Delayed respiratory failure during the treatment of myxedema coma

Three male patients (aged 41, 71 and 65 years) with untreated severe hypothyroidism of long duration were in a state of coma. This had been preceded by respiratory symptoms accompanied by hypoxemia and hypercapnea. There were also various chest radiographic findings. All the patients were treated with mechanical ventilatory assistance, circulatory support and i. v. administration of high doses of l-triiodo-thyronine (T3) during the early period of treatment. None of the patients showed any serious cardiac ill-effects immediately or a few days following the intravenous administration of T3. In spite of the stabilisation of vital signs and improvement in arterial oxygenation, the patients remained in a comatous or semicomatous state for the first few days. During the second week, the condition of their lungs deteriorated and prolonged respiratory failure ensued with fever, rales, excessive bronchial secretion, homogeneous densities in the chest radiograms and persistent hypoxemia even though mechanical ventilatory treatment was continued. The implications of this delayed respiratory failure during the treatment of myxedema coma are discussed.     

An unusual case of cardiomyopathy in a 75-year-old woman

In this report we describe a 75-year-old woman who presented with an acute coronary syndrome and transient catecholamine-induced cardiomyopathy with severe pulmonary oedema necessitating mechanical ventilation. During mechanical ventilation several episodes of hypertension occurred despite severe left ventricular systolic dysfunction. A pheochromocytoma was diagnosed and after successful surgical resection the patient''s condition improved. Three months after surgery myocardial scintigraphic examination demonstrated a normal ejection fraction and no signs of adenosine-induced ischaemia.     

Fulminant Type 1 diabetes in a pregnant woman as an initial manifestation of the insulin autoimmune syndrome

Diabet. Med. 29, 1335-1338 (2012) ABSTRACT: Fulminant Type 1 diabetes is a subtype of Type 1 diabetes characterized by (1) abrupt onset of diabetes, (2) very short duration of hyperglycaemia with mildly elevated HbA(1c) (相似文献   

Cytologic manifestation of an unusual bacterial form, Simonsiella species

Puzzling rodlike structures overlying benign squamous cells in exfoliative cytologic specimens from the upper gastrointestinal and respiratory tracts were initially considered to be fungi, protozoa, bronchodilator crystals, hemoglobin tactoids or plastic fragments. Their morphologic similarity to Simonsiella, a gram-negative bacteria frequently found in the oral cavity, was ultimately recognized. Further studies of smears and cultures obtained from the oral cavities of the authors and from the American Type Culture Collection confirmed the nature of the original findings. These giant bacterial forms were usually found in caterpillarlike side-by-side arrangements of 10 to 12 organisms. Cytologists should be aware of their appearance to avoid possible confusion with pathogenic organisms.     

Mastocytosis: unusual manifestation; clinical and radiologic changes.

Two patients with mast cell disease presented with unusual features. In one the absence of skin lesions made the diagnositic problem a challenging one. Certain of the laboratory findings, especially those related to the serum cholesterol concentration and platelet function tests, were particularyl interesting. Chemotherapy induced partial remission. The second patient had a long, relatively benign course complicated by two episodes of herpes zoster, the last being associated with the Landry-Guillain-Barre syndrome. In both patients the skeletal abnormalities were radiologically similar. When these are present they should be considereed sufficiently characteristic to indicate strongly a diagnosis of mastocytosis.     

Multi-stress resilience in plants recovering from submergence

Submergence limits plants' access to oxygen and light, causing massive changes in metabolism; after submergence, plants experience additional stresses, including reoxygenation, dehydration, photoinhibition and accelerated senescence. Plant responses to waterlogging and partial or complete submergence have been well studied, but our understanding of plant responses during post-submergence recovery remains limited. During post-submergence recovery, whether a plant can repair the damage caused by submergence and reoxygenation and re-activate key processes to continue to grow, determines whether the plant survives. Here, we summarize the challenges plants face when recovering from submergence, primarily focusing on studies of Arabidopsis thaliana and rice (Oryza sativa). We also highlight recent progress in elucidating the interplay among various regulatory pathways, compare post-hypoxia reoxygenation between plants and animals and provide new perspectives for future studies.     

Origin of the left anterior descending coronary artery from the pulmonary artery: An unusual cause of angina in a middle-aged woman

A 48-year-old woman was admitted to our institution with angina pectoris and a systolic murmur. At cardiac catheterization, she was found to have an anomalous origin of the left anterior descending coronary artery from the pulmonary trunk. There was also an associated atrial septal defect and a bicuspid aortic valve.     

Thresholding rules for recovering a sparse signal from microarray experiments

We consider array experiments that compare expression levels of a high number of genes in two cell lines with few repetitions and with no subject effect. We develop a statistical model that illustrates under which assumptions thresholding is optimal in the analysis of such microarray data. The results of our model explain the success of the empirical rule of two-fold change. We illustrate a thresholding procedure that is adaptive to the noise level of the experiment, the amount of genes analyzed, and the amount of genes that truly change expression level. This procedure, in a world of perfect knowledge on noise distribution, would allow reconstruction of a sparse signal, minimizing the false discovery rate. Given the amount of information actually available, the thresholding rule described provides a reasonable estimator for the change in expression of any gene in two compared cell lines.     

Metabolic pathways in Ehrlich ascites tumor cells recovering from a low bioenergetic status

Ehrlich ascites tumor cells were found to be in a low bioenergetic status, as evaluated by acridine orange uptake and ATP content, when resuspended in a glucose medium shortly after removal from the animal. Dye uptake as well as ATP content then increased for about 2 h at room temperature. This effect was only slightly inhibited by oligomycin. Cells resuspended in a glucose-free medium initially showed high dye uptake and ATP level, which were stable over time: in this case oligomycin caused a drop in both dye uptake and ATP level. The above findings, which are indicative of a marked Crabtree effect in Ehrlich ascites tumor cells, means that it is unlikely that limiting ADP and P_i play an important role in the glucose-induced inhibition of oxidative phosphorylation in this system.