Spontaneous Leakage Research Articles

Spontaneous cerebrospinal fluid rhinorrhea in a patient with elevated body mass index: A case report

CSF rhinorrhoea is a rare clinical entity referring to the spontaneous leakage of CSF through the nasal passage. The primary cause of CSF rhinorrhoea can be either spontaneous, where the causes include a temporal bone anomaly, skull base defect, or dura mater defect, or non-spontaneous causes, including surgical or accidental trauma, tumors, and radiation therapy to the base of the skull. It is imperative to diagnose the condition in its early stages to avoid complications like meningitis, sepsis, and abscesses. Primary cases are uncommon and linked with increased BMI and intracranial hypertension (ICH). The beta-2 transferrin test is considered the gold standard for diagnosing a CSF leak; however, a clinical examination along with CT and MRI scans can also help with the diagnosis. In this report, the patient is a 49-year-old female who presented with an elevated BMI. The patient came to the emergency department with the complaint of ‘drooping’ on the right side of the face, weakness on the same side, and a history of diabetes mellitus, hypertension, and schizoaffective disorder. CT and MRI of the patient revealed acute infarcts in the brain and findings in the temporal bone which indicated a CSF leak. Initially, conservative management was initiated, but later on, the development of subsequent symptoms warranted surgical management. Following radiological diagnosis using CT scans, the patient underwent the transsphenoidal technique to address the CSF leak. This case highlights the complexities involved in diagnosing and managing CSF rhinorrhoea. Diagnostic assays, such as β-2 transferrin, along with imaging tests, are essential for accurate identification and treatment. Additionally, factors like obesity and coexisting health conditions can significantly influence treatment strategies and outcomes. However, the lack of comprehensive follow-up data and the reliance on a single case study limit the scope of the conclusions that can be drawn.

Vaginal Microflora in High Vaginal Swab in Prelabour Rupture of Membrane: A Descriptive Cross-sectional Study.

Premature rupture of membrane (PROM) refers to the disruption of the fetal membrane before the beginning of labor, resulting in spontaneous leakage of amniotic fluid. Cervicovaginal infection is an important risk factor of PROM and can lead to complications to mother and the child. This study aimed to delineate the bacterial patterns found in PROM so that the ideal appropriate responsive antibiotics can be chosen. A descriptive cross-sectional was done during the period of 6 months from December of 2023 to May 2023, to characterize the microorganisms in the vaginal fluid found in antenatal women presenting with premature rupture of membraneafter obtaining ethical approval (IRC number: 20102023/02). A total of 117 antenatal women diagnosed with premature rupture of membrane were included in the study. High vaginal swabs were collected for microbial culture and sensitivity. Data were entered using Microsoft Excel 2000 (v9.0) and Statistical Package for the Social Sciences (SPSS) software version 26.0 was used for analysis. Out of 117 samples, culture growth was present in the culture of high vaginal swabs of 23 (19.66%) women. The high vaginal swab cultures from the samples collected in women presenting with PROM reported 9 different types of pathogens E. coli in 12 (52.17%), Klebsiella in 4 (17.39%) and Pseudomonas in 2 (8.70%) cultures. This study reveals diverse microorganisms in premature rupture of membrane cases, with E. coli being the most common. Identifying these bacterial patterns is essential for selecting effective antibiotics, improving maternal and neonatal outcomes, and reducing morbidity and mortality by early detection and treatment of vaginal infections.

Fine-tuning of membrane permeability by reversible photoisomerization of aryl-azo derivatives of thymol embedded in lipid nanoparticles

Responsiveness of liposomes to external stimuli, such as light, should allow a precise spatial and temporal control of release of therapeutic agents or ion transmembrane transport. Here, some aryl-azo derivatives of thymol are synthesized and embedded into liposomes from 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine to obtain light-sensitive membranes whose photo-responsiveness, release behaviour, and permeability towards Cl- ions are investigated. The hybrid systems are in-depth characterized by dynamic light scattering, atomic force microscopy and Raman spectroscopy. In liposomal bilayer the selected guests undergo reversible photoinduced isomerization upon irradiation with UV and visible light, alternately. Non-irradiated hybrid liposomes retain entrapped 5(6)-carboxyfluorescein (CF), slowing its spontaneous leakage, whereas UV-irradiation promotes CF release, due to guest trans-to-cis isomerization. Photoisomerization also influences membrane permeability towards Cl- ions. Data processing, according to first-order kinetics, demonstrates that Cl- transmembrane transport is enhanced by switching the guest from trans to cis but restored by back-switching the guest from cis to trans upon illumination with blue light. Finally, the passage of Cl- ions across the bilayer can be fine-tuned by irradiation with light of longer λ and different light-exposure times. Fine-tuning the photo-induced structural response of the liposomal membrane upon isomerization is a promising step towards effective photo-dynamic therapy.

