Massive Leakage Research Articles

Failure Analysis of a Welded 316L Stainless-Steel Stack with Premature Damage Due to Stress-Corrosion Cracking

AbstractThis study analyzed the premature failure of a stainless-steel stack obtained from a mining company. The stack was manufactured using ASTM A240 Type 316L stainless steel. After one year of its service, massive leakages and cracks were observed near the welds. Following a visual examination of the stack, a representative sample was extracted and analyzed using visual and radiographic inspection, metallographic examination, scanning electron microscopy, energy-dispersive spectrometry, optical emission spectrometry, ferrite number analysis, and leak testing. Furthermore, corrosion mechanisms and the sequence of events leading to failure were determined. Two different mechanisms were identified: acid dew point corrosion caused by the condensation of H2SO4 and HCl at the inner walls of the chimney, followed by stress-corrosion cracking near the welded joints.

A preliminary study of contrast-enhanced ultrasound guided capsule-preserving hydrodilatation in shoulder adhesive capsulitis.

Capsule-preserving hydrodilatation is a common treatment for adhesive capsulitis (AC), and ultrasound (US) has recently become the most popular adjuvant tool for image-guided glenohumeral joint injection. However, traditional US is hardly adequate to assess extracapsular fluid leakage, which may decide the treatment outcomes. In this study, we explored the value of contrast-enhanced ultrasound (CEUS) guided capsule-preserving hydrodilatation with steroids and ultrasonic contrast agents for treatment of AC. A total of 40 consecutive patients with AC were prospectively enrolled and received CEUS-guided capsule-preserving hydrodilatation. The number of injection attempts, injection volume, and fluid leakage were recorded, and the correlations with clinical features were analyzed by Pearson or Spearman correlation coefficients. Outcome measures including visual analog scale (VAS) score, passive range of motion (ROM), and shoulder pain and disability index (SPADI) score were evaluated at baseline and 4 weeks after treatment. Comparisons between patients with good and poor clinical outcomes were performed with independent t-test, Mann-Whitney U test, and chi-square test. Logistic regression was used to identify predictors of good clinical outcomes. A P value <0.05 defined significance. Access to the glenohumeral joint was successful in 87.5% patients on the first attempt. The infused fluid volume was 21.0±3.40 mL. Longer symptom duration (r=-0.676, P<0.001), greater SPADI (r=-0.148, P=0.007), and decreased ROM in abduction (r=0.38, P=0.016) were associated with a decreased volume of infused fluid. CEUS detected massive fluid leakage in 5 (12.5%) patients, with 4 capsule ruptures confirmed by magnetic resonance imaging (MRI). Longer symptom duration (r=0.485, P=0.001), decreased ROM in the direction of abduction (r=-0.33, P=0.037), and external rotation (r=-0.34, P=0.032) were correlated with an increased incidence of massive fluid leakage. Moreover, patients with good outcomes had significantly shorter symptom duration (5.7±2.09 vs. 11.2±3.89 months, P=0.002) and greater initial VAS score (6.9±1.04 vs. 6.3±0.50, P=0.022) than those with poor outcomes. Absence of massive fluid leakage was an independent predictor of clinical good outcomes at 4 weeks after treatment [odd ratio (OR) =0.05, 95% confidential interval (CI): 0.003-0.882, P=0.041]. CEUS-guided capsule-preserving hydrodilatation allows real-time visualization of capsule dilatation, accurate detection of extracapsular fluid leakage, and identification of risks for capsule rupture. It provides an effective treatment for AC, and is useful to predict patients' clinical outcomes.

