Dear editor, Following its entrance into the human body through inhalation, carbon monoxide （CO） forms carboxyhemoglobin （COHb） by binding to hemoglobin （Hb） within the blood. Massive ischemic tissue necrosis oc...Dear editor, Following its entrance into the human body through inhalation, carbon monoxide （CO） forms carboxyhemoglobin （COHb） by binding to hemoglobin （Hb） within the blood. Massive ischemic tissue necrosis occurs in 0.5%-1% of cases with CO poisoning. The affinity of CO to Hb is 200-250 times more when compared to the affinity of oxygen. As a result of CO binding to Hb, oxygen delivery to the tissues is reduced, and tissue hypoxia develops. This affects mostly the brain and heart, which are the organs with the highest demand for oxygen.展开更多
Increasing cases of 9p syndrome have been reported since the first description in 1970. In the present case, a extra segment of the end of chromosome 9p resulting from a maternally inherited translocation t（4; 9）（q...Increasing cases of 9p syndrome have been reported since the first description in 1970. In the present case, a extra segment of the end of chromosome 9p resulting from a maternally inherited translocation t（4; 9）（q31 ;p24） was described in a liveborn boy with mental retardation and multiple congenital anomalies. The extra part of chromosome 9p includes segment of the chromosome region 4q31→qter of his mother but deletes a small segment 9p24→pter. To our knowledge, this is the first ease described in a liveborn child. This paper also includes a review and tabulation of clinical features seen in the 34 reported eases. The new ease had most characteristics reported eases besides worried-face, fat and abnormal lower digestion tract, which is a modification and double expansion of the previous summarization on 9p syndrome.展开更多
Dear editor, In July 2015, a 39-year-old gravida 2, para 0 lady at 35 weeks＇ gestation was found collapsed at home and sent to the emergency department （ED） by ambulance. She had a background of chronic hypertensio...Dear editor, In July 2015, a 39-year-old gravida 2, para 0 lady at 35 weeks＇ gestation was found collapsed at home and sent to the emergency department （ED） by ambulance. She had a background of chronic hypertension on anti- hypertensives and aspirin, but repeatedly refused in- patient treatment for her uncontrolled hypertension. She had received pre-hospital cardiopulmonary resuscitation （CPR） for 17 minutes en route to the ED.展开更多
Dear editor, We report a case of a 47-year-old female who presented with a toxic bupropion ingestion leading to cardiac arrest. She initially exhibited a loss of brainstem reflexes in conjunction with burst-suppressio...Dear editor, We report a case of a 47-year-old female who presented with a toxic bupropion ingestion leading to cardiac arrest. She initially exhibited a loss of brainstem reflexes in conjunction with burst-suppression pattern on EEG. Burst suppression is an EEG waveform pattern of alternating isoelectric suppressions and high voltage bursts, Our patient ultimately made a full neurologic recovery a few days later. While there are two other cases in the literature of bupropion overdose resulting in EEG burst-suppression and loss of brainstem reflexes, we believe this is the only reported adult case complicated by cardiac arrest.展开更多
Bipolar disorder is associated with high rates of general medical conditions, but few cases of overlap between bipolar disorder and chronic lymphocytic infammation with pontine perivascular enhancement responsive to s...Bipolar disorder is associated with high rates of general medical conditions, but few cases of overlap between bipolar disorder and chronic lymphocytic infammation with pontine perivascular enhancement responsive to steroids （CLIPPERS） have been reported in the current literature. The following is a case of a 29-year-old patient with a previous major depressive episode comorbid with CLIPPERS. Following glucocorticosteroid therapy, the patient switched to mania-like presentation and was diagnosed with bipolar disorder due to another medical condition. So it is strongly suggested that high-dose corticosteroid pulse therapy could easily induce psychiatric disturbances for patients with previous psychiatric symptoms, and there may be potential links between bipolar disorder and CLIPPERS in the area of infammation.展开更多
Here we present the case of a 20-year-old male with a known history of an artificial mechanical aortic valve replacement at ages four and twelve, on chronic warfarin therapy, who presented to our community emergency d...Here we present the case of a 20-year-old male with a known history of an artificial mechanical aortic valve replacement at ages four and twelve, on chronic warfarin therapy, who presented to our community emergency department for the evaluation of vomiting, diarrhea, generalized malaise and abdominal pain. He was seen at a local urgent care for similar symptoms earlier in the day, subsequently discharged with a diagnosis of mild gastroenteritis; however, according to the patient＇s sister, upon his return home he looked very unwell and she called an ambulance immediately.展开更多
We reported an 8-year-old boy with panscleritis in left eye and right epididymitis after falling on the ground.Etiologic diagnosis played a key role in this case.Systemic examinations ruled out systemic autoimmune dis...We reported an 8-year-old boy with panscleritis in left eye and right epididymitis after falling on the ground.Etiologic diagnosis played a key role in this case.Systemic examinations ruled out systemic autoimmune diseases,tumors,and infections as the cause of scleritis and suggested that the disease was caused by a local delayedtype hypersensitivity(DTH)induced by ocular trauma and was non-infectious.Still,the right epididymitis was infectious.Both conditions were treated successfully using steroids and antibiotics,respectively.Thus,early etiologic diagnosis and reasonable treatment are crucial to prevent visual loss.展开更多
文摘Dear editor, Following its entrance into the human body through inhalation, carbon monoxide （CO） forms carboxyhemoglobin （COHb） by binding to hemoglobin （Hb） within the blood. Massive ischemic tissue necrosis occurs in 0.5%-1% of cases with CO poisoning. The affinity of CO to Hb is 200-250 times more when compared to the affinity of oxygen. As a result of CO binding to Hb, oxygen delivery to the tissues is reduced, and tissue hypoxia develops. This affects mostly the brain and heart, which are the organs with the highest demand for oxygen.
