IgM-mediated Warm Autoimmune Hemolytic Anemia: An Autopsy Report.

A 79-year-old man with Sjögren's syndrome and systemic lupus erythematosus developed acute impaired consciousness and hemolytic anemia. The patient's red blood cells agglutinated spontaneously at 25-37°C. The treatment of red blood cells with 2-mercaptoethanol resulted in the loss of spontaneous agglutination. A diagnosis of IgM-mediated warm autoimmune hemolytic anemia was made. The patient received steroid pulse and plasma exchange therapies. Rituximab was also administered. However, the patient died from multiple organ failure at six days from the symptom onset. The clinical progress of the patient and autopsy findings suggested that complement activation might have been associated with the pathology.

Condensation of Si-rich region inside soda-lime glass by parallel femtosecond laser irradiation.

Local melting and modulation of elemental distributions can be induced inside a glass by focusing femtosecond (fs) laser pulses at high repetition rate (>100 kHz). Using only a single beam of fs laser pulses, the shape of the molten region is ellipsoidal, so the induced elemental distributions are often circular and elongate in the laser propagation direction. In this study, we show that the elongation of the fs laser-induced elemental distributions inside a soda-lime glass could be suppressed by parallel fsing of 250 kHz and 1 kHz fs laser pulses. The thickness of a Si-rich region became about twice thinner than that of a single 250 kHz laser irradiation. Interestingly, the position of the Si-rich region depended on the relative positions between 1 kHz and 250 kHz photoexcited regions. The observation of glass melt during laser exposure showed that the vortex flow of glass melt occurred and it induced the formation of a Si-rich region. Based on the simulation of the transient temperature and viscosity distributions during laser exposure, we temporally interpreted the origin of the vortex flow of glass melt and the mechanism of the formation of the Si-rich region.

Shape control of elemental distributions inside a glass by simultaneous femtosecond laser irradiation at multiple spots.

The spatial distributions of elements in a glass can be modulated by irradiation with high repetition rate femtosecond laser pulses. However, the shape of the distribution is restricted to being axially symmetric about the laser beam axis due to the isotropic diffusion of photo-thermal energy. In this study, we describe a method to control the shape of the elemental distribution more flexibly by simultaneous irradiation at multiple spots using a spatial light modulator. The accumulation of thermal energy was induced by focusing 250 kHz fs laser pulses at a single spot inside an alumino-borosilicate glass, and the transient temperature distribution was modulated by focusing 1 kHz laser pulses at four spots in the same glass. The resulting modification was square-shaped. A simulation of the mean diffusion length of molten glass demonstrated that the transient diffusion of elements under heat accumulation and repeated temperature elevation at multiple spots caused the square shape of the distribution.