Intracoronary transplantation of pluripotent stem cell-derived cardiomyocytes: Inefficient procedure for cardiac regeneration.

Advances in stem cell biology have facilitated cardiac regeneration, and many animal studies and several initial clinical trials have been conducted using human pluripotent stem cell-derived cardiomyocytes (PSC-CMs). Most preclinical and clinical studies have typically transplanted PSC-CMs via the following two distinct approaches: direct intramyocardial injection or epicardial delivery of engineered heart tissue. Both approaches present common disadvantages, including a mandatory thoracotomy and poor engraftment. Furthermore, a standard transplantation approach has yet to be established. In this study, we tested the feasibility of performing intracoronary administration of PSC-CMs based on a commonly used method of transplanting somatic stem cells. Six male cynomolgus monkeys underwent intracoronary administration of dispersed human PSC-CMs or PSC-CM aggregates, which are called cardiac spheroids, with multiple cell dosages. The recipient animals were sacrificed at 4 weeks post-transplantation for histological analysis. Intracoronary administration of dispersed human PSC-CMs in the cynomolgus monkeys did not lead to coronary embolism or graft survival. Although the transplanted cardiac spheroids became partially engrafted, they also induced scar formation due to cardiac ischemic injury. Cardiac engraftment and scar formation were reasonably consistent with the spheroid size or cell dosage. These findings indicate that intracoronary transplantation of PSC-CMs is an inefficient therapeutic approach.

High-Throughput Analysis of Bacterial Toxic Lipopolysaccharide in Water by Dual-Wavelength Monitoring Using a Ratiometric Fluorescent Chemosensor.

Lipopolysaccharide (LPS) is a bacterial toxin that causes fever in humans. Our small-molecule chemosensor named Zn-dpa-C2OPy shows rapid ratiometric fluorescence response to LPS in water with a detection limit of 11 pM, which is lower than that of our previously reported sensor. Spectroscopic measurements (fluorescence, absorbance, 1H NMR, and fluorescence lifetime), dynamic light scattering measurements, and transmission electron microscopy observations revealed that the fluorescence response was induced by the changes in the aggregation state via multi-point recognition of LPS through hydrophobic and electrostatic interactions, in addition to the coordination between the zinc(II)-dipicolylamine moiety of the chemosensor and the phosphate group of LPS. The proposed Zn-dpa-C2OPy chemosensor was applied to an original flow injection analysis (FIA) system with a self-developed dual-wavelength fluorophotometer, and a high throughput of 36 samples per hour was achieved. These results demonstrate the feasibility of this unique methodology combining a ratiometric fluorescent chemosensor and FIA for continuous online monitoring of LPS in water.

Prevalence and Impact of Infection during Extracorporeal Membrane Oxygenation in Oncologic Patients: A Retrospective Analysis of the Extracorporeal Life Support Organization (ELSO) Registry.

Background: Extracorporeal membrane oxygenation (ECMO) is widely utilized for severe cardiopulmonary insufficiency, but its application to the oncologic population has been debated given concern for increased risk of infection. This study aims to analyze the implications of infections acquired during ECMO runs in patients with malignancy. Methods: The Extracorporeal Life Support Organization (ELSO) database was queried for patients with an International Classification of Diseases code of neoplasms over the last two decades (2000-2019). Culture-proven infections during ECMO runs were analyzed and compared to previously reported data for all ECMO runs. Results: Two thousand, seven hundred and fifty-seven patients met inclusion criteria. Infection acquired during ECMO run was found in 687 patients, a significantly greater proportion compared to all ECMO runs (24.9% vs 11.7%; P = .001). Adult patients had a significantly higher rate of infection (27.0%; P < .001) compared to neonatal (11.0%) and pediatric (21.4%) patients. Prevalence of infection was highest in pulmonary ECMO (29.0%), while the infection rate standardized with ECMO duration was highest in extracorporeal cardiopulmonary resuscitation (55.03/1000-day ECMO run). Compared with ECMO for all diagnoses, the prevalence of Candida and Klebsiella infection was significantly higher in adult and pediatric oncologic patients. Regardless of the pathogen, the presence of infection was not associated with lower survival (38.6% vs 40.0%; P = .522). Conclusions: Oncologic patients had a significantly higher infection rate while on ECMO compared with the general ECMO population. However, the prognostic impact of these infections was minimal, thus ECMO should not be withheld in oncologic patients solely with concern for infection.

