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Abstract Background An aorto-caval fistula is a rare but critical complication of abdominal aortic aneurysm (AAA) rupture, leading to high-output heart failure and increased venous pressure. The anesthetic management of such cases, particularly when complicated by an intraoperative right-to-left shunt, is seldom reported. Case presentation A 71-year-old man with a history of atrial fibrillation and catheter ablation presented with heart failure and abdominal pain, leading to cardiac arrest. Imaging revealed an AAA rupture into the inferior vena cava. During emergency surgery, severe venous bleeding was managed using intra-aortic balloon occlusion (IABO). Transesophageal echocardiography (TEE) identified a right-to-left shunt due to an iatrogenic atrial septal defect. Conclusion Early TEE recognition and timely IABO intervention were crucial in managing this complex case, underscoring the importance of these techniques in similar emergency scenarios.

Abstract Recently, patients with out-of-hospital cardiac arrest (OHCA) refractory to conventional resuscitation have started undergoing extracorporeal cardiopulmonary resuscitation (ECPR). However, the mortality rate of these patients remains high. This study aimed to clarify whether a center ECPR volume was associated with the survival rates of adult patients with OHCA resuscitated using ECPR. This was a secondary analysis of a retrospective multicenter registry study, the SAVE-J II study, involving 36 participating institutions in Japan. Centers were divided into three groups according to the tertiles of the annual average number of patients undergoing ECPR: high-volume (≥ 21 sessions per year), medium-volume (11–20 sessions per year), or low-volume (

Background Risk stratification is important in patients with post–cardiac arrest syndrome. The Post‐Cardiac Arrest Syndrome for Therapeutic Hypothermia (CAST) and revised CAST (rCAST) scores have been well validated for predicting neurological outcomes, particularly for conventionally resuscitated patients with post–cardiac arrest syndrome. However, no studies have evaluated patients undergoing extracorporeal cardiopulmonary resuscitation. Methods and Results Adult patients with out‐of‐hospital cardiac arrest who underwent extracorporeal cardiopulmonary resuscitation were analyzed in this retrospective observational multicenter cohort study. We validated the accuracy of the CAST/rCAST scores for predicting neurological outcomes at 30 days. Moreover, we compared the predictive performance of these scores with the TiPS65 risk score derived from patients with out‐of‐hospital cardiac arrest who were resuscitated using extracorporeal cardiopulmonary resuscitation. A total of 1135 patients were analyzed. The proportion of patients with favorable neurological outcomes was 16.6%. In the external validation, the area under the receiver operating characteristic curve of the CAST score was significantly higher than that of the rCAST score (area under the receiver operating characteristic curve 0.677 versus 0.603; P

Abstract We study SU(2) gauge theories coupled to (A 1 , D N ) theories with or without a fundamental hypermultiplet. For even N, a formula for the contribution of (A 1 , D N ) to the Nekrasov partition function was recently obtained by us with Y. Sugawara and T. Uetoko. In this paper, we generalize it to the case of odd N in the classical limit, under the condition that the relevant couplings and vacuum expectation values of Coulomb branch operators of (A 1 , D N ) are all turned off. We apply our formula to the (A 2 , A 5) theory to find that its prepotential is related to that of the SU(2) gauge theory with four fundamental flavors by a simple change of variables.

Abstract An aspartate:alanine antiporter (AspT) from the lactic acid bacterium Tetragenococcus halophilus catalyzes the electrogenic aspartate1-:alanine0 exchange reaction. Our previous kinetic analyses of transport reactions mediated by AspT in reconstituted liposomes suggested that, although the substrate transport reactions are physiologically coupled, the putative binding sites of l-aspartate (-Asp) and l-alanine (-Ala) are independently located on AspT. By using the fluorescent probe Oregon Green maleimide (OGM), which reacts specifically with cysteine, we also found that the presence of l-Asp changes the conformation of AspT. In this study, we conducted an OGM labeling assay in the presence of l-Ala. The labeling efficiency of single cysteine mutants (G62C and P79C) in transmembrane helix 3 of the AspT showed novel patterns depending on the presence of l-Ala or analogs. A concentration-dependent shift of AspT from the conformation in the presence of one substrate to that specific to the substrate added subsequently (l-Ala or l-Asp) was observed. Moreover, size-exclusion-chromatography-based thermostability assays indicated that the thermal stability of AspT in the presence of l-Ala differed from that in the presence of l-Asp. From these results, we concluded that l-Ala binding yields a conformation different from the apo or l-Asp binding conformations.

