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Vascular Specialist International Jun 2024Although intravascular atherectomy is widely used for debulking calcified atheromas in peripheral arterial disease, it is associated with complications. Delayed rupture...
Although intravascular atherectomy is widely used for debulking calcified atheromas in peripheral arterial disease, it is associated with complications. Delayed rupture with pseudoaneurysm formation is rare. We report the case of a 73-year-old man who developed a 24 mm×20 mm×27 mm popliteal artery (PA) pseudoaneurysm after rotational atherectomy. Initially, the patient presented with intermittent claudication. Preoperative computed tomographic angiography (CTA) showed a severely calcified atheroma in the PA. Rotational atherectomy was performed using the Jetstream™ device (Boston Scientific). Postoperatively, the ankle-brachial index and symptoms improved. However, 6 days after the atherectomy, the patient complained of calf pain and swelling. Follow-up CTA revealed a pseudoaneurysm and hematoma in the popliteal fossa. Open conversion with removal of the heavily calcified plaque and patch angioplasty were performed via the posterior approach. Delayed PA rupture and pseudoaneurysm formation after rotational atherectomy are rare; however, they require prompt management.
PubMed: 38918946
DOI: 10.5758/vsi.240046 -
Journal of Cardiothoracic Surgery Jun 2024Tracheobronchial injuries caused by blunt chest trauma are rare in children, and such injuries usually involve multiple organs. Most cases involve respiratory failure on...
BACKGROUND
Tracheobronchial injuries caused by blunt chest trauma are rare in children, and such injuries usually involve multiple organs. Most cases involve respiratory failure on the way to the hospital, and the mortality rate is high. Herein, we describe the case of a 5-year-old patient who fell from an electric vehicle, causing complete rupture of the bilateral main bronchus.
CASE PRESENTATION
We treated a 5-year-old patient with complete bilateral main bronchus rupture. Chest computed tomography (CT) failed to detect bronchial rupture. Continuous closed thoracic drainage resulted in a large amount of bubble overflow. Tracheal rupture was suspected. Fibreoptic bronchoscopy revealed complete rupture of the right main bronchus and rupture of the left main bronchus. Emergency tracheoplasty was performed under cardiopulmonary bypass (CPB). During the operation, we found that the bilateral main bronchi were completely ruptured. Postoperative recovery was smooth. The traditional surgical method for treating these injuries is lateral thoracotomy. However, a median sternotomy provides a better opportunity for selective repair. Extracorporeal circulation-assisted surgery is required for patients with unstable breathing.
CONCLUSION
Complete fractures of the bilateral main bronchi are rare. Bronchial rupture should be suspected in the presence of expansion defect-dropped lungs and massive air leakage despite tube thoracostomy in haemopneumothorax developing after thoracic trauma. Extracorporeal circulation-assisted tracheoplasty is a relatively safe option for children whose respiratory system is difficult to maintain, thus ensuring oxygenation ventilation and a clear surgical field.
Topics: Humans; Bronchi; Child, Preschool; Male; Bronchoscopy; Wounds, Nonpenetrating; Tomography, X-Ray Computed; Rupture; Thoracic Injuries
PubMed: 38918860
DOI: 10.1186/s13019-024-02828-2 -
Scientific Reports Jun 2024Earthquake prevention and disaster mitigation are crucial aspects of social welfare that significantly impact national public security. This paper presents a seismic...
Earthquake prevention and disaster mitigation are crucial aspects of social welfare that significantly impact national public security. This paper presents a seismic risk assessment and hazard prediction of the Hunhe Fault in the Shengyang-Fushun (Shen-Fu) New District. The target area is at risk of seismic damage due to two major branch ruptures, namely, F9 and F1; these ruptures have the potential to generate maximum earthquakes with a magnitude of 6.0 in the next 50 to 100 years. A three-dimensional underground velocity structure and asperity source model were established for the target faults. Subsequently, a hybrid technique combining deterministic and empirical approaches was employed to simulate the broadband strong ground motion of the target region in anticipation of the occurrence of expected scenario earthquakes. The distributions of peak ground acceleration (PGA), peak ground velocity (PGV) and peak ground displacement (PGD) for the area are provided, and the results indicate that densely populated urban areas could experience PGA values close to 280 cm/s along the fault traces. This study provides a reliable basis for engineering construction and urban planning in the Shen-Fu New District.
PubMed: 38918401
DOI: 10.1038/s41598-024-64946-0 -
Nature Communications Jun 2024The central San Andreas Fault (CSAF) exhibits a simple linear large-scale fault geometry, yet seismic and aseismic deformation features vary in a complex way along the...
