Acute Viral Hepatitis C-Induced Jaundice in Pregnancy

SummaryObjectiveAcute viral hepatitis C-induced jaundice in pregnancy is very rare and may be fatal. Here, we report a complicated case with acute hepatitis C-induced jaundice in pregnancy with successful managementCase ReportA 27-year-old pregnant woman, gravida 2, para 1, with gestational age of 36 weeks and 5 days, was referred to our hospital due to jaundice and elevated liver enzymes of undetermined cause. She had been suffering from general weakness, diarrhea and vomiting for 1 week, and jaundice with tea-colored urine for 3 days. At our medical center, acute viral hepatitis C-induced jaundice was suspected. Since her general condition deteriorated at 36 weeks and 6 days of gestation, we decided to induce labor. A male baby was born smoothly via the vaginal route, with birth weight 2,857 g, birth length 48.6 cm, and 1- and 5-minute Apgar scores of 7 and 9, respectively. Maternal condition improved dramatically after delivery and her serum liver enzymes and bilirubin levels gradually approached normal ranges.ConclusionMothers and fetuses with acute viral hepatitis C-induced jaundice during pregnancy are at great risk of mortality and morbidity. Timely termination may be one of the choices of treatment when fetal maturity has been reached and the maternal condition has deteriorated

Use of sodium bicarbonate for acute dizziness after minor head injury

AbstractObjectiveDizziness after minor head injury (mHI) is common. In some eastern countries, it is treated with 7% sodium bicarbonate solution (SB). This prospective study evaluated the clinical efficacy of SB compared with normal saline (NS).Material and methodsFrom April 2009 to April 2010, we performed a prospective observational study on 228 patients (68% female, 32% male) with acute dizziness after mHI. At the emergency physician’s discretion, intravenous SB (1 mL/kg) in NS (250 mL) or NS (250 mL) was administered to 166 patients and 62 patients, respectively, as empiric antidizziness therapy. Outcome measures were severity of dizziness and treatment response, which were measured by a visual analog scale. Various characteristics were compared between treatment groups. Any continued dizziness of the patients during follow-up was also compared with their pre-injury condition, such as prior psychiatric disorders and the presence of vertigo.ResultsThe SB group had their visual analog scale scores reduced by 25.4% compared with 24.6% in the NS group. Both groups showed a statistically significant reduction in dizziness (p < 0.001); however, the dizziness improvement did not differ significantly between the two treatment groups (p = 0.699). Sixty-four patients (28.1%) suffered from continued dizziness during follow-up (mean period, 22.4 ± 28.9 days). The prevalence of continued dizziness was higher in patients with prior psychiatric disorders, although this was not statistically significant (40% vs. 27.2%, p = 0.276), whereas patients with prior vertigo did not experience a higher dizziness relapse rate (27% vs. 28.2%).ConclusionsSB and NS administrations are both effective individually when treating patients with acute dizziness from mHI; however, both results may be attributable to the placebo effect. Therefore more research is necessary to understand the complex conditions that determine the effects of SB on this disorder

THE PREDICTION OF PHYSICAL ACTIVITY USING TREADMILL VIBRATION

A lot of treadmills detect physical activity by running speed which is only horizontal information, but vertical information is also important, such as impact and ground reaction force. This study tried to find out the relationship among the treadmill impact vibration, ground reaction force and human body impact vibration information on runner. Three college males were recruited to walk and run on treadmill at different speeds. Accelerometer on treadmill, accelerometer on human body and four load-cells were used to measure physical activity. The results showed that treadmill vibration was significantly correlated with body impact and ground reaction force. In the same speed, treadmill vibration at running was greater than walking. In order to predict whole physical activity more accurately, three-dimensional information should be used instead of speed only

Analysis of Agreement on Traditional Chinese Medical Diagnostics for Many Practitioners

In Traditional Chinese Medicine (TCM) diagnostics, it is an important issue to study the degree of agreement among several distinct practitioners. In order to study the reliability of TCM diagnostics, we have to design an experiment to simultaneously deal with both of the cases when the data is ordinal and when there are many TCM practitioners. In this study, we consider a reliability measure called “Krippendorff's alpha” to investigate the agreement of tongue diagnostics in TCM. Besides, since it is not easy to obtain a large data set with patients rated simultaneously by many TCM practitioners, we use the renowned “bootstrapping” to obtain a 95% confidence interval for the Krippendorff's alpha. The estimated Krippendorff's alpha for the agreement among ten physicians that discerned fifteen randomly chosen patients is 0.7343, and the 95% bootstrapping confidence interval for the true alpha coefficient is [0.6570, 0.7349]. The data was collected and analyzed at the Department of Traditional Chinese Medicine, Changhua Christian Hospital (CCH) in Taiwan