Complete transection of the bilateral main bronchus in a 5-year-old patient: a case report

BackgroundTracheobronchial injuries caused by blunt chest trauma are rare in children, and such injuries usually involve multiple organs. Most cases involve respiratory failure on the way to the hospital, and the mortality rate is high. Herein, we describe the case of a 5-year-old patient who fell from an electric vehicle, causing complete rupture of the bilateral main bronchus.Case presentationWe treated a 5-year-old patient with complete bilateral main bronchus rupture. Chest computed tomography (CT) failed to detect bronchial rupture. Continuous closed thoracic drainage resulted in a large amount of bubble overflow. Tracheal rupture was suspected. Fibreoptic bronchoscopy revealed complete rupture of the right main bronchus and rupture of the left main bronchus. Emergency tracheoplasty was performed under cardiopulmonary bypass (CPB). During the operation, we found that the bilateral main bronchi were completely ruptured. Postoperative recovery was smooth. The traditional surgical method for treating these injuries is lateral thoracotomy. However, a median sternotomy provides a better opportunity for selective repair. Extracorporeal circulation-assisted surgery is required for patients with unstable breathing.ConclusionComplete fractures of the bilateral main bronchi are rare. Bronchial rupture should be suspected in the presence of expansion defect-dropped lungs and massive air leakage despite tube thoracostomy in haemopneumothorax developing after thoracic trauma. Extracorporeal circulation-assisted tracheoplasty is a relatively safe option for children whose respiratory system is difficult to maintain, thus ensuring oxygenation ventilation and a clear surgical field.

Multiscale Porous Architecture Consisting of Graphene Aerogels and Metastructures Enabling Robust Thermal and Mechanical Functionalities of Phase Change Materials

AbstractPassive thermal energy storage systems using phase change materials (PCMs) are promising for resolving temporal‐spatial overheating issues from small‐ to large‐scale platforms, yet their poor shape stability due to solid–liquid transition incurs PCM leakage and weak resistance against mechanical disturbance, limiting practical applications. While foam‐stable templates for PCMs have shown complement, they reveal massive leakage and collapse of liquefied PCMs under external loads or impacts. Herein, a multiscale porous architecture consisting of graphene aerogels (GAs) and meta structures enabling robust thermal‐mechanical functionalities of PCMs (3D‐MPGA) toward sustainable phase change thermal energy storage composites is reported. 3D‐printed mechanical metamaterials employing octet‐truss cells provide supportive strength and directionally‐assisted leakage reduction, while GAs serve as porous templates with surface‐interfacial contacts, thereby fixing paraffin wax as PCM inside their nano/micropores. The 3D‐MPGA shows intrinsic thermal characteristics of bulk PCMs, and improved thermal‐mechanical‐chemical stability, confirmed by long‐term heating‐cooling cycle tests over 10 h. Moreover, it exhibits highly reinforced strength (200–5000%) within a low density across ambient and melting temperatures, and maintains original shapes in the liquefied PCMs without severe leakage, against external loads. This work inspires rational strategies for advancing robust thermal‐mechanical functionalities for PCM‐based thermal energy storage systems.

The localization, origin, and impact of platelets in the tumor microenvironment are tumor type-dependent.

How platelets interact with and influence the tumor microenvironment (TME) remains poorly characterized. We compared the presence and participation of platelets in the TME of two tumors characterized by highly different TME, PyMT AT-3 mammary tumors and B16F1 melanoma. We show that whereas firmly adherent platelets continuously line tumor vessels of both AT-3 and B16F1 tumors, abundant extravascular stromal clusters of platelets from thrombopoietin-independent origin were present only in AT-3 mammary tumors. We further show that platelets influence the angiogenic and inflammatory profiles of AT-3 and B16F1 tumors, though with very different outcomes according to tumor type. Whereas thrombocytopenia increased bleeding in both tumor types, it further caused severe endothelial degeneration associated with massive vascular leakage, tumor swelling, and increased infiltration of cytotoxic cells, only in AT-3 tumors. These results indicate that while platelets are integral components of solid tumors, their localization and origin in the TME, as well as their impact on its shaping, are tumor type-dependent.

