Revisit of gastromalacia: a report of three cases and review of the literature.

Gastromalacia, a postmortem dissolution of the stomach, is caused by endogenous enzymes resulting in thinning and softening of the stomach wall with focal perforation. Thus, identifying gastromalacia and differentiating it from other causes of gastric perforation is essential to avoid misdiagnosis. Herein, three cases of gastromalacia are described. The victims died due to hyperthermia, leukemia complicated by cerebral hemorrhage, and asphyxia due to inhaled vomitus, respectively. The macroscopic and microscopic appearance in three cases indicated gastromalacia, although multiple factors confused the diagnosis. Furthermore, the differential diagnosis and the underlying mechanism are discussed.

Object-Based Dense Matching Method for Maintaining Structure Characteristics of Linear Buildings.

In this paper, we proposed a novel object-based dense matching method specially for the high-precision disparity map of building objects in urban areas, which can maintain accurate object structure characteristics. The proposed framework mainly includes three stages. Firstly, an improved edge line extraction method is proposed for the edge segments to fit closely to building outlines. Secondly, a fusion method is proposed for the outlines under the constraint of straight lines, which can maintain the building structural attribute with parallel or vertical edges, which is very useful for the dense matching method. Finally, we proposed an edge constraint and outline compensation (ECAOC) dense matching method to maintain building object structural characteristics in the disparity map. In the proposed method, the improved edge lines are used to optimize matching search scope and matching template window, and the high-precision building outlines are used to compensate the shape feature of building objects. Our method can greatly increase the matching accuracy of building objects in urban areas, especially at building edges. For the outline extraction experiments, our fusion method verifies the superiority and robustness on panchromatic images of different satellites and different resolutions. For the dense matching experiments, our ECOAC method shows great advantages for matching accuracy of building objects in urban areas compared with three other methods.

Methamphetamine-induced toxic leukoencephalopathy: clinical, radiological and autopsy findings.

Toxic leukoencephalopathy represents a process of structural alteration of the white matter. It is caused by substance abuse including drugs such as heroin, cocaine, toluene and ethanol. We reported the clinical, radiological and autopsy findings of a rare case of toxic leukoencephalopathy following chronic methamphetamine (MA) usage. A 34-year-old man with a 3-year history of MA abuse experienced progressive sluggish state, limb weakness, inability to stand and eating disorders, followed by rapid progression to coma and death. Imaging revealed hypodense CT and long T1 and T2 signals in MRI in the white matter of the bilateral periventricular and centrum semiovale regions. Histologically, white matter rarefaction, loss of myelin and axonal injury were observed. This pattern of clinical presentation, radiological manifestations and histological findings show a certain degree of particularity in toxic leukoencephalopathy. Clinically, the condition may be easily misdiagnosed as withdrawal symptoms. In suspected cases, MRI is recommended for diagnosis. The case reported here reminds clinicians and forensic pathologist of the possibility of toxic leukoencephalopathy related to MA abuse.

Clinical and Molecular Characteristics of Patients with Bloodstream Infections Caused by KPC and NDM Co-Producing Carbapenem-Resistant Klebsiella pneumoniae.

Purpose: Klebsiella pneumoniae carbapenemase (KPC) and New Delhi metallo-ß-lactamase (NDM) co-producing carbapenem-resistant Klebsiella pneumoniae (KPC-NDM-CRKP) isolates have been increasingly reported worldwide but have not yet been systematically studied. Thus, we have conducted a study to compare the risk factors, molecular characteristics, and mortality involved in clinical bloodstream infections (BSIs) caused by KPC-NDM-CRKP and KPC-CRKP strains. Methods: A retrospective study was conducted on 231 patients with BSIs caused by CRKP at Jinling Hospital in China from January 2020 to December 2022. Antimicrobial susceptibility testing, carbapenemase genes detection and whole-genome sequencing were performed subsequently. Results: Overall, 231 patients were included in this study: 25 patients with KPC-NDM-CRKP BSIs and 206 patients with KPC-CRKP BSIs. Multivariate analysis implicated ICU-acquired BSI, surgery within 30 days, and longer stay of hospitalization prior to CRKP isolation as independent risk factors for KPC-NDM-CRKP BSIs. The 30-day mortality rate of the KPC-NDM-CRKP BSIs group was 56% (14/25) compared with 32.5% (67/206) in the KPC-CRKP BSIs control group (P = 0.02). The ICU-acquired BSIs, APACHE II score at BSI onset, and BSIs caused by KPC-NDM-CRKP were independent predictors for 30-day mortality in patients with CRKP bacteremia. The most prevalent ST in KPC-NDM-CRKP isolates was ST11 (23/25, 92%), followed by ST15 (2/25, 8%). Conclusion: In patients with CRKP BSIs, KPC-NDM-CRKP was associated with an excess of mortality. The likelihood that KPC-NDM-CRKP will become the next "superbug" highlights the significance of epidemiologic surveillance and clinical awareness of this pathogen.

