Successful treatment of methemoglobinemia in an elderly couple with severe cyanosis: two case reports

INTRODUCTION: Methemoglobinemia should be considered in all cyanotic patients who remain unresponsive to oxygen therapy. Rapid diagnosis is very important in emergency cases. Here, we present the cases of two patients, a married couple, admitted to our hospital with methemoglobinemia after exposure to sodium nitrite. CASE PRESENTATION: Two patients, a married couple, presented with methemoglobinemia. The 72-year-old Taiwanese man and 68-year-old Taiwanese woman were referred to our hospital with dizziness and tachypnea. On examination, their mucous membranes were cyanotic, and their blood samples showed the classic ‘chocolate brown’ appearance. The man also reported having experienced twitching of his right arm for a few minutes before arrival at the hospital. The symptoms of both patients failed to improve in response to supplemental oxygen delivered via oxygen masks, although the arterial blood gas data of these patients were normal and their pulse oximetry showed oxyhemoglobin levels of approximately 85%. A carbon monoxide-oximeter showed that the man’s methemoglobin concentration was 48.3%, and the woman’s was 36.4%. Methylene blue (100mg) was administered intravenously to both patients, and their symptoms improved dramatically. They were admitted to the intensive care unit and discharged three days later, without neurological sequelae. CONCLUSION: Severe methemoglobinemia is a life-threatening condition and, if untreated, may result in death. Early diagnosis and appropriate antidotal treatment are crucial in treating this emergency situation

Topological optimization of hybrid quantum key distribution networks

With the growing complexity of quantum key distribution (QKD) network structures, aforehand topology design is of great significance to support a large-number of nodes over a large-spatial area. However, the exclusivity of quantum channels, the limitation of key generation capabilities, the variety of QKD protocols and the necessity of untrusted-relay selection, make the optimal topology design a very complicated task. In this research, a hybrid QKD network is studied for the first time from the perspective of topology, by analyzing the topological differences of various QKD protocols. In addition, to make full use of hybrid networking, an analytical model for optimal topology calculation is proposed, to reach the goal of best secure communication service by optimizing the deployment of various QKD devices and the selection of untrusted-relays under a given cost limit. Plentiful simulation results show that hybrid networking and untrusted-relay selection can bring great performance advantages, and then the universality and effectiveness of the proposed analytical model are verified.Comment: 12 pages, 4 figure

Estimating accuracy of RNA-Seq and microarrays with proteomics

<p>Abstract</p> <p>Background</p> <p>Microarrays revolutionized biological research by enabling gene expression comparisons on a transcriptome-wide scale. Microarrays, however, do not estimate absolute expression level accurately. At present, high throughput sequencing is emerging as an alternative methodology for transcriptome studies. Although free of many limitations imposed by microarray design, its potential to estimate absolute transcript levels is unknown.</p> <p>Results</p> <p>In this study, we evaluate relative accuracy of microarrays and transcriptome sequencing (RNA-Seq) using third methodology: proteomics. We find that RNA-Seq provides a better estimate of absolute expression levels.</p> <p>Conclusion</p> <p>Our result shows that in terms of overall technical performance, RNA-Seq is the technique of choice for studies that require accurate estimation of absolute transcript levels.</p

Peripheral Direct Adjacent Lobe Invasion Non-small Cell Lung Cancer Has a Similar Survival to That of Parietal Pleural Invasion T3 Disease

IntroductionThe postoperative prognosis of peripheral adjacent lobe invasion non-small cell lung cancer (NSCLC) is unclear. The purpose of this study was to determine the postoperative prognosis of NSCLC with direct adjacent lobe invasion by comparing it with that of visceral pleural invasion (primary lobe) T2 disease, and parietal pleural invasion T3 disease, and hence determine its most appropriate T category.MethodsA retrospective analysis was conducted to assess the survival of patients with peripheral direct adjacent lobe invasion NSCLC (group A), and it was compared with that of patients with visceral pleural invasion of the primary lobe (group B) and parietal pleural invasion (group C). All patients were node-negative on pathologic examination. Kaplan-Meier method was used to compare the postoperative survival between groups.ResultsA total of 263 patients were analyzed. The overall survival rates in groups A (n = 28), B (n = 167), and C (n = 68) at 5 years were 40.7, 54.6, and 41.9%, respectively; corresponding median survival in three groups were 53, 71, and 40 months, respectively. The survival difference among three groups was statistically significant (p = 0.031). A similar survival was observed between groups A and C, whereas group B had a much better survival than other groups.ConclusionsPeripheral adjacent lobe invasion NSCLC has a similar survival prognosis with that of parietal pleural invasion T3 disease and hence should be classified as T3 rather than T2. However, further studies are warranted

Risk assessment of oil price from static and dynamic modelling approaches

The price gap between West Texas Intermediate (WTI) and Brent crude oil markets has been completely changed in the past several years. The price of WTI was always a little larger than that of Brent for a long time. However, the price of WTI has been surpassed by that of Brent since 2011. The new market circumstances and volatility of oil price require a comprehensive re-estimation of risk. Therefore, this study aims to explore an integrated approach to assess the price risk in the two crude oil markets through the value at risk (VaR) model. The VaR is estimated by the extreme value theory (EVT) and GARCH model on the basis of generalized error distribution (GED). The results show that EVT is a powerful approach to capture the risk in the oil markets. On the contrary, the traditional variance–covariance (VC) and Monte Carlo (MC) approaches tend to overestimate risk when the confidence level is 95%, but underestimate risk at the confidence level of 99%. The VaR of WTI returns is larger than that of Brent returns at identical confidence levels. Moreover, the GED-GARCH model can estimate the downside dynamic VaR accurately for WTI and Brent oil returns

