A case of hyponatremia attributed to carboplatin-induced syndrome of inappropriate anti-diuretic hormone.

•A patient who used carboplatin in the treatment of ovarian cancer developed SIADH.•She was able to continue treatment with regular salt intake.•This treatment may be an option for similar patients in the future.

A case of sudden multiple hematomas during cesarean section due to amniotic fluid embolism.

INTRODUCTION: We report a case of multiple hematomas, a rare manifestation of amniotic fluid embolism (AFE), during cesarean section. PRESENTATION OF CASE: The patient had a history of pregnancy and cesarean section birth due to placental abruption. At 38 weeks and 2 days, her membrane ruptured, and an emergency cesarean section was performed. During uterine suturing, hematomas suddenly formed in multiple locations, and bleeding began. Intraoperative blood tests revealed decreased hemoglobin and fibrinogen levels, leading to the administration of red blood cells and fresh frozen plasma. Despite initial transfusions, hemoglobin and fibrinogen levels did not increase, necessitating additional transfusions, which ultimately improved the hemoglobin and fibrinogen levels. A post-discharge blood draw showed decreased C3 levels, supporting a diagnosis of disseminated intravascular coagulation (DIC)-type AFE. DISCUSSION: The sudden onset of hematomas in multiple locations other than the uterine incision wound was an atypical presentation of AFE in this case. The multiple hematomas were caused by DIC-induced hemostasis, and the decreased C3 level in the blood test supported the diagnosis of DIC-type AFE. CONCLUSION: Multiple hematomas may occur as a symptom of DIC-type AFE and require attention.

Crystal structures of the state 1 conformations of the GTP-bound H-Ras protein and its oncogenic G12V and Q61L mutants.

GTP-bound Ras adopts two interconverting conformations, "inactive" state 1 and "active" state 2. However, the tertiary structure of wild-type (WT) state 1 remains unsolved. Here we solve the state 1 crystal structures of H-Ras WT together with its oncogenic G12V and Q61L mutants. They assume open structures characterized by impaired interactions of both Thr-35 in switch I and Gly-60 in switch II with the γ-phosphate of GTP and possess two surface pockets of mutually different shapes unseen in state 2, a potential target for selective inhibitor development. Furthermore, they provide a structural basis for the low GTPase activity of state 1.