Hemophilia A developing cerebral infarction after surgical treatment of giant hemophilic pseudotumor: a case report.

BACKGROUND: Cerebral infarction (CI) is an unusual complication in patients with bleeding disorders. To our knowledge, this is the first case of postoperative internal border-zone infarction (I-BZI) from Hemophilia A. CASE PRESENTATION: We present a case of Hemophilia A developing I-BZI, after surgical treatment of giant hemophilic pseudotumor. A 36-year-old man was introduced from other hospital by Hemophilia with giant hemophilic pseudotumor in his left thigh. Patient and his relatives did not have a history of thrombophilia. After excluding the relevant surgical contraindications, we performed the operation of pseudotumor resection. Prior to surgery, blood tests revealed hemoglobin of 137 g/L. FVIII activity was 1.5%. Activated partial thromboplastin time (APTT) was 71.50 s and D-dimer was 3.33 mg/L FEU. Immediately before surgery, the patient received an intravenous infusion of FVIII products (Xyntha®) at a dose of 3500 IU for his body weight of 80 kg. Post-operative day two (POD2), patient developed vomiting, decreased response, and dysarthria. Hemoglobin was 54 g/L with blood pressure of 110/70 mmHg. Magnetic resonance imaging of the brain showed there were multiple acute cerebral infarctions in bilateral lateral ventricles (internal border zone) and multiple ischemic foci in the white matter areas and basal ganglia of the bilateral cerebral hemispheres. This case suggested that acute severe anemia can be one of the causes of I-BZI. CONCLUSIONS: For the treatment of I-BZI caused by acute anemia from Hemophilia A, volume expansion, red blood cell supplement and continuous improvement of coagulation with suitable dose of factor VIII (FVIII) should be considered to improve prognosis.

Selective determination of Ag+ using Salecan derived nitrogen doped carbon dots as a fluorescent probe.

We report that nitrogen doped carbon dots (N-CDs) represent a viable fluorescent probe for the determination of Ag+. The N-CDs can be fairly easily prepared by a hydrothermal treatment method using Salecan and dicyandiamide as the precursors, display excitation/emission maxima of 350/438nm. The N-CDs have an average diameter of about 3.8nm. The N-CDs exhibited blue fluorescence (quantum yield of 13.2%) and could response to Ag+ selectively and sensitively. Other ions nearly had no interference. The probe has excellent selectivity, high sensitivity, and a linear response range that extends from 0 to 40µM. The limit of detection is as low as 1.12×10-7mol/L. The method was applied to the determination of Ag+ dissolved in water.