Endoscopic endonasal transsphenoidal surgery in acromegaly with conchal sphenoid sinus.

BACKGROUND: A conchal non-pneumatized sphenoid sinus tends to be considered as unfavorable for transsphenoidal surgery because of procedural difficulties. Especially in acromegalic patients, the proportion of the conchal type of sphenoid sinus is potentially high compared with that of other patients who have a pituitary tumor. This report investigates the characteristics and surgery of the conchal type of sphenoid sinus in acromegaly along with the internal bone properties. CLINICAL PRESENTATION: A 70-year-old man with acromegaly underwent endoscopic endonasal transsphenoidal surgery. Intraoperatively, the anterior wall of the non-pneumatized sphenoid was cortical, however, the cancellous bone was very soft, included fatty tissue, and was easily removed by suction. The sellar lesion could be reached without any problems, and finally, total tumor resection was achieved. CONCLUSION: Based on this surgical case, the conchal sphenoid sinus of acromegaly is not always homogeneous solid bone but may contain soft fatty tissue. Therefore, although the sphenoidal characteristics may have an impact on the surgical procedures, precise assessment pre- and intraoperatively can make transsphenoidal surgery with conchal sphenoid sinus feasible.

Intraspinal canal platform system for coil embolization of anterior spinal artery aneurysm associated with spinal cord arteriovenous malformation: a case report and literature review.

BACKGROUND: The prognosis for spinal artery aneurysms associated with spinal cord arteriovenous malformations (AVMs) is poor because of the high rupture rate of aneurysms. However, endovascular treatment remains technically difficult because the catheter system must be constructed via the small-caliber anterior spinal artery (ASA) or posterior spinal artery (PSA), which feeds functionally eloquent spinal cord. A 2.6F Carnelian HF-S microcatheter (Tokai Medical Products, Aichi, Japan) has been specifically designed to assist a 1.6F Carnelian MARVEL S microcatheter (Tokai Medical Products) as a small-profile 'platform catheter' close to the target lesion. Here we present a prenidal ASA aneurysm treated using a 2.6F Carnelian HF-S microcatheter as an intraspinal canal platform catheter and review related literature. CASE PRESENTATION: A 50-year-old man presented with a subarachnoid haemorrhage due to cervical spinal cord AVM. Diagnostic vertebral angiography revealed the AVM supplied by the PSA originated from the right C2 segmental artery and ASA arising from the right V4 segment. Superselective angiography for each feeder was achieved through a 2.6F Carnelian HF-S microcatheter, and a prenidal ASA aneurysm was diagnosed, which was clinically consistent with haemorrhagic origin. A 1.6F Carnelian MARVEL S microcatheter was cannulated into the aneurysm through the 2.6F Carnelian HF-S microcatheter positioned at the ASA. The aneurysm coiling was successfully performed without system instability or periprocedural complications. CONCLUSIONS: Only a few cases have described endovascular treatment for spinal artery aneurysms. To date, no reports have been published regarding the use of an intraspinal canal platform catheter to treat spinal artery aneurysms. A 2.6F Carnelian HF-S microcatheter served as a useful intraspinal canal platform catheter for coil embolization of the ASA aneurysm. This system can provide excellent accessibility and controllability for endovascular treatment of spinal artery lesions.

Supramolecular Assemblies of Fluorescent Nitric Oxide Photoreleasers with Ultrasmall Cyclodextrin Nanogels.

