IMPORTANCE There are limited data from randomized clinical trials comparing propranolol and steroid medication for treatment of infantile hemangioma (IH). OBJECTIVE To determine the efficacy and safety of propranolol compared with steroid as a first-line treatment for IH. DESIGN, SETTING, AND PARTICIPANTS This randomized clinical noninferiority trial tested the efficacy and safety of propranolol vs steroid treatment for IH at a single academic hospital. All participants were diagnosed with IH between June 2013 and October 2014, had normal heart function, and had not been previously treated for IH. INTERVENTIONS The participants were randomly assigned to either the propranolol group or the steroid group. In the propranolol group, the patients were admitted, observed for adverse effects for 3 days after treatment initiation, and then released and treated as outpatients for 16 weeks (2 mg/kg/d). In the steroid group, the patients were seen as outpatients from the beginning and were also treated for 16 weeks (2 mg/kg/d). MAIN OUTCOMES AND MEASURES The primary efficacy variable was the response to treatment at 16 weeks, which was evaluated by the hemangioma volume using magnetic resonance imaging before and at 16 weeks after treatment initiation. While comparing the effect of medication between the groups, we monitored the adverse effects of both drugs. RESULTS A total of 34 patients (15 boys, 19 girls; mean age, 3.3 months; range, 0.3-8.2 months) were randomized to receive either propranolol or steroid treatment (17 in each treatment group). Guardians for 2 patients in the steroid group withdrew their consent, and 1 patient in the propranolol group did not complete the efficacy test. The intention-to-treat analysis, applying multiple imputations, found the treatment response rate in the propranolol group to be 95.65%, and that of the steroid group was 91.94%. Because the difference in response rate between the groups was 3.71%, propranolol was considered noninferior. We found that there was no difference between the groups in safety outcomes. CONCLUSIONS AND RELEVANCE Our trial demonstrated that propranolol was not inferior to steroid with respect to therapeutic effects in IH. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01908972

With the development of microelectronic devices having miniaturized and integrated electronic components, an efficient thermal management system with lightweight materials, which have outstanding thermal conductivity and processability, is becoming increasingly important. Recently, the use of polymer-based thermal management systems has attracted much interest due to the intrinsic excellent properties of the polymer, such as the high flexibility, low cost, electrical insulation, and excellent processability. However, most polymers possess low thermal conductivity, which limits the thermal management applications of them. To address the low thermal conduction of the polymer materials, many kinds of thermally conductive fillers have been studied, and the carbon-based polymer composite is regarded as one of the most promising materials for the thermal management of the electric and electronic devices. In addition, the next generation electronic devices require composite materials with various additional functions such as flexibility, low density, electrical insulation, and oriented heat conduction, as well as ultrahigh thermal conductivity. In this review, we introduce the latest papers on thermally conductive polymer composites based on carbon fillers with sophisticated structures to meet the above requirements. The topic of this review paper consists of the following four contents. First, we introduce the design of a continuous three-dimensional network structure of carbon fillers to reduce the thermal resistance between the filler–matrix interface and individual filler particles. Second, we discuss various methods of suppressing the electrical conductivity of carbon fillers in order to manufacture the polymer composites that meet both the electrical insulation and thermal conductivity. Third, we describe a strategy for the vertical alignment of carbon fillers to improve the through-plane thermal conductivity of the polymer composite. Finally, we briefly mention the durability of the thermal conductivity performance of the carbon-based composites. This review presents key technologies for a thermal management system of next-generation electronic devices.

In the current study, a polydiacetylene (PDA)-based sensor, derived from a chelidamic acid-picolylamine (CP)-substituted diacetylene monomer, displayed a selective colorimetric and fluorometric change in the presence of cadmium (Cd 2 + ) at pH 7.4. The PDAÀ CP solutions showed a colorimetric change from blue to violet in response to various amounts of Cd 2 + . The chemosensor also showed a rapid fluorescence turn-on response and significant selectivity to Cd 2 + compared with other metallic cations. The Cd 2 + -selective PDA-based sensor system facilitated the visual detection of Cd 2 + in aqueous solution. The Cd 2 + detection limit of PDAÀ CP was reduced to 1.85 × 10 À 5 M.

The optimal compression position in patients with a single ventricle is approximately 5-25% of the lower sternum. The optimal compression level for patients with a single ventricle is lower than that suggested in current guidelines for the normal population.

BACKGROUND: Manual inline stabilization of the head and neck is a recommended maneuver for tracheal intubation in patients with a suspected cervical injury. However, because applying this maneuver inevitably restricts neck flexion and head extension, indirect intubating devices such as a videolaryngoscope or a video stylet could be required for successful tracheal intubation. In this study, we compared the clinical performance of the McGrath MAC videolaryngoscope versus the Optiscope video stylet in patients with manual inline cervical stabilization during tracheal intubation. METHODS: In 367 consecutive patients undergoing elective cervical spine surgery, tracheal intubation was randomly performed with manual inline stabilization using either the McGrath MAC videolaryngoscope (group M, n = 183) or the Optiscope video stylet (group O, n = 184) by 2 experienced anesthesiologists in a single institution. The primary outcome was the first-attempt success rate of tracheal intubation. Secondary outcomes were intubation time and the incidence of postoperative airway complications, such as sore throat, hoarseness, blood in the oral cavity, and blood staining on the endotracheal tube. RESULTS: The first-attempt success rate of tracheal intubation was significantly higher in group M compared with group O (92.3% vs 81.0%; risk difference [95% confidence interval], 0.11 [0.05–0.18]; P = .002). The intubation time was significantly shorter in group M than in group O (35.7 ± 27.8 vs 49.2 ± 43.8; mean difference [95% confidence interval], 13.5 [5.9–21.1]; P = .001). The incidence of postoperative airway complications was not significantly different between the 2 groups. CONCLUSIONS: The McGrath MAC videolaryngoscope showed a higher first-attempt success rate for tracheal intubation and a shorter intubation time than the Optiscope video stylet in cervical spine patients with manual inline stabilization during tracheal intubation. These results suggest that the McGrath MAC videolaryngoscope may be a better option for tracheal intubation in such patients.

A chloroform extract of the edible mushroom Pleurotus eryngii showed an inhibitory effect on mammalian DNA topoisomerase I. The topoisomerase I inhibitory compound was purified and identified as ubiquinone-9. Ubiquinone-9 was shown to inhibit the activity of topoisomerase I with IC(50) of about 50 microM. Concentration of 110 microM ubiquinone-9 caused 50% growth inhibition of human leukaemia U937 cells, but not that of normal fibroblast NIH3T3 and 3Y1 cells. Ubiquinone-9-induced cell death was characterised with the cleavage of poly (ADP-ribose) polymerase and pro-caspase 3. Furthermore, ubiquinone-9 induced the fragmentation of DNA into an apoptotic DNA ladder, indicating that the inhibitor triggered apoptosis. The induction of apoptosis by ubiquinone-9 was also confirmed using flow cytometry analysis. Taken together, these results suggest that ubiquinone-9 may function by inhibiting oncogenic disease, at least in part, through the inhibition of topoisomerase I activity.

No abstract

No abstract