Tracking Active Phase Behavior on Boron Nitride during the Oxidative Dehydrogenation of Propane Using Operando X-ray Raman Spectroscopy.

Hexagonal boron nitride (hBN) is a highly selective catalyst for the oxidative dehydrogenation of propane (ODHP) to propylene. Using a variety of ex situ characterization techniques, the activity of the catalyst has been attributed to the formation of an amorphous boron oxyhydroxide surface layer. The ODHP reaction mechanism proceeds via a combination of surface mediated and gas phase propagated radical reactions with the relative importance of both depending on the surface-to-void-volume ratio. Here we demonstrate the unique capability of operando X-ray Raman spectroscopy (XRS) to investigate the oxyfunctionalization of the catalyst under reaction conditions (1 mm outer diameter reactor, 500 to 550 °C, P = 30 kPa C3H8, 15 kPa O2, 56 kPa He). We probe the effect of a water cofeed on the surface of the activated catalyst and find that water removes boron oxyhydroxide from the surface, resulting in a lower reaction rate when the surface reaction dominates and an enhanced reaction rate when the gas phase contribution dominates. Computational description of the surface transformations at an atomic-level combined with high precision XRS spectra simulations with the OCEAN code rationalize the experimental observations. This work establishes XRS as a powerful technique for the investigation of light element-containing catalysts under working conditions.

Malignant cerebral edema after cranioplasty, a rare complication: case series and literature review.

Cranioplasty is standard neurosurgery performed after decompressive craniectomy. Fatal malignant cerebral oedema complications associated with this procedure are rare and clinically distinct, although unpredictable. It is thought that the pressure difference from removing atmospheric pressure had a long-term effect on the brain. This combined with the negative pressure applied by intraoperative pressure drainage may impact the perfusion brain. Here, the authors report four cases of cerebral oedema after cranioplasty and review similar cases in the literature. Case presentation: The authors report on four cases of patients who underwent cranioplasty following decompressive craniotomy and subsequently died after surgery. Three of the patients had undergone craniotomy following trauma, while one patient had skull resorption. All four patients developed cerebral oedema immediately after surgery and exhibited significant craniofacial depression (also known as sunk flap syndrome). A negative pressure drainage system was utilized in all cases. One patient remained intubated, while the remaining three developed postoperative epilepsy and subsequently fell into a coma. Dilated and fixed pupils were observed in all patients, and computed tomography scans revealed diffuse cerebral oedema. Despite intensive resuscitation efforts and attempts at decompression, all four patients ultimately succumbed to their conditions. Conclusion: Fatal post-cranioplasty malignant cerebral oedema is a rare but very dangerous complication. Despite being rare, neurosurgeons should be aware that this fatal complication can occur after cranioplasty.

Dosing study of esmolol for reducing hemodynamic changes during lightwand intubation

Background@#Lightwand is a convenient tool that can be used instead of a laryngoscope for intubation. Tracheal intubation causes direct stimulation of the larynx, drastically increasing hemodynamic values including blood pressure and heart rate. This study aims to identify the effect of different doses of esmolol on hemodynamic changes during lightwand intubation. @*Methods@#The study subjects included 140 patients who underwent general anesthesia for elective surgery. The patients were randomly divided into four groups (35 patients in each group). The ‘C’ group only received 20 ml of normal saline, while the ‘E0.5’, ‘E1’, and ‘E2’ groups received 20 ml of normal saline containing esmolol—0.5 mg/kg, 1 mg/kg, and 2 mg/kg, respectively, injected 2 min prior to intubation. The patients’ blood pressure, heart rate, and rate-pressure product were measured six times, before and after the intubation. @*Results@#The degree of heart rate elevation was suppressed in the E1 and E2 groups compared to the C group, and RPP after intubation significantly decreased in the E2 group compared to the C group. @*Conclusions@#1–2 mg/kg of a single esmolol injection prior to lightwand intubation effectively blunts heart rate elevation, and 2 mg/kg of esmolol injection blunts rate-pressure product elevation.

Fluorescence microscope light source stability.

