensing leading to bioremediation. However, low energy yield, costly fabrication procedures and bulky devices are some of the limitations of such MiBFCs. In this work, for the first time a simple vacuum filtration fabrication technique is used for making thin and conductive electrodes with homogeneous CNT solution for MiBFC application. The fully paper-based MiBFC is integrated into a compact micro device with 3D printed components which adds novelty to the work. The MiBFC is capable of maintaining a stable open circuit voltage of 410 mV for more than 1 h and can deliver a maximum power density of 192 µW/cm2 which is reasonably high for such paper-based MiBFCs operating with micro-volume of substrate. This device will help in developing more freestanding power sources for instant diagnostics and data transfer.

Asymptomatic air collection in the left atrium after computed tomography-guided lung biopsy.

Systemic air embolism is a fatal lung biopsy complication, despite its low incidence. Incidental air immigration into the pulmonary vein passing through the left heart circulation results in air embolism in percutaneous lung biopsy. Herein, we report a 73-year-old man who presented with massive air collection in the left atrium after computed tomography-guided lung biopsy which resolved without any symptom. Computed tomography fluoroscopy confirmed the gradual absorption process.

Efficacy, safety, and optimal timing of single-trocar video-assisted flexible thoracoscopic debridement under local anesthesia for complicated parapneumonic empyema.

OBJECTIVE: Thoracoscopic debridement under local anesthesia is a useful approach for complicated parapneumonic effusion or empyema (CPE) and is a less invasive procedure than video-assisted thoracoscopic surgery under general anesthesia. There are various methods of thoracoscopic debridement under local anesthesia, although the optimal timing of treatment is unknown. The objective of this study was to verify the efficacy and safety of our video-assisted flexible thoracoscopic debridement (VAFTS-D) procedure under local anesthesia, and to investigate the clinical features associated with the success of VAFTS-D. METHODS: The study included 71 consecutive patients with CPE who underwent VAFTS-D. The primary outcome was success of VAFTS-D. We retrospectively analyzed the efficacy and safety of VAFTS-D from the clinical data obtained from hospital medical records, and used univariate logistic analyses to identify potential predictors of the outcome. RESULTS: VAFTS-D was considered successful in 62 of 71 patients (87.3%). Two of the remaining nine patients died and the other seven patients required subsequent operation under general anesthesia. Complications due to VAFTS-D occurred in six patients (8.5%). Duration of empyema < 10 days (P = 0.024) and negative bacterial culture in pleural effusion (P = 0.029) were independently associated with the success of VAFTS-D by univariate logistic regression analysis. CONCLUSION: VAFTS-D might be an acceptable first-line procedure in patients with suspected CPE. VAFTS-D should be performed as early as possible for a successful outcome, and to obtain useful information on the pleural cavity.

Supercritical Water Gasification of Guaiacol with Acetic Acid as a Radical Scavenger: Interaction Effect on Char Formation and Gas Composition.

Supercritical water gasification (SCWG) of mixtures of guaiacol and acetic acid was carried out in a continuous reactor at 600 °C and 25 MPa with a residence time of 94 s. Different concentrations of acetic acid were employed to investigate the effect of acetic acid on product yield and gas composition. The interaction between guaiacol and acetic acid during SCWG was discussed. Acetic acid, as a radical scavenger, was found to inhibit radical polymerization, resulting in the suppression of char formation.

Response of Palladium and Carbon Nanotube Composite Films to Hydrogen Gas and Behavior of Conductive Carriers.

To develop a high-performance hydrogen gas sensor, we fabricated a composite film made of carbon nanotubes (CNTs) and palladium nanoparticles. Carbon nanotubes were spin-coated onto a glass substrate, and subsequently, palladium nanoparticles were sputtered onto this film. The response to hydrogen gas was measured during two seasons (summer and winter) using a vacuum chamber by introducing a hydrogen/argon gas mixture. There was a clear difference in the sensor response despite the temperature difference between summer and winter. In addition, since a clean chamber was used, fewer water molecules acted as a dopant, and the behavior of the CNT changed from p-type to n-type because of the dissociative adsorption of hydrogen. This phenomenon was confirmed as the Seebeck effect. Finally, the work functions of Pd, PdHx, and CNT were calculated by first-principle calculations. As predicted by previous studies, a decrease in work function due to hydrogen adsorption was confirmed; however, the electron transfer to CNT was not appropriate from the perspective of charge neutrality and was found to be localized at the Pd/CNT interface. It seems that the Seebeck effect causes the concentration of conductive carriers to change.

