Introduction:VACTERL association is an acronym that includes vertebral anomalies (V), anal atresia (A), cardiac defects (C), tracheoesophageal fistula (TEF) or esophageal atresia (EA), renal anomalies (R), and limb defects (L). Airway anomalies have rarely been reported with VACTERL association.Patient concerns:A 10-month-old boy who had been diagnosed with anal atresia and received surgical corrections soon after birth consulted our institution by complaining repeated cough and fever.Diagnosis:Diagnosis of VACTERL association was finally made. Bronchoscopy and chest CT with computed tomography angiography confirmed multiple airway abnormalities including bridging bronchus, airway malacia, and complete tracheal rings.Interventions:Supplemental oxygen was provided and antibiotics was initiated.Outcomes:The patient resolved gradually and was discharged 10 days later. The follow-up showed the patient has remained well just with mild psychomotor retardation.Conclusion:Multiple airway anomalies may be seen in VACTERL association. It is worthwhile to make special note for evaluating the tracheobronchial pulmonary system by chest CT and bronchoscopy, especially patients presenting with breathing anomalies.
To fulfill high-reliability requirements for aerospace applications, a novel traveling wave rotary ultrasonic motor with a piezoelectric backup function (Backup motor) is proposed in this paper. The backup function is enabled by the addition of a set of piezoelectric ceramics (PZT). Based on the ultrasonic motor of the CSX-60, a cantilever-tooth backup motor (CTBM) is designed and fabricated. This backup motor can operate in three working modes according to the excitation settings of PZTs, namely normal mode, backup mode, and enhanced mode. The relationships between three working modes’ performances are analyzed by finite element (FE) analysis and prototype tests. The results show that backup mode, as the substitution, can nearly reach normal mode’s performance, while enhanced mode is obviously higher than others. Furthermore, a modified backup motor with straight-tooth (STBM) and different sizes of PZT is designed and tested as a supplement to verify the feasibility of the proposal. In addition, the effect of stress reduction on PZT damage is verified by extreme working experiments. The comparison between the two types of motors indicates that STBM can provide better frictional drive performance. This proposal can provide a new reference for the subsequent reliability study of ultrasonic motors.
Pseudomonas aeruginosa (P. aeruginosa) is a gram-negative aerobic
bacterium, which is rarely seen in community-acquired infection.
Attention should be paid to its high mortality and invasive progress.
X-linked hyper-IgM syndrome (XHIGM; HIGM1; OMIM:308230) is one type of
primary immunodeficiency disease (PIDs), characterized by markedly
decreased serum IgG, IgA, and IgE levels and normal or elevated serum
IgM levels. We report a patient who developed a particularly severe
community-acquired P. aeruginosa pneumonia-related septic shock, and a
delayed diagnosis of X-linked hyper IgM syndrome was made by genome
sequencing. Fatal community-acquired P. aeruginosa infections in
children, including previously healthy children, should be considered to
search for underlying PIDs by exome/genome sequencing.
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