The process of fluorescence starts with the efficient generation of light that is required for the excitation of fluorophores. As such, light sources are a crucial component of a fluorescence microscope. Choosing the right illumination tool can not only improve the quality of experimental results, but also the microscope's economic and environmental footprint. While arc lamps have historically proven to be a reliable light source for widefield fluorescence microscopy, solid-state light-emitting diodes (LEDs) have become the light source of choice for new fluorescence microscopy systems. In this paper, we demonstrate that LEDs have superior light stability on all timescales tested and use less electrical power than traditional light sources when used at lower power outputs. They can be readily switched on and off electronically, have a longer lifetime and they do not contain mercury, and thus are better for the environment. We demonstrate that it is important to measure light source power output during warm-up and switching, as a light source's responsiveness (in terms of power) can be quite variable. Several general protocols for testing light source stability are presented. A detailed life cycle analysis shows that an LED light source can have a fourfold lower environmental impact when compared to a metal halide source.

Cardiac Tamponade during Endovascular Repair of Thoracic Aortic Dissection

Endovascular aortic repair is often performed for the treatment of aortic disease because of less invasiveness and fewer complications. Cardiac tamponade is a fatal disease that can lead to death if not treated properly. Cardiac puncture by rigid guide wire used in endovascular aortic repair may cause cardiac tamponade. Rapid diagnosis and treatment are needed when cardiac tamponade occurs. Confirmation of the cardiac tamponade can be accomplished with echocardiography. Continuous echocardiography should be monitor for detection of cardiac complications during endovascular aortic repair.

Pharmacokinetic characteristics of cilostazol 200 mg controlled-release tablet compared with two cilostazol 100 mg immediate-release tablets (Pletal) after single oral dose in healthy Korean male volunteers

Cilostazol controlled-release (CR) tablets have recently been developed by Korea United Pharm (Seoul, Korea). The tablets use a patented double CR system, which improves drug compliance by allowing "once daily" administration and reduces adverse events by sustaining a more even plasma concentration for 24 h. We conducted an open, randomized, two-period, two-treatment, crossover study to compare the pharmacokinetic (PK) characteristics and tolerability of cilostazol when administered to healthy Korean male volunteers as CR or immediate release (IR) tablets (Pletal, Korea Otsuka Pharmaceutical Co., Gyeonggi-do, Korea). Each volunteer was randomly allocated to receive a single tablet of cilostazol CR (200 mg) or two tablets of cilostazol IR (100 mg) with a 7-day washout period between treatments. Plasma cilostazol, OPC-13015 (3,4-dehydrocilostazol), and OPC-13213 (4'-trans-hydroxycilostazol) were assayed using liquid chromatography-tandem mass spectrometry for PK analysis. Thirty participants completed the study with no clinically relevant safety issues. The peak concentrations (C(max), mean ± SD) of cilostazol CR and cilostazol IR were 1414.6 ± 49.3 and 1413.1 ± 35.2 ng/mL, respectively, and the areas under the plasma concentration-time curve from 0 to the last concentration (AUC(last)) were 23928.7 ± 65.9 and 25312.0 ± 62.6 ng·h/mL, respectively. The geometric mean ratios (cilostazol CR/cilostazol IR, GMR) of the C(max) and AUC(last) values were 1.001 (90% CI: 0.822, 1.220) and 0.945 (90% CI: 0.814, 1.098), respectively. The frequencies of adverse events were similar. The present study showed that cilostazol PK and tolerability were comparable when administered to healthy Korean men, regardless of whether administered as cilostazol CR or IR.

miR-526b targets 3' UTR of MMP1 mRNA

Regulation of matrix metalloproteinases (MMPs) is important for many physiological processes involving cancers, inflammation, tissue remodeling and skin aging. Here, we report the novel finding that the expression of MMP1 mRNA is downregulated by the overexpression of miR-526b which is a member of chromosome 19 microRNA cluster (C19MC). Our analysis using reporter constructs containing the 3' untranslated region (3' UTR) of MMP1 and its mutant form showed that the region from 377-383 in the 3' UTR of MMP1 is critical for targeting by miR-526b. In addition, the expression pattern of miR-526b and MMP1 mRNA showed reverse relation between adult dermal and neonatal fibroblasts. We show for the first time that miR-526b, an miRNA belonging to C19MC, can target the 377-383 region of the MMP1 3' UTR.

Novel inhibitory function of miR-125b in melanogenesis.