Spontaneous skull base cerebrospinal fluid leak during pregnancy: a case report and review of the literature

BackgroundIdiopathic intracranial hypertension can lead to dural defects and spontaneous leakage of cerebrospinal fluid (CSF) from the skull base. Skull base CSF leaks are rarely reported in pregnancy but pose unique challenges for obstetricians and anesthesiologists.Case presentationA 31-year-old G4P1021 at 14 weeks developed debilitating headaches and CSF rhinorrhea. Brain imaging revealed a bony defect of the sphenoid sinus with a meningoencephalocele and a partially empty sella, consistent with CSF leakage from a skull base defect. The patient was neurologically stable without signs of meningitis; thus, management was focused on symptomatic alleviation. A planned cesarean section was performed at 38 weeks under spinal anesthesia. The patient had spontaneous marked improvement of her symptoms postpartum.ConclusionPregnancy may exacerbate skull base CSF leaks, requiring careful management with a multidisciplinary team. Neuraxial anesthesia can safely be performed in pregnant individuals with spontaneous skull base CSF leakage, but further studies are needed to determine the safest mode of delivery in these patients.

Food intolerance in patients with functional abdominal pain: Evaluation through endoscopic confocal laser endomicroscopy.

Background and study aims Gastrointestinal symptoms assumed to be caused by food intolerance are reported frequently in the general population. There is a significant difference between self-reported and objective proven food intolerance, as shown by placebo-controlled, double-blind, randomized trials. This discrepancy may be overcome by endoscopic confocal laser endomicroscopy (eCLE). Patients and methods In an observational study we evaluated 34 patients with functional abdominal pain and adverse reaction to food by eCLE and local duodenal food challenge for the first time. Spontaneous and food-induced transfer of fluorescein into the duodenal lumen was detected 10 minutes after intravenously application of fluorescein and 10 minutes after duodenal food challenge (DFC). Results Of the patients, 67.6 % responded with a fluorescein leakage into the duodenal lumen. Frequency rank order of food antigens that induced a response were soy (50 %), wheat (46.1 %), milk (20 %), egg (12 %), and yeast (11.5 %), respectively. Of the patients, 23.5 % showed spontaneous leakage of fluorescein, suggesting leaky gut syndrome. Histology of duodenal biopsies and mast cell function were normal. Overall, 69.5 % of patients improved with food exclusion therapy and 13 % were symptom-free according to eCLE. Conclusions The results of our study indicate that eCLE is a clinically useful tool to evaluate patients with functional abdominal pain and adverse reaction to food and to create individualized dietary therapy with clinical benefit for patients.

Self-healing and corrosion-sensing coatings based on pH-sensitive MOF-capped microcontainers for intelligent corrosion control

Organic coatings are one of the most used and versatile technologies to mitigate corrosion of metals. However, organic coatings are susceptible to defects and damages that may not be easily detected. If not repaired timely, these defects may develop into major coating failures due to corrosion occurring in the damaged region, thereby limiting the lifetime of the to be protected structure. Thus, the development of smart coatings that can accurately identify corrosion location and reliably recover the damage autonomously is of particular interest. Herein, we reported a robust, corrosion-sensing and self-healing coating which incorporated pH-sensitive ZIF-8-capped CaCO3 microcontainers containing the healing agent tung oil (TO) and the corrosion indicator/inhibitor 1,10-phenanthrolin-5-amine (APhen). The spontaneous leakage of incorporated TO and APhen was restrained, and the release initiated when local pH variation occurred. The corrosion protection performance of the coatings implanted with different contents of smart microcontainers were evaluated. The intact epoxy coating containing 7.5 wt% of the microcontainers exhibited the best protection performance with low water absorption (0.65 wt%), low O2 permeability (0.21 × 10–15 cm3 cm cm−2 s−1 Pa−1), and a high storage modulus (3.0 GPa). Electrochemical impedance spectroscopy (EIS) measurements in 3.5 wt% NaCl solution demonstrated superior durability of the composite coating after self-healing. The immersion test and neutral salt spray test confirmed the coating can accurately report corrosion sites via coloration.

