Fusarium, a fungus, produces a potent mycotoxin that, when ingested with contaminated cereal grains, produces a serious illness in man called alimentary toxic aleukia (USSR) and Akakabi-byo (Japan). The illness includes gastrointestinal symptoms and weakness and if ingestion of Fusarium contaminated grain persists, culminates in aplastic anemia. A 66-year-old woman had Eaton-Lambert syndrome and a clinical course similar to alimentary toxic aleukia. Several months before her death, pancytopenia, initially thought guanidine-induced, developed and progressed to aplastic anemia despite discontinuation of guanidine 2 1/2 months before death. Autopsy showed numerous granuloma in the liver, spleen, esophagus, and cecum from which Fusarium oxysporum was isolated. Although the unique finding of systemic fusariosis may relate to altered host resistance terminally, a causal relationship with her defect of neuromuscular transmission and/or aplastic anemia is a distinct possibility.
An 80-year-old man was treated with rituximab for active rheumatoid arthritis until 2019, now controlled with Salazopyrin, prednisolone, methotrexate, and folic acid. However, laboratory data showed elevated C-reactive protein and erythrocyte sedimentation rate. Whole-body bone scan showed bony and joint destruction to the upper cervical vertebra (C spine), bilateral shoulders, wrists, finger joints, ankles, and left knee. SPECT/CT localized the upper C spine uptake to the C1/C2 joint and adjacent C1 and C2 with C1/C2 subluxation. C spine CT showed vertical atlantoaxial subluxation and bony erosions.
Objective: To examine the biofactors associated with bone mineral density (BMD) in southern Taiwanese adults. Materials and Methods: The medical records of 3242 adults who underwent health examinations between June 2014 and February 2018 at a regional hospital in southern Taiwan were reviewed. The data collected included health history, anthropomorphic characteristics, clinical laboratory results, biochemical parameters, and BMD. The data were used to identify the biofactors associated with BMD/T-scores at the lumbar spine and femoral neck by multivariate linear regression analysis with the stepwise method. Results: The mean age of the patients was 58.1 years, and 71.4% were male. Factors positively correlated with BMD and the T-score included body mass index (BMI), male gender, calcium, and creatinine. Age, alkaline phosphatase (ALP), triiodothyronine, serum thyroxine, low-density lipoprotein cholesterol, and a history of hyperlipidemia were negatively correlated with BMD and the T-score. Conclusion: The associated biofactors reported here were similar to and had similar relationships as the biofactors identified in previous literature reports. Not all of the sites examined for BMD were influenced by the same association factors, except for BMI, male gender, age, and ALP, implying that the bone remodeling processes that shape BMD involve a complex regulatory network and demonstrating that our extracted factors are the most useful for clinical practice.
The mechanism of focus latitude enhancement for contact/via hole printing is explained by approximating the axis intensity distribution of an image as a series of cosine functions to characterize the interference between each pair of diffraction beams. It is found that a phase-shifting mask ͑PSM͒ with symmetrical assist features improves the depth of focus ͑DOF͒ by introducing destructive interference to counterbalance the intensity fluctuation from constructive interference as defocus. A simple formula was derived to represent the capability of focus latitude enlargement. It shows that the extent of enhancement depends on the exposure wavelength and numerical aperture of a projection lens only. Increasing the degree of partial coherence degrades the focal range enlargement because a larger illumination angle elongates the destructive interference pattern in the optical-axis direction to weaken its ability for intensity compensation. On the other hand, the lack of constructive interference in dense hole imaging fails the mask pattern transfer, which limits the application of the phase-shifting method to pattern pitch greater than ͱ2/NA. A tiny amount of spherical aberration results in prominent asymmetrical defocus behavior because the wave deformation in the projection lens shifts the distribution of constructive and destructive interference patterns to opposite defocus directions. The printing characteristics of 0.17 m contact using an 18% transmission, rim-type attenuated phase-shifting mask are investigated to corroborate our analysis of defocus behavior. The dependence of depth of focus on pattern duty is stressed to elucidate the difference in mechanisms of focus latitude improvements for a sparse hole and periodic dense hole.
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