Retropharyngeal abscess coinfected with and after rhinoviral infection in a 1-month-old infant

A retropharyngeal abscess is a rare disease entity in young infants but can develop after nasopharyngeal viral infection. Group B Streptococcus and Staphylococcus aureus are the most common pathogens in young infants, however, Mycobacterium tuberculosis is very rare. We report the case of retropharyngeal abscess and coinfection with S. aureus and M. tuberculosis in a very young infant presenting with respiratory symptoms due to upper airway obstruction. Usually tuberculous retropharyngeal abscesses are caused by the direct invasion of the bacteria from the spine via anterior longitudinal ligament of the spine. However, in this case, no associated spinal disease was observed

Korean Society of Nephrology 2022 Recommendations on controversial issues in diagnosis and management of hyponatremia

The Korean Society for Electrolyte and Blood Pressure Research, in collaboration with the Korean Society of Nephrology, has published a clinical practice guideline (CPG) document for hyponatremia treatment. The document is based on an extensive evidence-based review of the diagnosis, evaluation, and treatment of hyponatremia with the multidisciplinary participation of representative experts in hyponatremia with methodologist support for guideline development. This CPG consists of 12 recommendations (two for diagnosis, eight for treatment, and two for special situations) based on eight detailed topics and nine key questions. Each recommendation begins with statements graded by the strength of the recommendations and the quality of the evidence. Each statement is followed by rationale supporting the recommendations. The committee issued conditional recommendations in favor of rapid intermittent bolus administration of hypertonic saline in severe hyponatremia, the use of vasopressin receptor antagonists in heart failure with hypervolemic hyponatremia, and syndrome of inappropriate antidiuresis with moderate to severe hyponatremia, the individualization of desmopressin use, and strong recommendation on the administration of isotonic fluids as maintenance fluid therapy in hospitalized pediatric patients. We hope that this CPG will provide useful recommendations in practice, with the aim of providing clinical support for shared decision-making to improve patient outcomes

Кераміка «terra sigillata» з с. Зимне на Волині

Стаття присвячена публікації чотирьох керамічних посудин типу «terra sigillata», знайдених на дні р. Луги у с. Зимне Володимир-Волинського району Волинської області. Попередній аналіз цих знахідок дозволяє віднести їх до Понтійського центру виробництва такого посуду. Вірогідним шляхом потрапляння цієї колекції на Волинь була готська експансія у Північне Причорномор’я

Comparison of Diagnostic Performance of Two-Dimensional and Three-Dimensional Fractal Dimension and Lacunarity Analyses for Predicting the Meningioma Grade

Background: To compare the diagnostic performance of two-dimensional (2D) and three-dimensional (3D) fractal dimension (FD) and lacunarity features from MRI for predicting the meningioma grade. Methods: This retrospective study included 123 meningioma patients [90 World Health Organization (WHO) grade I, 33 WHO grade II/III] with preoperative MRI including post-contrast T1-weighted imaging. The 2D and 3D FD and lacunarity parameters from the contrast-enhancing portion of the tumor were calculated. Reproducibility was assessed with the intraclass correlation coefficient. Multivariable logistic regression analysis using 2D or 3D fractal features was performed to predict the meningioma grade. The diagnostic ability of the 2D and 3D fractal models were compared. Results: The reproducibility between observers was excellent, with intraclass correlation coefficients of 0.97, 0.95, 0.98, and 0.96 for 2D FD, 2D lacunarity, 3D FD, and 3D lacunarity, respectively. WHO grade II/III meningiomas had a higher 2D and 3D FD (p=0.003 and p<0.001, respectively) and higher 2D and 3D lacunarity (p=0.002 and p=0.006, respectively) than WHO grade I meningiomas. The 2D fractal model showed an area under the curve (AUC), accuracy, sensitivity, and specificity of 0.690 [95% confidence interval (CI) 0.581-0.799], 72.4%, 75.8%, and 64.4%, respectively. The 3D fractal model showed an AUC, accuracy, sensitivity, and specificity of 0.813 (95% CI 0.733-0.878), 82.9%, 81.8%, and 70.0%, respectively. The 3D fractal model exhibited significantly better diagnostic performance than the 2D fractal model (p<0.001). Conclusion: The 3D fractal analysis proved superiority in diagnostic performance to 2D fractal analysis in grading meningioma. © 2020 The Korean Brain Tumor Society, The Korean Society for NeuroOncology, and The Korean Society for Pediatric Neuro-OncologyTRU

