A case of brain abscess accompanied with sudden-onset hemiplegia as initial manifestation

A 58-year-old male experienced a sudden stroke-like onset of right hemiplegia and numbness of his right upper limb while engaged in his desk-work on April 7, 1997. He had a past history of diabetes mellitus and hyperlipidemia. On admission, he had no fever and the blood pressure was 140/70 mmHg. General physical examination was unremarkable. Neurological examination showed 4/5 strength of his right unilateral extremities and numbness of his right upper limb. Clinical features and computed tomography (CT) without contrast medium at the onset of hemiplegia suggested a stroke. Seven days after admission, his consciousness worsened and body temperature fluctuated between 37 and 38 degrees C. Subsequent Gd-enhanced magnetic resonance (MR) which demonstrated an irregular shaped ring-enhancement lesion and lumbar puncture 9 days after admission was compatible with the diagnosis of brain abscess. Surgical drainage confirmed the presence of brain abscess due to alpha-streptococcus. It improved following surgical drainage and antibiotic therapy with PAPM.BP 2 g/day and PIPC 4 g/day. An afebrile patient of sudden stroke-like onset may be a rarity to be added to the differential diagnosis of brain abscess.     

Atypical acute dystonia

Acute dystonia is a common adverse effect following anti-psychotic medication, which mainly appears shortly after beginning treatment or increasing the dosage. Laryngeal dysfunction may carely occur as part of the picture of acute dystonia and, if so, usually with dyspnoea. We describe a case of acute dystonia with atypical onset without relation to changes in dosage and with laryngeal involvement with aphonia, but without dyspnoea.     

Sever acute pulmonary edema after peri-anesthetic laryngospasm in a newborn infant

Severe acute pulmonary oedema following peranaesthetic laryngospasm in a newborn. The authors report a case of severe acute pulmonary oedema secondary to a laryngeal spasm in a 3-week-old neonate, immediately after induction of anaesthesia with halothane. After emergency tracheal intubation, the infant experienced a severe, life-threatening pulmonary oedema requiring prolonged intensive care. Such a secondary time course is unusual. Usually pulmonary oedema has a favourable outcome after oxygen administration and maintenance of positive expiration pressure, except in the neonate.     

A 64-year-old man with recurrent blurred vision and an abdominal mass

We report a 64-year-old man with recurrent bouts of blurred vision who died after developing an abdominal mass. He was well until June of 1985 when he was 59-years-old when he had an acute onset of loss of vision in his right eye. He was treated by prednisolone with a complete remission. In August of 1986, he had another bout of blurring of vision in his left eye. Once he lost his left vision completely, from which he showed slow recovery. In January of 1987, he developed blurring of his right eye and loss of pain and touch sensation in his right leg. Since then he repeated loss of vision in his right or left eye five times, and he was admitted to our hospital in May of 1990. On admission, he was alert and oriented. General physical examination was unremarkable. Neurologic examination revealed bilateral optic nerve atrophy. He could not discriminate light or dark by either eye. Other cranial nerves were unremarkable. He could walk in a wide-base only with support; spasticity was noted in his left leg. Muscle strength was preserved. Deep reflexes were exaggerated in both legs with extensor plantar reflex bilaterally. Pain and touch sensation was decreased in the left leg by 30%, and vibration was diminished in both feet. Position sense was preserved. Routine blood counts and chemistries were unremarkable. Cranial MRI scans revealed multiple high-signal intensity lesions in both pontine bases, basal ganglia, thalami, and in the deep cerebral white matters. He was treated with oral prednisolone, plasmapheresis, lymphocytapheresis, and then immuran. His vision showed only slight recovery to discriminate light and dark. In October of 1990, slight weakness appeared in his both legs. In December of that year, he developed nausea, and a fiber colonoscopic study revealed a stenosis in the transverse colon. In March of 1991, he developed anemia and liver dysfunction. In July of that year, jaundice appeared, and his serum bilirubin was increased. In October, his leg weakness became more prominent, and his cranial CT scans at that time revealed a low density change in the right cerebellum in the right superior cerebellar artery territory; in addition, multiple low density spots were scattered to be seen in both cerebral hemispheres including the basal ganglia and thalamic areas with ventricular dilatation and cortical atrophy.(ABSTRACT TRUNCATED AT 400 WORDS)     

