Transplantation of a severely lacerated liver – a case report with review of the literature

Abstract:  Using lacerated livers for liver transplantation (LTx) can add an option to the extended donor criteria. We present an LTx case using a severely lacerated liver and review of the literature for reported cases. We used a high-grade lacerated liver from a 19-yr-old brain-dead patient caused by traffic accident. The liver had grade IV and II lacerations in the right and left lobe, respectively. Lacerations were managed by sealants, stitching and perihepatic packing. The liver was transplanted to a 49-yr-old man suffering from hepatocellular carcinoma on hepatitis C-induced liver cirrhosis. The two-yr follow-up was uneventful. All published LTx cases using traumatized livers (n = 18) were analyzed. The liver injury ranged from subcapsular hematoma to deep ruptures. Most reported lacerations were in the right lobe, which were managed by digital compression, suturing, electrocautery, and perihepatic packing. The reported complications were primary non- (18%), or poor function, liver abscess, bilioma, and subhepatic hematoma each in one case (5.5%). Six-month graft and patient survival were 71% and 88%, respectively. With meticulous management lacerated livers can be transplanted successfully. Because of complexity of the management, procurement and transplantation should be done by experienced liver surgeons. These organs are marginal grafts and should be offered to selected patients.     

Decarboxylative cross-coupling reactions for P(O)–C bond formation

Phosphorus-containing compounds are one of the most important classes of organic compounds, which have wide applications in organic chemistry, medicinal chemistry, agricultural chemistry, and materials chemistry. In particular, organophosphorus compounds bearing a P(O)–C bond have attracted significant attention in recent decades due to their widespread biological and pharmacological activities. In this review, we will highlight the most important developments in the construction of P(O)–C bonds through decarboxylative C–P cross-coupling reactions. The literature has been surveyed from 2011 to May 2018.

Phosphorus-containing compounds are one of the most important classes of organic compounds, which have wide applications in organic chemistry, medicinal chemistry, agricultural chemistry, and materials chemistry.     

Excessive carotid in-stent neointimal formation predicts late cardiovascular events.

PURPOSE: To examine if excessive in-stent neointimal formation causing a subcritical stenosis may indicate enhanced vascular reactivity in response to injury, thus predicting late cardiovascular events. METHODS: One hundred consecutive patients (64 men; median age 71 years) with high-grade internal carotid artery stenoses (68 asymptomatic, 32 symptomatic) underwent carotid artery stenting (CAS). High-sensitivity C-reactive protein (hs-CRP) was measured before CAS. Patients were monitored with duplex ultrasound for excessive in-stent neointimal formation (flow-compromising lumen diameter reduction >/=50%), critical restenosis (>/=70%), or the occurrence of late major adverse cardiovascular events (MACE) defined as myocardial infarction (MI), stroke, and death occurring later than 30 days poststenting. RESULTS: Over a median 23-month follow-up, excessive neointimal formation was observed in 14 (14%) patients, restenosis in 2 (2%), and 30 late MACE in 25 [25%: 4 MIs, 2 ipsilateral strokes (in the patients with restenosis), 8 contralateral strokes, and 16 cardiovascular deaths]. Cumulative MACE-free survival rates at 6, 12, and 24 months were 92%, 84%, and 77%, respectively. Baseline hs-CRP levels were associated both with neointimal hyperplasia (p=0.024) and MACE (p=0.021). Patients with excessive neointimal formation exhibited a significantly increased adjusted risk for MACE (hazard ratio 3.56, p=0.010). CONCLUSIONS: Excessive in-stent neointimal formation after CAS indicates an increased risk for late MACE, potentially reflecting a state of exaggerated vascular reactivity in response to injury. Inflammation, which is associated both with neointimal hyperplasia and MACE, seems a common characteristic of different vascular pathologies.     

Infants' growth charts for southern Iran

Currently there are no growth charts based on local norms available for infants in Iran, and their growth is assessed by the National Centre for Health Statistics (NCHS) reference data, which is misleading. Growth charts for a cohort of 317 infants (164 girls and 153 boys) born in Shiraz (Southern Iran) in 1996 and followed for 2 years from birth are presented. All the centiles of length and weight charts are slightly above those of the NCHS charts under the age of 6 months and fall substantially below those over the age of 6 months. However, the spread is similar, so there is no suggestion that the difference is due to the prevalence of gross malnutrition. The difference shows that the use of locally based growth charts are essential for assessing the growth of children in Iran. The representativeness of our data leads us to conclude that the charts presented here are likely to be applied to the urban infant population of Iran.

Gegenwärtig stehen im Iran für Kleinkinder keine auf lokalen Normdaten basierende Wachstumsdiagramme zur Verfügung. Das Wachstum dieser Kinder wird anhand der Referenzdaten des Nationalen Zentrums für Gesundheitsstatistik (NCHS) eingeschätzt, was zu Fehleinschätzungen führt. Es werden Wachstumsdiagramme für eine Kohorte von 317 Kleinkindern (164 Mädchen und 153 Jungen) vorgestellt, die 1996 in Shiraz (Südiran) geboren wurden und nach ihrer Geburt 2 Jahre lang untersucht wurden. Alle Längen- und Gewichtszentilen liegen bis zu einem Alter von unter 6 Monaten leicht über denjenigen der NCHS-Diagramme und fallen ab einem Alter von 6 Monaten beträchtlich unterhalb diese. Allerdings ist die Spannweite ähnlich und daher gibt es kein Anzeichen dafür, dass der Unterschied auf das Vorliegen einer schweren Unterernährung zurückzuführen ist. Die Unterschiede zeigen, dass die Verwendung von lokalen Wachstumsdiagrammen für die Einschätzung des Wachstums von Kindern im Iran notwendig ist. Die Tatsache, dass unsere Daten als repräsentativ anzusehen sind, veranlasst uns zu der Schlussfolgerung, dass die hier vorgestellten Charts wahrscheinlich für die städtische Kleinkinderpopulation im Iran anwendbar sind.

On ne dispose pas actuellement en Iran de tables normatives de la croissance établies sur des données locales, si bien que la croissance des enfants iraniens est inadéquatement observéeen référence aux données du National Centre for Health Statistics (NCHS). On présente ici des courbes de croissance établies à partir d'une cohorte de 317 enfants (164 filles et 153 garçons) nés à Shiraz (Iran méridional) en 1996 et suivis pendant leurs deux premières années. Tous les centiles de taille et de poids sont légèrement supérieurs à ceux des tables NCHS avant l'âge de six mois, puis leurs deviennent nettement inférieurs par la suite. L'évolution des courbes étant similaire, il n'y a donc pas raison de suspecter que la différence est due à de la malnutrition. Cet écart entre les deux tables montre que l'utilisation de courbes fondées sur des données locales est essentielle pour le suivi de la croissance des enfants en Iran. La représentativité de nos données nous conduit à estimer que les tables présentées dans ce travail sont applicables à la population infantile urbaine en Iran.     

A Multi‐Structural Model for Prediction of Effective Gas Permeability in Mixed‐Matrix Membranes

A new model for prediction of the effective permeability of gases in mixed matrix membranes (MMMs), considering the effects of particle shape and the interfacial layer, is presented. The proposed model treats core filler particles and interfacial shell layers as complex particles. Moreover, the Bruggman mathematical procedure is used to improve the accuracy of the presented model for high concentrations of fillers in MMMs. Also, an appropriate uniform criterion is established to make efficient use of the new model for various experimental data to avoid the need for curve‐fitting procedures. Finally, the proposed model is examined for several sets of experimental data.