Rare and common manifestation of musculoskeletal and sinonasal sarcoidosis: A case report.

Sarcoidosis is a systemic granulomatous disease that can affect multiple organ systems. Although many sarcoidosis patients are asymptomatic, the variable clinical progression of symptomatic patients and the nonspecific presentation make diagnosis difficult in certain cases. Musculoskeletal and sinonasal involvement of sarcoidosis are uncommon manifestations, and they are often only seen in patients with widespread disease. Diagnosis of osseous sarcoidosis, sarcoid arthropathy, and sarcoid rhinosinusitis are typically based on a combination of clinical history, radiological findings, and pathologic specimens. Although there are classic image findings, such as lacelike honeycomb appearance of small bones of the hands or hilar/mediastinal lymphadenopathy, sole reliance on image findings for the diagnosis of sarcoidosis is unreasonable as many findings are nonspecific. However, failure to include sarcoidosis in the differential diagnosis often leads to a delay in recognition of musculoskeletal or sinonasal involvement and results in ineffective treatment plan. Even in patients with biopsy-proven sarcoidosis, some image findings in isolation that may represent granulomatous infiltrates are disregarded as nonspecific without raising the possibility of sarcoidosis due to its rare occurrence. Here we discuss a case of multisystemic sarcoidosis in a 42-year-old female with a constellation of classic and rare findings of biopsy-proven sarcoidosis.

Erratum to "A case of spontaneous intracranial hypotension in a 45-year-old male with headache, behavior changes and altered mental status" [Radiology Case Reports 17 (2022) 2289-2294].

[This corrects the article DOI: 10.1016/j.radcr.2022.03.075.].

Super-Linear-Threshold-Switching Selector with Multiple Jar-Shaped Cu-Filaments in the Amorphous Ge3 Se7 Resistive Switching Layer in a Cross-Point Synaptic Memristor Array.

The learning and inference efficiencies of an artificial neural network represented by a cross-point synaptic memristor array can be achieved using a selector, with high selectivity (Ion /Ioff ) and sufficient death region, stacked vertically on a synaptic memristor. This can prevent a sneak current in the memristor array. A selector with multiple jar-shaped conductive Cu filaments in the resistive switching layer is precisely fabricated by designing the Cu ion concentration depth profile of the CuGeSe layer as a filament source, TiN diffusion barrier layer, and Ge3 Se7 switching layer. The selector performs super-linear-threshold-switching with a selectivity of > 107 , death region of -0.70-0.65 V, holding time of 300 ns, switching speed of 25 ns, and endurance cycle of > 106 . In addition, the mechanism of switching is proven by the formation of conductive Cu filaments between the CuGeSe and Ge3 Se7 layers under a positive bias on the top Pt electrode and an automatic rupture of the filaments after the holding time. Particularly, a spiking deep neural network using the designed one-selector-one-memory cross-point array improves the Modified National Institute of Standards and Technology classification accuracy by ≈3.8% by eliminating the sneak current in the cross-point array during the inference process.

A case of spontaneous intracranial hypotension in a 45-year-old male with headache, behavior changes and altered mental status.

Spontaneous intracranial hypotension is a rare disease that results from low cerebrospinal fluid (CSF) volume caused by leakage of CSF from the spine in the absence of lumbar puncture, spine surgery, or intervention. The most common presentation is the headache that is usually but not invariably orthostatic. The underlying pathology is a CSF leak resulting from dural weakness involving the nerve root sleeves, ventral dural tears associated with calcified disc herniations, or CSF venous fistula. In severe cases, neuropsychiatric symptoms and changes in mental status may develop. Some case reports also mention gait disturbances, slurred speech, and urinary incontinence. The constellation of neuropsychiatric symptoms similar to behavior variant frontotemporal dementia in the presence of "brain sag" on MRI is known as frontotemporal brain sagging syndrome, first described by Wicklund et al. (4). The disease presents a diagnostic challenge to the primary care physicians, who are the first to see these patients. Brain and spine imaging is key to diagnoses but requires a high index of suspicion, as very rarely are all classic findings of intracranial hypotension present in the same patient. Here we discuss a case of spontaneous intracranial hypotension in a 45-year-old male patient who presented with headache, drowsiness, incoherent speech, behavior symptoms, and altered mental status.

