Mycoplasma pneumoniae infection in patients with Kawasaki disease

PurposeKawasaki disease (KD) is the main cause of acquired heart disease in children. In addition to cardiovascular involvement, many complications have been recognized in KD. However, respiratory complications have been rarely reported. We investigated the differences in clinical characteristics, laboratory findings, radiography findings, and echocardiography findings of Mycoplasma pneumoniae infection and other types of pneumonia in KD patients.MethodsAmong 358 patients with KD, 54 developed concurrent pneumonia. Among the 54 patients, 12 (22.2%) with high titers of anti-M. pneumoniae antibody (AMA) (>1:640) were grouped in the M. pneumoniae group and 42 were included in the control group. Serum AMA was measured in each patient. Clinical laboratory findings and total duration of fever were analyzed.ResultsThe duration of fever, serum hemoglobin, white blood cell count, platelet count, erythrocyte sedimentation rate, C-reactive protein level, albumin level, and the incidence of coronary arterial lesions showed no statistical difference in the 2 groups. Neutrophil count was significantly higher in the M. pneumoniae group than in the control group. Among various radiography findings observed in pneumonia, consolidation and pleural effusion were more frequent in the M. pneumoniae group than in the control group. On the other hand, parahilar peribronchial opacification, diffuse interstitial lesion, and normal findings prevailed in the control group.ConclusionKD patients can have concurrent infections, especially pulmonary symptoms. The cause of KD is likely to be associated with M. pneumoniae infection. Thus, immediate treatment of M. pneumoniae infection in KD patients is very important

Classification of Metastatic versus Non-Metastatic Axillary Nodes in Breast Cancer Patients: Value of Cortex-Hilum Area Ratio with Ultrasound

Purpose: To investigate the significance of the cortex-hilum (CH) area ratio and longitudinal-transverse (LT) axis ratio and the blood flow pattern for diagnosis of metastatic axillary lymph nodes by ultrasound in breast cancer patients. Methods: From October 2005 to July 2006, we prospectively evaluated axillary nodes with ultrasound in 205 consecutive patients who had category 4B, 4C or 5 breast lesions according to the Breast Imaging Reporting and Data System-Ultrasound (BI-RADS-Ultrasound ®). Among the 205, there were 24 patients who had pathologic verification of breast cancer and axillary lymph node status. For a total of 80 axillary nodes we measured the areas of the cortex and hilum of lymph nodes and calculated the area ratio. We also measured the length of the longitudinal and transverse axis of the lymph nodes and calculated the length ratio. We evaluated the blood flow pattern on power Doppler imaging and classified each lymp

On‐Demand Reconfiguration of Nanomaterials: When Electronics Meets Ionics

Rapid advances in the semiconductor industry, driven largely by device scaling, are now approaching fundamental physical limits and face severe power, performance, and cost constraints. Multifunctional materials and devices may lead to a paradigm shift toward new, intelligent, and efficient computing systems, and are being extensively studied. Herein examines how, by controlling the internal ion distribution in a solid‐state film, a material’s chemical composition and physical properties can be reversibly reconfigured using an applied electric field, at room temperature and after device fabrication. Reconfigurability is observed in a wide range of materials, including commonly used dielectric films, and has led to the development of new device concepts such as resistive random‐access memory. Physical reconfigurability further allows memory and logic operations to be merged in the same device for efficient in‐memory computing and neuromorphic computing systems. By directly changing the chemical composition of the material, coupled electrical, optical, and magnetic effects can also be obtained. A survey of recent fundamental material and device studies that reveal the dynamic ionic processes is included, along with discussions on systematic modeling efforts, device and material challenges, and future research directions.By controlling the internal ion distribution in a solid‐state film, the material’s chemical composition and physical (i.e., electrical, optical, and magnetic) properties can be reversibly reconfigured, in situ, using an applied electric field. The reconfigurability is achieved in a wide range of materials, and can lead to the development of new memory, logic, and multifunctional devices and systems.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141225/1/adma201702770.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141225/2/adma201702770_am.pd

Diagnosis and Treatment of Latent Tuberculosis Infection in Arthritis Patients Treated with Tumor Necrosis Factor Antagonists in Korea

Tumor necrosis factor (TNF) is essential for host defense against Mycobacterium tuberculosis, and the risk of reactivation of latent tuberculosis infection (LTBI) increases with anti-TNF therapy. This study estimated the prevalence of LTBI and evaluated the safety and completion rate of short-course therapy with isoniazid plus rifampin for 3 months to treat LTBI in a cohort of Korean arthritis patients before initiating anti-TNF therapy. We retrospectively studied the files of 112 consecutive patients to evaluate LTBI before starting anti-TNF drugs. Screening tests were performed, including a tuberculin skin test and chest radiography. LTBI treatment was indicated in 41 patients (37%). Of these, three patients refused the LTBI treatment. Of the 38 patients who underwent LTBI treatment, 36 (95%) took isoniazid plus rifampin for 3 months. Six patients (16%) showed transient elevations of liver enzymes during the LTBI treatment. Overall, 35 patients (92%) completed the LTBI treatment as planned. In conclusion, LTBI was diagnosed in one-third of Korean arthritis patients before initiating anti-TNF therapy. A high percentage of these patients completed 3 months of LTBI treatment with isoniazid plus rifampin without serious complications

Antibacterial activity of Artemisia nilagirica leaf extracts against clinical and phytopathogenic bacteria

