Respiratory-like movements during an apnea test.

Background: Despite the possible occurrence of spontaneous movements during an apnea test, respiratory-like movements are rare. Case Presentation: A 51-year-old man was transferred to our hospital when a sudden disturbance of consciousness developed into cardiac arrest. After spontaneous circulation returned, we diagnosed bilateral cerebellar hemorrhage. He remained comatose with dilated pupils, absent brainstem reflexes, spontaneous breathing, and electrocerebral activity. After being considered brain dead, his family opted for organ donation. The first legal brain death examination on day 5 was aborted because of respiratory-like movements mimicking repetitive abdominal respiration during the apnea test. However, an enhanced magnetic resonance image of the head indicated no blood flow and somatosensory evoked potential testing revealed no brain-derived potentials. Conclusion: Respiratory-like movements can occur during the apnea test in patients considered brain dead. Further research is required to understand this phenomenon.

Adult-onset noncirrhotic hyperammonemic encephalopathy probably caused by splenorenal shunts.

This case illustrates adult-onset noncirrhotic hyperammonemic encephalopathy, which is most likely caused by splenorenal shunts and is a rare but potentially fatal cause of altered mentation in the critical care setting. Splenorenal shunts should be considered as a differential in cases of hyperammonemic encephalopathy without liver cirrhosis.

A novel transformation of a 1 : 1 : 1 racemic complex of 2,2'-dihydroxy-1,1'-binaphthyl, Me4N+ Cl- and MeOH into a conglomerate in the solid state by heating or contact with MeOH vapour.

The title racemate-to-conglomerate transformation which occurs in the solid state on heating or contact with MeOH vapour has been studied by IR and DTA spectral measurements, microscopic observation, and by X-ray structural and X-ray powder diffraction analysis.

Efficient resolution of 2,2'-dihydroxy-1,1'-binaphthyl by inclusion complexation with chiral N-(3-chloro-2-hydroxypropyl)-N,N,N-trimethylammonium chloride.

The complete resolution of 2,2[prime or minute]-dihydroxy-1,1[prime or minute]-binaphthyl into its enantiomers by inclusion complexation with a commercially available derivative of choline, is reported. The two enantiomers are recovered in >99% ee from the inclusion complexes by simple dissolution in a diethyl ether-water medium and the resolving agent can be recycled.

Isolation of an inclusion complex of naphthol and its benzoate as an intermediate in the solvent-free benzoylation reaction of naphthol.

Solvent-free benzoylation of naphthol was found to proceed via an inclusion complex intermediate of the naphthol and its benzoate by IR spectral monitoring.