The central San Andreas Fault (CSAF) exhibits a simple linear large-scale fault geometry, yet seismic and aseismic deformation features vary in a complex way along the fault. Here we investigate fault zone behaviors using geodetic observation, seismicity and microearthquake focal mechanisms. We employ an improved focal-mechanism characterization method using relative earthquake radiation patterns on 75,164 M ≥ 1 earthquakes along a 2-km-wide, 190-km-long segment of the CSAF, from 1984 to 2015. The data reveal the 3D fine-scale structure and interseismic kinematics of the CSAF. Our findings indicate that the first-order spatial variations in interseismic fault creep rate, creep direction, and the fault zone stress field can be explained by a simple fault coupling model. The inferred 3D mechanical properties of a mechanically weak and poorly coupled fault zone provide a unified understanding of the complex fine-scale kinematics, indicating distributed slip deficits facilitating small-to-moderate earthquakes, localized stress heterogeneities, and complex multi-scale ruptures along the fault. Through this detailed mapping, we aim to relate the fine-scale fault architecture to potential future faulting behavior along the CSAF.
PubMed: 38918370
DOI: 10.1038/s41467-024-49454-z -
Zhongguo Xiu Fu Chong Jian Wai Ke Za... Jun 2024To compare the short-term effectiveness of suture hook suture via double posteromedial approaches and Fast-Fix total internal suture in treatment of Ramp lesions. (Comparative Study)
Comparative Study
OBJECTIVE
To compare the short-term effectiveness of suture hook suture via double posteromedial approaches and Fast-Fix total internal suture in treatment of Ramp lesions.
METHODS
A clinical data of 56 patients with anterior cruciate ligament rupture combined with Ramp lesions, who met the selection criteria and admitted between December 2021 and February 2023, was retrospectively analyzed. The Ramp lesions were sutured using suture hook via double posteromedial approaches under arthroscopy in 28 cases (group A) and treated with Fast-Fix total internal suture under arthroscopy in 28 cases (group B). There was no significant difference in age, gender, cause of injury, type of injury, time from injury to operation, side of injury, body mass index, and preoperative Lysholm score, visual analogue scale (VAS) score, and Tegner score between the two groups ( >0.05). The patients were followed up regularly after operation, and the clinical and imaging healing of the Ramp lesion was evaluated according to the Barrett clinical healing standard and the MRI evaluation standard. Lysholm score, VAS score, and Tegner score were used to evaluate the function and pain degree of knee joint, and the results were compared with those before operation.
RESULTS
The incisions of the two groups healed by first intention. All patients were followed up 12-18 months (mean, 14.9 months). Postoperative McMurray tests were negative in both groups. The clinical healing rates of group A and group B were 71.4% (20/28) and 64.3% (18/28) at 6 months after operation, and 92.9% (26/28) and 82.1% (23/28) at 12 months after operation, respectively. The differences between the two groups was not significant ( =0.327, =0.567; =0.469, =0.225). There was no significant difference in Lysholm score, VAS score, and Tegner score between the two groups at each time point after operation ( >0.05). The postoperative scores in the two groups significantly improved when compared with those before operation, and the scores at 12 months after operation further improved when compared with those at 6 months after operation, showing significant differences between the different time points in the two groups ( <0.05). At last follow-up, MRI examination of the knee joint showed that there were 26 (92.9%), 2 (7.1%), and 0 (0) cases of complete healing, partial healing, and nonunion in the Ramp lesion of group A, and 25 (89.3%), 1 (3.6%), and 2 (7.1%) cases in group B, respectively. There was no significant difference between the two groups ( =-0.530, =0.596).
CONCLUSION
Suture hook suture via double posteromedial approaches and Fast-Fix total internal suture under arthroscopy are safe and reliable in the treatment of Ramp lesion, and the knee joint function significantly improves after operation.
Topics: Humans; Arthroscopy; Suture Techniques; Female; Male; Treatment Outcome; Anterior Cruciate Ligament Injuries; Sutures; Adult; Knee Joint; Anterior Cruciate Ligament Reconstruction
PubMed: 38918193
DOI: 10.7507/1002-1892.202403032 -
ImmunoHorizons Jun 2024Malaria is a serious vector-borne disease characterized by periodic episodes of high fever and strong immune responses that are coordinated with the daily synchronized...
Malaria is a serious vector-borne disease characterized by periodic episodes of high fever and strong immune responses that are coordinated with the daily synchronized parasite replication cycle inside RBCs. As immune cells harbor an autonomous circadian clock that controls various aspects of the immune response, we sought to determine whether the intensity of the immune response to Plasmodium spp., the parasite causing malaria, depends on time of infection. To do this, we developed a culture model in which mouse bone marrow-derived macrophages are stimulated with RBCs infected with Plasmodium berghei ANKA (iRBCs). Lysed iRBCs, but not intact iRBCs or uninfected RBCs, triggered an inflammatory immune response in bone marrow-derived macrophages. By stimulating at four different circadian time points (16, 22, 28, or 34 h postsynchronization of the cells' clock), 24-h rhythms in reactive oxygen species and cytokines/chemokines were found. Furthermore, the analysis of the macrophage proteome and phosphoproteome revealed global changes in response to iRBCs that varied according to circadian time. This included many proteins and signaling pathways known to be involved in the response to Plasmodium infection. In summary, our findings show that the circadian clock within macrophages determines the magnitude of the inflammatory response upon stimulation with ruptured iRBCs, along with changes of the cell proteome and phosphoproteome.
