The changes in plant life behaviors and water status are accompanied by electrophysiological activities. In this study, the theoretical relationship between clamping force (CF) and leaf resistance (R), capacitive reactance (XC), inductive reactance (XL), impedance (Z), and capacitance (C) were exposed as 3-parameter exponential decay and linear models based on bioenergetics, respectively, for mangrove species. The intracellular water metabolism parameters and salt transport characteristics were also determined based on mechanical equations with influences of Sodium nitroprusside (SNP) and rewatering (RW). The results show that the inherent capacitance and effective thickness could better represent Aegiceras corniculatum (A. corniculatum) species, and inherent resistance and impedance show obvious effects on Kandelia obovate (K. obovate) species at different salt levels. SNP application shows positive effect on different salt-resistance capacities of A. corniculatum, while K. obovate perform better in RW phase at high salt level. These outcomes indicates that K. obovate is more salt-resistant because RW process is consistent with actual situation, and response of A. corniculatum at high salt stress is irreversible, even in RW. It is concluded that the electrophysiological parameters could be used for the determination of salt-resistant capacities, which gave more enhanced and reliable information of mangroves\' life activities.

Nitric oxide releasing compound sodium nitroprusside (SNP) is regarded as novel chemical to beat the daunting challenges of postharvest losses in cut flowers. In the recent years, it has yielded propitious results as postharvest vase preservative for cut flowers. Our study explicates the efficacy of SNP in mitigating postharvest senescence in Consolida ajacis (L.) Schur cut spikes. The freshly excised C. ajacis spikes were subjected to different SNP treatments viz , 20μM, 40μM, 60μM and 80μM. The control spikes were held in distilled water. The spikes held in test solutions showed a marked improvement in vase life and flower quality. Our results indicate a profound surge in sugars, phenols and soluble proteins in SNP-treated spikes over control. Moreover, the SNP treatments improved membrane stability as signposted by decreased lipoxygenase activity (LOX). The SNP treatments also upregulated different antioxidant enzymes viz , ascorbate peroxidase (APX), catalase (CAT) and superoxide dismutase (SOD). The current study recommends 40μM SNP as optimum concentration for preserving floral quality and extending display period of C. ajacis spikes. Together, these findings reveal that SNP at proper dosage can efficiently alleviate deteriorative postharvest changes by modulating physiological and biochemical mechanisms underlying senescence.

In performing pulmonary endarterectomy (PEA) for a patient with chronic thromboembolic pulmonary hypertension (CTEPH), we encountered methemoglobinemia that was unmasked by hypothermia while on cardiopulmonary bypass (CPB). The patient on dapsone therapy for antiphospholipid antibody syndrome had developed acquired methemoglobinemia that went undiagnosed because her cyanosis was believed to be due to CTEPH and the resulting ventilation-perfusion (V/Q) mismatch. Although pharmacological triggers for methemoglobin are well known, causation by hypothermia is not described. Monitoring saturation while on CPB was challenging because of nonpulsatile blood flow but was overcome using cerebral oximetry.

BACKGROUND: Chronic total occlusion continues to be a challenging lesion subset for percutaneous coronary intervention.
METHODS: A 65-year-old male patient was admitted with symptoms of angina pectoris for 9 months.
METHODS: Coronary angiography showed a severe stenosis in the proximal left anterior descending artery and a chronic total occlusion (CTO) in the proximal right coronary artery. The complexity of the CTO was stratified using the J-CTO score and the PROGRESS CTO score.
METHODS: Antegrade wire escalation for CTO of RCA failed. The septal collaterals to RCA were initially judged to be poor and not suitable for intervention.
RESULTS: However, administration of sodium nitroprusside improved collateral flow and enabled the identification of retrograde channels suitable for wire crossing and successful retrograde PCI.
CONCLUSIONS: The study showed that faintly visible to even invisible septal collateral connections can be crossed with the septal \"trial and error\" surfing technique after the administration of sodium nitroprusside.

BACKGROUND: Glycyrrhizin is the main active component of licorice. Licorice and glycyrrhizin induced hypertension has been widely reported, yet licorice and glycyrrhizin induced hypertensive crisis has been rarely known.
METHODS: The case of this report was a 47-year-old woman, who took 225 mg of glycyrrhizin daily for 3 years due to primary biliary cholangitis. She was found to have a dramatically elevated blood pressure of about 230/110 mmHg without a history of hypertension and was referred to the emergency department.
METHODS: Hypokalemia, hypertensive retinopathy, and nephropathy were found during the following work-up. Since no other risk factors of hypertension were identified, she was suspected to have glycyrrhizin induced pseudo-hyperaldosteronism.
METHODS: Glycyrrhizin was discontinued. Intravenous sodium nitroprusside was used during the first few days. Nifedipine and irbesartan were taken after discharge, and the dosage was reduced gradually under supervision.
RESULTS: She stopped all the anti-hypertensive drugs 6 months since glycyrrhizin was stopped. Her blood pressure was about 110/60 mmHg after repetitive measurement. Her serum potassium and urine albumin/creatinine ratio were also normalized.
CONCLUSIONS: Licorice and glycyrrhizin induced hypertension due to pseudo-hyperaldosteronism has been widely reported, yet only 3 cases reported that excessive consumption of licorice could lead to hypertensive emergencies. This is the first case that glycyrrhizin induced hypertensive crisis with target organ impairment. By presenting this case, we remind clinicians of glycyrrhizin induced hypertension, a condition which could lead to medical emergencies.

