A multicenter study on anaphylaxis caused by peanut, tree nuts, and seeds in children and adolescents

Peanut (PN) and tree nuts (TNs) are common causes of anaphylaxis in Western countries, but no information is available in Korea. To feature clinical characteristics of anaphylaxis caused by PN, TNs, and seeds, a retrospective medical record review was performed in 14 university hospitals in Korea (2009-2013). One hundred and twenty-six cases were identified, with the mean age of 4.9 years. PN, walnut (WN), and pine nut accounted for 32.5%, 41.3%, and 7.1%, respectively. The median values of specific IgE (sIgE) to PN, WN, and pine nut were 10.50, 8.74, and 4.61 kU_A /l, respectively. Among 50 cases managed in the emergency department, 52.0% were treated with epinephrine, 66.0% with steroid, 94.0% with antihistamines, 36.0% with oxygen, and 48.0% with bronchodilator. In conclusion, WN, PN, and pine nut were the three most common triggers of anaphylaxis in Korean children, and anaphylaxis could occur at remarkably low levels of sIgE.

Robotic-assisted single incision myomectomy in large myoma cases

INTRODUCTION

Laparo-endoscopic single-incision surgery (LESS) has been developed and gradually adopted for both benign and malignant gynecological procedures. However, LESS has been hindered for use in procedures like myomectomy by limitations in natural architecture and instrumentation, especially in suturing. The da Vinci system features a single-site platform and wristed needle driver, which may help overcome conventional LESS limitations. This case report study describes the feasibility of this robotic single-site (RSS) platform in large myoma cases and offers suggestions.

RESULTS

Two cases of myomectomy with large myomas (with maximum diameters of 160 and 120 mm) with different locations, were addressed by RSS. Operative time was 180 and 240 minutes. Estimated blood loss was 200 and 150 ml. Pathologic analysis revealed uterine leiomyomas of 910 and 870 grams. No serious peri- or post-operative complications occurred.

DISCUSSION

Myomectomy with large myoma has presented a surgical challenge. RSS myomectomy appears to be a safe and feasible technique for it regardless of its localization. Advantages include less postoperative pain, fast recovery, less impact on quality of life, and improved cosmesis. LESS surgery has been challenging concerning suturing and multi-laparoscopic or multi-port robotic myomectomy can be difficult to extract myoma, especially with morcellation. RSS could be a solution that enables ease of manipflation and extraction.

Robot-assisted laparoscopic adenomyomectomy of adenomyotic nodule implanted in the uterine endometrium manifesting as endometrial cancer: a case report and literature review

Thickened uterine endometrium with abnormal uterine bleeding highly suggests endometrial hyperplasia or endometrial carcinoma. A case of 35-year-old nulliparous woman came to our department with endometrial mass manifesting as endometrial cancer. Transrectal ultrasonography and magnetic resonance imaging (MRI) showed an 8x6 cm multicystic, ill-defined mass compacted at the uterine endometrium, the anterior wall of the uterus, and 3x3 cm heterogenous mass at the left adnexa. The edometrial mass showed multiple septations with enhancement and low-signal intensity on T2-weighted images. After endometrial biopsy was done and simple hyperplasia without atypia was observed at the histopathologic finding, the patient underwent robot-assisted laparoscopy and diagnosed as adenomyoma at the frozen pathology. After adenomyomectomy, permanent pathologic analysis revealed the same result and she recovered without any complications and responded well to gonadotropin-releasing hormone (GnRH) agonist therapy.