Abstract Background Testicular torsion (TT) is common surgical emergency that requires early diagnosis and immediate intervention within 6 h since its onset to salvage the testis. However, the decision was made only by the surgeon’s experience whether it has to be resected or not. Recently, indocyanine green (ICG) has become an excellent tool to identify biliary and vascular anatomy, and assess perfusion abnormalities in tissues. In this case report, we successfully salvaged the twisted testis, since the testicular blood perfusion was confirmed by means of intraoperative ICG (IICG) fluorescence imaging. Case presentation A 14-year-old healthy male patient presented due to acute left testicular pain. The patient was diagnosed with TT and had immediate surgery. Macroscopically, the testis had stagnant blood flow and appeared to be dark colored. After manual detorsion, the testis remained cyanotic and with macroscopically poor blood flow. ICG angiography was performed under near-infrared light by laparoscopic camera to assess the perfusion of the affected testicle. An excellent ICG signal appeared after 45 s in the testis, and decision was made to be preserved. Therefore, left orchidopexy was performed to complete the operation. The patient had a good postoperative course and was discharged the day after surgery. Six months later, the testis did not show any shrinkage, and both sides of the testis showed the same size without any consequences. Conclusion The blood flow in the testis was visually confirmed during the IICG fluorescence method. ICG fluorescence imaging may become an effective alternative to evaluate whether a testis can be preserved following TT.

All-solid-state batteries (ASSBs) have attracted significant attention as alternatives to Li-ion batteries. In ASSBs, solid electrolytes (SEs) play a key role. While many halide Li-ion conductors have been reported, only a few Na-ion conductors have been reported. In this study, a new phase of Na3InCl6 with a cryolite-type monoclinic structure was prepared using a mechanochemical method. The new phase showed higher conductivity than the previously reported trigonal Na3InCl6 and underwent a phase transition to trigonal phase when heat-treated at 90 °C. A Zr-substituted system of Na3−xIn1−xZrxCl6 was mechanochemically prepared. The obtained solid solutions with monoclinic structures based on Na3InCl6 were formed in the compositions of x = 0.1–0.9. The Rietveld refinement results showed a decrease in Na occupancy at the octahedral sites and slight change at the prismatic sites. Bond valence sum mapping results showed that Na ions diffused alternately through two types of sites, suggesting that the introduction of Na vacancies at either site had a positive effect on Na-ion conduction. The ionic conductivity increased to approximately 10−5 S cm−1 with an increase in the number of Na vacancies when x was greater than 0.6. This report describes one of the few Na-ion conducting chlorides with high conductivity.

Abstract We propose a Nekrasov-type formula for the instanton partition functions of four-dimensional N $$ \mathcal{N} $$ = 2 U(2) gauge theories coupled to (A 1 , D 2n ) Argyres-Douglas theories. This is carried out by extending the generalized AGT correspondence to the case of U(2) gauge group, which requires us to define irregular states of the direct sum of Virasoro and Heisenberg algebras. Using our formula, one can evaluate the contribution of the (A 1 , D 2n ) theory at each fixed point on the U(2) instanton moduli space. As an application, we evaluate the instanton partition function of the (A 3 , A 3) theory to find it in a peculiar relation to that of SU(2) gauge theory with four fundamental flavors. From this relation, we read off how the S-duality group acts on the UV gauge coupling of the (A 3 , A 3) theory.

Development of oxide solid electrolytes for all-solid-state batteries is attracting increasing attention. In this study, amorphous Li2O–LiI materials are prepared via a mechanochemical process to achieve high lithium ionic conductivity and good compatibility to lithium metal. Amorphous 66.7Li2O·33.3LiI (mol%) electrolyte shows a high ionic conductivity of 3.1 × 10−5 S cm−1 at 25 °C with a relative density of 96 %. An all-solid-state Li symmetric cell (Li/66.7Li2O·33.3LiI/Li) operates without an increase in overvoltage. A simple combination of lithium oxide and lithium iodide exhibits high ionic conductivity, ductility, and stability to lithium metal.