Pulmonary cyst newly formed after lobectomy in various underlying lung conditions

BackgroundIt has been recently recognized that pulmonary cyst may develop after pulmonary resection, causing various symptoms. Most previously reported cases were after upper lobectomy in patients with chronic obstructive lung disease (COPD).Case presentationCase 1 was a man in his 70 s with interstitial pneumonia (IP). Right lower lobectomy was performed for metastatic lung tumor using video-assisted thoracoscopic surgery (VATS). On postoperative day (POD) 19, computed tomography (CT) revealed a large cyst at the upper interlobular surface of the middle lobe, with pneumoderma and pneumomediastinum. The cyst was incised, polyglycolic acid (PGA) sheet and fibrin glue were applied, and the cyst was sutured. The sutured line was covered again with PGA sheet and fibrin glue. Case 2 was a man in his 70 s with COPD. Right upper lobectomy for primary lung cancer was performed using VATS. On POD 17, CT revealed a large pulmonary cyst at the apex of S6 and massive air leakage was observed. The same surgical procedure as that used in case 1 was performed. Cases 3 and 4 were healthy donors for living-donor lung transplantation. Two months after the right lower lobectomy in Case 3 and 3 months after the left lower lobectomy in Case 4, the patients had respiratory symptoms such as dyspnea and hemosputum. CT revealed a large cyst on the diaphragmatic surface of the right middle lobe in Case 3 and on the posterior mediastinal surface of the left upper lobe in Case 4. Cyst incision, soft coagulation, and application of PGA sheet with fibrin glue were performed in both cases. CT performed 1 year after surgery showed no development of a pulmonary cyst or air space in these four cases.ConclusionsPulmonary cysts newly formed after lobectomy can develop not only in COPD or IP but also in healthy lungs. Our findings suggest that incision of the cyst and application of fibrin glue and PGA sheet with or without suturing the cyst wall is effective for management.

Chyle leak after head and neck surgeries: a comprehensive review of diagnosis and management strategies.

Chyle leaks are uncommon complications after head and neck surgeries. Although uncommon, such a complication is noteworthy mention due to its perplexing diagnosis and management strategies. This scoping review aims to highlight and emphasize the diagnosis and management options proposed in the literature. A comprehensive search was performed in PubMed, Google Scholar, Cochrane Library, and Scopus databases and identified 617 articles that were reduced to 40 studies and reports after applying the eligibility criteria. Although numerous treatment options ranging from simple, conservative measures to invasive surgical procedures have been mentioned for low-output, high-output, and massive leaks, there is no concrete evidence on the best method. Thus, a combination of management options must be customized by case for optimum results.

A mathematical model describing an unsteady leak of compressed air from an open underwater storage tank

A new mathematical model is developed here to predict the discharge dynamics of compressed air from a massive leak occurring at the top of a submerged storage tank with an original bottom opening. The model represents a transient leak due to variations in the air volume and air pressure remaining inside the tank using a mass balance equation and the compressible Bernoulli equation. A first-order-non-linear ordinary differential equation is solved in terms of the air height inside the reservoir for different tank geometries: a right circular cylinder and a remaining combined with a hemisphere of the same radius to form a bell. The total discharge time is obtained by analytical integration. The model is then applied to a case study in which the amount of air is fixed, and the investigated parameters are the immersion depth (ranging from 75 to 200 m) and the radius of the storage tanks (5 or 7.5 m) on the discharge time. Finally, a representative steady rate is given based on the average discharge rate in order to rapidly estimate the discharge time without further knowledge of the storage tank configuration. The immersion depth has no influence in the discharge time of a cylindrical tank, and a wide tank causes a longer discharge than a narrow one. It has also been shown that, in the range of initial air height considered (close to ten meters), the variation of density can be neglected in the model for the cylindrical geometry, and for the bell geometry provided that the ratio radius-to-initial height remains low.

Nanosensor detection of reactive oxygen and nitrogen species leakage in frustrated phagocytosis of nanofibres.

