Successful treatment of tracheal stenosis due to a broken uncovered metallic stent placed over 20 years ago in a patient with recurrent polychondritis using argon plasma coagulation and airway ballooning.

A woman in her mid-60s with recurrent polychondritis was admitted to our hospital due to airway stenosis secondary to an uncovered metallic stent. She underwent a bronchoscopic intervention under general anaesthesia. During the procedure, the stent fracture was cauterized using Argon Plasma Coagulation (APC) cauterisation, performed with argon flow at 1 L/min and power set at 70 W. APC cauterisation caused the stent wire to flex circularly, gradually improving the stenosis. Tracheal dilatation was then performed using an airway balloon. Following the ballooning, a thin bronchoscope was easily passed through the lower trachea, and the left and right main bronchi were observed; therefore, the procedure was completed without any complications. APC coagulation and airway ballooning are viable choices for the temporary treatment of airway stenosis due to broken metallic stents.

Successful Treatment with Mepolizumab for Coronary Spastic Angina Associated with Eosinophilic Granulomatosis with Polyangiitis.

A 46-year-old man with a history of bronchial asthma and chronic sinusitis presented to our hospital with chest pain. We suspected angina evoked by epicardial coronary spasm and performed an ergonovine provocation test to diagnose coronary spastic angina (CSA). The patient also met the diagnostic criteria for eosinophilic granulomatosis with polyangiitis (EGPA) and was treated with 60 mg prednisolone (PSL) for EGPA-associated CSA. After PSL administration, eosinophils decreased, and angina attacks disappeared. However, when PSL was tapered to 12.5 mg, chest pain recurred. We administered mepolizumab subcutaneously and chest pain disappeared. Additional mepolizumab may be effective for EGPA with CSA.

Isolation, identification of sludge-lysing strain and its utilization in thermophilic aerobic digestion for waste activated sludge.

A strain of sludge-lysing bacteria was isolated from waste activated sludge (WAS) in this study. The result of 16S rRNA gene analysis demonstrated that it was a species of new genus Brevibacillus (named Brevibacillus sp. KH3). The strain could release the protease with molecule weight of about 40 kDa which could enhance the efficiency of sludge thermophilic aerobic digestion. During the sterilized sludge digestion experiment inoculated with Brevibacillus sp. KH3, the maximum protease activity was 0.41 U/ml at pH 8 and 50 degrees C, and maximum TSS removal ratio achieved 32.8% after 120 h digestion at pH 8 and 50 degrees C. In the case of un-sterilized sludge digestion inoculated with Brevibacillus sp. KH3, TSS removal ratio in inoculated-group was 54.8%, increasing at 11.86% compared with un-inoculation (46.2%). The result demonstrated that inoculation of Brevibacillus sp. KH3 could help to degrade the EPS and promote the collapse of cells and inhibit the growth of certain kinds of microorganisms. It indicated that Brevibacillus sp. KH3 strain had a high potential to enhance WAS-degradation efficiency in thermophilic aerobic digestion.