MicroRNAs are known to be the important regulators of skin physiology and considered as new therapeutic targets to treat skin diseases. In this study, miR-125b was identified as a potent regulator of steady-state melanogenesis. We found that the expression of miR-125b was inversely related to pigment levels. A miR-125b mimic decreased the expression of pigmentation-related gene and melanin content, implying that miR-125b functions to decrease pigmentation. Moreover, we observed that the reduction in miR-125b expression in pigmented cells was at least partially due to the hypermethylation of the MIR125B-1 promoter, and miR-125b expression was regulated by intracellular cAMP levels.

Outcome and Current Status of Therapeutic Hypothermia Following Out-of-hospital Cardiac Arrest in Korea from the Korea Hypothermia Network Registry

PURPOSE: Therapeutic hypothermia (TH) has become a standard strategy for reducing brain damage in the postresuscitation period. The aim of this study is to investigate the outcomes and current performance of TH with out-of-hospital cardiac arrest (OHCA) survivors through the Korean hypothermia network (KORHN) registry. METHODS: We used the KORHN registry, a web-based, multicenter registry that includes 24 participating hospitals throughout the Republic of Korea. Adult comatose OHCA survivors treated with TH from 2007 to 2012 were included. The primary outcomes were neurologic outcome at hospital discharge and in-hospital mortality. The secondary outcomes were TH performance and adverse events during TH. RESULTS: A total of 930 patients were included; of these, 556 (59.8%) patients survived to discharge and 249 (26.8%) were discharged with good neurologic outcomes. The median time from return of spontaneous circulation (ROSC) to the start of TH was 101 (interquartile range (IQR): 46-200) minutes. The induction, maintenance, and rewarming durations were 150 (IQR: 80-267) minutes, 1440 (IQR: 1290-1440) minutes, and 708 (IQR: 420-900) minutes, respectively. The time from the ROSC to coronary angiography was 1,045 (IQR: 121-12,051) hours. Hyperglycemia (46.3%) was the most frequent adverse event. CONCLUSION: Over one quarter of OHCA survivors (26.8%) were discharged with good neurologic outcome. TH performance was managed appropriately in terms of the factors related to the timing of TH, which were the start time for cooling and the rewarming duration.

E-learning can be Helpful for Mastering Basic Life Support Skills on Public

PURPOSE: Barriers to cardiopulmonary resuscitation (CPR) education are magnified by relative cost and course availability. E-learning has emerged as a viable solution for continuous, on-demand training and organizational learning. We assessed the hypothesis that E-learning is a viable strategy for CPR training of the general public and sought to evaluate its effects on CPR quality compared to traditional classroom-based methods. METHODS: The E-learning program was specifically designed to teach basic life support skills, and consisted of 50 minutes internet lectures and simulation videos. The training session was freely available to twenty two officers in rural South Korea. The trainees were able to practice with a mannequin and an automated external defibrillator (AED) trainer at their place of employment over the course of 3 days. The control group was trained at a hospital by certified instructors using the same equipment during a 2 hour period. At the end of the course, the participant's skills were evaluated using a checklist and a skill performance test. RESULTS: Forty two subjects were enrolled finally with 19 and 23 belonging to the E-learning and the control groups, respectively. One E-learning trainee was excluded because he was absent from the skills test. The mean time to learn CPR and AED techniques was 29.0+/-24.5 minutes in the elearning group. The mean age of the E-learning group was significantly older than that of the control group (32.4+/-4.0 vs. 26.0+/-1.5, p<0.001). However, we did not find any significant differences in their weight, height or CPR educational status. Before the education sessions, the willingness to perform CPR and their confidence in performing CPR were not significantly different among the two groups. Regarding skill performance, there were no significant differences between the groups except the volume of ventilation. The control group showed a higher volume of ventilation than the elearning group (1,031.7+/-521.6 vs. 548.8+/-303.3, p=0.004). CONCLUSION: E-learning accompanied with appropriate practice can be a helpful tool for public CPR training. The demand for E-learning will increase, and this study shows that e-learning programs can be successful, yielding similar results as traditional, classroom-based training.