Ex situ soil washing of highly contaminated silt loam soil using core-crosslinked amphiphilic polymer nanoparticles.

Non-ionic surfactants (Triton X-100 and Brij 30) and core-crosslinked amphiphilic polymer (CCAP) nanoparticles were used as extractants in the ex situ soil washing of silt loam soil contaminated with large quantities of petroleum oil, and their soil-washing performances were compared. Following washing with the surfactants, highly turbid aqueous solutions containing large numbers of soil and petroleum oil particles were produced. In contrast, the CCAP nanoparticles successfully extracted the petroleum oils from the soil samples without the formation of such a turbid aqueous solution. In addition, the CCAP nanoparticles extracted 96% of the petroleum oils, which is a significantly larger quantity than that by Brij 30 and Triton X-100 under equivalent conditions. Indeed, owing to their crosslinked micelle-like structure, the CCAP nanoparticles maintained their nanostructure even upon contact with a highly contaminated silt loam soil matrix, thereby resulting in the extraction of only the hydrophobic oily contaminants from the soil matrix and avoiding the formation of dispersions of soil particles and hydrophobic contaminants. As such, CCAP nanoparticles could be considered as suitable washing materials for highly contaminated silt loam soils.

The antimicrobial effect of thiamine dilauryl sulfate in tofu inoculated with Escherichia coli O157:H7, Salmonella Typhimurium, Listeria monocytogenes and Bacillus cereus.

Thiamine dilauryl sulfate (TDS) is a food additive that is used as a bactericidal agent. This study examines the antimicrobial effect of TDS on tofu inoculated with Escherichia coli O157:H7, Salmonella Typhimurium, Listeria monocytogenes, and Bacillus cereus. Tofu was inoculated with 100 µL of each microorganism and TDS solution (0.1, 0.5, 1, and 2%) was added to all bags, which were stored at 5 and 25 °C for 5 days. Sensory evaluations were conducted with tofu stored at 5 °C. At 5 °C, with a 2% TDS, E. coli O157:H7, S. Typhimurium, L. monocytogenes, and B. cereus were reduced by 0.29, 0.36, 0.70, and 1.47 log CFU/g, respectively. None of the sensory characteristics of tofu treated with TDS were significantly different from those of the control. Consequently, this study shows the potential of TDS as an antimicrobial agent with a practical application in tofu to ensure food safety.

Growth behavior comparison of Listeria monocytogenes between Type strains and beef isolates in raw beef.

This study was conducted to compare the growth parameters of Listeria monocytogenes between beef isolates and Type strains in raw beef. Beef was artificially inoculated with 3 Log CFU/g levels and growth was measured during storage at various temperatures (5-25 °C) using conventional plating methods. The R2 value for lag time (λ) and specific growth rate (µ) were determined using modified-Gompertz model, which were greater than 0.98 at all storage temperature except at 5 °C. B f , A f , and RMSE showed acceptable ranges, showed that the models are suitable for the modeling the growth of L. monocytogenes. At all temperatures, the λ of L. monocytogenes beef isolates was shorter than that of the L. monocytogenes Type strains, and the µ of beef isolates was higher than that of Type strains. These results showed that growth pattern prediction of beef inoculated with L. monocytogenes beef isolates gives more actual results than with Type strains.

Interscalene brachial plexus bolus block versus patient-controlled interscalene indwelling catheter analgesia for the first 48 hours after arthroscopic rotator cuff repair.