A case of adult type adrenoleukodystrophy with an acute onset and repeated episodes of ataxic dysarthria

We report a 30-year-old man with adult type adrenoleukodystrophy (ALD) who manifested an acute onset and repeated episodes of ataxic dysarthria. He noticed a moderate dysarthria after a high grade fever in February of 1995; however, two weeks later his symptom disappeared completely. Three months later, he noticed the dysarthria again and he was referred to our hospital for further examination. General physical findings on admission revealed a dark skin color, pigmentation of gingivae and reduced body hair. Neurologically he was normal except for a moderate ataxic dysarthria. Cranial T2-weighted MRI showed multiple high intensity lesions in the subcortical white matter of frontal lobe, bilateral peritrigonal white matter, splenium of the corpus callosum and bilateral cerebellar white matter. Only cerebellar lesions responsible for his symptom were enhanced on MRI after gadolinium administration. Initially we diagnosed him with multiple sclerosis (MS) based upon the clinical course and MRI findings, and then started corticosteroid treatment. His dysarthria was slightly improved after the treatment and bilateral gadolinium-enhanced lesions of cerebellar white matter on MRI disappeared. Multimodality evoked potentials such as short latency somatosensory evoked potentials, brainstem auditory evoked potentials and pattern-reversal visual evoked potentials, disclosed a prolonged central conduction time associated with bilaterally symmetric individual interpeak latencies. These findings, which supported diffuse and bilateral subclinical demyelinating lesions in the central nervous system, were unusual for MS; therefore his plasma very-long-chain fatty acids (VLCFA) were assayed for ALD. Finally, he was diagnosed with adult type ALD because of the high ratio of C26: 0/C22: 0 (0.075; normal 0.033). It is very difficult to clinically distinguish the early stage of adult type ALD especially in patients like this from MS. Therefore it is useful and important to evaluate not only the level of plasma VLCFA, but also to evaluate multimodality evoked potentials.     

Influence of cold bath on maximum handgrip strength

12 female college students participated in a repeated-measures experiment, receiving an experimental treatment and a control treatment. The former was a 30-min. cold bath to the forearm while the control was a simolar 30-min. period without the cold bath. Subjects' maximum handgrip strength was measured 11 times, immediately prior to treatment, immediately following treatment, and then every 20 min. for 3 hr. The subjects were tested at the same time of the day, on the same day of the week, for two consecutive weeks. Grip strength was significantly decreased immediately following the experimental treatment below pre-treatment measures and post-treatment measures for the control session. Grip strength during the experimental session significantly increased at 80 min. post-treatment when compared to the strength measures for the control at the same time interval or when compared to pre-treatment measures for either treatment. The strength measures for the two treatments remained significantly different over the rest of the testing occasions.     

Liquid metal corrosion of 316L,Fe<Subscript>3</Subscript>Al,and FeCrSi in molten Zn-Al baths

