Objectives: Report a novel case of new-onset type 1 diabetes in a pediatric patient presenting with DKA and concurrent Streptococcus intermedius brain abscess. Case presentation: The following case report is that of a previously healthy 12 year-old girl presenting with new-onset type 1 diabetes with mild diabetic ketoacidosis and subsequently found to have a brain abscess. Over the course of her hospital stay, she developed seizures and was found to have a 1.3 × 1.0 × 1.2 cm right frontal parasagittal mass culture-positive for S. intermedius. Neurologic symptoms were unmasked once insulin treatment was initiated and ketosis improved, supporting the relationship between therapeutic ketosis and the management of medication-refractory epilepsy. Conclusions: This case both supports the relationship between therapeutic ketosis and the management of medication-refractory epilepsy and highlights the need to carefully consider comorbid conditions in patients with DKA and new onset neurological symptoms.

Does the active membrane transporter, Na+,K+-ATPase dimerize? If it does, whatis the functional benefit? Does it increase or decrease the turnover rate? Theseare still unanswered questions and current research topics. Previous studies havedemonstrated dimerizations in closely related proteins of the P-type ATPase family.For the Na+, K+-ATPase a first indication of dimerization has been shown viaFluorescence lifetime imaging microscopy (FLIM) or Fluorescence resonance energytransfer - Fluorescence correlation spectroscopy (FRET-FCS) experiments. Theprecise dimer structure, dimerization process, and its ultimate functional effecthowever, remain to be found. This master thesis approaches those questions froma co-evolutionary standpoint. It predicts a possible dimer structure by starting with amultiple sequence alignment, direct coupling analysis, and structural contact filteringalgorithm. This model would strengthen the dimerization model of a decreasedturnover rate due to a competitive behavior of two Na+, K+-ATPases for its energysource ATP. / Dimeriserar den aktiva membrantransporten Na+,K+-ATPas? Om den gör det,vad är den funktionella nyttan? Ökar eller minskar det omsättningshastigheten?Dessa är obesvarade frågor och rådande forskningsämnen. Tidigare studier hardemonstrerat dimeriseringar i nära relaterade proteiner av P-typ ATPas-familjen.För Na+, K+-ATPas har en första indikation av dimerisering visats via ”Flourescencelifetime imaging microscopy (FLIM)” eller ”Flourescence resonance energy transfer- Flourescence correlation spectroscopy (FRET-FCS)”. Den precisa dimerstrukturen,dimeriseringsprocessen och dess slutgiltiga funktionella effekt emellertid, återståratt ses. Detta examensarbete på masternivå närmar sig dessa frågor från ettsamevolutionärt perspektiv. Det förutser en möjlig dimerstruktur genom att utgåfrån en flersekvenslinjering, direkt kopplingsanalys och en strukturell kontaktfiltreringsalgoritm. Denna modell skulle stärka dimeriseringsmodellen av minskadomsättningshastighet till följd av tävlingsbeteende mellan två Na+,K+-ATPaser fördess energikälla ATP.