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Wernicke's encephalopathy (WE) is a neuropsychiatric disorder caused by a thiamine deficiency. Although WE has been recognized in cancer patients, it can be overlooked because many patients do not exhibit symptoms that are typical of WE, such as delirium, ataxia, or ocular palsy. Furthermore, outpatients with WE who intermittently present at psycho-oncology clinics have not been described as far as we can ascertain.
This report describes two patients who did not exhibit the complete classic triad of symptoms among a series with cancer and WE, and who attended a psycho-oncology outpatient clinic.
Case 1, a 76-year-old woman with pancreatic cancer and liver metastasis, periodically attended a psycho-oncology outpatient clinic. She presented with delirium and ataxia as well as appetite loss that had persisted for 8 weeks. We suspected WE, which was confirmed by low serum thiamine levels and the disappearance of delirium after thiamine administration. Case 2, a 79-year-old man with advanced stomach cancer, was referred to a psycho-oncology outpatient clinic with depression that had persisted for about 1 month. He also had appetite loss that had persisted for several weeks. He became delirious during the first visit to the outpatient clinic. Our initial suspicion of WE was confirmed by low serum thiamine levels and the disappearance of delirium after thiamine administration. The key indicator of a diagnosis of WE in both patients was appetite loss.
Significance of results
This report emphasizes awareness of WE in the outpatient setting, even when patients do not exhibit the classical triad of WE. Appetite loss might be the key to a diagnosis of WE in the absence of other causes of delirium.
To improve conversion efficiency of silicon nanowire (SiNW) solar cells, it is very important to reduce the surface recombination rate on the surface of SiNWs, since SiNWs have a large surface area. We tried to cover SiNWs with aluminum oxide (Al2O3) and titanium oxide (TiO2) by atomic layer deposition (ALD), since Al2O3 grown by ALD provides an excellent level of surface passivation on silicon wafers and TiO2 has a higher refractive index than Al2O3, leading to the reduction of surface reflectance. The effective minority carrier lifetime in SiNW arrays embedded in a TiO2/Al2O3 stack layer of 94 μsec was obtained, which was comparable to an Al2O3 single layer. The surface reflectance of SiNW solar cells was drastically decreased below around 5% in all of the wavelength range using the Al2O3/TiO2/Al2O3 stack layer. Heterojunction SiNW solar cells with the structure of ITO/p-type hydrogenated amorphous silicon (a-Si:H)/n-type SiNWs embedded in Al2O3 and TiO2 stack layer for passivation/n-type a-Si:H/back electrode was fabricated, and a typical rectifying property and open-circuit voltage of 356 mV were successfully obtained.
We report the preparation and thermoelectric properties of oriented higher manganese silicide (HMS) with a composition of MnSi1.73 bulk. The grain alignment and densification were achieved by rotating high magnetic field and spark plasma sintering (SPS) techniques, respectively. The easy magnetization axis of MnSi1.73 was found to be c-axis, and the applied magnetic field of 2 T was strong enough to rotate the powder with a mean grain size of 1 μm. The c-axis of grains was oriented when applying the magnetic field, and the degree of orientation was further increased after heat treatment. However, a secondary phase that was mono manganese silicide (MnSi) was observed as a result of oxidation on the surface of synthesized powder. The electrical conductivity of the c-axis oriented specimen along the ab-plane was about 40% larger than that for sample processed only by SPS, while the Seebeck coefficient of oriented and nonoriented specimens showed similar values regardless of existence of the second phase. Consequently, the power factor of the c-axis oriented specimen along the ab-plane was enhanced by about 35% compared to the nonoriented one. The proposed approach is found to be very effective not only in obtaining the oriented materials with nonductility but also in enhancing the thermoelectricity.
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