OBJECTIVE: Through 3.0 T MRI study the ear and sinus lesions of patients with acute carbon monoxide poisoning. METHOD: From 2012 to 2015 collected the MRI images of the 45 patients with acute carbon monoxide poisoning, observe their changes of middle ear and mastoid and sinus imaging. RESULT: The middle ear injury of mastoid 41 cases (91.1%), 22 cases (48.9%) of maxillary sinus injury, ethmoid sinus injury in 20 cases (44.4%), sphenoid sinus 9 cases (20.0%), 5 cases (11.1%) of frontal sinus injury. Carbon monoxide poisoning patients according to clinical symptoms can be divided into light, medium and heavy 3 groups, observing the ear sinus damage degree for comparison between groups, found to have significant differences (P < 0.05). CONCLUSION The patients with acute carbon monoxide poisoning ear and sinus injury should cause the attention of the medical staff, MRI can reflect people's ears from the details and the damage degree of the sinuses.
Carbon Monoxide Poisoning ; diagnosis ; Ear, Middle ; pathology ; Ethmoid Sinus ; pathology ; Frontal Sinus ; pathology ; Humans ; Magnetic Resonance Imaging ; Maxillary Sinus ; pathology ; Paranasal Sinuses ; pathology ; Sphenoid Sinus ; pathology

This study was performed to investigate the hematologic changes and its pathogenesis in acute carbon monoxide (CO) intoxication. Serial complete blood counts (CBC) were obtained in 17 patients with acute CO intoxication five times in two weeks. Peripheral blood smear, bone marrow aspiration and biopsy were obtained in 7 patients within the first week. We analyzed the results of serial CBC's. Levels of hemoglobin and hematocrit rose only initially, probably due to dehydration and hemoconcentration rather than hypoxia. Leukocytosis, mainly neutrophilic, observed during the first few days seemed to be a physiological phenomena due to a stressful situation, such as hypoxia. Levels of platelet increased steadily after a initial decrease. We found no specific findings in bone marrow.
Acute Disease ; Adolescent ; Adult ; Aged ; Biopsy ; Blood Cell Count ; Bone Marrow/pathology ; Carbon Monoxide Poisoning/*blood/pathology ; Female ; Human ; Male ; Middle Age

OBJECTIVETo explore the diagnostic value of magnetic resonance (MR) diffusion tensor imaging (DTI) in detecting brain white matter (WM) damage of patients with delayed encephalopathy after acute carbon monoxide poisoning (DEACMP) and evaluating their cognitive dysfunction.

METHODSThirteen patients with DEACMP and thirteen age- and sex-matched volunteers underwent DTI using 1.5T MR scanner. FA and ADC values of 16 WM regions of interests (ROIs) were measured on DTI by two experienced radiologists independently with double blind methods, cognitive functions were evaluated by another experienced neurologist blinded to patient's medical history using the Montreal cognitive assessment (MoCA). ADC and FA values in DEACMP patients, and their correlations with cognitive dysfunction were analyzed.

RESULTSADC values of DEACMP patients increased significantly in all ROIs (P < 0.05) in comparison with the corresponding ROIs of healthy controls, whereas FA values were significantly decreased in all ROIs (P < 0.05) in comparison with that in controls except the bilateral optic radiations, anterior and posterior internal capsules. MoCA scores were positively correlated with FA values of bilateral lower frontal (r(L) = 0.736, P = 0.011; r(R) = 0.762, P = 0.003) lobe, temporal lobe (r(L) = 0.605, P = 0.016; r(R) = 0.559, P = 0.021) and total average WM (r(A) = 0.688, P = 0.001), however it inversely correlated with ADC values of bilateral lower frontal WM (r(L) = -0.674, P = 0.007; r(R) = -0.681, P = 0.019).

CONCLUSIONDTI can quantitatively reveal WM microstructure damage of DEACMP patients, indicate the severity of cognitive dysfunctions, and provide important information for pathogenesis and pathological study for DEACMP.

Brain ; pathology ; Brain Diseases ; diagnosis ; etiology ; Carbon Monoxide Poisoning ; complications ; Cognition ; Cognition Disorders ; Diffusion Magnetic Resonance Imaging ; Diffusion Tensor Imaging ; Double-Blind Method ; Humans ; White Matter ; pathology

