Cutaneous Mycobacterium intracellulare infection presenting as multiple asymptomatic papulonodules in an immunocompetent adult: A case report and review of the literature

AbstractDisseminated cutaneous nontuberculous mycobacteria infection is rare in immunocompetent hosts. We report a case of Mycobacterium intracellulare infection in an immunocompetent patient presenting with simultaneously developing multiple asymptomatic cutaneous papulonodules. The possibility of lung lesions as the primary focus is suspected. We review the literature for other cases of multiple cutaneous M avium complex infections in immunocompetent hosts. There are differences in the virulence of M avium and M intracellulare, and hence in the underlying immune status of the hosts

Evidence of d-phenylglycine as delivering tool for improving l-dopa absorption

<p>Abstract</p> <p>Background</p> <p><it>l</it>-Dopa has been used for Parkinson's disease management for a long time. However, its wide variety in the rate and the extent of absorption remained challenge in designing suitable therapeutic regime. We report here a design of using <it>d</it>-phenylglycine to guard <it>l</it>-dopa for better absorption in the intestine via intestinal peptide transporter I (PepT1).</p> <p>Methods</p> <p><it>d</it>-Phenylglycine was chemically attached on <it>l</it>-dopa to form <it>d</it>-phenylglycine-<it>l</it>-dopa as a dipeptide prodrug of <it>l</it>-dopa. The cross-membrane transport of this dipeptide and <it>l</it>-dopa via PepT1 was compared in brush-boarder membrane vesicle (BBMV) prepared from rat intestine. The intestinal absorption was compared by <it>in situ </it>jejunal perfusion in rats. The pharmacokinetics after i.v. and p.o. administration of both compounds were also compared in Wistar rats. The striatal dopamine released after i.v. administration of <it>d</it>-phenylglycine-<it>l</it>-dopa was collected by brain microdialysis and monitored by HPLC. Anti-Parkinsonism effect was determined by counting the rotation of 6-OHDA-treated unilateral striatal lesioned rats elicited rotation with (+)-methamphetamine (MA).</p> <p>Results</p> <p>The BBMV uptake of <it>d</it>-phenylglycine-<it>l</it>-dopa was inhibited by Gly-Pro, Gly-Phe and cephradine, the typical PepT1 substrates, but not by amino acids Phe or <it>l</it>-dopa. The cross-membrane permeability (Pm*) determined in rat jejunal perfusion of <it>d</it>-phenylglycine-<it>l</it>-dopa was higher than that of <it>l</it>-dopa (2.58 ± 0.14 vs. 0.94 ± 0.10). The oral bioavailability of <it>d</it>-phenylglycine-<it>l</it>-dopa was 31.7 times higher than that of <it>l-</it>dopa in rats. A sustained releasing profile of striatal dopamine was demonstrated after i. v. injection of <it>d</it>-phenylglycine-<it>l</it>-dopa (50 mg/kg), indicated that <it>d</it>-phenylglycine-<it>l</it>-dopa might be a prodrug of dopamine. <it>d</it>-Phenylglycine-<it>l</it>-dopa was more efficient than <it>l-</it>dopa in lowering the rotation of unilateral striatal lesioned rats (19.1 ± 1.7% vs. 9.9 ± 1.4%).</p> <p>Conclusion</p> <p>The BBMV uptake studies indicated that <it>d</it>-phenylglycine facilitated the transport of <it>l</it>-dopa through the intestinal PepT1 transporter. The higher jejunal permeability and the improved systemic bioavailability of <it>d-</it>phenylglycine-<it>l</it>-dopa in comparison to that of <it>l</it>-dopa suggested that <it>d-</it>phenylglycine is an effective delivery tool for improving the oral absorption of drugs like <it>l</it>-dopa with unsatisfactory pharmacokinetics. The gradual release of dopamine in brain striatum rendered this dipeptide as a potential dopamine sustained-releasing prodrug.</p

Sustained Robust Exciton Emission in Suspended Monolayer WSe_2 within the Low Carrier Density Regime for Quantum Emitter Applications

