Clinically suspected acute myopericarditis with cardiac tamponade associated with peripheral blood eosinophilia presenting in early pregnancy: a case report

INTRODUCTION: The clinical presentation of eosinophilic myocarditis may vary from asymptomatic to the manifestation of severe symptoms, including cardiac tamponade and arrhythmias. In pregnant patients with this condition, drugs must be used cautiously up to approximately the 4th month of pregnancy because drug use should be limited during the period of fetal organogenesis. CASE PRESENTATION: A 30-year-old Asian woman at 14 weeks of pregnancy with progressive malaise was hospitalized. The electrocardiogram revealed ST elevation and low QRS voltage. Echocardiography revealed massive pericardial effusion and myocardial swelling. A laboratory examination revealed an increase in her white blood cell count, with a predominance of neutrophils. Pericardial drainage was performed for relief of the cardiac tamponade. The pericardial effusion revealed an abundance of eosinophils. Subsequently, the peripheral blood eosinophil count began to rise, and the patient was clinically diagnosed with eosinophilic myopericarditis. The patient’s condition improved rapidly following the initiation of prednisolone treatment, and she finally delivered a full-term normal infant. CONCLUSIONS: A patient with clinically suspected myopericarditis in the early stage of pregnancy who improved rapidly with pericardial drainage and prednisolone therapy, and successfully delivered a normal full-term infant; the diagnosis was made in the early stage of the disease, based on the detection of an abundance of eosinophils in the pericardial effusion preceding the subsequent development of peripheral blood eosinophilia

Supersaturated state of diazepam injection following dilution with infusion fluid

BackgroundSignificant precipitation produced by the dilution of diazepam (DZP) injection with an infusion fluid is a great concern for the clinical practice. In this study, the precipitation behavior under different conditions was investigated.MethodFor the sample preparation, DZP injections (Horizon injection and Cercine injection) were diluted with various infusion fluids (Saline, 5% glucose infusion fluid and Soldem 3A) at designated dilution ratios ranging from 1× to 40× (5 mg/mL to 0.125 mg/mL). In addition, to measure the solubility of DZP in the samples, the saturated solutions of DZP were prepared. The DZP concentrations in the samples were measured by high-performance liquid chromatography (HPLC). This study also investigated the precipitate using various analytical methods: infrared microscopy, 1H-NMR, differential scanning calorimetry, and powder X-ray deflection.ResultsFirst, the compatibility of injection with infusion fluids was investigated. Significant precipitation occurred at dilution ratios ranging from 2× to 20×. No significant effects of formulations and infusion fluids on the compatibility were observed. The solubility of DZP was then further investigated. The concentration of DZP dissolved in the admixtures was higher than the solubility. This indicated that DZP existed in a supersaturated state in the infusion fluid admixtures. In the next phase of this study, the precipitate was investigated using various analytical methods. Results showed that the precipitate in infusion fluid admixtures was mostly composed of DZP, but also contained small amounts of the ingredients of DZP injection, such as benzoic acid and benzyl alcohol.ConclusionsThis study clarified details of the precipitation occurring after dilution of DZP injection with infusion fluids. It is worth noting that DZP in an infusion admixture existed in a supersaturated state. These findings offer important insight into the clinical practice of DZP injection

Survey of Period Variations of Superhumps in SU UMa-Type Dwarf Novae

We systematically surveyed period variations of superhumps in SU UMa-type dwarf novae based on newly obtained data and past publications. In many systems, the evolution of superhump period are found to be composed of three distinct stages: early evolutionary stage with a longer superhump period, middle stage with systematically varying periods, final stage with a shorter, stable superhump period. During the middle stage, many systems with superhump periods less than 0.08 d show positive period derivatives. Contrary to the earlier claim, we found no clear evidence for variation of period derivatives between superoutburst of the same object. We present an interpretation that the lengthening of the superhump period is a result of outward propagation of the eccentricity wave and is limited by the radius near the tidal truncation. We interpret that late stage superhumps are rejuvenized excitation of 3:1 resonance when the superhumps in the outer disk is effectively quenched. Many of WZ Sge-type dwarf novae showed long-enduring superhumps during the post-superoutburst stage having periods longer than those during the main superoutburst. The period derivatives in WZ Sge-type dwarf novae are found to be strongly correlated with the fractional superhump excess, or consequently, mass ratio. WZ Sge-type dwarf novae with a long-lasting rebrightening or with multiple rebrightenings tend to have smaller period derivatives and are excellent candidate for the systems around or after the period minimum of evolution of cataclysmic variables (abridged).Comment: 239 pages, 225 figures, PASJ accepte

