Gas-forming liver abscess associated with rapid hemolysis in a diabetic patient

We experienced a case of liver abscess due to Clostridium perfringens(CP) complicated with massive hemolysis and rapid death in an adequately controlled type2 diabetic patient. The patient died 6 h after his first visit to the hospital. CP was later detected in a blood culture. We searched for case reports of CP septicemia and found 124 cases. Fifty patients survived, and 74died. Of the 30 patients with liver abscess, only 3 cases survived following treatment with emergency surgica drainage. For the early detection of CP infection, detection of Gram-positive rods in the blood or drainage fluid is important. Spherocytes and ghost cells indicate intravascular hemolysis. The prognosis is very poor once massive hemolysis occurs. The major causative organisms of gas-forming liver abscess in diabetic patients are Klebsiella pneumoniae(K. pneumoniae) and Escherichia coli(E. coli). Although CP is relatively rare,the survival rate is very poor compared with those of K. pneumoniae and E. coli. Therefore, for every case that presents with a gas-forming liver abscess, the possibility of CP should be considered, and immediate aspiration of the abscess and Gram staining are important.

Kinetics and fractionation of hydrogen isotopes during gas formation from representative functional groups

A gold tube simulation device was used to study the cleavage of representative compounds into gas.The goal of this study is to investigate hydrogen isotope composition change of gaseous hydrocarbons during maturity.Gas chromatography and isotopic analyses were conducted to determine how the yield of natural gas components and their hydrogen isotopic composition were related to experimental temperature and heating rate.A chemical kinetic model for the generation of each component of the natural gas and for the hydrogen isotopic fractionation was established and calibrated based on the results.Results indicate that the hydrogen isotopic fractionation during the evolution of various gas-forming organic materials can be satisfactorily described by chemical kinetic models.During regular methane generation,the reactions at low-activation-energy region had a greater contribution than the high-activation-energy region.While the reactions with high-activation-energy region had greater contribution of deuterium-rich methane.Compared with carbon isotope fractionation,this results in a greater hydrogen isotopic fractionation,which is more sensitive to changes in maturity.This study lays a foundation for further investigations of genesis and maturity of natural gas provided by hydrogen isotopic fractionation.It also provides fundamental knowledge for investigating the filling history of natural gas reservoir and for identifying.

Emphysematous pancreatitis associated with penetrating duodenal ulcer

In the "proton pump inhibitors era",a penetrating peptic ulcer(PPU) represents an exceptional cause of abdominal pain,and was more frequently observed in the past where there was not an effective antacid treatment. Ulcer-induced pancreatitis is very rare,too,and manifests with persistent,intense pain radiating to the back. A mild to severe pancreatitis with peripancreatic fluid collection can be observed at imaging. However,only a few cases of association between PPU and emphysematous pancreatitis(EP) have been published in the literature. EP is a rare but potentially fatal form of acute necrotizing pancreatitis in which gas grows in and outside the pancreas,and typically involves the whole parenchyma in diabetic individuals.Here we report an extremely rare case of a duodenal ulcer penetrating the pancreas and complicated with EP.Unlike the classic form of EP,which involves the whole parenchyma and has a poor prognosis,we found that the emphysematous involvement of the pancreas by PPU has a benign course if a conservative therapy is promptly established. Gas is confined to the site of penetration,usual y the pancreatic head,and ulcers most often involve the duodenum.