A Post-hoc Study of D-Amino Acid Oxidase in Blood as an Indicator of Post-stroke Dementia

Stroke is an important risk factor for dementia. Epidemiological studies have indicated a high incidence of dementia in stroke patients. There is currently no effective biomarker for the diagnosis of post-stroke dementia (PSD). D-amino acid oxidase (DAO) is a flavin-dependent enzyme widely distributed in the central nervous system. DAO oxidizes D-amino acids, a process which generates neurotoxic hydrogen peroxide and leads to neurodegeneration. This study aimed to examine post-stroke plasma DAO levels as a biomarker for PSD. In total, 53 patients with PSD, 20 post-stroke patients without dementia (PSNoD), and 71 age- and gender-matched normal controls were recruited. Cognitive function was evaluated at more than 30 days post-stroke. Plasma DAO was measured using the enzyme-linked immunosorbent assay. White matter hyperintensity (WMH), a neuroimaging biomarker of cerebral small vessel diseases, was determined by magnetic resonance imaging. We found that plasma DAO levels were independently higher in PSD subjects than in PSNoD subjects or the controls and were correlated with the WMH load in stroke patients. Using an area under the curve (AUC)/receiver operating characteristic analysis, plasma DAO levels were significantly reliable for the diagnosis of PSD. The sensitivity and specificity of the optimal cut-off value of 321 ng/ml of plasma DAO for the diagnosis of PSD were 75 and 88.7%, respectively. In conclusion, our data support that plasma DAO levels were increased in PSD patients and correlated with brain WMH, independent of age, gender, hypertension, and renal function. Plasma DAO levels may therefore aid in PSD diagnosis

Thyroid Cancer Presenting with Concomitant Metastatic Breast Cancer in the Thyroid

The thyroid is an unusual site to find cancer metastasis. When it does occur, such cancer spread is often manifested in multiple metastases and generally suggests a poor prognosis. We presented here a 49-year-old woman recently diagnosed with thyroid cancer, who had been treated for stage IIA breast cancer 8 years ago. After radical right thyroidectomy and left subtotal thyroidectomy, her pathological report showed papillary thyroid carcinoma, right thyroid, with concomitant metastatic breast carcinoma. This is the first case of which we are aware involving coexisting thyroid cancer and metastatic breast cancer in the ipsilateral lobe. Moreover, the circumstances of this case show a very unique clinical course compared with previous studies. Given the unusual circumstances of our case, we further discuss the relationship between thyroid cancer and breast cancer

Non-compressibility Ratio of Sonography in Deep Venous Thrombosis

BackgroundThe risk of post-thrombotic syndrome and pulmonary embolism can be increased if there is failure to diagnose deep venous thrombosis (DVT) promptly. Emergency physicians (EPs) need a quick and readily available test to diagnose, treat and help them decide whether to discharge or admit DVT patients in a timely manner. The aim of this study was to investigate the value of the non-compressibility ratio of thrombosed veins in DVT patients, and give EPs an objective value to aid them in their decision-making with regard to DVT patients in the emergency department.MethodsWe reviewed 34 adult patients with DVT diagnosed by sonography in an emergency department. Medical records including demographic data and sonography results were retrospectively reviewed and analyzed.ResultsMean age was 72.9 ± 16.5 years. Group I comprised 14 patients (41.2%) who had DVT in the popliteal and femoral veins. Group II comprised 8 patients (23.5%) who had DVT isolated to the popliteal vein and 12 patients (35.3%) who had DVT isolated to the femoral vein. Group I had a significantly higher non-compressibility ratio than Group II (93.4 ± 6.2% vs. 80.1 ± 19.2%, p < 0.05). The area under the receiver operating characteristic curve of the non-compressibility ratio between discriminating groups was 0.711 (95% confidence interval, 0.527-0.854; p < 0.05). The clinical prognostic score of Group I was significantly higher than that of Group II (6.2 ± 1.8 vs. 4.1 ± 2.6, p < 0.05). There was a significant positive correlation between the non-compressibility ratio of the thrombosed vein and the clinical prognostic score (p = 0.001).ConclusionThe non-compressibility ratio of the thrombosed vein provides EPs with an objective test to evaluate the severity of DVT and to admit patients for consideration of adverse outcomes

Effectiveness of salt substitute on cardiovascular outcomes: A systematic review and meta‐analysis

