To determine the relationship between the oral ingestion volume of xylene and methyl hippuric acid (MHA) in urine, we measured MHA in 11 patients whose ingested xylene volume was identified. The best-fit equation between urine MHA and ingested amount of xylene was as follows: y (ingested amount of xylene, mL/kg) = −0.052x² + 0.756x (x = MHA in urine in g/g creatinine). From this equation, we estimated the ingested xylene volume in 194 patients who had ingested pesticide of which the formulation was not available. Our results demonstrated that oxadiazole, dinitroaniline, chloroacetamide, organophosphate, and pyrethroid were xylene-containing pesticide classes, while the paraquat, glyphosate, glufosinate, synthetic auxin, fungicide, neonicotinoid, and carbamate classes were xylene-free pesticides. Sub-group univariate analysis showed a significant association between MHA levels in urine and ventilator necessity in the pyrethroid group. However, this association was not observed in the organophosphate group. Our results suggest that MHA in urine is a surrogate marker for xylene ingestion, and high urine MHA levels may be a risk factor for poor clinical outcome with some pesticide poisoning.
Biomarkers ; Eating ; Humans ; Indoleacetic Acids ; Paraquat ; Pesticides ; Poisoning* ; Respiratory Insufficiency ; Risk Factors ; Ventilators, Mechanical ; Xylenes*

Disseminated intravascular coagulation (DIC) is a rare complication of aortic dissection. We report an unusual case of a 64-year-old woman with DIC associated with chronic aortic dissection who developed catastrophic intracranial hemorrhage. Computed tomography (CT) revealed partially thrombosed false lumen in the chronic dissected aneurysm of the thoracoabdominal aorta, which remained after surgery for acute type A aortic dissection. The laboratory profile showed features of DIC, including thrombocytopenia, hypofibrinogenemia, and increased D-dimer levels. Bleeding diathesis, including ecchymosis and coagulopathy, showed improvement following treatment with protease inhibitors (nafamostat and camostat).
Aneurysm ; Aorta ; Dacarbazine ; Disease Susceptibility ; Disseminated Intravascular Coagulation ; Ecchymosis ; Female ; Fibrin Fibrinogen Degradation Products ; Guanidines ; Hemorrhage ; Heparin ; Humans ; Intracranial Hemorrhages ; Middle Aged ; Protease Inhibitors ; Thrombocytopenia

Swallow syncope (also known as deglutition syncope) is a relatively rare type of syncope that is treatable if diagnosed correctly. We report a case of a 39-year-old man with recurrent swallow syncope. The patient did not have structural heart disease. He developed a complete atrioventricular block upon drinking a cold beverage (Chilsung cider) while undergoing a repeated head-up tilt test. The patient was advised to avoid cold beverages and has been symptom free for 5 months.
Adult ; Atrioventricular Block ; Beverages ; Cold Temperature ; Deglutition ; Drinking ; Eating ; Heart Diseases ; Humans ; Syncope