OR08-5 Associations Between Signal Transducer and Activator of Transcription (STAT) Mutations and Galactorrhea

Abstract Background Prolactin (PRL) is responsible for the development of mammary glands and milk production. STAT1 and STAT3 are genes that express transcription factors that mediate PRL's intracellular signaling, but an association between their function and galactorrhea has not yet been identified. Here we describe three patients with somatic STAT mutations and galactorrhea. A 27-year-old woman with hyper-IgE syndrome (Job's Syndrome) due to a STAT3 deletion mutation (p.Val463del) associated with recurrent infections reported thin, white, bilateral discharge with breast manipulation beginning in adolescence. She did not have spontaneous leakage or pain. At presentation, PRL was slightly elevated to 27.9 (ref. 2.0-25.0 mcg/L) with otherwise normal levels of anterior pituitary hormones. She was not on any drugs known to cause hyperprolactinemia. MRI showed a 5×4 mm microadenoma without any mass effect. A 32-year-old woman also with Job's syndrome due to a heterozygous loss-of-function STAT3 mutation (p.R382Q) associated with recurrent infections and papillary thyroid cancer described unilateral, chronic, thin, white nipple discharge with light touch of her right breast for "as long as she could remember." She had a history of breast abscesses, but at presentation there was no evidence of abscess or infection. PRL was 15.1 mcg/L, and other anterior pituitary hormones were normal. MRI showed a structurally normal pituitary. A 22-year-old woman with a STAT1 activating mutation (p.E235A) associated with recurrent infections, autoimmune hypothyroidism, T1DM, and hypogonadotropic hypogonadism requiring pubertal induction at age 12y reported bilateral galactorrhea starting at age 18y. A white, milky discharge could be expressed with light manipulation, but no discharge was produced spontaneously. PRL was 16.2 mcg/L with serial dilution and has consistently been in the reference range. Anterior pituitary evaluation was normal except for elevated TSH of 12.5 (ref. 0.27-4.2) consistent with autoimmune hypothyroidism. MRI revealed a diffusely enlarged pituitary gland (12mm in the cranio-caudal dimension) without focal hypo-enhancement. Conclusions It is known that PRL signaling involves the JAK/STAT pathway, and an analysis of human milk cells showed upregulated STAT3 and downregulated STAT1 during lactation (PMID 26909879). These three cases provide clinical evidence for a mechanistic connection between STAT signaling and galactorrhea and suggest that STAT3 and STAT1 function in opposite directions to regulate lactation. In our cases, increased STAT1 or decreased STAT3 activity are associated with normal-PRL, inducible galactorrhea. Beyond understanding the specific intracellular signaling pathways leading to galactorrhea, these observations may be utilized for developing therapies for those with impaired lactation. Presentation: Saturday, June 11, 2022 12:30 p.m. - 12:45 p.m.

Fueling DNA Self-Assembly via Gel-Released Regulators.

The development of responsive, multicomponent molecular materials requires means to physically separate yet easily couple distinct processes. Here we demonstrate methods to use molecules and reactions loaded into microliter-sized polyacrylamide hydrogels (mini-gels) to control the dynamic self-assembly of DNA nanotubes. We first characterize the UV-mediated release of DNA molecules from mini-gels, changing diffusion rates and minimizing spontaneous leakage of DNA. We then demonstrate that mini-gels can be used as compartments for storage and release of DNA that mediates the assembly or disassembly of DNA nanotubes in a one-pot process and that the speed of DNA release is controlled by the mini-gel porosity. With this approach, we achieve control of assembly and disassembly of nanotubes with distinct kinetics, including a finite delay that is obtained by loading distinct DNA regulators into distinct mini-gels. We finally show that mini-gels can also host and localize enzymatic reactions, by transcribing RNA regulators from synthetic genes loaded in the mini-gels, with diffusion of RNA to the aqueous phase resulting in the activation of self-assembly. Our experimental data are recapitulated by a mathematical model that describes the diffusion of DNA molecules from the gel phase to the aqueous phase in which they control self-assembly of nanotubes. Looking forward, DNA-loaded mini-gels may be further miniaturized and patterned to build more sophisticated storage compartments for use within multicomponent, complex biomolecular materials relevant for biomedical applications and artificial life.