Developing biocompatible nitric oxide (NO) photoreleasing nanoconstucts is of great interest in view of the large variety of biological roles that NO plays and the unique advantage light offers in controlling NO release in space and time. In this contribution, we report the supramolecular assemblies of two NO photodonors (NOPDs), NBF-NO and RHD-NO, as water-dispersible nanogels, ca. 10 nm in diameter, based on γ-cyclodextrins (γ-CDng). These NOPDs, containing amino-nitro-benzofurazan and rhodamine chromophores as light harvesting antennae, can be activated by visible light, are highly hydrophobic and can be effectively entrapped within the γ-CDng. Despite being confined in a very restricted environment, neither NOPD suffer self-aggregation and preserve their photochemical and photophysical properties well. The blue light excitation of the weakly fluorescent γ-CDng/NBF-NO complex results in effective NO release and the concomitant generation of the highly green, fluorescent co-product, which acts as an optical NO reporter. Moreover, the green light excitation of the persistent red fluorescent γ-CDng/RHD-NO triggers NO photorelease without significantly modifying the emission properties. The activatable and persistent fluorescence emissions of the NOPDs are useful for monitoring their interactions with the Gram-positive methicillin-resistant Staphylococcus aureus, whose growth is significantly inhibited by γ-CDng/RHD-NO upon green light irradiation.

Aggregation-Based Bacterial Separation with Gram-Positive Selectivity by Using a Benzoxaborole-Modified Dendrimer.

Antimicrobial-resistant (AMR) bacteria have become a critical global issue in recent years. The inefficacy of antimicrobial agents against AMR bacteria has led to increased difficulty in treating many infectious diseases. Analyses of the environmental distribution of bacteria are important for monitoring the AMR problem, and a rapid as well as viable pH- and temperature-independent bacterial separation method is required for collecting and concentrating bacteria from environmental samples. Thus, we aimed to develop a useful and selective bacterial separation method using a chemically synthesized nanoprobe. The metal-free benzoxaborole-based dendrimer probe BenzoB-PAMAM(+), which was synthesized from carboxy-benzoxaborole and a poly(amidoamine) (PAMAM) dendrimer, could help achieve Gram-positive bacterial separation by recognizing Gram-positive bacterial surfaces over a wide pH range, leading to the formation of large aggregations. The recognition site of benzoxaborole has a desirable high acidity and may therefore be responsible for the improved Gram-positive selectivity. The Gram-positive bacterial aggregation was then successfully collected by using a 10 µm membrane filter, with Gram-negative bacteria remaining in the filtrate solution. BenzoB-PAMAM(+) will thus be useful for application in biological analyses and could contribute to further investigations of bacterial distributions in environmental soil or water.

Reviewing ACGME Plastic Surgery Fellowship Case Logs: Is Surgical Experience Increasing?

INTRODUCTION: Over the last decade, there has been a 32% decrease in independent plastic surgery fellowships. The growing prevalence of 6-year integrated plastic surgery residencies, duty hour restrictions, and new subspecialty training fellowships for general surgeons have changed the training experience of plastic surgery fellows. METHODS: A retrospective review of the Accreditation Council for Graduate Medical Education (ACGME) case logs for graduating fellows of independent plastic surgery fellowships in the United States was conducted from 2011 to 2019. A linear regression analysis was conducted for each case log code and category, and a 95% level of confidence was assumed (α = 0.05). RESULTS: In 2011, 141 residents from 69 programs graduated with an average of 1469.7 cases. In 2019, 84 residents from 47 programs graduated with an average of 1952 cases. Index procedures significantly increased overall during the 9 y (P < 0.001). Categorical cases increased in esthetics (P < 0.001), including facelift, browlift, blepharoplasty, and more. Categorical cases increased in reconstructive surgery (P < 0.001), including treatment of deformities of the skin, lower extremities, and trunk, nerve decompression, and hand reconstruction. In breast procedures, an increase was seen in the reduction of mammoplasty, reconstruction, and treatment of other breast deformities. In head and neck procedures, an increase was seen in resection of head and neck neoplasms and secondary cleft lip repair. Decreases in procedural numbers were seen in primary cleft lip repair and hand reconstruction by primary closure. CONCLUSIONS: Despite a 32% decline in the number of independent plastic surgery fellowships over the last 9 y, plastic surgery fellows are obtaining significantly more surgical experience, both in esthetic and reconstructive surgery.

Outcome of Extracorporeal Membrane Oxygenation for Pediatric Patients With Neoplasm: An Extracorporeal Life Support Organization Database Study (2000-2019).