<p>Abstract</p> <p>Background</p> <p>The six organic solvent extracts of <it>Artemisia nilagirica </it>were screened for the potential antimicrobial activity against phytopathogens and clinically important standard reference bacterial strains.</p> <p>Methods</p> <p>The agar disk diffusion method was used to study the antibacterial activity of <it>A. nilagirica </it>extracts against 15 bacterial strains. The Minimum Inhibitory Concentration (MIC) of the plant extracts were tested using two fold agar dilution method at concentrations ranging from 32 to 512 μg/ml. The phytochemical screening of extracts was carried out for major phytochemical derivatives in <it>A. nilagirica</it>.</p> <p>Results</p> <p>All the extracts showed inhibitory activity for gram-positive and gram-negative bacteria except for <it>Klebsiella pneumoniae, Enterococcus faecalis </it>and <it>Staphylococcus aureus</it>. The hexane extract was found to be effective against all phytopathogens with low MIC of 32 μg/ml and the methanol extract exhibited a higher inhibition activity against <it>Escherichia coli, Yersinia enterocolitica, Salmonella typhi</it>, <it>Enterobacter aerogenes</it>, <it>Proteus vulgaris</it>, <it>Pseudomonas aeruginosa </it>(32 μg/ml), <it>Bacillus subtilis </it>(64 μg/ml) and <it>Shigella flaxneri </it>(128 μg/ml). The phytochemical screening of extracts answered for the major derivative of alkaloids, amino acids, flavonoids, phenol, quinines, tannins and terpenoids.</p> <p>Conclusion</p> <p>All the extracts showed antibacterial activity against the tested strains. Of all, methanol and hexane extracts showed high inhibition against clinical and phytopathogens, respectively. The results also indicate the presence of major phytochemical derivatives in the <it>A. nilagirica </it>extracts. Hence, the isolation and purification of therapeutic potential compounds from <it>A. nilagirica </it>could be used as an effective source against bacterial diseases in human and plants.</p

Migraine features in patients with Meniere's disease

Objectives/hypothesisTo better understand the features of migraine in Meniere's disease (MD).Study designRetrospective review of prospectively obtained surveys in an outpatient clinic of a tertiary medical center.MethodsDetailed questionnaires on headaches and dizziness were given to consecutive patients presenting with dizziness. The responses were verified by the clinician with the patient. The data, in addition to the clinical history and audiogram, were used to diagnose patients with migraine headaches and MD using criteria set by the International Headache Society (IHS) and the American Academy of Otolaryngology-Head and Neck Surgery, respectively. The prevalence of migraine-like symptoms in those patients with MD, who did not fit the diagnostic criteria for migraine, was evaluated.ResultsThirty-seven patients with definite MD were included. There was a predominance of females (female/male:26/11). Mean age of patients was 52 ± 14 years. Nineteen patients (51%) had migraine headaches. Fifteen patients fulfilled the criteria for definite vestibular migraine. Of those who did not fulfill the IHS migraine criteria, a majority had characteristics such as a family history of migraine, visual motion sensitivity, or lifelong motion sickness that were highly suggestive of a migraine disorder.ConclusionsA majority of patients with MD have migraine headaches as defined by the IHS. Sensitivity to visual motion, light and sound, head motion, smells, weather changes, or medication was present in 95% of all patients with definite MD and 82% of non-IHS migraine MD patients. This may suggest that MD may be an atypical variant of migraine

Material model for modeling clay at high strain rates

This paper was accepted for publication in the journal International Journal of Impact Engineering and the definitive published version is available at http://dx.doi.org/10.1016/j.ijimpeng.2015.11.005Modeling clay is a soft malleable material made from oils and waxes. This material is fundamental for ballistic evaluation of body armors because it is used as backing material in ballistic tests. After a ballistic impact, a back-face indentation is measured to assess performance of the armor. Due to the important role of modeling clay in this particular application, its mechanical characterization and comprehension of penetration mechanics are essential for development of new personal protection systems. This paper presents a two-step computational methodology to calibrate parameters of a Cowper-Symonds material model for modeling clay at characteristic strain rates up to 1.8×104 s-1. In the first stage, a high-speed camera is used to record the penetration of a gas-gun launched cylindrical mass with a hemispherical cap into a block of clay. Image-processing software is used to capture the tail of the projectile as it penetrates into the clay. These data are then used to sample the penetration depth as function of time. In the second stage, an in-house developed model of penetration, based on both the spherical cavity expansion theory and the Tate penetration equation, is used to determine, by inverse analysis, the parameters of the Cowper-Symonds clay model. The proposed constitutive relationship for clay and the determined material parameters can be applied accurately to problems involving high strain rates

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A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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The Social Structure of the Market for Force

Over the past two decades, governments have increasingly contracted private military and security companies (PMSCs) to support military operations in conflicts. However, many observers have argued that such companies are ‘greedy market actors’ or ‘reckless mercenaries’ and their level of performance very poor. A minority has defended them as security professionals. If market competition is present, the level of performance is high and positive contributions to the client’s military operation can be expected. However, neither PMSC opponents nor proponents can account for the variance in the level of performance in three crucial cases – Sierra Leone, Iraq, and Afghanistan. This article argues that different market structures explain this variance. At least three ideal configurations exist: collaborative, competitive, and rival structures. These structures influence the level of performance. PMSC performance levels are expected to decrease from the first configuration, being positive, to the last, being negative