The Neurotrophic Receptor Tyrosine Kinase in MEC-mPFC Neurons Contributes to Remote Memory Consolidation.

The PFC is thought to be the region where remote memory is recalled. However, the neurotrophic receptors that underlie the remote memory remain largely unknown. Here, we benefited from auto-assembly split Cre to accomplish the neural projection-specific recombinase activity without spontaneous leakage. Deletion of tropomyosin receptor kinase B (TrkB) in neurons projecting from the medial entorhinal cortex to the mPFC displayed reduced remote memory recall from the male mice, but the recent recall was intact. We found that the TrkB deletion attenuates the participation of mPFC cells in the remote fear memory recall. The disruption of remote recall was attributed to reduced reactivation of cells in the mPFC. Notably, TrkB deletion seriously inhibited experience-dependent maturation of oligodendroglia in the PFC, resulting in defects in remote recall that were rescued by clemastine administration. Together, our data suggest that TrkB in intercortical circuits functions in remote memory consolidation.SIGNIFICANCE STATEMENT Retrieving the past experiences or events is essential for the ones to lead life. The investigations performed in the rodent model have disclosed that the systems consolidation of memory accompanying changes of cortical circuits and transcriptome is required for maintaining the memory for a long time. In this study, the split Cre with TrkBflox/flox mice were subjected to discover that TrkB in the neurons plays a role in remote memory consolidation. We evaluated the contextual fear memory and labeled cells, which revealed deletion of TrkB interrupts newborn oligodendrocyte and reactivation of cells in mPFC at remote recall. Our data provide the implication that remote memory is relevant to neurotrophic receptor signaling as well as its influence on non-neuronal cells.

Leakages in District Heating Networks-Model-Based Data Set Quality Assessment and Localization.

Large spontaneous leakages in district heating networks (DHNs) require a separation of the affected network part, as interruption of the heat supply is imminent. Measurement data of 22 real events was analyzed for localization, but suitable results were not always achieved. In this paper, the reasons are investigated and a model for data evaluation (MoFoDatEv) is developed for further insights. This contains prior knowledge and a simplified physical model for the reaction of the DHN in the case of a large spontaneous leakage. A model like this does not exist so far. It determines the time point and the duration of the pressure drop of the pressure wave which is caused by such leakages. Both parameters and the evaluation time frame are optimized for each event separately. The quality assessment leads to a categorization of the events based on several parameters, and correlations between the pressure and the refill mass flow are found. A minimum leakage size is deduced for successful evaluation. Furthermore, MoFoDatEv can also be used for leakage localization directly, combining two steps from previous publications. Therefore, more data contribute to the result. The application is conducted with artificial data to prove the model concept, and also with real measurement data.

Optimal Sensor Placement and Influence of Noise on Pressure Wave Evaluation for Leakage Localization in a District Heating Network

Pipe bursts and leakages in district heating networks are a problem both for the economic operation and the supply reliability. In order to minimize costs and secondary damages, an efficient and accurate leakage localization is necessary. If this is possible, only the affected network part needs to be shut down and operation in the remaining heating network can be maintained. One method will be the pressure wave detection. In case of a large spontaneous leakage, the pressure wave propagates throughout the entire network. Each sensor within the network is reached at a different time point due to its position. This allows a leakage localization. In this paper, a framework published previously was extended to deal with noise. Leakage attribution to exclusion areas is calculated based on pressure drop time points extracted from measurement data. A performance criterion is used to evaluate how well leakage localization is working. The framework can be used for optimal sensor placement and for the investigation of noise. Optimal sensor placement for up to five sensors in a network with 90 km trench length is calculated with a high performance criterion. Further, the influence of noise of the pressure drop time points is investigated. To this end, the extent of noise on the pressure drop time points determined from real measurement data of ten real events was examined. Acceptable noise levels, which allow sufficient leakage localization quality, are evaluated for different numbers of optimal placed sensors. The results are presented and further improvements are discussed.