[Costochondritis and Osteomyelitis of the Ribs after Intercostal Thoracotomy].

A 53-year-old man underwent surgical repair and drainage of a spontaneous esophageal rupture through a left anterolateral intercostal thoracotomy. Thereafter, wound infection persisted for 3 years with formation of cutaneous fistulae and granulation tissue. Chest computed tomography revealed osteolysis, swollen ribs and costal cartilage, and cutaneous fistulous tracts. Bone scintigraphy with 99mTechnetium revealed abnormal accumulation in the ribs and costal cartilage, indicating costochondritis and osteomyelitis of ribs with cutaneous fistulae. Surgical resection of the skin including the cutaneous fistulae, infected ribs and costal cartilage were performed successfully.

Single-trocar thoracoscopic pericardio-pleural fenestration under local anesthesia for malignant pleural effusion: a case report.

BACKGROUND: Pericardio-pleural fenestration by video-assisted thoracoscopic surgery is an efficient procedure for malignant pericardial effusion, but requires general anesthesia with single-lung ventilation. CASE PRESENTATION: A 43-year-old woman was referred with complaints of deteriorating dyspnea and orthopnea. Chest computed tomography revealed right massive pleural effusion and pericardial effusion. Echocardiography demonstrated collapse of both the right atrium and right ventricle due to cardiac tamponade. Semi-rigid thoracoscopic pleural biopsy and pericardio-pleural fenestration were successfully performed under local anesthesia via a single trocar, because surgical procedures under general anesthesia with single-lung ventilation might have been intolerable for the patient. Adequate biopsy specimens of pleura and pericardium and immediate relief of serious symptoms were obtained without perioperative complications. No recurrence of pleural or pericardial effusion was observed for 3 months postoperatively. CONCLUSION: Thoracoscopic pericardio-pleural fenestration under local anesthesia via a single trocar is feasible as an alternative approach in critically ill patients, allowing effective pericardial drainage, evaluation of the pleural cavity, and accurate biopsies of the pericardium and parietal pleura simultaneously.

What factors determine the survival of patients with an acute exacerbation of interstitial lung disease after lung cancer resection?

PURPOSES: Acute exacerbation of interstitial pneumonia (AEIP) is a leading cause of death after lung cancer resection in patients with interstitial lung disease. METHODS: We retrospectively analyzed 1763 patients with non-small cell lung cancer with a clinical diagnosis of interstitial lung disease (ILD) who underwent lung cancer resection between 2000 and 2009 at 61 hospitals in Japan. AEIP occurred in 164 of 1763 (9.3%) patients with a mortality rate of 43.9% (72/164). Univariate and multivariate analyses were carried out to identify possible risk factors of fatal AEIP. We then analyzed the 164 patients who developed postoperative AEIP and identified the preoperative and postoperative risk factors. RESULTS: A multivariate regression analysis identified that the sex, percent vital capacity, neoadjuvant radiation, preoperative history of AEIP, preoperative use of steroids, usual interstitial pneumonia pattern on CT, and surgical procedures were independent preoperative risk factors for death due to AEIP. ILD patients with emphysema somehow showed a lower risk of fatal AEIP than those without emphysema in this study. CONCLUSIONS: This study revealed eight risk factors for fatal AEIP.

Synaptonemal complex protein 3 is associated with lymphangiogenesis in non-small cell lung cancer patients with lymph node metastasis.

BACKGROUND: The interaction of vascular endothelial growth factor-C (VEGF-C)/VEGF-D/VEGF receptor-3 is considered to be a major driver of lymphangiogenesis, however the mechanism of this process remains unclear. We aimed to investigate the possible lymphangiogenic significance of synaptonemal complex protein 3 (SCP3) in non-small cell lung cancer (NSCLC). METHODS: The expression of SCP3, VEGF-C, and VEGF-D were measured and examined a correlation between SCP3 and VEGF-C or VEGF-D in various human lung cancer cell lines. Subsequently, we assessed SCP3, VEGF-A, VEGF-B, VEGF-C, and VEGF-D expression in archival tumor tissues from 89 NSCLC patients with lymph node (LN) metastasis by combined immunohistochemistry with quantitative digital image analysis. RESULTS: Positive correlations between SCP3 and VEGF-C expression (R 2  = 0.743) and VEGF-D expression (R 2  = 0.932) were detected in various human lung cancer cell lines. The high expression of SCP3, VEGF-A, VEGF-B, VEGF-C, and VEGF-D were detected in 24 (27.0%), 22 (24.7%), 27 (30.3%), 27 (30.3%), and 24 cases (27.0%), respectively. Notably, SCP3 positively correlated with VEGF-C and VEGF-D expression (for both, P < 0.001) and negatively correlated with VEGF-A and VEGF-B expression (P = 0.029 and P = 0.026, respectively). In multivariate analysis of patients with LN metastasis, SCP3 expression predicted worse overall survival (hazard ratio = 1.86, P = 0.008). CONCLUSIONS: SCP3 is associated with lymphangiogenesis and provides insight into the SCP3-VEGF-C/VEGF-D axis based cancer therapy strategy.

