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Insulin resistance may be overestimated by using these markers if the patient has carbohydrate malabsorption, or that carbohydrate malabsorption may be present prior to the development of insulin resistance. Hence carbohydrate malabsorption should be taken into account for estimating insulin resistance and beta-cell function.

Volumetric video (or hologram video), the medium for representing natural content in VR/AR/MR, is presumably the next generation of video technology and a typical use case for 5G and beyond wireless communications. To realize volumetric video applications, efficient volumetric video streaming is in critical demand. This article responds to the challenges of and propose solutions to wireless transmission systems of point cloud video, which is the most popular and favored way to represent volumetric media and significantly differs from the other types of videos. In particular, we first introduce point cloud video technology and its applications, and then discuss the challenges of and solutions to point cloud video streaming, including encoding, tiling, viewing angle prediction, decoding, quality assessment and transmission optimization. Furthermore, we explain a prototype of MPEG DASH-based point cloud video streaming system as a preliminary study, along with more simulation results to verify its performance. Finally, we identify future research directions for providing high-quality point cloud video streaming.

Dear Editor, Multiple myeloma, a B-cell malignancy characterized by clonal proliferation of plasma cells in the bone marrow, has been associated with unique clinicopathologic features, genetic abnormalities, and response to therapy [1][2][3]. Immunoglobulin D (IgD) myeloma is a rare disease, accounting for about 2% of all myelomas. Pleural effusions occur in 6% of myeloma patients. The etiology is multifactorial and effusions due to pleural myelomatous involvement are rare, occurring in <1% of the cases [4].We experienced a patient with IgD 1 multiple myeloma, which was first indicated by plasma cells in the peripheral blood. Furthermore, cytogenetic study of the pleural effusion revealed several abnormalities. We reviewed the clinical and cytogenetic features of this case and report the findings in detail.An 82-year-old man was admitted to our hospital in February 2002 with the chief complaint of dyspnea on effort and arrhythmia. His medical history included myocardial infarction in 1991. Chest X-ray results showed cardiomegaly and bilateral pleural effusion. He was diagnosed with acute heart failure as a result of previous myocardial infarction. The administration of diuretics and an antiarrhythmic resulted in a rapid improvement. However, the recovery did not last; the pleural effusion slowly increased and diuretics were ineffective. Moderate anemia worsened and transfusion was necessary. Hematological examination revealed plasma cells in the peripheral blood and a hematologist was consulted. On physical examination, there was anemia in the connective pulp, and heart sounds showed a systolic murmur. There was a decrease in breath sounds at the base of both lungs. Bilateral presidiapitting edema was evident. Hematological examination revealed anemia (hemoglobin 7.7 g/dl) with plasma cells in the peripheral blood (18%). Total serum protein was 6.0 g/dl with 64.9% albumin and 14.5% γ-globulin. Creatinine 1.35 mg/dl, blood urea nitrogen 27 mg/dl, uric acid 13.3 mg/dl, and lactate dehydrogenase 679 IU/L (reference range 230-460). Immunoelectrophoresis showed monoclonal IgD (λ) in the serum and Bence Jones protein (1) in the urine. Quantitative immunoglobulin determination showed a marked increase in IgD, 934 mg/dl, while IgG, IgA and IgM levels were decreased (Table 1). Bone marrow aspiration resulted in dry tap and biopsy results showed multiple myeloma. Chest X-ray results showed bilateral pleural effusion, whereas X-ray examination of the rest of the body was normal. Echocardiography results did not indicate amyloid deposition in the myocardium, but the ejection fraction was decreased because of a previous myocardial infarction.The patient also underwent thoracentesis. Cytological examination of the pleural effusion showed numerous plasma cells. There were two sizes of atypical plasma cells: small, round-shaped, mature plasma cells, and large, round-shaped, immature plasma cells. Clusters of differentiation 38 (CD38) and CD138 surface markers were investigated in the pleural effusion and found to be positive in...

BackgroundPure akinesia (PA) is a distinct form of parkinsonism characterized by freezing phenomena. Little is known about brain tumor-associated PA. We highlight the clinicoradiological changes in a patient with PA and central nervous system (CNS) metastases of natural killer/T-cell lymphoma (NKTL).Case presentationA 68-year-old man with stage IVB extranodal NKTL developed a gait disturbance. Neurological examination of his gait revealed freezing, start hesitation, short step, forward flexion posture, festination and postural instability. Mild facial hypomimia and micrographia were observed. There was no rigidity or tremor in any of the four extremities. Brain magnetic resonance imaging (MRI) displayed T2-hyperintense lesions in the dorsal brainstem, cerebellum and periventricular white matter. Diffusion-weighted imaging (DWI) and the apparent diffusion coefficient (ADC) revealed hyperintensity in these regions. Cerebrospinal fluid cytology revealed CD56-positive cells on immunohistochemical staining. The patient's neurological deficits did not respond to L-dopa treatment and intrathecal administration of methotrexate (MTX). Two weeks later, he displayed confusion and generalized convulsions. T2-hyperintense lesions spread to the basal ganglia and the infratentorial regions. Gadolinium enhancement was observed in the cerebellum and frontal subcortex. DWI and the ADC revealed diffusion-restricted lesions in the middle cerebellar peduncles, left internal capsules and cerebral white matter. MTX pulse therapy and intrathecal administration of cytosine arabinoside and MTX were performed. Two months later, his ambulatory state was normalized. Brain MRI also revealed marked alleviation of the infratentorial and supratentorial lesions.ConclusionsThe clinicoradiological profile of our patient suggested that dorsal ponto-mesencephalic lesions could contribute to the pathogenesis of PA. Physicians should pay more attention to striking CNS seeding of metastatic NKTL. MTX pulse therapy had an excellent effect in improving serious symptoms and brain lesions in our patient.