• Journal of Dental Anesthesia and Pain Medicine
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• 제21권5호
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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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• 제8권3_4호
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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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• 제5권2호
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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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• 제18권1호
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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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• 제6권3호
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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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• 제7권1호
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• pp.45-50
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• 1992

항체 유도 염증 반응인 항체 매개형 과민 반응과 지연형 과민 반응은 족척 두께가 다당류에 의해 거의 정상 수준까지 회복되었다. anilline으로 유도한 methemoglobin의 함량도 거의 차이가 없었다. PFC/spleen cell과 PEC/$10^5$ slpeen cell의 경우 다소 증가를 나타내었으나, PEC는 뚜렷한 증가나 감소를 나타내지 않았으며, 적혈구 응집소가는 다소 증가하였으나 적혈구 용혈소가는 거의 차이가 없었다. 마우스의 plasma corticosterone의 농도는 사육실 및 다당류 투여에 따른 stress요소는 거의 없었다.

• 대한임상독성학회지
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• 제15권2호
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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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• 제21권4호
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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.

• 한국어병학회지
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• 제4권1호
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• pp.1-11
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• 1991

가온(加溫) 양어장(養魚場)에서 자란 참장어(뱀장어) Anguilla japonica의 병리조직학적(病理組織學的) 변화(變化)와 Methemoglobin증(症)에 대(對)해서 조사(調査)한 결과(結果)는 다음과 같다. 1. 양어장(養魚場)의 수질(水質)은 수온(水溫) $22.0{\sim}29.0^{\circ}C$, DO 4.33~7.33ppm, pH 6.1~8.2, $NO_2$ - N 0.03~10.1ppm의 범위(範圍)였다. 2. 조사(調査) 대상(對象)인 참상어는 외관상(外觀狀)으로는 활력(活力)이나 체색(體色) 및 혈액(血液)에 이상(異常)이 없었고, pH 6.0 정도(程度)로 낮은 양어장(養魚場)이 참상어는 체표면(體表面)에 점액질(粘液質)이 많았으며 점착력(粘着力)이 컸었다. 3. Methemoglobin양(量)은 12월(月)에 총(總) 적혈구(赤血球)의 1.03~9.86%, 6월(月)에 5.05~25.69%였으며, 변형적혈구(變形赤血球)의 양(量)은 12월(月)에 5.83~30.17%, 6월(月)에 8.67~74.45%로서 Methemoglobin이나 변형적혈구(變形赤血球)의 출현량(出現量)이 다 같이 하계(夏季)에 많은 증가(增加)를 보인 것은 양어장(養魚場)의 물 관리(管理)가 겨울철에도 좋지 못했지만 여름철에 더 좋지못했다는 결과(結果)인 것 같다. 4. 아가미, 간(肝) 및 신장(腎臟) 조직(組織)은 조사(調査)한 양어장(養魚場) 전체(全體)에서 중급(中級) 이상(以上)의 부종증상(浮腫症狀)을 보였고, 3월(月)과 6월(月)에 아가미는 2차새변 상피세포(上皮細胞)(호흡세포((呼吸細胞))의 박리(剝離)가 일어나는 심(甚)한 변성(變性)을 보인 양어장(養魚場)에 많아졌으며 간장(肝臟)은 핵농축(核濃縮)이나 동공화(洞空化)된 세포(細胞)가 많아졌고 신장(腎臟)은 대다수(大多數)의 양어장(養魚場)에서 혈철증(血鐵症)이 생겼다. 5. 아질산(亞窒酸) 농도(濃度)가 높은 양어장(養魚場)에서 Methemoglobin이 증가(增加)하는 경향(傾向)은 있었으나 반드시 일치(一致)하지는 않았고, pH가 6.0 정도(程度)로 낮은 양어지(養魚池)에서는 아질산(亞窒酸) 농도(濃度)에 관계(關係)없이 Methemoglobin과 변형적혈구(變形赤血球)의 출현량(出現量)이 대체(大體)로 증가(增加)했으며 아가미, 간(肝) 및 신장(腎臟) 조직(組織)의 퇴행성(退行性) 변성(變性)이 심(甚)했다.

• 한국어병학회지
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• 제18권2호
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• pp.179-185
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• 2005

과망간산칼륨 ($KMnO_4$), 안정화이산화염소 ($S-ClO_2$, 3% 수용액), 포르말린 (37% formaldehyde), 황산동 ($CuSO_4$)을 이용하여 넙치 적혈구의 cell damage에 미치는 효과를 알아보고자 in vitro 용혈작용과 methemoglobin (MetHb) 생성을 조사하였다. 실험의 농도는 과망간산칼륨 2-250 ppm, 안정화이산화염소 3.13-400 ppm, 포르말린 31.3-2,000 ppm, 황산동 0.04-5 ppm 이었다. 과망간산칼륨은 31.3-250 ppm, 황산동은 0.63 -5 ppm에서 현저한 용혈작용을 나타내었으나 이와는 반대로 MetHb 생성은 전혀 없었다. 따라서 과망간산칼륨과 황산동은 넙치 적혈구에 대한 cell damage system이 매우 유사한 것으로 생각되었다. 안정화이산화염소의 경우, 용혈작용은 25 ppm 이상의 농도에서 그리고 MetHb 생성은 6.25 ppm 이상의 농도에서 높게 증가하였다. 본 실험에서 유일하게 용혈작용과 MetHb 생성을 양쪽 다 현저하게 나타내었다. 포르말린은 2,000 ppm의 고농도에서도 용혈작용은 없었으며, MetHb 생성은 250-2,000 ppm에서 완만하게 증가하였다. 따라서 안정화이산화염소와 포르말린은 넙치 적혈구에 대하여 과망간산칼륨 및 황산동과는 또 다른 cell damage system을 가지고 있는 것으로 나타났다.