Long-term stimulation of a diaphragm muscle pouch

Denervated hydraulic pouches were fashioned from a retrosternal portion of the right hemidiaphragm and electrically stimulated for several hours at voltages selected to achieve pressures commensurate with those encountered in the right ventricle. The data revealed a progressive decline in pressures generated by the pouch with time, the deterioration perhaps enhanced by inpaired perfusion of the pouch but statistically independent of systemic blood pressures. Therefore it was concluded that contraction of the diaphragm muscle could not be used clinically to assist the heart.     

A young adult patient with septic pulmonary emboli of undetermined origin

A 25-year-old male who had no significant medical history presented abrupt onset of high-grade fever and chills without noticeable trigger. The patient sought for medical attention for subsequently developed dyspnea and chest pain. Radiological examinations revealed bilateral lung peripheral multiple opacities, some of which were cavitating, suggesting of septic pulmonary emboli (SPE). Isolation of Staphylococcus aureus in blood and sputum culture confirmed the diagnosis. Extensive examinations disclosed neither underlying immunocompromising conditions nor infectious foci, which are usually notable in patients with SPE. The present patient illustrates that there are patients with SPE in whom underlying conditions or infectious foci are difficult to determine, and that suspicion of the disease based on characteristic radiological findings is critical for appropriate management in those patients.     

Neonatal iliopsoas abscess

Iliopsoas abscess (IPA) is rare in children, particularly in neonates. A male neonate was born at 38 weeks of gestation with a weight of 2915 g. On day 22 after birth, his family noticed that his right thigh was swollen. Abdominal computed tomography showed a mass extending to the right iliopsoas from the right thigh with thick septa. Puncture to the right groin yielded purulent fluid, and so a diagnosis of abscess was made. The puncture was followed by surgical drainage through a small inguinal incision, and the abscess cavity was irrigated thoroughly using normal saline. Culture of abscess fluid was positive for Streptococcus pneumoniae, so intravenous ABPC infusion was continued. The postoperative magnetic resonance imaging indicate that the IPA was derived from arthritis of the hip, and the patients received Riemenbügel for the incomplete hip dislocation. He is doing well at 2 years of age.     

Radically resected epithelioid angiosarcoma that originated in the mediastinum

Angiosarcoma is a rare neoplasm, accounting for only 1%–2% of all sarcomas. It occurs most frequently in the skin and soft tissue and rarely in the thoracic region. To our knowledge, a mediastinal angiosarcoma is extremely rare. We report on the surgical resection of a rare case of giant epithelioid angiosarcoma originating in the anterior mediastinum, followed by six courses of adjuvant chemotherapy (doxorubicin + ifosfamide). The patient is alive and asymptomatic 1 year after surgery. As the prognosis for unresectable cases is generally dismal, surgical resection and adjuvant therapy can be an option for mediastinal angiosarcoma.     

Positively Charged Gelatin Microspheres as Gastric Mucoadhesive Drug Delivery System for Eradication of H. pylori

Gastric mucoadhesive drug delivery systems are very promising for eradication of Helicobacter pylori (H. pylori), a spiral bacterium that resides in the gastric mucus layer and at the mucus- epithelial cell interface. New positively charged biodegradable microspheres were prepared using aminated gelatin by surfactantfree emulsification in olive oil, followed by a cross-linking reaction with glutaraldehyde. The amino group contents of the modified gelatin and the microspheres were determined using a 2,4,6-trinitrobenzenesulfonic acid method. With the increase of glutaraldehyde concentration, the amino group content of the microspheres decreased accordingly. The influence of glutaraldehyde concentration, cross-linking reaction time, drug-loading patterns, and type of release media on the in vitro release characteristics of amoxicillin from the microspheres was investigated. Amoxicillin release rate from the modified gelatin microspheres was significantly reduced compared with that from gelatin microspheres. Furthermore, the release was decreased with the increase of glutaraldehyde concentration and/or cross-linking time. On the other hand, a faster release was observed in a lower pH release medium and/or using a lower pH solution for amoxicillin loading. The gastric mucoadhesive properties of the microspheres were evaluated using RITC-labeled microspheres in an isolated rat stomach. The gastric mucoadhesion of the modified gelatin microspheres was markedly improved compared with that of gelatin microspheres. The modified gelatin microsphere proves to be a possible candidate delivery system for the effective eradication of H. pylori.