The development of semiconductor optoelectronic devices is moving toward low power consumption and miniaturization, especially for high-efficiency quantum emitters. However, most of these quantum sources work at low carrier density region, where the Shockley-Read-Hall recombination may dominant and seriously reduce the emission efficiency. In order to diminish the affection of carrier trapping and sustain a strong photoluminescence emission under low power pumping condition, we investigated on the influence of Suspending to monolayered tungsten diselenide, novel two-dimensional quantum material. Not only the PL intensity, but also the fundamental photoluminescence quantum yield has exhibited a huge, order-scale enhancement through suspending, even surprisingly, we found the PLQY improvement revealed far significantly under small pumping power and came out an exponential increase tendency toward even lower carrier density region. With its strong excitonic effect, suspended WSe_2 offers a solution to reduce carrier trapping and participate in non-radiative processes. Moreover, in the low-power range where SRH recombination dominates, suspended WSe_2 exhibited remarkably higher percentage of excitonic radiation compared to contacted WSe_2. Herein, we quantitatively demonstrate the significance of suspended WSe_2 monolayer at low carrier density region, highlighting its potential for developing compact, low-power quantum emitters in the future

Quantitative measures of functional outcomes and quality of life in patients with C5 palsy

AbstractBackgroundIt is generally understood that postoperative C5 palsy can occur with anterior or posterior decompression surgery, but functional measures of the palsy have not been well documented. This study aimed to investigate the incidence of C5 palsy in different surgical procedures, examine the correlations between muscle strength, upper extremity functional measures, and health-related quality of life, and to observe potential risk factors contributing to C5 palsy.MethodsOur investigation involved a retrospective study design. A total of 364 patients who underwent decompression surgery were indicated within the selected exclusion criteria. Additionally, 12 C5 palsy patients were recruited. The relationships between the manual muscle test (MMT), the action research arm test (ARAT), the Jebsen test of hand function (JTHF), and the European quality of life-5 dimensions (EQ-5D) were studied, and univariate analyses were performed to search possible risk factors and recovery investigation.ResultsThe data analyzed in the 12 cases and C5 palsy incidences (3.3%) were: 0.7% in anterior procedures (n = 2), 8.8% in posterior procedures (n = 6), and 36.4% in combined procedures (n = 4). Moderate-to-high correlations were observed between the ARAT, JTHF, EQ-5D visual analog scale scores, and MMT (r = 0.636–0.899). There were significant differences in patient age, etiology of cervical lesion, variable decompression procedures, and the number of decompression levels between the C5 palsy and non-C5 palsy groups. For female patients (p = 0.018) and number of decompression levels (p = 0.028), there were significant differences between the complete recovery and the incomplete recovery groups.ConclusionPatients undergoing combined anterior–posterior decompression surgery had the highest incidence of C5 palsy, and correlations between the ARAT, JTHF, EQ-5D visual analog scale clinical tools, and MMT scores supported these findings. Female status and lower decompression levels could also be predictive factors for complete recovery, although additional research is needed to substantiate these findings

Phenotype-based and Self-learning Inter-individual Sleep Apnea Screening with a Level IV Monitoring System

Purpose: We propose a phenotype-based artificial intelligence system that can self-learn and is accurate for screening purposes, and test it on a Level IV monitoring system. Methods: Based on the physiological knowledge, we hypothesize that the phenotype information will allow us to find subjects from a well-annotated database that share similar sleep apnea patterns. Therefore, for a new-arriving subject, we can establish a prediction model from the existing database that is adaptive to the subject. We test the proposed algorithm on a database consisting of 62 subjects with the signals recorded from a Level IV wearable device measuring the thoracic and abdominal movements and the SpO2. Results: With the leave-one cross validation, the accuracy of the proposed algorithm to screen subjects with an apnea-hypopnea index greater or equal to 15 is 93.6%, the positive likelihood ratio is 6.8, and the negative likelihood ratio is 0.03. Conclusion: The results confirm the hypothesis and show that the proposed algorithm has great potential to screen patients with SAS

