A Case of Systemic Lupus Erythematosus Presenting with an Acute Abdomen: Successful Treatment with Steroid

Abdominal pain continues to pose diagnostic challenges for emergency clinicians. A 56-year-old Japanese woman was referred to our hospital due to severe abdominal pain which presented as occasional epigastric pain five months before and intermittent abdominal pain. She had a past history of ileus twice, for both of which laparotomy was performed without an alimentary tract resection. The wall thickening with marked three-wall structure from terminal ileum to sigmoid colon was seen and bladder wall was irregularly thick and enhanced irregularly. Among the differential diagnosis of the acute abdomen, autoimmune diseases were suspected, especially lupus erythematosus and Henoch-Schönlein purpura. On the second day of admission, abdominal pain worsened. The results of examinations of antinuclear antibody, anti-double-stranded DNA antibody, ANCA, and the complements were not obtained at that time; however, we started 1-g steroid pulse treatment for three days with success. With the results obtained later, the patient was given a diagnosis of probable systemic lupus erythematosus (SLE). The present case shows that SLE can present with acute abdomen and should be included in the wide range of the differential diagnosis of acute abdomen

Metastatic breast cancer presenting as severe anemia, platelet reduction and abnormal cells in peripheral blood

　Worldwide, breast cancer accounts for 22.9% of all cancers excluding non-melanoma skin cancers in women. More than 80% of breast cancer cases are discovered when a woman discovers a lump that feels different from the rest of the breast tissue. We report the case of a 60-year-old woman who had been treated for one year at a psychiatric hospital for suspected schizophrenia, and was referred to our hospital on March 23, 2011 for consultation regarding complete blood count abnormalities: hemoglobin, 4.8g/㎗ ; Plt, 1.9×104/μl ; WBC, 12,700/μl with 18.5% abnormal cells. Computed tomography revealed an enhanced, irregular mass in her right breast as well as right axillary lymph node swelling, suggestive of breast cancer. BM biopsy confirmed the presence of abnormal, keratin-positive cells, suggesting metastasis to the bone. CA15-3 was 300U/㎖ (normal range ＜25). The patient died on April 11, 2011, post-admission day 20. We found a rare case of terminal breast cancer that presented with peripheral blood abnormality. Breast cancer in patients who do not notice breast abnormality can present with peripheral blood abnormality

Metastatic breast cancer presenting as severe anemia, platelet reduction and abnormal cells in peripheral blood

　Worldwide, breast cancer accounts for 22.9% of all cancers excluding non-melanoma skin cancers in women. More than 80% of breast cancer cases are discovered when a woman discovers a lump that feels different from the rest of the breast tissue. We report the case of a 60-year-old woman who had been treated for one year at a psychiatric hospital for suspected schizophrenia, and was referred to our hospital on March 23, 2011 for consultation regarding complete blood count abnormalities: hemoglobin, 4.8g/㎗ ; Plt, 1.9×104/μl ; WBC, 12,700/μl with 18.5% abnormal cells. Computed tomography revealed an enhanced, irregular mass in her right breast as well as right axillary lymph node swelling, suggestive of breast cancer. BM biopsy confirmed the presence of abnormal, keratin-positive cells, suggesting metastasis to the bone. CA15-3 was 300U/㎖ (normal range ＜25). The patient died on April 11, 2011, post-admission day 20. We found a rare case of terminal breast cancer that presented with peripheral blood abnormality. Breast cancer in patients who do not notice breast abnormality can present with peripheral blood abnormality

Türkçeden garp dillerine tercümeler

Taha Toros Arşivi, Dosya Adı: Namık Kemalİstanbul Kalkınma Ajansı (TR10/14/YEN/0033) İstanbul Development Agency (TR10/14/YEN/0033

Case Report A Case of Systemic Lupus Erythematosus Presenting with an Acute Abdomen: Successful Treatment with Steroid

Abdominal pain continues to pose diagnostic challenges for emergency clinicians. A 56-year-old Japanese woman was referred to our hospital due to severe abdominal pain which presented as occasional epigastric pain five months before and intermittent abdominal pain. She had a past history of ileus twice, for both of which laparotomy was performed without an alimentary tract resection. The wall thickening with marked three-wall structure from terminal ileum to sigmoid colon was seen and bladder wall was irregularly thick and enhanced irregularly. Among the differential diagnosis of the acute abdomen, autoimmune diseases were suspected, especially lupus erythematosus and Henoch-Schönlein purpura. On the second day of admission, abdominal pain worsened. The results of examinations of antinuclear antibody, anti-double-stranded DNA antibody, ANCA, and the complements were not obtained at that time; however, we started 1-g steroid pulse treatment for three days with success. With the results obtained later, the patient was given a diagnosis of probable systemic lupus erythematosus (SLE). The present case shows that SLE can present with acute abdomen and should be included in the wide range of the differential diagnosis of acute abdomen

Agreement among human and automated transcriptions of global songs

Cross-cultural musical analysis requires standardized symbolic representation of sounds such as score notation. However, transcription into notation is usually conducted manually by ear, which is time-consuming and subjective. Our aim is to evaluate the reliability of existing methods for transcribing songs from diverse societies. We had 3 experts independently transcribe a sample of 32 excerpts of traditional monophonic songs from around the world (half a cappella, half with instrumental accompaniment). 16 songs also had pre-existing transcriptions created by 3 different experts. We compared these human transcriptions against one another and against 10 automatic music transcription algorithms. We found that human transcriptions can be sufficiently reliable (~90% agreement, κ ~.7), but current automated methods are not (<60% agreement, κ <.4). No automated method clearly outperformed others, in contrast to our predictions. These results suggest that improving automated methods for cross-cultural music transcription is critical for diversifying MIR

Agreement among human and automated transcriptions of global songs

Cross-cultural musical analysis requires standardized symbolic representation of sounds such as score notation. However, transcription into notation is usually conducted manually by ear, which is time-consuming and subjective. Our aim is to evaluate the reliability of existing methods for transcribing songs from diverse societies. We had 3 experts independently transcribe a sample of 32 excerpts of traditional monophonic songs from around the world (half a cappella, half with instrumental accompaniment). 16 songs also had pre-existing transcriptions created by 3 different experts. We compared these human transcriptions against one another and against 10 automatic music transcription algorithms. We found that human transcriptions can be sufficiently reliable (~90% agreement, k ~.7), but current automated methods are not (<60% agreement, k <.4). No automated method clearly outperformed others, in contrast to our predictions. These results suggest that improving automated methods for cross-cultural music transcription is critical for diversifying MIR

Analysis of the Molecular Score Performance.

<p>(<b>A</b>) Relative signal intensity heatmaps for hepatitis A virus cellular receptor 1 (HAVCR1), lipocalin 2 (LCN2), SRY-box 9 (SOX9), WAP four-disulfide core domain 2 (WFDC2), and NK6 homeobox 2 (NKX6-2) in relation to renal histopathology. (<b>B</b>) The distribution of molecular score based on histological grades. (<b>C</b>) The area under the receiver operating characteristics curve (AUC) for the molecular score of each biopsy, plotted against the grade of tubulointerstitial fibrosis and tubular cell damage.</p

Prediction of Kidney Histopathology.

<p>Subjects with a molecular score > Threshold I or > Threshold II were considered to be ≥ 3 or ≥ 4, respectively.</p><p>*Histopathology grades were consistent with the predicted value using Threshold I.</p><p>^†Histopathology grades were consistent with the predicted value using Threshold II.</p><p>Prediction of Kidney Histopathology.</p