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High doses of dextromethorphan induced shock and convulsions in a 19-year-old female:A case report

World Journal of Clinical Cases 2023年第16期11卷 3870-3876页

作者： Shintaro Shimozawa Daisuke Usuda Toru Sasaki Shiho Tsuge Riki Sakurai Kenji Kawai Shun Matsubara risa Tanaka Makoto Suzuki Yuta Hotchi Shungo Tokunaga Ippei Osugi risa Katou Sakurako Ito Suguru Asako Kentaro Mishima Akihiko Kondo Keiko Mizuno Hiroki Takami Takayuki Komatsu Jiro Oba Tomohisa Nomura Manabu Sugita Department of Emergency and Critical Care Medicine Juntendo University Nerima HospitalNerima-city 177-8521TokyoJapan Clinical Training Center Juntendo University Nerima HospitalNerima-city 177-8521TokyoJapan Department of Sports Medicine Faculty of MedicineJuntendo UniversityBunkyo-city 113-8421TokyoJapan

BACKGROUND Dextromethorphan is a prevalent antitussive agent that can be easily obtained as an over-the-counter *** has been a growing number of reported cases of toxicity in recent ***,there are numerous instances of mild symptoms,with only a limited number of reports of severe cases necessitating intensive *** presented the case of a female who ingested 111 tablets of dextromethorphan,leading to shock and convulsions and requiring intensive care that ultimately saved her *** SUMMARY A 19-year-old female was admitted to our hospital via ambulance,having overdosed on 111 tablets of dextromethorphan(15 mg)obtained through an online importer in a suicide *** patient had a history of drug abuse and multiple self-inflicted *** the time of admission,she exhibited symptoms of shock and altered ***,upon arrival at the hospital,the patient experienced recurrent generalized clonic convulsions and status epilepticus,necessitating tracheal *** convulsions were determined to have been caused by decreased cerebral perfusion pressure secondary to shock,and noradrenaline was administered as a *** lavage and activated charcoal were also administered after *** systemic management in the intensive care unit,the patient’s condition stabilized,and the need for vasopressors *** patient regained consciousness and was *** patient was subsequently transferred to a psychiatric facility,as suicidal ideation *** We report the first case of shock caused by an overdose of dextromethorphan.

关键词： Dextromethorphan Drug overdose Shock Symptom Treatment Case report

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A Conservative Approach to Treatment of Dental Erosion: Case Report

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Open Journal of Stomatology 2019年第11期9卷 241-248页

作者： Khaila Davis risa Yuk Low Reisha Rafeek School of Dentistry Faculty of Medical Sciences University of the West Indies St Augustine Trinidad & Tobago

Tooth surface loss is a common condition with nearly three-quarter of the population in Trinidad & Tobago exhibiting signs and about one-fifth of those persons have moderate or severe wear. These patients become difficult to treat due mainly to loss of clinical crown height and also loss of occlusal vertical dimension. This case depicts the use of a conservative approach to treating a patient with moderate tooth surface loss, as assessed via the tooth wear index, with aetiology of acid erosion. The poor appearance of the dentition was the patient’s chief presenting complaint. With the use of 3M Filtek? Z 250 Universal Restorative Composite (St Paul, MN, USA), temporary posterior build-ups were placed to increase the patient’s Occlusal Vertical Dimension (OVD) and were subsequently replaced with metal onlays. Anterior composite veneers were placed to achieve an aesthetically pleasing result at the increased OVD. The combined use of composite and metal onlays allowed for an economical and more conservative treatment modality for dental erosion rather than full coverage posterior and anterior crowns.

关键词： Erosion Tooth Wear Onlays Veneers

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Counter-Rotating Type Pump-Turbine Unit Stabilizing Momentarily Fluctuating Power from Renewable Energy Resources

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Journal of Energy and Power Engineering 2014年第6期8卷 981-989页

作者： Toshiaki Kanemoto risa Kasahara Hirotaka Honda Toru Miyaji Faculty of Engineering Kyushu Institute of Technology Kitakyushu 804-8550 Japan Graduate School of Engineering Kyushu Institute of Technology Kitakyushu 804-8550 Japan

It is difficult for renewable energy resources to provide constant power with excellent quality for the grid system. This serial research proposes a power stabilization system with a pumped storage to guarantee power quality and capacity, while the outputs from the energy resources are at unstable and/or fluctuating conditions. The power stabilization system with a counter-rotating type pump-turbine unit was prepared and operated at the pumping and the turbine modes. The unit composed of the tandem impellers/runners connected to the inner and the outer armatures of the unique motor/generator. The experiments have verified that this type pump-turbine unit is reasonably effective to stabilize momentarily/instantaneously the fluctuating power from the renewable energy resources.