文摘Increasing cases of 9p syndrome have been reported since the first description in 1970. In the present case, a extra segment of the end of chromosome 9p resulting from a maternally inherited translocation t（4; 9）（q31 ;p24） was described in a liveborn boy with mental retardation and multiple congenital anomalies. The extra part of chromosome 9p includes segment of the chromosome region 4q31→qter of his mother but deletes a small segment 9p24→pter. To our knowledge, this is the first ease described in a liveborn child. This paper also includes a review and tabulation of clinical features seen in the 34 reported eases. The new ease had most characteristics reported eases besides worried-face, fat and abnormal lower digestion tract, which is a modification and double expansion of the previous summarization on 9p syndrome.
文摘Dear editor, In July 2015, a 39-year-old gravida 2, para 0 lady at 35 weeks＇ gestation was found collapsed at home and sent to the emergency department （ED） by ambulance. She had a background of chronic hypertension on anti- hypertensives and aspirin, but repeatedly refused in- patient treatment for her uncontrolled hypertension. She had received pre-hospital cardiopulmonary resuscitation （CPR） for 17 minutes en route to the ED.
文摘Dear editor, We report a case of a 47-year-old female who presented with a toxic bupropion ingestion leading to cardiac arrest. She initially exhibited a loss of brainstem reflexes in conjunction with burst-suppression pattern on EEG. Burst suppression is an EEG waveform pattern of alternating isoelectric suppressions and high voltage bursts, Our patient ultimately made a full neurologic recovery a few days later. While there are two other cases in the literature of bupropion overdose resulting in EEG burst-suppression and loss of brainstem reflexes, we believe this is the only reported adult case complicated by cardiac arrest.
文摘Bipolar disorder is associated with high rates of general medical conditions, but few cases of overlap between bipolar disorder and chronic lymphocytic infammation with pontine perivascular enhancement responsive to steroids （CLIPPERS） have been reported in the current literature. The following is a case of a 29-year-old patient with a previous major depressive episode comorbid with CLIPPERS. Following glucocorticosteroid therapy, the patient switched to mania-like presentation and was diagnosed with bipolar disorder due to another medical condition. So it is strongly suggested that high-dose corticosteroid pulse therapy could easily induce psychiatric disturbances for patients with previous psychiatric symptoms, and there may be potential links between bipolar disorder and CLIPPERS in the area of infammation.
文摘Here we present the case of a 20-year-old male with a known history of an artificial mechanical aortic valve replacement at ages four and twelve, on chronic warfarin therapy, who presented to our community emergency department for the evaluation of vomiting, diarrhea, generalized malaise and abdominal pain. He was seen at a local urgent care for similar symptoms earlier in the day, subsequently discharged with a diagnosis of mild gastroenteritis; however, according to the patient＇s sister, upon his return home he looked very unwell and she called an ambulance immediately.
基金Supported by Beijing Natural Science Foundation(7202229).
文摘We reported an 8-year-old boy with panscleritis in left eye and right epididymitis after falling on the ground.Etiologic diagnosis played a key role in this case.Systemic examinations ruled out systemic autoimmune diseases,tumors,and infections as the cause of scleritis and suggested that the disease was caused by a local delayedtype hypersensitivity(DTH)induced by ocular trauma and was non-infectious.Still,the right epididymitis was infectious.Both conditions were treated successfully using steroids and antibiotics,respectively.Thus,early etiologic diagnosis and reasonable treatment are crucial to prevent visual loss.
