Adsorbed Molecules as Interchangeable Dopants and Scatterers with a Van der Waals Bonding Memory in Graphene Sensors.

Molecular adsorption-induced doping and scattering play a central role in the detection mechanism of graphene gas sensors. However, while the doping contributions in electric field-enhanced gas sensing is well studied, an understanding of the effects of scattering is still lacking. In this work, the scattering contribution of the graphene-molecule van der Waals (vdW) complex is studied under various electric fields and the associated vdW bonding retention in the complex is investigated. We show that contrary to the generally opined view, doping does not always dominate the graphene-molecule vdW complex interaction and consequently the conductivity response in graphene sensors, rather the vdW complex interaction only shows doping-dominated interaction at zero electric fields while scattering increases with electric field modulation. The experimentally observed electric field-dependent scattering response agrees with electron difference density analysis from density functional theory (DFT) calculations, which shows that scattering is directly dependent on the electric field-induced molecular reorientation as well as the redistribution and delocalization of charge in the graphene-gas molecule vdW complex. Furthermore, "vdW bonding memory", i.e., retention of electric field-induced vdW bonding states after turning off the electric field, is observed and shown to result from the high binding energies of the vdW complexes, which are an order of magnitude higher than the sensing measurement thermal energy. This vdW bonding memory in the graphene-molecule complexes is important for the molecular identification of adsorbed gases based on their tunable charge transfer characteristics.

Eculizumab for Severe Thrombotic Microangiopathy Secondary to Surgical Invasive Stress and Bleeding.

Atypical hemolytic uremic syndrome (aHUS) is an extremely rare condition caused by an excessive activation of the complement pathway based on genetic or acquired dysfunctions in complement regulation, leading to thrombotic microangiopathy (TMA). A complement-amplifying condition (CAC) can trigger aHUS occurrence along with complement abnormality. We herein report a case of severe TMA after laparoscopic myomectomy in a healthy woman. This case was eventually diagnosed as complement-mediated TMA secondary to surgical invasive stress as a CAC, with no definitive diagnosis of aHUS despite a genetic test. The patient fully recovered after several eculizumab administrations.

Pulmonary edema caused by inhalation of vapors from water-soluble paint.

AIM: To report the effects of inhaling vapor from water-soluble paint after a recent encounter with 16 patients treated in our emergency department. METHODS: We examined a series of chest computed tomography (CT) images from the 16 affected patients. Computed tomography was carried out on days 1, 2, 5, and 19 after the inhalation event. RESULTS: Twelve of the patients were found to have pulmonary edema, based on their CT findings. Patients with pulmonary edema were classified as its persisted period. In the severe group, its pulmonary edema persisted over 5 days include, exacerbated edema, delayed-onset edema (during the follow-up), or edema amelioration. One patient had exacerbated edema, three patients had delayed-onset edema, and one patient experienced amelioration of their edema in the severe group. In all cases, the pulmonary edema had disappeared from the CT images by day 19 after the inhalation event. Thirteen of the 16 patients had a fever of ≥37°C. Three kinds of solutes (ethylene glycol, titanium dioxide, and silicon oxide) had been blended in the water-soluble paint. The titanium dioxide was considered the probable cause of the pulmonary edema. CONCLUSION: Inhalation of vapors from water-soluble paints is considered relatively safe. However, our observations suggest that new lesions might develop and existing lesions could worsen, even if the edema is not severe immediately after the exposure. Thus, follow-up imaging is needed for approximately 2 weeks in such cases.

A vascular anomaly of the iliac artery in a patient with VATER association.

In patients with VATER association, some have vascular anomaly that makes procedure difficult. Pretreatment CT angiography should be necessary for the patients with VATER association's feature.

Fatal delayed rupture of the subclavian artery in a patient with first-rib fracture caused by blunt trauma.

This case highlights the probable association of significantly displaced posterior first-rib fracture and jagged edges of the fracture line following blunt chest trauma with delayed ipsilateral subclavian artery rupture. Early angiography and first-rib repair should promptly be considered under such circumstances.

Electrically Tunable van der Waals Interaction in Graphene-Molecule Complex.

van der Waals (vdW) interactions play a central role in the surface-related physics and chemistry. Tuning of the correlated charge fluctuation in a vdW complex is a plausible way of modulating the molecules interaction at the atomic surface. Here, we report the vdW interaction tunability of the graphene-CO2 complex by combining the first-principles calculations with the vdW density functionals and the time evaluation measurements of CO2 molecules adsorption/desorption on graphene under an external electric field. The field-dependent charge transfer within the complex unveils the controllable tuning of CO2 from acceptor to donor. Meanwhile, the configuration of the adsorbed molecule, the equilibrium distance from graphene and O-C-O bonding angle, is modified accordingly. The range of electrical tunability is a unique feature for each type of molecule.

[Investigation of the Hounsfield number of drugs in stomach using computed tomography in vitro].