E-learning can be Helpful for Mastering Basic Life Support Skills on Public

PURPOSE: Barriers to cardiopulmonary resuscitation (CPR) education are magnified by relative cost and course availability. E-learning has emerged as a viable solution for continuous, on-demand training and organizational learning. We assessed the hypothesis that E-learning is a viable strategy for CPR training of the general public and sought to evaluate its effects on CPR quality compared to traditional classroom-based methods. METHODS: The E-learning program was specifically designed to teach basic life support skills, and consisted of 50 minutes internet lectures and simulation videos. The training session was freely available to twenty two officers in rural South Korea. The trainees were able to practice with a mannequin and an automated external defibrillator (AED) trainer at their place of employment over the course of 3 days. The control group was trained at a hospital by certified instructors using the same equipment during a 2 hour period. At the end of the course, the participant's skills were evaluated using a checklist and a skill performance test. RESULTS: Forty two subjects were enrolled finally with 19 and 23 belonging to the E-learning and the control groups, respectively. One E-learning trainee was excluded because he was absent from the skills test. The mean time to learn CPR and AED techniques was 29.0+/-24.5 minutes in the elearning group. The mean age of the E-learning group was significantly older than that of the control group (32.4+/-4.0 vs. 26.0+/-1.5, p<0.001). However, we did not find any significant differences in their weight, height or CPR educational status. Before the education sessions, the willingness to perform CPR and their confidence in performing CPR were not significantly different among the two groups. Regarding skill performance, there were no significant differences between the groups except the volume of ventilation. The control group showed a higher volume of ventilation than the elearning group (1,031.7+/-521.6 vs. 548.8+/-303.3, p=0.004). CONCLUSION: E-learning accompanied with appropriate practice can be a helpful tool for public CPR training. The demand for E-learning will increase, and this study shows that e-learning programs can be successful, yielding similar results as traditional, classroom-based training.

The Effect of Human Adipose Tissue Derived Mesenchymal Stem Cells and Growth Hormone on the Recovery of Neurological Deficits due to Experimental Spinal Cord Injury in Rat

PURPOSE: Human adipose tissue-derived mesenchymal stem cells(hATSCs) can be differentiated into multiple mesenchymal lineages, including bone, cartilage, and muscle. And growth hormone play important roles in the normal growth and development of the CNS. In this study, we explored whether the transplanted hATSCs and growth hormones could improve functional recoveries from rats with contusive spinal cord injury. METHODS: We divided 30 female rats, which were subjected to a weight driven implant spinal cord injury, into 3 groups with 10 rats each; Group A as a control group, group B with hATSCs transplantation on injured region, and group C with hATSCs transplantation and GH administration for 7 days. Then, we researched their neurologic functional recoveries before and 2, 4, and 8 weeks after transplantation using Basso-Beattie-Bresnahan (BBB) locomotor rating scale. And we checked Y- chromosome positive cells by FISH(Fluorescent in situ hybridization) to identify the survival of transplanted mesenchymal stem cells. RESULTS: After 4 weeks of transplantation, the group B and group C showed significant improvement of neurologic function on BBB locomotor rating scale in comparison with the group A(Group A: 13.1+/-0.58, Group B: 14.6+/-0.69, Group C: 14.9+/-0.56). Moreover, the group C displayed meaningful recovery of neurologic function after 8 weeks in comparison with group B (Group B: 15.7+/-0.63, Group C: 16.5+/-1.14). The group A, the control one, improved for 5 weeks after injury, and had no more recovery. On the other hand, Group B and C showed the improvement of neurologic function continuously for 9 weeks after injury. CONCLUSION: In this study, we found out that hATSCs transplantation have an effect on neurologic functional recovery of spinal cord injured rat and GH injection seems to bring the synergistic results on this good tendency.

