Keiichi Tada

A resuscitation puzzle: acute acquired methemoglobinemia.

We treated a 32-day-old baby suffering acute acquired methemoglobinemia induced by topical application of aniline cocaine. Although acute acquired methemoglobinemia with severe cyanosis and distress is potentially fatal, this rare syndrome is easily curable if it is correctly diagnosed.

Guanidino Compounds and Hemodialysis

Despite a large number of reports that have appeared recently in regard to guanidino compounds and their role in causing uremia and aggravating renal failure, many points are still unclear. There are very few reports on guanidino compounds in acute renal failure, and those that are available have deficiencies related to the clinical assessment or etiological research. Furthermore, many of the patients admitted to the Intensive Care Unit have renal failure in a high risk situation of multiple organ failure, thus contributing to the difficulty of treatment by dialysis. The clinical picture varies, and can include those with infective foci, decreased immunological capacity, and unstable circulatory and respiratory system, abnormality of the central nervous system, and hepatic failure or disseminated intravascular coagulation. The pathophysiology of acute renal failure was investigated to elucidate the miscellaneous complicating factors by analyzing guanidino compounds in patients requiring hemodialysis.