The role of mitochondrial complex I in ultraweak photon-induced delayed photon emission [delayed luminescence (DL)] of human leukemia Jurkat T cells was probed by using complex I targeting agents like rotenone, menadione, and quercetin. Rotenone, a complex I-specific inhibitor, dose-dependently increased the mitochondrial level of reduced nicotinamide adenine dinucleotide (NADH), decreased clonogenic survival, and induced apoptosis. A strong correlation was found between the mitochondrial levels of NADH and oxidized flavin mononucleotide (FMNox) in rotenone-, menadione- and quercetin-treated cells. Rotenone enhanced DL dose-dependently, whereas quercetin and menadione inhibited DL as well as NADH or FMNox. Collectively, the data suggest that DL of Jurkat cells originates mainly from mitochondrial complex I, which functions predominantly as a dimer and less frequently as a tetramer. In individual monomers, both pairs of pyridine nucleotide (NADH/reduced nicotinamide adenine dinucleotide phosphate) sites and flavin (FMN-a/FMN-b) sites appear to bind cooperatively their specific ligands. Enhancement of delayed red-light emission by rotenone suggests that the mean time for one-electron reduction of ubiquinone or FMN-a by the terminal Fe/S center (N2) is 20 or 284 μs, respectively. All these findings suggest that DL spectroscopy could be used as a reliable, sensitive, and robust technique to probe electron flow within complex I in situ.

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Gossypiboma” – retained foreign object (more frequently a surgical sponge) – is a rare complication of a surgical intervention, usually during an emergency or a time-consuming procedure. The clinical features include nonspecific general and digestive symptoms. Due to the surrounding inflammatory reaction, it leads to the formation of tumoral masses or fistulas, making the differential diagnosis even more difficult. We present the case of a 60-year-old woman with a history of diabetes, arterial hypertension and multiple surgical procedures of the upper abdomen, who was admitted for altered general state and a pain in the right upper and lower quadrant, where an abdominal mass that covered the skin and the right costal margin was found, mild fever and anemia. The MRI raises the suspicion of a sarcoma. The first surgical procedure (June 2014) uncovers a pus-filled collection which was drained resulting a fistula with a continuous secretion (the Pathology report suggested Actinomycosis). The patient received multiple antibiotics, without an improvement. In January 2015, a CT exam revealed a possible retained foreign object situated deeply in the hepatorenal recess. The patient had undergone surgery, through the peritoneal cavity, thus confirming the diagnosis, with the excision of the surgical sponge. The patient had a favorable postoperative course with the closure of the fistula. Even though the diagnosis of a retained foreign object may prove difficult, it needs to be taken into consideration for the differential diagnosis of any postoperative case presenting an abdominal mass, with inflammatory reaction and chronic post-excisional fistula.

Objectives To analyze the midterm results of aortic root replacement using the valved, all biological, No React®, BioConduit™. Methods From 2017 to 2020, we prospectively followed 91 consecutive patients who underwent a Bentall procedure with a BioConduit™ valved graft in our institution. The primary outcomes were aortic bioprosthetic valve dysfunction and mortality according to Valve Academic Research Consortium 3 (VARC3). Results Mean age was 70 ± 10 years and 67 patients (74%) were men. Ascending aortic aneurysm (72%), aortic valve regurgitation (51%) or stenosis (20%) and acute endocarditis (14%) were the main indications for surgery. Seventy-four patients (81.3%) were followed up at 1 year. The perioperative mortality was 8% (n = 8), the early, 1 year, mortality was 2% (n = 2) and the midterm mortality, at 4 years of follow up, was 4% (n = 3). Ten patients fulfilled the criteria for hemodynamic valve deterioration at 1 year (13%) and 14 for a bioprosthetic valve failure during the entire follow-up (17%). Conclusions We are reporting early and midterm results of Bentall procedures with the all-biological, valved, No-React® BioConduit™. To our knowledge, this is the first study reporting an early and midterm unexpectedly high rate of non-structural prosthetic hemodynamic deterioration. The rate of endocarditis and atrioventricular disconnections remain similar to previous studies.