An autopsy case of acute fibrinous and organizing pneumonia with periorbital MRSA cellulitis and rheumatoid arthritis.

This case report details a 78-year-old male with periorbital Methicillin-resistant Staphylococcus aureus (MRSA) cellulitis whose condition rapidly deteriorated despite treatment. An autopsy confirmed acute fibrinous and organizing pneumonia (AFOP), revealing fibrin ball formation and organizing pneumonia. While both idiopathic and secondary AFOP cases often exhibit bilateral consolidation on CT, our patient presented with ground-glass opacities, which are frequently associated with secondary AFOP. Notably, secondary AFOP, linked to higher mortality, can result from various factors. In this case, well-controlled rheumatoid arthritis and prolonged oral medication use suggest bilateral periorbital MRSA cellulitis as a significant factor. The study underscores AFOP's diagnostic challenges and the necessity for further research on effective treatments.

How do symptoms of each joint contribute to global pain, disease activity and functional disability in rheumatoid arthritis?-A comprehensive association study using a large cohort.

BACKGROUND: Established assessment tools for patients with rheumatoid arthritis (RA), including disease activity scores (DASs), disease activity indexes (DAIs), visual analog scales (VASs), and health assessment questionnaires (HAQs), are widely used. However, comparative associations between joint involvement and disease status assessment tools have rarely been investigated. METHODS: We included a dataset of 4016 patients from a large RA cohort from 2012 to 2019. The tenderness and swelling of each joint were counted as a symptom, with 70 and 68 affected joints throughout the body, respectively. The relative contribution of various joints to the disease status assessment tools, VAS scores, and functional disability indexes was analyzed using multiple regression analysis. RESULTS: The wrist showed the most significant contribution overall, especially in DASs and VASs, while the metacarpophalangeal and proximal interphalangeal joints made significant contributions to DASs and DAIs, but not to VASs and HAQs. The shoulder and the elbow significantly contributed to HAQs, but only the shoulder did to the VASs. The knee universally contributed to all of the tools, but the ankle played a minor but important role in most assessment tools, especially in HAQs. Similar but different contribution ratios were found between the sets of DASs, DAIs, VASs, or HAQs. CONCLUSIONS: Each joint makes a unique contribution to these assessment tools. The improvement or aggravation of symptoms in each joint affects the assessment tools in different manners.

Knee Alignment Correction by High Tibial Osteotomy Reduces Symptoms and Synovial Inflammation in Knee Osteoarthritis Accompanied by Macrophage Phenotypic Change From M1 to M2.

OBJECTIVE: This study aimed to determine whether alignment correction by high tibial osteotomy (HTO) can change the biologic intraarticular microenvironment of osteoarthritic (OA) knees. METHODS: Synovial tissue (ST) and fluid (SF) were collected from the affected knees of 31 OA patients during initial HTO and plate removal surgeries. Changes in gene expression in ST were investigated by microarray and real-time polymerase chain reaction (PCR). ST specimens were also evaluated histologically using synovitis scores and immunofluorescence staining to determine macrophage polarity. Cytokines and chemokines in SF were analyzed by enzyme-linked immunosorbent assays. The mechanism of macrophage polarization was investigated in human peripheral blood mononuclear cell-derived macrophages and fibroblast-like synoviocytes (FLS) stimulated with cartilage fragments. We also evaluated Spearman correlations between Knee Injury and Osteoarthritis Outcome scores (KOOS) and macrophage-related gene expression. RESULTS: The microarray results indicated down-regulated inflammatory genes and pathways. Real-time PCR determined that genes expressing proinflammatory IL1B and IL6 were down-regulated and M2 macrophage-related IL1RA, IL10, CCL18, and CD206 were up-regulated. Histologic findings revealed attenuated synovitis scores and a shift from M1 to M2 macrophages. Interleukin-1ß (IL-1ß) concentrations in SF decreased after HTO. Cartilage fragments were responsible for M1 macrophage polarization and proinflammatory gene and protein expression in macrophages, whereas cartilage fragments up-regulated only IL-6 protein in FLS. Postoperative KOOS positively correlated with the expression of the M2-related genes CCL18 and CD206. CONCLUSION: Correction of lower limb alignment with HTO attenuated synovial inflammation and changed macrophage polarization from M1 to M2, suggesting an improved intraarticular environment in knee OA.

Duodenal Heterotopic Pancreas with a Large Retention Cyst: A Case Report and Literature Review.

