Multiple metastatic calcifications detected by bone scintigraphy and demonstrated by CT.

Metastatic calcifications according to histopathologic and scintigraphic findings have been well-defined. The authors report a postoperative case of hyperparathyroidism with multiple metastatic calcifications in the lung, kidney, stomach, heart, and vessels that were primarily detected by bone scintigraphy and demonstrated by CT. Tc-99m MDP bone scintigraphy showed a markedly increased accumulation of radioactivity diffusely throughout the lung, left ventricular wall, both kidneys, and the gastric cardia and body. In the lung, plain films showed almost normal lung. CT, however, demonstrated patchy, slightly increased densities in the lung bilaterally. Cardiac CT indicated a considerably increased density of the ventricular myocardium and remarkable calcification in or near the atrioventricular septum or annulus fibrosus. Upper abdominal CT demonstrated increased densities diffusely throughout the gastric mucosa and renal cortex. Only vascular calcifications were depicted by plain films. Using both bone scintigraphy and CT provides accurate information about each lesion and each tissue, allowing precise diagnosis of even a questionable lesion in the early stage of metastatic calcification. Early diagnosis and early therapy offer the best chance for cure or palliative therapy.     

GABA(A) receptor-mediated inspiratory termination evoked by vagal stimulation in decerebrate cats.

To identify the GABAergic inhibitory mechanisms involved in inspiratory termination or off-switching (IOS), the effects of a specific enhancer of GABA(A) receptors, midazolam, and an antagonist, bicuculline, on vagally evoked inspiratory inhibitions and IOS were investigated in decerebrate cats. Stimulation of vagal afferents at late inspiration provoked either reversible inspiratory inhibition or IOS, depending on the stimulus intensity. Each response occurred at a constant latency (phase 1). The reversible response was triphasic, consisting of an early (phase 2) inhibition, a brief (phase 3) excitation and a late (phase 4) inhibition in the phrenic neurogram, and early (phase 2) IPSPs, brief (phase 3) EPSPs and late (phase 4) IPSPs in bulbar inspiratory (I) neurones. With an increasing stimulus intensity, phase 4 inhibitions were increased in amplitude and duration, leading to IOS. Midazolam (0.1 mg/kg i.v.) increased more selectively phase 4 IPSPs than phase 2 IPSPs in I neurones, and decreased the threshold for evoking IOS by producing an earlier and larger phase 4 IPSPs. Bicuculline (1.0 mg/kg i.v.) had an opposite effect. These results suggest that the late inhibitory response evoked by vagal stimulation in the I neuronal pool organizes an initial phase of IOS which is mediated by GABA(A) receptors.     

Prevention of anterior cruciate ligament injuries in soccer

Proprioceptive training has been shown to reduce the incidence of ankle sprains in different sports. It can also improve rehabilitation after anterior cruciate ligament (ACL) injuries whether treated operatively or nonoperatively. Since ACL injuries lead to long absence from sports and are one of the main causes of permanent sports disability, it is essential to try to prevent them. In a prospective controlled study of 600 soccer players in 40 semiprofessional or amateur teams, we studied the possible preventive effect of a gradually increasing proprioceptive training on four different types of wobble-boards during three soccer seasons. Three hundred players were instructed to train 20 min per day with 5 different phases of increasing difficulty. The first phase consisted of balance training without any balance board; phase 2 of training on a rectangular balance board; phase 3 of training on a round board; phase 4 of training on a combined round and rectangular board; phase 5 of training on a so-called BABS board. A control group of 300 players from other, comparable teams trained normally and received no special balance training. Both groups were observed for three whole soccer seasons, and possible ACL lesions were diagnosed by clinical examination, KT-1000 measurements, magnetic resonance imaging or computed tomography, and arthroscopy. We found an incidence of 1.15 ACL injuries per team per year in the control group and 0.15 injuries per team per year in the proprioceptively trained group (P<0.001). Proprioceptive training can thus significantly reduce the incidence of ACL injuries in soccer players.     

Spontaneous pneumatocele and pneumocephalus associated with mastoid hyperpneumatization

We present a case of spontaneous pneumatocele and pneumocephalus associated with mastoid hyperpneumatization. Collections of air such as these are normally due to injury or surgery, and more rarely, infection or tumor; exceptionally they may be spontaneous. The patient in question complained of a progressively enlarging retroauricular mass which increased in size on Valsalva maneuvers; he had no other symptoms. The etiology, skull X-rays, computed tomography and follow-up after surgery are shown here.     

石榴花多酚对链脲佐菌素诱发2型糖尿病大鼠糖代谢的影响

目的:研究石榴花多酚(pomegranate flower polyphenol,PFP)对2型糖尿病(type2diabetes mellitus,T2DM)大鼠胰岛素抵抗(IR)作用以及糖代谢的影响。方法:高糖高脂饲料喂养加STZ一次性腹腔注射(45mg.kg-1)建立2型糖尿病大鼠模型。分别以石榴花多酚100,300mg.kg-1干预4周后,检测空腹血糖(Fasting plasma glucose,FPG)、空腹胰岛素水平(Fast-ing insulin,FIns)、血清游离脂肪酸(Free fatty acid,FFA)浓度;白介素-6(Interleukin IL-6);肌糖原(Muscle glycogen,MG)和肝糖原(Hepatic glycogen,HG)含量及糖代谢中关键酶己糖激酶(Hexokinase,HK)和苹果酸脱氢酶(Malic dehydrogenase,MDH)活性。结果:与模型组相比,石榴花多酚各剂量组均可有效降低2型糖尿病大鼠FPG、FIns(P<0.05或P<0.01),显著降低FFA浓度、IL-6浓度和肝脏MDH活性,增加骨骼肌中HK的活性和MG的含量。对HG含量...     

