In-cell NMR: a topical review

Classical structural biology approaches allow structural characterization of biological macromolecules in vitro, far from their physiological context. Nowadays, thanks to the wealth of structural data available and to technological and methodological advances, the interest of the research community is gradually shifting from pure structural determination towards the study of functional aspects of biomolecules. Therefore, a cellular structural approach is ideally needed to characterize biological molecules, such as proteins, in their native cellular environment and the functional processes that they are involved in. In-cell NMR is a new application of high-resolution nuclear magnetic resonance spectroscopy that allows structural and dynamical features of proteins and other macromolecules to be analyzed directly in living cells. Owing to its challenging nature, this methodology has shown slow, but steady, development over the past 15 years. To date, several in-cell NMR approaches have been successfully applied to both bacterial and eukaryotic cells, including several human cell lines, and important structural and functional aspects have been elucidated. In this topical review, the major advances of in-cell NMR are summarized, with a special focus on recent developments in eukaryotic and mammalian cells

Delayed onset of impaired consciousness complicated with ketoacidosis after disulfiram overdose

Abstract Background We report a case of disulfiram overdose that caused a delayed onset of impaired consciousness and ketoacidosis. Case presentation A 61‐year‐old man was transferred to our hospital following a suicide attempt. The patient lost consciousness after an overdose of disulfiram and brotizolam. He was diagnosed with acute drug intoxication and was intubated. On day 2, he showed an improved consciousness response and was successfully extubated. On day 5, the state of consciousness worsened again, and ketoacidosis progressed. The patient required hemodialysis and suffered from impaired consciousness for the following 2 weeks. Eventually, he recovered gradually and was discharged to the rehabilitation ward. Conclusions The delayed appearance of symptoms after the disulfiram overdose was thought to be related to the slow metabolism of disulfiram in the body. Our case suggests the necessity of careful follow‐up for delayed impaired consciousness

Peripheral VA-ECMO and pericardial drainage connected to the ECMO circuit for cardiac tamponade from blowout rupture: a case report

Abstract Background Left ventricular free wall rupture, particularly the blowout type, is still one of the most lethal complications of myocardial infarction and can cause catastrophic cardiac tamponade. Extracorporeal membrane oxygenation (ECMO) is often used to treat haemodynamic instability due to cardiac tamponade. However, elevated pericardial pressure can cause collapse of the right atrium, resulting in inadequate ECMO inflow and preventing the stabilisation of the circulation. Further, it can interfere with the venous return from the superior vena cava (SVC), increasing the intracranial pressure and reducing cerebral perfusion levels. Case presentation A 65-year-old man was hospitalised for out-of-hospital cardiac arrest. We used ECMO for cardiopulmonary resuscitation. After the establishment of ECMO, transthoracic echocardiography and left ventriculography revealed massive pericardial effusion. The treatment was supplemented with pericardial drainage since ECMO flow was frequently hampered by suction events. However, the blowout rupture led to the requirement of constant drainage from the pericardial catheter. To tend to this leak, we connected the venous cannula of ECMO and the pericardial drainage catheter. The surgery was performed with stable circulation without suction failure of ECMO. During the course of the intensive care management, the neurological prognosis of the patient was revealed to be poor, and the patient was shifted to palliative care. Unfortunately, the patient died on day 10 of hospitalisation. Conclusion We present a case wherein the combination of pericardial drainage and ECMO was used to maintain circulation in a patient with massive pericardial effusion due to cardiac rupture

Diagonally arranged louvers in integrated facade systems - effects on the interior lighting environment

Building facades play an important role in creating the urban landscape and they can be used effectively to reduce energy usage and environmental impacts, while also incorporating structural seismic-resistant elements in the building perimeter zone. To address these opportunities, the authors propose an integrated facade concept which satisfies architectural facade and environmental design requirements. In Europe, remarkable facade engineering developments have taken place over the last two decades resulting in elegant facades and a reduction in environmental impact; however modifications are needed in Japan to take account of the different seismic and environmental situations. To satisfy these requirements, this paper proposes the use of a diagonally disposed louver system. Diagonally arranged louvers have the potential to provide both seismic resistance and environment adaptation. In many cases, louvers have been designed but not installed due to concerns relating to restricted external sight lines and low levels of natural lighting in the building interior. To overcome these problems, full-scale diagonally arranged louver mock-ups were created to evaluate illumination levels, the quality of the internal daylight environment and external appearance. Interior illumination levels resulting from a series of mock-up experiments were evaluated and correlated with results from a daylight analysis tool

Klebsiella pneumoniae sepsis complicated with central nervous system involvement: A case series

Abstract Central nervous system (CNS) infection with Klebsiella pneumoniae can be a complication of invasive liver abscess syndrome; however, CNS infections due to K. pneumoniae without liver abscesses are rare. We report three fatal cases of CNS infection due to K. pneumoniae that lacked liver abscesses during the initial investigation