Herein, we describe the rare anatomy of an abnormal shunt from the left atrium to the coronary sinus, which ruptured during a percutaneous ablation for atrial fibrillation. The iatrogenic lesion was successfully repaired after emergent extracorporeal membrane oxygenation set up followed by surgical exploration. The patient's postoperative course was uneventful, and she was regularly followed up without any complications.
Stem cell-based in vitro models may provide potential therapeutic strategies and allow drug screening for neurodegenerative diseases, including Alzheimer’s disease (AD). Herein, we develop a neural stem cell (NSC) spheroid-based biochip that is characterized by a brain-like structure, well-defined neural differentiation, and neural network formation, representing a brain-on-a-chip. This system consisted of microelectrode arrays with a multichannel platform and allowed the real-time monitoring of network formation and degeneration by impedance analysis. The parameters of this platform for the real-time tracking of network development and organization were established based on our previous study. Subsequently, β-amyloid (Aβ) was added into the brain-on-a-chip system to generate an AD-on-a-chip model, and toxic effects on neurons and the degeneration of synapses were observed. The AD-on-a-chip model may help us to investigate the neurotoxicity of Aβ on neurons and neural networks in real time. Aβ causes neural damage and accumulates around neurites or inside neurospheroids, as observed by immunostaining and scanning electron microscopy (SEM). After incubation with Aβ, reactive oxygen species (ROS) increased, synapse function decreased, and the neurotransmitter-acetylcholine (ACh) concentration decreased were observed. Most importantly, the real-time analysis system monitored the impedance value variation in the system with Aβ incubation, providing consecutive network disconnection data that are consistent with biological data. This platform provides simple, real-time, and convenient sensing to monitor the network microenvironment. The proposed AD-on-a-chip model enhances the understanding of neurological pathology, and the development of this model provides an alternative for the study of drug discovery and cell–protein interactions in the brain.
Background: In tradition, bilateral small pulmonary nodules are localized in a computed tomography room and operation twice for fear of complications. In contrast, image-guided video-assisted thoracoscopic surgery (iVATS) is applied to localize small pulmonary nodules and resect these nodules in a single stage. The application of iVATS for bilateral pulmonary nodule localization and resection has not been explored. This study describes the methods and outcomes of bilateral small pulmonary nodule localization and resection in a single-staged method. Materials and Methods: This study is a retrospective analysis in our institute (Changhua Christian Hospital, Changhua, Taiwan). Patients with bilateral small pulmonary nodules who received single-staged iVATS from July 2018 to May 2020 were included in the study. The outcome measurements include operative time, localization time of one side, nodule pathologies, operative method, presence of complications, chest tube duration, and length of hospital stay (LOS). Results: Twenty-one patients with bilateral pulmonary nodules were included in this study, and a total of 50 pulmonary nodules were resected. The average operative time for a procedure was 203 min (95% confidence interval [CI]: 160–246 min), which included 18 min (95% CI: 13–23 min) of localization time for each side. Eight of 21 patients (38.10%) showed different pathologies among their bilateral nodules. There was only one complication noted; it was due to prolonged air leakage at the left side. Conclusion: There were about 40% different pathologies for synchronous bilateral lung nodules. Single-staged iVATS is feasible and efficient for bilateral small lung nodules resection.
Abstract Background We demonstrated the safety and feasibility of image-guided video-assisted thoracoscopic surgery (iVATS) of bilateral lung lesions in a hybrid operating room. Methods This study was a retrospective analysis of a case series. A total of 7 patients with 15 small lung nodules underwent bilateral iVATS between July 2018 and May 2019. All procedures were completed within a single anesthesia procedure and performed in a hybrid operating room that had a cone-beam computed tomography (CT) apparatus equipped with a laser navigation system. The lesion characteristics, operation methods, and peri-operative clinical outcomes were summarized. Results A total of 7 patients with 15 resected lung nodules were analyzed. The most common pathological result of our bilateral iVATS was metastasis. The median length of hospital stay was 5 days (range from 3 to 10 days). The median right chest tube duration was 2 days (range from 1 to 8 days), and the median left chest tube duration was 3 days (range from 2 to 5 days). Only one patient had a complication during his hospitalization period. There was no surgery-related mortality observed. Conclusions The bilateral iVATS procedure seems to be a feasible, safe and cost-effective approach for successful resection of bilateral lung lesions.
Abstract Background We demonstrated the safety and feasibility of image-guided video-assisted thoracoscopic surgery (iVATS) of bilateral lung lesions in a hybrid operating room. Methods This study was a retrospective analysis of a case series. A total of 7 patients with 15 small lung nodules underwent bilateral iVATS between July 2018 and May 2019. All procedures were completed within a single anesthesia procedure and performed in a hybrid operating room that had a cone-beam computed tomography (CT) apparatus equipped with a laser navigation system. The lesion characteristics, operation methods, and peri-operative clinical outcomes were summarized. Results A total of 7 patients with 15 resected lung nodules were analyzed. The most common pathological result of our bilateral iVATS was metastasis. The median length of hospital stay was 5 days (range from 3 to 10 days). The median right chest tube duration was 2 days (range from 1 to 8 days), and the median left chest tube duration was 3 days (range from 2 to 5 days). Only one patient had a complication during his hospitalization period. There was no surgery-related mortality observed. Conclusions For bilateral pulmonary nodules, the iVATS procedure seems to be a feasible and cost-effective approach.
A 3D neural spheroid-based system with an interstitial level of flow for simulating the brain microenvironment toward a dynamic amyloid-β induced neuronal toxic model was established. A real-time impedance recording was used to monitor the neural network formation and disconnection.
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