A Case Report: An Acute Spinal Epidural Hematoma after Acupuncture Mimicking Stroke.

BACKGROUND: Spinal epidural hematoma (SEH) after acupuncture is rare and may present with acute or subacute onset and varied symptoms, making it difficult to diagnose. This condition can mimic acute stroke, so it is vital to establish a clear diagnosis before considering thrombolytic therapy, which could be disastrous if applied inappropriately. CASE REPORT: We describe a 52-year-old man who presented to our emergency department (ED) with acute onset of unilateral weakness of the limbs for 3.5 h immediately after receiving acupuncture at the bilateral neck and back. The acute stroke team was activated. In the ED, computer tomography angiography from the aortic arch to the head revealed spinal epidural hematoma. The patient was admitted to the ward for conservative treatment and was discharged with subtle residual symptoms of arm soreness 5 days later. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Acute spinal epidural hematoma rarely presents with unilateral weakness of the limbs, mimicking a stroke. Because inappropriate thrombolysis can lead to devastating symptoms, spinal epidural hematoma should be excluded when evaluating an acute stroke patient with a history of acupuncture who is a possible candidate for thrombolytic therapy.

First Observation of Physically Capturing and Maneuvering Bacteria using Magnetic Clays.

A new class of nanohybrids composed of structurally exfoliated silicate platelets and magnetic iron oxide nanoparticles was synthesized and shown to be capable of capturing microbes in liquid microbiological media. Nanoscale silicate platelets with an approximate thickness of 1.0 nm were prepared from the naturally occurring mineral clays montmorillonite and mica; these clays yielded platelets with lateral dimensions on the order of 80-100 nm and 300-1000 nm, respectively. The magnetic Fe3O4 nanoparticles, approximately 8.3 nm in diameter, were coated in situ onto the silicates during the synthesis process, which involved the coprecipitation of aqueous Fe(2+)/Fe(3+) salts. Owing to the high surface area-to-volume ratios and the presence of ionically charged groups (i.e., ≡SiO(-)Na(+)), the silicate nanoplatelets exhibited intense noncovalent bonding forces between Fe3O4 nanoparticles and the surrounding microorganisms. The Fe3O4-on-nanoplatelet nanohybrids enabled the entrapment of bacterial cells in liquid microbiological media. These captured bacteria formed bacterial aggregates on the order of micrometers that became physically maneuverable under a magnetic field. This phenomenon was demonstrated with Staphylococcus aureus in liquid microbiological media by physically removing them using a magnetic bar; in two experimental examples, bacterial concentrations were reduced from 10(6) to 10(2) and from 10(4) to 10(0) CFU/mL (colony formation unit/mL con). Under a scanning electron microscope, these bacteria appeared to have rough and wrinkled surfaces due to the accumulated silicate platelets. Furthermore, the external application of a high-frequency magnetic field completely destroyed these aggregated microbes by the magnetically induced heat. Hence, the newly developed nanohybrids were shown to be viable for physically capturing microbes and also for potential hyperthermia treatment applications.