Portal Vein Gas in a Diabetic Patient with Gas-forming Pararenal Abscess

The incidence of portal vein gas (PVG), which used to be an ominous sign of intestinal sepsis, has increased with progressive improvements in imaging modalities. Therefore, the clinical significance of PVG has changed. Emphysematous pyelonephritis (EPN) is a rare, potentially life-threatening and gas-forming infection of the renal parenchyma and/or its surroundings. Gas-forming pararenal abscess presenting with PVG is even rarer. We hereby present the case of a diabetic female with poor glycemic control, who was diagnosed to have EPN and PVG concurrently by computed tomography. She underwent percutaneous catheter drainage (PCD) of the pyelonephritis. Both cultures of blood and pus grew Klebsiella pneumoniae. Her subsequent clinical course was uneventful. In summary, EPN is a rare but potentially fatal urinary tract infection in diabetic patients, and finding PVG on computed tomography can aid in diagnosis. Conservative treatment with intravenous antibiotics and PCD of pus may be adequate for the patient with EPN. However, nephrectomy may be necessary if the patient deteriorates and PCD fails to contain the infection

Developing new heat pump system to improve indoor living space in senior long-term care house

The issue of an aging population is becoming increasingly acute in Taiwan; in 2018, seniors comprised over 14 % of the total population. The quality of care for senior citizens hinges on the ability of long-term care facilities to create comfortable living spaces while ensuring energy efficiency by reducing electricity consumption, thereby providing them with an environment for aging in an active and positive way. This study proposes a new heat pump system that offers a cold source in the summer and a heat source in the winter. In addition, the air-conditioning and ventilation rates required for comfort in indoor living spaces are established to ensure the high quality of the care spaces in these types of institutions. The results after installation of the heat pump system were as follows: (1) Performance of the heat pump system: the inlet temperature of the heat pump chilled water was maintained at 7-10 °C, and the outlet temperature, at 42-54 °C. (2) Energy efficiency: Based on a 95 % confidence interval, the average annual electricity consumption was 32.65 kwh/day, which was 32.65 % of the prior consumption level; the reduction of 67.35 % is comparable to those of most heat pump systems. (3) Improvement of the indoor environment: In the hottest scenario, the indoor temperature was reduced by 3 °C and the relative humidity to 55-65 %, which fall within comfortable ranges. After the heat pump system was introduced, significant improvements in ventilation, air quality and comfort were noted, as well as significant improvement in average total satisfaction scores. All improvements reached statistical significance. The overall objective of the system is to enhance the environmental quality in long-term senior care facilities and make them healthier and more energy efficient

Quantitative assessment of female pattern hair loss

AbstractBackground/ObjectiveThe conventional approach to evaluate female pattern hair loss (FPHL) is to visually inspect and score images of balding area (BA). However, visual estimates vary widely among different physicians, and may hinder objective assessment of hair loss and subsequent treatment response. For this reason, we propose a quantitative method using a computer-aided imaging system to help physicians evaluate the severity of FPHL clinically.MethodsWe use a series of digital image processing techniques to measure the width of central balding area of FPHL. A total of 184 photos were collected form 33 Chinese women with FPHL (stages I-2 to II-2 on the Savin scale). Each photograph underwent standardized exposure correction. The balding areas were detected through this computer system and then transformed into an equivalent ellipse by principal component analysis. The width of ellipse [balding width (BW)] was measured. Spearman's rank correlation was used to detect the correlation between our measurements and clinical staging.ResultsExposure correction resulted in a 16.97% (|BWcorrected − BWoriginal|/BWcorrected) difference in BW.‏ The average BW was 54.98 mm in all patients, 25.79 mm in type I-2 patients, 37.41 mm in I-3, 54.08 mm in I-4, 72.10 mm in II-1, and 85.53 mm in II-2. The values of BW were correlated with Savin scale stages clinically (rBW = 0.967), which was significant statistically (p < 0.05).ConclusionA computer-aided imaging system could be a useful tool to assist physicians to evaluate the balding area more precisely for clinical staging in FPHL. The BW instead of the balding area is simple to use clinically to represent the severity of FPHL

Interplay between the magnetic and electric degrees-of-freedom in multiferroic Co3TeO6

Neutron diffraction, magnetic susceptibility, specific heat, and dielectric constant measurements of single crystal Co3TeO6 have been measured to study the interplay between the ferroelectricity and magnetic order. Long range incommensurate magnetic order develops below TM1=26 K, which is followed by three additional zero-field phase transitions at TM2=19.5 K, TM3=18 K, and TM4=16 K where the incommensurate order changes and commensurate order develops. In magnetic fields up to 14 T we find that the magnetic intensities and incommensurate wave vector are dramatically altered as ferroelectricity develops, with a fifth abrupt transition around 10 T. The overall behavior characterizes Co3TeO6 as a type-II multiferroic.Comment: Phys. Rev. B (in press

原位表征技术揭示析氢电催化剂活性中心

文章简介课题组以导电碳布上生长的氢氧化镍纳米片为模板,通过与对苯二硫酚配体反应,成功合成出具有平面Ni（SR）4配位结构的镍—硫醇配位聚合物纳米片,并发现该材料在碱性析氢测试中,催化活性随测试时间逐渐加存在明显诱导期的现象。在保持20m A/cm2的电流密度条件下,析氢所需过电位逐渐降低,约10小时后该

Transgenic Expression of Decoy Receptor 3 Protects Islets from Spontaneous and Chemical-induced Autoimmune Destruction in Nonobese Diabetic Mice

