Methemoglobin (MetHb) is an oxidation product of hemoglobin in which the sixth coordination position of ferric iron is bound to a water molecule or to a hydroxyl group. The most common cause of acquired MetHb-emia is accidental poisoning which usually is the result of ingestion of water containing nitrates or food containing nitrite, and sometimes the inhalation or ingestion of butyl or amyl nitrite used as an aphrodisiac. We herein report a case of MetHb-emia after ingestion of an aphrodisiac, later identified as dapsone by gas chromatograph/mass selective detector (GC/MSD). A 24-year old male was admitted due to cyanosis after ingestion of a drug purchased as an aphrodisiac. On arterial blood gas analysis, pH was 7.32, PaCO2 26.8 mmHg, PaO2 75.6 mmHg, and bicarbonate 13.9 mmol/L. Initial pulse oxymetry was 89%. With 3 liter of nasal oxygen supplement, oxygen saturation was increased to 90-92%, but cyanosis did not disappear. Despite continuous supplement of oxygen, cyanosis was not improved. On the fifth hospital day, MetHb was 24.9%. Methylene blue was administered (2 mg/kg intravenously) and the patient rapidly improved. We proved the composition of aphrodisiac as dapsone by the method of GC/MSD.
Administration, Oral ; Adult ; Antidotes/therapeutic use ; Aphrodisiacs/adverse effects* ; Case Report ; Cyanosis/drug therapy ; Cyanosis/chemically induced ; Cyanosis/blood ; Dapsone/adverse effects* ; Human ; Male ; Methemoglobinemia/drug therapy ; Methemoglobinemia/chemically induced* ; Methylene Blue/therapeutic use

Raynaud's phenomenon manifests as triphasic color change episodes of blanching, cyanosis, and reddening of the digits, induced by exposure to low temperature or emotional stress. It is a relatively common disorder, estimated to affect 5-10% of the general population and 20-30% of otherwise healthy women. Most cases of primary Raynaud's phenomenon also called Raynaud's disease, are mild and self-limited. Secondary Raynaud's phenomenon presents as a secondary manifestation of an underlying disease and are complicated by ulcerations and tissue necrosis. From March 1996 to August 1998, we experienced 4 patients with Raynaud's phenomenon. Two patients were diagnosed Raynaud's disease and the other two were secondary. Raynaud's disease responded to drug therapy and sympatetic ganglion block. Secondary Raynaud's syndrome was treated with vein graft and free tissue transfer. During postoperative follow-up of 33-49 months, both severity and symptomatic intervals were improved.
Cyanosis ; Drug Therapy ; Female ; Follow-Up Studies ; Ganglion Cysts ; Humans ; Necrosis ; Raynaud Disease ; Stress, Psychological ; Transplants ; Ulcer ; Veins

Pneumocystis carinii pneumonia is caused by Pneumocystis carinii. It usually occurs in premature or debilitated infants. Recently sporadic cases of human disease in patients who have been on long term steroid therapy, cytotoxic drug therapy, immunosuppressive drug were significantly increased. We recently experienced 35 cases of Pneumocystis carinii pneumonia in infants of an institution for foreign adoption in three epidemic period of Feb.1979, Mar. 1980, and Jan. 1980. The clinical review of 35 cases was made. Patients' age was between 1 to 4 months. Twenty-one cases (60%) occurred in 2-month-old infants. Many patients were included in poor weight gain and development. The common symptoms were tachypnea, cyanosis, restlessness, cough, diarrhea in order of frequency. The roentgenological findings were classified into three groups. normal finding, pulmonary emphysema only, and various forms of pneumonic infiltration. The roentgenological findings were somewhat characteristic. The most common finding (24 cases) showed streaky and mottled densities which began in both hill and were spreaded peripherally. The pneumonic infiltrations were spared peripheral lung, but progressed to total involvement. The prominence between alveolar and interstitial infiltration was almostly equal when patients were admitted. Nineteen cases (54%) showed pulmonary emphysema.
Cough ; Cyanosis ; Diarrhea ; Drug Therapy ; Humans ; Infant ; Lung ; Pneumocystis carinii ; Pneumonia ; Pneumonia, Pneumocystis ; Psychomotor Agitation ; Pulmonary Emphysema ; Tachypnea ; Weight Gain