OBJECTIVES: This study update in usage and outcomes of pediatric extracorporeal membrane oxygenation (ECMO) for patients with neoplasm analyzed according to demographics, clinical variables, and complications. DESIGN: Retrospective database review of the Extracorporeal Life Support Organization registry from the last 2 decades (2000-2019). The data were divided between two decades in order to compare patients' backgrounds and outcomes over time. SETTING: ECMO centers reporting to Extracorporeal Life Support Organization. PATIENTS: Patients equal to or younger than 18 years old with International Classification of Diseases, 9th Revision and International Classification of Diseases, 10th Revision codes that referred to neoplasms who were managed with ECMO. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Demographics, cancer subtype, clinical variables, and ECMO complications were assessed in relation to the primary study outcome of survival to hospital discharge. Nine-hundred two patients met inclusion criteria; 699 patients were in the latest decade, which is more than three times the number from the previous decade (203 patients). On univariate analysis, compared with the previous decade, in the later decade, ECMO was more frequently applied in patients with pre-ECMO cardiac arrest (31.3% vs 17.1%; p < 0.001), and/or lower oxygenation index (38.0 vs 48.1; p < 0.001). We failed to identify a difference in survival between the 2 decades (42.8% vs 37.9%; p = 0.218). On multivariable analysis, diagnosis of hematologic malignancy, post-cardiopulmonary resuscitation support type, hematopoietic stem cell transplant, and age older than seven were each associated with greater odds of mortality. CONCLUSIONS: The use of ECMO in children with neoplasm has expanded over the latest decade with changes in patient selection. Mortality remains unchanged. Hence, although the clinician still should stay cautious in its application, ECMO can be considered as an option to rescue pediatric oncologic patients in the setting of worsening cardiopulmonary status in the PICU.

Effectiveness of the intraoperative magnetic resonance imaging during endoscopic endonasal approach for acromegaly.

PURPOSE: Acromegaly is an acquired disorder usually caused by growth hormone-secreting pituitary adenoma, resolution of which requires correction of the excess hormone production. Recently, intraoperative magnetic resonance imaging (iMRI) was reported to be useful during the endoscopic endonasal approach (EEA) for pituitary adenoma. The present study was performed to quantitatively assess the role of iMRI in improving surgical outcomes in EEA for acromegaly. METHODS: Twenty surgeries for acromegaly in EEA performed at Shinshu University Hospital between April 2016 and March 2020 were reviewed retrospectively. The inclusion criteria were cases without severe cavernous sinus tumor invasion (Knosp grade 0 - 3) or history of prior pituitary surgery. Fifteen consecutive patients were enrolled in this study. Clinical characteristics and postoperative clinical outcomes were compared between patients with and without use of iMRI during EEA for acromegaly. RESULTS: Conventional navigation-guided surgery was performed in nine patients, and six underwent iMRI-guided EEA for acromegaly. Gross total resection (GTR) was obtained in the six (100%) patients in the iMRI group, and in four (44.4%) patients in the conventional group without iMRI. Postoperative clinical outcomes, including hormonal remission rate and surgical complications, were comparable between the two groups. CONCLUSION: Although iMRI significantly increased the GTR rate, we found no direct evidence of increased hormonal remission rate by use of iMRI. It is important to confirm complete tumor resection carefully with not only iMRI findings, but also with intraoperative high-definition endoscopic direct visualization to increase the hormonal remission rate of acromegaly.

Endoscopic diving technique for surgery of brain abscess.

BACKGROUND: Recent advances in neuroendoscopic surgery have led to the minimally invasive treatment of brain abscesses using various endoscopy techniques. The endoscopic diving technique (EDT) involving the formation of fluid lenses to improve the visibility of the endoscope has been reported to be useful in the endoscopic endonasal approach (EEA) for pituitary and midline cranial base lesions. Here, we report a case of brain abscess treated endoscopically using EDT in cylinder surgery. CLINICAL PRESENTATION: A 29-year-old man with 11q trisomy syndrome developed a fever and progressive right hemiparesis was observed. A diagnosis of a brain abscess was made based on neuroradiological imaging, and endoscopic irrigation and drainage with EDT via a transparent endoscopic sheath were performed, which provided a clear operative field and allowed satisfactory irrigation without bacterial contamination. The bacterium identified by PCR was Streptococcus intermedius, and antibiotic therapy was administered. Postoperatively, his symptoms gradually improved. CONCLUSION: This is the first technical case report describing the clinical experience of EDT in brain abscess surgery. EDT may be a useful technique not only in EEA but also in cylinder surgery for brain abscesses.

o-Azophenylboronic Acid-Based Colorimetric Sensors for d-Fructose: o-Azophenylboronic Acids with Inserted Protic Solvent Are the Key Species for a Large Color Change.

