Using oxygen/ozone nanobubbles for in situ oxidation of dissolved hydrogen sulfide at a residential tunnel-construction site.

Hydrogen sulfide (H2S) is a toxic gas, and considerable research has been conducted for its control and removal from industrial wastewater and sewage water. However, no simple and practical technology is available for degrading H2S in situ at tunnel constructing sites. On May 11, 2020, an H2S blowout accident occurred in underground soil at a residential sewer-tunnel construction site in Iwakuni City, Yamaguchi Prefecture, Japan, filling the tunnel with high concentrations of H2S gas, causing the fatality of one worker owing to emphysema. River water flowing near the site was immediately introduced into the tunnel to trap the H2S gas, generating 652-m3 water that contained high concentrations (120 mg/L) of dissolved H2S in the tunnel. To safely and quickly remove H2S in situ, the contaminated water was treated with high-density oxygen and ozone nanobubbles (O2/O3-HDNBs) generated using the ultrafine pore method. Consequently, H2S was removed from the contaminated water in 3 days. This is the first successful application of O2/O3-HDNB technology for the in situ oxidation of H2S in environmental water at a construction site. This study reports the practical application of this advanced technology and the system performance.

[A case of Guillain-Barré syndrome with severe pain successfully controlled with acetaminophen, gabapentin, and parenterally infused fentanyl].

We presented a case of an 8-year-old boy with Guillain-Barré syndrome characterized by severe intractable pain in the soma and lower extremities, which appeared 2 weeks after a febrile cold. At his first visit to our hospital, he could not stand or walk because of the severe pain, and muscle weakness and absence of deep tendon reflexes were observed. Guillain-Barré syndrome was diagnosed on the basis of cerebrospinal fluid study results, nerve conduction velocity, and spinal cord magnetic resonance imaging. His pain was scored as a five on a six-point visual analog scale, and it persisted despite routine supportive therapy. The pain was successfully controlled with parenterally infused fentanyl. It is suspected that opioid analgesics are useful for severe pain control in patients with Guillain-Barré syndrome.

Myocarditis in a pediatric case of pandemic 2009H1N1 influenza.

We report a 6-year-old boy with no major disease history or allergic conditions initially presented with pneumonia, progressed to acute respiratory distress syndrome and acute myocarditis caused by pandemic 2009H1N1 influenza diagnosed with RT-PCR testing, successfully managed with mechanical ventilation and percutaneous cardiopulmonary support system. Marked transient elevation of IgE in acute phase of the disease and the subsequent diagnosis of atopic asthma in our patient suggested a possible role of an underlying allergic condition in the clinicopathological process. Critically ill 2009H1N1-infected patient with acute respiratory failure should carefully be physiologically monitored together with serial assessment of biomarkers aiming at a favorable cardiac outcome by giving the timely diagnosis and intervention.

Intravenous immune globulin plus corticosteroids in refractory Kawasaki disease.

BACKGROUND: The aim of the present study was to investigate the efficacy of i.v. immune globulin (IVIG) therapy combined with corticosteroids for additional treatment of acute Kawasaki disease (KD) unresponsive to initial IVIG treatment. METHODS: In 50 prospective KD patients, six IVIG non-responders without clinical improvement within 24-48 h after completion of initial IVIG, received 2 g/kg IVIG concurrently with 2 mg/kg i.v. prednisolone sodium succinate (PSL) until normalization of C-reactive protein level. Treatment was then changed to oral PSL, which was tapered over time. Clinical and coronary artery lesion (CAL) outcomes were compared with those of 13 IVIG non-responders who received additional heterogeneous therapies in 125 retrospective KD patients. In addition, the scoring system of Kobayashi et al. for prediction of non-responsiveness to initial IVIG treatment was retrospectively verified in 175 KD subjects, consisting of 50 prospective and 125 retrospective patients in order to evaluate the efficacy of the re-treatment regimen. RESULTS: Incidence of CAL in the study patients was lower than in the control patients, although differences were not significant both in the acute stage (within 1 month: 1/6, 16.7% vs 7/13, 53.8%; P= 0.177) and in the convalescent stage (after 1 month: 0/6, 0.0% vs 4/13, 30.8%; P= 0.255). According to the non-responder prediction system, the scores of six study and 13 control patients before initial IVIG treatment were similar (7.2 ± 1.9 vs 5.3 ± 3.1; P= 0.200). No serious adverse effects related to each treatment were noted in patients of either group. CONCLUSIONS: Additional IVIG combined with concurrent PSL appears to be safe and worth evaluation for the treatment of acute KD unresponsive to initial IVIG treatment.