BACKGROUND: Based on the assertion that apocynin diminishes acute lung injury (ALI) by inhibition of NADPH oxidase, the effect of apocynin was tested in interleukin-1alpha (IL-1)-induced ALI in rats. METHODS: IL-1 was insufflated into the trachea of Sprague-Dawley rats to induce ALI, and apocynin (8 mg/kg) was given intravenously for inhibition of NADPH oxidase. In addition, we determined whether apocynin inhibited generation of superoxide anions from isolated human neutrophils. Five hours after IL-1 instillation, lung injury parameters, expression of cytosolic phospholipase A2 (cPLA2) by cells from bronchoalveolar lavage (BAL), an index of oxidative stress in lung tissues (gamma-glutamyltranspeptidase, activity), and ultrastructure of alveolar type II (AT II) cells were evaluated. RESULTS: Apocynin decreased the generation of free radicals from phorbol myristate (PMA)-activated neutrophils in vitro, but did not ameliorate ALI. IL-1 induced enhancement of the expression of cPLA2 on neutrophils was not altered by apocynin. CONCLUSION: Apocynin induced suppression of the generation of superoxide anions from neutrophils by inhibition of NADPH oxidase does not attenuate IL-1-induced ALI in rats.
Acetophenones ; Acute Lung Injury ; Animals ; Bronchoalveolar Lavage ; Cytosol ; Free Radicals ; Humans ; Interleukin-1 ; Interleukin-1alpha ; Lung ; Lung Injury ; Myristic Acid ; NADPH Oxidase ; Neutrophils ; Oxidative Stress ; Phorbols ; Phospholipases A2 ; Rats ; Rats, Sprague-Dawley ; Superoxides ; Trachea

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is characterized by air flow limitation, which is one of the leading causes of mortality worldwide. There have been many studies on survival rates in the world literature, but there have been few reports regarding the survival rate in Korean patients with COPD. Acute exacerbation is regarded as a risk factor for mortality in patients with COPD. The purpose of this study was to investigate the survival rate and the effect of acute exacerbations on the survival rate of Korean patients with COPD. METHODS: A total of 502 COPD patients who were diagnosed on the basis of history and lung function tests were enrolled in this study. The frequency of acute exacerbations, body mass index (BMI), C-reactive protein (CRP) and pulmonary hypertension were analyzed. RESULTS: The 3- and 5-year survival rates were 98% and 83%, respectively. The median survival time was 78 months. The median survival time was 55 months in 322 patients with one or more acute exacerbations. The 3- and 5-year survival rates were significantly lower in the 322 patients with one or more acute exacerbations than in those without any. The mortality rate was significantly higher in patients with CRP >3 mg/L than in those with CRP < or =3 mg/L (p<0.005); it was significantly higher in patients with pulmonary hypertension than in those without it (p<0.01). CONCLUSION: Because the 5-year survival rate is 83% in Korean patients with COPD, the management of stable patients with COPD should focus on the prevention of acute exacerbations.
Body Mass Index ; C-Reactive Protein ; Disease Progression ; Humans ; Hypertension, Pulmonary ; Lung Diseases ; Pulmonary Disease, Chronic Obstructive ; Respiratory Function Tests ; Risk Factors ; Survival Rate

BACKGROUND: Smoking is a risk factor for idiopathic pulmonary fibrosis (IPF), but the mechanism of the association remains obscure. There is evidence demonstrating that plasminogen activator inhibitor-1 (PAI-1) is involved in the progression of pulmonary fibrosis. This study was to determine whether the administration of small interfering RNA (siRNA) targeting PAI-1 or PAI-1 inhibitor to the cigarette smoking extract (CSE)-exposed rat alveolar type II epithelial cells (ATII cells) limits the epithelial-mesenchymal transition (EMT). METHODS: ATII cells were isolated from lung of SD-rat using percoll gradient method and cultured with 5% CSE. The EMT was determined from the ATII cells by measuring the real-time RT PCR and western blotting after the PAI-1 siRNA transfection to the cells and after administration of tiplaxtinin, an inhibitor of PAI-1. The effect of PAI-1 inhibitor was also evaluated in the bleomycin-induced rats. RESULTS: PAI-1 was overexpressed in the smoking exposed ATII cells and was directly associated with EMT. The EMT from the ATII cells was suppressed by PAI-1 siRNA transfection or administration of tiplaxtinin. Signaling pathways for EMT by smoking extract were through the phosphorylation of SMAD2 and ERK1/2, and finally Snail expression. Tiplaxtinin also suppressed the pulmonary fibrosis and PAI-1 expression in the bleomycin-induced rats. CONCLUSION: Our data shows that CSE induces rat ATII cells to undergo EMT by PAI-1 via SMAD2-ERK1/2-Snail activation. This suppression of EMT by PAI-1 siRNA transfection or PAI-1 inhibitor in primary type II alveolar epithelial cells might be involved in the attenuation of bleomycin-induced pulmonary fibrosis in rats.
Animals ; Blotting, Western ; Epithelial Cells ; Epithelial-Mesenchymal Transition ; Idiopathic Pulmonary Fibrosis ; Indoleacetic Acids ; Lung ; Phosphorylation ; Plasminogen ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Polymerase Chain Reaction ; Povidone ; Pulmonary Fibrosis ; Rats ; Risk Factors ; RNA, Small Interfering ; Silicon Dioxide ; Smoke ; Smoking ; Snails ; Transfection