Influence of acidic pH, aluminum and manganese on reproductive physiology of Astyanax bimaculatus males (Characiformes: Characidae)

Os metais podem causar efeitos adversos de grande amplitude na função reprodutiva de animais, principalmente em organismos aquáticos. Eles podem alterar o sistema endócrino, atuando na esteroidogênese, afetando o processo reprodutivo dos peixes. Nosso objetivo foi investigar os efeitos dos metais alumínio (Al) e manganês (Mn) em pH ácido sobre a esteroidogênese de machos de Astyanax bimaculatus, sexualmente maduros, após uma exposição aguda de 96 horas e avaliar se os animais foram capazes de recuperar dos possíveis efeitos destes metais em água livre de metais. Esses animais foram expostos a uma concentração nominal de 0,5 mg.L-1 de Al e Mn (isolados ou combinados), e os grupos experimentais foram mantidos em pH ácido (5,5) para manter os metais biodisponíveis. Foi realizada uma exposição aguda de 96 horas, com amostragens em 24h e 96h, e depois também um período de 96h em água livre de metais, com amostragens em 120h e 192h, a partir do o início do experimento. Foram determinadas as concentrações plasmáticas de testosterona (T), 11-cetotestosterona (11-KT), 17β-estradiol (E2) e cortisol (C) por ELISA. Além disso, foram realizadas análises histológicas dos testículos e avaliação da concentração espermática. Os metais estudados, além do pH ácido, foram capazes de aumentar as concentrações plasmáticas dos androgénos T e 11-KT. Também foi observado um aumento transitório de E2 em 24h, mas apenas em animais expostos ao Mn e depois uma diminuição em 96h. A exposição ao pH ácido e metais, sozinhos ou combinados não provocou alterações nos níveis de C. Sendo assim, Al e Mn , assim como a acidez da água podem atuar como desregulador endócrino em machos de A. bimaculatus, principalmente por estimulação da síntese de androgénos, causando alterações no sistema fisiológico. No entanto, 96 horas não foram suficientes para que os animais se recuperassem. Os testículos encontravam-se em estágio avançado de maturação, enquanto que a concentração espermática não apresentou alterações significativas que indicassem a atuação dos metais em conjunto ao pH ácido. Táticas reprodutivas podem ter sido utilizadas pela espécie para desencadear alterações na esteroidogênese testicular, principalmente acelerando o processo de espermatogênese e espermiogênese, o que pode interferir com a dinâmica reprodutivaMetals can cause adverse wide range effects on reproductive function of animals, mostly in aquatic organisms. They can alter the endocrine system, acting on gonadal steroidogenesis, affecting the reproductive process of fish. We aimed to investigate the effects of the metals aluminum (Al) and manganese (Mn) in acidic pH on the steroidogenesis of Astyanax bimaculatus males, sexually mature, after an acute exposure of 96 hours and evaluate if the animals were able to recover of the possible effects of these metals in the water free of metals. Mature males were exposed to a concentration of 0.5 mg.l-1 of Al and Mn (isolated or combined) and the experimental groups were maintained at acidic pH (5.5) to keep the metals bioavailable. We performed an acute exposure of 96 hours, with samplings at 24h and 96h, and then also a period of 96h in water free of metals, with samplings at 120h and 192h from the beginning of the experiment. We measured the plasma levels of testosterone (T), 11-ketotestosterone (11-KT), 17?-estradiol (E2) and cortisol (C) by elisaimmunoassay. Furthermore, histological analysis of testes and evaluation of the sperm concentration were performed. The metals studied, in addition to acidic pH, were able to alter the plasma concentration of the androgens T and 11KT. A transitory increase (24h) of E2 levels was also observed, but only in animals exposed to Mn and then a decrease in 96h occurred. Exposure to acidic pH and metals, alone or combined did not trigger changes in C plasma levels. Generally, Al and Mn as well as the acidity of water can act as endocrine disruptor in A. Bimaculatus males, mainly by stimulating the androgens synthesis, causing changes on physiological system. However, 96 hours in water free of metals were not enough for the animals to recover from the effects of the metals. The testes were in the advanced stage of maturation, while sperm concentration was not significantly changed to suggest any influence of metals together with acidic pH in altering this variable. Reproductive tactic could be used by the species to trigger changes in testicular steroidogenesis, mainly accelerating the process of spermatogenesis and spermiogenesis, what may interfere with the reproductive dynamic

