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

Unraveling the Role of the rssC Gene of Serratia marcescens by Atomic Force Microscopy

100學年度研究獎補助論文[[abstract]]The product and direct role of the rssC gene of Serratia marcescens is unknown. For unraveling the role of the rssC gene, atomic force microscopy has been used to identify the surfaces of intact S. marcescens wild-type CH-1 cells and rssC mutant CH-1ΔC cells. The detailed surface topographies were directly visualized, and quantitative measurements of the physical properties of the membrane structures were provided. CH-1 and CH-1ΔC cells were observed before and after treatment with lysozyme, and their topography-related parameters, e.g., a valley-to-peak distance, mean height, surface roughness, and surface root-mean-square values, were defined and compared. The data obtained suggest that the cellular surface topography of mutant CH-1ΔC becomes rougher and more precipitous than that of wild-type CH-1 cells. Moreover, it was found that, compared with native wild-type CH-1, the cellular surface topography of lysozyme-treated CH-1 was not changed profoundly. The product of the rssC gene is thus predicted to be mainly responsible for fatty-acid biosynthesis of the S. marcescens outer membrane. This study represents the first direct observation of the structural changes in membranes of bacterial mutant cells and offers a new prospect for predicting gene expression in bacterial cells.[[journaltype]]國外[[incitationindex]]SCI[[booktype]]紙本[[countrycodes]]GB

Egy hazai matematikai felmérés eredményei nemzetközi összehasonlításban

<p><b>Comparisons of the effect of different dipeptidyl peptidase-4 inhibitor treatment for 1 year on adjusted mean changes in fasting plasma glucose (FPG) (A) and glycated hemoglobin (HbA</b>_<b>1</b><b>c) (B) in the patients with a low and high hemoglobin glycation index (HGI).</b> Factors included in the analysis of variance statistical model were baseline oral anti-diabetes drugs, age, sex and renal function. VI = vildagliptin (n = 24 in the low HGI and n = 36 in the high HGI groups), LI = linagliptin (n = 33 in the low HGI and n = 31 in the high HGI groups), SA = saxagliptin (n = 45 in low HGI and n = 64 in the high HGI groups), SI = sitagliptin (n = 97 in the low HGI and n = 138 in the high HGI group). Error bars represent 95% confidence interval (CI). p-value for between-group difference. (To convert glucose to millimoles per liter, multiply by 0.0555)</p

Majorana Zero-modes and Topological Phases of Multi-flavored Jackiw-Rebbi model

Motivated by the recent Kitaev's K-theory analysis of topological insulators and superconductors, we adopt the same framework to study the topological phase structure of Jackiw-Rebbi model in 3+1 dimensions. According to the K-theory analysis based on the properties of the charge conjugation and time reversal symmetries, we classify the topological phases of the model. In particular, we find that there exist $\mathbf{Z}$ Majorana zero-modes hosted by the hedgehogs/t'Hooft-Polyakov monopoles, if the model has a $T^2=1$ time reversal symmetry. Guided by the K-theory results, we then explicitly show that a single Majorana zero mode solution exists for the SU(2) doublet fermions in some co-dimensional one planes of the mass parameter space. It turns out we can see the existence of none or a single zero mode when the fermion doublet is only two. We then take a step further to consider four-fermion case and find there can be zero, one or two normalizable zero mode in some particular choices of mass matrices. Our results also indicate that a single normalizable Majorana zero mode can be compatible with the cancellation of SU(2) Witten anomaly.Comment: 29 pages, 3 figures; v2, typos correcte

Neuroimaging of the dopamine transporter in Parkinson s disease: first study using [99mTc]-TRODAT-1 and SPECT in Brazil

BACKGROUND: Dopamine transporter (DAT) neuroimaging radiotracers were developed to estimate dopamine neuronal loss in vivo in Parkinson s disease (PD). OBJECTIVE: To evaluate DAT density in vivo using [99mTc]-TRODAT-1 and single photon computerized tomography (SPECT) in a population of Brazilian PD. METHOD: Fifteen PD patients and 15 matched healthy controls scanned with [99mTc]-TRODAT-1 (INER-Taiwan) and SPECT. Estimates of striatum DAT density were calculated using binding potential (BP). Patients were assessed with PD scales. RESULTS: PD patients had significantly lower striatal DAT-BP (mean±SD) (0.38±0.12) compared to controls (BP=0.84±0.16; p<0.01). A 100% sensitivity and 100% specificity was obtained to discriminate PD cases from controls. Negative correlations between striatal DAT-BP and PD severity (rho= -0.7, p<0.001) and motor scales (rho= -0.80, p<0.001) were found. CONCLUSION: [99mTc]TRODAT-1 SPECTs scanning was able to discriminate PD patients from controls. The technique is a powerful instrument to measure DAT density that can be used in clinical and research settings in Brazil.INTRODUÇÃO: Radiotraçadores para neuroimagem de transportador de dopamina (TDA) foram desenvolvidos para estimar a perda de neurônios dopaminérgicos in vivo na doença de Parkinson (DP). OBJETIVO: Avaliar a densidade de TDA in vivo utilizando [99mTc]-TRODAT-1 (INER-Taiwan) e SPECT em uma população de pacientes brasileiros com DP. MÉTODO: Quinze pacientes com DP e 15 controles saudáveis pareados realizaram exames de SPECT com [99mTc]-TRODAT-1 (INER-Taiwan). Estimativas da densidade de TDA estriatal foram calculadas usando potencial de ligação (PL). Pacientes foram avaliados com escalas para PD. RESULTADOS: Pacientes com DP apresentaram redução significativa do PL-TDA (0,38±0,12) comparado aos controles (0,84±0,16, p<0,01). Foi possível discriminar casos de DP de controles com uma sensibilidade de 100% e especificidade de 100%. Foram obtidas correlações negativas entre PL-TDA e escalas de severidade da DP (rho= -0,7, p<0,001) e disfunção motora (rho= -0,8, p<0,001). CONCLUSÃO: Exames de SPECT com [99mTc]-TRODAT-1 foram capazes de discriminar pacientes com DP de controles. Esta técnica é um instrumento útil para medir a densidade de TDA e pode ser utilizado para clínica e pesquisa no Brasil.Universidade Federal de São Paulo (UNIFESP) Laboratório Interdiciplinar de Neuroimagem e CogniçãoHIAE Instituto Israelita de Ensino e Pesquisa Albert EinsteinHospital Israelita Albert Einstein Departamento de ImagemInstitute of Nuclear Energy Research TaiwanUNIFESP Departamento de NeurologiaUNIFESP Departamento de PsicobiologiaUNIFESP Departamento de PsiquiatriaUNIFESP, Laboratório Interdiciplinar de Neuroimagem e CogniçãoUNIFESP, Depto. de NeurologiaUNIFESP, Depto. de PsicobiologiaUNIFESP, Depto. de PsiquiatriaSciEL