Vaccination in adults is recommended according to the age group and underlying diseases or risks of exposure. Patients with chronic diseases including chronic obstructive pulmonary diseases are susceptible to infectious diseases and related serious complications. They need risk-related vaccination along with age-related vaccination. Both influenza and pneumococcal vaccination are recommended in patients with chronic obstructive pulmonary diseases. They are additive if administered simultaneously. Pertussis vaccination is also needed in adolescents and adults. Although there is strong need for these vaccinations, the actual vaccination rate is low. Measures to effectively enhance the vaccination rate are needed.
Adolescent ; Adult ; Chronic Disease ; Communicable Diseases ; Humans ; Influenza, Human ; Lung Diseases, Obstructive ; Respiratory Tract Infections ; Streptococcus pneumoniae ; Vaccination ; Whooping Cough

Essential thrombocythemia (ET), a subcategory of chronic myeloproliferative disorder, is characterized by absolute thrombocytosis due to excessive clonal proliferation of platelets, hyperaggregability of platelets, and increased incidence of thrombosis and hemorrhage. We consider a diagnosis of ET when an unexplained and persistent thrombocytosis is observed. It is difficult to consider ET first when we meet a patient with esophageal varix bleeding or unusual multiple thromboses like mesenteric vein, splenic vein, and portal vein. This article reports a patient who presented initially with esophageal varix bleeding and unusual multiple thromboses, thereafter, she was diagnosed with ET after testing positive for the Janus Tyrosine Kinase 2 (JAK2) V617F mutation. In conclusion, in patients with varix bleeding and unusual multiple thromboses, myeloproliferative disorders like essential thrombocythemia should be considered as a potential cause and testing for the JAK2 mutation is warranted.
Blood Platelets ; Esophageal and Gastric Varices ; Hemorrhage ; Humans ; Incidence ; Mesenteric Veins ; Myeloproliferative Disorders ; Portal Vein ; Splenic Vein ; Thrombocythemia, Essential ; Thrombocytosis ; Thrombosis ; TYK2 Kinase ; Varicose Veins

One of the most popular types of vaporizer mounting sytems is Selectatec, as it possesses a simple detachment mechanism. Detachable units can loosen between the vaporizer and anesthetic machine, which can cause vapor leakage. A locking system was subsequently developed to prevent this issue; however, we report a case of an unexpected vapor leakage from a locked vaporizer.
Anesthesia ; Anesthetics ; Inhalation ; Nebulizers and Vaporizers

Although amiodarone is generally regarded as safe with a low incidence of associated arrhythmias, torsade de pointes (TdP) has been observed usually in the presence of predisposing factors. We report a case of amiodarone-induced TdP after long-term administration of a low dose of oral amiodarone in the absence of predisposing factors.
Amiodarone ; Arrhythmias, Cardiac ; Incidence ; Torsades de Pointes

Brunneroma, also known as Brunner's gland adenoma or harmatoma, is a very rare benign tumor of the duodenum, which is usually asymptomatic, and is discovered incidentally during endoscopic exam. These lesions are most commonly located in the duodenal bulb and clinical manifestations are variable. We report on a case of a large Brunner's gland adenoma in a 54-year-old man, which was successfully removed by endoscopic resection without complications, such as bleeding or perforation. Microscopically, it was composed entirely of variable Brunner's gland.
Adenoma ; Duodenum ; Endoscopy ; Hemorrhage ; Humans ; Middle Aged

Non-islet cell tumor-induced hypoglycemia (NICTH) is associated with mesenchymal tumor types, including hemangiopericytoma, fibrosarcoma, mesothelioma, and neurofibroma, as well as carcinoma of the liver, adrenal glands, and kidneys. Non-islet cell tumors induce hypoglycemia by overproducing an abnormal form of insulin-like growth factor II (IGF II). Complete removal of the tumor or reduction of the tumor mass is a successful therapeutic strategy in cases of NICTH. However, if the tumor re-grows, curative resection is nearly impossible, and hypoglycemia occurs repeatedly. Glucocorticoids are effective in terms of long-term relief from hypoglycemia through promotion of gluconeogenesis in the liver, tumor suppression, production of 'big'-IGF-II, and correction of the attendant biochemical abnormalities involving the growth hormone (GH)-IGF axis. We found that administration of corticosteroid therapy to a patient suffering from NICTH resulted in improvement of hypoglycemia associated symptoms.
Adrenal Glands ; Axis, Cervical Vertebra ; Fibrosarcoma ; Glucocorticoids ; Gluconeogenesis ; Growth Hormone ; Hemangiopericytoma ; Humans ; Hypoglycemia ; Insulin-Like Growth Factor II ; Kidney ; Liver ; Mesothelioma ; Neurofibroma ; Prednisolone ; Stress, Psychological

Rhabdomyosarcomas are soft tissue sarcomas; while extremely rare in adults, they are one of the most common neoplasms in children and adolescents. Histologically, they can be classified into embryonal(ERMS), alveolar(ARMS), pleomorphic, and undifferentiated types. The ARMS type is very rare, and is associated with a poor prognosis. Common primary sites of ARMS are the trunk and extremities. We report on a case of paraaortic, supraclavicular, and axillary lymph node metastasis from paratesticular ARMS treated with VAC(vincristine, dactinomycin, cyclophosphamide)/ IE(ifosfamide, etoposide) chemotherapy in a young adult. Administration of six cycles of chemotherapy with VAC/ IE resulted in complete remission. The patient has maintained complete remission over the past 27 months.
Adolescent ; Adult ; Arm ; Child ; Dactinomycin ; Extremities ; Humans ; Lymph Nodes ; Lymphatic Metastasis ; Neoplasm Metastasis ; Prognosis ; Rhabdomyosarcoma ; Rhabdomyosarcoma, Alveolar ; Young Adult