Isolated reversal of flow in the vertebral artery - A missed entity.

Isolated reversal of flow in the vertebral artery is a rare phenomenon occurring in the general population and is due to intrinsic anatomical defects. The most common cause is subclavian stenosis; however, reversal of flow in the vertebral artery can occur regardless of any detection of anatomic deterioration. In this series, we report three asymptomatic cases where the extracranial Doppler scan preceding off-pump coronary arterial bypass grafting showed isolated reversal of flow in the vertebral artery. No signs of subclavian stenosis or steal syndrome were elicited. However, all patients subsequently suffered from a posterior circulation stroke following off-pump coronary arterial bypass grafting but recovered fully with medical management. We conclude that a detailed pre-operative neurological investigation can mitigate this risk and improve neurological outcomes following off-pump coronary arterial bypass grafting.

Primary spindle cell sarcoma of heart: case report and review of literature.

Primary spindle cell sarcoma of the heart is a rare malignant tumor of the heart. A 65-year-old woman was admitted under our care with complaints of shortness of breath. Echocardiogram showed pedunculated mass in the left atrium. Cardiac magnetic resonance imaging done elsewhere had confirmed a left atrial tumor. No further investigations were considered with a diagnosis of left atrial myxoma. She underwent total excision of the tumor: mitral valve involvement necessitated a repair all of which was done under cardiopulmonary bypass. Histopathology showed a primary spindle cell sarcoma. In view of histology, chemotherapy was planned and initiated. A month after surgery, she presented again with a recurrence.

Study of the Oxygen Evolution Reaction Catalytic Behavior of CoxNi1-xFe2O4 in Alkaline Medium.

Catalysts for the oxygen evolution reaction (OER) play an important role in the conversion of solar energy to fuel of earth-abundant water into H2 and O2 through splitting/electrolysis. Heterogeneous electrocatalysts for hydrogen and oxygen evolution reactions (HER and OER) exhibit catalytic activity that depends on the electronic properties, oxidation states, and local surface structure. Spinel ferrites (MFe2O4; M = Ni and Co) based materials have been attractive for the catalytic water oxidation due to their well-known stability in alkaline medium, easy synthesis, existence of metal cations with various oxidation states, low cost, and tunable properties by the desired metal substitution. To understand the better catalytic activity of MFe2O4 in detail the role of Ni and Co was studied through MxNi1-xFe2O4 (M = Co; 0 < x < 1), which was prepared by the sol-gel method. The results showed that bare NiFe2O4 has better catalytic activity (η = 381 mV at 10 mA cm-2 and Tafel slope of 46.4 mV dec-1) compared to Co-containing MxNi1-xFe2O4 (η = 450-470 mV at 10 mA cm-2 and Tafel slope of 50-73 mV dec-1) in alkaline medium, and the substitution of Co is found to suppress the catalytic activity of NiFe2O4. The degradation of catalytic activity with an increase in Co content was accounted for in further detailed investigations.

Efficacy of tranexamic acid as compared to aprotinin in open heart surgery in children.

BACKGROUND: Coagulopathy is a major issue in children undergoing high-risk pediatric cardiac surgery. Use of anti-fibrinolytics is well documented in adults, but recently there are questions raised about safety and effectiveness of their use on routine use. Tranexamic acid is a potent anti-fibrinolytic, but its role is not fully understood in children. This study aims to study the benefits tranexamic acid in controlling postoperative bleeding in pediatric cardiac surgical patients. METHODS AND RESULTS: Fifty consecutive children who underwent cardiac surgery were randomized prospectively to receive either aprotinin (Group A; n = 24) or tranexamic acid (Group B; n = 26) from September 2009 to February 2010 were studied. Primary end points were early mortality, postoperative drainage, reoperation for bleeding and complications. Mean age and body weight was smaller in Group A (Age: 48.55 vs. 64.73 months; weight 10.75 vs. 14.80 kg) respectively. Group A had more cyanotic heart disease than Group B (87.5% vs. 76.92%). Mean cardiopulmonary bypass time (144.33 vs. 84.34 min) and aortic cross-clamp time (78.5 vs. 41.46 min) were significantly higher in group A. While the blood and products usage was significantly higher in Group A, there was no difference in indexed postoperative drainage in first 4, 8 and 12 h and postoperative coagulation parameters. Mean C-reactive protein was less in Group A than B and renal dysfunction was seen more in Group A (25% vs. 7.6%). Mortality in Group A was 16.66% and 7.6% in Group B. CONCLUSION: Anti-fibrinolytics have a definitive role in high-risk children who undergo open-heart surgery. Tranexamic acid is as equally effective as aprotinin with no additional increase in morbidity or mortality.

Giant solitary fibrous tumor of the pleura.

