Haemophilus Aphrophilus Associated Spleen Abscess: An Unusual Presentation of Subacute Endocarditis

The HACEK group of bacteria (Haemophilus spp., Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, Kingella spp.), is uncommon pathogens of infective endocarditis, but can cause life-threatening events such as heart failure or formation of lethal emboli. Here we report a 58-year-old Asian man with a past history of congenital valvular heart disease who presented with sudden onset of left flank pain followed by fever with chills for 2 weeks. Abdominal computed tomography (CT) indicated a 1.6 cm abscess in the spleen. Culturing indicated the presence of Haemophilus aphrophilus. We diagnosed the patient with subacute endocarditis complicated with spleen abscess. The patient recovered fully after two weeks antibiotic (Ceftriaxone) treatment. Clinicians should give further attention to infective endocarditis caused by bacteria in the HACEK group in patients with metastatic infection such as spleen abscess with suspected valvular heart disease

Role of Bell Singlet State in the Suppression of Disentanglement

The stability of entanglement of two atoms in a cavity is analyzed in this work. By studying the general Werner states we clarify the role of Bell-singlet state in the problem of suppression of disentanglement due to spontaneous emission. It is also shown explicitly that the final amount of entanglement depends on the initial ingredients of the Bell-singlet state.Comment: 5 pages, 2 figures, accepted by Phys. Rev.

Deep Learning-based Fall Detection Algorithm Using Ensemble Model of Coarse-fine CNN and GRU Networks

Falls are the public health issue for the elderly all over the world since the fall-induced injuries are associated with a large amount of healthcare cost. Falls can cause serious injuries, even leading to death if the elderly suffers a "long-lie". Hence, a reliable fall detection (FD) system is required to provide an emergency alarm for first aid. Due to the advances in wearable device technology and artificial intelligence, some fall detection systems have been developed using machine learning and deep learning methods to analyze the signal collected from accelerometer and gyroscopes. In order to achieve better fall detection performance, an ensemble model that combines a coarse-fine convolutional neural network and gated recurrent unit is proposed in this study. The parallel structure design used in this model restores the different grains of spatial characteristics and capture temporal dependencies for feature representation. This study applies the FallAllD public dataset to validate the reliability of the proposed model, which achieves a recall, precision, and F-score of 92.54%, 96.13%, and 94.26%, respectively. The results demonstrate the reliability of the proposed ensemble model in discriminating falls from daily living activities and its superior performance compared to the state-of-the-art convolutional neural network long short-term memory (CNN-LSTM) for FD

Rupture of Renal Pelvis in an Adult with Congenital Ureteropelvic Junction Obstruction After Blunt Abdominal Trauma

Isolated injury to the renal pelvis following blunt abdominal trauma is very rare. However, a pre-existing renal abnormality will increase the risk of rupture. We present a 24-year-old man with rupture of the left renal pelvis following blunt abdominal trauma. He had pre-existing left ureteropelvic junction (UPJ) obstruction. Delayed computed tomography scan with excretory phase revealed contrast medium extravasation from the left UPJ, and left renal pelvis rupture was diagnosed. He was managed successfully with ureteral double-J stenting for 2 months

Comparison of secondary signs as shown by unenhanced helical computed tomography in patients with uric acid or calcium ureteral stones

AbstractUnenhanced helical computed tomography (UHCT) has evolved into a well-accepted diagnostic method in patients with suspected ureterolithiasis. UHCT not only shows stones within the lumen of the ureter, it also permits evaluation of the secondary signs associated with ureteral obstruction from stones. However, there we could find no data on how secondary signs might differ in relation to different compositions of ureteral stones. In this study, we compared the degree of secondary signs revealed by UHCT in uric acid stone formers and in patients forming calcium stones. We enrolled 117 patients with ureteral stones who underwent UHCT examination and Fourier transform infra-red analysis of stone samples. Clinical data were collected as follows: age, sex, estimated glomerular filtration rate (eGFR), urine pH, and radiological data on secondary signs apparent on UHCT. The uric acid stone formers had significantly lower urine pH and eGFR in comparison to calcium stone formers, and on UHCT they also had a higher percentage of the secondary signs, including rim sign (78.9% vs. 60.2%), hydroureter (94.7% vs. 89.8%), perirenal stranding (84.2% vs. 59.2%) and kidney density difference (73.7% vs. 50.0%). The radiological difference was statistically significant for perirenal stranding (p=0.041). In conclusion, we found that UHCT scanning reveals secondary signs to be more frequent in patients with uric acid ureteral stones than in patients with calcium stones, a tendency that might result from an acidic urine environment

