Pheochromocytoma (PCC) is a rare catecholamine-producing tumor with the incidence in hypertension of 0.1-0.6%. PCC crisis is an endocrine emergency that can lead to hemodynamic disturbance and organ failure such as catecholamine-induced cardiomyopathy. The circulatory collapse caused by it often requires mechanical support. The author reports an unusual case in which a patient who previously underwent surgery for malignant PCC developed catecholamine-induced cardiomyopathy, and successfully recovered using extracorporeal membrane oxygenation.
Cardiomyopathies ; Emergencies ; Extracorporeal Membrane Oxygenation ; Hemodynamics ; Humans ; Hypertension ; Incidence ; Pheochromocytoma ; Shock ; Shock, Cardiogenic

Pheochromocytoma (PCC) is a rare catecholamine-producing tumor with the incidence in hypertension of 0.1-0.6%. PCC crisis is an endocrine emergency that can lead to hemodynamic disturbance and organ failure such as catecholamine-induced cardiomyopathy. The circulatory collapse caused by it often requires mechanical support. The author reports an unusual case in which a patient who previously underwent surgery for malignant PCC developed catecholamine-induced cardiomyopathy, and successfully recovered using extracorporeal membrane oxygenation.

OBJECTIVE: Delayed sleep phase disorder (DSPD) is a condition in which patients often fall asleep some hours after midnight and have difficulty waking up in the morning. Circadian chronotype questionnaires such as Horne-Ostberg Morningness-Eveningness Questionnaire (MEQ) and Basic Language Morningness (BALM) scale have been used for screening for DSPD. This study was to evaluate these two chronotype questionnaires for screening of DSPD. METHODS: The study samples were 444 DSPD and 438 controls. Cronbach's alpha coefficient was calculated to evaluate for internal consistency. An exploratory factor analysis was conducted using principal-axis factoring. The diagnostic performance of a test was evaluated using Receiver Operating Characteristic (ROC) curve analysis. A discriminant function analysis was also performed. RESULTS: For internal consistency, Cronbach's alpha of 0.898 for BALM was higher than the 0.837 for MEQ, though both have acceptable internal consistency. BALM has better construct validity than the MEQ because some MEQ items measure different dimensions. However, when we evaluated the efficiency of two questionnaires for DSPD diagnosis by using the ROC curve, the BALM was similar to the MEQ. In a discriminant analysis with the BALM to classify the two groups (DSPD vs. normal), 6 items were identified that resulted in good classification accuracy. Upon examination of the classification procedure, 94.2% of the originally grouped cases were classified correctly. CONCLUSION: These findings suggest that the BALM has better psychometric properties than the MEQ in screening and discriminating DSPS.
Circadian Rhythm ; Humans ; Mass Screening ; Psychometrics ; Surveys and Questionnaires ; ROC Curve

Chronic lymphedema is caused by an impairment of the lymphatic system due to primary or secondary causes. Vascularized lymph node transplantation (VLNT) is currently the most promising and frequently used technique besides lymphaticovenous anastomosis. However, the vessel anatomy in the lateral thoracic region is sometimes quite variable. Based on our experiences with vascular anatomical inconstancy in the lateral thoracic region, we planned a lateral intercostal artery perforator flap for VLNT in a female patient with chronic stage II lymphedema of both legs after cervical cancer treatment. After surgery, the patient reported significant improvement in limb volume and the accompanying symptoms. The limb circumference was reduced by an average of 19.2% at 6 months postoperatively. Despite having a short pedicle and small vessel caliber, the lateral intercostal artery perforator flap can safely be used for VLNT in lymphedema patients with anatomical variants.
Arteries* ; Extremities ; Female ; Free Tissue Flaps ; Humans ; Leg ; Lymph Nodes* ; Lymphatic System ; Lymphedema ; Microsurgery ; Perforator Flap ; Tissue Donors* ; Transplantation, Autologous ; Uterine Cervical Neoplasms

OBJECTIVE: The biomechanical stabilities between the anterior plate fixation after anterior discectomy and fusion (ACDFP) and the posterior transpedicular fixation after ACDF(ACDFTP) have not been compared using human cadaver in bilateral cervical facet dislocation. The purpose of this study is to compare the stability of ACDFP, a posterior wiring procedure after ACDFP(ACDFPW), and ACDFTP for treatment of bilateral cervical facet dislocation. METHODS: Ten human spines(C3-T1) were tested in the following sequence: the intact state, after ACDFP(Group 1), ACDFPW(Group 2), and ACDFTP(Group 3). Intervertebral motions were measured by a video-based motion capture system. The range of motion(ROM) and neutral zone(NZ) were compared for each loading mode to a maximum of 2.0Nm. RESULTS: ROMs for Group 1 were below that of the intact spine in all loading modes, with statistical significance in flexion and extension, but NZs were decreased in flexion and extension and slightly increased in bending and axial rotation without significances. Group 2 produced additional stability in axial rotation of ROM and in flexion of NZ than Group 1 with significance. Group 3 provided better stability than Group 1 in bending and axial rotation, and better stability than Group 2 in bending of both ROM and NZ. There was no significant difference in extension modes for the three Groups. CONCLUSION: ACDFTP(Group 3) demonstrates the most effective stabilization followed by ACDFPW(Group 2), and ACDFP(Group 1). ACDFP provides sufficient strength in most loading modes, ACDFP can provide an effective stabilization for bilateral cervical facet dislocation with a brace.
Braces ; Cadaver ; Diskectomy ; Dislocations* ; Humans ; Spine

