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BACKGROUND: Othello syndrome (OS) is characterized by delusional beliefs concerning the infidelity of a spouse or sexual partner, which may lead to extreme behaviors. Impulse control disorders refer to behaviors involving repetitive, excessive, and compulsive activities driven by an intense desire. Both OS and impulse control disorders in Parkinson's disease (PD) may be side effects of dopamine agonists. At present, there are only a few case reports and studies related to PD with concomitant OS and impulse control disorders. CASE SUMMARY: We describe a 70-year-old male patient with PD, OS, and impulse control disorders, who presented with a six-month history of the delusional belief that his wife was having an affair with someone. He began to show an obvious increase in libido presenting as frequent masturbation. He had been diagnosed with PD ten years earlier and had no past psychiatric history. In his fourth year of PD, he engaged in binge eating, which lasted approximately one year. Both OS and hypersexuality were alleviated substantially after a reduction of his pramipexole dosage and a prescription of quetiapine. CONCLUSION: Given its potential for severe consequences, OS should be identified early, especially in patients undergoing treatment with dopamine agonists.
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OBJECTIVE: To summarize the clinical features of mercury poisoning diagnosed by blood and urine tests for improving the diagnosis and treatment of the disease. METHODS: Poisoning causes, clinical manifestations, diagnosis, treatment and prognosis were retrospectively reviewed in 92 in-patients with mercury poisoning in our hospital from January 2000 to April 2010. RESULTS: Of the 92 patients, 37 were male and 55 were female with an average age of 33.1 (2 - 65) years old. The mercury poisoning was caused by occupational exposure and non-occupational exposure, such as iatrogenic exposure, life exposure and wrong intake or suicidal intake of mercury-containing substances, mainly through respiratory tract, digestive tract and skin absorption. The most common clinical symptoms were as the followings: nervous system symptom, such as memory loss in 50 cases (54.3%), fatigue in 34 (37.0%), numb limb in 25 (27.2%), dizziness and headache in 22 (23.9%), cacesthesia in 20 (21.7%), fine tremor (finger tip, tongue tip, eyelids) in 15 (16.3%), insomnia and more dreams in 12 (13.0%); gastrointestinal symptoms: nausea in 16 (17.4%), abdominal pain in 14 (15.2%), stomatitis in 5 (5.4%); joint and muscle symptoms: muscle pain in 16 (17.4%), joint pain in 5 (5.4%); cardiovascular system: chest tightness, heart palpitations in 6 (6.5%); urinary system: edema in 9 (9.8%); other system: hidrosis in 20 (21.7%). After the treatment with sodium dimercaptopropane sulfonate (DMPS), the symptoms were gradually alleviated. Their gastrointestinal, cardiovascular symptoms were alleviated within 2 weeks; neurological symptoms were alleviated within 3 months; kidney damage showed a slower recovery and could be completely alleviated within 6 months. CONCLUSIONS: Because of its diverse clinical symptoms, the mercury poisoning was easy to misdiagnosis and missed diagnosis; therefore the awareness of the disease should be further enhanced. Leaving from the poisoning environment timely and giving appropriate treatment with DMPS will lead to a satisfactory prognosis.
Asunto(s)
Intoxicación por Mercurio/diagnóstico , Intoxicación por Mercurio/terapia , Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Humanos , Masculino , Mercurio/sangre , Mercurio/orina , Intoxicación por Mercurio/epidemiología , Persona de Mediana Edad , Estudios Retrospectivos , Adulto JovenRESUMEN
OBJECTIVE: To investigate the associations between the different breast cancer subtypes and survival in Chinese women with operable primary breast cancer. METHODS: A total of 1538 Chinese women with operable primary breast cancer were analyzed in this study, the median follow-up was 77 months. Estrogen receptor (ER), progesterone receptor (PR), and HER2 status were available for these patients. RESULTS: Luminal A (ER+ and/or PR+, HER2-) had a favorable disease-free survival (DFS) and overall survival (OS) compared with other subtypes in the entire cohort. Using the luminal A as a reference, among the patients with lymph node positive disease, HER2+ (ER-, PR-, HER2+) had the worst DFS (hazard ratio, HR=1.80, 95% CI 1.11 to 2.91, P=0.017) and luminal B (ER+ and/or PR+, HER2+) had the worst OS (HR=2.27, 95% CI 1.50 to 3.45, P<0.001); among the patients with lymph node negative disease, triple-negative (ER-, PR-, HER2-) had the worst DFS (HR=2.21, 95% CI 1.43 to 3.41, P<0.001), whereas no significant difference in DFS between HER2+ and luminal B or luminal A was observed. CONCLUSION: As compared with luminal A, luminal B and HER2+ have the worst survival in patients with lymph node positive disease, but this is not the case in patients with lymph node negative disease; triple-negative subtype has a worse survival in both lymph node positive and lymph node negative patients.