Many boronic acid-based chemosensors for saccharides have been developed; however, their detection mechanisms have seldom been studied. In this study, we synthesized 10 o-azophenylboronic acid derivatives (azoBs) and conducted a fundamental study on the reactivity and the sensing mechanism of azoBs, which undergoes a large color change, e.g., from red to yellow, upon a reaction with saccharides. Their pH-independent formation constants were determined by spectrophotometric titration and then converted to the conditional formation constant K' at pH 7.4. A linear free energy relationship was established between log K' and the pKa of azoB. 11B NMR measurements indicate that in aprotic solvents, azoB forms a trigonal planar structure, while in protic solvents, it forms a quasi-tetrahedral structure (azoB-ROH) with a protic solvent molecule (ROH) inserted between the boronic acid moiety and the azo group. In addition, UV-vis spectroscopic studies showed that the color change during the reaction between azoB and d-fructose in ROH was caused by the release of the ROH from azoB-ROH by d-fructose. Based on the findings in this study, we proposed a guideline for designing an azoB-based chemosensor that exhibits high reactivity toward saccharides and a sufficient color change to allow for the visual detection of saccharides.

Reactivity of Boronic Acids toward Catechols in Aqueous Solution.

Fundamental information on the reactivities of boronic acids toward catechols in aqueous solution is required in all the fields dealing with boronic acid. However, comprehensive studies on reactivity are often hindered by so-called "proton ambiguity," which makes it impossible for the rate constants of boronic acid and boronate ion to be determined separately. Herein, we set up two reaction systems without proton ambiguity: (1) Alizarin Red S and (2) Tiron with several boronic acids (RB(OH)2) with different pKas and performed kinetic and equilibrium studies on the reaction systems. It was shown that the logarithms of the rate constants of RB(OH)2 and its conjugate boronate ion (RB(OH)3-) decreased and increased linearly, respectively, with increasing pKa of RB(OH)2 for both systems. Consequently, the reactivities of RB(OH)2 and RB(OH)3- were reversed at high RB(OH)2 pKa. It was also shown that the bulky o- substituents of phenylboronic acids retarded the backward reactions, resulting in enhancement of the formation constants of boronic acid-catechol esters.

Highly Selective Aluminum(III) Ion Sensing with Luminescent Iridium(III) Complexes Bearing a Distorted 2,2'-Bipyridine-3,3'-diol Moiety Utilizing a Rigidified Seven-Membered Chelate Ring.

To create an ion sensor utilizing a rigidified seven-membered chelate ring, we developed two Ir(III) complexes with 2,2'-bipyridine-3,3'-diol (bpy(OH)2, bpydL) ligands as reaction centers, namely Ir1 ([Ir(ppy)2{bpy(O-)(OH)}], ppy = 2-phenylpyridine) and Ir2 ([Ir(bzq)2{bpy(O-)(OH)}], bzq = benzo[h]quinoline), and evaluated their reactivities toward metal ions by spectrophotometry. When they are reacted with Al3+, these complexes exhibit dramatic enhancements in emission intensity (775-fold for Ir1 and 51.0-fold for Ir2) and distinct orange to green changes in emission color. The reactions of Ir1 and Ir2 with Al3+ were found to barely be affected by nearly all common metal ions. We conclude that these high selectivities arise from the high affinities of the (O,O) atoms in bpydL for hard metal ions and the increased strain of the seven-membered chelate ring due to the coordination of bpydL to the Ir(III) center in each complex, which excludes large metal ions out of the chelate ring.

Results of Clipping Surgery for Aneurysmal Subarachnoid Hemorrhage in Elderly Patients Aged 90 or Older.