Corrosion tests of 316L and two intermetallic compounds Fe₃Al and FeCrSi in industrial Galvanizing (Zn-0.18Al), GALFAN (Zn-5Al), GALVALUME (Zn-55Al), and Aluminizing (Al-8Si) baths and lab-scale static baths were conducted. In on-line tests in industrial hot-dip baths, 316L steel shows better corrosion resistance than Fe₃Al in Galvanizing, GALFAN, and GALVALUME baths. The corrosion resistance of 316L and Fe₃Al is similar in Aluminizing bath. In static tests, FeCrSi shows the best corrosion resistance in pure Zn, Zn-55Al, and Al-8Si baths. The corrosion resistance of 316L is better than that of Fe₃Al. In Zn-5Al bath, 316L shows no thickness loss after the test. For the same bath composition, the corrosion rates of the alloys in industrial baths are higher than those in static baths. Bath temperature and chemical composition play important roles in corrosion and intermetallic layer formation. Increasing bath temperature accelerates the corrosion process and changes the nature of intermetallic layers. A small amount of aluminum reduces the corrosion process by reducing the activity of Zn and forming inhibition layer. However, after aluminum content reaches the critical point, the dominant corrosion process changes from Zn-Fe reaction to Al-Fe reaction, and, consequently, the corrosion process accelerates by increasing aluminum content in the bath.     

Liquid Mixing in Thick-Slag-Covered Metallurgical Baths—Blending of Bath

Liquid mixing in bottom-blown, gas-stirred reactors has a significant impact on process efficiency and product quality. Cold physical models were used to simulate liquid bath mixing behavior covered with a thick slag layer. The dependence of blending time on specific energy input rate, slag height, and physical properties of metal and slag was studied. A new parameter, called the “effective bath height,” is defined as a function of the slag and metal thicknesses and their relative densities to develop a unified correlation for blending time of slag-covered baths and baths without slags. Furthermore, energy dissipation associated with an increase in interfacial area was evaluated.     

The pitfalls of palliative care

An eight-year-old Highland pony which had previously shown normal laryngeal function, underwent general anaesthesia for surgical treatment of a mandibular sinus. During its recovery from the anaesthesia, the pony suffered great respiratory distress and stridor, due to total bilateral laryngeal paralysis and pulmonary oedema. The animal was immediately given a temporary tracheostomy. Some hours later, postoperative myositis developed; it resolved within two days and the pony's laryngeal function returned to normal during the following year.     

Bacillary angiomatosis associated with myositis in a patient infected with human immunodeficiency virus

PURPOSE: To report a patient with optic nerve avulsion caused by forceful rotation of the globe that occurred when his thumb penetrated the orbit while he was diving. METHODS: A 17-year-old boy was initially examined for sudden loss of vision after jumping feet first from a bridge 50 feet above a river. Upon hitting the water, he felt his right thumb push into his right globe. The patient underwent ophthalmologic and imaging examination. RESULT: Examination disclosed a tear of the optic nerve head from the sclera temporally in the right eye. CONCLUSION: Optic nerve avulsion occurs secondary to forceful rotation of the eye with tearing of the optic nerve as it exits the globe.     

离子熔体在热处理中的应用—45~#钢模具热处理用盐浴配方研究

为选择一种价廉、无公害、热处理效果又好的盐浴组成,本文在分析盐系物理化学性质的基础上,分别以50％NaCl-50％KCl;70％NaCl-30％KCl和30％NaCl-70％BaCl_2的盐浴组成,对45~#钢制成的小模具进行了热处理。研究了淬火温度、保温时间、盐浴搅拌状况和盐浴组成及配比对模具硬度的影响,确定了最佳热处理工艺参数,并提出了45~#钢小型模具热处理用的一个优化的盐浴配方——用70％NaCl-30％KCl的盐浴取代30％NaCl-70％BaCl_2的盐浴。     

Laryngeal oedema as an obstetric anaesthesia complication: case reports

Three cases of laryngeal oedema leading to endotracheal intubation difficulties in obstetric anaesthesia are described. The first case occurred immediately postpartum in a patient who developed a swollen face from strenuous bearing down efforts in the second stage of labour. The other two cases were patients with severe preeclampsia including marked generalized oedema. The possibility of the occurrence of laryngeal oedema with resultant endotracheal intubation difficulties in obstetrics should be remembered when endotracheal intubation is considered to avoid the hazard of acid aspiration. The authors prefer the use of regional anaesthetic techniques (if not contraindicated) in obstetrics, and emphasize the use of prophylactic methods to minimize the risk of acid aspiration in connection with general anaesthesia, particularly where endotracheal intubation may be difficult.     