Photothermal Tautomerization of a UV Sunscreen (4-<i>tert</i>-Butyl-4′-methoxydibenzoylmethane) in Acetonitrile Studied by Steady-State and Laser Flash Photolysis

The photothermal tautomerization processes between enol and keto forms of 4-<i>tert</i>-butyl-4′-methoxydibenzoylmethane (trade name, Avobenzone) in acetonitrile have been studied by steady-state and laser flash photolysis. The keto form is produced upon photolysis of the enol in only acetonitrile with a quantum yield of 0.014. The molar absorptivity of the keto form was determined. Phototautomerization from the keto to the enol form was not seen. Laser flash photolysis of the keto form recognized the formation of the triplet state. In the dark, the keto form underwent thermal tautomerization to the enol with a lifetime of 5.1 h at 295 K. The enolization rate in acetonitrile was not accelerated by the presence of alcohols and/or water but increased with increasing temperature and followed the Arrhenius expression. The activation energy and the frequency factor were determined for the enolization process from the keto to the enol form. On the basis of the energy states of the tautomers and isomers as estimated by DFT calculations, a schematic energy diagram was determined for the photothermal tautomerization processes in acetonitrile

Evaluation of the reverse transcription loop-mediated isothermal amplification (RT-LAMP) as a screening method for the detection of influenza viruses in the fecal materials of water birds.

Migratory water birds are a natural reservoir for influenza A viruses. Viruses replicate in the intestines of ducks and are shed with the fecal materials. Virus isolation from collected fecal materials, therefore, is an integral part of the surveillance of avian influenza in water birds. In the present study, reverse transcription loop-mediated isothermal amplification (RT-LAMP) was assessed for its usefulness in detecting the RNA of influenza A viruses in fecal materials. It was found that, RT-LAMP specifically and sensitively detects the matrix gene of influenza A viruses. Influenza A viruses were isolated from the fecal materials in which viral RNA were detected by RT-LAMP in 35 min. The present findings indicate that RT-LAMP is useful as a high throughput screening method for field samples prior to virus isolation, allowing the processing of hundreds of samples per day

A low pathogenic H5N2 influenza virus isolated in Taiwan acquired high pathogenicity by consecutive passages in chickens.

H5N2 viruses were isolated from cloacal swab samples of apparently healthy chickens in Taiwan in 2003 and 2008 during surveillance of avian influenza. Each of the viruses was eradicated by stamping out. The official diagnosis report indicated that the Intravenous Pathogenicity Indexes (IVPIs) of the isolates were 0.00 and 0.89, respectively, indicating that these were low pathogenic strains, although the hemagglutinin of the strain isolated in 2008 (Taiwan08) had multibasic amino acid residues at the cleavage site (PQRKKR/G). In the present study, these H5N2 viruses were assessed for their intravenous and intranasal pathogenicity for chickens. It was examined whether Taiwan08 acquires pathogenicity through consecutive passages in chickens. Intravenous pathogenicity of Taiwan08 depended upon the age of the chickens used for the IVPI test; all of the eight-week-old chickens intravenously inoculated with Taiwan08 showed clinical signs but survived for ten days post inoculation (IVPI=0.68), whereas all the six-week-old chickens died (IVPI=1.86). Taiwan08-P8, which were passaged in chickens for eight times, killed all the eight-week-old chickens (IVPI=2.36). The four-week-old chickens died after intranasal inoculation of Taiwan08-P8, indicating that Taiwan08 must have become highly pathogenic during circulation in chicken flocks. These results emphasize the importance of a stamping out policy for avian influenza even if the IVPI of the causal virus is low