Nitric oxide (NO) induces apoptotic cell death in murine RAW 264.7 macrophages. To elucidate the roles of SEK1/MKK4, a upstream kinase for both c-Jun N-terminal kinase/stress-activated protein kinase (JNK/SAPK) and p38 kinase, on NO-induced apoptosis, we generated clones of RAW 264.7 cells which stably overexpressd kinase inactive SEK1 (RAW/SEK1-Kl) or wild type SEK1 (RAW/SEK1-WT). Treatment of kinase inactive SEK1 transfected RAW 264.7 cells (RAW/SEK1-Kl) with sodium nitroprusside (SNP), a NO generating agent, significantly decreased the cell viability up to 20% of RAW control cells which were treated with the same amount of SNP. However, RAW/SEK1-WT cells were less susceptible to NO induced apoptosis. For a while, caspase-3 like activity in NO treated RAW/SEK1-Kl cells was significantly increased with parallell to apoptotic death rate. However, caspase1 like activity was not affected by NO in any transfectants. The NO induced apoptosis in RAW/SEK1-Kl cells was significantly prevented by the addition of caspase-3 like inhibitor (N-Ac- DEVD-CHO). In addition, the phosphotransferase activity of JNK1 in NO-treated RAW/SEK1-WT is significantly increased, but not in RAW/SEK1-Kl cells. These results suggest that SEK1 may play anti-apoptotic role in RAW cells from NO-induced apoptosis.
Apoptosis ; Caspase 3 ; Cell Death ; Cell Survival ; Clone Cells ; Macrophages ; Mortality ; Nitric Oxide* ; Nitroprusside ; Phosphotransferases ; Protein Kinases

No abstract available.

Purpose: The Prescott nomogram has been utilized to forecast hepatotoxicity from acute acetaminophen poisoning. In developing countries, emergency medical centers lack the resources to report acetaminophen concentrations; thus, the commencement and cessation of treatment are based on the reported dose. This study investigated risk factors that can predict acetaminophen detection after 15 hours for safe treatment termination. Methods: Data were collected from an urban emergency medical center from 2010 to 2020. The study included patients ≥14 years of age with acute acetaminophen poisoning within 15 hours. The correlation between risk factors and detection of acetaminophen 15 hours after ingestion was evaluated using logistic regression, and the area under the curve (AUC) was calculated. Results: In total, 181 patients were included in the primary analysis; the median dose was 150.9 mg/kg and 35 patients (19.3%) had acetaminophen detected 15 hours after ingestion. The dose per weight and the time to visit were significant predictors for acetaminophen detection after 15 hours (odds ratio, 1.020 and 1.030, respectively). The AUCs were 0.628 for a 135 mg/kg cut-off value and 0.658 for a cut-off 450 minutes, and that of the combined model was 0.714 (sensitivity: 45.7%, specificity: 91.8%). Conclusion Where acetaminophen concentrations are not reported during treatment following the UK guidelines, it is safe to start N-acetylcysteine immediately for patients who are ≥14 years old, visit within 15 hours after acute poisoning, and report having ingested ≥135 mg/kg. Additional N-acetylcysteine doses should be considered for patients visiting after 8 hours.

Carbon dioxide is a colorless, odorless, nonirritating gas with many practical uses. In particular, because it can displace oxygen from the environment, it is used as a fire extinguisher. We describe an incident that occurred as a result of malfunction of a carbon dioxide-based fire extinguishing system in our hospital. Twelve casualties reached our emergency department. Symptoms of exposure included nausea, dizziness, loss of consciousness, vomiting, chest discomfort, and seizure. Results of initial arterial blood gas analysis showed acidosis in five patients. A new pneumonic infiltration at the left. upper lung field was observed in one patient, while sinus tachycardia in electrocardiography (ECG) was observed in another patient. Oxygen was initially supplied to all casualties, until symptoms of intoxication had disappeared. Three patients were admitted to the hospital, but were discharged without complication. Despite occurrence of massive casualties, with significant symptoms due to unintentional exposure to high concentrations of carbon dioxide, patients' symptoms were relieved by supportive care.
Acidosis ; Blood Gas Analysis ; Carbon ; Carbon Dioxide ; Dizziness ; Electrocardiography ; Emergencies ; Fire Extinguishing Systems ; Fires ; Humans ; Lung ; Mass Casualty Incidents ; Nausea ; Oxygen ; Seizures ; Tachycardia, Sinus ; Thorax ; Unconsciousness ; Vomiting