Systemic air embolism during pleural lavage for empyema.

Pleural lavage has been considered a convenient and safe method that is often performed for empyema. We report a case of systemic air embolism that developed during pleural lavage. A 53-year-old man with empyema in the organizing phase suddenly developed paralysis of the left side of the body and altered level of consciousness during pleural lavage, which was performed in a sitting position without negative pressure suction. Systemic air embolism was diagnosed based on computed tomography. In this case, use of fibrinolytic agents, positioning during pleural lavage, and pressure in an empyema cavity may have predisposed to development of systemic air embolism. Conversion from thoracoscopic therapy to open decortication or fenestration should be considered to prevent this type of complication.

Thoracolithiasis diagnosed by thoracoscopy under local anesthesia.

A 68-year-old woman was referred to our hospital for a lung nodule identified on chest radiography. Computed tomography (CT) showed a 10-mm calcified nodule in the left thoracic cavity. On follow-up CT, the nodule was found in a different location within the left thoracic cavity. Thoracoscopy was performed under local anesthesia, removing a pearl-like pleural stone. Thoracolithiasis was therefore diagnosed without any complications. To the best of our knowledge, this is the first report on thoracoscopy under local anesthesia for the diagnosis of thoracolithiasis. When thoracolithiasis is suspected, thoracoscopy under local anesthesia is minimally invasive and useful, and could be considered as an option for definite diagnosis.

Zeaxanthin and Echinenone Protect the Repair of Photosystem II from Inhibition by Singlet Oxygen in Synechocystis sp. PCC 6803.

Carotenoids are important components of antioxidative systems in photosynthetic organisms. We investigated the roles of zeaxanthin and echinenone in the protection of PSII from photoinhibition in Synechocystis sp. PCC 6803, using mutants of the cyanobacterium that lack these carotenoids. The activity of PSII in mutant cells deficient in either zeaxanthin or echinenone was more sensitive to strong light than the activity in wild-type cells, and the activity in mutant cells deficient in both carotenoids was hypersensitive to strong light, indicating that the absence of these carotenoids increased the extent of photoinhibition. Nonetheless, the rate of photodamage to PSII, as measured in the presence of chloramphenicol, which blocks the repair of PSII, was unaffected by the absence of either carotenoid, suggesting that these carotenoids might act by protecting the repair of PSII. Knockout of the gene for the so-called orange carotenoid protein (OCP), in which the 3'-hydroxyechinenone cofactor, a derivative of echinenone, is responsible for the thermal dissipation of excitation energy, increased the extent of photoinhibition but did not affect photodamage, suggesting that thermal dissipation also protects the repair of PSII. In mutant cells lacking OCP, as well as those lacking zeaxanthin and echinenone, the production of singlet oxygen was stimulated and the synthesis de novo of various proteins, including the D1 protein, was markedly suppressed under strong light. These observations suggest that the carotenoids and thermal dissipation might protect the repair of photodamaged PSII by depressing the levels of singlet oxygen that inhibits protein synthesis.

Single-trocar thoracoscopy under local anesthesia for pleural space infection.

OBJECTIVE: The role of single-trocar thoracoscopy for complicated parapneumonic effusion (CPE) and pleural empyema is not established as yet. The aim of this study was to report our experience and analyze the efficacy and safety of debridement by single-trocar thoracoscopy for the patients with CPE and multiloculated empyema. METHODS: We performed a retrospective study reviewing the medical records of the patients treated parapneumonic effusion and multiloculated empyema by single-trocar thoracoscopy under local anesthesia at our department from January 2000 to December 2012. RESULTS: A total 29 patients with CPE and multiloculated empyema were treated by single-trocar thoracoscopy. As the staging of pleural infection, class 5 and class 7 by Light classification were 21 and 8 patients, respectively. The onset of the symptom was on average 13.9 ± 11.7 days before the procedure. This procedure was successful in 23 of 29 patients (79.3%) without further operation under general anesthesia. Complication occurred in 1 case of 29 patients (3.4%). Six patients required subsequently the operation under general anesthesia, and one of the 6 patients died to multiple organ failure caused by sepsis. A microbiological diagnosis could be made in fifteen patients (51.7%). CONCLUSIONS: Debridement by single-trocar thoracoscopy can be an acceptable approach as the first-line procedure in patients with CPE and empyema. This procedure can provide not only appropriate and expeditious treatment but also information of pleural cavity to decide indication for thoracotomy under general anesthesia.