关键词： Renewable energy power stabilization grid system pumped storage pump-turbine counter-rotation.

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Numerical Flow Simulation in Turbine Mode of Counter-Rotating Type Pumping Unit to Cooperate with Wind Turbine

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Journal of Energy and Power Engineering 2013年第9期7卷 1770-1777页

作者： Tengen Murakami Toshiaki Kanemoto Gohki Takano risa Kasahara Faculty of Engineering Kyushu Institute of Technology Fukuoka 804-8550 Japan Graduate School of Engineering Kyushu Institute of Technology Fukuoka 804-8550 Japan

This serial research has proposed the hybrid power system combined the wind power unit with the counter-rotating type pump-turbine unit, to provide the constant output for the grid system, even at the suddenly fluctuating/turbulent wind circumstance. In this paper, the tandem impellers prepared for the counter-rotating type pumping unit were operated at the turbine mode, and the performances and the flow conditions were investigated numerically with accompanying the experimental results. Even though providing the pumping unit for the turbine mode, the maximum hydraulic efficiency is close to one of the counter-rotating type hydroelectric unit designed exclusively for the turbine mode. Besides, the runners/impellers of the unit work evidently so as to coincide the angular momentum change through the front runners/impellers with that through the rear runners/impellers, namely to take the axial flow at not only the inlet but also the outlet, without the guide vanes. From these results, it can be concluded that this type unit is effective to work at not only the pumping but also the turbine modes.

关键词： Pump-turbine pumping mode turbine mode power supply grid system counter-rotation.

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Secondary pulmonary infection by Fusarium solani and Aspergillus niger during systemic steroid treatment for COVID-19:A case report

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世界临床病例杂志 2023年第26期11卷 6280-6288页

作者： Daisuke Usuda Masashi Kato Yuto Sugawara Runa Shimizu Tomotari Inami Shiho Tsuge Riki Sakurai Kenji Kawai Shun Matsubara risa Tanaka Makoto Suzuki Shintaro Shimozawa Yuta Hotchi Ippei Osugi risa Katou Sakurako Ito Kentaro Mishima Akihiko Kondo Keiko Mizuno Hiroki Takami Takayuki Komatsu Jiro Oba Tomohisa Nomura Manabu Sugita Department of Emergency and Critical Care Medicine Juntendo University Nerima HospitalNerima 177-8521TokyoJapan Department of Sports Medicine Juntendo UniversityBunkyo 113-8421TokyoJapan

BACKGROUND Coronavirus disease 2019(COVID-19)-associated invasive pulmonary aspergillosis presents a diagnostic challenge due to its non-specific clinical/imaging features,as well as the fact that the proposed clinically diagnostic algorithms do not necessarily apply to COVID-19 *** addition,Fusarium *** a rare cause of opportunistic life-threatening fungal *** Fusarium infection in an immunocompromised host is intractable,with a high likelihood of resulting *** our knowledge,this is the first case of secondary pulmonary infection by Fusarium solani(***)and Aspergillus niger(***)during systemic steroid treatment for *** SUMMARY A 62-year-old male was transported to our hospital by ambulance with a complaint of fever and *** established a diagnosis of pneumococcal pneumonia,complicated with COVID-19 and septic shock,together with acute renal *** was admitted to the intensive care unit,to be treated with piperacillin/tazobactam,vancomycin,and 6.6 mg per day of dexamethasone sodium phosphate,along with noradrenaline as a vasopressor,ventilator management,and continuous *** condition improved,and we finished the vasopressor on the fifth hospital *** administered dexamethasone for ten days,and finished the course of *** the eleventh day,patient respiratory deterioration was observed,and a computed tomography scan showed an exacerbation of bilateral ground-glass-opacity-like consolidation,together with newly appeared cavitary lesions in the *** changed antibiotics to meropenem plus *** addition,a fungal infection was considered as a possibility based on microscopic findings of sputum,and we began coadministration of ***,the pneumonia worsened,and the patient died on the seventeenth day of ***,*** and *** were identified from sputum collected on the twelfth *** was believed that he developed a cell-mediated immune defic