BACKGROUND: Takayasu arteritis is a rare, chronic, granulomatous systemic vasculitis of unknown etiology and a few cases have been reported in pregnancy. In pregnancies concomitant with Takayasu arteritis or after diagnosis, Takayasu arteritis negatively affects pregnancy by increasing 13-fold the odds of complications such as hypertensive disorders. The best recommendations in this scenario are still to be made.
METHODS: We present a case of 21-year-old, gravid 1, Mexican woman of Mestizo descent with chronic hypertension diagnosed since she was 15-years old who presented severe hypertension during pregnancy (early second trimester); the diagnosis of hypertensive disorder of pregnancy was ruled out requiring first-line and second-line antihypertensive therapy without serious associated maternal or fetal morbidity.
CONCLUSIONS: Takayasu arteritis and pregnancy play an important role in maternal and fetal outcomes. Efforts should be made to further investigate the Takayasu arteritis diagnosis in pregnant women with refractory hypertension.

BACKGROUND: A case of hyperacute vasospasm, indicating a poor prognosis after aneurysmal subarachnoid hemorrhage (SAH), is reported, and a review is presented of the literature addressing use of nitric oxide (NO) donors in cases of refractory vasospasm and recurrent delayed cortical ischemias (DCI).
METHODS: A 65-year-old woman was admitted within 1 hour after aneurysmal SAH (Hunt and Hess grade III, Fisher modified by Frontera grade IV). A hyperacute vasospasm had been confirmed arteriographically, the right middle cerebral artery (MCA) aneurysm was immediately coiled and a standard antivasospastic therapy was started. Within 48 hours, the patient developed cerebral vasospasm with DCI. Because the standard therapy failed to control clinical symptoms and to address severe vasospasm, an individualized rescue treatment with NO donors was initiated. A continuous intravenous molsidomine infusion was started and clinical stabilization was achieved for a week (Hunt and Hess grade I; World Federation of Neurological Surgeons grade I; Glasgow Coma Scale score, 15) after which vasospasm and DCI recurred. During a subsequent DCI, we escalated NO donor therapy by adding intraventricular boluses of sodium nitroprusside (SNP). Over the course of the following 22 days, 7 transient DCIs (Glasgow Coma Scale score, 8) were treated with boluses of SNP during continued molsidomine therapy and each time vasospasm and DCI were completely reversed. Despite initial poor prognosis, the clinical outcome was excellent; at 3, 6, and 12 months follow-up the patient\'s modified National Institutes of Health-Stroke Scale and modified Rankin Scale scores were 0, with no cognitive deficits.
CONCLUSIONS: The review of the literature suggested that combined intravenous molsidomine with intraventricular SNP treatment reversed refractory, recurrent vasospasm and DCIs probably by addressing the hemoglobin NO sink effect, NO depletion, and decreased NO availability after aneurysmal SAH.

The treatment of calcific aortic stenosis is well established and includes careful monitoring of patients who have no symptoms and surgical aortic valve replacement in the patients who do have symptoms. Patients who cannot undergo open heart surgery can now undergo valve replacement via a minimally invasive transcatheter approach. In this article, we use clinical vignettes to illustrate the management of patients with severe aortic stenosis.

The scorpion envenomation is considered the second event by poisonous animals in importance around the world according to the World Health Organization. In Colombia there are 35 species of clinical significance, among them, the genus Tityus, which contains the most deadly scorpions in South America and is represented by 29 species of wide distribution in Colombia, which include Tityus pachyurus causing life-threatening events, especially in children. The present work shows the case of a 12 years old boy, from Tolemaida to 2 h of Bogotá D.C., who was stung by a scorpion on his right thigh, with the onset of intense signs and symptoms of local effect rapidly progressing to severe systemic involvement causing myocardial dysfunction, cardiovascular collapse and heart arrest, and his favorable response to adequate basic and advanced life support and use of scorpion-specific F(ab\')2 antivenom.

The case of a 50 year-old woman who developed a sudden decrease in arterial pressure while she was being prepared for surgery for a fractured lumbar spine in the prone position, is reported. She was receiving propofol, remifentanil, and sodium nitroprusside via three syringe pumps through an intravenous cannula at the dorsum of her left hand. The cause of the vascular collapse was the purge of the syringe pumps during the self-check process.