Cases of isolated hepatic tuberculosis (TB) are rare. The diagnosis is often delayed or missed because of nonspecific symptoms and laboratory findings. Besides, the disease is extremely rare even in a country where TB is an alarming public health problem. This report demonstrates the difficulty in correctly diagnosing local hepatic TB. We report the case of a 62‐year‐old male patient with end‐stage renal disease treated with hemodialysis, who developed 2 months of abdominal distension and general anorexia, with hyperechoic hepatic lesions on ultrasound. Computed tomography suspected multiple liver tumors. The liver biopsy finally led to the diagnosis of TB of the liver without other involvements. We conclude that isolated hepatic TB is one of the rare forms of extrapulmonary TB in dialysis patients. A greater awareness of this rare clinical entity may prevent needless surgical interventions. 相似文献
The cover image is based on the Research Article V2O5/RGO/Pt nanocomposite on oxytetracycline degradation and pharmaceutical effluent detoxification by Mohan, H et al., DOI: 10.1002/jctb.6238 .
The use of hydrogen as a fuel is increasing exponentially, and the most economical way to store and transport hydrogen for fuel use is as a high-pressure gas. Polymers are widely used for hydrogen distribution and storage systems because they are chemically inert towards hydrogen. However, when exposed to high-pressure hydrogen, some hydrogen diffuses through polymers and occupies the preexisting cavities inside the material. Upon depressurization, the hydrogen trapped inside polymer cavities can cause blistering or cracking by expanding these cavities. A continuum mechanics–based deformation model was deployed to predict the stress distribution and damage propagation while the polymer undergoes depressurization after high-pressure hydrogen exposure. The effects of cavity size, cavity location, and pressure inside the cavity on damage initiation and evolution inside the polymer were studied. The stress and damage evolution in the presence of multiple cavities was also studied, because interaction among cavities alters the damage and stress field. It was found that all these factors significantly change the stress state in the polymer, resulting in different paths for damage propagation. The effect of adding carbon black filler particles and plasticizer on the damage was also studied. It was found that damage tolerance of the polymer increases drastically with the addition of carbon black fillers, but decreases with the addition of the plasticizer. 相似文献
The case-based learning (CBL) approach has gained attention in medical education as an alternative to traditional learning methodology. However, current CBL systems do not facilitate and provide computer-based domain knowledge to medical students for solving real-world clinical cases during CBL practice. To automate CBL, clinical documents are beneficial for constructing domain knowledge. In the literature, most systems and methodologies require a knowledge engineer to construct machine-readable knowledge. Keeping in view these facts, we present a knowledge construction methodology (KCM-CD) to construct domain knowledge ontology (i.e., structured declarative knowledge) from unstructured text in a systematic way using artificial intelligence techniques, with minimum intervention from a knowledge engineer. To utilize the strength of humans and computers, and to realize the KCM-CD methodology, an interactive case-based learning system(iCBLS) was developed. Finally, the developed ontological model was evaluated to evaluate the quality of domain knowledge in terms of coherence measure. The results showed that the overall domain model has positive coherence values, indicating that all words in each branch of the domain ontology are correlated with each other and the quality of the developed model is acceptable. 相似文献