[Drug overdose patients: do all of them need hospitalization?].
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Adult↗
Biomedical subjects
Yasufumi Miyake
Publications and source records attributed to Yasufumi Miyake.
[Intestinal edema caused by ingested formalin].
A 65-yr-old man treated for depression was transferred to our hospital. He ingested over 150 ml of formalin for suicidal attempt. On admission, he was hypotensive, developing acute renal failure and liver dysfunction. During first 36 hours, he needed 21 l of lactate Ringer solutions to maintain enough urination. The abdominal computed tomography showed obvious edema of intestine and endoscopic findings of the upper digestive tract were corrosive erosions. We started proton pump inhibiter on the first day. After a week, they changed in many ulcers with smooth-surfaced elevation on the greater curvature of the stomach. On the 15th hospitalized day, he was discharged from our hospital without sequelae. Formalin consists of forty percent solution of formaldehyde and methanol. Ingestion of formaldehyde may cause burning in the digestive systems and harmful effect to major organ such as kidney or liver. Although previous reports said that formalin has direct toxicity to major organs, we could discharge him without sequelae by treatment with large amount of fluid resuscitation.
Aged↗
Elevated plasma levels of bilirubin in patients with neurotrauma reflect its pathophysiological role in free radical scavenging.
Bilirubin, a powerful endogenous antioxidant, is one of the catabolites of heme oxygenases (HOs). In this study, the plasma bilirubin concentration was measured to establish bilirubin kinesis after traumatic brain injury (TBI). Furthermore, in in vitro studies, the free radical scavenging activity and antioxidant potency of bilirubin was also investigated at various concentrations, including physiological ones. Indirect plasma bilirubin was measured in 25 patients on days 1, 2, 3 and 4 after presentation with TBI. The ability of bilirubin to scavenge the hydroxyl (OH) and 1,1-diphenyl-2-picrylhyrazyl (DPPH) radicals, and its antioxidant potency, were also analyzed using electron spin resonance (ESR) and the bioantioxidant power (BAP) methods, respectively. Plasma bilirubin levels were significantly higher on days 2, 3 and 4 than on patient admission (day 1; p < 0.05). ESR and BAP results revealed that bilirubin has direct OH and DPPH radical scavenging activities and potent antioxidant effects in vitro at physiological concentrations. These data indicate that physiological concentrations of bilirubin have antioxidant properties and that it constitutes one of the biological defense mechanisms in neurotrauma patients.
Adolescent↗