• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.5
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• pp.471-474
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• 2021

Methemoglobinemia is rare. It is classified into two types: congenital methemoglobinemia and acquired methemoglobinemia. Methemoglobin is incapable of binding oxygen, leading to complications such as cyanosis, dyspnea, headache, and heart failure. In the present case, a 35-year-old man with congenital methemoglobinemia underwent general anesthesia for thyroidectomy. The patient was diagnosed with hemoglobin M at 7 years of age. Ventilation was performed with FiO₂ 1.0. Arterial blood gas analysis showed that the pH was 7.4, PaO₂ 439 mmHg, PaCO₂ 40.5 mmHg, oxyhemoglobin level of 83.2%, and methemoglobin level of 15.5%. The patient had a stable course, although cyanosis was observed during surgery.

• Environmental Analysis Health and Toxicology
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• v.8 no.3_4
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• pp.33-41
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• 1993

This study was designed to determine the hemolytic mechanism of antitumor agent tetraphosphine platinum (II) complex (RC-1), which was synthesized recently. Erythrocytes treated with RC-1 showed concentration and time dependent lipid peroxydation, methemoglobin synthesis and hemolysis. And also treatment of radical scavengers showed the inhibitory effect of hemolysis and the decrease of malondialdehyde levels in RC-1 treated erythrocytes. So, the mechanism of hemolysis was considered to be the generation of free radicals, methemoglobin synthesis and the lipid peroxidation of phospholipid which composed of erythrocyte membrane.

• Toxicological Research
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• v.5 no.2
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• pp.97-104
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• 1989

A new exposure system was developed to generate p-dinitrobenzene (p-DNB) containing atmosphere. A glass column was filled with small glass beads coated with the chemical. The p-DNB containing medium was heated to a temperature beyond the boiling point of p-DNB. A stream of air flow was forced to pass through the column and let it mixed with fresh air before introducing into an inhalation chamber. The concentration of p-DNB in the chamber air was measured by direct assaying the air directly and by sampling the chemical using a microfilter installed in the chamber.

• Journal of Medicine and Life Science
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• v.18 no.1
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• pp.20-23
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• 2021

Methemoglobin is generated by the oxidation of ferrous iron to ferric iron within a hemoglobin molecule. Methemoglobin is unable to bind and transport oxygen, resulting in methemoglobinemia, which can lead to fatal tissue hypoxia. The most common cause of methemoglobinemia is poisoning by oxidizing agents such as dapsone, benzocaine, and primaquine. However, methemoglobinemia can also be caused by normal dietary sources. We present two cases of methemoglobinemia that developed after a normal diet in two male patients. In this case report, the patients suddenly developed dyspnea and cyanosis after eating the same meal. They had no history of suspected poisoning, such as the use of drugs, exposure to chemicals, or gas inhalation. Their symptoms did not improve even after a high dose of oxygen was administered; further, an abnormal 'oxygen saturation gap' was observed. Because of CO-oximetry, the methemoglobin levels of the patients were 50.0% and 46.6%, respectively. We administered methylene blue (1 mg/kg), and the patients recovered completely without any complications. Emergency physicians should, therefore, be aware that methemoglobinemia can also be caused by normal dietary sources. In addition, if the source and route of contamination are unclear, an epidemiological investigation should be conducted.

• Journal of Community Nutrition
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• v.6 no.3
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• pp.146-154
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• 2004

This study compared intake of vitamins and antioxidant nutritional status of smokers and nonsmokers, and the effect of supplementation of vitamin C and vitamin E on antioxidant system of smokers and nonsmokers. Subjects were 30 smokers and 30 non-smokers of male university students. They were divided into groups of 10 subjects each one with supplementation for 4 weeks, to investigate the effects of supplementation. Smokers were divided into vitamin C supplement group, vitamin E supplement group and vitamin C and vitamin E combination supplement group, and so were nonsmokers. The supplementation of vitamin C was 500mg and vitamin E was 400IU. There was no significant difference of antioxidant vitamin intakes between smokers and non-smokers, and plasma concentration of vitamin C in smokers was lower than non-smokers (p<0.05). Blood pressure was higher in smokers (p<0.05), with no difference in blood glucose levels, methemoglobin and TBARS, but SOD activity was significantly higher in non-smokers (p<0.001). Vitamin C supplementation resulted in a significant decrease of diastolic blood pressure (p<0.01), systolic blood pressure (p<0.001) and methemoglobin (p<0.001) in smokers. Also a significant decrease of diastolic blood pressure (p<0.05), systolic blood pressure (p<0.05), blood glucose (p<0.05), methemoglobin (p<0.001) and TBARS (p<0.05), with significant increase of SOD activity (p<0.001) were found in vitamin E supplement group. In vitamin C and vitamin E combination supplement group, there was a significant decrease of diastolic blood pressure (p<0.05), methemoglobin (p<0.01) and TBARS (p<0.05). In non-smokers, methemoglobins (p<0.001) of vitamin C supplement group and vitamin E supplement group decreased, and diastolic pressure (p<0.05), methemoglobin (p<0.01) and TBARS (p<0.05) significantly decreased in vitamin C and vitamin E combination supplement group. These results indicated better efficacy of antioxidant supplementation in smokers than in nonsmokers, suggesting that the supplementation of vitamin C and vitamin E might decrease the oxidative stress and various risk factors of smoking-related diseases.