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BACKGROUND: Hemichorea usually results from vascular lesions of the basal ganglia. Most often, the lesion is contralateral to the affected limb but rarely, it may be ipsilateral. The pathophysiology of ipsilateral hemichorea is still poorly understood. We review the literature on hemichorea due to ipsilateral cerebral infarction and explore possible mechanisms for its occurrence. CASE SUMMARY: A 72-year-old woman presented with complaints of involuntary movements of the muscles of the left side of the face and mild weakness of the right limbs. Her symptoms had started suddenly 1 d earlier. After admission to the hospital, the involuntary movements spread to involve the left limbs also. Magnetic resonance imaging revealed a left thalamic infarction. The patient's hemichorea subsided after treatment with haloperidol (2 mg per time, 3 times/d) for 3 d; the hemiparesis resolved with rehabilitation physiotherapy. She is presently symptom free and on treatment for prevention of secondary stroke. We review the literature on the occurrence of ipsilateral hemichorea following thalamic infarction and discuss the possible pathomechanisms of this unusual presentation. CONCLUSION: Ipsilateral hemichorea following a thalamic stroke is rare but it can be explained by structure of the extrapyramidal system. The thalamus is a relay station that exerts a bilateral control of motor function.
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BACKGROUND: The aim of this study was to discuss the value of susceptibility-weighted imaging (SWI) in evaluating the ischemic penumbra of patients with acute cerebral ischemic stroke. METHODS: Data were collected from 52 patients with acute cerebral ischemic stroke upon clinical diagnosis and routine examinations of magnetic resonance imaging (MRI), including SWI, diffusion-weighted imaging (DWI), and perfusion-weighted imaging (PWI) within 72 hours after onset in this retrospective study. The methods also included fusing the DWI and SWI images and calculating the volume of anomaly extension of DWI and PWI-MTT (mean transit time) using semi-automatic analysis software. The SWI-DWI and PWI-DWI mismatches were interpreted, and the statistical analysis was completed. RESULTS: The two physicians found that the ischemic penumbra consistency is high throughout the SWI-DWI and PWI-DWI mismatches, without a significant difference (P > 0.05). CONCLUSION: SWI-DWI mismatch can prevent the injection of contrast agents and make an accurate diagnosis of acute stroke ischemic penumbra, which helps guide the selection of the clinical therapeutic plan.
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Herein, we describe the synthesis and characterization of three Os(ii) complexes (i.e., [Os(fptz)2(PPhMe2)2] (1, fptzH = 3-trifluoromethyl-5-pyridyl-1,2,4-triazole), [Os(fptz)2(CO)(L1)] (2, L1 = PPh3; 3, L1 = pyridine)) that have been successfully utilized as good photocatalysts to promote aerobic oxidative coupling of amines to imines with molecular oxygen in air as a green oxidant. Complex 1 is the most effective catalyst for the oxidative coupling of benzylamine with molecular O2 (air) as the oxidant because of the complex's strong absorption of visible light and long-lived triplet state. The application of a low catalyst loading (0.06 mol%) of complex 1 to the oxidative coupling of a wide range of amines affords the corresponding imines efficiently and selectively in most cases. The reaction mechanism was investigated via relevant control and quenching experiments. The results indicated that the reaction occurs via an active (1)O2-involved pathway. The (1)O2-generating ability of complex 1 as a photosensitizer was evaluated using 9,10-dimethylanthracene (DMA) as a chemical trap for (1)O2.
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To improve the biomass and lipid productivity of the microalgae Chlorella pyrenoidosa-15, the carbon and nitrogen sources were screened to culture it heterotrophically. The best carbon and nitrogen sources were glucose and soy peptone, respectively. The carbon and nitrogen concentrations were optimized with the help of response surface design. The maximum biomass productivity was predicted to be 0.62 g x (L x d)(-1) with glucose and soy peptone concentrations of 17.53 g x L(-1) and 8.67 g x L(-1), respectively. The results of response surface design were validated with biomass productivity of 0.63 g x (L x d)(-1) and lipid content of 19.25%. The lipid productivity reached 121.3 mg x (L x d)(-1). In the research of Chlorella pyrenoidosa-15 cultured in non-autoclaved Beijing urban wastewater, the maximum algae biomass dry weight of 1.00 g x L(-1) was achieved with a lipid content of 24.12%. Results also showed that the treatment using Chlorella pyrenoidosa-15 effectively reduced the COD values and total nitrogen content in the wastewater, with a COD degradation rate of 80.9%, and a 69% decrease in total nitrogen content.