Topics: Animals; Macrophages; Mice; Erythrocytes; Malaria; Plasmodium berghei; Circadian Rhythm; Mice, Inbred C57BL; Reactive Oxygen Species; Cytokines; Circadian Clocks; Cells, Cultured; Proteome
PubMed: 38916585
DOI: 10.4049/immunohorizons.2400021 -
Cureus May 2024Triceps tendon ruptures are uncommon injuries that account for less than 1% of all upper extremity tendon injuries. Medial ulnar collateral ligament injury...
Triceps tendon ruptures are uncommon injuries that account for less than 1% of all upper extremity tendon injuries. Medial ulnar collateral ligament injury (mUCL), while common in overhead athletes as a result of valgus forces during the throwing mechanics, has scarcely been reported in non-overhead, throwing individuals. Traumatic assault to the elbow may result in the rupture of the triceps tendon with concomitant mUCL injury. As such an injury pattern typically presents in middle-aged males, weightlifters, or American football players from eccentric overloading of the elbow. We present an adolescent, elite-level, competitive skier with traumatic onset distal triceps rupture with concomitant medial ulnar collateral ligament rupture suffered via a fall on an outstretched hand (FOOSH) mechanism. Magnetic resonance imaging (MRI) showed acute full-thickness avulsion of the distal triceps tendon occurring at the olecranon enthesis. An open tendon repair was performed, and the patient was able to report significant symptom resolution over the course of six months postoperatively and successfully return to elite-level competition. This was a unique and rare case of triceps tendon rupture with concomitant mUCL injury in an adolescent via a non-contact, high-velocity injury mechanism. While a rare injury combination, this case nevertheless identifies an area of research not currently extensively covered-trampoline training and associated injuries in adolescents. This case, therefore, not only adds a novel dimension to the understanding of triceps and mUCL injuries in young athletes but also underscores the need for heightened awareness and specific safety protocols in sports training involving equipment like trampolines.
PubMed: 38915996
DOI: 10.7759/cureus.61026 -
Journal of the Belgian Society of... 2024Magnetic resonance imaging (MRI) has significantly improved the evaluation of brachial plexus injuries, offering new possibilities for microsurgical repair and...
Magnetic resonance imaging (MRI) has significantly improved the evaluation of brachial plexus injuries, offering new possibilities for microsurgical repair and contributing to the functional prognosis.
PubMed: 38915314
DOI: 10.5334/jbsr.3415 -
Scientific Reports Jun 2024To achieve high-efficiency combustion of heavy fuel oil (HFO), this study investigated the combustion characteristics of methanol/HFO droplets with methanol content from...
To achieve high-efficiency combustion of heavy fuel oil (HFO), this study investigated the combustion characteristics of methanol/HFO droplets with methanol content from 10 to 30% using the suspension method under ambient temperature from 923 to 1023 K. The combustion of methanol/HFO droplets was summarized as a two-phase process consisting of six typical stages, emphasizing liquid phase. Especially, the fluctuation evaporation stage, induced by frequent and intense puffing, was identified as prominent character. Both the ignition delay and lifetime of HFO and methanol/HFO droplets decreased with increasing ambient temperatures. For the methanol/HFO droplet, the ignition delay and droplet lifetime increased with the increasing methanol content. Prominently, compared to HFO, HM10 had the most significant reduction in droplet lifetime and TINL under the same operating conditions, which indicated that the addition of 10% methanol accelerated the combustion process and reduced soot generation. Additionally, the thermos-dynamic characteristics of methanol/HFO droplets were investigated. Puffing was primarily attributed to superheating of methanol and pyrolysis of heavy components in HFO, which resulted in active and passive rupture of bubbles. Similarity and maximum deformation were employed to qualitatively distinguish between them. The obtained findings aimed to develop a promising alternative fuel to reduce emissions and preserve energy.
PubMed: 38914642
DOI: 10.1038/s41598-024-64482-x -
Scientific Reports Jun 2024Whether the Main Himalayan Thrust can host a single surface-rupturing event in the Himalaya with a rupture length of > 700 km remains controversial. Previous...
Whether the Main Himalayan Thrust can host a single surface-rupturing event in the Himalaya with a rupture length of > 700 km remains controversial. Previous paleoseismological studies in the Darjeeling-Sikkim Himalaya (DSH) suggested medieval surface-rupturing earthquakes, correlating them with the eleventh-thirteenth century events from Nepal and Bhutan and extending the coseismic rupture length > 700 km. Conversely, there is no rupture evidence of the 1714 Bhutan and 1934 Bihar-Nepal earthquakes in the DSH, resulting in a discrepancy in the rupture extent of the great earthquakes. Consequently, we conducted a paleoseismological investigation across a ~ 10 m-high fault scarp on the Himalayan Frontal Thrust at Chenga village, DSH, revealing a surface-faulting event during 1313-395 BCE. We suggest that the DSH is a 150 km-long independent segment bounded by a transverse ridge and fault and has a recurrence interval of ~ 949-1963 years, which is significantly larger than Nepal (~ 700-900 years) and Bhutan Himalaya (~ 339-761 years).
PubMed: 38914592
DOI: 10.1038/s41598-024-63539-1