Exposure to widely used inert fibrous nanomaterials (for example, glass fibres or carbon nanotubes) may result in asbestos-like lung pathologies, becoming an important environmental and health concern. However, the origin of the pathogenesis of such fibres has not yet been clearly established. Here we report an electrochemical nanosensor that is used to monitor and quantitatively characterize the flux and dynamics of reactive species release during the frustrated phagocytosis of glass nanofibres by single macrophages. We show the existence of an intense prolonged release of reactive oxygen and nitrogen species by single macrophages near their phagocytic cups. This continued massive leakage of reactive oxygen and nitrogen species damages peripheral cells and eventually translates into chronic inflammation and lung injury, as seen during in vitro co-culture and in vivo experiments.

PGFed: Personalize Each Client's Global Objective for Federated Learning.

Personalized federated learning has received an upsurge of attention due to the mediocre performance of conventional federated learning (FL) over heterogeneous data. Unlike conventional FL which trains a single global consensus model, personalized FL allows different models for different clients. However, existing personalized FL algorithms only implicitly transfer the collaborative knowledge across the federation by embedding the knowledge into the aggregated model or regularization. We observed that this implicit knowledge transfer fails to maximize the potential of each client's empirical risk toward other clients. Based on our observation, in this work, we propose Personalized Global Federated Learning (PGFed), a novel personalized FL framework that enables each client to personalize its own global objective by explicitly and adaptively aggregating the empirical risks of itself and other clients. To avoid massive communication overhead and potential privacy leakage while achieving this, each client's risk is estimated through a first-order approximation for other clients' adaptive risk aggregation. On top of PGFed, we develop a momentum upgrade, dubbed PGFedMo, to more efficiently utilize clients' empirical risks. Our extensive experiments on four datasets under different federated settings show consistent improvements of PGFed over previous state-of-the-art methods. The code is publicly available at https://github.com/ljaiverson/pgfed.

The Angiopoietin-2/Angiopoietin-1 ratio increases early in burn patients and predicts mortality

BackgroundAngiopoietin-2 (Angpt-2) is involved in the pathogenesis of the capillary leak syndrome in sepsis and has been shown to be associated with worse outcomes in diverse critical illnesses. It is however unclear whether Angpt-2 plays a similar role in severely burned patients during the early phase characterized by massive capillary leakage. Our aim was to analyze the Angiopoietin-2/Angiopoietin-1 ratio (Angpt-2/Angpt-1 ratio) over the first two days in critically ill burn patients and examine its association with survival and further clinical parameters. MethodsAdult burn patients with a total burn surface area (TBSA) ≥ 20% treated in the burn intensive care unit (ICU) of the University Hospital of Zurich, Switzerland, were included. Serum samples were collected prospectively and serum Angpt-1 and Angpt-2 were measured by enzyme-linked immunosorbent assay (ELISA) over the first two days after burn insult and stratified according to survival status, TBSA and the abbreviated burn severity index (ABSI). Due to hemodilution in the initial resuscitation phase, the Angpt-2/Angpt-1 ratio was normalized to albumin. ResultsFifty-six patients were included with a median age of 51.5 years. Overall mortality was 14.3% (8/56 patients). The total amount of infused crystalloids was 12́902 ml (IQR 9́362–16́770 ml) at 24 h and 18́461 ml (IQR 13́024–23́766 ml) at 48 h. The amount of substituted albumin was 20 g (IQR 10–50 g) at 24 h and 50 g (IQR 20–60 g) at 48 h.The albumin-corrected Angpt-2/Angpt-1 ratios increased over the first 48 h after the burn insult (d0: 0.5 pg*l/ml*g [IQR 0.24 – 0.80 pg*l/ml*g]; d1: 0.83 pg*l/ml*g [IQR 0.29 – 1.98 pg*l/ml*g]; d2: 1.76 pg*l/ml*g [IQR 0.70 – 3.23 pg*l/ml*g]; p < 0.001) and were significantly higher in eventual ICU non-survivors (p = 0.005), in patients with a higher TBSA (p = 0.001) and in patients with a higher ABSI (p = 0.001). ConclusionsIn analogy to the pathological host response in sepsis, the Angpt-2/Angpt-1 ratio steadily increases in the first two days in critically ill burn patients, suggesting a putative involvement in the pathogenesis of capillary leakage in burns. A higher Angpt-2/Angpt-1 ratio is associated with mortality, total burn surface area and burn scores.