We studied the effect of carbon monoxide (CO)-induced hypoxia on synaptosomal uptake and release of dopamine (DA) in rat striatum. When the rats were intoxicated at a blood level of carboxyhemoglobin (HbCO), 60-70% for 3-4hrs, [3H] DA uptake was inhibited as much as 80% of control activity. This suppressed activity remained as long as 12 hrs after termination of the intoxication. After a week recovery period, the suppressed uptake activity was restored completely. When the rats were intoxicated maintaining a blood level of HbCO at 30-40% for 6-7hrs, the uptake was inhibited to 57% of the control actvity and this suppressed activity was restored within 12hrs. For the rats maintaining a blood level of HbCO at 15-25% for 6-7hrs, uptake inhibition was not shown. Acute CO intoxication(at 60-70% of HbCO for 3-4 hrs) caused an increase in K+-stimulated DA release to 147% of the control value. In conclusion, the diminished uptake and increased release of striatal DA in a CO intoxicated brain would cause an extraneuronal accumulation of DA with depletion of intraneuronal DA level, which may play a role in CO-induced hypoxic cell damage.
Animal ; Carbon Monoxide Poisoning/*complications ; Corpus Striatum/*ultrastructure ; Culture Media ; Dopamine/*metabolism ; Female ; Hypoxia, Brain/chemically induced/*pathology ; In Vitro ; Male ; Rats ; Synaptosomes/*metabolism

OBJECTIVE: To explore the expression of tryptase and chymase in human lung tissue of anaphylactic shock and its value for forensic medicine. METHODS: With ten carbon monoxide poisoning cases as control group, the levels of tryptase and chymase were observed by immunofluorescence and analyzed using the Image Analyze and the Image-pro plus 5.0.2. The positive mast cells were counted and the levels of the tryptase and chymase were calculated respectively. RESULTS: There was a statistically significant difference (P < 0.05) for the tryptase and chymase concentrations in the lung tissue between the anaphylactic shock group and the control group. CONCLUSION The levels of the tryptase and the chymase expression are greatly increased in human lung tissue of anaphylactic shock, which may provide the morphological evidence and reference for the diagnosis of anaphylactic shock in forensic practice.
Adolescent ; Adult ; Anaphylaxis/pathology* ; Cadaver ; Carbon Monoxide Poisoning/pathology* ; Child ; Child, Preschool ; Chymases/metabolism* ; Female ; Fluoroimmunoassay/methods* ; Forensic Pathology ; Humans ; Infant ; Lung/pathology* ; Male ; Mast Cells/enzymology* ; Middle Aged ; Staining and Labeling ; Tryptases/metabolism* ; Young Adult

Adult ; Aged ; Carbon Monoxide Poisoning ; blood ; pathology ; Creatine Kinase ; blood ; Female ; Humans ; Male ; Middle Aged ; Myocardium ; pathology ; Natriuretic Peptide, Brain ; blood ; Peptide Fragments ; blood ; Troponin I ; blood ; Young Adult

OBJECTIVETo investigate clinical and imaging characteristics of delayed encephalopathy after acute carbon monoxide poisoning (DEACMP) and their relationship to the prognosis.

METHODSThe clinical, CT and MRI findings in 46 patients with DEACMP were analysed and compared.

RESULTSThe main manifestations of the disease were mental and extrapyramidal impairment. CT scan showed diffuse low density changes in bilateral cerebral white matter, bilateral or unilateral globus pallidus or basal ganglia areas. The MRI showed necrosis and degeneration of glodus pallidus and cerebral white matter demyelination mainly around the ventricles, with high signal intensity in T(2)-weighted and equal or low signal intensity in T(1)-weighted as well as the lesions in hippocampus and brain stem. There was the sign of encephalatrophy in the late stage. The positive detectable rate of MRI was 82.1%, higher than that of CT, 43.2%. MRI was more sensitive than CT.

CONCLUSIONThe prognosis of the patients is closely related with the age, time of come after DEACMP and the effectiveness of treatment. Both CT and MRI are valuable in the diagnosis and evaluation of the prognosis for DEACMP. MRI is more sensitive than CT in the diagnosis of DEACMP.

Acute Disease ; Adult ; Aged ; Brain ; diagnostic imaging ; pathology ; Brain Diseases ; chemically induced ; diagnosis ; diagnostic imaging ; Carbon Monoxide Poisoning ; complications ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Prognosis ; Sensitivity and Specificity ; Tomography, X-Ray Computed

A 59-year-old man with a history of major depression was found by his wife to be unconscious and foaming at the mouth. On arrival at the emergency department, the patient was noted to be unresponsive. Computed tomography of the brain showed symmetrical ill-defined areas of hypoattenuation involving the medial aspects of both lentiform nuclei, while magnetic resonance images of the brain showed symmetrical increased signal in the bilateral globi pallidi on diffusion weighted, T2-weighted and fluid attenuated inversion recovery sequences. These findings were those of acute carbon monoxide poisoning. Despite aggressive treatment, the patient's condition continued to deteriorate and he eventually passed away. The various imaging findings of carbon monoxide poisoning in the brain and the differential diagnoses are discussed.
Brain ; diagnostic imaging ; Carbon Monoxide Poisoning ; diagnosis ; diagnostic imaging ; Depressive Disorder, Major ; complications ; Diagnostic Imaging ; Fatal Outcome ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pulmonary Edema ; pathology ; Radiography, Thoracic ; Suicide, Attempted ; Tomography, X-Ray Computed