Case 1 describe a 73-year-old man with an abnormal opacity in the upper lobe of the right lung on chest computed tomography (CT), which was done during the postoperative follow-up for bile duct cancer. The chest CT scan showed a ground glass nodule (GGN) measuring 1.0 cm and another one measuring 0.6 cm of the right lung. Case 2 involved a 79-year-old woman with an abnormal opacity in the upper lobe of the right lung on a chest CT that was obtained after she fell down the stairs. The CT scan showed a solid mass measuring 3.0 cm in the right upper lung. Both the patients underwent bronchoscopy before surgery and showed bronchial branching abnormalities. The surgical procedures could be performed accurately since sufficient information had been acquired pre-operatively and they diagnosed lung cancer. Both the patients were able to undergo radical surgery for lung cancer and are currently doing well with no postoperative complications or recurrence of lung cancer.

The development of solid electrolytes is necessary for practical applications of all-solid-state Na-ion batteries. In this study, we systematically developed sulfide Na-ion conductors with central In cations, prepared by solid-state reaction and mechanochemical methods. Thermodynamically stable crystals of Na5InS4 and NaInS2 were obtained by the solid-state reaction method, whereas amorphous and/or metastable phases were produced by the mechanochemical method. Two new metastable phases, Na5InS4 and NaInS2, are expected to be examined in the future as end-members of sulfide Na-ion conductors with central In cations.

Liver resident macrophages designated Kupffer cells (KCs) form the largest subpopulation of tissue macrophages. KCs are involved in the pathogenesis of liver inflammation. However, the role of KCs in the systemic inflammation is still elusive. In this study, we examined whether KCs are involved in not only intrahepatic inflammation but also extrahepatic systemic inflammation. Administration of clodronate liposomes resulted in the KC deletion and in the suppression of liver injury in T cell-mediated hepatitis by ConA as a local acute inflammation model, while the treatment did not influence dextran sulfate sodium- (DSS-) induced colitis featured by weight loss, intestinal shrink, and pathological observation as an ectopic local acute inflammation model. In contrast, KC deletion inhibited collagen-induced arthritis as a model of extrahepatic, systemic chronical inflammation. KC deleted mice showed weaker arthritic scores, less joint swelling, and more joint space compared to arthritis-induced control mice. These results strongly suggest that KCs are involved in not only intrahepatic inflammatory response but also systemic (especially) chronic inflammation.

Large-conductance Ca2+-activated K+ (BK) channel regulates action potential firing in pancreatic β-cells. We cloned novel spliced variants of the BK-channel β2-subunit (BKβ2b), which consisted of 36 amino acids including the N-terminal in the original human BKβ2 (BKβ2a), from human and rodent pancreas. Real-time PCR analysis showed the abundant expression of BKβ2b transcripts in human and rodent pancreas and also in the RINm5f insulinoma cell line. In addition, up-regulation of both BK-channel α-subunit (BKα) and BKβ2b transcripts was observed in pancreas tissues from diabetes mellitus patients. In HEK293 cells co-expressing BKα and BKβ2b, the inactivation of BK-channel currents, which is typical for BKα + BKβ2a, was not observed, and electrophysiological and pharmacological properties of BKα + BKβ2b were almost identical to those of BKα alone. In HEK293 cells stably expressing BKα, the transient co-expression of yellow fluorescence protein (YFP)-tagged BKβ2a proteins resulted in their distribution along the cell membrane. In contrast, the co-expression of YFP-tagged BKβ2b with BKα showed diffusely distributed fluorescence signals throughout the cell body. Taken together, the predominant splicing of BKβ2b versus that of BKβ2a presumably enhances the contribution of BK channels to membrane potential and may possibly be a factor modulating insulin secretion in a suppressive manner in pancreatic β-cells. Keywords:: Ca2+-activated K+ channel, β2-subunit, spliced variant, pancreatic islet β-cell, diabetes mellitus