Pediatric pleuropulmonary synovial sarcoma: A case report in a recurrent spontaneous pneumothorax.

Pleuropulmonary Synovial Sarcoma is a rare lung cancer with a prevalence of <1% among all lung cancers. Little is known about the clinical presentation, disease process, and appropriate treatment. Here we present a 9-year-old male who was taken to the operating room for pleurodesis and blebectomy due to a recurrent spontaneous pneumothorax. Final pathology showed a bleb with an associated mass positive for Pleuropulmonary synovial sarcoma.

Emergent robotic versus laparoscopic surgery for perforated gastrojejunal ulcers: a retrospective cohort study of 44 patients.

BACKGROUND: Perforated gastrojejunal ulcers are a known complication following Roux-en-Y gastric bypass (RYGB) surgery requiring emergent surgical repair. The robotic approach has not been evaluated for emergency general surgery. METHODS: A retrospective cohort study from 2015 to 2019 was performed identifying all patients who underwent repair of perforated gastrojejunal ulcers after RYGB at a single institution. Patient characteristics and outcomes were compared by robotic or laparoscopic approach. RESULTS: Of the 44 patients analyzed, there were 24 robotic and 20 laparoscopic repairs of perforated gastrojejunal ulcers. No patients were initially approached with open surgery. In-room-to-surgery-start time was significantly faster in the robotic group than the laparoscopic group (25 versus 31 min, p = 0.01). Complication rate, complication severity, operating time, hospital length of stay, postoperative vasopressor requirement, discharge to home, hospital length of stay and 30-day readmission were all improved in the robotic group, although these were not statistically significant. Both total inpatient and procedural costs were more in the robotic group than the laparoscopic group. CONCLUSION: Perforated hollow viscus is not a contraindication for the use of the surgical robot, which may improve outcomes.

Rh2(II)-Catalyzed Intermolecular N-Aryl Aziridination of Olefins Using Nonactivated N Atom Precursors.

The development of the first intermolecular Rh2(II)-catalyzed aziridination of olefins using anilines as nonactivated N atom precursors and an iodine(III) reagent as the stoichiometric oxidant is reported. This reaction requires the transfer of an N-aryl nitrene fragment from the iminoiodinane intermediate to a Rh2(II) carboxylate catalyst; in the absence of a catalyst only diaryldiazene formation was observed. This N-aryl aziridination is general and can be successfully realized by using as little as 1 equiv of the olefin. Di-, tri-, and tetrasubstituted cyclic or acylic olefins can be employed as substrates, and a range of aniline and heteroarylamine N atom precursors are tolerated. The Rh2(II)-catalyzed N atom transfer to the olefin is stereospecific as well as chemo- and diastereoselective to produce the N-aryl aziridine as the only amination product. Because the chemistry of nonactivated N-aryl aziridines is underexplored, the reactivity of N-aryl aziridines was explored toward a range of nucleophiles to stereoselectively access privileged 1,2-stereodiads unavailable from epoxides, and removal of the N-2,4-dinitrophenyl group was demonstrated to show that functionalized primary amines can be constructed.

Frontal plane margin of stability is increased during texting while walking.

Injurious falls associated with cell phone use during ambulation are increasingly common. Studies examining texting while walking suggest this task alters the attentional component of walking to the extent that safety may be compromised. Here, we quantified the extent to which frontal plane dynamic stability while walking was affected by the cognitive and physical demands of texting. Twenty experienced texters performed four, 10-min treadmill walking tasks at a self-selected velocity in random order: (1) normal walk (control), (2) walking while verbally performing mathematical calculations (cognitive demand), (3) walking while bimanually holding and looking directly at a phone (physical demand), and (4) walking while texting continuous mathematical calculations (cognitive and physical). We quantified the frontal plane minimum margin of stability (MOSmin), a measure that considers the position and normalized velocity of the center of mass with respect to the lateral border of the base of support was calculated over each 10-min walking period. Compared to the normal walking condition, the texting and phone holding conditions resulted in a small but significant (6%) increase in MOSmin (p=0.005 and 0.026, respectively). Compared to normal walking, the effect of performing mathematical calculations on MOSmin was not significant (p=0.80). These results suggest that frontal plane stability of experienced texters during controlled treadmill walking conditions can be affected by the physical, but not the cognitive demand of texting. This may represent a compensatory mechanism by the CNS to ensure stability in the event of an unexpected disturbance.