Comparison of Clinical Manifestations between Patients with Ocular Myasthenia Gravis and Generalized Myasthenia Gravis

PURPOSE: To compare the clinical manifestations between patients with ocular myasthenia gravis and those with generalized myasthenia gravis (MG). METHODS: The medical records of 71 patients diagnosed with MG between January 1995 and December 2007 were reviewed. Demographics, sensitivities of diagnostic methods, the presence of systemic autoimmune diseases, ophthalmic complications caused by MG, and treatments were evaluated and compared. RESULTS: Fourteen patients (20%) were diagnosed with ocular MG and 57 patients (80%) with generalized MG. Sensitivities of anti-acetylcholine receptor antibody and repetitive nerve stimulation tests were significantly higher in the generalized MG group (84%, 89%) compared to those in the ocular MG group (50%, 54%) (p = 0.011, p = 0.008). The sensitivity of the neostigmine test was the highest in both groups (98% of generalized MG, 79% of ocular MG), and the difference between the two groups was borderline significant (p = 0.058). The most common symptoms were ptosis and diplopia, and both groups presented with pain, blurred vision, and tearing. Systemic autoimmune disease was more prominent in the generalized MG group (21%) than in the ocular MG group (14%), and steroid therapy was used more frequently in the generalized MG group (82%) than in the ocular MG group (57%). Ophthalmic complications associated with long-term steroid treatment were more profound in the generalized MG (30%) compared to those of the ocular MG (21%). CONCLUSIONS: The generalized MG group was associated with higher sensitivities to diagnostic tests, more systemic steroid use, higher ophthalmic complications caused by systemic autoimmune disease, and long-term steroid treatment compared to those of the ocular MG groupope

Quantitative Screening of Cervical Cancers for Low-Resource Settings: Pilot Study of Smartphone-Based Endoscopic Visual Inspection After Acetic Acid Using Machine Learning Techniques

Background: Approximately 90% of global cervical cancer (CC) is mostly found in low- and middle-income countries. In most cases, CC can be detected early through routine screening programs, including a cytology-based test. However, it is logistically difficult to offer this program in low-resource settings due to limited resources and infrastructure, and few trained experts. A visual inspection following the application of acetic acid (VIA) has been widely promoted and is routinely recommended as a viable form of CC screening in resource-constrained countries. Digital images of the cervix have been acquired during VIA procedure with better quality assurance and visualization, leading to higher diagnostic accuracy and reduction of the variability of detection rate. However, a colposcope is bulky, expensive, electricity-dependent, and needs routine maintenance, and to confirm the grade of abnormality through its images, a specialist must be present. Recently, smartphone-based imaging systems have made a significant impact on the practice of medicine by offering a cost-effective, rapid, and noninvasive method of evaluation. Furthermore, computer-aided analyses, including image processing-based methods and machine learning techniques, have also shown great potential for a high impact on medicinal evaluations

Encoder-Weighted W-Net for Unsupervised Segmentation of Cervix Region in Colposcopy Images

Simple Summary The cervix region segmentation significantly affects the accuracy of diagnosis when analyzing colposcopy. Detecting the cervix region requires manual, intensive, and time-consuming labor from a trained gynecologist. In this paper, we propose a deep learning-based automatic cervix region segmentation method that enables the extraction of the region of interest from colposcopy images in an unsupervised manner. The segmentation performance with a Dice coefficient improved from 0.612 to 0.710 by applying the proposed loss function and encoder-weighted learning scheme and showed the best performance among all the compared methods. The automatically detected cervix region can improve the performance of image-based interpretation and diagnosis by suggesting where the clinicians should focus during colposcopy analysis. Cervical cancer can be prevented and treated better if it is diagnosed early. Colposcopy, a way of clinically looking at the cervix region, is an efficient method for cervical cancer screening and its early detection. The cervix region segmentation significantly affects the performance of computer-aided diagnostics using a colposcopy, particularly cervical intraepithelial neoplasia (CIN) classification. However, there are few studies of cervix segmentation in colposcopy, and no studies of fully unsupervised cervix region detection without image pre- and post-processing. In this study, we propose a deep learning-based unsupervised method to identify cervix regions without pre- and post-processing. A new loss function and a novel scheduling scheme for the baseline W-Net are proposed for fully unsupervised cervix region segmentation in colposcopy. The experimental results showed that the proposed method achieved the best performance in the cervix segmentation with a Dice coefficient of 0.71 with less computational cost. The proposed method produced cervix segmentation masks with more reduction in outliers and can be applied before CIN detection or other diagnoses to improve diagnostic performance. Our results demonstrate that the proposed method not only assists medical specialists in diagnosis in practical situations but also shows the potential of an unsupervised segmentation approach in colposcopy