Continuous Administration of Human Endostatin in Xenografted Human Neuroblastoma

PURPOSE: The purpose of this study was to examine whether recombinant human endostatin (rhEndostatin), an antiangiogenic agent, is effective against a human neuroblastoma cell line (designated TNB9). We employed a human neuroblastoma xenograft model, and we investigated whether continuous infusion is more effective than an intermittent administration. METHODS: In the first experiment, when the tumors on the backs of nude mice reached a weight of 90 mg, rhEndostatin was administered subcutaneously to the mice (n=5) every day for 10 consecutive days. In the second experiment, the same daily dose of rhEndostatin was administered continuously to the TNB9- bearing mice (n=6) via subcutaneous infusion pumps for 3 consecutive days with the total dose being 30% of the dose given in the first experiment. Nestin and factor VIII expression levels were assessed immunohistochemically to elucidate whether the effects of rhEndostatin was present according to the histologic evidence at day 4 in the second experiment. RESULTS: In the first experiment, the relative tumor weight in treated mice (n=5) was significantly less than that in the controls (n=12) on day 2 after treatment initiation only (P<.05). The maximum inhibition rate (MIR) of TNB9 xenograft growth by rhEndostatin was 46.4%, indicating the lack of efficacy. In the second experiment, the effects of rhEndostatin were much more marked than those noted in the first experiment, with the MIR being 60.7%. The mean relative tumor weight in the treated group (n=6) in the second experiment was significantly less than that in the controls (n=10) on days 2, 4 and 6 (P<.01), as well as on days 8 and 10 (P<.05). The nestin staining in the endothelium of the control tumors (n=2) was remarkable, whereas the nestin staining showed as a loss of fibrillar structure in the rhEndostatin-treated tumors (n=2). The number of vessels immunostained with antifactor VIII antibody was markedly reduced in the tumors (n=2) from the rhEndostatin-treated mice compared with that from the control mice (n=2). CONCLUSION: Continuous administration of rhEndostatin resulted in more significant tumor regression than an intermittent administration of the agent. This result suggests that the continuous infusion of rhEndostatin is an effective agent and administration method for treating patients with neuroblastoma in the future.

The Sagittal Balance and Compensatory Mechanisms in Lumbar Spinal Stenosis / 대한척추외과학회지

PURPOSE: To evaluate the sagittal alignment and the main factors contributing to sagittal compensatory mechanism in lumbar stenosis. MATERIALS AND METHODS: 63 patients of spinal stenosis surgically treated were evaluated using 14x36 inch standing lateral films. The global sagittal balance was measured with C7 plumb line and hip flexion angle. The thoracic kyphosis, lumbar lordo-sis and pelvic tilting angle were compared to each of normal korean values to find out main factors participating in compensatory mechanism. At last follow-up, at least 6 months after surgery, the changes of sagittal parameters and global balance were evaluated according to the correction amount of pathologic segments angle to understand the compensatory mechanism and its contributing factors. RESULTS: The C7 plumb line was +3.04 cm(/0.91 SD), thoracic kyphosis 30.0dgree(/12.1), lumbar lordosis 43.1dgree(/14.7) and pelvic tilting angle 21.7dgree(/8.2). All patients except 8 showed global compensation state. The differences compared to normal korean values were 10 dgree of pelvic tilting angle and 2dgreeof thoracic kyphosis. Pelvic tilting angle was more contributing factor of compensatory mechanism than thoracic kyphosis. At last follow up, 14 patients surgically corrected 5dgreeor more showed significant posterior shift of C7 plumb line and increased lumbar lordosis(p<0.05). 11 patients aggravated 5dgree or more showed significant increase of adjacent segment angle to participate in compensatory mechanism(p<0.05). CONCLUSION: Most lumbar spinal stenosis patients showed compensated sagittal balance state. Adjacent segments and pelvic tilting were thought as main contributing factors of compensation mechanism.

Experimental Studies on the Lower Abdominal Flap of the Rabbit by using the Laser Doppler Flowmetry and PGE1

The survival of flap has a vital importance in the reconstructive surgery. This study was designed to investigate the relation of the survival area and the variation of flow value measured by laser Doppler flowmetry and to elucidate the effect of PGE1 on flap survival with an objective index. Sixteen New Zealand White rabbits were divided into 3 groups (8 of control group, 4 of intravenous PGE1 group and 4 of topical PGE1 group). The lower abdominal island flap (10 x 5 cm) based on the superficial epigastric pedicle was elevated and reset again at the previous location. The flow values were checked and it was taken as the value of LD. LD ratio was obtained by calculating the ratio of LD value in each experimental period to that of the baseline data taken before flap elevation. Finally, the data of flap survival area on the 8th experimental day was collected by using the plannimetry method. The results: the survival areas of intravenous PGE1 group (72.0 +/- 22.3%) and topical PGE1 group (78.0 +/- 22.7%) showed a significant increase compared to that of control group (46.5 +/- 14.3%, p < 0.01). The flap survival has the close relationship of the LD ratio measured immediately after flap elevation. The neovascularization period for the survival is considered at least 6 days. In conclusion, these experimental results can show an evident relation between the survival area of the flap and the LD ratio value measured immediately after the flap elevation. The LD ratio value measured immediately after flap elevation has the great significance as a critical limit for expecting the fate of flap survival. Therefore this value will be used as one of the beneficial standards for expecting the prognosis of microsurgical reconstruction in clinical trials.