PURPOSE: Convulsive status epilepticus(SE) is a serious, life-threatening neurological condition that requires immediate treatment to avoid significant morbidity and mortality. Despite improvements in the diagnosis and treatment of SE in the last two decades, SE in young infancy is still associated with high morbidity and mortality. Thus, understanding the varied etiology and clinical presentation and prognosis of SE is very important for improving the methods of evaluation and treatment of this major neurological condition. METHODS: Eighty-eight cases with 53 who have been admitted to the Department of Pediatrics, Fatima Hospital during the period of July, 1992 to June, 1997 were included. We described age distribution, etiologic classification according to age, seizure type, neurologic outcome, recurrence of SE and epileptic seizure. RESULTS: SE was frequent in young infant less than 3 years of age. Major etiology of SE was acute symptomatic(34.1%) and febrile(31.8%). In the seizure type, the majority(92.1%) was generalized convulsive, many cases(69.3%) of SE were first seizures. The neurologic sequelae were found in 15.9% and mortality rate in 5.7%. The neurologic sequelae and mortality were higher in acute symptomatic. In sixty-three follow-up cases, eleven cases were epileptic seizure, eight cases were recurred SE and two cases were recurred febrile SE. CONCLUSION: SE is a life-threatening neurological condition and occurrs mostly in young infants less than 3 years of age. It requires immediate detection of etiology in SE and aggressive treatment for reducing mortality and morbidity rates.
Age Distribution ; Child* ; Classification ; Diagnosis ; Epilepsy ; Follow-Up Studies ; Humans ; Infant ; Mortality ; Pediatrics ; Prognosis ; Recurrence ; Seizures ; Status Epilepticus*

Compared with organophosphate or carbamate insecticides, neonicotinoids have several pharmacological benefits such as a broad spectrum of insecticidal activity, low application rate, and highly selective toxicity to insects. Imidacloprid was the first neonicotonid introduced in the market, in 1991. It has become one of the best selling insecticides globally. Several cases of imidacloprid intoxication have been reported worldwide, but few have been reported in Korea. Recently, we experienced a severe imidacloprid intoxication with delayed respiratory insufficiency and several toxicities. We report the case with the literature review.
Imidazoles ; Insecticides ; Insects ; Korea ; Nitro Compounds ; Respiratory Insufficiency

PURPOSE: Recent studies indicate that widely used chemotherapeutic agents induce apoptosis in susceptible cells. One of the effector arms in this cell death pathway is composed of cysteine proteases belonging to the caspase family. In cells, caspase-3 has been shown to play an important role as a downstream member of protease cascade, where various cell death pathways converge into the same effector pathway. JNK, a member of the mitogen-activated protein kinase pathway, is activated in response to many stressful stimuli including heat shock, UV irradiation, protein synthesis inhibitors, and inflammatory cytokines. In this study, we investigated whether JNK1 & caspase-3 play a role in the apoptosis induced by adriamycin (ADR). METHODS: U937 cells were cultured in RPMI 1640 and treated with different concentrations of ADR. Cellular DNA was extracted and analyzed by electrophoresis on a 1.5% agarose gel to detect DNA fragmentation. The activity of caspase-3 was measured by the proteolytic cleavage of the fluorogenic substrate DEVD-AMC. The activity of JNK1 was measured by in vitro immunocomplex kinase assay with 2 microgram of GST-c Jun as a substrate and quanititated using phosphoimager analyzer. RESULTS: ADR induced the apoptotic death of U937 myeloid cells in a dose-dependent manner, which was characterized by increasing ladder-pattern DNA fragmentation. Consistent with apoptotic death of U937 cells, ADR induced the catalytic activation of caspase-3 as well as JNK1 at 2.5 microgram/mL of concentrations. CONCLUSION: Adriamycin induces apoptosis of human myeloid leukemic U937 cells via activation of caspase-3 and cJun-N terminal kinase1 (JNK1)/Stress activated protein kinase (SAPK).
Apoptosis* ; Arm ; Caspase 3* ; Cell Death ; Cysteine Proteases ; Cytokines ; DNA ; DNA Fragmentation ; Doxorubicin* ; Electrophoresis ; Fluorescent Dyes ; Hot Temperature ; Humans* ; Myeloid Cells ; Phosphotransferases ; Protein Kinases ; Protein Synthesis Inhibitors ; Sepharose ; Shock ; U937 Cells*

Parvovirus B19 is a minute, single stranded DNA virus which has been identified as the etiological agent of pure red cell aplasia, erythremia infectiosum (5th disease), hydrops fetalis, or arthralgia. We report a case of pure red cell aplasia caused by parvoviurs B19 in renal transplantation. The patient was 39-year-old male who had been diagnosed as chronic renal failure 22 months ago and taken hemodialysis twice a week. He had been taken renal transplantation in October 30th, 1997. But anemia was not improved in first postoperative period. Bone marrow revealed hypocellularity (about 30%) with maturation arrest of erythroid series at pronormoblasts. The pronormoblasts showed very large size, deep blue cytoplasm, cytoplasmic projection, cytoplasmic vacuole and distinct intranuclear eosinophilic inclusions. The parvovirus B19 PCR and anti-parvovirus B19 IgM were positive, but anti-parvovirus B19 IgG was negative. The patient was treated with intravenous immunoglobulin and then reticulocyte count was increased three weeks later. The follow-up bone marrow revealed normal erythroid precursors and was not found infected giant pronormoblasts seven weeks later.
Adult ; Anemia ; Arthralgia ; Bone Marrow ; Cytoplasm ; DNA, Single-Stranded ; Eosinophils ; Erythroblasts ; Follow-Up Studies ; Humans ; Hydrops Fetalis ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins ; Kidney Failure, Chronic ; Kidney Transplantation* ; Male ; Parvovirus* ; Polycythemia Vera ; Polymerase Chain Reaction ; Postoperative Period ; Red-Cell Aplasia, Pure* ; Renal Dialysis ; Reticulocyte Count ; Vacuoles