PURPOSE: To efficiently evaluate phased array coil performance using a software tool box with which we can make visual comparison of the sensitivity of every coil element between the real experiment and EM simulation. MATERIALS AND METHODS: We have developed a C++- and MATLAB-based software tool called Phased Array Coil Evaluator (PACE). PACE has the following functions: Building 3D models of the coil elements, importing the FDTD simulation results, and visualizing the coil sensitivity of each coil element on the ordinary Cartesian coordinate and the relative coil position coordinate. To build a 3D model of the phased array coil, we used an electromagnetic 3D tracker in a stylus form. After making the 3D model, we imported the 3D model into the FDTD electromagnetic field simulation tool. RESULTS: An accurate comparison between the coil sensitivity simulation and real experiment on the tool box platform has been made through fine matching of the simulation and real experiment with aids of the 3D tracker. In the simulation and experiment, we used a 36-channel helmet-style phased array coil. At the 3D MRI data acquisition using the spoiled gradient echo sequence, we used the uniform cylindrical phantom that had the same geometry as the one in the FDTD simulation. In the tool box, we can conveniently choose the coil element of interest and we can compare the coil sensitivities element-by-element of the phased array coil. CONCLUSION: We expect the tool box can be greatly used for developing phased array coils of new geometry or for periodic maintenance of phased array coils in a more accurate and consistent manner.
Electromagnetic Fields ; Magnetic Resonance Imaging ; Magnets ; Retrospective Studies*

Various vaccines have been developed to fight severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for the coronavirus disease 2019 pandemic.However, new variants of SARS-CoV-2 undermine the effort to fight SARS-CoV-2. Here, we produced S proteins harboring the receptor-binding domain (RBD) of the Omicron variant in plants. Plant-produced S proteins together with adjuvant CIA09A triggered strong immune responses in mice. Antibodies in serum inhibited interaction of recombinant human angiotensinconverting enzyme 2 with RBD of the Omicron variant, but not RBD of other variants. These results suggest that antibodies induced by RBD of the Omicron variant are highly specific for the Omicron RBD, but not for that of other variants.

Catamenial hemoptysis is a rare condition, characterized by recurrent hemoptysis associated with the presence of intrapulmonary or endobronchial endometrial tissue. Therapeutic strategies proposed for intrapulmonary endometriosis with catamenial hemoptysis consist of medical treatments and surgery. Bronchial artery embolization is a well-established modality in the management of massive or recurrent hemoptysis, but has seldom been used for the treatment of catamenial hemoptysis. We report a case of catamenial hemoptysis associated with pulmonary parenchymal endometriosis, which was successfully treated by a bronchial artery embolization.
Bronchial Arteries* ; Embolization, Therapeutic ; Endometriosis ; Female ; Hemoptysis*

OBJECTIVE: Low back pain, caused intervertebral disc degeneration has been treated by thermal annuloplasty procedure, which is a non-surgical treatement. The theoretical backgrounds of the annuloplasty are thermal destruct of nociceptor and denaturization of collagen fiber to induce contraction, to shrink annulus and thus enhancing stability. This study is about temperature and its distribution during thermal annuloplasty using 1414 nm Nd : YAG laser. METHODS: Thermal annuloplasty was performed on fresh human cadaveric lumbar spine with 20 intact intervertebral discs in a 37℃ circulating water bath using newly developed 1414 nm Nd : YAG laser. Five thermocouples were attached to different locations on the disc, and at the same time, temperature during annuloplasty was measured and analyzed. RESULTS: Thermal probe's temperature was higher in locations closer to laser fiber tip and on lateral locations, rather than the in depth locations. In accordance with the laser fiber tip and the depth, temperatures above 45.0℃ was measured in 3.0 mm depth which trigger nociceptive ablation in 16 levels (80%), in accordance with the laser fiber end tip and laterality, every measurement had above 45.0℃, and also was measured temperature over 60.0℃, which can trigger collagen denaturation at 16 levels (80%). CONCLUSION: When thermal annuloplasty is needed in a selective lesion, annuloplasty using a 1414 nm Nd : YAG laser can be one of the treatment options.
Baths ; Cadaver* ; Collagen ; Humans ; Intervertebral Disc Degeneration ; Intervertebral Disc* ; Lasers, Solid-State ; Low Back Pain ; Nociceptors ; Spine ; Water

Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease. In patients with SLE, the prevalence of antiphospholipid antibodies is considerably higher, and is largely responsible for thrombosis. Splenic infarction is a rare complication of arterial thrombosis in patients with SLE. It is important to consider splenic infarction in a patient with SLE complaining of left upper quadrant (LUQ) pain because of the possibility of severe infarction-related complications, such as subcapsular hemorrhage and splenic rupture. We report a case of solitary splenic infarction in a patient with SLE. The only symptom was LUQ pain of 3-day duration. Lupus anticoagulant activity was positive and abdominal-pelvic computed tomography (CT) was consistent with splenic infarction. She did not show any other evidence of thrombotic events. The patient was diagnosed with antiphospholipid syndrome that presented as a splenic infarction in a SLE patient.
Antibodies, Antiphospholipid ; Antiphospholipid Syndrome* ; Autoimmune Diseases ; Hemorrhage ; Humans ; Lupus Coagulation Inhibitor ; Lupus Erythematosus, Systemic* ; Prevalence ; Splenic Infarction* ; Splenic Rupture ; Thrombosis