Cardiac Tamponade due to Suprahepatic Surgical Exploration in Liver Retransplantation: A Case Report.

BACKGROUND: Cardiac tamponade is an emergency condition that requires early recognition and prompt pericardial decompression. Little has been reported on cardiac tamponade in liver retransplantation (reLT), but most cases are fatal. We managed a case of reLT complicated by accidental cardiac tamponade. CASE REPORT: A 59-year-old man underwent an emergency reLT because of liver cirrhosis with recurrent hepatitis B. During the dissection, suprahepatic exploration was attempted, but this resulted in severe hemorrhage because of the many tissue adhesions. After 1 hour of allograft reperfusion, the cardiac index and blood pressure dropped markedly despite volume resuscitation, and the central venous pressure increased abruptly. Using transthoracic echocardiography, cardiac tamponade was diagnosed, and an urgent pericardiotomy was performed. Although bizarre changes in the electrocardiogram were observed briefly, the vital signs normalized. After a short period of hypotension and hyperlactatemia in the intensive care unit, the patient was transferred to a ward in satisfactory condition on postoperative day 7. CONCLUSION: This case demonstrates the need for careful monitoring of hemodynamics during suprahepatic exploration with marked tissue adhesions in reLT.

Nitrogen removal characteristics analyzed with gas and microbial community in thermophilic aerobic digestion for piggery waste treatment.

In order to characterize the nitrogen conversion characteristics in a thermophilic aerobic digestion (TAD) system, a laboratory study has been conducted with the analysis of effluent gas and microbial community in the sludge samples. The lab TAD system was operated with HRT of 3 days and 60 degrees C. Based on the nitrogen mass balance, it has been found that about 2/3 of the daily load of nitrogen was converted to the gaseous form of nitrogen whereas cellular transformation and unmetabolized nitrogen accounted for about 1/3. Among the gaseous nitrogen transformation, significant amount of influent nitrogen had been converted to N2 gas (29% of influent N) and N2O (9% of influent N). Ammonia conversion was only 28% of influent N. The detection of N2O gas is a clear indication of the biological nitrogen reduction process in the thermophilic aerobic digester. No conclusive evidence for the existence of aerobic deammonification has been found. The microbial community analysis showed that thermophilic bacteria such as Bacillus thermocloacae, Bacillus sp. and Clostridial groups dominated in this TAD reactor. The diverse microbial community in TAD sludge may play an important role in removing both strong organics and nitrogen from piggery waste.

Gas analysis reveals novel aerobic deammonification in thermophilic aerobic digestion.

A laboratory-scale thermophilic aerobic digester was operated with piggery wastewater. The operating temperature varied from 50-70 degrees C. It has been found that excessive nitrogen removal occurred in the laboratory-scale thermophilic system at various HRTs. Nitrite and nitrate were not observed in the effluent. Gas measurement reveals the presence of significant amount of N2O along with NH3 gas. The rational production of N2O gas in accordance with temperature and HRT suggests that biologically mediated deammonification processes significantly contribute to the N removal. Although further microbiological investigation is required to clarify the exact nitrogen removal mechanism, the large production of N2O gas seems to be a result of the existence of a rapid growing heterotrophic deammonification process in the thermophilic system.

Isolation of an extragenic suppressor of the rna1-1 mutation in Saccharomyces cerevisiae.

The small GTPase Ran is essential for nucleocytoplasmic transport of macromolecules. In the yeast Saccharomyces cerevisiae, Rna1p functions as a Ran-GTPase activating protein (RanGAP1). Strains carrying the rna1-1 mutation exhibit defects in nuclear transport and, as a consequence, accumulate precursor tRNAs. We have isolated two recessive suppressors of the rna1-1 mutation. Further characterization of one of the suppressor mutations, srn10-1, reveals that the mutation (i) can not bypass the need for Rna1p function and (ii) suppresses the accumulation of unspliced pre-tRNA caused by rna1-1. The SRN10 gene is not essential for cell viability and encodes an acidic protein (pI = 5.27) of 24.8 kDa. Srn10p is located in the cytoplasm, as determined by indirect immunofluorescence microscopy. Two-hybrid analysis reveals that there is a physical interaction between Srn10p and Rna1p in vivo. Our results identify a protein that interacts with the yeast RanGAP1.