Tetrafluoroethane (R134a) hydrate formation within variable volume reactor accompanied by evaporation and condensation

Vast size hydrate formation reactors with fast conversion rate are required for the economic implementation of seawater desalination utilizing gas hydrate technology. The commercial target production rate is order of thousand tons of potable water per day per train. Various heat and mass transfer enhancement schemes including agitation, spraying, and bubbling have been examined to maximize the production capacities in scaled up design of hydrate formation reactors. The present experimental study focused on acquiring basic knowledge needed to design variable volume reactors to produce tetrafluoroethane hydrate slurry. Test vessel was composed of main cavity with fixed volume of 140 ml and auxiliary cavity with variable volume of 0 ∼ 64 ml. Temperatures at multiple locations within vessel and pressure were monitored while visual access was made through front window. Alternating evaporation and condensation induced by cyclic volume change provided agitation due to density differences among water and vapor, liquid and hydrate R134a as well as extended interface area, which improved hydrate formation kinetics coupled with latent heat release and absorption. Influences of coolant temperature, piston stroke/speed, and volume change period on hydrate formation kinetics were investigated. Suggestions of reactor design improvement for future experimental study are also made.

Removal of road deposited sediments by sweeping and its contribution to highway runoff quality in Korea

Highway runoff is known to be an important non-point source (NPS), increasing the load of pollutants in receiving water. For reducing NPS pollutants in runoff, removal of road deposited sediment (RDS) by sweeping is considered effective. However, the contribution of sweeping to the improvement of runoff quality has not been clearly and quantitatively demonstrated so far. In this study, a field test was carried out on a section of operating highway in Korea to investigate the effectiveness of sweeping on improving the quality of highway runoff. Results showed that the average reduction in the load of RDS by sweeping was 61.10% with a standard deviation of 1.74%. RDS removal efficiency decreased when the sweeping speed increased from 4-8 to 20 km h(-1), the load decreased from 12.5 to 1.25 g m(-2) and particle size decreased from sand to silt/clay size ranges. Runoff was induced by applying a 15 mm h(-1) artificial rainfall to both swept and non-swept sections. Analysis of runoff quality showed that the event mean concentrations of total suspended solid, biological oxygen demand, chemical oxygen demand, nutrients and most of the heavy metals were reduced by 31-87% after sweeping. In addition, field tests for RDS build-up indicated a sweeping frequency of once every four or five days to prevent re-suspension of RDS. The results of this study suggest that sweeping can be the best management practice for effectively reducing RDS on highways and improving the quality of highway runoff.

Cyclophilin B is involved in p300-mediated degradation of CHOP in tumor cell adaptation to hypoxia

The regulation of CCAAT/enhancer-binding protein-homologous protein (CHOP), an endoplasmic reticulum (ER) stress-response factor, is key to cellular survival. Hypoxia is a physiologically important stress that induces cell death in the context of the ER, especially in solid tumors. Although our previous studies have suggested that Cyclophilin B (CypB), a molecular chaperone, has a role in ER stress, currently, there is no direct information supporting its mechanism under hypoxia. Here, we demonstrate for the first time that CypB is associated with p300 E4 ligase, induces ubiquitination and regulates the proteasomal turnover of CHOP, one of the well-known pro-apoptotic molecules under hypoxia. Our findings show that CypB physically interacts with the N-terminal α-helix domain of CHOP under hypoxia and cooperates with p300 to modulate the ubiquitination of CHOP. We also show that CypB is transcriptionally induced through ATF6 under hypoxia. Collectively, these findings demonstrate that CypB prevents hypoxia-induced cell death through modulation of ubiquitin-mediated CHOP protein degradation, suggesting that CypB may have an important role in the tight regulation of CHOP under hypoxia.

Ovarian cryopreservation

Cryopreservation of ovarian tissue and future autotransplantation are new promising strategies for fertility preservation in various malignant and non-malignant diseases facing the risk of ovarian failure. Ovarian cortrical tissue pieces or intact whole ovary can be removed by laparoscopy without any significant delay in chemotherapy. Slow freezing and vitrification methods are developed to avoid damage to follicles. Ovarian tissue can be transplanted in an orthotopic or heterotopic location when the patient is cured from the disease. Autotransplantation can be performed if absence of malignant cells in the graft is confirmed. Although the procedures are still experimental, ovarian cryopreservation is the single option in prepubertal girls who have not sexual maturity. Earlier team approach of oncologists and reproductive endocrinologists may provide a more successful and professional way of fertility preservation.