• KSBB Journal
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• v.7 no.1
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• pp.45-50
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• 1992

Footpad swelling having the relationship with arthus-reaction of antibody-mediated hypersensitivity and delayed type hypersensitivity was recovered to the almost normal level. The nethemoglobin induced by aniline showed no significant deviation. PFC/spleen cell and PFC/106 spleen cell were increased slightly, but not in case of RFC. Hemagglutination value was increased slightly, but hemolytic value was not changed significantly. Mice in the administration of the polysaccharide does not show any significant stress factor in the cage for mice admlrustered plasma corticosterone. Key words: antibody-mediated hypersensitivity, delayed type hypersensitivity, methemoglobin, Hemagglutination value, hemolytic value, plasma corticosterone.

• Journal of The Korean Society of Clinical Toxicology
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• v.15 no.2
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• pp.148-151
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• 2017

Methemoglobinemia is a condition in which the iron portion of hemoglobin, which binds to oxygen, is oxidized to produce methemoglobin, which increases blood concentration. There are many causes of methemoglobinemia, the most common being food, drugs, and chemicals. A 75-year-old male patient who had taken an herbicide did not notice any nonspecific symptoms. However, after 4 hours, his methemoglobin levels increased to 17.1%, while after 7 hours it increased to 26.5%, at which time intravenous administration of methylene blue 1 mg/kg (an antidote) was started. After a total of five doses of methylene blue at 1 mg/kg due to reactive methemoglobinemia for about 36 hours, the methemoglobin levels increased to 23.7%. Because no more methylene blue could be administered, 10 g of ascorbic acid (vitamin C) was administered intravenously. After 82 hours, ascorbic acid 10 g was administered six times for repeated reactive methemoglobinemia. No additional reactive methemoglobinemia was observed. The ventilator and endotracheal tube were successfully removed on day 5 after admission.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.4
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• pp.357-361
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• 2021

Methemoglobinemia is a blood disorder in which an abnormal amount of methemoglobin is produced, and prilocaine is one of the drugs that can cause this disorder. The maximum recommended dose of prilocaine is 8 mg/kg. We report a case of methemoglobinemia caused by the administration of 4.2 mg/kg of prilocaine without other methemoglobinemia-inducing drugs during general anesthesia. A 17-year-old girl with hyperthyroidism and anemia was scheduled to undergo maxillary sinus floor elevation and tooth extraction. The patient's peripheral oxygen saturation (SpO₂) decreased from 100% at arrival to 95% after receiving prilocaine with felypressin following induction of general anesthesia. However, the fraction of inspired oxygen was 0.6. Blood gas analysis showed that the methemoglobin level was 3.8% (normal level, 1%-2%), fractional oxygen saturation was 93.9%, partial pressure of oxygen was 327 mmHg, and arterial oxygen saturation was 97.6%. After administration of 1 mg/kg of methylene blue, her SpO₂ improved gradually to 99%, and the methemoglobin value decreased to 1.2%. When using prilocaine as a local anesthetic, it is important to be aware that methemoglobinemia may occur even at doses much lower than the maximum recommended dose.

• Journal of fish pathology
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• v.4 no.1
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• pp.1-11
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• 1991

Histopathological changes and methemoglobinemia of the eels (Anguilla japonica) reared at six culture farms in the vicinity of Y$\check{o}$su city were investigated under the conditions of $22.0{\sim}29^{\circ}C$, 4.33~7.33ppm of D.O., pH 6.1~8.2 and 0.03~10.1ppm of nitrite from December, 1989 to June, 1990. All of the eels showed no any abnormal state in action, color and blood, but the eels reared in pH 6.0 had planty of mucus and stickiness on their body surface. Methemoglobin levels were 1.03~9.86% of total erythrocyes in Dec. and 5.05~25.69% in June, and poikilocyte levels were 5.8~30.17% in Dec. and 8.67~74.45% in June. These results indicate the fact that the water management of the culture farms was worse in summer than in winter, even though not good in winter. Hypertrophy was found in the gill, hepatic and kidney tissue of the eels in all the culture farms. In March and June, Fish of all culture farms appeared the detachment of gill lamella epithelium cells, pyknosis and sinusoids of nucleus in the hepatic tissue and hemosiderosis in the kidney tissue. The trend of increase in methemoglobin levels appeared in the fish of culture farms with high nitrite concentration, which didn't appear equally in all the culture farms. However, in the culture farms of pH 6.0, methemoglobin and poikilocyte levels were increased independently of concentration of nitrite, and degeneration in the tissue of the gill, liver and kidney was also appeared.

• Journal of fish pathology
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• v.18 no.2
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• pp.179-185
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• 2005

In Vitro hemolysis and methemoglobin (MetHb) formation in olive flounder rythrocytes were investigated using potassium permanganate ($KMnO_4$) ranging from 2 to 250 ppm, stabilized chlorine dioxide ($S-ClO_2$)ranging from 3.13 to 400 ppm, formalin (37% formaldehyde) ranging from 31.3 to 2,000 ppm and copper sulphate ($CuSO_4$) ranging from 0.04 to 5 ppm. Remarkable hemolysis was found to be induced at $KMnO_4$ concentrations of 31.3-250 ppm and $CuSO_4$ concentrations of 0.63-5 ppm. On the other hand, MetHb formation could not be found at the same treatment concentrations. It is suggested that the cell-damaging system of $KMnO_4$ may be similar from that of $CuSO_4$ in the erythrocytes of olive flounder. Remarkable hemolysis and MetHb formation were found to be induced at $S-ClO_4$ concentrations of more than 25 ppm and 6.25 ppm, respectively. Only $S-ClO_2$ showed both hemolysis and MetHb formation among the chemicals used in the present study. Formalin did not provoke hemolysis at the highest concentration of 2,000 ppm but induced MetHb formation at ranging from 250 to 2,000 ppm. These findings reveal that the mechanism involved in formalin-induced cell-damaging effects differs from that induced by $S-ClO_2$ to olive flounder erythrocytes compared with $KMnO_4$ and $CuSO_4$.