An Uncommon Manifestation of Fitz-Hugh-Curtis Syndrome with Right-side Chest Pain

Fitz-Hugh-Curtis syndrome is characterized by an inflammation of the perihepatic capsules associated with pelvic inflammatory disease. The typical symptom is severe right upper quadrant abdominal pain. We report a patient with Fitz-Hugh-Curtis syndrome who presented with an atypical chief complaint of right-side chest pain unaccompanied by symptoms specific to pelvic inflammatory disease. This case indicates that Fitz-Hugh-Curtis syndrome should be considered in the differential diagnosis of right-side chest pain in young women, because early diagnosis and treatment of the disease are essential to prevent chronic complications

Label-free Evaluation of Myocardial Infarct in Surgically Excised Ventricular Myocardium by Raman Spectroscopy

Understanding the viability of the ischemic myocardial tissue is a critical issue in determining the appropriate surgical procedure for patients with chronic heart failure after myocardial infarction (MI). Conventional MI evaluation methods are; however, preoperatively performed and/or give an indirect information of myocardial viability such as shape, color, and blood flow. In this study, we realize the evaluation of MI in patients undergoing cardiac surgery by Raman spectroscopy under label-free conditions, which is based on intrinsic molecular constituents related to myocardial viability. We identify key signatures of Raman spectra for the evaluation of myocardial viability by evaluating the infarct border zone myocardium that were excised from five patients under surgical ventricular restoration. We also obtain a prediction model to differentiate the infarcted myocardium from the non-infarcted myocardium by applying partial least squares regression-discriminant analysis (PLS-DA) to the Raman spectra. Our prediction model enables identification of the infarcted tissues and the non-infarcted tissues with sensitivities of 99.98% and 99.92%, respectively. Furthermore, the prediction model of the Raman images of the infarct border zone enabled us to visualize boundaries between these distinct regions. Our novel application of Raman spectroscopy to the human heart would be a useful means for the detection of myocardial viability during surgery

Atomic-scale characterization of nitrogen-doped graphite: Effects of dopant nitrogen on the local electronic structure of the surrounding carbon atoms

We report the local atomic and electronic structure of a nitrogen-doped graphite surface by scanning tunnelling microscopy, scanning tunnelling spectroscopy, X-ray photoelectron spectroscopy, and first-principles calculations. The nitrogen-doped graphite was prepared by nitrogen ion bombardment followed by thermal annealing. Two types of nitrogen species were identified at the atomic level: pyridinic-N (N bonded to two C nearest neighbours) and graphitic-N (N bonded to three C nearest neighbours). Distinct electronic states of localized {\pi} states were found to appear in the occupied and unoccupied regions near the Fermi level at the carbon atoms around pyridinic-N and graphitic-N species, respectively. The origin of these states is discussed based on the experimental results and theoretical simulations.Comment: 6 Pages, with larger figure

CORONARY ARTERY MORPHPLOGY AND REACTIVITY TO ACUTE HYPOXIA IN CHRONIC PULMONARY DISEASE

In patients with chronic pulmonary disase (CPD), myocardial infarction is rare. To elucidate why this is so, we investigated the morphological changes and the reactivity of the coronary artery to acute hypoxia in patients with CPD. Sixty patients with CPD and 28 normal subjects were studied. Measurements of pulmonary homodynamics and coronary angiography were undertaken before and after inhalation of 13%O2 for 15 minutes. The size of the coronary arteries was measured using a densitometric method, and a coronary narrowing score was calculated according to the WHO criteria. The size of the left anterior descending artery of patients with low %VC and hypoxia was larger than that of the normal subjects. In patients with CPD, the coronary narrowing score was low and the atherosclerotic change was minimal. The reactivity of the coronary arteries to acute hypoxia was reduced in patients with CPD when compared with normal subjects

Prevalence of and Risk Factors for the Progression of Upper Cervical Lesions in Patients with Rheumatoid Arthritis

We investigated the prevalence of and risk factors for the progression of upper cervical lesions (UCLs) in patients with rheumatoid arthritis (RA). A retrospective analysis of 49 patients with RA (4 males, 45 females) was conducted. The UCLs included atlanto-axial subluxation and vertical subluxation. We investigated the clinical factors including the Disease Activity Score 28 based on C-reactive protein (DAS28-CRP) and the modified Health Assessment Questionnaire-Disability Index as well as radiographic changes between the baseline (at May 2010 to April 2013) and final follow-up. Forty patients (81.6%) were classified as the non-progressive group, and the other 9 patients (18.4%) comprised the progressive group. The progressive group’s final CRP values, baseline or final MMP-3 levels, DAS28-CRP, and rate of pre-existing lesions at baseline were all significantly higher than those of the non-progressive group (p=0.017, p=0.043, p=0.002, p=0.008, p<0.001, and p=0.008 respectively). A multivariate logistic regression analysis demonstrated that DAS28-CRP at baseline was a risk factor for radiographic progression (p=0.018, odds ratio: 2.54, 95% confidence interval: 1.17-5.51). Our findings indicate that higher disease activity might influence the progression of UCLs in patients with RA