Percutaneous management of atrial wall perforation during transeptal puncture with an Amplatzer vascular plug in 3 patients: keep calm, think fast

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Atrial wall perforation is a rare but serious complication of transeptal puncture in AF catheter ablation procedure. In patients with uninterrupted anticoagulation associated to non-fractionated heparin bolus this may lead to cardiac tamponade and dramatic consequences. Urgent surgical drainage and repair is mandatory in the most dramatic cases. We report the successful closure of such complication by an Amplatzer vascular plug leading to a rapid and total recovery in 3 patients. Methods Three patients (male, 43, 77 and 84 yo) referred for persistent atrial fibrillation ablation (1 RF and 2 cryoablations). After transeptal puncture, they became severely hypotensive with echographic evidence of tamponade. Results Heart perforation with massive leakage of contrast in the pericardial space was evident. The perforation was anterior near aorta in one, on the posterior wall of the right atrium in one and on the posterior wall of the left atria though the right atria in one. After heparin antagonization by protamin, the pericardial space was drained percutaneously (1 to 3 l drained and in 1 reinjected through a "cell saver" system). Rapidly, a 0,035 J guide wire was passed through the perforation and an Amplatzer vascular Plug 2 (4 mm in 2 patients and 6 mm in one) was released resulting in an immediate closure of the leak and recovery of the patient after completion of the pericardial drainage. The drainage was monitored 24h and patients were discharged on Day 2 with a good evolution over a median follow-up of 1.5 year. CT scan at 3 and 6 month showed total recovery. Conclusion In patients with left atrial wall perforation and tamponade related to failed transeptal puncture in patients under uninterrupted oral anticoagulation for AF ablation, rapid release of a closure device and pericardial evacuation allowed to successfully manage the cardiac tamponade and avoid a surgical option.

Postoperative management using a digital drainage system for massive air leakage after pulmonary resection.

To elucidate clinical outcomes using a digital drainage system (DDS) for massive air leakage (MAL) after pulmonary resection. A total of 135 consecutive patients with pulmonary resection air leakage of > 100ml/min on the DDS were evaluated retrospectively. In this study, MAL was defined as ≥ 1000ml/min on the DDS. We analyzed the clinical characteristics and surgical outcomes of patients with MAL compared with non-MAL (101-999ml/min). Using the DDS data, the duration of the air leak was plotted with the Kaplan‒Meier method and compared using the log-rank test. MAL was detected in 19 (14%) patients. The proportions of heavy smokers (P = 0.04) and patients with emphysematous lung (P = 0.03) and interstitial lung disease (P < 0.01) were higher in the MAL group than in the non-MAL group. The MAL group had a higher persistence rate of air leakage at 120h after surgery than the non-MAL group (P < 0.01) and required significantly more frequent pleurodesis (P < 0.01). Drainage failure occurred in 2 (11%) and 5 (4%) patients from the MAL and non-MAL groups, respectively. Neither reoperation nor 30-day surgical mortality was observed in patients with MAL. MAL was able to be treated conservatively without surgery using the DDS.