BACKGROUND: A high density area (HDA) that may represent ingested drugs was detected in the stomach of a patient with a drug overdose (OD) by computed tomography (CT). However, there is no prior evidence that drugs can be visualized as an HDA by abdominal CT. We investigated whether drugs can be imaged as an HDA by CT. METHODS: Ten tablets, 5 tablets, 1 tablet and 0.1 tablet of either Solanax (0.4 mg) or Depas (0.5 mg) or Tryptanol (10 mg) or Paxil (10 mg) or Wintermin (25 mg) or Phenobal (30 mg) or Hiberna (25 mg) were each added to 10 ml of artificial gastric juice. We then measured the Hounsfield numbers immediately after mixing, 1 hour later and 7 hours later using CT images. RESULTS: All of the drugs precipitated in the artificial gastric juice and these precipitations were imaged as HDAs over 100 Hounsfield units. Moreover, the drugs maintained high Hounsfield numbers after 7 hours although there was a trend to decrease sequentially. CONCLUSION: We demonstrated that the precipitated drugs in the artificial gastric juice could be imaged as HDAs by CT.

Usefulness of computed tomography in the diagnosis of an overdose.

Computed tomography (CT) is superior for the detection of substances with low radiolucency in comparison with abdominal roentgenograms. In the present study, medical chart review was retrospectively performed for patients who were admitted and underwent plain CT including the stomach on arrival to investigate whether CT is useful for diagnosing overdose (OD). The subjects were divided into patients with OD who did not undergo gastric lavage (OD group) and those without OD (Control group). The presence of a radiopaque area (Hounsfield number over 100 on a range of interest of 3 mm2) in the stomach on CT was defined as a positive finding. The average Glasgow Coma Scale in the OD group (n=11) was significantly lower than that in the Control group (n=137). Positive findings on CT were found more frequently in the OD group than in the Control group (100 vs. 19.7%, p＜0.0001). Based on the finding of a high-density deposition in the bottom of the stomach, the CT predicted OD with 98.5% specificity. Accordingly, CT findings of a high-density deposition in the stomach of a patient with a diminished consciousness may suggest the presence of a recent overdose.

Two cases of acute poisoning with acetamiprid in humans.

INTRODUCTION: Acetamiprid is a potent and a relatively new neonicotinoid insecticide. Animal studies have indicated that it has a low toxicity to mammals. Despite wide usage, human exposure resulting in toxicity is quite limited, and this is the first report in the English literature about acute acetamiprid poisoning in humans. CASE DETAILS: We herein describe two cases of acute poisoning with an insecticide formulation containing acetamiprid for suicidal purposes. Both cases experienced severe nausea and vomiting, muscle weakness, hypothermia, convulsions, and clinical manifestations including tachycardia, hypotension, electrocardiogram changes, hypoxia, and thirst in the case with the higher serum concentration of acetamiprid. The symptoms were partially similar to acute organophosphate intoxication. Supportive treatments for a variety of symptoms were sufficient for recovery, and both individuals were discharged without any complications 2 days after ingestion.

Precise size determination of amphotericin B and nystatin channels formed in erythrocyte and liposomal membranes based on osmotic protection experiments.

The colloid osmotic nature of the cell lysis can be prevented by adding osmotic protectants of appropriate sizes to the outer medium. We introduced inorganic and organic electrolytes as protectants to determine the precise channel sizes of the polyene antibiotics, amphotericin B and nystatin, in addition to the sugars so far widely used for this purpose. Because colloid osmotic cell lysis is evidenced by the loss of membrane permeability barriers for small sizes of ions, such as K(+), preceding hemolysis, we firstly simultaneously monitored the time response of the K(+) efflux and hemolysis induced by amphotericin B by combining a fiber-optic spectrometer with a K(+)-selective electrode. Based on this experiment, we evaluated the sizes of channels of the polyene antibiotics formed in the erythrocyte membrane using the radii of hydrated ions calculated from a modified Stokes' law, as well as the radii of sugars. The radii of channels formed by amphotericin B and nystatin were found to be in a very narrow range of 0.36 - 0.37 nm. Similar experiments were performed using calcein-loaded liposomes containing cholesterol or ergosterol, and the radii of channels formed in these liposomal membranes were also found to be the same as when formed in an erythrocyte membrane. The present results demonstrated that introducing the sizes of hydrated ions can afford a more precise channel size than the use of sugars alone.

Simultaneous measurements of K+ and calcein release from liposomes and the determination of pore size formed in a membrane.

The changes induced by biologically active substances in the permeability to K+ and calcein of liposomes composed of egg phosphatidylcholine and cholesterol were measured simultaneously in order to rapidly screen the sizes of pores formed in a membrane, using different sized markers. The substances examined in the present study were classified into three types based on differences in the rates at which K+ and calcein were released. The first type released only K+, and included gramicidin A. The second type predominantly released K+, preceding the release of calcein, and included amphotericin B and nystatin. The third type, including antimicrobial peptides, such as gramicidin S, alamethicin, and melittin, and several membrane-active drugs, like celecoxib (non-steroidal anti-inflammatory drug), 1-dodecylazacycloheptan-2-one (named azone; skin permeation enhancer), and chlorpromazine (tranquilizer), caused the release of K+ and calcein simultaneously. Thus, the sizes of pores formed in a liposomal membrane increased in the following order: types one, two, and three. We determined the size more precisely by conducting an osmotic protection experiment, measuring the release of calcein in the presence of osmotic protectants of different sizes. The radii of pores formed by the second type, amphotericin B and nystatin, were 0.36 - 0.46 nm, while the radii of pores formed by the third type were much larger, 0.63 - 0.67 nm or more. The permeability changes induced by substances of the third type are discussed in connection with a transient pore formed in a lipid packing mismatch taking place during the phase transition of dipalmitoylphosphatidylcholine liposomes.