关键词： Fusarium solani Aspergillus niger Pulmonary infection Cell-mediated immune deficiency Coronavirus disease 2019 Case report

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Penile and scrotal strangulation by stainless steel rings in an human immunodeficiency virus positive man: A case report

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世界临床病例杂志 2023年第24期11卷 5811-5816页

作者： Daisuke Usuda Nobuyoshi Kaminishi Masashi Kato Yuto Sugawara Runa Shimizu Tomotari Inami Shiho Tsuge Riki Sakurai Kenji Kawai Shun Matsubara risa Tanaka Makoto Suzuki Shintaro Shimozawa Yuta Hotchi Ippei Osugi risa Katou Sakurako Ito Kentaro Mishima Akihiko Kondo Keiko Mizuno Hiroki Takami Takayuki Komatsu Jiro Oba Tomohisa Nomura Manabu Sugita Emergency and Critical Care Medicine Juntendo University Nerima HospitalNerima 177-8521TokyoJapan Clinical Training Center Juntendo University Nerima HospitalNerima 177-8521TokyoJapan Sports Medicine Juntendo UniversityBunkyo 113-8421TokyoJapan

BACKGROUND Penoscrotal constriction devices are either used as autoerotic stimuli or to increase sexual pleasure or performance by maintaining an erection for a longer period,and a variety of metallic and non-metallic objects are *** the other hand,penile strangulation is a rare urologic emergency that requires prompt evaluation and intervention to prevent long-term *** goal of treating penile incarceration is to remove the foreign object as soon as *** the other hand,removal can be very challenging,and often requires resourcefulness and a multidisciplinary *** SUMMARY A 47-year-old man who has sex with men was transferred to our hospital for persistent phallodynia and scrotal pain,accompanying swelling due to strangulation by stainless steel *** medical history included acquired immunodeficiency *** day prior,he had put three stainless steel rings on his penis and scrotum before sexual *** sexual intercourse,he was unable to remove them,due to swelling of his penis and *** swelling persisted,and he felt pain in the affected area the next day,then he was transferred to our hospital by *** emergency department found that his penis and scrotum were markedly engorged and *** established a diagnosis of penile and scrotal strangulation by stainless steel *** unsuccessfully attempted to cut the rings using a cutter,then requested a rescue team via emergency medical *** cut through each ring in two places,using an electric-powered angle grinder,and successfully removed all of the ***,he was discharged and went *** We report the first case of penile and scrotal strangulation by stainless steel rings in an human immunodeficiency virus positive person.

关键词： Penile strangulation Stainless steel ring Human immunodeficiency virus Urologic emergency Management Case report

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Magnetic bioassembly platforms towards the generation of extracellular vesicles from human salivary gland functional organoids for epithelial repair

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Bioactive Materials 2022年第12期7卷 151-163页

作者： Ajjima Chansaenroj Christabella Adine Sawanya Charoenlappanit Sittiruk Roytrakul Ladawan Sariya Thanaphum Osathanon Sasitorn Rungarunlert Ganokon Urkasemsin risa Chaisuparat Supansa Yodmuang Glauco R.Souza Joao N.Ferreira Avatar Biotechnologies for Oral Health and Healthy Longevity Research Unit Faculty of DentistryChulalongkorn UniversityBangkok10330Thailand Faculty of Dentistry National University of Singapore119077SingaporeSingapore Department of Biomedical Engineering Faculty of EngineeringNational University of Singapore119077SingaporeSingapore Functional Ingredients and Food Innovation Research Group National Center for Genetic Engineering and BiotechnologyNational Science and Technology Development AgencyPathum Thani12120Thailand The Monitoring and Surveillance Center for Zoonotic Diseases in Wildlife and Exotic Animals Faculty of Veterinary ScienceMahidol UniversityNakhon Pathom73170Thailand Department of Anatomy Faculty of DentistryChulalongkorn UniversityBangkok10330Thailand Department of Preclinical and Applied Animal Science Faculty of Veterinary ScienceMahidol UniversityNakhon Pathom73170Thailand Research Affairs Faculty of MedicineChulalongkorn UniversityBangkok10330Thailand University of Texas Health Sciences Center at Houston HoustonTX77030USA Nano3D Biosciences Inc. HoustonTX77030USA Greiner Bio-One North America Inc MonroeNC28110USA