A 75-year-old man was referred to our hospital with a suspected pancreatic cyst. Imaging tests revealed a 3-cm cystic lesion located ventrally in the duodenal bulbus, which was suspected to be a duplication cyst with its muscularis propria contiguous to that of the duodenum. One year later, the cyst grew to 6 cm due to intracystic hemorrhaging; therefore, surgery was performed. Histopathology revealed a heterotopic pancreas (HP) in the duodenal wall. The diagnosis was a large, non-malignant retention cyst. Inflammation due to impaired outflow of pancreatic juice from the HP was identified as the cause of cyst enlargement.

A symptomatic intercalated duct lesion of the parotid gland: a case report with immunohistochemical and genetic analyses.

Intercalated duct lesions (IDLs) are usually asymptomatic. We report a case of IDL, in which a palpable mass formed. The patient was a 45-year-old Japanese male, who noticed a mass in the left parotid region. The nodular lesion was well-circumscribed, but did not have a fibrous capsule or exhibit infiltrative growth. It contained a small cystic space and consisted of basaloid cells arranged in a cribriform pattern and inner ductal cells. It had some solid areas of nest-like proliferation displaying mild cellular atypia. Immunohistochemically, the luminal cells were positive for cytokeratin (CK)7 and epithelial membrane antigen, and the abluminal cells were positive for CK5/6, p63, and DOG1. S-100 protein-positive stromal cells were also seen. The lesion's cells were all positive for SOX10, and the nuclei of some basaloid cells were positive for ß-catenin. The Ki-67 labeling index was 3.8%. The ductal cells contained diastase-digestion-resistant, Periodic acid Schiff-positive zymogen granules. Genetically, the lesion harbored a missense mutation in the CTNNB1 gene. We diagnosed the lesion as an IDL. As IDLs are usually small non-neoplastic lesions, symptomatic cases are rare. Based on its common immunohistochemical and genetic features, IDL may be a precursor of basal cell adenoma/adenocarcinoma, such as intercalated duct adenoma.

Periostin expression and its supposed roles in benign and malignant thyroid nodules: an immunohistochemical study of 105 cases.

BACKGROUND: Thyroid tumors are often difficult to histopathologically diagnose, particularly follicular adenoma (FA) and follicular carcinoma (FC). Papillary carcinoma (PAC) has several histological subtypes. Periostin (PON), which is a non-collagenous extracellular matrix molecule, has been implicated in tumor invasiveness. We herein aimed to elucidate the expression status and localization of PON in thyroid tumors. METHOD: We collected 105 cases of thyroid nodules, which included cases of adenomatous goiter, FA, microcarcinoma (MIC), PAC, FC, poorly differentiated carcinoma (PDCa), and undifferentiated carcinoma (UCa), and immunohistochemically examined the PON expression patterns of these lesions. RESULTS: Stromal PON deposition was detected in PAC and MIC, particularly in the solid/sclerosing subtype, whereas FA and FC showed weak deposition on the fibrous capsule. However, the invasive and/or extracapsular regions of microinvasive FC showed quite strong PON expression. Except for it, we could not find any significant histopathological differences between FA and FC. There were no other significant histopathological differences between FA and FC. Although PDCa showed a similar PON expression pattern to PAC, UCa exhibited stromal PON deposition in its invasive portions and cytoplasmic expression in its carcinoma cells. Although there was only one case of UCa, it showed strong PON immunopositivity. PAC and MIC showed similar patterns of stromal PON deposition, particularly at the invasive front. CONCLUSIONS: PON may play a role in the invasion of thyroid carcinomas, particularly PAC and UCa, whereas it may act as a barrier to the growth of tumor cells in FA and minimally invasive FC.

Near-infrared absorbing boron-dibenzopyrromethenes that serve as light-harvesting sensitizers for polymeric solar cells.

Hexylthiophene-conjugated boron-dibenzopyrromethenes with benzo[1,3,2]oxazaborinine rings, 1, that absorb near-infrared light with relatively high molecular extinction coefficients have been synthesized. The incorporation of 3-hexylthiophene-conjugated dye 1a at a blend ratio of 5 wt % into a polymeric solar cell based on a P3HT/indene-C(70) bisadduct (IC(70)BA) bulk heterojunction structure improved power conversion efficiency from 3.7 to 4.3%. The present work suggests that well-defined near-infrared absorbing BODIPY analogues can potentially be used as photosensitizers in polymeric solar cells.

Ab initio study of ultrafast photochemical reaction dynamics of phenol blue.

