Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome: A case report

AbstractRemitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare form of paraneoplastic tenosynovitis, which is more prone to occur in elderly males. A 78-year-old male had a past history of gastric cancer 23 years ago and underwent subtotal gastrectomy then. He led a fair life after the surgery. However, fever, edema in four extremities, gait disturbance, and liver function impairment bothered him for 5 months, which caused significant physical functional decline. Despite of extensive laboratory and imaging examinations, no definite diagnosis and treatment were provided. He was referred to Kyoto University hospital and RS3PE was diagnosed. After the diagnosis of RS3PE syndrome was made, systemic steroid was given and fever, edema and liver function impairment improved dramatically within 7 days. The patient was well managed by oral prednisolone 30mg per day after discharge. RS3PE should be considered when an elderly man with aforementioned presentations in order to prevent significant functional decline in daily living

Gender differences in ankylosing spondylitis-associated cumulative healthcare utilization: a population-based cohort study

BACKGROUND: Ankylosing spondylitis (AS) is one of the most common rheumatic diseases with gender differences in prevalence and clinical presentation. This study aimed to examine whether such gender differences are correlated with cumulative healthcare utilization in Taiwan. METHODS: The National Health Insurance Research Database supplied claim records of one million individuals from 1996 to 2007. Selected cases included patients aged >16 years. Certified rheumatologists diagnosed the patients in three or more visits and gave prescriptions for AS. Multivariate adjusted logistic regression analyses were used to calculate the influence of gender on cumulative healthcare utilization associated with AS. RESULTS: The study included 228 women and 636 men. After adjustment for potential confounding factors, men had more cumulative outpatient visits associated with AS (odds ratio, 1.59; 95% confidence interval, 1.13 -2.23; p = 0.008). Men also exhibited a trend for higher frequency of AS-related hospitalization (p = 0.054). CONCLUSION: Men are more likely to have high cumulative AS-associated healthcare utilization than women. Further investigation of the causal factors is warranted

The Incidence and Prevalence of Thromboangiitis Obliterans in Taiwan: A Nationwide, Population-based Analysis of Data Collected from 2002 to 2011

OBJECTIVE: To estimate the incidence and prevalence of thromboangiitis obliterans in Taiwan in the period spanning from 2002 to 2011. METHODS: We identified all incident and prevalent cases with a diagnosis of thromboangiitis obliterans (International Classification of Diseases, Ninth Revision code 443.1) in the period spanning from 2002 to 2011 using Taiwan’s National Health Insurance Research Database. We calculated the age- and sex-specific incidence and prevalence rates of thromboangiitis obliterans during the study period. RESULTS: From 2002 to 2011, 158 patients were diagnosed with thromboangiitis obliterans; of these, 76% were men. Most (63%) of the patients wer

The Hot and Clumpy Molecular Cocoon Surrounding the Ultracompact HII Region G5.89-0.39

We present observations of CH3CN (12-11) emission at a resolution of 2" toward the shell-like ultracompact HII region G5.89-0.39 with the Submillimeter Array. The integrated CH3CN emission reveals dense and hot molecular cocoon in the periphery of the HII region G5.89-0.39, with a CH3CN deficient region roughly centered at G5.89-0.39. By analyzing the CH3CN emission using population diagram analysis, we find, for the first time, a decreasing temperature structure from 150 to 40 K with the projected distance from Feldt's star, which is thought to be responsible for powering the HII region. Our results further indicate that the majority of the heating energy in the observed dense gas is supplied by the Feldt's star. From the derived CH3CN column density profile, we conclude that the dense gas is not uniformly-distributed but centrally-concentrated, with a power-law exponent of 5.5 for r < 8000 AU, and 2.0 for 8000 AU < r < 20000 AU, where r is the distance to Feldt's star. The estimated large power index of 5.5 can be attributed to an enhancement of CH3CN abundance in the close vicinity of Feldt's star.Comment: accepted for publication in The Astrophysical Journal Letter

The Artificial Neural Networks Applied to Servo Control Systems

This chapter utilizes the direct neural control (DNC) based on back propagation neural networks (BPN) with specialized learning architecture applied to the speed control of DC servo motor. The proposed neural controller can be treated as a speed regulator to keep the motor in constant speed, and be applied to DC servo motor speed control. The proposed neural control applied to position control for hydraulic servo system is also studied for some modern robotic applications. A tangent hyperbolic function is used as the activation function, and the back propagation error is approximated by a linear combination of error and error!s differential. The simulation and experiment results reveal that the proposed neural controller is available to DC servo control system and hydraulic servo system with high convergent speed, and enhances the adaptability of the control system

FOXO/Fringe is necessary for maintenance of the germline stem cell niche in response to insulin insufficiency

AbstractThe stem cell niche houses and regulates stem cells by providing both physical contact and local factors that regulate stem cell identity. The stem cell niche also plays a role in integrating niche-local and systemic signals, thereby ensuring that the balance of stem cells meets the needs of the organism. However, it is not clear how these signals are merged within the niche. Nutrient-sensing insulin/FOXO signaling has been previously shown to directly control Notch activation in the Drosophila female germline stem cell (GSC) niche, which maintains the niche and GSC identity. Here, we demonstrate that FOXO directly activates transcription of fringe, a gene encoding a glycosyltransferase that modulates Notch glycosylation. Fringe facilitates Notch inactivation in the GSC niche when insulin signaling is low. We also show that the Notch ligand predominantly involved is GSC niche-derived Delta. These results reveal that FOXO-mediated regulation of fringe links the insulin and Notch signaling pathways in the GSC niche in response to nutrition, and emphasize that stem cells are regulated by complex interactions between niche-local and systemic signals

Scientific and Regulatory Perspective on Monoclonal Antibody Biosimilars

Similar biotherapeutic products (SBPs), also called biosimilars, exhibit similar biological and clinical properties to authorized reference products. Biosimilars, including small molecules like erythropoietin and complex macromolecules like monoclonal antibodies (mAbs), have been used extensively in disease treatment. Monoclonal antibody biosimilars have gradually become a dominant development in the global pharmaceutical industry since their patents or data protection have been expired or nearing expiration. Since the mAb biosimilars are complex biological macromolecules with various post-translation modifications, it is important to evaluate whether these tiny differences significantly affect the quality. From a regulatory perspective, the comparability study needs to be performed to demonstrate that the quality, safety, and efficacy are similar to the biological reference. Based on these comprehensive comparative results, the indicated extrapolation might be acceptable. Post-market surveillance is also required because of unexpected biological variation caused by slightly different manufacturing processes. This chapter presents the scientific and regulatory considerations for monoclonal antibody biosimilar products for manufactures and for the regulatory authorities to administrate wisely and comprehensively