A phase II study of docetaxel plus nedaplatin in patients with metastatic non-small-cell lung cancer.

PURPOSE: Nedaplatin is a cisplatin derivative, which has similar activity to cisplatin in non-small-cell lung cancer (NSCLC) when combined with vindesine, and causes less nausea/vomiting and nephrotoxicity compared with cisplatin. The aim of this study was to evaluate the efficacy and safety of combination chemotherapy with docetaxel plus nedaplatin in patients with metastatic NSCLC. METHODS: Patients with metastatic stage IIIB excluding locally advanced diseases or stage IV NSCLC were enrolled between March 2004 and March 2006. They were treated with docetaxel (60 mg/m(2)) and nedaplatin (80 mg/m(2)) on day 1 every 3-4 weeks until progression or intolerable toxicity for up to 4 cycles. RESULTS: Forty-four patients (mean age, 65 years; range, 40-79 years) received a total of 140 treatment cycles. Responses could be assessed in all patients (complete response, 0; partial response, 22; stable disease, 11; and progressive disease, 11). Response rate was 50.0 % (95 % confidence interval [CI], 35.2-64.8 %) with a disease control rate of 75.0 % (95 % CI, 62.2-87.8 %). A high response rate was achieved in patients with squamous cell carcinoma (66.7 %) compared with that in patients with adenocarcinoma (41.4 %). Median survival time from the start of the combination chemotherapy was 13.0 months, and the progression-free survival time was 7.4 months. Grade 3 or 4 hematologic toxicities included leukopenia (28.6 %) and neutropenia (61.4 %). Nonhematologic toxicities were mild. CONCLUSION: The combination of docetaxel plus nedaplatin was well tolerated and demonstrated potent activity in patients with metastatic NSCLC, particularly squamous cell carcinoma of the lung.

[A case of anesthetic management using levobupivacaine in epidural anesthesia combined with general anesthesia for thymectomy with thoracoscopy for generalized type myasthenia gravis].

Combined epidural and general anesthesia has become a standard anesthetic method for thymectomy. We employed levobupivacaine for epidural anesthesia combined with general anesthesia using remifentanil and sevoflurane for thymectomy with thoracoscopy for generalized type of myasthenia gravis. After decreasing the high level of antibodies to acethylcholine receptor by plasmapheresis, we could perform a stable and successful anesthetic management without the use of any muscle relaxants for the thymectomy. And a myasthenic crisis did not occur after the procedure. We concluded that levobupivacaine would be one of the appropriate options in epidural anesthesia for thymectomy for myasthenia gravis.

Mycobacterium kansasii pulmonary infection: CT findings in 29 cases.

PURPOSE: Our aim was to assess computed tomography (CT) features of Mycobacterium kansasii pulmonary infection (M. kansasii infection). MATERIALS AND METHODS: A total of 29 cases confirmed to have M. kansasii infections were analyzed. The main locations of pulmonary changes, incidence, and various imaging features of the cavity (location, maximum diameter, wall thickness, satellite nodules, intracavitary fluid), and other imaging findings such as nodules, consolidation, and bronchiectasis, were visually assessed on CT images. RESULTS: Locations of the main abnormalities were as follows: right S2 41%; right S1 31%; left S1+S2 2: 21%. A total of 49 cavities were observed in 24 (83%) cases. The mean maximum diameter, wall thickness, and ratio of wall thickness to the maximum diameter were 33.0 mm, 4.7 mm, and 0.19, respectively. Shapes of the cavities were round in nine (18.4%), oval in 17 (34.7%), and tubular/meandering in 23 (47%). Satellite nodules were found in only 30.6% of patients (n = 15). Small nodules were found in 26 (89.7%) patients, and most of them showed a centrilobular distribution. CONCLUSION: The characteristic CT findings suggestive of M. kansasii infection include cavities located in the right posterior or apical segment with a tubular/meandering shape and a thin wall.