BACKGROUND: We sought to compare the efficacy of interscalene brachial plexus bolus blockade (IBPBB) and patient-controlled interscalene indwelling catheter analgesia (PCIA) for postoperative pain management within 48 hours postoperatively in patients undergoing arthroscopic rotator cuff repairs (ARCR). METHODS: Patients undergoing ARCR were randomized into 3 groups by postoperative analgesia method. The IBPBB group received a mixed solution of 16 mL of 0.75% ropivacaine and 4 mL of 2% lidocaine as a bolus postoperatively. The PCIA group received a 10-mL bolus solution of 0.75% ropivacaine (4 mL) and 5% dextrose water (6 mL) just after the operation and continuous infusion of this solution. The control received only meperidine as needed, 12.5 mg, intravenously. Visual analog scale (VAS) pain scores were evaluated for the first 48 hours postoperatively. RESULTS: For the first 2 hours postoperatively, VAS scores in the IBPBB group were significantly lower than in the PCIA group and control group, but at 12 and 24 hours postoperatively, VAS scores of the IBPBB group were significantly higher than the PCIA group (P < .05). At 48 hours postoperatively, there was no significant difference in VAS scores among the 3 groups (P = .169). The method of analgesia was the only factor affecting pain scores at 24 hours postoperatively (P < .05). CONCLUSIONS: IBPBB provided effective immediate postoperative analgesia until 6 hours postoperatively. Especially until postoperative 2 hours, the VAS pain score was less than 1 point in the IBPBB group; however, there was significant rebound pain at 12 hours after surgery. During the first 24 hours postoperatively, PCIA reduced postoperative pain without rebound pain. Surgeons should choose methods for control of postoperative pain considering the advantages and disadvantages of each analgesic method.

A concise evidence-based physical examination for diagnosis of acromioclavicular joint pathology: a systematic review.

OBJECTIVES: The clinical examination of the shoulder joint is an undervalued diagnostic tool for evaluating acromioclavicular (AC) joint pathology. Applying evidence-based clinical tests enables providers to make an accurate diagnosis and minimize costly imaging procedures and potential delays in care. The purpose of this study was to create a decision tree analysis enabling simple and accurate diagnosis of AC joint pathology. METHODS: A systematic review of the Medline, Ovid and Cochrane Review databases was performed to identify level one and two diagnostic studies evaluating clinical tests for AC joint pathology. Individual test characteristics were combined in series and in parallel to improve sensitivities and specificities. A secondary analysis utilized subjective pre-test probabilities to create a clinical decision tree algorithm with post-test probabilities. RESULTS: The optimal special test combination to screen and confirm AC joint pathology combined Paxinos sign and O'Brien's Test, with a specificity of 95.8% when performed in series; whereas, Paxinos sign and Hawkins-Kennedy Test demonstrated a sensitivity of 93.7% when performed in parallel. Paxinos sign and O'Brien's Test demonstrated the greatest positive likelihood ratio (2.71); whereas, Paxinos sign and Hawkins-Kennedy Test reported the lowest negative likelihood ratio (0.35). CONCLUSION: No combination of special tests performed in series or in parallel creates more than a small impact on post-test probabilities to screen or confirm AC joint pathology. Paxinos sign and O'Brien's Test is the only special test combination that has a small and sometimes important impact when used both in series and in parallel. Physical examination testing is not beneficial for diagnosis of AC joint pathology when pretest probability is unequivocal. In these instances, it is of benefit to proceed with procedural tests to evaluate AC joint pathology. Ultrasound-guided corticosteroid injections are diagnostic and therapeutic. An ultrasound-guided AC joint corticosteroid injection may be an appropriate new standard for treatment and surgical decision-making. LEVEL OF EVIDENCE: II - Systematic Review.

Electro-Forming and Electro-Breaking of Nanoscale Ag Filaments for Conductive-Bridging Random-Access Memory Cell using Ag-Doped Polymer-Electrolyte between Pt Electrodes.

Ag-doped polymer (polyethylene oxide: PEO) conductive-bridging-random-access-memory (CBRAM) cell using inert Pt electrodes is a potential electro-forming free CBRAM cells in which electro-forming and electro-breaking of nanoscale (16~22-nm in diameter) conical or cylindrical Ag filaments occurs after a set or reset bias is applied. The dependency of the morphologies of the Ag filaments in the PEO polymer electrolyte indicates that the electro-formed Ag filaments bridging the Pt cathode and anode are generated by Ag+ ions drifting in the PEO polymer electrolyte toward the Pt anode and that Ag dendrites grow via a reduction process from the Pt anode, whereas electro-breaking of Ag filaments occurs through the oxidation of Ag atoms in the secondary dendrites and the drift of Ag+ ions toward the Pt cathode. The Ag doping concentration in the PEO polymer electrolyte determines the bipolar switching characteristics; i.e., the set voltage slightly decreases, while the reset voltage and memory margin greatly increases with the Ag doping concentration.

