UKnowledge

Background: Primary graft dysfunction (PGD) contributes substantially to both short- and long-term mortality after lung transplantation, but the mechanisms that lead to PGD are not well understood. Exposure to ambient air pollutants is associated with adverse events during waitlisting for lung transplantation and chronic lung allograft dysfunction, but its association with PGD has not been studie…

BACKGROUND One third of organ donors suffer catastrophic brain injury (CBI). There are no standard guidelines for the management of traumatic CBI prior to brain death, and not all trauma centers have institutional CBI guidelines. In addition, there is high variability in management between institutions with guidelines. Catastrophic brain injury guidelines vary and may include various combinations…

A paediatric patient presented with periorbital oedema and fever. Initially, there was low suspicion for cavernous sinus thrombosis and orbital cellulitis due to the presence of full extraocular movements. However, given worsening bilateral periorbital oedema, lethargy and sepsis, neuroimaging was performed demonstrating inflammation and enhancement of the leptomeninges and left cavernous sinus, …

Background: Donor lung procurement and preservation is critical for lung transplantation success. Unfortunately, the large variability in techniques impacts organ utilization rates and transplantation outcomes. Compounding this variation, recent developments in cold static preservation and new technological advances with machine perfusion have increased the complexity of the procedure. The object…

Hermansky-Pudlak syndrome (HPS) is a genetic disorder of endosomal protein trafficking associated with pulmonary fibrosis in specific subtypes, including HPS-1 and HPS-2. Single-mutant HPS1 and HPS2 mice display increased fibrotic sensitivity while double-mutant HPS1/2 mice exhibit spontaneous fibrosis with aging, which has been attributed to HPS mutations in alveolar epithelial type II (AT2) cel…

Background: Accidental catheter removal or drain dislodgment, including tube thoracostomy, is a common, high-risk complication in hospitalized and ambulatory patients that often necessitates an additional procedure, increased length of stay, and increased cost. Methods: The aim of this study was to compare the tensile strength of pigtail catheter fixation using a simple interrupted suture, a U-st…

Background and Objectives: Incisional hernias are a common and costly complication of surgery, occurring in up to 20% of midline incisions within 3 years of initial operation. Risk factors for incisional hernia include incision site, fascial closure technique, body mass index (BMI), surgical site infections, and gastrointestinal surgery. Limited studies have compared procedural type as a risk fac…

Background: Kentucky is within the top five leading states for breast cancer mortality nationwide. This study investigates the association between neighborhood socioeconomic disadvantage and breast cancer outcomes, including surgical treatment, radiotherapy, chemotherapy, and survival, and how associations vary by race and ethnicity in Kentucky. Methods: We conducted a retrospective cohort analys…

Background. Significant numbers of cardiac implantable electronic devices are placed in the United States, and infection can be a severe consequence of implantation. Despite guideline recommendations and data demonstrating that lead extraction improves mortality for patients with device infection, rates of lead removal are lower than guideline recommendations. We report the outcomes associated wi…

Bronchiolitis obliterans syndrome (BOS) is a progressive, fatal obstructive lung disease that occurs following lung transplant, where it is termed chronic lung allograft dysfunction BOS (CLAD-BOS), or as the primary manifestation of pulmonary chronic graft versus host disease (cGVHD-BOS) following allogeneic hematopoietic stem cell transplant. Disease pathogenesis is poorly understood; however, c…

Introduction: For Jehovah’s Witness (JW) patients requiring cardiac surgery, various strategies such as preoperative use of erythropoietin stimulating agents (ESAs), intravenous iron (IVI), and non-pharmacologic interventions have emerged to prevent complications from blood loss given transfusion is not acceptable in this population. Methods: Retrospective case-control of cardiac surgeries perfor…

PURPOSEEndometrial cancer (EC) is the most common gynecologic cancer in the United States with rising incidence and mortality. Despite optimal treatment, 15%-20% of all patients will recur. To better select patients for adjuvant therapy, it is important to accurately predict patients at risk for recurrence. Our objective was to train, validate, and test models of EC recurrence using lasso regress…

Delayed cerebral ischemia (DCI) is a significant complication of aneurysmal subarachnoid hemorrhage (aSAH). This study profiled immune responses after aSAH and evaluated their association with DCI onset. Twelve aSAH patients were enrolled. Leukocyte populations and cytokine levels were analyzed in cerebrospinal fluid (CSF) and peripheral blood (PB) on days 3, 5, 7, 10, and 14 post-aSAH. PB mononu…

We previously demonstrated that neurotensin, a 13-amino-acid gut hormone peptide, enhances small intestinal epithelial cell fatty acid uptake through inhibition of AMPK. Here, utilizing Drosophila and mouse models in vivo, as well as mouse and human small intestinal epithelial organoids or monolayers ex vivo, we determine the targets of neurotensin and AMPK associated with obesity and aging. High…

Objective: To discuss technical strategies and considerations to facilitate intraoperative extracorporeal membrane oxygenation (ECMO) management during lung transplantation. Methods: We review our institutional approach to the management of intraoperative ECMO during bilateral lung transplantation. Our proposed algorithm summarizes technical considerations based on the mechanical circulatory supp…

Tracking T cells in vivo using MRI is a major challenge due to the difficulty of labeling these non-phagocytic cells with a sufficient contrast agent to generate a detectable signal change. In this study, we explored CD4-Superparamagnetic iron oxide nanoparticles (SPION), which is commonly used in magnetic cell sorting, as a potential receptor-mediated, specific CD4+ T cell MRI labeling agent. We…

Background: The International Soft Tissue Sarcoma Consortium (INSTRuCT) was established in 2017 to enhance international collaboration. This study describes the characteristics of rhabdomyosarcoma (RMS) patients in the INSTRuCT database and examines differences across contributing groups. Methods: INSTRuCT includes data Children’s Oncology Group (COG), Cooperative Weichteilsarkom Studiengruppe (C…

Introduction Ventral hernia repair is among the most commonly performed general surgical procedures, during which meshes are often used to provide further support to weakened or damaged tissue surrounding the hernia repair site. Slowly resorbable synthetic meshes have recently emerged as a valid choice, as confirmed by published clinical evidence on launched meshes in the repair of ventral hernia…

Thoracic aortopathies are life-threatening diseases including aneurysm, dissection, and rupture. Cilostazol, a phosphodiesterase (PDE) 3 inhibitor, and sildenafil, a PDE5 inhibitor, have been used clinically for peripheral arterial disease and erectile dysfunction or pulmonary hypertension, respectively. Recent studies report their effects on abdominal aortic aneurysm formation. However, their im…

Background: Mutational landscape is prognostic in colorectal cancer (CRC). Rat sarcoma (RAS) oncogenes, such as KRAS and NRAS, with driver mutations, portend poor survival outcomes, whereas pathologic mutations in HRAS are extremely rare, and their prognostic value remains uncertain. Methods: This retrospective study analyzed the Oncology Research Information Exchange Network (ORIEN) alliance tum…