Solitary fibrous tumors are rare mesenchymal tumors accounting for <5% of all neoplasms in the pleura and other sites. A 45-year-old man reported to us with cough and dyspnea. Radiological investigations revealed a giant mass displacing the mediastinum to the left. The tumor weighing 3.0 kg was successfully resected via a right thoracotomy. Histology and immunohistochemistry confirmed a benign tumor. Recurrence and malignant transformation of these benign tumors have been reported. Our patient has been followed up for 4 years with no recurrence.

Triboluminescence and vapor-induced phase transitions in the solids of methyltriphenylphosphonium tetrahalomanganate(II) complexes.

Triboluminescence (TL) of the methyltriphenylphosphonium tetrahalomanganate(II) complexes such as bis(methyltriphenylphosphonium) tetrabromomanganate (PMBB) and bis(methyltriphenylphosphonium) dibromodichloromanganate (PMBC) was switched ON and OFF reversibly by vapors of aprotic and protic solvents, respectively, for the first time. Detailed analyses indicate that solids of the PMBB and the PMBC undergo phase transitions depending on the environment, which regulate the TL activity of these compounds. The combined results of luminescence, powder X-ray diffraction, differential scanning calorimetry, and electron paramagnetic resonance were used to demonstrate crystal dynamism as well as the TL emission of PMBB and PMBC.

Unusual case of chondroblastic osteosarcoma of the rib in an adult.

Primary osteosarcoma arising from the ribs is very rare. An unusual case of a primary chondroblastic osteosarcoma of the rib in a 30-year-old woman is described here. The patient underwent wide excision of the tumor along with the involved rib, followed by chemotherapy. Although clinically unsuspected in this unusual site, pathology confirmed a completely resected chondroblastic osteosarcoma.

4-Nitro-phenol-piperazine (2/1).

In the title adduct, C6H5NO3·0.5C4H10N2, the piperazine ring possesses inversion symmetry and has a chair conformation. Its mean plane makes a dihedral angle of 65.45 (7)° with the 4-nitro-phenol ring. In the crystal, the piperazine ring is linked to two 4-nitro-phenol mol-ecules via O-H⋯N hydrogen bonds. The mol-ecules are also linked via bifurcated N-H⋯(O,O) hydrogen bonds involving the NO2 O atoms, forming a two-dimensional network lying parallel to (102). The networks are linked via C-H⋯O hydrogen bonds, forming a three-dimensional structure.

2-Amino-4-methyl-pyridinium 2-nitro-benzoate.

In the title mol-ecular salt, C6H9N2 (+)·C7H4NO4 (-), the original pyridine N atom of 2-amino-4-methyl-pyridine is protonated and the carb-oxylic acid group of nitro-benzoic acid is deprotonated. In the crystal, the ions are linked by N-H⋯O hydrogen bonds, forming chains propagating along [001]. The chains are linked via C-H⋯O hydrogen bonds, forming two-dimensional networks lying parallel to the bc plane.

l-Histidinium p-toluene-sulfonate.

In the title salt, C6H10N3O2 (+)·C7H7O3S(-), the imidazole ring makes a dihedral angle of 70.93 (12)° with the plane of the toluene ring. In the crystal, the ions are linked via N-H⋯O and weak C-H⋯O hydrogen bonds forming two-dimensional networks lying parallel to (001). These networks are linked via C-H⋯π inter-actions, forming a three-dimensional structure.

Morpholine-4-nitro-phenol (1/2).

In the title adduct, 2C6H5NO3·C4H9NO, the morpholine ring adopts a chair conformation. The dihedral angle between the two nitro-phenol rings is 69.47 (9)°. The nitro groups attached to the benzene rings make dihedral angles of 3.37 (16) and 3.14 (13)° in the two mol-ecules of nitro-phenol. The crystal structure is stabilized by N-H⋯O, O-H⋯N and O-H⋯O hydrogen bonds and further consolidated by C-H⋯O inter-actions, resulting in a three-dimensional network.

3-Methyl-4-nitro-phenol-4-dimethyl-amino-pyridine (1/1).

In the title adduct, C(7)H(7)NO(3) (.)C(7)H(10)N(2), the dihedral angle betwen the benzene ring and pyridine rings is 9.60 (8)° while the nitro group attached to the benzene ring makes a dihedral angle of 21.76 (13)°. The hydroxyl O atom deviates by 0.0247 (15) Šfrom the plane of the benzene ring. The crystal packing features O-H⋯N hydrogen bonds.

Idiopathic pulmonary artery aneurysm with pulmonary regurgitation.

Idiopathic pulmonary artery aneurysms are rare and need a multidisciplinary approach to diagnosis and treatment. Surgery is the treatment of choice, especially when the aneurysms are large and when they are associated with pulmonary regurgitation. This report highlights a case in which successful surgical repair preserved the native pulmonary valve after pulmonary artery reconstruction.