Functional bracing for delayed union of a femur fracture associated with Paget's disease of the bone in an Asian patient: a case report

Paget's disease of the bone is a common metabolic bone disease in most European countries, Australia, New Zealand, and North America. Conversely, this disease is rare in Scandinavia, Asia, and Africa. In Japan, it is extremely rare, with a prevalence of 0.15/100000. Paget's disease is a localized disorder of bone remodeling. Excessive bone resorption and abnormal bone formation result in biomechanically weakened bone and predispose patients to fracture. Delayed union and non-union of fractures have been reported in patients with Paget's disease. Therefore, open reduction and internal fixation of fractures has been recommended to prevent such complications. Here we report an unusual case of a 63-year-old Asian woman with delayed union of a femur fracture secondary to Paget's disease, which was treated successfully by functional bracing

Cardiac Sarcoidosis Culminating in Severe Biventricular Failure

A 59-year-old woman with a history of lung sarcoidosis developed general edema and exertional dyspnea. An electrocardiogram showed first-degree atrioventricular block with complete right bundle branch block. Chest X-ray showed cardiomegaly. Echocardiography showed diffuse and severe hypokinesis of the left ventricle (LV) and biventricular enlargement with severe tricuspid regurgitation. Myocardial scintigraphy disclosed a perfusion defect at the ventricular septum and hypoperfusion at the posterior wall and the apex. On cardiac catheterization, pulmonary capillary wedge pressure, right ventricular, and right atrial pressures were elevated. Coronary angiograms were normal. Myocardial biopsy of the right ventricle histologically revealed epithelioid cell granuloma with infiltration of fibrous cells. The patient's symptom and LV function were improved with conventional medical therapy for heart failure. This is a rare case of cardiac sarcoidosis resulting in biventricular failure

Site-dependent Local Spin Susceptibility and Low-energy Excitation in a Weyl Semimetal WTe2_2

Site-dependent local spin susceptibility is investigated with $^{125}$Te nuclear magnetic resonance in a Weyl semimetal WTe$_2$. The nuclear spin-lattice relaxation rate $1/T_1T$ shows a dependence of the square of temperature $T$ at high temperatures, followed by a constant behavior below 50 K. The temperature dependence features Weyl fermions appearing around the linearly crossing bands. The Knight shift $K$ scales to the square root of $1/T_1T$, corroborating a predominant spin contribution in low-lying excitation. The observed dependence of $K$ and $1/T_1T$ on the four Te sites shows the site-dependent electron correlation and density of states. The angular profile of the NMR spectrum gives the anisotropic hyperfine coupling tensor, consistent with $5p$ hole occupations on Te sites.Comment: 6 pages, 5 figure

Optimization of Microchannels and Application of Basic Activation Functions of Deep Neural Network for Accuracy Analysis of Microfluidic Parameter Data

The fabrication of microflow channels with high accuracy in terms of the optimization of the proposed designs, minimization of surface roughness, and flow control of microfluidic parameters is challenging when evaluating the performance of microfluidic systems. The use of conventional input devices, such as peristaltic pumps and digital pressure pumps, to evaluate the flow control of such parameters cannot confirm a wide range of data analysis with higher accuracy because of their operational drawbacks. In this study, we optimized the circular and rectangular-shaped microflow channels of a 100 mu m microfluidic chip using a three-dimensional simulation tool, and analyzed concentration profiles of different regions of the microflow channels. Then, we applied a deep learning (DL) algorithm for the dense layers of the rectified linear unit (ReLU), Leaky ReLU, and Swish activation functions to train and test 1600 experimental and interpolation of data samples which obtained from the microfluidic chip. Moreover, using the same DL algorithm, we configured three models for each of these three functions by changing the internal middle layers of these models. As a result, we obtained a total of 9 average accuracy values of ReLU, Leaky ReLU, and Swish functions for a defined threshold value of 6 x 10(-5) using the trial-and-error method. We applied single-to-five-fold cross-validation technique of deep neural network to avoid overfitting and reduce noises from data-set to evaluate better average accuracy of data of microfluidic parameters

Clinical and Arthroscopic Findings of Acute Anterior Cruciate Ligament Tears of the Knee

Clinical, arthrographic, and arthroscopic findings in 53 patients with acutely torn anterior cruciate ligaments (ACLs) were documented. Arthroscopy and instability tests under anesthesia were performed on all patients within 2 weeks after the initial injury. Twenty-three patients complained of extension blocks, and localized tenderness on the medial side was revealed in 26 patients at the initial examination. Aspiration from joints exhibited hemarthrosis in 52 patients. Arthroscopy revealed ACL ruptures in all patients. Four Segond's fractures, 26 meniscus tears (8 medial and 18 lateral), 1 osteochondral fracture, and 19 medial collateral ligament ruptures were revealed. Arthroscopy detected only 1 of the 5 ruptures of the posteromedial corner of the medial meniscus, which were noted on arthrography. Three ACL stumps were protruding among the femorotibial joint, which seemed to be restricting full extension. Statistical analysis showed that tenderness on the medial side was not revealed more frequently in knees with medial collateral ligament injuries than in the others. The volume of aspirated fluids in knees with no leakage in arthrography significantly increased over those with leakages (p < 0.05). Diagnosis of ACL injuries should be completed by clinical, arthrographic, and arthroscopic examinations

Changing Pattern of Deiminated Proteins in Developing Human Epidermis

Peptidylarginine deiminases are widely distributed, calcium-ion-dependent enzymes that convert arginine residues of proteins into citrulline residues. This reaction, deimination, is thought to be an important event during the final stage of epidermal differentiation, possibly associated with integration and disintegration of keratin filaments. To elucidate the possible roles of protein deimination during human epidermal development we investigated localization of deiminated proteins using anti-citrulline peptide antibody, which preferentially recognizes citrulline residues in the V subdomains of keratin 1, and anti-chemically modified citrulline antibody, which enables detection of citrulline residues independent of amino acid sequences. Anti-chemically modified citrulline antibody, but not anti-citrulline peptide antibody stained the periderm in two-layered epidermis of 49 d and 57 d estimated gestational age. In the stratified epidermis of 88 d, 96 d, and 108 d estimated gestational age fetal skin, anti-citrulline peptide antibody and anti-chemically modified citrulline antibody staining was seen in the periderm and intermediate cell layers. After periderm cells regressed and keratinization began in the interfollicular epidermis, anti-citrulline peptide antibody and anti-chemically modified citrulline antibody were restricted to the cornified cell layers of the interfollicular epidermis, similar to the distribution patterns of that in adult epidermis. Postembedding immunoelectron microscopy showed anti-citrulline peptide antibody immunogold labeling over the cytoplasmic intermediate filament network in the periderm and the intermediate cell layers. These results demonstrate an orderly formation of deiminated proteins in different layers of embryonic epidermis and suggest important roles for peptidylarginine deiminases in human epidermal morphogenesis