Modern approaches to the diagnosis and treatment of spontaneous intracranial hypotension (a literature review)

The aim of this review is to analyze and summarize the existing evidence regarding the diagnosis and treatment of spontaneous intracranial hypotension. Spontaneous intracranial hypotension occurs due to a decrease in cerebrospinal fluid (CSF) volume as a result of its spontaneous leakage and has a variety of clinical and neuroimaging features, sometimes different from CSF hypotension after a lumbar puncture. Anatomical changes in spontaneous CSF leakage are complex and are often associated with structural disorders of the connective tissue, weakness of certain areas of the dura mater and its diverticulosis. One consequence of decreased CSF volume is brain descent. This leads to traction of pain-sensitive brain structures and, therefore, to headaches that are orthostatic or with some orthostatic features. The methods of choice to identify the site of CSF leak are CT-myelography and radioisotope cisternography. Epidural blood patch is the main treatment in most cases. Conclusions. The study on the most informative and minimally invasive methods to locate the site of CSF leak, conservative and surgical methods of treatment efficacy evaluation depending on the etiological factors of spontaneous intracranial hypotension are extremely important and promising scientific fields requiring further research with the development of personalized approaches considering the individual characteristics of each patient.

Magnetic memory detection of corroded reinforced concrete considering the influence of tensile load

Both corrosion defects and stress can cause magnetic field mutations, so the effect of stress must be considered in the magnetic detection of steel corrosion. This paper focuses on exploring the influence law of tension on magnetic signals of the corroded specimens. Based on the spontaneous magnetic leakage mechanism of steel bar corrosion and the stress magnetization model, the magnetic memory detection of corroded reinforced concrete under tension was carried out. The magnetic characteristics of corroded specimens before and after loading were analyzed. The corrosion positions of the specimens can be determined according to the representative mutation points (RMP) of the B yc(0) curves, and the magnetic index I 2 was proposed to roughly determine the corrosion degree of the specimens when the specimens were not subjected to tensions. The experimental results showed that the RMP of B yc( F) curves can still represent corrosion positions when the specimens were under tension. The theoretical derivation showed that the magnetic field change caused by tensile force is limited, and the maximum value of the magnetic field change caused by tensile force can be obtained. Based on this, the corresponding I 3- F curves were obtained through the test. The magnetic field change caused by the most unfavorable tensions was calculated to analyze its influence on corrosion magnetic detection. Compared with I 2, the relationship between I 3 and the corrosion degree was more discrete, indicating that tensile forces affected the quantitative detection of corrosion. Still, the magnetic field caused by corrosion played a leading role. The verification showed that the measured corrosion positions of reinforced concrete specimens were in good agreement with those detected by the magnetic memory method.

A Secretory Vesicle Failure in Parkinson's Disease Occurs in Human Platelets.

ObjectiveThe presence of elevated dopamine (DA) and its major metabolites in the cytosol of neurons has been associated with their vulnerability in Parkinson's disease (PD). Over 99% of the cell's amines are confined to secretory vesicles (SVs), making these structures fundamental in the regulation of cytosolic DA levels. SVs of platelets use similar, if not the same mechanisms to accumulate serotonin in SVs as dopaminergic neurons do to store DA. Hence, any functional defects in platelets probably mirrors events in DA neurons.MethodsWe have isolated fresh platelets from the blood of 75 PD patients, 116 matched controls and 24 patients with Parkinsonism, assaying serotonin handling (basal content, accumulation, secretion and spontaneous leakage).ResultsWe found a dramatic decrease in the serotonin content and uptake by SVs, as well as decreased thrombin‐induced release by platelets from PD patients but not in those from most Parkinsonism cases. Platelets from PD patients also failed to retain serotonin in SVs.InterpretationThese findings indicate a functional impairment in the handling of amines by SVs in PD patients. This defect may serve as a biomarker of PD, and the approach described here may be potentially used for the subclinical detection of PD and to establish a platform to assay disease modifying drugs. ANN NEUROL 2022

Downstream resource leakage a necessary condition for the stress-gradient hypothesis in processing chain commensalisms