A practical, evidence-based, comprehensive (PEC) physical examination for diagnosing pathology of the long head of the biceps.

BACKGROUND: Clinical examination of the shoulder joint has gained attention as clinicians aim to use an evidence-based examination of the biceps tendon, with the desire for a proper diagnosis while minimizing costly imaging procedures. The purpose of this study is to create a decision tree analysis that enables the development of a clinical algorithm for diagnosing long head of biceps (LHB) pathology. METHODS: A literature review of Level I and II diagnostic studies was conducted to extract characteristics of clinical tests for LHB pathology through a systematic review of PubMed, Medline, Ovid, and Cochrane Review databases. Tests were combined in series and parallel to determine sensitivities and specificities, and positive and negative likelihood ratios were determined for each combination using a subjective pretest probability. The "gold standard" for diagnosis in all included studies was arthroscopy or arthrotomy. RESULTS: The optimal testing modality was use of the uppercut test combined with the tenderness to palpation of the biceps tendon test. This combination achieved a sensitivity of 88.4% when performed in parallel and a specificity of 93.8% when performed in series. These tests used in combination optimize post-test probability accuracy greater than any single individual test. CONCLUSION: Performing the uppercut test and biceps groove tenderness to palpation test together has the highest sensitivity and specificity of known physical examinations maneuvers to aid in the diagnosis of LHB pathology compared with diagnostic arthroscopy (practical, evidence-based, comprehensive examination). A decision tree analysis aides in the practical, evidence-based, comprehensive examination diagnostic accuracy post-testing based on the ordinal scale pretest probability.

Effects of malic acid or/and grapefruit seed extract for the inactivation of common food pathogens on fresh-cut lettuce.

This study investigated the antimicrobial activity of malic acid (MA), grapefruit seed extract (GSE), and combined (MA+GSE) treatment against Escherichia coli O157:H7, Salmonella Typhimurium, and Listeria monocytogenes on fresh-cut lettuce. The antimicrobial effects of 1% MA and 0.5% GSE alone and in combination (1% MA+0.5% GSE) were tested on artificially inoculated lettuce during storage at 5°C for 14 days. The maximum reductions of E. coli O157:H7, S. Typhimurium, and L. monocytogenes were 4.96, 4.80, and 3.95 log CFU/g observed with MA+GSE during storage for 14 days, respectively. MA+GSE showed the greatest reduction against in E. coli O157:H7 and L. monocytogenes. These results indicate that the combined treatment was more effective than MA and GSE alone treatment. Therefore, it suggests that MA + GSE could be used as an effective intervention method for improving microbiological safety of fresh-cut lettuce.

The effects of neuromuscular electrical stimulation on pharyngeal transit time.

[Purpose] The purpose of this study was to identify the effects of Neuromuscular Electrical Stimulation (NMES) on pharyngeal transit time. [Subjects] Subjects were divided into normal old persons aged over 70 (N=18), and normal young persons aged under 30 (N=10). [Method] We measured the Pharyngeal Transit Time (PTT) to determine their swallowing characteristics. NMES was used to stimulate old group's suprahyoid and infrahyoid muscles 60 minutes a day, 5 days a week for 2 weeks using four electrodes. We used SPSS version 14.0 to analyze and compare the data between the 2 groups. [Results] After NMES, PTT of the normal old group became significantly shorter. PTT was much shorter, but was still longer than that of the normal young group. [Conclusion] The PTTs of the two groups classified by age were significantly different.

Structure analysis of inorganic crystals by energy-filtered precession electron diffraction.