3种不同溶剂提取新疆塔城红花挥发油的化学成分分析

目的分析新疆塔城红花的正己烷、石油醚和二氯甲烷3种溶剂提取物及挥发油的化学成分。方法利用索氏提取法对新疆塔城红花挥发油进行提取,并采用气相色谱-质谱联用法分析挥发油中的化学成分。结果分析红花挥发油,有106种化学成分被鉴定出来,其中石油醚所提取的红花挥发油中的挥发性成分最多,正己烷次之,二氯甲烷提取最少。3种溶剂提取所得挥发油的主要成分相似,但存在一定差异。提取的共同成分为26种,含有9,12,15-十八碳酸三烯-1-醇(含量分别为14.27%、11.95%和11.23%)、2,4-二十三烷二酮(6.99%、12.82%和20.54%)、棕榈酸(13.39%、9.93%和6.66%),各自提取的化学成分中也存在较大差异,正己烷提取的含量较高的是壬酸-2-丙烯酯(8.82%)和反式-双环[10.8.0]二十烷(8.34%),石油醚提取的含量较高的化合物是1,4-二十九碳二烯(3.68%)和环己酸-10-十一烯酯(1.48%),二氯甲烷提取的独有成分含量较高的化合物有乙酸羽扇醇酯(2.87%)和1,2-环氧十九烷(2.75%)。结论联合应用可以相对全面地分析挥发油的化学成分,也可以根据各自特点,针对性地采用某种提取溶剂和方法而分离得到相关成分。     

Prediction of Compressive Strength of Sustainable Foam Concrete Using Individual and Ensemble Machine Learning Approaches

The entraining and distribution of air voids in the concrete matrix is a complex process that makes the mechanical properties of lightweight foamed concrete (LFC) highly unpredictable. To study the complex nature of aerated concrete, a reliable and robust prediction model is required, employing different machine learning (ML) techniques. This study aims to predict the compressive strength of LFC by using a support vector machine (SVM) as an individual learner along with bagging, boosting, and random forest (RF) as a modified ensemble learner. For that purpose, a database of 191 data points was collected from published literature, where the mix design ingredients, i.e., cement content, sand content, water to cement ratio, and foam volume, were chosen to predict the compressive strength of LFC. The 10-K fold cross-validation method and different statistical error and regression tools, i.e., mean absolute error (MAE), root means square error (RMSE), and coefficient of determinant (R²), were used to evaluate the performance of the developed ML models. The modified ensemble learner (RF) outperforms all models by yielding a strong correlation of R² = 0.96 along with the lowest statistical error values of MAE = 1.84 MPa and RMSE = 2.52 MPa. Overall, the result suggests that the ensemble learners would significantly enhance the performance and robustness of ML models.     

Cytomegalovirus reactivation in patients with multiple myeloma

The introduction of novel antimyeloma agents has improved the outcome of multiple myeloma (MM) dramatically. However, it has also led to an increasing incidence of Herpesviridae family virus infections, including a high incidence of post‐transplant cytomegalovirus (CMV) reactivation after treatment with novel agents. We herein retrospectively assessed the CMV reactivation in all 120 newly diagnosed patients with MM consecutively seen and treated at our hospital. CMV antigenemia tests were ordered in 58 patients depending on the clinical context, and the incidence of CMV reactivation and proven/suspected CMV disease requiring antiviral therapy was 20% (24 of 120) and 11% (13 of 120) respectively, including those without stem cell transplantation (SCT). The clinical and laboratory characteristics of these patients were compared with those in 34 CMV antigenemia‐negative (CMV‐negative) patients. Patients with extramedullary disease or a low absolute lymphocyte count (ALC) had a higher risk of developing CMV reactivation. In addition, the median duration from the time of MM diagnosis to CMV reactivation was 5.0 months. These results suggest that, regardless of whether or not undergoing SCT, elderly patients with MM receiving novel agents should be monitored for CMV reactivation to allow for the timely diagnosis and treatment, especially for those with extramedullary disease.     

Mobile Based mhGAP-IG Depression Screening in Kenya

We aimed to determine the prevalence and determinants of depression using mobile based mental health Global Action Programme Intervention guide (mhGAP-IG) in remote health care settings where most priority mental health problems are managed by non-mental health specialists and evaluate the feasibility of the application. Adult patients were recruited from four rural public health facilities in Kenya using systematic random sampling and screened for depression. There were no missing items since the application prevented saving of data unless all the items were answered. The prevalence of depression was 25% with suicidal behavior being the most significant comorbid problem. Older age, personal and a family history of a mental disorder were significantly correlated with depression. Exploring the use of health-related mobile applications in identification of priority mental health problems is useful notably in low-resource settings; and also forms a basis for prevention of mental disorders and intervention at acute stages.