HLA typing in Taiwanese patients with oral squamous cell carcinoma

AbstractBackground/purposeThe human leukocyte antigen (HLA) system, which plays a vital role in immunity, is the most polymorphic gene complex found in the human genome. This study investigated HLA-related alleles and haplotypes in Taiwanese patients with oral squamous cell carcinoma (OSCC).Materials and methodsHLA class I (HLA-A and HLA-B) antigens and class II (HLA-DRB1) alleles were determined in 105 patients with OSCC and compared with those in 190 healthy controls. The antigens were measured serologically and the alleles by sequencing-based typing.ResultsCompared with the control group, patients with OSCC had higher frequencies of HLA-A24, HLA-B54, HLA-DRB1*0405, and HLA-DRB1*1201, while they had lower frequencies of HLA-B58 and HLA-DRB1*1302. Haplotype frequencies also varied significantly in individuals with OSCC, with certain haplotypes associated with lymph node metastases or a particular tumor stage.ConclusionThese results suggest that HLA genetic factors influence susceptibility to OSCC and perhaps to lymph node metastasis and tumor progression

Sarcoma of the Larynx: Treatment Results and Literature Review

BackgroundSarcomas of the larynx are rare neoplasms that constitute less than 1% of laryngeal malignancies. A Medline search found no large series focusing on laryngeal sarcomas. We reviewed the cases of laryngeal sarcomas treated in our cancer center and compared our experiences and treatment results with those from other centers.MethodsA retrospective review of 10 patients with laryngeal sarcoma treated in our institute between 1980 and 2000 was done to identify tumor characteristics, therapeutic modalities, and treatment outcomes.ResultsThe patients showed a male predominance (9/10) and presented 8 types of pathology. Nine patients underwent surgery, including 2 total laryngectomy, 4 partial laryngectomy, and 3 endoscopic laser cordectomy. During a median follow-up of 92 months, the 5-year overall survival and disease-specific survival were 76% and 90%, respectively. Two patients developed recurrence, including 1 local recurrence and 1 distant metastasis.ConclusionSurgical intervention was the first choice in the treatment of laryngeal sarcomas. The prognosis is relatively good when compared with sarcoma originating from other anatomic sites

Comparison of diffusion-weighted imaging and contrast-enhanced T1-weighted imaging on a single baseline MRI for demonstrating dissemination in time in multiple sclerosis

BACKGROUND: The 2010 Revisions to the McDonald Criteria have established that dissemination in time (DIT) of multiple sclerosis (MS) can be demonstrated by simultaneous presence of asymptomatic gadolinium-enhancing and nonenhancing lesions on a single magnetic resonance imaging (MRI). However, gadolinium-based contrast agents (GBCAs) have contraindications. Diffusion-weighted imaging (DWI) can detect diffusion alterations in active inflammatory lesions. The purpose of this study was to investigate if DWI can be an alternative to contrast-enhanced T1-weighted imaging (CE T1WI) for demonstrating DIT in MS. METHODS: We selected patients with clinically definite MS and evaluated their baseline brain MRI. Asymptomatic lesions were identified as either hyperintense or nonhyperintense on DWI and enhancing or nonenhancing on CE T1WI. Fisher’s exact test was performed to determine whether the hyperintensity on DWI was related to the enhancement on CE T1WI (P < 0.05). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the DWI to predict lesion enhancement were calculated. RESULTS: Twenty-two patients with 384 demyelinating lesions that were hyperintense on T2-weighted imaging and more than 3 mm in size were recruited. The diffusion hyperintensity and lesion enhancement were significantly correlated (P <0.001). The sensitivity, specificity, PPV, NPV and accuracy were 100%, 67.9%, 32.3%, 100% and 72.1%, respectively. CONCLUSIONS: A hyperintense DWI finding does not necessarily overlap with contrast enhancement. There are many false positives, possibly representing other stages of lesion development. Although DWI may not replace CE T1WI imaging to demonstrate DIT due to the low PPV, it may serve as a screening MRI sequence where the use of GBCAs is a concern