The stress-gradient hypothesis (SGH) in ecology predicts that the strength and frequency of positive interspecific interactions, including processing chain commensalisms (PCCs), increase with environmental stress. Although observed in some empirical PCC studies, a recent theoretical study of PCCs using a consumer–resource-type model found that, given the model’s assumptions, the SGH never occurs. To investigate if this is a true reflection of PCCs or merely an artefact of the model, in this study, we modified this earlier model formulation by incorporating generalized, monotonically increasing resource uptake functions in place of linear functions, and added a term to represent the spontaneous leakage of the downstream resource to the environment. Mathematical analyses of the model revealed two key insights: 1) the specific algebraic forms of the functional responses of the species in a PCC do not affect the long-term behaviour of the system; 2) the SGH can occur in a facilitative interaction only if the consumer-independent leakage rate of the downstream resource exceeds the consumer-independent input rate. The first insight shows that the outcomes of consumer–resource interactions are robust to details of the functional responses when the functional responses are monotonically increasing, while the second insight shows that the SGH is not a universal feature of positive interactions but instead holds only under a well-defined set of conditions which may vary between PCC interactions and the environmental contexts in which they take place.

Fetal-Maternal Complications due to Premature Rupture of Membranes: A Prospective Study at Valley’s Famous Maternity Hospital

Background: The fetal membrane remains intact till the labor starts in order to maintain the protective intrauterine fluid environment. However, sometimes membranes ruptures prematurely (PROM), a condition in which the disruption of fetal membranes takes place before the beginning of labor that ultimately results in spontaneous leakage of amniotic fluid. The present study is aimed to evaluate the feto-maternal outcomes due to premature rupture of membranes at term. Methods: A total 70 pregnant women patients with premature rupture of membranes after 37 completed weeks were selected in the study after they properly signed the consent form. Gestational age was confirmed from LMP, clinically, and radiologically. Cervical dilatation of <3 cms, Lack of uterine contractions for at least 1 hour from PROM, Single live pregnancy in vertex presentation and PROM confirmed by Direct visualization or Litmus. Results: Febrile illness as maternal outcome was found in 18.6% patients followed by wound infection in 4.3%. Rest of the patients had pph (2.9%), UTI (1.4%) and sepsis (2.9) as maternal outcome. Perinatal outcome was assessed among the studied patients and it was found that (17.1%) had birth asphyxia followed by (5.7%) patients with septicemia perinatal outcome. Only (2.9%) patients had death as perinatal outcome. Conclusion: The present study revealed that PPROM is undoubtedly associated with a prenatal morbidity and mortality. However, early diagnosis and timely management is must in order to reduce the associated complications due to PROM. Keywords: Premature rupture of membrane, perinatal complications, gestational age.

The Polar Lipid Fraction E from Sulfolobus acidocaldarius Can Be Used as Liposomal Drug Stabilizing Agents to Reduce the Leakage of the Antivascular Drug Combretastatin A4 Disodium Phosphate from Tetraether/Diester Hybrid Archaeosomes

Liposomes have many advantages as therapeutic capsules over free drugs such as small molecule drugs and nucleic acids. Cholesterol is commonly used as a membrane stabilizing agent in liposomal drugs (e.g., mRNA-lipid nanoparticle COVID-19 vaccines). However, due to the vulnerability of cholesterol to oxidation and the etiological role of cholesterol in many disorders, it is desirable to find an alternative means to stabilize liposomal membranes for drug delivery. In this study, we demonstrated that the polar lipid fraction E (PLFE), which contains exclusively bipolar tetraether macrocyclic lipids, isolated from the thermoacidophilic archaeon S. acidocaldarius can greatly stabilize the liposomal formulation of the anti-vascular drug, combretastatin A4 disodium phosphate (CA4P). Stability was assessed by determining the leakage rate constant k of entrapped CA4P fluorometrically. We found that, at 37 °C, PLFE decreases the k value monotonically from 1.54 × 10−2 s−1 for 100% 1-palmitoyl-2-oleoyl-glycero-3-phosphocholine (POPC) liposomes to 3.4 × 10−5 s−1 for 100% PLFE archaeosomes, a change of k by two orders of magnitude. The changes in k of CA4P leakage are correlated well with the changes in liposomal CA4P’s cytotoxicity against MCF-7 breast cancer cells. We further showed that the reduction in spontaneous leakage of entrapped CA4P by PLFE can be attributed to the increased membrane surface charge and the increased membrane order and packing tightness in liposomes, as reflected by the zeta potential (−6.83 to −41.1 mV from 0 to 100 mol% PLFE) and diphenylhexatriene (DPH) fluorescence polarization (0.13 to 0.4 from 0 to 100 mol% PLFE) measurements. Moreover, we showed that PLFE slows down CA4P leakage more than cholesterol in POPC liposomes. These results together suggest that PLFE lipids can serve as an effective stabilizing agent for liposomal drugs and could potentially be useful for the optimization of liposomal CA4P for cancer treatment.