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

LrrA, a novel leucine-rich repeat protein involved in cytoskeleton remodeling, is required for multicellular morphogenesis in Dictyostelium discoideum

AbstractCell sorting by differential cell adhesion and movement is a fundamental process in multicellular morphogenesis. We have identified a Dictyostelium discoideum gene encoding a novel protein, LrrA, which composes almost entirely leucine-rich repeats (LRRs) including a putative leucine zipper motif. Transcription of lrrA appeared to be developmentally regulated with robust expression during vegetative growth and early development. lrrA null cells generated by homologous recombination aggregated to form loose mounds, but subsequent morphogenesis was blocked without formation of the apical tip. The cells adhered poorly to a substratum and did not form tight cell–cell agglomerates in suspension; in addition, they were unable to polarize and exhibit chemotactic movement in the submerged aggregation and Dunn chamber chemotaxis assays. Fluorescence-conjugated phalloidin staining revealed that both vegetative and aggregation competent lrrA− cells contained numerous F-actin-enriched microspikes around the periphery of cells. Quantitative analysis of the fluorescence-stained F-actin showed that lrrA− cells exhibited a dramatically increase in F-actin as compared to the wild-type cells. When developed together with wild-type cells, lrrA− cells were unable to move to the apical tip and sorted preferentially to the rear and lower cup regions. These results indicate that LrrA involves in cytoskeleton remodeling, which is needed for normal chemotactic aggregation and efficient cell sorting during multicellular morphogenesis, particularly in the formation of apical tip

Implementing a Cooking and Dietary Management System Using RFID Technology

The establishment of a database of nutritional ingredients with electronic scales feature provides chefs with conducted cooking; as long as the food category is selected and weighed by order, the nutritional content of the dish will be known. By RFID electronic scales and electronic plate function, the meal intake of nutrients and measurement of food nutrients per meal can reach a daily diet control purpose. The so-called RFID electronic plate is embedded into the chassis and aplate composed of a plurality of dishes to detect information in the chassis and the various subdishes through RFID reader. The chassis provides users with automatic identification such as physiological signals and doctor’s prescription as an individual dietary recommendation through dietary database. The dietary database, in addition to providing essential food nutrients, can be used to query using keywords and classification methods so as to quickly find the sum ingredients for cooking and ingredients. The chefs instantly know the meals nutrition during ingredients weighing by using RFID electronic scales. End users only need to place the allocated cooking dishes on electronic scales; they can easily know the total own meal intake nutrition

Direction controllable linearly polarized laser from a dye-doped cholesteric liquid crystal

We demonstrate a direction controllable linearly polarized laser from a dye-doped cholesteric liquid crystal (CLC) in a homogeneous cell coated with a metallic mirror on the inner side of a glass substrate. Due to coherent superposition of two orthogonal polarization states, the output laser light becomes linearly polarized and its output energy is greatly enhanced. Moreover, the linear polarization direction angle is proportional to the product of the CLC effective birefringence and cell gap. Hence direction tunable laser devices can be demonstrated by controlling the cell gap and the operating temperature

Comparisons of the GlideScope and Macintosh Laryngoscope in Tracheal Intubation by Medical Students on Fresh Human Cadavers

AbstractObjectiveThe GlideScope Video Laryngoscope (GS) is an intubating device that provides equal or better glottic views than conventional laryngoscopes, but correct tube placement is more time-consuming, even when performed by experienced operators. The aim of this study was to investigate the use of the GS compared with the more conventional Macintosh laryngoscope in easy and difficult tracheal intubation when performed by inexperienced medical students on fresh human cadaversPatients and MethodsForty-one medical students were assigned to perform tracheal intubation using the direct Macintosh laryngoscope (DL) and the GS. Each student was given four attempts, with a maximum of 180 seconds for each attempt, to successfully intubate the trachea with a 6.5-mm tracheal tube in each of two scenarios, one with an easy airway and the other with a difficult airway cadaver.ResultsThe total time of intubation for the easy airway cadaver was significantly longer in the GS group (61.4 ± 4.8 seconds vs. 40.6 ± 5.3 seconds; p < 0.001) despite the modified Cormack-Lehane scores showing no difference between the two groups. In the difficult airway cadaver, total time of intubation was significant shorter in the GS group (64.3 ± 6.5 seconds vs. 98.7 ± 10.2 seconds; p < 0.001)ConclusionMost inexperienced operators found the GS to be more time-consuming for tracheal intubation than DL in the easy airway cadaver. However, an obvious advantage was demonstrated when the GS was used for the difficult airway