Candida Arthritis after Arthroscopic Arthroplasty in a Patient without Predisposing Factors

Because candidiasis is usually associated with immunosuppression, candida arthritis in an immunocompetent patient is rare. The symptoms of candidiasis are similar to bacterial infections, tuberculosis, and autoimmune diseases. In our patient with no predisposing factors, candida arthritis was initially excluded because the probability of occurrence was low. The patient had no leukocytosis, the acid-fast bacteria (AFB) stain was negative, and the autoimmune antibody screen was negative. After Candida parapsilosis was cultured in the synovial fluid, the patient was treated with amphotericin B (0.7 mg/kg/day) and oral fluconazole (400 mg/day). The treatment was successful and there were no side effects of the medications

In situ X-ray based analysis of anode materials for lithium-ion batteries: Current status and future implications

The past several decades witnessed a significant advance in the X-ray based analytical devices, which were employed in various applications ranging from airport security to material analysis. Particularly, since the early 1990s, much work has been devoted to employ various kinds of real time (in situ) X-ray based analytical tools such as in situ X-ray diffractometers (XRD), in situ X-ray absorption spectroscopy, and in situ X-ray tomography to understand the redox reactions within the lithium-ion batteries. Amongst components in the lithium-ion batteries, anode materials play an important role in that they are responsible for Li+ storage during the charging process. Reaction mechanisms of graphite, Si, and many other prospective anode materials have been elucidated by various in situ X-ray analytical tools but none of the comprehensive summary and evaluation on the current status of the research and future directions on employing in situ X-ray based analysis for further investigating these anode materials are presented up to this point. In this review, we have examined and highlighted our focus on X-ray based analysis that was used to probe the reaction pathway of various anode materials used for lithium-ion batteries, which provides a milestone and comprehensive understanding for reaction mechanism of anode materials in lithium-ion batteries using in situ X-ray methods

WAVE INTERACTION WITH INJECTOR FLOWFIELD IN ROTATING DETONATION ENGINE

Rotating Detonation Engines (RDE) utilize detonative combustion processes for heat release instead of deflagration, which is more commonly used in conventional combustors. Potential benefits of RDE include pressure gain combustion, efficient energy conversion, and simpler designs that avoid combustion instability problems due to their cyclic nature of operation. It has been observed, however, that RDE operation can become unsteady due to the onset of counter-rotating detonation waves. In addition, the random presence of residual liquid fuel droplets and their unexpected breakup could also affect the periodic operation of RDE. This study aims to better understand the physical mechanisms that destabilize the RDE’s periodic processes and lead to unsteady operation. Specifically, the investigation focuses on understanding physical mechanisms associated with two key off-design scenarios: (i) the onset of counter-rotating detonation waves and their impact on next cycle fuel injection, and (ii) the breakup of liquid fuel droplets by detonation wave and decoupled detonation wave which consists of shock and flame fronts. Experiments using either hydrogen-oxygen or ethylene-oxygen detonation in linear channel simulate an unwrapped RDE combustor process. For the counter-rotating wave study, detonation waves are initiated from both ends of the channel, and complex recovery behavior associated with colliding detonation waves is examined providing insights into RDE slapping mode operation. For the fuel droplet breakup study, 2-mm diameter ethanol and JP-8 droplets are placed on the downstream path of detonation waves and decoupled shock-flame fronts, which propagate at average wave speeds of Mach 7.3, 3.6, and 2.6, respectively. Liquid droplets break up faster when exposed to slower decoupled shock-flame waves compared to faster detonation waves. This unexpected difference is attributed to the initial slip flow Mach number around the droplet, which is subsonic for detonation waves but supersonic for decoupled waves. Research findings suggest that the slip flow Mach number, along with the Weber number, plays a crucial role in RDE fuel droplet breakup

Is It Really Safe to Discontinue Anticoagulant Treatment Before Ptosis Surgery From Serious Bleeding?

Abstract The study aimed to evaluate the surgical effect of discontinuing anticoagulants preoperatively in patients with blepharoptosis. Patients were classified into two groups depending on anticoagulant treatment or otherwise. All patients taking anticoagulant discontinued with the treatment one week prior to surgery in accordance with our clinical guidelines. Preoperative and postoperative marginal reflex distance 1(MRD1) and ecchymosis grade were compared.Group 1 (anticoagulant treatment cessation) included 93 eyelids, and group 2 (control) included 98 eyelids. The preoperative MRD1 showed no significant difference between groups. Group 1 showed a significantly higher rate of severe ecchymosis (41.8 vs. 22.4%, p = 0.004) at 1 week of surgery as well as 'persistent ecchymosis (58.8 vs. 7.3%, p=0.000) postoperatively at 1 month. Postoperative MRD1 was significantly lower in group 1 at 1 week (p=0.019). However, the MRD1 and degree of improvement in lid height was not significantly different between the two groups (p = 0.499, p = 0.058) at 1 month postoperatively.</jats:p

Intraoperative use of fibrin glue in blepharoplasty: a possible solution to reduce postoperative complication

Abstract The purpose of this study was to investigate the effects of intraoperative fibrin glue use on surgery for blepharoptosis. This retrospective study included patients with acquired blepharoptosis who underwent surgical correction and were followed for at least one month. Patients were classified into two groups depending on whether treated with antithrombotic agents or otherwise. All patients taking antithrombotic agents discontinued with the treatment one week prior to surgery in accordance with our clinical guidelines. Preoperative and postoperative marginal reflex distance 1(MRD1) and ecchymosis grade were evaluated and compared. The subjects were 56 patients (111 eyes) who discontinued antithrombotic agents before surgery and 59 patients (117 eyes) who had never taken antithrombotic agents. Fibrin glue was used in 13 patients (26 eyes, 23.4%) in the antithrombotic group, and 11 patients (21 eyes, 17.9%) in the non-antithrombotic group. The rate of severe ecchymosis was significantly lower in patients who used fibrin glue in the antithrombotic group at 1 week (11.5 vs 40.0%, p = 0.008). However, in non-antithrombotic group, there was no difference in the rate of severe ecchymosis according to the use of fibrin glue at 1 week (14.3 vs 30.2%, p = 0.181). In patients with a history of taking antithrombotic agents, the intraoperative use of fibrin glue is thought to be helpful as it could significantly reduce significant ecchymosis