Status and development for detection and control of ammonium bisulfate as a by-product of SCR denitrification.

When denitrification technology using NH3 or urea as the reducing agent is applied to remove NOx from the flue gas, ammonium bisulfate (ABS) by-product will also be generated in the flue gas. ABS has an impact on catalyst life span, denitrification efficiency etc., air preheater and its downstream thermal equipment also have a significant negative impact due to its plugging and corrosion. The requirement for NOx removal efficiency is improved by ultra-low emissions in China. However, wide-load denitrification makes the flue gas composition and temperature changing more complicated. Increasing ammonia injection can improve the NOx removal effect, but too much ammonia injection will lead to the formation of ABS and the increase of deposition risk, the contradiction between these two aspects is amplified by ultra-low emissions and wide-load denitrification in many plants. Coordinating NOx control and reducing the impact of ABS on equipment are issues that the industry needs to solve urgently. In recent years, extensive research on ABS had been carried out deeply, consequently, there has been a relatively in-deepth knowledge foundation for ABS formation, formation temperature, deposition temperature, dew point temperature, decomposition behavior, etc., but the existing researches are insufficient to support the problem of ABS under full load denitrification completely resolved. Therefore, some analysis and detection methods related to ABS are reviewed in this paper, and the impact of ABS on SCR, air preheater and other equipment and the existing research results on reducing the impact of ABS are summarized also. It is hoped that this review will provide a reference for the industry to solve the problems of ABS that hinder wide-load denitrification and affect ultra-low emissions.

Cardiac rupture with intact pericardium: A report of four cases and short review of the literature.

Cardiac rupture with intact pericardium is a dangerous lesion due to high and rapid mortality. Its most common etiologies are blunt chest trauma and myocardial infarction. In forensic practice, this type of rupture can involve a complex relationship between trauma and cardiac disease, so clarifying the main cause of rupture is critical. Herein, we present four cases of cardiac rupture with intact pericardium, which were due to trauma, pathology or both. We propose several diagnostic pointers to analyze this uncommon lesion. Furthermore, the possibility of cardiac rupture induced by cardiopulmonary resuscitation should also be discriminated in such cases.

Sudden cardiac death due to the Wolff-Parkinson-White syndrome: A case report with genetic analysis.

RATIONALE: The Wolff-Parkinson-White syndrome (WPW) is a benign heart disease with accessory pathways, which can result in cardiac arrhythmias. The purpose of this case report is to introduce a rare case of sudden cardiac death (SCD) with a mild myocardial bridge and a history of WPW. PATIENT CONCERNS: A 25-year-old man with known WPW syndrome died at night while sleeping. DIAGNOSES: Diagnosis of WPW syndrome is based on typical electrocardiogram findings with a documented dysrhythmia before the victim's death. INTERVENTIONS: At autopsy, no traumatic injury or common poisons were found, only a slight myocardial bridge was detected. We performed whole exome sequencing and identified several genetic variations related to SCD. OUTCOMES: We considered that the cause of death in this case was SCD in which arrhythmia might play an important role. LESSONS: This case highlights SCD can occur in WPW patients with mild or unrecognized structural abnormality. Postmortem genetic examination can assist the diagnosis of sudden cardiac death, especially when no lethal structural abnormality is found in the decedent.