Axillary Contracture Due to Seroma with Fibrous Capsule Formation after mastectomy: A case report

No abstract available.

Diffuse Idiopathic Skeletal Hyperostosis and Thoracic Myelopathy in Spondyloepiphyseal Dysplasia Congenita: A Case Report / 대한정형외과학회잡지

Diffuse Idiopathic Skeletal Hyperostosis (DISH) had been regarded as a radiologic entity with an innocuous clinical course, but recent years it has been reported as potentially devastating, such as dysphagia, fracture following minor trauma and myelopathy. Spondyloepiphyseal dysplasia congenita is a rare condition with spinal involvement such as flat vertebrae and spinal deformities. We experienced a case of DISH with thoracic myelopathy in spondyloepiphyseal dysplasia congenita patient, and this report can elicit further concern to these disease entities.

Clincal Experience of the Median Mandibular Facial Cleft

A median mandibular facial cleft(Tessier 30) is a rare congenital anomaly. It was first described by Couronne' in 1819, and classified by Tessier as a type 30 craniofacial cleft in 1976. Recently, Oostrom et al have reported a new embryologic hypothesis and subdivision. They reported that the hypoplasia of the mandibular processes during the early embryonic period will lead to the severest cleft of mandible which extends into the neck, whereas during the late embryonic period, the less severe median cleft will develop. The authors have experienced one case of the median cleft of the lower lip and mandible with associated bifid tongue and ankyloglossia. And the double inlet single ventricle at heart lesion was also present. She was operated at 3 month of age. Our procedure consisted of a one-stage correction of the clefts of the lip, tongue, and mandible(repair a cleft of lower lip using w-plasty and a cleft of mandible by manual reduction and internal fixation with 6-hole plate and screws).

A Frontal Sinus Osteoma Presenting as Periorbital Cellulitis

Osteoma is the most common benign tumor of the paranasal sinuses and the frontal sinus is the most frequently involved site. Osteomas are slow growing osteoblastic lesions commonly seen in the outer table of the calvarium, the mandible, the frontal and ethmoid sinus, and occasionally in tubular bones. They are usually detected during the second to fifth decades of life, and reported ratio of male to female is 1.5:1 to 2:1. The symptoms of osteomas are usually developed as gradual growth. They are headaches, facial pain, proptosis, decreased visual acuity, chemosis, diplopia, epiphora, nonpulsating exophthalmus, and transient blindness. Posterior intracranial extension of a frontoethmoid osteoma may lead to brain abscess, intracranial mucocele, tension pneumocephalus. We experienced a 60-year-old male patient who came to the emergency room with acute and severe left periorbital swelling, red eye, and epiphora lasted for 10 days. In a plain radiographs and computerized tomographic scans, a 2.5 x 2.5 x 3.0 cm well marginated mass impressed by osteoma in frontoethmoidal sinus was detected. After the symptoms subsided by conservative treatment, total excision was made by bicoronal approach. Authors reported a frontoethmoidal osteoma presenting periorbital cellulitis without orbital mucocele, which is very rare symptom.

Clinical Considerations of Gigantic Lipoma

The gigantic lipoma could be categorized into subcutaneous and subfascial type. We experienced eight cases from seven patients. Five cases of them were proved to be subcutaneous gigantic lipomas, and three cases were proved to be subfascial gigantic lipomas. Among the subcutaneous type, three cases of liposarcomas were confirmed by final biopsy results. And three cases of recurrences were shown. Among the subfascial type, one case of chondrolipoma was confirmed by final biopsy result and no recurrence was not found. In brief, subcutaneous and subfascial gigantic lipoma had a specific characteristics as followings: Subcutaneous type showed asymptomatic mass with bulging, multilobulated and poorly marginated. And it was difficult for complete removal with a high recurrence rate. Radical excision and liposuction recommended for its treatment. On the other hand, subfascial type showed diffuse expansion, late onset of symptom. And it was readiness for complete removal with no recurrence after complete excision.