We performed structure analysis of Si single crystal and CaMoO(4) inorganic crystal by energy-filtered precession electron diffraction (PED). Structure analysis was performed using conventional selected area electron diffraction, PED and energy-filtered PED (EF-PED). The EF-PED method proved to be advantageous in determining the crystal structures and accurate cell parameters of inorganic crystals due to resolution enhancement by sharpening the peak shapes and reducing inelastic scattering. Among the EF-PED methods, zero-loss PED was most useful for structure analysis by minimizing inelastic scattering intensities, while plasmon-loss PED could be used effectively to determine crystal symmetry by closely observing the conditions of forbidden reflections.

Size effect of Pt nanoparticle on catalytic activity in oxidation of methanol and formic acid: comparison to Pt(111), Pt(100), and polycrystalline Pt electrodes.

This work presents variation of oxidative catalytic activities of methanol and formic acid on Pt nanoparticles of various sizes and a comparison to the results observed on Pt(111), Pt(100), and polycrystalline Pt. The Pt nanoparticles dispersed on platelet carbon nanofiber are cuboctahedral particles, whose sizes span from 5.6 to 1.1 nm. The electrochemically active surface areas, measured using charges of hydrogen adsorption/desorption and stripping of adsorbed CO, are reasonably consistent with those calculated theoretically with a simple cuboctahedron model. However, Pt nanoparticles with extremely small size (<1.8 nm) aggregate to reduce their surface areas. The size effect of Pt nanoparticles in oxidation of methanol and formic acid is discussed in terms of specific activity (current per unit surface area) and mass activity (current per unit mass).

Controlled synthesis and characterization of the enhanced local field of octahedral Au nanocrystals.

Octahedral Au nanocrystals with localized surface plasmon-assisted enhancing optical properties can be prepared in aqueous solution via the forced reduction of Au ions by ascorbic acid through the addition of NaOH.

Electrochemical capacitances of well-defined carbon surfaces.

Reported is the capacitive behavior of homogeneous and well-defined surfaces of pristine carbon nanofibers (CNFs) and surface-modified CNFs. The capacitances of the well-defined CNFs were measured with cyclic voltammetry to correlate the surface structure with capacitance. Among the studied pristine CNFs, the edge surfaces of platelet CNFs (PCNF) and herringbone CNFs were more effective in capacitive charging than the basal plane surface of tubular CNF by a factor of 3-5. Graphitization of PCNF (GPCNF) changed the edge surface of PCNF into a domelike basal plane surface, and the corresponding capacitances decreased from 12.5 to 3.2 F/g. A chemical oxidation of the GPCNF, however, recovered a clear edge surface by removal of the curved basal planes to increase the capacitance to 5.6 F/g. The difference in the contribution of the edge surface and basal-plane surface to the capacitance of CNF was discussed in terms of the anisotropic conductivity of graphitic materials.

In-vivo measurements of the dielectric properties of breast carcinoma xenografted on nude mice.

A developing method of cancer detection is to use electromagnetic waves to compare the dielectric properties of normal and cancerous tissue. Because most of the previous studies consisted of dielectric measurements taken ex-vivo, this study investigated the advantages of in-vivo measurements, obtained using the newly developed insertion-type planar probe, through the measurements of cancer (MDA MB 231), which was cultivated and implanted into the mammary fat pad of nude mice. Reflection coefficients were obtained in the broadband frequency range from 0.5 to 30 GHz, from which broadband complex permittivity data was extracted. Complex permittivity, in addition to other parameters such as conductivity and characteristic frequency, were used to make comparisons between cancerous tissue, normal muscle tissue and fat tissue, as well as comparisons between in-vivo and ex-vivo measurements. This study investigated the suitability of in-vivo cancer detection using microwaves with the newly developed insertion-type planar probe. Results showed that both sensitivity and specificity of the current method was 97%. In addition, predictive values were 99% for the positive and 94% for the negative, thus greatly enhancing the practicality of this method. In conclusion, it was demonstrated that in-vivo measurements are highly beneficial in studying the potential of microwaves as a diagnostic tool of breast cancer, especially in combination with the newly developed insertion-type planar probe.