Cytomegalovirus enteritis in immunocompetent patients: Report of two cases diagnosed using single-balloon enteroscopy

SummaryCytomegalovirus (CMV) infection of the gastrointestinal tract involves mostly the colon and rectum and mainly develops in immunocompromised patients. CMV infection in the small intestines has rarely been reported in immunocompetent patients. We report two cases of CMV enteritis that developed in immunocompetent patients and involved the ileum and jejunum, respectively. Both of them were diagnosed with single-balloon enteroscopy (SBE) and further confirmed with histopathology. The first case is a 71-year-old woman with a presentation of obscure gastrointestinal bleeding and severe anemia. Neither esophagogastroduodenoscopy nor colonoscopy identified any active bleeding. SBE and biopsy disclosed multiple scattered ulcers in the distal ileum and histopathology confirmed CMV ileitis. The hemorrhage subsided after conservative medical treatment. The second case is a 59-year-old woman with a presentation of progressive abdominal pain. SBE showed diffuse irregularly-shaped ulcers located from the upper to middle jejunum, and CMV jejunitis was confirmed with endoscopic biopsy and histopathological examination. Antiviral therapy was prescribed and her abdominal pain improved gradually. We discuss the clinical manifestations and management strategies of CMV infection that develops in the small intestines of immunocompetent patients. In addition, we highlight the endoscopic characteristics of CMV enteritis and the clinical utilities of SBE in the evaluation of patients with suspected CMV infection of the small intestines

Levitation by a dipole electric field

The phenomenon of floating can be fascinating in any field, with its presence seen in art, films, and scientific research. This phenomenon is a captivating and pertinent subject with practical applications, such as Penning traps for antimatter confinement and Ion traps as essential architectures for quantum computing models. In our project, we reproduced the 1893 water bridge experiment using glycerol and first observed that lump-like macroscopic dipole moments can undergo near-periodic oscillations that exhibit floating effects and do not need classical bridge form. By combining experimental analysis, neural networks, investigation of Kelvin force generated by the Finite element method, and exploration of discharging, we gain insights into the mechanisms of motion. Our discovery has overturned the previous impression of a bridge floating in the water, leading to a deeper understanding of the new trap mechanism under strong electric fields with a single pair of electrodes.Comment: 5 pages, 5 figure

Osseous wound repair under inhibition of the axis of advanced glycation end-products and the advanced glycation end-products receptor

Background/PurposeBlockade of advanced glycation end-products (AGE) is able to reduce diabetic complications and control periodontitis. This study aimed to determine whether the application of aminoguanidine (AG), an AGE inhibitor, or N-phenacylthiazolium bromide (PTB), an AGE breaker, facilitates the healing of an osseous wound in non-diabetic animals.Methods2.6 mm diameter full-thickness osseous wounds were created bilaterally in 54 healthy Sprague–Dawley rats. Rats received daily normal saline, AG, or PTB injections respectively and were euthanized after 7 days, 14 days, or 28 days (n = 6). The wound healing pattern was assessed by micro-computed tomography, histology, histochemistry for the fiber arrangement, and the gene expression levels of AGE receptor, tumor necrosis factor-α, type I collagen, and fibronectin.ResultsUnder the AG and PTB administration, osteogenesis was apparently promoted in the early stages of healing, but the union of the osseous wound and the fibril re-arrangement was apparently retarded. No significant difference was found in any of the micro-computed tomography parameters as compared to the control in the first 14 days, whereas the relative bone volume was significantly higher in the control at Day 28. AGE receptor and tumor necrosis factor-α were depressed in the PTB group, but only temporarily at Day 14 in the AG group. Therefore, at Day 14, type I collagen was significantly upregulated in the PTB group, and fibronectin was significantly increased in the AG group.ConclusionAnti-AGE agents reduced inflammation but did not apparently facilitate osteogenesis during the osseous wound repair