Investigating the Challenges of Ammonia Emission in Firuzabad Sodium Carbonate Factory Incident: A Case Study

Background: An ammonia gas explosion poses immediate health hazards such as respiratory tract burns, skin and eye irritation, and potential death within seconds. It also causes long-term negative impacts on biodiversity, affecting aquatic life and vegetation. An explosion in the Firuzabad sodium carbonate factory in Iran led to massive ammonia gas leakage and the poisoning of several employees. This study evaluates the risks of ammonia gas release caused by the explosion and the rescue team’s response in the same factory. Materials and Methods: This study was conducted in 2020 in Firuzabad City, Iran. The investigation was based on case reports and data analysis obtained via field observations, document reviews, interviews, and experiments. Technical and specialized information on explosion were analyzed by ALOHA software. Results: Based on data analysis, red, orange, and yellow zones around the explosion area were identified. The red zone had an ammonia emission range of 1.2 km with an explosive power of 10 kW, causing potential death in 60 seconds. Orange zone had a range of about 1.7 km, an explosive power of 5 kW, and the potential for second-degree burns and respiratory damage within 60 seconds of release. The yellow zone covered an area of about 3.3 km. Interviews and field observations provided information on the risk-based response process, response equipment, medical treatment, hazardous materials, handling and response equipment, personal protective equipment, mutual aid, and resource typing. Conclusion: The results of this study show that the immediate evacuation of the area, employment of the rapid warning system, the triage of the injured, the presence of an emergency operation plan to control hazardous and toxic materials disasters, the performance of the rapid response team and multi-specialty teams were among the existing challenges of the operation team. Background of this study confirms the potential hazards associated with ammonia gas emissions from explosions in sodium carbonate plants.

Causes of nephrotic syndrome in Sweden: The relevance of clinical presentation and demographics.

Many pathological processes can disrupt the integrity of the glomerular capillary wall and cause a massive leakage of protein, resulting in nephrotic syndrome (NS). Clinical parameters such as age, sex, renal function, presence of diabetes, and how NS is defined influence the spectrum of underlying diseases. In this study, we examine how these parameters interact. Age, sex, hematuria, proteinuria, plasma creatinine plasma albumin levels, and final diagnosis were retrieved for all adult patients with NS as an indication for biopsy and/or massive albuminuria in conjunction with low plasma albumin from the biopsy module of the Swedish Renal Registry (SRR) between 2014 and 2019.A basic calculator was developed to demonstrate the importance of clinical presentation in relation to the likelihood of having a specific diagnosis. A total of 913 unique patients were included in the study. Diabetic nephropathy (DN) and membranous nephropathy (MN) (both found in 17% of patients) were the most common diagnoses. With a stringent definition of NS, MN and minimal change nephropathy (MCN) increased in proportion. Among the cohort as a whole, MCN was the most frequent diagnosis in women and those <50 years of age (found in 21% and 17%, respectively). In the case of patients aged between 50 and 70 years, those with chronic kidney disease stage 4, and those with negative dipstick tests for hematuria, the most common underlying disease was DN (in 23%, 30%, and 21% of cases, respectively). Among those with high-grade hematuria (dipstick grade 3 or 4), membranoproliferative glomerulonephritis was the most common diagnosis (14%), closely followed by IgA nephropathy (13%). Focal segmental glomerulosclerosis (9.7%) was less common than in many comparable studies. Clinical parameters have a profound impact on the likelihood of different diagnoses in adult patients with NS. Differences in clinical practice and study inclusion criteria may be more important than genetic background and environmental factors when explaining differences between studies in different parts of the world.

Improved partially saturated method for the lattice Boltzmann pseudopotential multicomponent flows.