Diagnosis of pulmonary tuberculosis among asymptomatic HIV+ patients in Guangxi, China

BACKGROUND: Pulmonary tuberculosis (PTB) among asymptomatic Chinese patients with HIV infection has not been investigated despite high tuberculosis burden in China. This study was aimed to evaluate the prevalence, risk factors and clinical outcomes of PTB among asymptomatic patients with HIV/AIDS in Guangxi to facilitate the development of diagnostic and treatment strategies. METHODS: All asymptomatic adult HIV-infected patients with CD4 < 350 cells/µl who attended four HIV clinics in Guangxi between August 2006 and March 2008 were evaluated for active PTB with physical examination, chest X-ray (CXR), sputum smear and/or sputum liquid culture. Data were described using median (interquartile range, IQR) and frequencies. Univariate and multivariate Logistic regression analyses were performed to identify risk factors associated with PTB. RESULTS: Among 340 asymptomatic subjects, 15 (4%) were diagnosed with PTB, with 4 (27%) sputum smear positive and 8 (53%) sputum culture positive. CXR has higher diagnostic sensitivity (87%) than sputum smear (25%) and sputum culture (67%), but lower specificity (56%) compared with sputum smear (99%) and culture (100%). In univariate analysis, injection drug user, body mass index (BMI) < 18 kg/m(2), CD4 < 50 cells/µl and presence of peripheral lymphadenopathy were associated with an increased risk of asymptomatic PTB, while in multivariate analysis only peripheral lymphadenopathy maintained statistical significance (OR = 7.6, 95%CI 1.4 - 40). Patients with negative smear and minor or no abnormalities on CXR had longer interval between screening and TB treatment. CONCLUSIONS: PTB was relatively common in this group of HIV(+) asymptomatic Chinese patients. Diagnosis is challenging especially where sputum culture is unavailable. These findings suggest that an enhanced evaluation for PTB needs to be integrated with HIV care in China and transmission prevention in China to control at both households and health care facilities, especially for patients with factors associated with a higher risk of PTB

Highly efficient and stable planar heterojunction solar cell based on sputtered and post-selenized Sb2Se3 thin film

Antimony selenide (Sb2Se3) is regarded as one of the key alternative absorber materials for conventional thin film solar cells due to its excellent optical and electrical properties. Here, we proposed a Sb2Se3 thin film solar cell fabricated using a two-step process magnetron sputtering followed by a post-selenization treatment, which enabled us to optimize the best quality of both the Sb2Se3 thin film and the Sb2Se3/CdS heterojunction interface. By tuning the selenization parameters, a Sb2Se3 thin film solar cell with high efficiency of 6.06% was achieved, the highest reported power conversion efficiency of sputtered Sb2Se3 planar heterojunction solar cells. Moreover, our device presented an outstanding open circuit voltage (VOC) of 494 mV which is superior to those reported Sb2Se3 solar cells. State and density of defects showed that proper selenization temperature could effectively passivate deep defects for the films and thus improve the device performance

Skp2 expression unfavorably impacts survival in resectable esophageal squamous cell carcinoma

<p>Abstract</p> <p>Background</p> <p>The correlation of S-phase kinase–associated protein 2 (Skp2) with metastasis and prognosis in esophageal squamous cell carcinoma (ESCC) is controversial. The purpose of this study was to explore whether there was a correlation between the expression of Skp2 evaluated by immunohistochemistry and the clinical outcome of patients with operable ESCC, and to further determine the possible mechanism of the impact of Skp2 on survival.</p> <p>Methods</p> <p>Tissue microarrays that included 157 surgically resected ESCC specimens was successfully generated for immunohistochemical evaluation. The clinical/prognostic significance of Skp2 expression was analyzed. Kaplan-Meier analysis was used to compare the postoperative survival between groups. The prognostic impact of clinicopathologic variables and Skp2 expression was evaluated using a Cox proportional hazards model. A cell proliferation assay and a colony formation assay were performed in ESCC cell lines to determine the function of Skp2 on the progression of ESCC <it>in vitro</it>.</p> <p>Results</p> <p>Skp2 expression correlated closely with the T category (<it>p</it> = 0.035) and the pathological tumor-node-metastasis (TNM) stage (<it>p</it> = 0.027). High expression of Skp2 was associated with poor overall survival in resectable ESCC (<it>p</it> = 0.01). The multivariate Cox regression analysis demonstrated that pathological T category, pathological N category, cell differentiation, and negative Skp2 expression were independent factors for better overall survival. <it>In vitro</it> assays of ESCC cell lines demonstrated that Skp2 promoted the proliferative and colony-forming capacity of ESCCs.</p> <p>Conclusions</p> <p>Negative Skp2 expression in primary resected ESCC is an independent factor for better survival. Skp2 may play a pro-proliferative role in ESCC cells.</p

Total synthesis of (±)-Nimbonone

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