BACKGROUND: The number of elderly patients with aneurysmal subarachnoid hemorrhage (SAH) is increasing. Although advanced age is one of the recognized risk factors for poor outcome, conservative treatment for aneurysmal subarachnoid hemorrhage cannot provide satisfactory outcome in elderly patients. The aim of this study is to assess the outcome in patients aged 90 or older, for whom ruptured aneurysms were treated by clipping. METHODS: We retrospectively reviewed the medical records of non-traumatic SAH patients who were hospitalized at the Chiba Neurosurgical Clinic between 2004 and 2013. Of the 702 patients, 8 patients (1.1 %) were aged 90 or older. Of them, four underwent clipping surgery and the other four died or were managed conservatively. Their preoperative conditions were evaluated with the World Federation of Neurosurgical Societies Grading Scale of SAH, and the Fisher classification was used to assess the bleeding severity. The location of the ruptured aneurysm was determined by three-dimensional computed tomographic angiography or cerebral angiography. The Glasgow Outcome Scale evaluation was assigned at discharge. RESULTS: Four patients (four female, all WFNS grade 1), aged 90 or older, underwent clipping surgery. Fisher classification was three in two patients and four in the other two. Location of the ruptured aneurysm was internal carotid artery in two, anterior communicating artery in one, and posterior inferior cerebellar artery in one patient. Two of these four patients had a favorable outcome. CONCLUSIONS: We propose that advanced age alone does not exclude suitable surgical clipping in patients with aneurysmal rupture in the tenth decade of life.

Clipping Surgery for Paraclinoid Carotid Aneurysm.

BACKGROUND: Paraclinoid carotid aneurysm is widely treated with coil embolization. However, all paraclinoid carotid aneurysms cannot be obliterated by the endovascular approach. METHODS: Our direct surgical procedure was presented. The clinical data of surgically treated paraclinoid carotid aneurysms were retrospectively reviewed. RESULTS: One hundred ninety paraclinoid carotid aneurysms in 181 patients were directly obliterated at the Shinshu University Hospital and its affiliated hospitals between 1991 and 2013. CONCLUSIONS: Direct surgical repair of the paraclinoid carotid aneurysm is still useful, even in the era of endovascular treatment.

Exploring the Potential of Nanogels: From Drug Carriers to Radiopharmaceutical Agents.

Nanogels open up access to a wide range of applications and offer among others hopeful approaches for use in the field of biomedicine. This review provides a brief overview of current developments of nanogels in general, particularly in the fields of drug delivery, therapeutic applications, tissue engineering, and sensor systems. Specifically, cyclodextrin (CD)-based nanogels are important because they have exceptional complexation properties and are highly biocompatible. Nanogels as a whole and CD-based nanogels in particular can be customized in a wide range of sizes and equipped with a desired surface charge as well as containing additional molecules inside and outside, such as dyes, solubility-mediating groups or even biological vector molecules for pharmaceutical targeting. Currently, biological investigations are mainly carried out in vitro, but more and more in vivo applications are gaining importance. Modern molecular imaging methods are increasingly being used for the latter. Due to an extremely high sensitivity and the possibility of obtaining quantitative data on pharmacokinetic and pharmacodynamic properties, nuclear methods such as single photon emission computed tomography (SPECT) and positron emission tomography (PET) using radiolabeled compounds are particularly suitable here. The use of radiolabeled nanogels for imaging, but also for therapy, is being discussed.

A rare pure intraventricular hemorrhage caused by ruptured internal carotid artery-anterior choroidal artery aneurysm: a case report and literature review.