This paper extends the partially saturated method (PSM), used for curved or complex walls, to the lattice Boltzmann (LB) pseudopotential multicomponent model and adapts the wetting boundary condition to model the contact angle. The pseudopotential model is widely used for various complex flow simulations due to its simplicity. To simulate the wetting phenomenon within this model, the mesoscopic interaction force between the boundary fluid and solid nodes is used to mimic the microscopic adhesive force between the fluid and the solid wall, and the bounce-back (BB) method is normally adopted to achieve the no-slip boundary condition. In this paper, the pseudopotential interaction forces are computed with eighth-order isotropy since fourth-order isotropy leads to the condensation of the dissolved component on curved walls. Due to the staircase approximation of curved walls in the BB method, the contact angle is sensitive to the shape of corners on curved walls. Furthermore, the staircase approximation makes the movement of the wetting droplet on curved walls not smooth. To solve this problem, the curved boundary method may be used, but due to the interpolation or extrapolation process, most curved boundary conditions suffer from massive mass leakage when applied to the LB pseudopotential model. Through three test cases, it is found that the improved PSM scheme is mass conservative, that nearly identical static contact angles are observed on flat and curved walls under the same wetting condition, and that the movement of a wetting droplet on curved and inclined walls is smoother compared to the usual BB method. The present method is expected to be a promising tool for modeling flows in porous media and in microfluidic channels.

Panophthalmitis in Patient With Dengue Hemorrhagic Fever

Abstract Dengue fever can lead to serious complications of severe bleeding, massive capillary leakage causing dengue shock syndrome and vital organ involvement. Ocular manifestations in dengue fever are rare but may sometimes lead to permanent disability. Here we report a case of rare complication of dengue fever in a 35-year-old man presenting with panophthalmitis, leading to rapidly progressive and painful visual loss. With this case, it can be emphasized that early identification and management of dengue complication may prevent vision loss.

Mechanism of membrane damage to Shigella sonnei by linalool from plant essential oils: A driver of oxidative stress

This work explored the antibacterial mechanism of linalool on Shigella sonnei (S. sonnei) based on membrane damage driven by oxidative stress. The results revealed that linalool had excellent inhibition towards S. sonnei under a concentration of 1.5 mL/L. Furthermore, cell structure was disrupted with massive leakage of K+ and Mg2+ with linalool according to scanning electron microscopy, zeta potential and probes staining of fluorescein diacetate and Rhodamine 123 combined with fluorescence spectroscopy. Changes in membrane protein conformation were also monitored as a result of fluorescence spectroscopy when exposed to linalool. In addition, oxidative stress was appeared after exposure to linalool due to the increase of malondialdehyde, hydrogen peroxide, superoxide anion and oxidized glutathione, and the decrease of reduced glutathione. The activity of defense enzyme including superoxide dismutase, catalase and peroxidase, and antioxidant enzyme including glutathione reductase and glutathione S-transferase was also inhibited. In all, oxidative stress-driven membrane damage was considered as the main mechanism by which linalool inhibited S. sonnei. Our findings provide theoretical support for linalool as a promising natural antibacterial agent against S. sonnei contamination.

The Application of The Massive Socio-Economic Development Leakage from Corruption Index (∂ -n -Index) in the Case of Guatemala

The Application of The Massive Socio-Economic Development Leakage from Corruption Index (∂ -n -Index) in the Case of Guatemala

Immediate surgical treatment for massive extravasation of computed tomography contrast medium in the hand: a case report

There are no treatment guidelines for the extravasation of contrast medium. A 71-year-old man underwent coronary artery computed tomography. When contrast medium (iohexol) was injected through the right cephalic vein, massive leakage into the surrounding tissues occurred. A physical examination showed severe swelling of the hand and a prolonged capillary refill time. X-rays showed a massive accumulation of contrast medium in the hand. We immediately performed surgical treatment, including four skin incisions on the hand, subcutaneous dissection, and squeezing, which led to the removal of 50 mL of liquid. The immediate postoperative radiographic findings showed dramatic fading of most of the contrast medium. Four days postoperatively, radiography showed complete dissolution of all contrast medium, and a physical examination revealed full recovery of skin color and capillary refill time. We successfully managed massive extravasation of contrast medium in the hand with immediate surgical treatment. An immediate surgical approach for massive extravasation should be considered to achieve favorable outcomes.