Magnetic resonance imaging–based 3-dimensional fractal dimension and lacunarity analyses may predict the meningioma grade

Objective: To assess whether 3-dimensional (3D) fractal dimension (FD) and lacunarity features from MRI can predict the meningioma grade. Methods: This retrospective study included 131 patients with meningiomas (98 low-grade, 33 high-grade) who underwent preoperative MRI with post-contrast T1-weighted imaging. The 3D FD and lacunarity parameters from the enhancing portion of the tumor were extracted by box-counting algorithms. Inter-rater reliability was assessed with the intraclass correlation coefficient (ICC). Additionally, conventional imaging features such as location, heterogeneous enhancement, capsular enhancement, and necrosis were assessed. Independent clinical and imaging risk factors for meningioma grade were investigated using multivariable logistic regression. The discriminative value of the prediction model with and without fractal features was evaluated. The relationship of fractal parameters with the mitosis count and Ki-67 labeling index was also assessed. Results: The inter-reader reliability was excellent, with ICCs of 0.99 for FD and 0.97 for lacunarity. High-grade meningiomas had higher FD (p < 0.001) and higher lacunarity (p = 0.007) than low-grade meningiomas. In the multivariable logistic regression, the diagnostic performance of the model with clinical and conventional imaging features increased with 3D fractal features for predicting the meningioma grade, with AUCs of 0.78 and 0.84, respectively. The 3D FD showed significant correlations with both mitosis count and Ki-67 labeling index, and lacunarity showed a significant correlation with the Ki-67 labeling index (all p values < 0.05). Conclusion: The 3D FD and lacunarity are higher in high-grade meningiomas and fractal analysis may be a useful imaging biomarker for predicting the meningioma grade. Key Points: • Fractal dimension (FD) and lacunarity are the two parameters used in fractal analysis to describe the complexity of a subject and may aid in predicting meningioma grade. • High-grade meningiomas had a higher fractal dimension and higher lacunarity than low-grade meningiomas, suggesting higher complexity and higher rotational variance. • The discriminative value of the predictive model using clinical and conventional imaging features improved when combined with 3D fractal features for predicting the meningioma grade. © 2020, European Society of Radiology.FALS

Metabolite profiling of rambutan (Nephelium lappaceum L.) seeds using uplc-qtofms/ms and senomorphic effects in aged human dermal fibroblasts

Nephelium lappaceum(rambutan) is an edible tropical fruit that is widely grown in Southeast Asia. In general, the seeds contain high nutrients, but rambutan seeds are thrown out during processing. In this study, the anti-aging activity of rambutan seeds was evaluated with a new approach through the selective inhibition of the senescence-associated secretory phenotype (senomorphics). Luciferase promoter assays using p16INK4A and SA-beta-gal promoters for rambutan showed that its seeds possessed strong senomorphic activity. Molecular networking using ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-qTOF-MS) with a tandem database (UPLC-qTOF-MS/MS) was applied to determine the chemical composition of rambutan. Based on the activity results, nine compounds, one new (7) and eight known kaempferol type compounds, were isolated from the seeds. Compounds2,4and9significantly reduced the mRNA expression levels of senescence markers, such as p16INK4A, p21CIP1, p53 and SA-beta-gal. These compounds also significantly increased the level of SIRT1, a longevity modulator. Compounds2,4and9decreased the mRNA expression levels of senescence-associated secretory phenotypes (SASPs) and subsequently decreased the number of SA-beta-gal-positive cells. Thus, rambutan seeds and its constituents might be able to protect against age-related problems.Y