Diagnosis of pulmonary thromboembolism in a cat using echocardiography and pulmonary scintigraphy

A 10-year-old male cat was presented with sudden onset of respiratory difficulties. Clinical examination revealed an acute dyspnoea with cyanosis associated with a left systolic heart murmur. Standard thoracic radiographs excluded pulmonary oedema and showed very few pulmonary changes given the intensity of the respiratory compromise. Echocardiographic examination revealed hypertrophic cardiomyopathy and a thrombus in the right pulmonary artery. Pulmonary scintigraphy confirmed a pulmonary thromboembolism with hypovascularisation of the left cranial lobe and of the ventral segment of the right lobe. Conservative treatment was instituted using an antibiotic (doxycycline), anticoagulants (heparin, coumadine) and a calcium inhibitor (diltiazem). The cat was given absolute rest. The general condition of the animal improved.     

Syncope during bathing in infants, a pediatric form of water-induced urticaria?

BACKGROUND: Apparent life-threatening events in infants are a difficult and frequent problem in pediatric practice. The prognosis is uncertain because of risk of sudden infant death syndrome. CASE REPORTS: Eight infants aged 2 to 15 months were admitted during a period of 6 years; they suffered from similar maladies in the bath: on immersion, they became pale, hypotonic, still and unreactive; recovery took a few seconds after withdrawal from the bath and stimulation. Two diagnoses were initially considered: seizure or gastroesophageal reflux but this was doubtful. The hypothesis of an equivalent of aquagenic urticaria was then considered; as for patients with this disease, each infant's family contained members suffering from dermographism, maladies or eruption after exposure to water or sun. All six infants had dermographism. We found an increase in blood histamine levels after a trial bath in the two infants tested. The evolution of these "aquagenic maladies" was favourable after a few weeks without baths. After a 2-7 year follow-up, three out of seven infants continue to suffer from troubles associated with sun or water. CONCLUSION: "Aquagenic maladies" could be a pediatric form of the aquagenic urticaria.     

Cold shock before associative conditioning blocks memory retrieval, but cold shock after conditioning blocks memory retention.

The effects of cooling on associative learning and memory processes in Caenorhabditis elegans were investigated by giving the worms cold shock at various times before or after conditioning. A pretraining cold shock in the 30 min immediately before conditioning and a postraining cold shock in the 30 min immediately after conditioning both disrupted learning and memory processes tested a short time after conditioning. However, if tested 3 hr after conditioning, worms given a pretraining cold shock demonstrated learned preferences, whereas worms given a posttraining cold shock still had memory deficits. These results suggest that the effects of cold shock on associative learning and memory can be dissociated into effects on memory retrieval and memory retention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of a baby whey bath on skin physiology parameters in young children

Although the skin of babies is very sensitive to irritants and baby baths are widely used in child care, there have been no investigations concerning their efficacy and safety so far. In the presented work we investigate the effect of a baby bath containing 80% and after another 2 weeks of treatment with a whey baby bath. During the study all infants were bathed at a temperature between 35 and 38 degrees C for 5 to 15 min every other day. The results showed a slightly lower skin moisture, a lower skin-pH and after an initial minimal increase a reduction of skin redness values. However, none of the results were statistically significant. The tested baby bath was well tolerated by the babies' skin based on a reduction of skin-pH. In contrast to relatively aggressive soaps we found a protective effect of the tested baby bath on the acid mantle of the skin.     

