A Case of Mixed Connective Tissue Disease That Transformed Into Systemic Lupus Erythematosus After a Long Clinical Course.

Mixed connective tissue disease (MCTD), a multisystem autoimmune disease that was first proposed in 1972, has overlapping features with other autoimmune diseases. In recent studies, mixed connective tissue disease has been reported to change into other connective tissue diseases (CTD; such as systemic lupus erythematosus [SLE], polymyositis, and systemic sclerosis [SSc]) in the long term. We report the case of a 58-year-old Japanese man diagnosed with mixed connective tissue disease 15 years ago. During his clinical course, he developed discoid lupus erythematosus, pancytopenia, a low complement titer, proteinuria, and hematuria. He also turned positive for the anti-double-stranded deoxyribonucleic acid (dsDNA) antibody. A kidney biopsy revealed lupus nephritis (LN) class IV. Therefore, we considered this to be a shift from mixed connective tissue disease to systemic lupus erythematosus. We changed his treatment to lupus nephritis, after which he remained in remission. Our case suggests that mixed connective tissue disease may shift to other connective tissue diseases over a long period; therefore, it is necessary to identify whether patients with mixed connective tissue disease fulfill the diagnostic criteria for other connective tissue diseases when new manifestations appear.

Teardrop owl eye appearance in enhanced MDCT for diagnosis of ectopic pregnancy with tubal rupture.

A 31-year-pld female patient, presented to the emergency room with vaginal bleedingand a three day history of left sided lower abdominal pain. he showed shock status and an'' as ``She came in with a hypovuoluminc shock and an enhanced 3-dimensional multidetector-computed tomography (3D-MDCT) images showed a specific teardropping owl's eye appearance consistent with an active bleeding around fetal sac and from ruptured tubal ectopic pregnancy (EP) spreading into peritoneum at the 9th gestational week. According to accurate radiological diagnosis, she has been able to receive a successful urgent transportation via helicopter to the consultee obstetricians and received an urgent salpingectomy with the diagnosis of tubal rupture in EP. Her post-surgical course was uneventful and discharged hospital on 8th day. From this case experience, an urgent diagnosis of a ruptured tubal EP in shocked female using not US but MDCT is accurately diagnosed because MDCT has radiological advantage to visualize active hemorrhage using contrast-medium.

A rare case of scleritis and multiple rheumatoid pulmonary nodules associated with seronegative rheumatoid arthritis.

Seronegative rheumatoid arthritis (RA) is less likely to have extra-articular manifestations than seropositive RA. An 80-year-old man with polyarthritis was diagnosed with seronegative RA in which rheumatoid factors and anti-cyclic citrullinated peptides were not detected. He had multiple pulmonary nodules that diminished in size following treatment for RA, leading to the diagnosis of pulmonary rheumatoid nodules. During his treatment course, he developed scleritis, which could have resulted in blindness. As oral steroids did not improve his condition, topical steroid injections were administered, and his symptoms gradually improved. Here, we present a case of seronegative RA with an unusual combination of extra-articular manifestations: rheumatoid pulmonary nodules and scleritis.

Robot-assisted anterior resection for rectal cancer with double inferior vena cava: A case report.

Double inferior vena cava (DIVC) is a rare but generally asymptomatic condition that is often detected incidentally by radiological examinations such as computed tomography (CT). Here, we describe the case of a 73-year-old woman with DIVC, who underwent robot-assisted surgery (RS) for rectal cancer. In this case, 3D CT angiography showed DIVC with an interiliac vein from the left common iliac vein and a tortuous aorta. Intraoperatively, we identified the presence of the left IVC in addition to the inferior mesenteric vein, gonadal vein, and ureter, which require meticulous attention during vascular processing. By optimizing the port placement, we were able to ensure mobility of the robotic arm and sufficient field of view to safely perform a robot-assisted anterior resection with lymph node dissection. Careful preoperative assessment and development of a strategy for port placement using CT imaging are essential in avoiding iatrogenic injury and performing safe RS.

Codeposition of Platinum and Gold on Nickel Wire Electrodes via Galvanic Replacement Reactions for Electrocatalytic Oxidation of Alcohols.

Codeposition of Pt and Au on Ni wire was performed using a simple treatment of immersing Ni wire in aqueous solutions containing both K2PtCl4 and HAuCl4. For evaluating the electrochemical properties of the thus-prepared electrodes, cyclic voltammograms (CVs) of 1.0 M ethanol in 1.0 M NaOH aqueous solutions were recorded. Compared with Pt- or Au-deposited Ni wire electrodes prepared by treating Ni wire in aqueous solutions of a single component, e.g., 1.0 mM K2PtCl4 or 1.0 mM HAuCl4, a noteworthy increase in the electrocatalytic current was observed for the oxidation of ethanol with a PtAu-codeposited Ni (PtAu/Ni) wire electrode even when it was prepared in an aqueous solution containing both 0.10 mM K2PtCl4 and 0.10 mM HAuCl4. In addition, the shape and the peak potentials of CVs recorded using PtAu/Ni wire electrodes were found to be different from those recorded with the Pt- or Au-deposited Ni wire electrodes. Because the CV responses typical of the PtAu/Ni wire electrodes were observed even when a PtAu/Ni wire electrode was prepared in an aqueous solution containing both 0.010 mM K2PtCl4 and 1.0 mM HAuCl4, it is considered that a small amount of Pt was effectively modified or incorporated and affected the electrochemical properties significantly. The CV results for ethanol oxidation were compared with those for the electrocatalytic oxidations of methanol, 1-propanol, and 2-propanol. Besides, the CV results recorded with the present PtAu/Ni wire electrodes are discussed in comparison with some previous results obtained using other PtAu nanoelectrocatalysts.

GaP Raman Terahertz high accuracy spectrometer and its application to detect organic and inorganic crystalline defects.

One of the most important uses of THz spectrometry is to detect defects in molecular structure or in crystals efficiently. We applied GaP Raman THz (GRT) spectrometer to detect and evaluate defects in inorganic and organic materials. High THz-wave absorption due to high defect density of GaSe crystal lowered the efficiency of THz wave generation, when the crystal is used as nonlinear material for DFG (Difference Frequency Generation). Defects in organic molecules could be observed as changes in frequency, intensities of the absorption, and broadenings of the spectra.