BACKGROUND While sunburns are very common,especially in pediatrics,curling ulcers secondary to sunburns are a very rare entity that has not been noted in the literature in over fifty years.This case is the first addit...BACKGROUND While sunburns are very common,especially in pediatrics,curling ulcers secondary to sunburns are a very rare entity that has not been noted in the literature in over fifty years.This case is the first addition to the literature since the originally documented case.CASE SUMMARY A previously healthy 17 year old male presents to the emergency room with lethargy,shortness of breath on exertion,dark stools and nausea.His fatigue started to become significantly worse four days prior to admission.Approximately two weeks prior to admission,the patient was on a beach vacation with his family at which time he suffered severe sunburns.He had developed crampy epigastric abdominal pain,which was followed by dark,loose stools.On exam,he is non-toxic appearing,but with pallor and peeling skin on his face and chest with epigastric tenderness.Infectious stool studies were all negative including Helicobacter pylori.He denies use of any non-steroidal anti-inflammatory drugs and also denies alcohol or recreational drug use.While admitted he is found to be significantly anemic with his hemoglobin as low as 6.3 requiring two units of packed red blood cells.Endoscopy revealed several severe and deep ulcerations in the antrum and body of the stomach indicative of stress or curling ulcers.CONCLUSION While the incidence of stress ulcers is not known,it is most common with severe acute illness,most commonly presenting as upper gastrointestinal(GI)bleeding.It is essential to be aware of the risk of curling ulcers secondary to severe sunburns as patients with stress ulcer GI bleeding have increased morbidity and mortality compared to those who do not have GI bleed.展开更多
Based on the Simple Ocean Data Assimilation （SODA） products, we study the mean properties and variations of the Southern Hemisphere subpolar gyres （SHSGs） in this paper. The results show that the gyre strengths in...Based on the Simple Ocean Data Assimilation （SODA） products, we study the mean properties and variations of the Southern Hemisphere subpolar gyres （SHSGs） in this paper. The results show that the gyre strengths in the SODA estimates are （55.9±9.8）×108 ma/s for the Weddell Gyre （WG）, （37.0±6.4） ×106 ma/s for the Ross Gyre （RG）, and （27.5±8.2）x 106 ma/s for the Australian-Antarctic Gyre （AG）, respectively. There exists distinct connectivity between the adjacent gyres and then forms an oceanic super gyre structure in the southern subpolar oceans. And the interior exchanges are about （8.0±3.2）× 106 ma/s at around 70°E and （4.3±3.1）× 106 m3/s at around 140°E. The most pronounced variation for all three SHSGs occurs on the seasonal time scale, with generally stronger （weaker） SHSGs during austral winter （summer）. And the seasonal changes of the gyre structures show that the eastern boundary of the WG and AG extends considerably further east during winter and the interior exchange in the super gyre structure increases accordingly. The WG and RG also show significant semi-annual changes. The correlation analyses confirm that the variations of the gyre strengths are strongly correlated with the changes in the local wind forcing on the semi-annual and seasonal time scales.展开更多
文摘BACKGROUND While sunburns are very common,especially in pediatrics,curling ulcers secondary to sunburns are a very rare entity that has not been noted in the literature in over fifty years.This case is the first addition to the literature since the originally documented case.CASE SUMMARY A previously healthy 17 year old male presents to the emergency room with lethargy,shortness of breath on exertion,dark stools and nausea.His fatigue started to become significantly worse four days prior to admission.Approximately two weeks prior to admission,the patient was on a beach vacation with his family at which time he suffered severe sunburns.He had developed crampy epigastric abdominal pain,which was followed by dark,loose stools.On exam,he is non-toxic appearing,but with pallor and peeling skin on his face and chest with epigastric tenderness.Infectious stool studies were all negative including Helicobacter pylori.He denies use of any non-steroidal anti-inflammatory drugs and also denies alcohol or recreational drug use.While admitted he is found to be significantly anemic with his hemoglobin as low as 6.3 requiring two units of packed red blood cells.Endoscopy revealed several severe and deep ulcerations in the antrum and body of the stomach indicative of stress or curling ulcers.CONCLUSION While the incidence of stress ulcers is not known,it is most common with severe acute illness,most commonly presenting as upper gastrointestinal(GI)bleeding.It is essential to be aware of the risk of curling ulcers secondary to severe sunburns as patients with stress ulcer GI bleeding have increased morbidity and mortality compared to those who do not have GI bleed.
基金The Shandong Provincial Natural Science Foundation,China under contract No.ZR2014DP011the National Natural Science Foundation of China under contract No.41406012+2 种基金the Basic Scientific Research Fund for National Public Institutes of China under contract No.2015G05the Chinese Polar Science Strategy Research Foundation under contract NO.20150305the Open Fund of the Key Laboratory of Ocean Circulation and Waves,Chinese Academy of Sciences under contract No.KLOCAW1405
文摘Based on the Simple Ocean Data Assimilation （SODA） products, we study the mean properties and variations of the Southern Hemisphere subpolar gyres （SHSGs） in this paper. The results show that the gyre strengths in the SODA estimates are （55.9±9.8）×108 ma/s for the Weddell Gyre （WG）, （37.0±6.4） ×106 ma/s for the Ross Gyre （RG）, and （27.5±8.2）x 106 ma/s for the Australian-Antarctic Gyre （AG）, respectively. There exists distinct connectivity between the adjacent gyres and then forms an oceanic super gyre structure in the southern subpolar oceans. And the interior exchanges are about （8.0±3.2）× 106 ma/s at around 70°E and （4.3±3.1）× 106 m3/s at around 140°E. The most pronounced variation for all three SHSGs occurs on the seasonal time scale, with generally stronger （weaker） SHSGs during austral winter （summer）. And the seasonal changes of the gyre structures show that the eastern boundary of the WG and AG extends considerably further east during winter and the interior exchange in the super gyre structure increases accordingly. The WG and RG also show significant semi-annual changes. The correlation analyses confirm that the variations of the gyre strengths are strongly correlated with the changes in the local wind forcing on the semi-annual and seasonal time scales.