Phenol blue (PB) is a primary skeletal structure part of indoaniline dyes and well-known as a solvatochromic dye. It has been recently observed by pump-probe (PP) transient absorption measurements that PB shows ultrafast ground state recovery within a few hundred femtoseconds after photoexcitation. In this work, the ultrafast photochemical reaction mechanism of PB has been investigated using direct ab initio (CASSCF) nonadiabatic molecular dynamics with the trajectory surface hopping (TSH) method. The swarm of trajectories starting from the S1 Franck-Condon (FC) point has mostly shown surface hops (nonadiabatic transitions) from the S1 state to the S0 state at 110-120 fs in the vicinity of an S1/S0 conical intersection and after decay to the S0 state bifurcated into two (Reverse and Forward) directions with almost the same branching ratio and reached the vicinity of the S0 minimum energy point at 200-300 fs, which is in good agreement with the fast time component of the ground state recovery in the PP measurements. After reaching the vicinity of the S0 minimum energy point, the trajectories showed a coherent vibration of bending motion between quinoneimine and aniline rings with a low frequency of 43 cm-1, which presumably corresponds to a coherently photoexcitation-induced vibrational mode with a low frequency recently observed by the PP measurements.

Characterization of cationic diarylethene by electron spin resonance and absorption spectra-ratio of open/closed-ring isomers.

Electrochemical cyclization/cycloreversion reactions of a diarylethene, 1,2-bis(3-methyl-2-thienyl)perfluorocyclopentene, are examined experimentally by electron spin resonance (ESR) and absorption spectra. To understand the ESR spectrum, the hyperfine coupling constants are calculated by the density functional theory (DFT) with the B3LYP exchange-correlation functional. The averaged values of the hyperfine coupling constants are approximated by imposing the C(2) symmetry on the structure of the diarylethene. We found that the spectral width of the ESR is significantly different between the open- and closed-ring isomers. This is due to the difference in the pi-conjugation between two isomers. The ESR spectral width analysis could, thus, be used to identify the isomerization of the radical species, which involve the change of the pi-conjugation. The experimentally observed spectrum is found to be the mixture of the open- and closed-ring isomers of the diarylethene. The excitation energies of the cationic diarylethenes are further identified by the SAC-CI calculations.

Three bits eight states photochromic recording and nondestructive readout by using IR light.

A photochromic polymer film containing three different diarylethene derivatives, that is, 1,2-bis(3,5-dimethyl-2-thienyl)perfluorocyclopentene (1), 1,2-bis(2,5-dimethyl-3-thienyl)perfluorocyclopentene (2), and 1,2-bis(2-methyl-5-phenyl-3-thienyl)perfluorocyclopentene (3) was prepared. Upon UV irradiation, the three derivatives changed to their closed-ring isomers having different colors, yellow, red, and blue. They showed different spectra not only in UV/Vis region but also in the IR spectral region. Upon irradiation with visible light of appropriate wavelengths, each closed-ring isomer was selectively bleached, and three bits eight states recording was performed. The eight states could be read out nondestructively by using IR light of appropriate wavenumbers.

Theoretical study on the photochromic cycloreversion reactions of dithienylethenes; on the role of the conical intersections.

The mechanism of the photochromic cycloreversion reactions is theoretically examined in a model system of dithienylethenes by means of the CASSCF and CASPT2 methods. The structures of its conical intersections (CIs), which are the branching points of the internal conversions, were obtained. The analyses of the minimum energy paths from the Franck-Condon states and the CI points suggest that the cycloreversion reaction occurs during the intramolecular vibrational energy redistribution (IVR) toward the quasi-equilibrium on the 2A state. The current study of the model system will provide a basic insight for the photochromic molecular design.

CASSCF and CASPT2 studies on the structures, transition energies, and dipole moments of ground and excited states for azulene.

The electronic structure of azulene molecule has been studied. We have obtained the optimized structures of ground and singlet excited states by using the complete active space self-consistent-field (CASSCF) method, and calculated vertical and 0-0 transition energies between the ground and excited states with second-order Møller-Plesset perturbation theory (CASPT2). The CASPT2 calculations indicate that the bond-equalized C(2v) structure is more stable than the bond-alternating C(s) structure in the ground state. For a physical understanding of electronic structure change from C(2v) to C(s), we have performed the CASSCF calculations of Duschinsky matrix describing mixing of the b(2) vibrational mode between the ground (1A(1)) and the first excited (1B(2)) states based on the Kekule-crossing model. The CASPT2 0-0 transition energies are in fairly good agreement with experimental results within 0.1-0.3 eV. The CASSCF oscillator strengths between the ground and excited states are calculated and compared with experimental data. Furthermore, we have calculated the CASPT2 dipole moments of ground and excited states, which show good agreement with experimental values.