Saxitoxin Exposure Confirmed by Human Urine and Food Analysis.

A case of an elderly female with suspected paralytic shellfish poisoning (PSP) is presented. The patient shared a meal of recreationally-harvested shellfish with her family and soon began to experience nausea and weakness. She was taken to the local emergency department and then transported to a larger hospital in Anchorage where she was admitted to the intensive care unit with respiratory depression and shock. Her condition improved, and she was discharged from the hospital 6 days later. No others who shared the meal reported symptoms of PSP. A clam remaining from the meal was collected and analyzed for paralytic shellfish toxins (PST) by the Alaska Department of Environmental Conservation Environmental Health Laboratory; the clam tested positive for saxitoxin (STX; 277 µg/100 g), neosaxitoxin (NEO; 309 µg/100 g), multiple gonyautoxins (GTX; 576-2490 µg/100 g), decarbamoyl congeners (7.52-11.3 µg/100 g) and C-toxins (10.8-221 µg/100 g) using high-pressure liquid chromatography with post-column oxidation (AOAC Method 2011.02). Urine from the patient was submitted to Centers for Disease Control for analysis of selected PSTs and creatinine. STX (64.0 µg/g-creatinine), NEO (60.0 µg/g-creatinine) and GTX1-4 (492-4780 µg/g-creatinine) were identified in the urine using online solid phase extraction with HPLC and tandem mass spectrometry. This was the first time GTX were identified in urine of a PSP case from Alaska, highlighting the need to include all STX congeners in testing to protect the public's health through a better understand of PST toxicity, monitoring and prevention of exposures.

Near-field optical studies of local photomodification in nanostructured materials.

Fractal aggregates of silver nanoparticles are studied experimentally using atomic force microscopy and photon scanning tunnelling microscopy. Large changes in the near-field optical response of fractal aggregates are observed after the irradiation of samples with nanosecond laser pulses. The threshold energy density for photomodification using a 532 nm laser is measured to be 9 mJ cm(-2). It is shown that photomodification-induced changes in the local optical response can be two orders of magnitude larger than changes in far-field absorption.

Morgagni hernias: an uncommon cause of chest masses in adults.

Morgagni hernia is a congenital diaphragmatic hernia that occurs secondary to potential anterior medial defects in the diaphragm. Although the hernia usually is diagnosed incidentally, appearing as a mass on chest radiograph, symptoms of bowel obstruction may occur. Surgical repair is required in all cases and may be performed with either the abdominal or transthoracic approach.

Profile of trauma due to violence in a statewide prison population.

Acts of violence within a statewide prison population were reviewed to determine the incidence, types of injuries, surgical procedures required, persons involved in the trauma, and weapons used to inflict the injuries. The objective was to identify trends to aid in developing methods of prevention. Over a 3-year period, 1600 prisoners from the state of Tennessee were hospitalized at our institution. The majority were from the maximum security unit. There were 133 episodes of trauma. Our study focused on the first admission of 94 inmates. Fourteen (15%) of the injuries were self-inflicted, including seven self-inflicted penetrating wounds. Nineteen different weapons were used to inflict trauma. Prison cafeteria utensils and workshop utility and office devices may need to be redesigned because these items are frequently used in acts of violence. Victims subjected to repeated episodes of violence should be relocated. Lastly, self-mutilators may need to be transferred to an institution for the mentally impaired for their own protection.