Abstract Hypertension‐related death is the leading cause of mortality worldwide, making blood pressure (BP) control an important issue. Salt substitute is a non‐pharmaceutical strategy to improve hypertension control. The goal of this study was to evaluate the effect of salt substitute on BP and cardiovascular disease. The authors searched the Cochrane Library and PubMed databases through March 2022, and assessed the risk‐of‐bias for included studies by the Cochrane risk‐of‐bias tool. Twenty‐three randomized controlled trials with 32073 patients were included in our systematic review. A meta‐analysis with random effects was performed to analyze the effects of salt substitute on systolic and diastolic BP, 24‐h urinary sodium and potassium, and cardiovascular and all‐cause mortality. In the random‐effects model, participants consuming salt substitute showed significant reduction in systolic BP (mean difference (MD) −4.80 mmHg, 95% confidence interval (CI) −6.12 to −3.48, P < 0.0001) and diastolic BP (MD −1.48 mmHg, 95% CI −2.06 to −0.90, P < 0.0001) compared with participants consuming normal salt. In the urine electrolyte analysis, the salt substitute group had significant reduction in 24‐h urine sodium (MD −22.96 mmol/24‐h, P = 0.0001) and significant elevation in 24‐h urine potassium (MD 14.41 mmol/24‐h, P < 0.0001). Of the five studies with mortality outcome data, salt substitute significantly reduced all‐cause mortality (hazard ratio 0.88, P = 0.0003). In conclusion, our analyses showed that salt substitute has a strong effect on lowering BP and reducing all‐cause mortality. By modifying the daily diet with salt substitute, the authors can improve BP control by using this non‐pharmaceutical management

Platelet-Derived Biomaterials Exert Chondroprotective and Chondroregenerative Effects on Diabetes Mellitus-Induced Intervertebral Disc Degeneration

Complications of diabetes mellitus (DM) range from acute to chronic conditions, leading to multiorgan disorders such as nephropathy, retinopathy, and neuropathy. However, little is known about the influence of DM on intervertebral disc degeneration (IVDD). Moreover, traditional surgical outcomes in DM patients have been found poor, and to date, no definitive alternative treatment exists for DM-induced IVDD. Recently, among various novel approaches in regenerative medicine, the concentrated platelet-derived biomaterials (PDB), which is comprised of transforming growth factor-β1 (TGF-β1), platelet-derived growth factor (PDGF), etc., have been reported as safe, biocompatible, and efficacious alternatives for various disorders. Therefore, we initially investigated the correlations between DM and IVDD, through establishing in vitro and in vivo DM models, and further evaluated the therapeutic effects of PDB in this comorbid pathology. In vitro model was established by culturing immortalized human nucleus pulposus cells (ihNPs) in high-glucose medium, whereas in vivo DM model was developed by administering streptozotocin, nicotinamide and high-fat diet to the mice. Our results revealed that DM deteriorates both ihNPs and IVD tissues, by elevating reactive oxygen species (ROS)-induced oxidative stress, inhibiting chondrogenic markers and disc height. Contrarily, PDB ameliorated IVDD by restoring cellular growth, chondrogenic markers and disc height, possibly through suppressing ROS levels. These data imply that PDB may serve as a potential chondroprotective and chondroregenerative candidate for DM-induced IVDD

羅浮合流部落土石流之致災機制分析與數值模擬

Typhoon Soudelor brought abundant rainfall in northern Taiwan on August 8, 2015. The rainfall caused a shallow landslide which was transformed instantly into a debris flow disaster in the Heliu catchment. We integrate remote sensing, rainfall analysis, micro-topography interpretation, lineament of tree fall, field investigation, a UAV survey, and RAMMS simulation to explore the failure mechanism and flow dynamics of this rainfall-induced debris flow. The high resolution shading relief map depicts the landforms of both the old deep-seated landslide and the ancient debris-flow fan. In this study, different numerical scenarios are performed by RAMMS to analyze the possible influence area via adopting the back-analysis approach. In comparison with the post-disaster landform model, the bestfit parameters for Heliu debris flow were also obtained. In addition, verification of dynamic images demonstrates that the maximum flow velocities for the event and deposition height on the debris-flow fan are about 14.3 m/s and 1-5 m, respectively.桃園市復興區羅浮里合流部落集水區，於 2015 年 8 月 8 日蘇迪勒颱風期間因強降雨誘發邊坡岩屑 崩滑形成土石流，造成下游 15 戶民宅遭到破壞或淤埋。本研究以遙測影像、UAV 攝影測量、致災雨量分析、 微地形判釋、崩塌地倒樹線型、現地勘查及數值模擬探討土石流致災機制與災害成因。合流集水區上游為一 舊岩體滑動區，且存在古土石流堆積扇地貌，本案例災害主要受降雨形成之地表逕流沖刷，導致坡腳失穩之 後退式岩屑崩滑。本文採 RAMMS 數值模擬以參數逆推法探尋土石流發生之可能情境，並與災後地貌進行驗 證。災害動態影片分析與數值模擬驗證則顯示合流部落土石流之流動段流速約 14.3 m/s，受災堆積段之溢淹深 度則介於 1-5 m

Additional file 1: of No difference in the functional improvements between unilateral and bilateral total knee replacements

Table S1. Characteristics between patients who loss to follow-up or not. (DOCX 35 kb