The effect of iron oxide as an inhibition layer on iron-zinc reactions during Hot-Dip galvanizing

A study was conducted on the effect of a uniform oxide layer on the galvanizing reaction in 0.20 wt pct Al-Zn and pure Zn baths at 450 °C. In the 0.20 wt pct Al-Zn bath, poor wettability of the oxide layer was observed. No significant liquid Zn penetration of the oxide occurred and, therefore, attack of the steel substrate to form localized Fe-Zn growth did not occur. It was found that the iron oxide acted as a physical barrier or inhibition layer in the pure Zn bath, similar to the Fe₂Al₅ inhibition layer that forms at the steel interface in Al-Zn baths. The inhibition effect of the oxide in the pure Zn bath was temporary, since cracks and other macrodefects in the oxide acted as fast diffusion paths for Zn. Localized Fe-Zn growth (outbursts) formed at the steel/coating interface, and the number of outbursts was generally inversely proportional to the oxide layer thickness at constant immersion times. Increased immersion time for a constant oxide layer thickness led to an increase in the number of outbursts. These results simulate the diffusion short circuit mechanisms for Fe₂Al₅ inhibition layer breakdown in Al-containing Zn baths.     

Central nervous system infection by free-living amebas: report of 3 Venezuelan cases

INTRODUCTION: Infection of the Central Nervous System by free living amebas is an unusual event, 344 cases have been reported to date. The disease becomes evident in two different clinical fashions: Primary Amebic Meningoencephalitis (PAM) caused by Naegleria fowleri and Granulomatous Amebic Encephalitis (GAE) induced by Spp. of Acanthamoeba and Balamuthia. CLINICAL CASES: The authors report three new cases from Venezuela. Case 1. 34 years old man, with a chief complaint of general malaise, headache and fever, a diagnosis of common cold was made and the patient was treated as such, he did not improve and was admitted to the hospital with deterioration of his clinical status; the patient died 10 days after the onset of his illness which was determined to be GAE produced by Balamuthia mandrillaris. Case 2. 8 years old female admitted to the hospital because of fever, headache and generalized seizures of sudden onset; neurocysticercosis was diagnosed and following improvement the patient was discharged and readmitted on two occasions because of relapse and worsening of her illness, she died 2 months after the onset of her disease that was diagnosed by autopsy as GAE due to Balamuthia mandrillaris. Case 3. 16 years old male, previously healthy, who following immersion in a water tank was admitted to the hospital because of meningeal irritation that progressed to coma and death in a 7 day lapse; autopsy revealed PAM by Naegleria fowleri. The two cases of GAE due to Balamuthia mandrillaris occurred in apparently immunocompetent individuals, contrary to the statement that these microorganisms are opportunistic. CONCLUSION: We believe that neurological infection by amphizoic amebas is being underdiagnosed, probably due to ignorance regarding this pathology or because of a very low autopsy rate in most countries.     

Mathematical Simulation of Process Parameters in the case of Rapid Solidification of Steel

Rapid solidification of steel was investigated experimentally under laboratory conditions by immersion of cold copper rods in steel baths. For a better understanding of the process parameters during rapid solidification, an explicit finite difference model was employed. In the calculation, a coefficient of heat transfer between a frozen steel shell and solid copper of α = 40 [KW/m²·K] is assumed in good agreement with experimental data derived from temperature measurements. The solidification parameters such as local time of solidification (LST), local time of the superheat reduction (LShRT), local solidification and cooling rates (LSR, LCR) and local heat flux density of solidification and superheat reduction (LSHFD, LShRHFD) can be calculated using the developed model, in dependence on the processing conditions. This influence of processing parameters, such as steel bath superheat, steel bath material, immersed body material, initial temperature of immersed body and immersed body geometry, were the subject of intensive investigations.     

Prognostic criteria of sudden deafness as deduced by electrocochleography

Electrocochleography was performed at first examination in 34 patients with sudden deafness. Recording was made with the use of the transtympanic needle electrode technique. A notable difference in the electrocochleographic findings was shown between the cases of complete recovery or remarkable improvement and the cases of slight improvement or no change. Electrocochleography may be prognostic of sudden deafness at initial onset.