Optimal Sensor Placement for Pressure Wave Detection for Leakage Localization in a District Heating Network

The occurrence of a large spontaneous leakage in a district heating network leads to a pressure wave through the entire network. For safe operation, it is necessary to determine the leakage location and to exclude the affected network part. For optimal evaluation of the pressure wave, pressure sensors must be placed in the network to provide high-quality data. Already installed sensors can be used, but improved transmission technology is needed. For practical application, as few sensors as possible should have to be equipped accordingly. This paper addresses the questions of how many sensors are needed and where they need to be placed for a given network. In a joint research project, a method was developed that allows the evaluation of the pressure wave even with noisy input data. The method used for pressure wave evaluation works in two stages. In the first stage, the pressure drop times are determined from the measurement data. In the second stage, these times are compared with test leakages, for which corresponding pressure drop times are calculated. The second stage provides the test leakage locations at which the leakage can probably be localized. For the placement evaluation, all possible leakages should be included and compared with all test leakages. This paper shows how the resulting large amount of data is consolidated to achieve a suitable metric for the quality of the placement. This procedure is used for the optimal positioning of the sensors and the network is currently equipped accordingly. From the calculations, results for different positioning and with different numbers of sensors are shown. Additionally, it is addressed that some positions in the network might be unsuitable due to unfavorable superposition of traversing waves and resulting difficulties to detect the pressure drop time points. Exemplarily simulation results and measurement data are shown.

Treatment Options and Outcome of Premature Rupture of Membranes at Zagazig University Hospitals

Background: PROM premature rupture of membrane is defined as a spontaneous leakage of amniotic fluid from the amniotic sac before onset of labor. Objecitve: The aim of this work was to verify better management and improve outcome of PROM cases. Patients and Methods: A prospective cohort study was conducted at High Risk Pregnancy Room, Emergency Hospital Obstetrics and Gynecology Department, Faculty of Medicine, Zagazig University. It included 80 women with PROM. The study was between August 2019 and March 2020. All patients were subjected to detailed history taking, general, obstetric examination, and laboratory Investigations. Results: The gestational age at labor was 35.6 weeks compared to gestational age at PROM, which was 34.3 weeks; the difference was statistically significant, mean increase of gestational age was 1.27 weeks. The incidence of postpartum complication was 1.25% of mothers in the form of chorioamnionitis. Conclusions: that conservative procedures like antibiotics, corticosteroids, tocolytics and magnesium sulphate could prolong latency period, improves the fetomaternal outcome and decreases the need for incubators.

OSA: Special suspected in spontaneous cerebrospinal fluid leakage

Objectives: Loss of Cerebrospinal Fluid (CSF-L) results from a rupture of the skull base and overlying meninges, and pathological communication between the subarachnoid space and the nasal or middle ear cavity. Recently, the pathogenesis has been linked with Intracranial Hypertension (IIH), elevated Body Mass Index (BMI) and Obstructive Sleep Apnea (OSA). Methods: A single institution retrospective study was conducted on 14 patients from our spontaneous CSFL series, which included 167 patients over a 15-year period from 2004 to 2019. All patients underwent to home respiratory polygraphy. Epidemiological and clinical data were reviewed. For the statistical analysis, the confidence interval for a proportion was defined, according to the methods described by RG Newcombe. Results: 14 patients, previously operated on duraplasty in our ENT department, were enrolled. They underwent to polygraphy. The data were compared with those derived from the literature and the results are neither in the range of the general population nor in the non-spontaneous CSFL Conclusion: OSA can increase Intracranial Pressure (ICP) and thus spontaneous CSF losses. However, OSA and BMI may not be independent. Therefore, further studies are needed to analyze the data in detail.