PURPOSE: The purpose of this study is to investigate the clinical characteristics of patients admitted to emergency rooms with ocular chemical injuries, the substances responsible for such injuries, in order to improve their prevention and treatment. METHODS: The subjects of this study were 73 patients admitted to the hospital with ocular chemical injuries from January 1, 2009 to December 31, 2010. The subjects were divided into groups based on the PSS (poisoning severity score) grade of their injuries, where grades 0 and 1 were classified as the low group (low PSS) and grades 2 and 3 were classified as the high group (high PSS). There were 28 subjects in the low PSS group (38.3%) and 45 subjects in the high PSS group (61.6%). The results were retrospectively reviewed by examining the medical records of the patients. RESULTS: Upon their arrival to the hospital, the most common symptoms were red eye (50.7%), pain (39.7%), and eye irritation (39.7%). Red eyes were more frequently observed from 27 persons (60%) in the high PSS group (p=0.04). The most common causative substances were chemicals and adhesives/glues for both groups (21 cases each). Among the 15 patients exposed to acids or alkalis, 13 patients belonged to the high PSS group. Only two patients visited the hospital after having washed their eyes. CONCLUSION: Worse damage was observed from work-related exposure (including alkali or acid exposure), causing red eye and ocular chemical injuries. Onsite first aid was lacking.
Alkalies ; Burns, Chemical ; Emergency Service, Hospital ; Eye Injuries* ; First Aid ; Humans ; Medical Records ; Occupational Exposure ; Poisoning ; Retrospective Studies ; Therapeutic Irrigation

BACKGROUND: Periampullary cancer is referred to malignant tumor that occurs in pancreatic head, distal common bile duct, ampulla of Vater and duodenum according to anatomical position and poor prognosio he clinical symptoms, diagnosis and treatments are identical to positional characteristics. Since 1935, after Whipple originally described the removal of periampullary tumors, both the surgical method and the outcome associated with it have changed extensively. The mortality and morbidity rates associated with the procedure as performed today have decreased. (Objective) The authors evaluated the incidence, resectability and the clinical outcome of periampullary cancer. PATIENTS AND METHODS: We performed the clinical analysis retrospectively on 124 cases of periampullary cancer in the Department of Surgery and Internal medicine, School of Medicine, Wonkwang University from Oct. 1986 to July 1996. RESULTS: There were 77 men and 47 women and the male to female ratio was 1.64:1. The prevalent ages were in the 7th decade (44.4%), and 8th decade (27.4%). Fifty-four pancreatic head carcinomas(43.4%), 40 distal common bile duct carcinomas(32.3%), 28 Ampulla of Vater carcinomas( 22.6%), and 2 carcinomas of the periampullary duodenum(1.6%) were found. The major clinical symptoms and signs were abdominal pain (71%), jaundice (60.5%), and weight loss(33.1%). Resectability of pancreatic head cancer, distal common bile duct cancer, and ampulla of Vater cancer were 44.4%, 72.5%, and 85.7%, respectively. The mean resectability rate was 63.7%. The resection was performed in 60 cases ; Pylorus-preserving pancreaticoduodenectomy (29 cases), Whipple's operation (28 cases), total pancreatectomy (3 cases). The palliative procedure was performed in 14 cases ; gastrojejunostomy (6 cases), choledochotomy with T-tube drainage (5 cases), explolaparotomy with biopsy (4 cases). Postoperative mortality in resection surgery was 8.3%. Postoperative complication in resection surgery was 36.7%. The major causes of postoperative complications were wound complication( 16.7%) and respiratory complication(5.0%). The 1- year and 3-year survival rates after the resection were 47.1% and 22.0%, but those of nonresection group were 15.4% and 0%. The survival rate of resection group was significantly better than that of nonresection group (p<0.05). In the nonresection group, the 1-year survival rate in conservative treatment group including interventional procedure was 8.7% and 0% in palliative surgery group. Survival of nonoperable group was significantly better than that of palliative surgery group (p<0.05). According to anatomical tumor site, the 1-year and 3-year survival rates of pancreatic head cancer were 23.1%, 11.8%, and those of distal common bile duct cancer were 34.2%, 6.5%, and Ampulla of vater cancer 63.0%, 27.0%, respectively. SUMMARY: The pancreas head is the most common site of periampullary cancer. Survival of resection group and conservative treatment group is better than that of nonresection group and palliative surgery group, respectively.
Abdominal Pain ; Ampulla of Vater ; Biopsy ; Common Bile Duct ; Diagnosis ; Drainage ; Duodenum ; Female ; Gastric Bypass ; Head ; Head and Neck Neoplasms ; Humans ; Incidence ; Internal Medicine ; Jaundice ; Male ; Mortality ; Palliative Care ; Pancreas ; Pancreatectomy ; Pancreaticoduodenectomy ; Postoperative Complications ; Retrospective Studies ; Survival Rate ; Wounds and Injuries