Decoy receptor 3 (DCR3) halts both Fas ligand– and LIGHT-induced cell deaths, which are required for pancreatic β cell damage in autoimmune diabetes. To directly investigate the therapeutic potential of DCR3 in preventing this disease, we generated transgenic nonobese diabetic mice, which overexpressed DCR3 in β cells. Transgenic DCR3 protected mice from autoimmune and cyclophosphamide-induced diabetes in a dose-dependent manner and significantly reduced the severity of insulitis. Local expression of the transgene did not alter the diabetogenic properties of systemic lymphocytes or the development of T helper 1 or T regulatory cells. The transgenic islets had a higher transplantation success rate and survived for longer than wild-type islets. We have demonstrated for the first time that the immune-evasion function of DCR3 inhibits autoimmunity and that genetic manipulation of grafts may improve the success and survival of islet transplants

Association between plasma levels of hyaluronic acid and functional outcome in acute stroke patients

BACKGROUND: Activation of hyaluronic acid (HA) and associated enzyme synthesis has been demonstrated in experimental stroke animal models. Our study aimed to investigate the plasma levels of HA in acute stroke patients and the associations between HA levels and functional outcome. METHODS: This was a multicenter case–control study. Acute stroke patients and age- and sex-matched non-stroke controls were recruited. Plasma levels of HA in acute stroke patients were determined at <48 hours and at 48 to 72 hours after stroke onset by standard ELISA. Favorable functional outcome was defined as modified Rankin scale ≤2 at 3 months after stroke. RESULTS: The study included 206 acute stroke patients, including 43 who had intracerebral hemorrhage and 163 who had ischemic stroke, and 159 controls. The plasma levels of HA in the acute stroke patients were significantly higher than those in the controls (219.7 ± 203.4 ng/ml for <48 hours and 343.1 ± 710.3 ng/ml for 48 to 72 hours versus 170.4 ± 127.9 ng/ml in the controls; both P < 0.05). For intracerebral hemorrhage patients, HA ≤500 ng/ml (<48 hours) was an independent favorable outcome predictor (P = 0.016). For ischemic stroke patients, an inverted U-shaped association between plasma HA (48 to 72 hours) and outcome was noted, indicating that ischemic stroke patients with too high or too low plasma HA levels tended to have an unfavorable outcome. CONCLUSION: HA plasma level was elevated in patients with acute stroke, and can predict 3-month functional outcome, particularly for patients with intracerebral hemorrhage

The Efficacy of Endoscopic Papillary Balloon Dilation for Patients with Acute Biliary Pancreatitis

Background. No study investigated the efficacy and safety of endoscopic papillary balloon dilation (EPBD) for the treatment of acute biliary pancreatitis (ABP). Method. We retrospectively reviewed the effects of EPBD on patients with ABP from February 2003 to December 2012. The general data, findings of image studies, details of the procedure, and outcomes after EPBD were analyzed. Result. Total 183 patients (male/female: 110/73) were enrolled. The mean age was 65.9 years. Among them, 155 patients had mild pancreatitis. The meantime from admission to EPBD was 3.3 days. Cholangiogram revealed filling defects inside the common bile duct (CBD) in 149 patients. The mean dilating balloon size was 10.5 mm and mean duration of the dilating procedure was 4.3 minutes. Overall, 124 patients had gross stones retrieved from CBD. Four (2.2%) adverse events and 2 (1.1%) intraprocedure bleeding incidents but no procedure-related mortality were noted. Bilirubin and amylase levels significantly decreased after EPBD. On average, patients resumed oral intake within 1.4 days. The clinical parameters and outcomes were similar in patients with different severity of pancreatitis. Conclusion. EPBD can be effective and safe for the treatment of ABP, even in patients presenting with severe disease

Effective gene expression in the rat dorsal root ganglia with a non-viral vector delivered via spinal nerve injection

Delivering gene constructs into the dorsal root ganglia (DRG) is a powerful but challenging therapeutic strategy for sensory disorders affecting the DRG and their peripheral processes. The current delivery methods of direct intra-DRG injection and intrathecal injection have several disadvantages, including potential injury to DRG neurons and low transfection efficiency, respectively. This study aimed to develop a spinal nerve injection strategy to deliver polyethylenimine mixed with plasmid (PEI/DNA polyplexes) containing green fluorescent protein (GFP). Using this spinal nerve injection approach, PEI/DNA polyplexes were delivered to DRG neurons without nerve injury. Within one week of the delivery, GFP expression was detected in 82.8% ± 1.70% of DRG neurons, comparable to the levels obtained by intra-DRG injection (81.3% ± 5.1%, p = 0.82) but much higher than those obtained by intrathecal injection. The degree of GFP expression by neurofilament(+) and peripherin(+) DRG neurons was similar. The safety of this approach was documented by the absence of injury marker expression, including activation transcription factor 3 and ionized calcium binding adaptor molecule 1 for neurons and glia, respectively, as well as the absence of behavioral changes. These results demonstrated the efficacy and safety of delivering PEI/DNA polyplexes to DRG neurons via spinal nerve injection.National Science Council of Taiwan (100-2321-B-002-007)National Science Council of Taiwan (100-2320-B-002-083-MY3)Taiwan. Ministry of Science and Technology (104-2300-B-002-019-MY3)National Taiwan University. College of Medicine (Translational Medicine Project)National Taiwan University Hospital (101C101-201