Salivary glands(SG)are exocrine organs with secretory units commonly injured by ***-engineered organoids and extracellular vesicles(EV)are currently under investigation as potential strategies for SG ***,three-dimensional(3D)cultures of SG functional organoids(SGo)and human dental pulp stem cells(hDPSC)were generated by magnetic 3D bioassembly(M3DB)*** growth factor 10(FGF10)was used to enrich the SGo in secretory epithelial *** 11 culture days via M3DB,SGo displayed SG-specific acinar epithelial units with functional properties upon *** consistently develop 3D hDPSC in vitro,3 culture days were sufficient to maintain hDPSC undifferentiated genotype and phenotype for EV *** isolation was performed via sequential centrifugation of the conditioned media of hDPSC and SGo *** were characterized by nanoparticle tracking analysis,electron microscopy and *** were in the exosome range for hDPSC(diameter:88.03±15.60 nm)and for SGo(123.15±63.06 nm).Upon ex vivo administration,exosomes derived from SGo significantly stimulated epithelial growth(up to 60%),mitosis,epithelial progenitors and neuronal growth in injured SG;however,such biological effects were less distinctive with the ones derived from ***,these exosome biological effects were investigated by proteomic *** spectrometry profiling of SGo exosomes predicted that cellular growth,development and signaling was due to known and undocumented molecular targets downstream of *** were identified as one of the novel targets requiring further ***,M3DB platforms can generate exosomes with potential to ameliorate SG epithelial damage.

关键词： Salivary gland Hyposalivation Human dental pulp stem cells Magnetic bioassembly Organoids Exosome

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Predictors of Comorbid Psychological Symptoms among Patients with Social Anxiety Disorder after Cognitive-Behavioral Therapy

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Open Journal of Psychiatry 2016年第1期6卷 102-106页

作者： Sei Ogawa risa Imai Masaki Kondo Toshi A. Furukawa Tatsuo Akechi Department of Psychiatry and Cognitive-Behavioral Medicine Nagoya City University Graduate School of Medical Sciences Nagoya Japan Department of Health Promotion and Human Behavior Kyoto University Graduate School of Medicine/School of Public Health Kyoto Japan

Aim: The present study aimed to examine the predictors of comorbid psychological symptoms in social anxiety disorder (SAD) after cognitive-behavioral therapy (CBT). Methods: One hundred fourteen SAD patients completed manualized group CBT. We examined associations between the personality dimensions of NEO Five Factor Index (NEO-FFI) and the subscales of Symptom Checklist-90 Revised (SCL-90-R) in SAD patients after CBT using multiple regression analysis. Results: High levels of conscientiousness at baseline predicted symptom reduction on 4 SCL-90-R scales, including somatization, obsessive-compulsive, anxiety and global severity index in patients with SAD after CBT. And high levels of agreeableness predicted symptom reduction on 2 SCL-90-R scales, including Hostility and Paranoid Ideation. High levels of openness predicted psychoticism. Conclusion: The present study suggested that high levels of three NEO-FFI dimensions (openness, agreeableness, conscientiousness) might predict comorbid psychological symptoms reduction in SAD patients after CBT. For the purpose of improving comorbid psychological symptoms with SAD patients, it might be useful to pay more attention to these dimensions of NEO-FFI at baseline.

关键词： Social Anxiety Disorder Cognitive-Behavioral Therapy Comorbid Psychological Symptoms

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Current profile and outcome of 100 esophageal atresia patients in the Kyushu area of Japan

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Open Journal of Pediatrics 2013年第3期3卷 239-242页

作者： Nagata Kouji Esumi Genshirou Teshiba risa Kinoshita Yoshiaki Taguchi Tomoaki Department of Pediatric Surgery Reproductive and Developmental Medicine Graduate School of Medical Sciences Kyushu University Fukuoka Japan