Wells' Syndrome Associated with Churg-Strauss Syndrome

Churg-Strauss syndrome (CSS) is a multisystem granulomatous vasculitis that is characterized by peripheral eosinophilia and the infiltration of eosinophils into systemic organs. The skin lesions of CSS consist mainly of palpable purpura and nodules. Wells' syndrome (WS) is a rare inflammatory dermatosis that is associated with recurrent granulomatous dermatitis and eosinophilia. Since these two diseases are rare, any overlap between them is very unusual. Herein, we report a patient with CSS, who initially presented a skin eruption of erythematous urticarial-plaques, vesicles, and blisters. Upon biopsy, the histology of these plaques indicated eosinophilic infiltration and "flame figures" within the dermis, which was consistent with a diagnosis of WS. Although the association between WS and CSS that was observed in our patient may be purely coincidental, it could also suggest a common pathogenetic background of these two distinct diseases, as both share several many common features

6,7-Dimethoxy-4-methylcoumarin suppresses pro-inflammatory mediator expression through inactivation of the NF-kappaB and MAPK pathways in LPS-induced RAW 264.7 cells

In this study, we investigated the ability of 6,7-dimethoxy-4-methylcoumarin (DMC) to inhibit lipopolysaccharide (LPS)-induced expression of pro-inflammatory mediators in mouse macrophage (RAW 264.7) cells, and the molecular mechanism through which this inhibition occurred. Our results indicated that DMC down regulated LPS-induced nitric oxide (NO) synthase (iNOS) and cyclooxygenase-2 (COX-2) expression, thereby reducing the production of NO and prostaglandin E2 (PGE2) in LPS-activated RAW 264.7 cells. Furthermore, DMC suppressed LPS-induced production of pro-inflammatory cytokines such as interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α. To elucidate the mechanism underlying the anti- inflammatory activity of DMC, we assessed its effects on the mitogen-activated protein kinase (MAPK) pathway and the activity and expression of nuclear transcription factor kappa-B (NF-κB). The experiments demonstrated that DMC inhibited LPS-induced phosphorylation of extracellular signal-regulated kinases (ERKs), c-Jun N-terminal kinase (JNK), and p38. In addition, it attenuated LPS-induced NF-κB activation via the inhibition of IκB-α phosphorylation. Taken together, these data suggest that DMC exerts its anti-inflammatory effects in RAW 264.7 cells through the inhibition of LPS-stimulated NF-κB and MAPK signaling, thereby downregulating the expression of pro-inflammatory mediators

Adrenoleukodystrophy 1례

We describe a 9-year-old boy who showed typical neurologic manifestations i.e., progressive behavioral changes, intellectual impairment, visual disturbances and hearing loss, cerebellar and pyramidal signs with characteristic neuroimaging features, which led us to make a clinical deagnosis of ALD. It was confirmed later by demonstration of increased VLCFA levels in RBC membrane using HPLC. He has no family history of neurologic or endocrine disorder. Prophylactic antiepileptic medicaion could not prevent the development of seizure disorder

Customized Energy Down-Shift using Iridium Complexes for Enhanced Performance of Polymer Solar Cells

School of Molecular Sciences(Chemistry)For the higher performance of polymer solar cells (PSCs), many researchers tried to develop new polymers that can absorb broader range of spectrum. However, there are some limits to absorb broader range with single donor. Therefore, multi donor systems and energy transfer systems have been researched. With two different donors it is easier to enhance absorption range. As a result, multi donor and energy transfer was successful to increase performance. However, the existing systems are applying polymer-polymer systems. When two different polymers are mixed, the compatibility between two polymers is critical to morphology of blend film. Also, in polymer-polymer energy transfer, the boundary between charge transfer and energy transfer is unclear. Therefore, for the first time, we developed customized iridium (Ir(III)) complexes, with Ir(III) complex incorporated into the active materials poly(thieno[3,4-b]-thiophene/benzodithiophene) (PTB7, amorphous) or poly(3-hexylthiophene) (P3HT, high crystalline) as energy donor additives. The Ir(III) complex with the 2-phenyl quinolone ligand energy donor increased the power conversion efficiency of the corresponding devices by approximately 20%. The enhancements are attributed to the improved molecular compatibility and energy level between the Ir(III) complex and the active materials, long F??rster resonance energy transfer radius, and high energy down-shift efficiency. Overall, we reveal Ir(III) complex additives for amorphous and highly crystalline polymer active materialsthese additives would enable efficient energy transfer in polymer solar cells, while retaining the desirable active layer morphology, thereby resulting in improved light absorption and conversion.ope