Case report: A case of acute exacerbation of interstitial pneumonia associated with TAFRO syndrome

Cytokine storm caused by the overproduction of inflammatory interleukin (IL)-6 plays a central role in the development of acute inflammation. The extremely rare disease, TAFRO syndrome, progresses quickly. Renal dysfunction, fever, reticulin fibrosis, anasarca, thrombocytopenia, and organomegaly with pathological findings such as idiopathic multicentric Castleman disease are all characteristics of TAFRO syndrome. Interstitial pneumonia (IP), which is not characteristic of this disease, is probably a complication of the inflammatory process. An 88-year-old man presented with a 3-day history of fever, dry cough, and progressive dyspnea. After he was first treated with antibiotics, he was transferred to our hospital because he showed no improvement. Data showed hemoglobin Hb 90.00 (SI) (9.0 g/dL); leukocyte count WBC 23 × 109/L (SI) [23,000/μL (neutrophils 87.5%, lymphocytes 2.5%, blast cells 0%)]; hemoglobin 90 g/L (9.0 g/dL); platelet count 101.00 × 109/L (10 100/μL); lactate dehydrogenase 4.78 μkat/L (286 U/L); serum albumin 25.00 g/L (2.5 g/dL); blood urea nitrogen 18.17 μmol/L (50.9 mg/dL); creatinine 285.53 μmol/L (3.23 mg/dL); C-reactive protein 161.50 mg/L (16.15 mg/dL); IL-61830 pg/mL; and surfactant protein D level 26.6 ng/mL. Findings from computed tomography indicated increased ground-glass opacities without traction bronchiectasis consistent with acute IP. The diagnosis was leukocytosis and progressive kidney injury. After bone marrow aspiration caused by persistent pancytopenia, mild reticulin fibrosis was identified. Because of the high IL-6 concentration, which revealed small atrophic follicles with regressed germinal centers surrounded by several lymphocytes, right inguinal lymph node biopsy was performed. Two minor and three major criteria led to diagnosis of TAFRO syndrome. Administrations of antibiotic therapy and methylprednisolone pulse therapy were ineffective. After rapid progress of respiratory failure, the patient died on day 30 of hospitalization. Autopsy of lung tissues showed diffuse alveolar damage with hyaline membranes. Based on these findings, we diagnosed acute exacerbation of IP associated with TAFRO syndrome due to IL-6 overproduction-associated cytokine storm

Complex domain structure in relaxed PbTiO3 thick films grown on (100)cSrRuO3//(100)SrTiO3 substrates

Domain structures of epitaxial PbTiO3 films grown on (100)cSrRuO3//(100)SrTiO3 substrates by metalorganic chemical vapor deposition were investigated by x-ray diffraction (XRD) and piezoresponse force microscopy (PFM) techniques. It was found that with increasing film thickness, the domain structure changed from simple (001) polarization orientation to a complicated mixture of (001) and (100) orientations. PFM mappings showed that in the thicker films (~1100 nm), the zigzag (001)/(100) domain boundaries made an angle of approximately 87° instead of 90° typically observed in (001)/(100) domain patterns in thinner (\u3c300 nm) films. Full-relaxed tilting angle θ1+ θ2+θ3=3.4° obtained from cross-sectional profile analysis of topological step-terrace structure was in good agreement with 3.4° and 3.6° angle values obtained from XRD measurements and theoretical prediction, respectively

Electric-field-temperature phase diagram of Mn-doped Bi0.5(Na0.9K0.1)0.5TiO3 ceramics

An electric field–temperature (E-T) phase diagram for a lead-free 0.5 mol. % Mn-doped Bi(Na0.1K0.9)TiO3 ceramics was investigated. The x-ray diffraction, dielectric and polarization measurements revealed relaxor behavior and were used to characterize the stability regions of the non-ergodic relaxor, ergodic relaxor and electric field induced ferroelectric states. As indicated by the polarization–current density profiles, transformation between two electric fields, induced ferroelectric states with opposite polarization direction arise via a two-step process through an intermediate relaxor state. Interplay between the ferroelectric state conversion and intermediate relaxor state is governed by the dynamics of polarization relaxation. The presented E-T phase diagram revealed the effects of the applied electric field and temperature on stability regions. This is of special interest since the Bi0.5(Na0.1K0.9)0.5TiO3 ceramics were proposed as a potential piezoceramic material

Phase transformation induced by electric field and mechanical stress in Mn-doped (Bi1/2Na1/2)TiO3-(Bi1/2K1/2)TiO3 ceramics

Electric-field- and stress-induced phase transformations were investigated in polycrystalline 0.5 mol. % Mn-doped (1�x)(Bi1/2Na1/2)TiO3-x(Bi1/2K1/2)TiO3 (x ¼ 0.1, 0.2). To characterize the effect of electric field and stress on the stability of the ferroelectric and relaxor states, polarizationand current density-electric field curves, as well as the stress-strain response as a function of temperature were characterized. Analogous to the observed electrical behavior, the macroscopic mechanical constitutive behavior showed a closed hysteresis at elevated temperatures, indicating a reversible stress-induced relaxor-to-ferroelectric transformation. The electrical and mechanical measurements were used to construct electric field–temperature and stress-temperature phase diagrams, which show similar characteristics. These data show that a mechanical compressive stress,similarly to an electric field, can induce long-range ferroelectric order in a relaxor ferroelectric

Electric field–temperature phase diagram of sodium bismuth titanate-based relaxor ferroelectrics

The electric field–temperature phase diagrams of three bismuth sodium titanatebased relaxor ferroelectrics are reported, namely 0.94(Na1/2Bi1/2TiO3)–0.06(BaTiO3), 0.80(Na1/2Bi1/2TiO3)–0.20(K1/2Bi1/2TiO3) and 0.75(Na1/2Bi1/2TiO3)–0.25(SrTiO3). Relaxor behavior is demonstrated by temperature-dependent dielectric permittivity measurements in the unpoled and poled states, as well as by the field-induced phase transition into a ferroelectric phase from the relaxor phase. From temperature-dependent thermometry measurements, we identified the threshold electric field to induce the ferroelectric phase and obtained the released latent heat of the phase transition. We determined the nonergodic and ergodic relaxor phase temperature range based on the absence or presence of reversibility of the relaxor to ferroelectric transition. For all three compositions, the electric field–temperature phase diagram was constructed and a critical point was identified. The constructed electric field–temperature phase diagrams are useful to find optimum operational ranges of ferroelectrics and relaxors for electromechanical and electrocaloric applications