Objectives: Since Spitz et al. reported the prognostic classification of esophageal atresia (EA) patients in 1994, decades have been past and there have been many advances in surgery and neonatology. Nevertheless, there have been very few reports according to the recent outcome of the neonates with EA, and otherwise, time has come to re-evaluate the credibility of this classification. The aim of this study was to validate the recent prognosis of the EA. Methods: Patient data were collected from 22 cooperative facilities during the 5 year period from 2005 to 2009 in Kyushu area, Japan. Total of 100 EA patients were retrospectively reviewed according to their characteristics and the outcome. Patient who missed the characteristics and outcome was excluded from the respective data. Results: Only 29.8% (28/94) was prenatally diagnosed and 52.0 (52/100) had associated anomalies including major congenital heart disease (CHD), abnormal chromosome, and others. According to the operation, primary anastomosis was performed 57.0% (57/100) and the staged operation was performed 34.0% (34/100). Survival rate in the neonatal period was 89.0% (89/ 100), and overall survival rate was 78.0% (78/100). According to the Spitz classification, if patients with associated anomalies were excluded, survival rate of Group 1 (>1500 g and no CHD) was 93.8% (61/65), Group 2 (<1500 g or CHD) was 68.4% (13/19), and Group 3 (<1500 g and CHD) was 50% (1/2). Conclusion: EA was proved to be rarely diagnosed prenatally. Primary outcome of the Group 1 and Group 3 in Spitz classification were fairly good, but Group 2 was worse as ever. The comprehensive treatment strategy for EA patients with birth weight under 1500 g or CHD should be reconsidered to improve the overall outcome.

关键词： Esophageal Atresia Outcome Low-Birth-Weight Infant Congenital Heart Disease Operation

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Quantitative Assessment of Protective Effects of Antioxidant Agents against Drug-Induced Nephrotoxicity Using Dynamic Contrast-Enhanced Computed Tomography

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Open Journal of Medical Imaging 2016年第3期6卷 53-71页

作者： Kenya Murase Akihiro Kitamura Atsushi Tachibana Yoshinori Kusakabe risa Matsuura Shohei Miyazaki Department of Medical Physics and Engineering Division of Medical Technology and Science Faculty of Health Science Graduate School of Medicine Osaka University Osaka Japan

Purpose: The purpose of this study was to develop a method for quantifying the extent of renal dysfunction due to drug-induced nephrotoxicity using dynamic contrast-enhanced computed tomography (DCE-CT) and to investigate the protective effects of various antioxidant agents against cis-dichlorodiammineplatinum (cisplatin)-induced nephrotoxicity in rats using this method. Materials and Methods: The DCE-CT studies were performed in 8-week-old male Sprague-Dawley rats. The CT scanning started 4 s before a bolus intravenous injection of iodinated contrast agent (CA) (150 mgI/kg) from the tail vein using an automatic injector and lasted 90 s at 1-s intervals. The contrast clearance per unit renal volume (K1) was estimated from the DCE-CT data using the Patlak model. The renal volume (V) was calculated by manually delineating the kidney on the CT image. The contrast clearance of the entire kid-ney (K) was obtained by . First, to investigate the effect of CA itself, the DCE-CT studies were performed without injecting cisplatin 2, 4, and 7 days after the first DCE-CT study on day 0. Second, to investigate the effect of injected dose of cisplatin, the DCE-CT study was performed after the intraperitoneal (i.p.) injection of cisplatin (1.8 mg/kg) and was repeated every other day for one week. Finally, to investigate the protective effects of antioxidant agents [L-arginine (300 mg/kg), N-acetylcysteine (500 or 1000 mg/kg), methimazole (40 mg/kg), captopril (60 mg/kg), and taurine (750 mg/kg)], the DCE-CT studies were performed on days 0, 2, 4, and 7 after the i.p. injection of cisplatin (3.6 mg/kg). For comparison, the DCE-CT data were also acquired without injecting the antioxidant agents (CDDP group). Results: When cisplatin was not injected, there were no significant changes in the K value as compared to that on day 0 within the studied period. The K valuesignificantly (p < 0.05) decreased with increasing dose of cisplatin. Although some differences were observed in the exte

关键词： Dynamic Contrast-Enhanced Computed Tomography Drug-Induced Nephrotoxicity Cisplatin Glomerular Filtration Rate Creatinine Clearance Animal Experiments

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