Although intraventricular hemorrhage (IVH) frequently develops secondary to intraparenchymal or subarachnoid hemorrhage, pure IVH-non-traumatic spontaneous intracranial hemorrhage confined to the cerebral ventricular system-is rare. Moreover, pure IVH caused by ruptured proximal aneurysm is an extremely rare but life-threatening condition. Herein, we present a case of pure IVH due to a ruptured internal carotid artery -anterior choroidal artery (ICA-AChA) aneurysm and review related literature. A 77-year-old man presenting with altered mental status was hospitalized due to a massive pure IVH with ventriculomegaly. The patient was conservatively managed because his consciousness level improved. On the following day, computed tomography angiography revealed a right ICA-AChA aneurysm embedded in the temporal lobe adjacent to the anterior part of the inferior horn of the lateral ventricle, which was consistent with the hemorrhagic origin. Coil embolization of the aneurysm was successfully performed, and the postprocedural course was uneventful. To date, only a few cases have described pure IVH caused by a ruptured proximal aneurysm. If the ruptured proximal aneurysm remains unnoticed, catastrophic rehemorrhage may occur. Aneurysm obliteration should precede the treatment of acute hydrocephalus. Neurosurgeons/neurointerventionalists must be aware about pure IVH caused by a ruptured proximal aneurysm even if it rarely occurs.

Extracorporeal Membrane Oxygenation for Adult Patients With Neoplasms: Outcomes and Trend Over the Last 2 Decades.

Extracorporeal membrane oxygenation (ECMO) is utilized in the management of severe respiratory and circulatory failure. Advanced malignancy is a relative contraindication, but the indication for ECMO in the oncologic population has not been clearly established because of the wide spectrum of malignant disease and prognoses. The Extracorporeal Life Support Organization database was queried for patients older than 18 years with an International Classification of Diseases code of neoplasm over the past 2 decades (2000-2019). The data were divided into 2 decades to analyze and compare the trends with background and outcomes. One thousand six-hundred ninety-seven patients met inclusion criteria from the latest decade which is over 15 times the previous decade (n = 110). Compared with the previous decade, ECMO was used more in patients with older age (56 vs . 50.5 years old; p < 0.001), cardiac and extracorporeal cardiopulmonary resuscitation (ECPR) support type ( p = 0.011), and lower oxygenation index (23.0 vs . 35.6; p < 0.001) in the latest decade. Although overall survival did not show significant improvement overall (38.9% vs . 33.6%; p = 0.312), survival in pulmonary ECMO has significantly improved in the latest decade (41.6% vs . 29.1%; p = 0.032). Compared with the previously reported data for all adult ECMO, our patients had a significantly lower survival with pulmonary (41.6% vs . 61.1%; p < 0.001) and cardiac (38.4% vs . 44.3%; p = 0.008) support while not with ECPR.

Recognition of d-Glucose in Water with Excellent Sensitivity, Selectivity, and Chiral Selectivity Using γ-Cyclodextrin and Fluorescent Boronic Acid Inclusion Complexes Having a Pseudo-diboronic Acid Moiety.

Fluorescence recognition of d-glucose in water with excellent sensitivity, selectivity, and chiral selectivity is desired because d-glucose is an essential component in biological and pathological processes. We report an innovative approach that exploits the 1:2 stoichiometric inclusion complexes of γ-cyclodextrin (γ-CyD) with two molecules of fluorescent monoboronic acid-based receptors, which form a pseudo-diboronic acid moiety as the recognition site for d-glucose in water. Two monoboronic acids (1F and 2N) were easily synthesized without heating or column purification. The 1:2 stoichiometric inclusion complexes (1F/γ-CyD and 2N/γ-CyD) were prepared in a mixture of dimethyl sulfoxide/water (2/98 in v/v) by mixing γ-CyD and the corresponding monoboronic acids. Both 1F/γ-CyD and 2N/γ-CyD exhibited strong turn-on response to d-glucose with excellent selectivity over nine other saccharides in the water-rich solvent at pH 7.4 owing to the ditopic recognition of d-glucose by the pseudo-diboronic acid moieties. The limits of detection of 1F/γ-CyD and 2N/γ-CyD for d-glucose were 1.1 and 1.8 µM, respectively, indicating the remarkable sensitivity for the detection of d-glucose at µM levels. 1F/γ-CyD and 2N/γ-CyD also demonstrated chiral-selective recognition of d-glucose, which is apparent from the 2.0- and 6.3-fold enhancement of fluorescence by the addition of d-glucose relative to l-glucose addition, owing to the chiral pseudo-diboronic acid moieties produced by the chiral γ-CyD cavity. To the best of our knowledge, 2N/γ-CyD has the highest d/l selectivity among hitherto reported fluorescent diboronic acid-based receptors.