Preoperative prognostic predictors and treatment strategies for surgical procedure focused on the sequential organ failure assessment score in nonocclusive mesenteric ischemia: a multicenter retrospective cohort study.

BACKGROUND: Several large-scale studies have assessed endovascular and surgical treatment methods for nonocclusive mesenteric ischemia (NOMI); however, the prognostic factors for NOMI remain unclear. Therefore, this study aimed to evaluate risk factors for in-hospital mortality among patients with NOMI who underwent laparotomy and to examine therapeutic strategies that may improve the prognosis. MATERIALS AND METHODS: In this multicenter retrospective study, the authors reviewed the electronic medical records retrieved from the inpatient database of patients with NOMI at eight district general hospitals between January 2011 and January 2021. A total of 88 patients who underwent laparotomies were divided into survivor and nonsurvivor groups, and statistical analysis was performed to determine clinical and physiological factors. RESULTS: Exploratory laparotomy based on second-look surgery was the first treatment choice. The overall mortality rate was 48.8%, with a male-to-female ratio of 1.1:1. The median Sequential Organ Failure Assessment (SOFA) score was 8 [interquartile range: 3.75-14.2], and the median SOFA scores were 5 [3-7] in the survivor group and 13 [9-17.5] in the nonsurvivor group. Univariate analysis revealed a significant difference in BMI ( P <0.001), hypoglycemia ( P =0.0012), previous cardiovascular surgery ( P =0.0019), catecholamine use ( P <0.001), SOFA score ( P <0.001), platelet count ( P =0.0023), and lactate level ( P <0.001). Logistic regression analysis using the factors with significant differences revealed that SOFA score ≥10 (odds ratio 23.3; 95% CI: 1.94-280.00; P =0.013) was an independent prognostic factor. In addition, catecholamine use was suggested as a factor with a SOFA score greater than or equal to 10. CONCLUSION: This study confirmed that a SOFA score of greater than or equal to 10 may be associated with increased mortality. While closely monitoring low blood pressure and renal dysfunction, survival rates may be improved if surgical intervention is performed before the SOFA score reaches greater than or equal to 10.

Production of Fungal Nanochitosan Using High-Pressure Water Jet System for Biomedical Applications.

In this present work, fungal nanochitosans, with very interesting particle size distribution of 22 µm, were efficiently generated in high-yield production using a high-pressure water jet system (Star Burst System, Sugino, Japan) after 10 passes of mechanical treatment under high pressure. The specific characterization of fungal chitosan nanofibers suspensions in water revealed a high viscosity of 1450 mPa.s and an estimated transparency of 43.5% after 10 passes of fibrillation mechanical treatment. The mechanical characterization of fungal nanochitosan (NC) film are very interesting for medical applications with a Young's modulus (E), a tensile strength (TS), and elongation at break (e%) estimated at 2950 MPa, 50.5 MPa, and 5.5%, respectively. Furthermore, we exhibited that the fungal nanochitosan (NC) film presented very good long-term antioxidant effect (reached 82.4% after 96 h of contact with DPPH radical solution) and very interesting antimicrobial activity when the nanochitosan (NC) fibers are mainly activated as NC-NH3+ form at the surface of the film with 45% reduction and 75% reduction observed for S. aureus (Gram-positive) and E. coli (Gram-negative), respectively, after 6 h of treatment. These promising antimicrobial and antioxidant activities indicated the high potential of valorization toward biomedical applications.

Adventitial cystic disease of the popliteal artery treated by bypass graft utilizing the short saphenous vein: A case report.

INTRODUCTION: Adventitial cystic disease is relatively rare vascular disease, frequently occurred in the popliteal artery. No definitive treatment has been established yet. PRENTATION OF CASE: A 53-year-old woman presenting intermittent claudication of the right leg was diagnosed as adventitial cystic disease of popliteal artery. Percutaneous balloon dilation yielded an immediate recurrence. The disease was successfully treated by bypass grafting utilizing the short saphenous vein to replace the part of the popliteal artery containing the adventitial cyst. No postoperative complication was found six months after surgery. DISCUSSION: Comparing to a great saphenous vein, a short saphenous vein as a material of bypass graft has a significant advantage, as only a single surgical field is necessary. CONCLUSION: We propose that bypass graft surgery employing a short saphenous vein is worth considering as a treatment of adventitial cystic disease at the popliteal artery.

Remarkable effect of pore size on the catalytic activity of mesoporous silica for the acetalization of cyclohexanone with methanol.

The catalytic activity of mesoporous silica (MCM-41) for the acetalization of cyclohexanone shows a volcano-shaped dependence on the pore diameter. The diameter of the cyclohexanone molecule is ca. 0.75 nm, while its acetalization with methanol was well accelerated on MCM-41 with a pore diameter of approximately 1.9 nm, and smaller or larger pores were not suitable for the catalysis. The catalytic activity was independent of the Al concentration.